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

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Hospital

KIMBALL HEALTH SERVICES

Kimball, NE · CCN 281305 · Rates published

Your selected procedure

You selected 93350 (HCPCS)

Ultrasound of heart during rest, exercise and/or drug-induced stress with report

This hospital’s price: $1,510 across 6 payers · range $723-$1,991

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbKHSKIMBALLNE&type=CDMWithoutLabel&fileType=CSV · observed 2026-10-12

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

3,131 distinct procedures filed
6 distinct payers
22,869 rate rows
2026-10-12 last MRF observed
Data quality

22,110 of 22,869 rate rows are consumer-grade (96.7%)

759 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
per-diem day rate — not a per-procedure price 357
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 348
percent-of-charges filed in the dollar field — excluded from medians 54
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbKHSKIMBALLNE&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Kimball_Health.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-20
Content fingerprint 77c1a4552598bd67… · 8,533,681 bytes · first seen 2026-10-13

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
22513
HCPCS 		Treatment Of Broken Middle Spine Bone With Placement Of Stabilizing Device Using… 6 $4,782.80 $11,478.72 $9,338.42 nat. median
$8,377
1.1× median
47600
HCPCS 		Removal Of Gallbladder 6 $4,212.06 $10,108.93 $8,224.04 nat. median
$2,752
outlier · 3.0×
22514
HCPCS 		Treatment Of Broken Lower Spine Bone With Placement Of Stabilizing Device 6 $4,048.80 $9,717.12 $7,905.28 nat. median
$8,399
0.9× median
47564
HCPCS 		Removal Of Gallbladder With Exploration Of Common Bile Duct Using An Endoscope 6 $4,030.00 $9,672.00 $7,868.57 nat. median
$8,871
0.9× median
44970
HCPCS 		Removal Of Appendix Using An Endoscope 6 $4,029.80 $9,671.51 $7,868.17 nat. median
$6,040
1.3× median
47563
HCPCS 		Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 6 $4,029.80 $9,671.51 $7,868.17 nat. median
$6,020
1.3× median
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 6 $3,965.57 $9,517.37 $7,742.78 nat. median
$1,659
outlier · 4.7×
01209656
CDM 		Operating Room Services - General Classification 6 $3,820.51 $9,169.23 $7,459.55 nat. median
$7,460
1.0× median
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 6 $3,683.62 $8,840.68 $7,192.26 nat. median
$3,787
1.9× median
01200460
CDM 		Operating Room Services - General Classification 6 $3,352.80 $8,046.72 $6,546.34 nat. median
$1,685
outlier · 3.9×
J0840
HCPCS 		Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 6 $3,331.63 $7,995.92 $6,505.01 nat. median
$3,452
1.9× median
C1766
HCPCS 		Introducer/sheath, Guiding, Intracardiac Electrophysiological, Steerable, Other… 6 $3,297.20 $7,913.28 $6,437.78 nat. median
$1,536
outlier · 4.2×
L8699
HCPCS 		Prosthetic Implant, Not Otherwise Specified 6 $2,825.20 $9,729.60 $6,257.82 nat. median
$2,008
outlier · 3.1×
22533
HCPCS 		Fusion Of Lower Spine Bone Through Side With Partial Removal Of Disc, 1 Bone 6 $3,013.49 $7,232.37 $5,883.84 nat. median
$8,059
0.7× median
49505
HCPCS 		Repair Of Groin Hernia (5 Years Or Older) 6 $2,777.70 $6,666.47 $5,423.45 nat. median
$3,855
1.4× median
47562
HCPCS 		Removal Of Gallbladder Using An Endoscope 6 $2,756.25 $6,615.00 $5,381.59 nat. median
$5,988
0.9× median
04008011
CDM 		Stem Cell Therapy - 2 Joints 6 $2,496.00 $5,990.40 $4,873.44 nat. median
$4,873
1.0× median
07000634
CDM 		Directinject 10cc 6 $2,415.60 $5,797.44 $4,716.46 nat. median
$4,716
1.0× median
07000663
CDM 		Directinject 5cc 6 $2,415.60 $5,797.44 $4,716.46 nat. median
$4,716
1.0× median
49507
HCPCS 		Repair Of Trapped Groin Hernia (5 Years Or Older) 6 $2,395.20 $5,748.48 $4,676.63 nat. median
$3,886
1.2× median
74174
HCPCS 		CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 6 $2,356.24 $5,654.98 $4,600.56 nat. median
$998
outlier · 4.6×
26035
HCPCS 		Release Of Pressure On Tissues Of Fingers And/or Hand 6 $2,355.20 $5,652.48 $4,598.53 nat. median
$3,334
1.4× median
24565
HCPCS 		Closed Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow With Manipulati… 6 $2,200.00 $5,280.00 $4,295.50 nat. median
$1,679
outlier · 2.6×
07000679
CDM 		Std Flare Sz 14 Str Short Neck 6 $2,198.00 $5,275.20 $4,291.60 nat. median
$4,292
1.0× median
07000678
CDM 		Std Flare Sz 15 Str Short Neck 6 $2,198.00 $5,275.20 $4,291.60 nat. median
$4,292
1.0× median
Q5135
HCPCS 		Injection, Tocilizumab-aazg (tyenne), Biosimilar, 1 Mg 6 $2,106.98 $5,056.74 $4,113.88 nat. median
$997
outlier · 4.1×
36482
HCPCS 		Chemical Destruction Of First Incompetent Vein Of Arm Or Leg Using Imaging Guida… 6 $2,045.50 $4,909.21 $3,993.85 nat. median
$6,034
0.7× median
95811
HCPCS 		Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 6 $2,035.37 $4,884.89 $3,974.06 nat. median
$1,894
outlier · 2.1×
Q5111
HCPCS 		Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 6 $2,004.05 $4,809.72 $3,912.90 nat. median
$1,984
2.0× median
70001021
CDM 		Std Flare Sz 11 Str Short Neck 6 $1,998.00 $4,795.20 $3,901.10 nat. median
$4
outlier · 884.6×
93229
HCPCS 		Electrocardiogram (ecg) Up To 30 Days Continuous With Transmission Of Patient Tr… 6 $1,980.00 $4,752.00 $3,865.95 nat. median
$632
outlier · 6.1×
24535
HCPCS 		Closed Treatment Of Upper Arm Bone Broken At Elbow With Manipulation 6 $1,966.00 $4,718.40 $3,838.61 nat. median
$1,679
outlier · 2.3×
01509292
CDM 		Trauma Team Activation Without Critical Care 6 $1,922.38 $4,613.72 $3,753.45 nat. median
$3,753
1.0× median
57288
HCPCS 		Creation Of Sling Around Urethra In Female To Control Leakage 6 $1,891.46 $4,539.51 $3,693.09 nat. median
$5,177
0.7× median
40654
HCPCS 		Repair Of Vertical Lip Wound Extending To Over Half Of Lip 6 $1,874.00 $4,497.60 $3,658.99 nat. median
$1,882
1.9× median
72156
HCPCS 		MRI Scan Of Upper Spinal Canal Before And After Contrast 6 $1,866.08 $4,478.58 $3,643.51 nat. median
$1,110
outlier · 3.3×
70549
HCPCS 		MRI Scan Of Blood Vessels Of Neck Before And After Contrast 6 $1,858.98 $4,461.54 $3,629.65 nat. median
$1,063
outlier · 3.4×
J0897
HCPCS 		Injection, Denosumab, 1 Mg 6 $1,709.77 $4,832.06 $3,619.14 nat. median
$1,982
1.8× median
06052199
CDM 		Ryanodex 250 Mg Vial 6 $1,817.04 $4,360.90 $3,547.77 nat. median
$3,548
1.0× median
78815
HCPCS 		Nuclear Medicine Study From Skull Base To Mid-thigh With CT Scan 6 $1,788.40 $4,292.16 $3,491.85 nat. median
$2,822
1.2× median
70543
HCPCS 		MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 6 $1,764.90 $4,235.75 $3,445.96 nat. median
$1,087
outlier · 3.2×
J1306
HCPCS 		Injection, Inclisiran, 1 Mg 6 $1,749.36 $4,198.47 $3,415.63 nat. median
$44
outlier · 78.1×
70540
HCPCS 		MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 6 $1,732.50 $4,158.00 $3,382.71 nat. median
$799
outlier · 4.2×
70553
HCPCS 		MRI Scan Of Brain Before And After Contrast 6 $1,730.19 $4,152.46 $3,378.20 nat. median
$1,136
outlier · 3.0×
72197
HCPCS 		MRI Scan Of Pelvis Before And After Contrast 6 $1,725.47 $4,141.13 $3,368.98 nat. median
$1,074
outlier · 3.1×
72157
HCPCS 		MRI Scan Of Middle Spinal Canal Before And After Contrast 6 $1,720.95 $4,130.28 $3,360.16 nat. median
$1,114
outlier · 3.0×
72158
HCPCS 		MRI Scan Of Lower Spinal Canal Before And After Contrast 6 $1,720.95 $4,130.28 $3,360.16 nat. median
$1,097
outlier · 3.1×
J0490
HCPCS 		Injection, Belimumab, 10 Mg 6 $1,703.62 $4,088.69 $3,326.32 nat. median
$1,026
outlier · 3.2×
74183
HCPCS 		MRI Scan Of Abdomen Before And After Contrast 6 $1,699.95 $4,079.88 $3,319.14 nat. median
$1,105
outlier · 3.0×
07000431
CDM 		Osteoboost Bone Filler 10cc 6 $1,692.80 $4,062.72 $3,305.19 nat. median
$3,305
1.0× median

Other procedures at this hospital

Browse this hospital's 3,131 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
             
22513 HCPCS Treatment Of Broken Middle Spine Bone With Placement Of Stabilizing Device Using… 6 6 $11,957.00 $11,957.00 $4,782.80 $11,478.72 $9,338.42 2026-10-12
47600 HCPCS Removal Of Gallbladder 6 6 $10,530.14 $10,530.14 $4,212.06 $10,108.93 $8,224.04 2026-10-12
22514 HCPCS Treatment Of Broken Lower Spine Bone With Placement Of Stabilizing Device 6 6 $10,122.00 $10,122.00 $4,048.80 $9,717.12 $7,905.28 2026-10-12
47564 HCPCS Removal Of Gallbladder With Exploration Of Common Bile Duct Using An Endoscope 6 6 $10,075.00 $10,075.00 $4,030.00 $9,672.00 $7,868.57 2026-10-12
47563 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 6 6 $10,074.49 $10,074.49 $4,029.80 $9,671.51 $7,868.17 2026-10-12
44970 HCPCS Removal Of Appendix Using An Endoscope 6 6 $10,074.49 $10,074.49 $4,029.80 $9,671.51 $7,868.17 2026-10-12
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 6 6 $9,913.93 $9,913.93 $3,965.57 $9,517.37 $7,742.78 2026-10-12
01209656 CDM Operating Room Services - General Classification 6 6 $9,551.28 $9,551.28 $3,820.51 $9,169.23 $7,459.55 2026-10-12
J3101 HCPCS Injection, Tenecteplase, 1 Mg 6 6 $9,209.04 $9,209.04 $3,683.62 $8,840.68 $7,192.26 2026-10-12
01200460 CDM Operating Room Services - General Classification 6 6 $8,382.00 $8,382.00 $3,352.80 $8,046.72 $6,546.34 2026-10-12
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 6 6 $8,329.08 $8,329.08 $3,331.63 $7,995.92 $6,505.01 2026-10-12
C1766 HCPCS Introducer/sheath, Guiding, Intracardiac Electrophysiological, Steerable, Other … 6 6 $8,243.00 $8,243.00 $3,297.20 $7,913.28 $6,437.78 2026-10-12
L8699 HCPCS Prosthetic Implant, Not Otherwise Specified 12 6 $8,599.00 $8,599.00 $2,825.20 $9,729.60 $6,257.82 2026-10-12
22533 HCPCS Fusion Of Lower Spine Bone Through Side With Partial Removal Of Disc, 1 Bone 6 6 $7,533.72 $7,533.72 $3,013.49 $7,232.37 $5,883.84 2026-10-12
49505 HCPCS Repair Of Groin Hernia (5 Years Or Older) 6 6 $6,944.24 $6,944.24 $2,777.70 $6,666.47 $5,423.45 2026-10-12
47562 HCPCS Removal Of Gallbladder Using An Endoscope 6 6 $6,890.63 $6,890.63 $2,756.25 $6,615.00 $5,381.59 2026-10-12
04008011 CDM Stem Cell Therapy - 2 Joints 6 6 $6,240.00 $6,240.00 $2,496.00 $5,990.40 $4,873.44 2026-10-12
07000663 CDM Directinject 5cc 6 6 $6,039.00 $6,039.00 $2,415.60 $5,797.44 $4,716.46 2026-10-12
07000634 CDM Directinject 10cc 6 6 $6,039.00 $6,039.00 $2,415.60 $5,797.44 $4,716.46 2026-10-12
49507 HCPCS Repair Of Trapped Groin Hernia (5 Years Or Older) 6 6 $5,988.00 $5,988.00 $2,395.20 $5,748.48 $4,676.63 2026-10-12
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 6 6 $5,890.60 $5,890.60 $2,356.24 $5,654.98 $4,600.56 2026-10-12
26035 HCPCS Release Of Pressure On Tissues Of Fingers And/or Hand 6 6 $5,888.00 $5,888.00 $2,355.20 $5,652.48 $4,598.53 2026-10-12
24565 HCPCS Closed Treatment Of Broken Outer Part Of Upper Arm Bone At Elbow With Manipulati… 6 6 $5,500.00 $5,500.00 $2,200.00 $5,280.00 $4,295.50 2026-10-12
07000679 CDM Std Flare Sz 14 Str Short Neck 6 6 $5,495.00 $5,495.00 $2,198.00 $5,275.20 $4,291.60 2026-10-12
07000678 CDM Std Flare Sz 15 Str Short Neck 6 6 $5,495.00 $5,495.00 $2,198.00 $5,275.20 $4,291.60 2026-10-12
Q5135 HCPCS Injection, Tocilizumab-aazg (tyenne), Biosimilar, 1 Mg 6 6 $5,267.44 $5,267.44 $2,106.98 $5,056.74 $4,113.88 2026-10-12
36482 HCPCS Chemical Destruction Of First Incompetent Vein Of Arm Or Leg Using Imaging Guida… 6 6 $5,113.76 $5,113.76 $2,045.50 $4,909.21 $3,993.85 2026-10-12
95811 HCPCS Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 6 6 $5,088.43 $5,088.43 $2,035.37 $4,884.89 $3,974.06 2026-10-12
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 6 6 $5,010.12 $5,010.12 $2,004.05 $4,809.72 $3,912.90 2026-10-12
70001021 CDM Std Flare Sz 11 Str Short Neck 6 6 $4,995.00 $4,995.00 $1,998.00 $4,795.20 $3,901.10 2026-10-12
93229 HCPCS Electrocardiogram (ecg) Up To 30 Days Continuous With Transmission Of Patient Tr… 6 6 $4,950.00 $4,950.00 $1,980.00 $4,752.00 $3,865.95 2026-10-12
24535 HCPCS Closed Treatment Of Upper Arm Bone Broken At Elbow With Manipulation 6 6 $4,915.00 $4,915.00 $1,966.00 $4,718.40 $3,838.61 2026-10-12
01509292 CDM Trauma Team Activation Without Critical Care 6 6 $4,805.96 $4,805.96 $1,922.38 $4,613.72 $3,753.45 2026-10-12
57288 HCPCS Creation Of Sling Around Urethra In Female To Control Leakage 6 6 $4,728.66 $4,728.66 $1,891.46 $4,539.51 $3,693.09 2026-10-12
40654 HCPCS Repair Of Vertical Lip Wound Extending To Over Half Of Lip 6 6 $4,685.00 $4,685.00 $1,874.00 $4,497.60 $3,658.99 2026-10-12
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 6 6 $4,665.19 $4,665.19 $1,866.08 $4,478.58 $3,643.51 2026-10-12
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 6 6 $4,647.44 $4,647.44 $1,858.98 $4,461.54 $3,629.65 2026-10-12
J0897 HCPCS Injection, Denosumab, 1 Mg 12 6 $4,653.91 $4,653.91 $1,709.77 $4,832.06 $3,619.14 2026-10-12
06052199 CDM Ryanodex 250 Mg Vial 6 6 $4,542.60 $4,542.60 $1,817.04 $4,360.90 $3,547.77 2026-10-12
78815 HCPCS Nuclear Medicine Study From Skull Base To Mid-thigh With CT Scan 6 6 $4,471.00 $4,471.00 $1,788.40 $4,292.16 $3,491.85 2026-10-12
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 6 6 $4,412.24 $4,412.24 $1,764.90 $4,235.75 $3,445.96 2026-10-12
J1306 HCPCS Injection, Inclisiran, 1 Mg 6 6 $4,373.41 $4,373.41 $1,749.36 $4,198.47 $3,415.63 2026-10-12
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 6 6 $4,331.25 $4,331.25 $1,732.50 $4,158.00 $3,382.71 2026-10-12
70553 HCPCS MRI Scan Of Brain Before And After Contrast 6 6 $4,325.48 $4,325.48 $1,730.19 $4,152.46 $3,378.20 2026-10-12
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 6 6 $4,313.68 $4,313.68 $1,725.47 $4,141.13 $3,368.98 2026-10-12
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 6 6 $4,302.38 $4,302.38 $1,720.95 $4,130.28 $3,360.16 2026-10-12
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 6 6 $4,302.38 $4,302.38 $1,720.95 $4,130.28 $3,360.16 2026-10-12
J0490 HCPCS Injection, Belimumab, 10 Mg 6 6 $4,259.05 $4,259.05 $1,703.62 $4,088.69 $3,326.32 2026-10-12
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 6 6 $4,249.87 $4,249.87 $1,699.95 $4,079.88 $3,319.14 2026-10-12
07000431 CDM Osteoboost Bone Filler 10cc 6 6 $4,232.00 $4,232.00 $1,692.80 $4,062.72 $3,305.19 2026-10-12
49521 HCPCS Repair Of Trapped Or Strangulated Groin Hernia 6 6 $4,188.00 $4,188.00 $1,675.20 $4,020.48 $3,270.83 2026-10-12
01202464 CDM Operating Room Services - General Classification 6 6 $4,187.45 $4,187.45 $1,674.98 $4,019.95 $3,270.39 2026-10-12
01209560 CDM Operating Room Services - General Classification 6 6 $4,187.45 $4,187.45 $1,674.98 $4,019.95 $3,270.39 2026-10-12
04008010 CDM Stem Cell Therapy - 1 Joint 6 6 $4,160.00 $4,160.00 $1,664.00 $3,993.60 $3,248.96 2026-10-12
49520 HCPCS Repair Of Groin Hernia That Is Not Trapped 6 6 $4,078.00 $4,078.00 $1,631.20 $3,914.88 $3,184.92 2026-10-12
49550 HCPCS Repair Of Femoral Groin Hernia 6 6 $4,078.00 $4,078.00 $1,631.20 $3,914.88 $3,184.92 2026-10-12
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 6 6 $4,073.65 $4,073.65 $1,629.46 $3,910.70 $3,181.52 2026-10-12
73220 HCPCS MRI Scan Of Arm Before And After Contrast 6 6 $4,070.10 $4,070.10 $1,628.04 $3,907.30 $3,178.74 2026-10-12
22510 HCPCS Stabilization Of Upper Spine Bone 6 6 $4,051.00 $4,051.00 $1,620.40 $3,888.96 $3,163.83 2026-10-12
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 6 6 $4,042.50 $4,042.50 $1,617.00 $3,880.80 $3,157.19 2026-10-12
95810 HCPCS Sleep Study In Sleep Lab (6 Years Or Older) 12 6 $4,051.69 $4,051.69 $1,543.50 $4,074.84 $3,156.46 2026-10-12
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 6 6 $4,017.09 $4,017.09 $1,606.84 $3,856.41 $3,137.35 2026-10-12
01204950 CDM Operating Room Services - General Classification 6 6 $3,959.45 $3,959.45 $1,583.78 $3,801.07 $3,092.33 2026-10-12
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 6 6 $5,521.59 $5,521.59 $2,208.64 $4,538.75 $3,091.82 2026-10-12
78582 HCPCS Nuclear Medicine Study Of Lung Ventilation And Circulation 6 6 $3,943.80 $3,943.80 $1,577.52 $3,786.05 $3,080.11 2026-10-12
42826 HCPCS Removal Of Tonsils (12 Years Or Older) 6 6 $3,851.93 $3,851.93 $1,540.77 $3,697.85 $3,008.36 2026-10-12
01202465 CDM Operating Room Services - General Classification 6 6 $3,851.93 $3,851.93 $1,540.77 $3,697.85 $3,008.36 2026-10-12
22511 HCPCS Stabilization Of Lower Spine Bone 6 6 $3,817.58 $3,817.58 $1,527.03 $3,664.88 $2,981.53 2026-10-12
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 6 6 $3,816.94 $3,816.94 $1,526.78 $3,664.26 $2,981.03 2026-10-12
70000096 CDM Std Flare Sz 17 Str Short Neck 6 6 $3,787.00 $3,787.00 $1,514.80 $3,635.52 $2,957.64 2026-10-12
70000106 CDM Classic Rdc Flare Sz 15 Str Short Neck 6 6 $3,787.00 $3,787.00 $1,514.80 $3,635.52 $2,957.64 2026-10-12
11771 HCPCS Extensive Removal Of Cyst Of Tailbone 6 6 $3,760.59 $3,760.59 $1,504.24 $3,610.17 $2,937.03 2026-10-12
73720 HCPCS MRI Scan Of Leg Before And After Contrast 6 6 $3,752.69 $3,752.69 $1,501.08 $3,602.58 $2,930.85 2026-10-12
70552 HCPCS MRI Scan Of Brain With Contrast 6 6 $3,747.98 $3,747.98 $1,499.19 $3,598.06 $2,927.18 2026-10-12
01209587 CDM Operating Room Services - General Classification 6 6 $3,741.94 $3,741.94 $1,496.78 $3,592.26 $2,922.45 2026-10-12
C9361 HCPCS Collagen Matrix Nerve Wrap (neuromend Collagen Nerve Wrap), Per 0.5 Centimeter L… 30 6 $3,940.00 $3,940.00 $1,316.00 $4,083.84 $2,917.82 2026-10-12
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 6 6 $3,724.88 $3,724.88 $1,489.95 $3,575.88 $2,909.13 2026-10-12
05509300 CDM Operating Room Services - General Classification 6 6 $3,724.19 $3,724.19 $1,489.68 $3,575.22 $2,908.59 2026-10-12
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 6 6 $3,696.00 $3,696.00 $1,478.40 $3,548.16 $2,886.57 2026-10-12
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 6 6 $3,641.95 $3,641.95 $1,456.78 $3,496.27 $2,844.36 2026-10-12
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 12 6 $3,636.19 $3,636.19 $1,419.00 $3,575.88 $2,836.23 2026-10-12
G0390 HCPCS Trauma Response Team Associated With Hospital Critical Care Service 12 6 $3,999.19 $3,999.19 $1,276.97 $4,613.72 $2,828.49 2026-10-12
07000823 CDM Proximal Lateral Humerus Plate For Right 6 6 $3,605.00 $3,605.00 $1,442.00 $3,460.80 $2,815.51 2026-10-12
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 6 6 $3,604.07 $3,604.07 $1,441.63 $3,459.91 $2,814.78 2026-10-12
54150 HCPCS Removal Of Foreskin Using Clamp Or Device 6 6 $3,580.19 $3,580.19 $1,432.08 $3,436.98 $2,796.13 2026-10-12
70001033 CDM Std Flare Sz 18 Str Short Neck 6 6 $3,570.00 $3,570.00 $1,428.00 $3,427.20 $2,788.17 2026-10-12
36561 HCPCS Insertion Of Central Venous Tube With Port (5 Years Or Older) 6 6 $3,540.90 $3,540.90 $1,416.36 $3,399.26 $2,765.44 2026-10-12
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 6 6 $4,835.44 $4,835.44 $1,934.18 $3,974.73 $2,763.22 2026-10-12
36475 HCPCS Destruction Of First Incompetent Vein Of Arm Or Leg Using Radiofrequency And Ima… 6 6 $3,512.75 $3,512.75 $1,405.10 $3,372.24 $2,743.46 2026-10-12
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 6 6 $3,497.11 $3,497.11 $1,398.84 $3,357.23 $2,731.24 2026-10-12
J0875 HCPCS Injection, Dalbavancin, 5 Mg 6 6 $3,481.15 $3,481.15 $1,392.46 $3,341.90 $2,718.78 2026-10-12
64721 HCPCS Release And/or Relocation Of Hand Nerve 6 6 $3,453.45 $3,453.45 $1,381.38 $3,315.31 $2,697.14 2026-10-12
70551 HCPCS MRI Scan Of Brain Without Contrast 6 6 $3,438.70 $3,438.70 $1,375.48 $3,301.15 $2,685.62 2026-10-12
49418 HCPCS Insertion Of Abdominal Tube Using Imaging Guidance With Review By Radiologist 6 6 $3,411.82 $3,411.82 $1,364.73 $3,275.35 $2,664.64 2026-10-12
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 6 6 $3,397.50 $3,397.50 $1,359.00 $3,261.60 $2,653.45 2026-10-12
07000597 CDM Avive 3x4cm 6 6 $3,396.00 $3,396.00 $1,358.40 $3,260.16 $2,652.28 2026-10-12
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 6 6 $5,527.00 $5,527.00 $2,210.80 $4,543.19 $2,648.91 2026-10-12
01209120 CDM Operating Room Services - General Classification 6 6 $3,386.25 $3,386.25 $1,354.50 $3,250.80 $2,644.66 2026-10-12
01208500 CDM Operating Room Services - General Classification 6 6 $3,386.25 $3,386.25 $1,354.50 $3,250.80 $2,644.66 2026-10-12
74181 HCPCS MRI Scan Of Abdomen Without Contrast 6 6 $3,382.34 $3,382.34 $1,352.94 $3,247.05 $2,641.61 2026-10-12
28810 HCPCS Amputation Of Toe And Midfoot Bone 6 6 $3,347.00 $3,347.00 $1,338.80 $3,213.12 $2,614.01 2026-10-12
07000492 CDM Mesh Hybrid Small 60x60x.3 6 6 $3,343.00 $3,343.00 $1,337.20 $3,209.28 $2,610.89 2026-10-12
Q4116 HCPCS Alloderm, Per Square Centimeter 6 6 $3,339.90 $3,339.90 $1,335.96 $3,206.30 $2,608.47 2026-10-12
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 12 6 $6,028.89 $6,028.89 $263.11 $10,944.00 $2,595.73 2026-10-12
52402 HCPCS Incision Or Removal Of Ejaculatory Duct Using An Endoscope 6 6 $3,297.04 $3,297.04 $1,318.82 $3,165.16 $2,574.99 2026-10-12
36478 HCPCS Laser Destruction Of Incompetent Vein Of Arm Or Leg Using Imaging Guidance 6 6 $3,287.00 $3,287.00 $1,314.80 $3,155.52 $2,567.14 2026-10-12
06051804 CDM *botox Therapeutic Vial 200 Units 6 6 $3,284.16 $3,284.16 $1,313.66 $3,152.79 $2,564.93 2026-10-12
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 6 6 $3,274.81 $3,274.81 $1,309.92 $3,143.82 $2,557.62 2026-10-12
14060 HCPCS Repair Of Wound Of Eyelids, Nose, Ears, Or Lips By Transferring Skin, 10.0 Sq Cm… 6 6 $3,247.50 $3,247.50 $1,299.00 $3,117.60 $2,536.30 2026-10-12
07000819 CDM Absorbatack 5mm Single Use Fixation Devi 6 6 $3,218.00 $3,218.00 $1,287.20 $3,089.28 $2,513.26 2026-10-12
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 6 6 $3,211.25 $3,211.25 $1,284.50 $3,082.80 $2,507.99 2026-10-12
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 12 6 $3,224.89 $3,224.89 $1,137.60 $3,461.56 $2,503.03 2026-10-12
07000493 CDM Hydroset 5cc Inject Cement 6 6 $3,163.00 $3,163.00 $1,265.20 $3,036.48 $2,470.30 2026-10-12
07000953 CDM Stimulan 10cc 6 6 $3,159.00 $3,159.00 $1,263.60 $3,032.64 $2,467.18 2026-10-12
J1561 HCPCS Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)… 12 6 $3,874.32 $3,874.32 $1,033.15 $4,959.13 $2,466.65 2026-10-12
72195 HCPCS MRI Scan Of Pelvis Without Contrast 6 6 $3,140.16 $3,140.16 $1,256.06 $3,014.55 $2,452.47 2026-10-12
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 12 6 $3,139.64 $3,139.64 $1,157.60 $3,249.88 $2,441.99 2026-10-12
11770 HCPCS Simple Removal Of Cyst Of Tailbone 6 6 $3,108.00 $3,108.00 $1,243.20 $2,983.68 $2,427.35 2026-10-12
74185 HCPCS MRI Scan Of Blood Vessels Of Abdomen 6 6 $3,089.63 $3,089.63 $1,235.85 $2,966.04 $2,413.01 2026-10-12
36473 HCPCS Mechanochemical Destruction Of First Incompetent Vein Of Arm Or Leg Using Imagin… 6 6 $3,069.81 $3,069.81 $1,227.92 $2,947.02 $2,397.52 2026-10-12
37765 HCPCS Removal Of Varicose Veins Of Arm Or Leg, 10-20 Incisions 6 6 $3,069.81 $3,069.81 $1,227.92 $2,947.02 $2,397.52 2026-10-12
37766 HCPCS Removal Of Varicose Veins Of Arm Or Leg, More Than 20 Incisions 6 6 $3,069.81 $3,069.81 $1,227.92 $2,947.02 $2,397.52 2026-10-12
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 6 6 $3,053.97 $3,053.97 $1,221.59 $2,931.81 $2,385.15 2026-10-12
28820 HCPCS Amputation Of Toe At Joint Between Forefoot And Toes 14 6 $3,047.93 $3,047.93 $992.75 $3,648.00 $2,380.43 2026-10-12
71552 HCPCS MRI Scan Of Chest Before And After Contrast 6 6 $3,045.00 $3,045.00 $1,218.00 $2,923.20 $2,378.14 2026-10-12
06052744 CDM Paxlovid 300-100 Mg Dose Pack 6 6 $3,044.98 $3,044.98 $1,217.99 $2,923.18 $2,378.13 2026-10-12
26765 HCPCS Treatment Of Broken End Of Finger Or Thumb 6 6 $3,036.89 $3,036.89 $1,214.76 $2,915.41 $2,371.81 2026-10-12
C8930 HCPCS Transthoracic Echocardiography, With Contrast, Or Without Contrast Followed By W… 6 6 $3,034.00 $3,034.00 $1,213.60 $2,912.64 $2,369.55 2026-10-12
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 6 6 $3,020.00 $3,020.00 $1,208.00 $2,899.20 $2,358.62 2026-10-12
J7168 HCPCS Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity 12 6 $3,749.67 $3,749.67 $974.78 $4,859.90 $2,327.28 2026-10-12
70000105 CDM Bf Shell 60mm Group G 6 6 $2,970.00 $2,970.00 $1,188.00 $2,851.20 $2,319.57 2026-10-12
C1602 HCPCS Orthopedic/device/drug Matrix/absorbable Bone Void Filler, Antimicrobial-eluting… 6 6 $2,958.00 $2,958.00 $1,183.20 $2,839.68 $2,310.20 2026-10-12
30310 HCPCS Removal Of Foreign Body In Nose Under Anesthesia 6 6 $2,933.68 $2,933.68 $1,173.47 $2,816.33 $2,291.20 2026-10-12
70000816 CDM Omnicurve 11g 15mm Fracture Kit 6 6 $2,918.00 $2,918.00 $1,167.20 $2,801.28 $2,278.96 2026-10-12
07000814 CDM Omnicurve 11g 20mm Fracture Kit 6 6 $2,918.00 $2,918.00 $1,167.20 $2,801.28 $2,278.96 2026-10-12
46260 HCPCS Removal Of Multiple Hemorrhoid Groups 6 6 $2,917.13 $2,917.13 $1,166.85 $2,800.44 $2,278.28 2026-10-12
70000510 CDM Natrelle Te Smooth 700cc 6 6 $2,916.00 $2,916.00 $1,166.40 $2,799.36 $2,277.39 2026-10-12
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 6 6 $2,907.33 $2,907.33 $1,162.93 $2,791.04 $2,270.62 2026-10-12
70000582 CDM 1.2mm Dynamic Mesh, Mall,small 6 6 $2,902.00 $2,902.00 $1,160.80 $2,785.92 $2,266.46 2026-10-12
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 6 6 $4,179.00 $4,179.00 $1,671.60 $3,435.14 $2,252.19 2026-10-12
07000069 CDM Kugel Hernia Lrg Patch 6 6 $2,860.00 $2,860.00 $1,144.00 $2,745.60 $2,233.66 2026-10-12
73718 HCPCS MRI Scan Of Leg Without Contrast 6 6 $2,859.56 $2,859.56 $1,143.82 $2,745.18 $2,233.32 2026-10-12
74160 HCPCS CT Scan Of Abdomen With Contrast 6 6 $2,856.55 $2,856.55 $1,142.62 $2,742.29 $2,230.97 2026-10-12
A4265 HCPCS Paraffin, Per Pound 6 6 $2,849.28 $2,849.28 $1,139.71 $2,735.31 $2,225.29 2026-10-12
C9359 HCPCS Porous Purified Collagen Matrix Bone Void Filler (integra Mozaik Osteoconductive… 6 6 $2,824.00 $2,824.00 $1,129.60 $2,711.04 $2,205.55 2026-10-12
57415 HCPCS Removal Of Impacted Foreign Body In Vagina Under Anesthesia 6 6 $2,813.54 $2,813.54 $1,125.42 $2,701.00 $2,197.38 2026-10-12
73702 HCPCS CT Scan Of Leg Before And After Contrast 6 6 $2,799.32 $2,799.32 $1,119.73 $2,687.35 $2,186.27 2026-10-12
72193 HCPCS CT Scan Of Pelvis With Contrast 6 6 $2,783.65 $2,783.65 $1,113.46 $2,672.30 $2,174.03 2026-10-12
46930 HCPCS Destruction Of Internal Hemorrhoids Using Heat 6 6 $2,776.00 $2,776.00 $1,110.40 $2,664.96 $2,168.05 2026-10-12
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 6 6 $2,758.00 $2,758.00 $1,103.20 $2,647.68 $2,154.00 2026-10-12
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 6 6 $2,758.00 $2,758.00 $1,103.20 $2,647.68 $2,154.00 2026-10-12
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 6 6 $2,758.00 $2,758.00 $1,103.20 $2,647.68 $2,154.00 2026-10-12
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 6 6 $2,751.82 $2,751.82 $1,100.73 $2,641.75 $2,149.18 2026-10-12
C8929 HCPCS Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi… 6 6 $2,746.00 $2,746.00 $1,098.40 $2,636.16 $2,144.62 2026-10-12
27842 HCPCS Closed Treatment Of Dislocated Ankle Under Anesthesia 6 6 $2,743.65 $2,743.65 $1,097.46 $2,633.90 $2,142.79 2026-10-12
70487 HCPCS CT Scan Of Face With Contrast 6 6 $2,740.42 $2,740.42 $1,096.17 $2,630.80 $2,140.27 2026-10-12
01209110 CDM Operating Room Services - General Classification 6 6 $2,738.09 $2,738.09 $1,095.24 $2,628.57 $2,138.45 2026-10-12
07000956 CDM Smart Toe 2 21mm Angled 6 6 $2,729.00 $2,729.00 $1,091.60 $2,619.84 $2,131.35 2026-10-12
01205260 CDM Operating Room Services - General Classification 6 6 $2,728.11 $2,728.11 $1,091.24 $2,618.99 $2,130.66 2026-10-12
70001034 CDM Bf Shell 64mm Group H 6 6 $2,700.00 $2,700.00 $1,080.00 $2,592.00 $2,108.70 2026-10-12
45380 HCPCS Biopsy Of Large Bowel Using A Flexible Endoscope 6 6 $2,652.18 $2,652.18 $1,060.87 $2,546.09 $2,071.35 2026-10-12
05509098 CDM Operating Room Services - General Classification 6 6 $2,652.18 $2,652.18 $1,060.87 $2,546.09 $2,071.35 2026-10-12
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 6 6 $2,647.63 $2,647.63 $1,059.05 $2,541.72 $2,067.80 2026-10-12
72129 HCPCS CT Scan Of Middle Spine With Contrast 6 6 $2,645.00 $2,645.00 $1,058.00 $2,539.20 $2,065.74 2026-10-12
95805 HCPCS Sleep Study, Multiple Trials 6 6 $2,641.80 $2,641.80 $1,056.72 $2,536.13 $2,063.24 2026-10-12
73218 HCPCS MRI Scan Of Arm Without Contrast 6 6 $2,636.45 $2,636.45 $1,054.58 $2,530.99 $2,059.07 2026-10-12
99291 HCPCS Critical Care, First 30-74 Minutes 6 6 $2,621.60 $2,621.60 $1,048.64 $2,516.74 $2,047.47 2026-10-12
72125 HCPCS CT Scan Of Upper Spine Without Contrast 6 6 $2,597.99 $2,597.99 $1,039.20 $2,494.07 $2,029.03 2026-10-12
15877 HCPCS Suction Assisted Removal Of Fat Of Body 1 1 $3,976.00 $3,976.00 $2,021.68 $2,021.68 $2,021.68 2026-10-12
72128 HCPCS CT Scan Of Middle Spine Without Contrast 6 6 $2,577.50 $2,577.50 $1,031.00 $2,474.40 $2,013.03 2026-10-12
72131 HCPCS CT Scan Of Lower Spine Without Contrast 6 6 $2,577.48 $2,577.48 $1,030.99 $2,474.38 $2,013.01 2026-10-12
07000764 CDM Prosthesis Head A 6 6 $2,574.00 $2,574.00 $1,029.60 $2,471.04 $2,010.30 2026-10-12
70000890 CDM Prosthesis Head A 36mm - 4s 6 6 $2,574.00 $2,574.00 $1,029.60 $2,471.04 $2,010.30 2026-10-12
78709 HCPCS Nuclear Medicine Studies Of Kidney, Blood Flow, And Function 6 6 $2,573.00 $2,573.00 $1,029.20 $2,470.08 $2,009.52 2026-10-12
72126 HCPCS CT Scan Of Upper Spine With Contrast 6 6 $2,571.03 $2,571.03 $1,028.41 $2,468.19 $2,007.97 2026-10-12
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 6 6 $2,569.00 $2,569.00 $1,027.60 $2,466.24 $2,006.39 2026-10-12
73201 HCPCS CT Scan Of Arm With Contrast 6 6 $2,567.79 $2,567.79 $1,027.12 $2,465.08 $2,005.44 2026-10-12
J1439 HCPCS Injection, Ferric Carboxymaltose, 1 Mg 6 6 $2,551.08 $2,551.08 $1,020.43 $2,449.04 $1,992.39 2026-10-12
06052835 CDM Kyleena 19.5 Mg System 6 6 $2,544.99 $2,544.99 $1,018.00 $2,443.19 $1,987.63 2026-10-12
06052778 CDM Mirena 52 Mg System 6 6 $2,544.38 $2,544.38 $1,017.75 $2,442.60 $1,987.16 2026-10-12
J2426 HCPCS Injection, Paliperidone Palmitate Extended Release (invega Sustenna), 1 Mg 18 6 $2,890.75 $2,890.75 $740.07 $4,404.27 $1,987.13 2026-10-12
01202903 CDM Operating Room Services - General Classification 6 6 $2,542.63 $2,542.63 $1,017.05 $2,440.92 $1,985.80 2026-10-12
73725 HCPCS MRI Scan Of Blood Vessels Of Leg 6 6 $2,541.00 $2,541.00 $1,016.40 $2,439.36 $1,984.52 2026-10-12
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 6 6 $3,346.49 $3,346.49 $1,338.60 $2,750.81 $1,984.40 2026-10-12
71550 HCPCS MRI Scan Of Chest Without Contrast 6 6 $2,520.00 $2,520.00 $1,008.00 $2,419.20 $1,968.12 2026-10-12
71270 HCPCS CT Scan Of Chest Before And After Contrast 6 6 $2,496.00 $2,496.00 $998.40 $2,396.16 $1,949.38 2026-10-12
72132 HCPCS CT Scan Of Lower Spine With Contrast 6 6 $2,490.18 $2,490.18 $996.07 $2,390.57 $1,944.83 2026-10-12
73701 HCPCS CT Scan Of Leg With Contrast Material 6 6 $2,487.48 $2,487.48 $994.99 $2,387.98 $1,942.72 2026-10-12
43251 HCPCS Removal Of Polyps Or Growths Of Esophagus, Stomach, And/or Upper Small Bowel Usi… 6 6 $2,476.32 $2,476.32 $990.53 $2,377.27 $1,934.01 2026-10-12
05503247 CDM Operating Room Services - General Classification 6 6 $2,475.00 $2,475.00 $990.00 $2,376.00 $1,932.97 2026-10-12
J7318 HCPCS Hyaluronan Or Derivative, Durolane, For Intra-articular Injection, 1 Mg 6 6 $2,455.70 $2,455.70 $982.28 $2,357.47 $1,917.90 2026-10-12
C1776 HCPCS Joint Device (implantable) 210 6 $2,665.00 $2,665.00 $19.98 $12,483.84 $1,912.38 2026-10-12
01202468 CDM Operating Room Services - General Classification 6 6 $2,446.29 $2,446.29 $978.52 $2,348.44 $1,910.55 2026-10-12
01201555 CDM Operating Room Services - General Classification 6 6 $2,433.80 $2,433.80 $973.52 $2,336.45 $1,900.80 2026-10-12
72192 HCPCS CT Scan Of Pelvis Without Contrast 6 6 $2,428.00 $2,428.00 $971.20 $2,330.88 $1,896.27 2026-10-12
72191 HCPCS CT Scan Of Blood Vessels Of Pelvis With Contrast 6 6 $2,424.00 $2,424.00 $969.60 $2,327.04 $1,893.14 2026-10-12
71250 HCPCS CT Scan Of Chest Without Contrast 6 6 $2,423.86 $2,423.86 $969.54 $2,326.91 $1,893.04 2026-10-12
36410 HCPCS Insertion Of Needle Into Vein (3 Years Or Older) 6 6 $3,020.00 $3,020.00 $20.00 $2,899.20 $1,887.50 2026-10-12
71555 HCPCS MRI Scan Of Blood Vessels Of Chest 6 6 $2,415.00 $2,415.00 $966.00 $2,318.40 $1,886.12 2026-10-12
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 6 6 $2,415.00 $2,415.00 $966.00 $2,318.40 $1,886.12 2026-10-12
70460 HCPCS CT Scan Head Or Brain With Contrast 6 6 $2,404.00 $2,404.00 $961.60 $2,307.84 $1,877.53 2026-10-12
06009138 CDM Hydroxocobalamin (cyanokit) 5g Injection 6 6 $2,395.18 $2,395.18 $958.07 $2,299.37 $1,870.63 2026-10-12
01202460 CDM Operating Room Services - General Classification 6 6 $2,387.50 $2,387.50 $955.00 $2,292.00 $1,864.64 2026-10-12
74150 HCPCS CT Scan Of Abdomen Without Contrast 6 6 $2,385.81 $2,385.81 $954.32 $2,290.38 $1,863.32 2026-10-12
81162 HCPCS Gene Analysis (breast Cancer 1 And 2) Of Full Sequence And Analysis For Duplicat… 6 6 $2,383.88 $2,383.88 $953.55 $2,288.52 $1,861.81 2026-10-12
70000300 CDM Delta Option Head 36mm 6 6 $2,376.00 $2,376.00 $950.40 $2,280.96 $1,855.65 2026-10-12
32555 HCPCS Aspiration Of Fluid From Chest Cavity Using Imaging Guidance 6 6 $2,374.00 $2,374.00 $949.60 $2,279.04 $1,854.10 2026-10-12
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 6 6 $2,362.00 $2,362.00 $944.80 $2,267.52 $1,844.72 2026-10-12
46505 HCPCS Injection Of Agent To Destroy Nerve To Internal Sphincter Of Anus 6 6 $2,357.19 $2,357.19 $942.88 $2,262.90 $1,840.96 2026-10-12
J1944 HCPCS Injection, Aripiprazole Lauroxil, (aristada), 1 Mg 6 6 $2,338.02 $2,338.02 $935.21 $2,244.50 $1,825.99 2026-10-12
20680 HCPCS Removal Of Deep Implant From Bone 2 2 $1,910.00 $1,910.00 $1,814.50 $1,833.60 $1,824.05 2026-10-12
70480 HCPCS CT Scan Of Cranial Cavity Without Contrast 6 6 $2,329.82 $2,329.82 $931.93 $2,236.63 $1,819.59 2026-10-12
07000068 CDM Kugel Hernia Md Patch Oval 6 6 $2,328.00 $2,328.00 $931.20 $2,234.88 $1,818.17 2026-10-12
78315 HCPCS Nuclear Medicine Study Of Bone Taken At Different Times 6 6 $2,302.98 $2,302.98 $921.19 $2,210.86 $1,798.63 2026-10-12
57461 HCPCS Cone Biopsy Of Cervix And Vagina Using An Endoscope With Loop Electrode 6 6 $2,300.00 $2,300.00 $920.00 $2,208.00 $1,796.30 2026-10-12
27786 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle 6 6 $2,300.00 $2,300.00 $920.00 $2,208.00 $1,796.30 2026-10-12
57460 HCPCS Biopsy Of Cervix Using An Endoscope With Loop Electrode 6 6 $2,300.00 $2,300.00 $920.00 $2,208.00 $1,796.30 2026-10-12
70490 HCPCS CT Scan Of Soft Tissue Of Neck Without Contrast 6 6 $2,282.50 $2,282.50 $913.00 $2,191.20 $1,782.63 2026-10-12
J7307 HCPCS Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 6 6 $2,267.40 $2,267.40 $906.96 $2,176.70 $1,770.84 2026-10-12
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 6 6 $2,543.31 $2,543.31 $1,017.32 $2,090.60 $1,763.55 2026-10-12
AC CDM Room & Board - Semi-private (two Beds) - General Classification 3 3 $1,850.00 $1,850.00 $1,520.70 $1,776.00 $1,757.50 2026-10-12
01200670 CDM Operating Room Services - General Classification 6 6 $2,236.00 $2,236.00 $894.40 $2,146.56 $1,746.32 2026-10-12
81408 HCPCS Molecular Pathology Procedure Level 9 Genetic Analysis 6 6 $2,227.00 $2,227.00 $890.80 $2,137.92 $1,739.28 2026-10-12
64635 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 6 6 $2,213.00 $2,213.00 $885.20 $2,124.48 $1,728.36 2026-10-12
52260 HCPCS Dilation Of Bladder Using An Endoscope Under General Or Spinal Anesthesia 6 6 $2,198.44 $2,198.44 $879.38 $2,110.50 $1,716.98 2026-10-12
09005002 CDM Autoplex Cement Mixer 6 6 $2,178.00 $2,178.00 $871.20 $2,090.88 $1,701.02 2026-10-12
73700 HCPCS CT Scan Of Leg Without Contrast 6 6 $2,165.93 $2,165.93 $866.37 $2,079.29 $1,691.59 2026-10-12
70488 HCPCS CT Scan Of Face Before And After Contrast 6 6 $2,163.00 $2,163.00 $865.20 $2,076.48 $1,689.30 2026-10-12
C1789 HCPCS Prosthesis, Breast (implantable) 54 6 $2,624.00 $2,624.00 $250.00 $3,266.88 $1,688.10 2026-10-12
78227 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs 6 6 $2,159.85 $2,159.85 $863.94 $2,073.46 $1,686.85 2026-10-12
A0434 HCPCS Specialty Care Transport (sct) 6 6 $2,146.00 $2,146.00 $858.40 $2,060.16 $1,676.03 2026-10-12
73202 HCPCS CT Scan Of Arm Before And After Contrast 6 6 $2,144.00 $2,144.00 $857.60 $2,058.24 $1,674.46 2026-10-12
70336 HCPCS MRI Scan Of Jaw Joint 6 6 $2,128.00 $2,128.00 $851.20 $2,042.88 $1,661.97 2026-10-12
01009026 CDM Operating Room Services - General Classification 6 6 $2,113.65 $2,113.65 $845.46 $2,029.10 $1,650.76 2026-10-12
19083 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 6 6 $2,107.00 $2,107.00 $842.80 $2,022.72 $1,645.57 2026-10-12
70486 HCPCS CT Scan Of Face Without Contrast 6 6 $2,097.35 $2,097.35 $838.94 $2,013.46 $1,638.03 2026-10-12
C2625 HCPCS Stent, Non-coronary, Temporary, With Delivery System 12 6 $2,092.50 $2,092.50 $819.60 $2,050.56 $1,632.46 2026-10-12
70000700 CDM Implant 70011 Propel 6 6 $2,090.00 $2,090.00 $836.00 $2,006.40 $1,632.29 2026-10-12
92960 HCPCS External Shock To Heart To Regulate Heart Beat 6 6 $2,083.75 $2,083.75 $833.50 $2,000.40 $1,627.41 2026-10-12
73200 HCPCS CT Scan Of Arm Without Contrast 6 6 $2,083.07 $2,083.07 $833.23 $1,999.75 $1,626.88 2026-10-12
28825 HCPCS Amputation Of Toe At Toe Joint 8 6 $2,600.00 $2,600.00 $1,040.00 $2,496.00 $1,625.00 2026-10-12
07000759 CDM Superior Plate Decreased 8 Hole Left 6 6 $2,075.00 $2,075.00 $830.00 $1,992.00 $1,620.58 2026-10-12
70481 HCPCS CT Scan Of Cranial Cavity With Contrast 6 6 $2,069.00 $2,069.00 $827.60 $1,986.24 $1,615.89 2026-10-12
55250 HCPCS Removal Of Sperm Duct 12 6 $2,061.28 $2,061.28 $732.90 $2,198.70 $1,600.47 2026-10-12
07000596 CDM Avive 2x2cs 6 6 $2,049.00 $2,049.00 $819.60 $1,967.04 $1,600.27 2026-10-12
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 6 6 $2,046.66 $2,046.66 $818.66 $1,964.79 $1,598.44 2026-10-12
78707 HCPCS Nuclear Medicine Study Of Kidney, Blood Flow, And Function 6 6 $2,041.00 $2,041.00 $816.40 $1,959.36 $1,594.02 2026-10-12
11626 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More Tha… 8 6 $2,256.00 $2,256.00 $902.40 $2,165.76 $1,591.68 2026-10-12
78803 HCPCS Nuclear Medicine Study, Spect Imaging, 1 Area Or Single Acquisition, Single Day … 6 6 $2,033.00 $2,033.00 $813.20 $1,951.68 $1,587.78 2026-10-12
13160 HCPCS Extensive Or Complicated Repair Of Surface Wound Reopening 6 6 $2,000.00 $2,000.00 $800.00 $1,920.00 $1,562.00 2026-10-12
07000769 CDM Superior Lateral Plate- 3 Hole/right 6 6 $2,000.00 $2,000.00 $800.00 $1,920.00 $1,562.00 2026-10-12
81490 HCPCS Test For Detecting Genes Associated With Rheumatoid Arthritis Using Immunoassay … 6 6 $1,978.00 $1,978.00 $791.20 $1,898.88 $1,544.82 2026-10-12
05500104 CDM Operating Room Services - General Classification 6 6 $1,974.00 $1,974.00 $789.60 $1,895.04 $1,541.70 2026-10-12
45378 HCPCS Diagnostic Exam Of Large Bowel Using A Flexible Endoscope 6 6 $1,974.00 $1,974.00 $789.60 $1,895.04 $1,541.70 2026-10-12
01206111 CDM Operating Room Services - General Classification 6 6 $1,970.00 $1,970.00 $788.00 $1,891.20 $1,538.57 2026-10-12
43246 HCPCS Insertion Of Stomach Tube Using A Flexible Endoscope 6 6 $1,968.75 $1,968.75 $787.50 $1,890.00 $1,537.60 2026-10-12
07000681 CDM 4.0 Can. Twist Drill 02.7 L160mm Ao 6 6 $1,956.00 $1,956.00 $782.40 $1,877.76 $1,527.63 2026-10-12
J0248 HCPCS Injection, Remdesivir, 1 Mg 6 6 $1,950.00 $1,950.00 $780.00 $1,872.00 $1,522.95 2026-10-12
73206 HCPCS CT Scan Of Blood Vessels Of Arm With Contrast 6 6 $1,944.00 $1,944.00 $777.60 $1,866.24 $1,518.26 2026-10-12
73706 HCPCS CT Scan Of Blood Vessels Of Lower Leg With Contrast 6 6 $1,944.00 $1,944.00 $777.60 $1,866.24 $1,518.26 2026-10-12
11646 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More… 8 6 $2,429.00 $2,429.00 $971.60 $2,331.84 $1,518.12 2026-10-12
06050141 CDM Paragard T IUD 6 6 $1,940.40 $1,940.40 $776.16 $1,862.78 $1,515.45 2026-10-12
93350 HCPCS Ultrasound Of Heart During Rest, Exercise And/or Drug-induced Stress With Report 12 6 $1,940.09 $1,940.09 $722.57 $1,990.80 $1,509.73 2026-10-12
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 6 6 $2,787.73 $2,787.73 $1,115.09 $2,291.51 $1,507.51 2026-10-12
05503248 CDM Operating Room Services - General Classification 6 6 $1,929.50 $1,929.50 $771.80 $1,852.32 $1,506.94 2026-10-12
05503245 CDM Operating Room Services - General Classification 6 6 $1,929.38 $1,929.38 $771.75 $1,852.20 $1,506.85 2026-10-12
52281 HCPCS Dilation Of Urethra Using An Endoscope 6 6 $1,922.00 $1,922.00 $768.80 $1,845.12 $1,501.08 2026-10-12
54700 HCPCS Incision And Drainage Of Sperm Reservoir, Testis, And/or Scrotal Area 6 6 $1,920.08 $1,920.08 $768.03 $1,843.28 $1,499.59 2026-10-12
71260 HCPCS CT Scan Of Chest With Contrast 6 6 $2,731.37 $2,731.37 $1,092.55 $2,245.19 $1,498.97 2026-10-12
01202466 CDM Operating Room Services - General Classification 6 6 $1,906.25 $1,906.25 $762.50 $1,830.00 $1,488.79 2026-10-12
07000146 CDM Kugel Hernia Sm Patch Rnd 6 6 $1,906.00 $1,906.00 $762.40 $1,829.76 $1,488.59 2026-10-12
62273 HCPCS Injection Of Blood Or Blood Clot Into Spinal Canal 6 6 $1,900.00 $1,900.00 $760.00 $1,824.00 $1,483.90 2026-10-12
01206040 CDM Operating Room Services - General Classification 6 6 $1,899.98 $1,899.98 $759.99 $1,823.98 $1,483.88 2026-10-12
07000683 CDM 4.0 Cann Screwdriver Blade Hd12 Ao 6 6 $1,890.00 $1,890.00 $756.00 $1,814.40 $1,476.09 2026-10-12
64633 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 6 6 $1,882.98 $1,882.98 $753.19 $1,807.66 $1,470.61 2026-10-12
23500 HCPCS Closed Treatment Of Broken Collar Bone 6 6 $1,875.00 $1,875.00 $750.00 $1,800.00 $1,464.38 2026-10-12
01211555 CDM Operating Room Services - General Classification 6 6 $1,854.93 $1,854.93 $741.97 $1,780.73 $1,448.70 2026-10-12
19100 HCPCS Needle Biopsy Of Breast 6 6 $1,854.93 $1,854.93 $741.97 $1,780.73 $1,448.70 2026-10-12
70000709 CDM 14mm 2.5 Micro Acutrak 3 Bone Screw 6 6 $1,844.00 $1,844.00 $737.60 $1,770.24 $1,440.16 2026-10-12
70000460 CDM 18mm 3.5 Mini Acutrak 3 Bone Screw 6 6 $1,844.00 $1,844.00 $737.60 $1,770.24 $1,440.16 2026-10-12
70000602 CDM 2.0mm Cann Drill Bit Qc/145mm 6 6 $1,839.60 $1,839.60 $735.84 $1,766.02 $1,436.72 2026-10-12
27552 HCPCS Closed Treatment Of Dislocated Knee Under Anesthesia 6 6 $1,837.50 $1,837.50 $735.00 $1,764.00 $1,435.09 2026-10-12
A0433 HCPCS Advanced Life Support, Level 2 (als 2) 6 6 $1,835.00 $1,835.00 $734.00 $1,761.60 $1,433.13 2026-10-12
07000763 CDM Innate Implant 4.5mm X 45mm 6 6 $1,807.00 $1,807.00 $722.80 $1,734.72 $1,411.26 2026-10-12
07000699 CDM Innate Implant 3.6mm X 45mm 6 6 $1,807.00 $1,807.00 $722.80 $1,734.72 $1,411.26 2026-10-12
J3304 HCPCS Injection, Triamcinolone Acetonide, Preservative-free, Extended-release, Microsp… 6 6 $1,795.50 $1,795.50 $718.20 $1,723.68 $1,402.29 2026-10-12
07000433 CDM 30.0 Acutrak 2 Bone Screw 6 6 $1,795.00 $1,795.00 $718.00 $1,723.20 $1,401.89 2026-10-12
SB CDM Room & Board - Semi-private (two Beds) - General Classification 3 3 $1,470.00 $1,470.00 $1,208.34 $1,411.20 $1,396.50 2026-10-12
R1 CDM Room & Board - Semi-private (two Beds) - General Classification 3 3 $1,470.00 $1,470.00 $1,208.34 $1,411.20 $1,396.50 2026-10-12
26080 HCPCS Incision Of Finger Joint For Exploration, Fluid Drainage, Or Removal Of Foreign … 6 6 $1,785.00 $1,785.00 $714.00 $1,713.60 $1,394.09 2026-10-12
01206160 CDM Operating Room Services - General Classification 6 6 $1,785.00 $1,785.00 $714.00 $1,713.60 $1,394.09 2026-10-12
01206115 CDM Operating Room Services - General Classification 6 6 $1,784.00 $1,784.00 $713.60 $1,712.64 $1,393.31 2026-10-12
70450 HCPCS CT Scan Head Or Brain Without Contrast 6 6 $2,139.98 $2,139.98 $855.99 $1,759.06 $1,392.28 2026-10-12
20103 HCPCS Exploration Of Wound Of Arm Or Leg 6 6 $1,764.00 $1,764.00 $705.60 $1,693.44 $1,377.68 2026-10-12
64483 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I… 6 6 $1,757.50 $1,757.50 $703.00 $1,687.20 $1,372.61 2026-10-12
15876 HCPCS Suction Assisted Removal Of Fat Of Head And Neck 1 1 $2,531.00 $2,531.00 $1,365.90 $1,365.90 $1,365.90 2026-10-12
64479 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Upper Or Middle Spine Nerve Roo… 6 6 $1,745.00 $1,745.00 $698.00 $1,675.20 $1,362.85 2026-10-12
43453 HCPCS Dilation Of Esophagus With A Guide Wire 6 6 $1,741.75 $1,741.75 $696.70 $1,672.08 $1,360.31 2026-10-12
J2357 HCPCS Injection, Omalizumab, 5 Mg 18 6 $2,351.54 $2,351.54 $553.32 $2,600.28 $1,354.69 2026-10-12
J0585 HCPCS Injection, Onabotulinumtoxina, 1 Unit 18 6 $1,866.00 $1,866.00 $14.06 $3,152.79 $1,347.25 2026-10-12
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