|
46221
|
HCPCS
|
Hemorrhoidectomy, Simple Ligature
|
32
|
13
|
$950.00
|
$950.00
|
$350.00
|
$931.00
|
$555.79
|
2026-05-01
|
|
76856
|
HCPCS
|
Ultrasound Pelvic
|
16
|
13
|
$840.00
|
$840.00
|
$420.00
|
$823.20
|
$565.90
|
2026-05-01
|
|
76770
|
HCPCS
|
Ultrasound Retroperitoneal/complete
|
16
|
13
|
$844.00
|
$844.00
|
$422.00
|
$827.12
|
$568.59
|
2026-05-01
|
|
99285
|
HCPCS
|
Emergency Department Visit Level V
|
32
|
13
|
$1,200.00
|
$1,200.00
|
$250.00
|
$1,176.00
|
$572.63
|
2026-05-01
|
|
76937
|
HCPCS
|
Ultrasound Guidance For Vascular Acce
|
16
|
13
|
$875.00
|
$875.00
|
$437.50
|
$857.50
|
$589.48
|
2026-05-01
|
|
92950
|
HCPCS
|
Cardiopulmonary Resuscitation
|
32
|
13
|
$1,015.00
|
$1,015.00
|
$369.00
|
$994.70
|
$590.49
|
2026-05-01
|
|
28011
|
HCPCS
|
Tenotomy, Percutaneous Toe, Mult Tendons
|
32
|
13
|
$1,185.00
|
$948.00
20% off
|
$292.50
|
$1,161.30
|
$596.21
|
2026-05-01
|
|
5855280
|
OTHER
|
Assist Lapar Assisted Vag Hysterectomy
|
16
|
13
|
$890.00
|
$890.00
|
$445.00
|
$872.20
|
$599.58
|
2026-05-01
|
|
64447
|
HCPCS
|
Inj Anes/steroid Femoral Nerve
|
16
|
13
|
$900.00
|
$900.00
|
$450.00
|
$882.00
|
$606.32
|
2026-05-01
|
|
76700
|
HCPCS
|
Ultrasound Abdomen Complete
|
16
|
13
|
$910.00
|
$910.00
|
$455.00
|
$891.80
|
$613.06
|
2026-05-01
|
|
120
|
RC
|
Skilled Care Room
|
48
|
13
|
$1,480.00
|
$1,480.00
|
$82.50
|
$1,450.40
|
$616.42
|
2026-05-01
|
|
Q5106
|
HCPCS
|
Epoetin Alfa Epbx Vial [ 40,000 UN/mL]
|
16
|
13
|
$917.00
|
$917.00
|
$458.50
|
$898.66
|
$617.77
|
2026-05-01
|
|
27818
|
HCPCS
|
Closed Tx Trimalleolar Ankle Fx W/mani
|
32
|
13
|
$1,000.00
|
$835.00
|
$417.50
|
$980.00
|
$618.11
|
2026-05-01
|
|
93931
|
HCPCS
|
Arterial Duplex Limited Upper
|
16
|
13
|
$930.00
|
$930.00
|
$465.00
|
$911.40
|
$626.53
|
2026-05-01
|
|
J9217
|
HCPCS
|
Eligard [22.5 Mg]
|
16
|
13
|
$938.00
|
$938.00
|
$469.00
|
$919.24
|
$631.92
|
2026-05-01
|
|
64415
|
HCPCS
|
Inj Anes/steroid Brach Plexus W/imaging
|
16
|
13
|
$950.00
|
$950.00
|
$475.00
|
$931.00
|
$640.00
|
2026-05-01
|
|
636
|
RC
|
Vancomycin Premix [1 Gm / 200 Ml]
|
688
|
13
|
$17,987.00
|
$17,987.00
|
$4.50
|
$17,627.26
|
$645.19
|
2026-05-01
|
|
173
|
RC
|
Nursery Room Level 3
|
16
|
13
|
$965.00
|
$772.00
20% off
|
$482.50
|
$945.70
|
$650.11
|
2026-05-01
|
|
25505
|
HCPCS
|
Closed Tx Radial Shaft Fx W/manipulation
|
19
|
13
|
$1,000.00
|
$1,000.00
|
$500.00
|
$980.00
|
$672.05
|
2026-05-01
|
|
27810
|
HCPCS
|
Closed Treat Ankle Fx With Manipulation
|
16
|
13
|
$1,000.00
|
$800.00
20% off
|
$500.00
|
$980.00
|
$673.69
|
2026-05-01
|
|
721
|
RC
|
Labor Service Level 3 (9-16 Hrs)
|
32
|
13
|
$1,785.00
|
$1,428.00
20% off
|
$112.50
|
$1,749.30
|
$677.06
|
2026-05-01
|
|
2781830
|
OTHER
|
Closed Tx Trimalleolar Ankle Fx W/mani
|
16
|
13
|
$1,010.00
|
$1,010.00
|
$505.00
|
$989.80
|
$680.42
|
2026-05-01
|
|
59425
|
HCPCS
|
Antepartum Care 4-6 Visits
|
16
|
13
|
$1,010.00
|
$808.00
20% off
|
$505.00
|
$989.80
|
$680.42
|
2026-05-01
|
|
27788
|
HCPCS
|
Closed Tx Distal Fibula Fx With Mani
|
32
|
13
|
$1,416.00
|
$1,132.80
20% off
|
$307.50
|
$1,387.68
|
$684.13
|
2026-05-01
|
|
77001
|
HCPCS
|
Fluoroguide Vad Placement
|
16
|
13
|
$1,020.00
|
$1,020.00
|
$510.00
|
$999.60
|
$687.16
|
2026-05-01
|
|
27266
|
HCPCS
|
Clst Tx Post Hip Arthorplasty Disl W/ane
|
32
|
13
|
$1,100.00
|
$1,000.00
|
$500.00
|
$1,078.00
|
$707.37
|
2026-05-01
|
|
25565
|
HCPCS
|
Closed Radial/ulnar Shft Fx W/manip
|
16
|
13
|
$1,060.00
|
$1,060.00
|
$530.00
|
$1,038.80
|
$714.11
|
2026-05-01
|
|
93926
|
HCPCS
|
Duplex Scan Lower Ext Limited Arterial
|
16
|
13
|
$1,070.00
|
$1,070.00
|
$535.00
|
$1,048.60
|
$720.85
|
2026-05-01
|
|
93975
|
HCPCS
|
Duplex Renal/abdominal, Complete Study
|
16
|
13
|
$1,075.00
|
$1,075.00
|
$537.50
|
$1,053.50
|
$724.21
|
2026-05-01
|
|
62322
|
HCPCS
|
Njx Interlaminar Lmbr/sac
|
16
|
13
|
$1,080.00
|
$1,080.00
|
$540.00
|
$1,058.40
|
$727.58
|
2026-05-01
|
|
93308
|
HCPCS
|
Echocardiograpy/follow Up-limited St
|
16
|
13
|
$1,100.00
|
$1,100.00
|
$550.00
|
$1,078.00
|
$741.06
|
2026-05-01
|
|
93971
|
HCPCS
|
Duplex Scan Extremity Veins Limited
|
16
|
13
|
$1,105.00
|
$1,105.00
|
$552.50
|
$1,082.90
|
$744.42
|
2026-05-01
|
|
62326
|
HCPCS
|
Njx Lmbr/sac Incl Indewelling
|
16
|
13
|
$1,110.00
|
$1,110.00
|
$555.00
|
$1,087.80
|
$747.79
|
2026-05-01
|
|
36430
|
HCPCS
|
Blood Administration - 5 Units
|
80
|
13
|
$1,340.00
|
$1,340.00
|
$442.50
|
$1,313.20
|
$748.47
|
2026-05-01
|
|
26418
|
HCPCS
|
Repair Extensor Tendon Finger
|
32
|
13
|
$1,500.00
|
$1,200.00
20% off
|
$362.50
|
$1,470.00
|
$749.48
|
2026-05-01
|
|
J0248
|
HCPCS
|
Remdesivir Vial [100 Mg]
|
16
|
13
|
$1,143.00
|
$1,143.00
|
$571.50
|
$1,120.14
|
$770.02
|
2026-05-01
|
|
27096
|
HCPCS
|
Inj Si Joint Anes/steroid With Imaging
|
16
|
13
|
$1,150.00
|
$1,150.00
|
$575.00
|
$1,127.00
|
$774.74
|
2026-05-01
|
|
99291
|
HCPCS
|
Critical Care Eval/manage 1st 30-74 Min
|
32
|
13
|
$1,800.00
|
$1,800.00
|
$250.00
|
$1,764.00
|
$774.74
|
2026-05-01
|
|
93017
|
HCPCS
|
ECG Stress Test-test Only
|
16
|
13
|
$1,150.00
|
$1,150.00
|
$575.00
|
$1,127.00
|
$774.74
|
2026-05-01
|
|
J1745
|
HCPCS
|
Infliximab Vial [100 Mg]
|
16
|
13
|
$1,198.00
|
$1,198.00
|
$599.00
|
$1,174.04
|
$807.08
|
2026-05-01
|
|
81539
|
HCPCS
|
4kscore Prostate Oncology
|
16
|
13
|
$1,199.00
|
$1,199.00
|
$599.50
|
$1,175.02
|
$807.75
|
2026-05-01
|
|
24075
|
HCPCS
|
Excision Tumor Soft Uparm/elbow <3cm
|
16
|
13
|
$1,200.00
|
$1,200.00
|
$600.00
|
$1,176.00
|
$808.42
|
2026-05-01
|
|
93882
|
HCPCS
|
Carotid Duplex Unilateral Or Limited
|
16
|
13
|
$1,205.00
|
$964.00
20% off
|
$602.50
|
$1,180.90
|
$811.79
|
2026-05-01
|
|
93925
|
HCPCS
|
Duplex Lower Ext Bilateral
|
16
|
13
|
$1,225.00
|
$1,225.00
|
$612.50
|
$1,200.50
|
$825.27
|
2026-05-01
|
|
30100
|
HCPCS
|
Biopsy, Intranasal
|
16
|
13
|
$1,230.00
|
$1,230.00
|
$615.00
|
$1,205.40
|
$828.64
|
2026-05-01
|
|
81206
|
HCPCS
|
Bcr/alb1 Major Quantatative
|
16
|
13
|
$1,232.00
|
$1,232.00
|
$616.00
|
$1,207.36
|
$829.98
|
2026-05-01
|
|
10005
|
HCPCS
|
Fine Needle Asp Biopsy; U/s Guide 1 Les
|
16
|
13
|
$1,250.00
|
$1,250.00
|
$625.00
|
$1,225.00
|
$842.11
|
2026-05-01
|
|
25605
|
HCPCS
|
Fracture Radius Distal W/manipulation
|
35
|
13
|
$1,400.00
|
$1,400.00
|
$617.50
|
$1,372.00
|
$891.10
|
2026-05-01
|
|
32551
|
HCPCS
|
Tube Thoracostomy, Open
|
16
|
13
|
$1,357.00
|
$1,357.00
|
$678.50
|
$1,329.86
|
$914.19
|
2026-05-01
|
|
93970
|
HCPCS
|
Bilateral Venous Duplex
|
16
|
13
|
$1,360.00
|
$1,360.00
|
$680.00
|
$1,332.80
|
$916.22
|
2026-05-01
|
|
92960
|
HCPCS
|
Cardioversion, Elective;external
|
16
|
13
|
$1,390.00
|
$1,112.00
20% off
|
$695.00
|
$1,362.20
|
$936.43
|
2026-05-01
|
|
43235
|
HCPCS
|
Upper Gi Endoscopy, Diagnostic
|
32
|
13
|
$2,050.00
|
$2,050.00
|
$367.00
|
$2,009.00
|
$937.77
|
2026-05-01
|
|
23071
|
HCPCS
|
Excision Tumor Soft Tis Shldr 3cm >
|
16
|
13
|
$1,425.00
|
$1,425.00
|
$712.50
|
$1,396.50
|
$960.00
|
2026-05-01
|
|
59409
|
HCPCS
|
Vaginal Delivery Only
|
16
|
13
|
$1,450.00
|
$1,160.00
20% off
|
$725.00
|
$1,421.00
|
$976.85
|
2026-05-01
|
|
112
|
RC
|
OB Private Room Level I
|
16
|
13
|
$1,470.00
|
$1,176.00
20% off
|
$735.00
|
$1,440.60
|
$990.32
|
2026-05-01
|
|
59514
|
HCPCS
|
Cesarean Delivery Only
|
32
|
13
|
$2,200.00
|
$1,760.00
20% off
|
$395.00
|
$2,156.00
|
$1,007.16
|
2026-05-01
|
|
93880
|
HCPCS
|
Duplex Scan Extracranial Ateries Bi
|
16
|
13
|
$1,535.00
|
$1,535.00
|
$767.50
|
$1,504.30
|
$1,034.11
|
2026-05-01
|
|
P9035
|
HCPCS
|
Platelets, Pheresis, Leukocytes Reduced
|
16
|
13
|
$1,545.00
|
$1,545.00
|
$772.50
|
$1,514.10
|
$1,040.85
|
2026-05-01
|
|
J7307
|
HCPCS
|
Nexplanon Implant [68 Mg]
|
16
|
13
|
$1,546.00
|
$1,546.00
|
$773.00
|
$1,515.08
|
$1,041.52
|
2026-05-01
|
|
110
|
RC
|
Skilled Care Isolation Room
|
32
|
13
|
$1,895.00
|
$1,895.00
|
$620.00
|
$1,857.10
|
$1,056.01
|
2026-05-01
|
|
14021
|
HCPCS
|
Adjacent Tissue S/a/l 10.1-30 Sqcm
|
16
|
13
|
$1,600.00
|
$1,600.00
|
$800.00
|
$1,568.00
|
$1,077.90
|
2026-05-01
|
|
G0105
|
HCPCS
|
Colorectal Cancer Screening High Risk
|
32
|
13
|
$2,200.00
|
$2,200.00
|
$508.50
|
$2,156.00
|
$1,083.63
|
2026-05-01
|
|
370
|
RC
|
Anesthesia 91-120 Minutes
|
256
|
13
|
$3,200.00
|
$3,200.00
|
$260.00
|
$3,136.00
|
$1,100.85
|
2026-05-01
|
|
C1781
|
HCPCS
|
Surgimesh Xb Rond 15cm
|
128
|
13
|
$3,578.00
|
$3,578.00
|
$245.00
|
$3,506.44
|
$1,109.65
|
2026-05-01
|
|
81163
|
HCPCS
|
Brca1/2
|
16
|
13
|
$1,658.00
|
$1,326.40
|
$829.00
|
$1,624.84
|
$1,116.97
|
2026-05-01
|
|
93350
|
HCPCS
|
Stress Echocariogram
|
16
|
13
|
$1,660.00
|
$1,328.00
20% off
|
$830.00
|
$1,626.80
|
$1,118.32
|
2026-05-01
|
|
43247
|
HCPCS
|
Upper Endoscopy W/removal Fb
|
32
|
13
|
$2,266.00
|
$2,266.00
|
$550.00
|
$2,220.68
|
$1,133.82
|
2026-05-01
|
|
78226
|
HCPCS
|
Hepatobiliary Imaging Without Contrst
|
16
|
13
|
$1,695.00
|
$1,695.00
|
$847.50
|
$1,661.10
|
$1,141.90
|
2026-05-01
|
|
G0121
|
HCPCS
|
Colorectal Cancer Screen/ Colonoscop
|
32
|
13
|
$2,200.00
|
$2,200.00
|
$600.00
|
$2,156.00
|
$1,145.27
|
2026-05-01
|
|
45378
|
HCPCS
|
Diagnostic Colonoscopy
|
32
|
13
|
$2,200.00
|
$2,200.00
|
$600.00
|
$2,156.00
|
$1,145.27
|
2026-05-01
|
|
52000
|
HCPCS
|
Cystourethroscopy
|
16
|
13
|
$1,755.00
|
$1,755.00
|
$877.50
|
$1,719.90
|
$1,182.32
|
2026-05-01
|
|
90375
|
HCPCS
|
Rabies Immune Globulin [300 Units/2 Ml]
|
16
|
13
|
$1,759.00
|
$1,759.00
|
$879.50
|
$1,723.82
|
$1,185.02
|
2026-05-01
|
|
J1439
|
HCPCS
|
Ferric Carboxy Vial [750 Mg/15 Ml]
|
16
|
13
|
$1,810.00
|
$1,810.00
|
$905.00
|
$1,773.80
|
$1,219.37
|
2026-05-01
|
|
45388
|
HCPCS
|
Colonoscopy W/ablation Of Lesion
|
32
|
13
|
$2,230.00
|
$2,230.00
|
$728.50
|
$2,185.40
|
$1,241.94
|
2026-05-01
|
|
P9073
|
HCPCS
|
Platelets, Phersis, Pathogenreduce Ea Un
|
16
|
13
|
$1,895.00
|
$1,895.00
|
$947.50
|
$1,857.10
|
$1,276.64
|
2026-05-01
|
|
71271
|
HCPCS
|
Low Dose CT Lung Screening
|
16
|
13
|
$1,900.00
|
$1,900.00
|
$950.00
|
$1,862.00
|
$1,280.01
|
2026-05-01
|
|
64483
|
HCPCS
|
Inj Anes/ster Transforaminal Epi W/image
|
16
|
13
|
$1,900.00
|
$1,900.00
|
$950.00
|
$1,862.00
|
$1,280.01
|
2026-05-01
|
|
59410
|
HCPCS
|
Vaginal Delivery Only With Postpartum Ca
|
16
|
13
|
$1,900.00
|
$1,520.00
20% off
|
$950.00
|
$1,862.00
|
$1,280.01
|
2026-05-01
|
|
78306
|
HCPCS
|
Bone Imaging, Whole Body
|
16
|
13
|
$1,905.00
|
$1,905.00
|
$952.50
|
$1,866.90
|
$1,283.38
|
2026-05-01
|
|
43239
|
HCPCS
|
Upper Gi Endoscopy, Biopsy
|
32
|
13
|
$2,730.00
|
$2,730.00
|
$550.00
|
$2,675.40
|
$1,290.11
|
2026-05-01
|
|
C1771
|
HCPCS
|
Advantage Fit Transvagl Mid-ureth Sling
|
16
|
13
|
$1,934.00
|
$1,934.00
|
$967.00
|
$1,895.32
|
$1,302.91
|
2026-05-01
|
|
70486
|
HCPCS
|
Cat Scan Maxillofacial Without Contrast
|
16
|
13
|
$1,935.00
|
$1,935.00
|
$967.50
|
$1,896.30
|
$1,303.59
|
2026-05-01
|
|
52310
|
HCPCS
|
Cystourethroscopy W/removal Stent
|
16
|
13
|
$1,950.00
|
$1,950.00
|
$975.00
|
$1,911.00
|
$1,313.69
|
2026-05-01
|
|
45331
|
HCPCS
|
Sigmoid, Flex W/biopsy
|
16
|
13
|
$1,950.00
|
$1,950.00
|
$975.00
|
$1,911.00
|
$1,313.69
|
2026-05-01
|
|
P9037
|
HCPCS
|
Platelets, Pheresis, Leukocytes Irradiat
|
16
|
13
|
$1,960.00
|
$1,960.00
|
$980.00
|
$1,920.80
|
$1,320.43
|
2026-05-01
|
|
78227
|
HCPCS
|
Hepatobiliary Imaging With Gbef
|
16
|
13
|
$1,960.00
|
$1,960.00
|
$980.00
|
$1,920.80
|
$1,320.43
|
2026-05-01
|
|
45380
|
HCPCS
|
Colonoscopy W/biopsy
|
32
|
13
|
$2,300.00
|
$2,300.00
|
$815.00
|
$2,254.00
|
$1,323.80
|
2026-05-01
|
|
28062
|
HCPCS
|
Fasciectomy, Plantar Fascia
|
32
|
13
|
$2,835.00
|
$2,268.00
20% off
|
$550.00
|
$2,778.30
|
$1,325.48
|
2026-05-01
|
|
45384
|
HCPCS
|
Colonoscopy W/tumor Removal Hotbxforceps
|
32
|
13
|
$2,500.00
|
$2,500.00
|
$735.00
|
$2,450.00
|
$1,337.27
|
2026-05-01
|
|
43246
|
HCPCS
|
Upper Gi Endoscopy; With Placement Percuta
|
16
|
13
|
$2,000.00
|
$2,000.00
|
$1,000.00
|
$1,960.00
|
$1,347.38
|
2026-05-01
|
|
28270
|
HCPCS
|
Capsulotomy Mtpj W/wo Tenorrhaphy Ea Joi
|
16
|
13
|
$2,000.00
|
$2,000.00
|
$1,000.00
|
$1,960.00
|
$1,347.38
|
2026-05-01
|
|
59426
|
HCPCS
|
Antepartum Care Only 7/> Visits
|
16
|
13
|
$2,000.00
|
$1,600.00
20% off
|
$1,000.00
|
$1,960.00
|
$1,347.38
|
2026-05-01
|
|
59300
|
HCPCS
|
Episiotomy/vaginal Repair By Oth Attend
|
16
|
13
|
$2,000.00
|
$2,000.00
|
$1,000.00
|
$1,960.00
|
$1,347.38
|
2026-05-01
|
|
45385
|
HCPCS
|
Colonoscopy W/tumor Removal, Snare
|
32
|
13
|
$2,500.00
|
$2,500.00
|
$775.00
|
$2,450.00
|
$1,364.22
|
2026-05-01
|
|
42975
|
HCPCS
|
Drug Induced Sleep Endoscopy
|
16
|
13
|
$2,035.00
|
$2,035.00
|
$1,017.50
|
$1,994.30
|
$1,370.95
|
2026-05-01
|
|
81408
|
HCPCS
|
Molecular Pathology Procedure Level 9
|
16
|
13
|
$2,040.00
|
$1,632.00
20% off
|
$1,020.00
|
$1,999.20
|
$1,374.32
|
2026-05-01
|
|
43251
|
HCPCS
|
Endoscopy With Removal By Snare Tech
|
32
|
13
|
$2,990.00
|
$2,990.00
|
$550.50
|
$2,930.20
|
$1,378.03
|
2026-05-01
|
|
27337
|
HCPCS
|
Excision Tumor Soft Tiss Thigh/knee 3cm<
|
32
|
13
|
$2,100.00
|
$2,030.00
|
$1,015.00
|
$2,058.00
|
$1,391.16
|
2026-05-01
|
|
49422
|
HCPCS
|
Removal Tunneled Intraperitoneal Cath
|
16
|
13
|
$2,080.00
|
$2,080.00
|
$1,040.00
|
$2,038.40
|
$1,401.27
|
2026-05-01
|
|
36590
|
HCPCS
|
Removal Of Implated Port
|
16
|
13
|
$2,100.00
|
$2,100.00
|
$1,050.00
|
$2,058.00
|
$1,414.74
|
2026-05-01
|
|
70490
|
HCPCS
|
Cat Scan Neck Without Contrast
|
16
|
13
|
$2,100.00
|
$2,100.00
|
$1,050.00
|
$2,058.00
|
$1,414.74
|
2026-05-01
|
|
28080
|
HCPCS
|
Excision Interdigit Neuroma, Single, Ea
|
16
|
13
|
$2,110.00
|
$1,688.00
20% off
|
$1,055.00
|
$2,067.80
|
$1,421.48
|
2026-05-01
|
|
70460
|
HCPCS
|
Cat Scan Head With Contrast
|
16
|
13
|
$2,115.00
|
$1,692.00
20% off
|
$1,057.50
|
$2,072.70
|
$1,424.85
|
2026-05-01
|
|
70450
|
HCPCS
|
Cat Scan Head Without Contrast
|
16
|
13
|
$2,125.00
|
$2,125.00
|
$1,062.50
|
$2,082.50
|
$1,431.59
|
2026-05-01
|
|
72132
|
HCPCS
|
Cat Scan Lumbar Spine With Contrast
|
16
|
13
|
$2,130.00
|
$1,704.00
20% off
|
$1,065.00
|
$2,087.40
|
$1,434.95
|
2026-05-01
|
|
69436
|
HCPCS
|
Tympanostomy Unilateral W Gen Anesthesia
|
16
|
13
|
$2,140.00
|
$2,140.00
|
$1,070.00
|
$2,097.20
|
$1,441.69
|
2026-05-01
|
|
73200
|
HCPCS
|
CT Scan Upper Extremity Wo Cont
|
16
|
13
|
$2,165.00
|
$2,165.00
|
$1,082.50
|
$2,121.70
|
$1,458.53
|
2026-05-01
|
|
26951
|
HCPCS
|
Amputation Finger/thumb W/directclosure
|
16
|
13
|
$2,205.00
|
$1,764.00
20% off
|
$1,102.50
|
$2,160.90
|
$1,485.48
|
2026-05-01
|
|
43249
|
HCPCS
|
Balloon Dilation Of Esophagus(<30mm)
|
32
|
13
|
$2,625.00
|
$2,625.00
|
$900.00
|
$2,572.50
|
$1,490.53
|
2026-05-01
|
|
722
|
RC
|
Birthing Service
|
16
|
13
|
$2,230.00
|
$1,784.00
20% off
|
$1,115.00
|
$2,185.40
|
$1,502.32
|
2026-05-01
|
|
52281
|
HCPCS
|
Cystourethroscopy W/dilation
|
16
|
13
|
$2,240.00
|
$2,240.00
|
$1,120.00
|
$2,195.20
|
$1,509.06
|
2026-05-01
|
|
278
|
RC
|
Tunnel Plug
|
1,040
|
13
|
$8,559.00
|
$8,559.00
|
$10.00
|
$8,387.82
|
$1,521.60
|
2026-05-01
|
|
29823
|
HCPCS
|
Arthroscopy, Shldr; Debride Extensive
|
16
|
13
|
$2,265.00
|
$2,265.00
|
$1,132.50
|
$2,219.70
|
$1,525.90
|
2026-05-01
|
|
81455
|
HCPCS
|
Myeloid Malignancies Mutation Panel
|
16
|
13
|
$2,270.00
|
$2,270.00
|
$1,135.00
|
$2,224.60
|
$1,529.27
|
2026-05-01
|
|
73201
|
HCPCS
|
CT Scan Upper Extremity W Contrast
|
16
|
13
|
$2,300.00
|
$2,300.00
|
$1,150.00
|
$2,254.00
|
$1,549.48
|
2026-05-01
|
|
21931
|
HCPCS
|
Excision Tumor, Soft Tissue Of Back 3 Cm
|
16
|
13
|
$2,300.00
|
$2,300.00
|
$1,150.00
|
$2,254.00
|
$1,549.48
|
2026-05-01
|
|
55250
|
HCPCS
|
Vasectomy
|
16
|
13
|
$2,310.00
|
$2,310.00
|
$1,155.00
|
$2,263.80
|
$1,556.22
|
2026-05-01
|
|
36569
|
HCPCS
|
Picc Line Insertion
|
16
|
13
|
$2,320.00
|
$2,320.00
|
$1,160.00
|
$2,273.60
|
$1,562.95
|
2026-05-01
|
|
93306
|
HCPCS
|
Echocardiography 2d, M-mode, Doppler
|
16
|
13
|
$2,320.00
|
$2,320.00
|
$1,160.00
|
$2,273.60
|
$1,562.95
|
2026-05-01
|
|
19120
|
HCPCS
|
Removal Of Breast Lesion
|
16
|
13
|
$2,325.00
|
$2,325.00
|
$1,162.50
|
$2,278.50
|
$1,566.32
|
2026-05-01
|
|
78315
|
HCPCS
|
Bone Imaging, 3 Phase Study
|
16
|
13
|
$2,330.00
|
$2,330.00
|
$1,165.00
|
$2,283.40
|
$1,569.69
|
2026-05-01
|
|
73722
|
HCPCS
|
MRI Lower Extremity Joint W/contrast
|
16
|
13
|
$2,335.00
|
$1,868.00
20% off
|
$1,167.50
|
$2,288.30
|
$1,573.06
|
2026-05-01
|
|
73700
|
HCPCS
|
CT Scan Lower Extremity Without Contrast
|
16
|
13
|
$2,340.00
|
$2,340.00
|
$1,170.00
|
$2,293.20
|
$1,576.43
|
2026-05-01
|
|
31254
|
HCPCS
|
Nsl/sins Endoscopy Ethmoidectomy Partial
|
16
|
13
|
$2,350.00
|
$2,350.00
|
$1,175.00
|
$2,303.00
|
$1,583.17
|
2026-05-01
|
|
42830
|
HCPCS
|
Adenoidectomy Age<12
|
16
|
13
|
$2,370.00
|
$2,370.00
|
$1,185.00
|
$2,322.60
|
$1,596.64
|
2026-05-01
|
|
72192
|
HCPCS
|
Cat Scan Pelvis Without Contrast
|
16
|
13
|
$2,370.00
|
$2,370.00
|
$1,185.00
|
$2,322.60
|
$1,596.64
|
2026-05-01
|
|
74150
|
HCPCS
|
Cat Scan Abdomen Without Contrast
|
16
|
13
|
$2,370.00
|
$2,370.00
|
$1,185.00
|
$2,322.60
|
$1,596.64
|
2026-05-01
|
|
72191
|
HCPCS
|
CT Angiogram Pelvis W/contrast
|
16
|
13
|
$2,400.00
|
$2,400.00
|
$1,200.00
|
$2,352.00
|
$1,616.85
|
2026-05-01
|
|
71250
|
HCPCS
|
Cat Scan Chest Without Contrast
|
16
|
13
|
$2,410.00
|
$2,410.00
|
$1,205.00
|
$2,361.80
|
$1,623.59
|
2026-05-01
|
|
46040
|
HCPCS
|
I&d Ischiorectal/perirectal Abscess (sp)
|
16
|
13
|
$2,415.00
|
$2,415.00
|
$1,207.50
|
$2,366.70
|
$1,626.96
|
2026-05-01
|
|
26160
|
HCPCS
|
Excision Lesion Tendon/joint Hnd/ft
|
16
|
13
|
$2,415.00
|
$1,932.00
20% off
|
$1,207.50
|
$2,366.70
|
$1,626.96
|
2026-05-01
|
|
J0875
|
HCPCS
|
Dalbavancin Vial [500 Mg]
|
16
|
13
|
$2,424.00
|
$2,424.00
|
$1,212.00
|
$2,375.52
|
$1,633.02
|
2026-05-01
|
|
72131
|
HCPCS
|
Cat Scan Lumber Spine Without Contrast
|
16
|
13
|
$2,440.00
|
$2,440.00
|
$1,220.00
|
$2,391.20
|
$1,643.80
|
2026-05-01
|
|
59515
|
HCPCS
|
C-section With Postpartum Care
|
16
|
13
|
$2,448.00
|
$1,958.40
|
$1,224.00
|
$2,399.04
|
$1,649.19
|
2026-05-01
|
|
72193
|
HCPCS
|
Cat Scan Pelvis With Contrast
|
16
|
13
|
$2,450.00
|
$2,450.00
|
$1,225.00
|
$2,401.00
|
$1,650.53
|
2026-05-01
|
|
72128
|
HCPCS
|
Cat Scan Thoracic Spine Without Contrast
|
16
|
13
|
$2,450.00
|
$2,450.00
|
$1,225.00
|
$2,401.00
|
$1,650.53
|
2026-05-01
|
|
25111
|
HCPCS
|
Excision Ganglion, Wrist, Prmary
|
16
|
13
|
$2,480.00
|
$1,984.00
20% off
|
$1,240.00
|
$2,430.40
|
$1,670.74
|
2026-05-01
|
|
29824
|
HCPCS
|
Arthroscopy, Shldr, Distl Claviculectomy
|
16
|
13
|
$2,500.00
|
$2,500.00
|
$1,250.00
|
$2,450.00
|
$1,684.22
|
2026-05-01
|
|
28285
|
HCPCS
|
Hammertoe Deformity Correction
|
16
|
13
|
$2,500.00
|
$2,500.00
|
$1,250.00
|
$2,450.00
|
$1,684.22
|
2026-05-01
|
|
26055
|
HCPCS
|
Tendon Sheath Incision,trigger Finger
|
16
|
13
|
$2,505.00
|
$2,505.00
|
$1,252.50
|
$2,454.90
|
$1,687.59
|
2026-05-01
|
|
73701
|
HCPCS
|
Cat Scan Lower Extremity,w Contrast
|
16
|
13
|
$2,505.00
|
$2,505.00
|
$1,252.50
|
$2,454.90
|
$1,687.59
|
2026-05-01
|
|
72125
|
HCPCS
|
Cat Scan C-spine Without Contrast
|
16
|
13
|
$2,510.00
|
$2,510.00
|
$1,255.00
|
$2,459.80
|
$1,690.96
|
2026-05-01
|
|
43250
|
HCPCS
|
Upper Gi Endoscopy With Removal Hot Forcep
|
16
|
13
|
$2,525.00
|
$2,525.00
|
$1,262.50
|
$2,474.50
|
$1,701.06
|
2026-05-01
|
|
20680
|
HCPCS
|
Removal Of Implant; Deep
|
16
|
13
|
$2,525.00
|
$2,525.00
|
$1,262.50
|
$2,474.50
|
$1,701.06
|
2026-05-01
|
|
74160
|
HCPCS
|
Cat Scan Abdomen With Contrast
|
16
|
13
|
$2,550.00
|
$2,550.00
|
$1,275.00
|
$2,499.00
|
$1,717.90
|
2026-05-01
|
|
52224
|
HCPCS
|
Cystourehtoscopy With Fulguration Minor
|
16
|
13
|
$2,550.00
|
$2,550.00
|
$1,275.00
|
$2,499.00
|
$1,717.90
|
2026-05-01
|
|
27691
|
HCPCS
|
Transfer/transplant Single Tendon Assist
|
32
|
13
|
$4,325.00
|
$3,460.00
20% off
|
$407.50
|
$4,238.50
|
$1,731.38
|
2026-05-01
|
|
70470
|
HCPCS
|
Cat Scan Head W/wo Contrast
|
16
|
13
|
$2,575.00
|
$2,575.00
|
$1,287.50
|
$2,523.50
|
$1,734.75
|
2026-05-01
|
|
70491
|
HCPCS
|
Cat Scan Neck With Contrast
|
16
|
13
|
$2,575.00
|
$2,575.00
|
$1,287.50
|
$2,523.50
|
$1,734.75
|
2026-05-01
|
|
45381
|
HCPCS
|
Colonoscopy W/submucosal Inj Any Substnc
|
16
|
13
|
$2,630.00
|
$2,630.00
|
$1,315.00
|
$2,577.40
|
$1,771.80
|
2026-05-01
|
|
71260
|
HCPCS
|
Cat Scan Chest W/contrast
|
16
|
13
|
$2,630.00
|
$2,630.00
|
$1,315.00
|
$2,577.40
|
$1,771.80
|
2026-05-01
|
|
Q5108
|
HCPCS
|
Fulphila Syr [6 Mg/ 0.6 Ml]
|
16
|
13
|
$2,633.00
|
$2,633.00
|
$1,316.50
|
$2,580.34
|
$1,773.82
|
2026-05-01
|
|
L0454
|
HCPCS
|
Brace Tlso
|
16
|
13
|
$2,667.00
|
$2,667.00
|
$1,333.50
|
$2,613.66
|
$1,796.72
|
2026-05-01
|
|
42825
|
HCPCS
|
Tonsillectomy Primary/secondary Under 12
|
16
|
13
|
$2,675.00
|
$2,675.00
|
$1,337.50
|
$2,621.50
|
$1,802.11
|
2026-05-01
|
|
73221
|
HCPCS
|
MRI Any Up Extremity Joint Wo Contrast
|
16
|
13
|
$2,705.00
|
$2,705.00
|
$1,352.50
|
$2,650.90
|
$1,822.33
|
2026-05-01
|
|
28043
|
HCPCS
|
Excision Tumor Soft Tissue Foot/toe <1.5
|
16
|
13
|
$2,710.00
|
$2,710.00
|
$1,355.00
|
$2,655.80
|
$1,825.69
|
2026-05-01
|
|
27347
|
HCPCS
|
Excision Lesion Menicus/capsule Knee
|
16
|
13
|
$2,720.00
|
$2,720.00
|
$1,360.00
|
$2,665.60
|
$1,832.43
|
2026-05-01
|
|
73721
|
HCPCS
|
MRI Lower Joints Without Contrast
|
16
|
13
|
$2,730.00
|
$2,730.00
|
$1,365.00
|
$2,675.40
|
$1,839.17
|
2026-05-01
|
|
71270
|
HCPCS
|
Cat Scan Thorax W/wo Contrast
|
16
|
13
|
$2,730.00
|
$2,730.00
|
$1,365.00
|
$2,675.40
|
$1,839.17
|
2026-05-01
|
|
29870
|
HCPCS
|
Arthroscopy; Knee; Diag W/wo Synovial Bx
|
16
|
13
|
$2,765.00
|
$2,765.00
|
$1,382.50
|
$2,709.70
|
$1,862.75
|
2026-05-01
|
|
J0129
|
HCPCS
|
Orencia 250 Mg Pwvl IV
|
16
|
13
|
$2,767.00
|
$2,767.00
|
$1,383.50
|
$2,711.66
|
$1,864.09
|
2026-05-01
|
|
70492
|
HCPCS
|
Cat Scan Neck W & Without Constrast
|
16
|
13
|
$2,780.00
|
$2,780.00
|
$1,390.00
|
$2,724.40
|
$1,872.85
|
2026-05-01
|
|
74185
|
HCPCS
|
MRA Abdomen W/wo Contrast
|
16
|
13
|
$2,830.00
|
$2,830.00
|
$1,415.00
|
$2,773.40
|
$1,906.54
|
2026-05-01
|
|
73718
|
HCPCS
|
MRI Lower Extremity Without Contrst Nonjoint
|
16
|
13
|
$2,832.00
|
$2,832.00
|
$1,416.00
|
$2,775.36
|
$1,907.88
|
2026-05-01
|
|
26535
|
HCPCS
|
Arthroplasty Interphalangeal Joint Ea
|
16
|
13
|
$2,840.00
|
$2,272.00
20% off
|
$1,420.00
|
$2,783.20
|
$1,913.27
|
2026-05-01
|
|
28122
|
HCPCS
|
Partial Excision Bone; Tarsal Or Metatar
|
48
|
13
|
$4,610.00
|
$4,610.00
|
$350.00
|
$4,517.80
|
$1,923.38
|
2026-05-01
|
|
73218
|
HCPCS
|
MRI Upper Extremity W/o, Non-joint
|
16
|
13
|
$2,855.00
|
$2,855.00
|
$1,427.50
|
$2,797.90
|
$1,923.38
|
2026-05-01
|
|
31267
|
HCPCS
|
Maxillary Antrostomy; Rmvl Tissue
|
16
|
13
|
$2,875.00
|
$2,875.00
|
$1,437.50
|
$2,817.50
|
$1,936.85
|
2026-05-01
|
|
28039
|
HCPCS
|
Excision Soft Tissue Mass Ft/toe 1.5cm >
|
16
|
13
|
$2,890.00
|
$2,890.00
|
$1,445.00
|
$2,832.20
|
$1,946.96
|
2026-05-01
|
|
28755
|
HCPCS
|
Arthrodesis, Great Toe; Interphal Joint
|
16
|
13
|
$2,895.00
|
$2,895.00
|
$1,447.50
|
$2,837.10
|
$1,950.33
|
2026-05-01
|
|
70488
|
HCPCS
|
Cat Scan Maxillofacial Area, W/wo Co
|
16
|
13
|
$2,900.00
|
$2,900.00
|
$1,450.00
|
$2,842.00
|
$1,953.69
|
2026-05-01
|
|
30140
|
HCPCS
|
Resection Inferior Turbinate
|
16
|
13
|
$2,925.00
|
$2,925.00
|
$1,462.50
|
$2,866.50
|
$1,970.54
|
2026-05-01
|
|
29825
|
HCPCS
|
Arthroscopy Shoulder W/lysis Adhesions
|
16
|
13
|
$2,930.00
|
$2,930.00
|
$1,465.00
|
$2,871.40
|
$1,973.90
|
2026-05-01
|
|
28090
|
HCPCS
|
Excision Lesion Tendon/sheath/capsule Ft
|
16
|
13
|
$2,941.00
|
$2,941.00
|
$1,470.50
|
$2,882.18
|
$1,981.32
|
2026-05-01
|
|
27045
|
HCPCS
|
Excise Tumor Softtis Pel/hip 5cmgreater
|
16
|
13
|
$3,000.00
|
$3,000.00
|
$1,500.00
|
$2,940.00
|
$2,021.06
|
2026-05-01
|
|
64561
|
HCPCS
|
Percut Implant Neurostim; Sacral Nerve
|
16
|
13
|
$3,000.00
|
$3,000.00
|
$1,500.00
|
$2,940.00
|
$2,021.06
|
2026-05-01
|
|
29875
|
HCPCS
|
Arthroscopy; Knee; Synovectomy Limited
|
16
|
13
|
$3,080.00
|
$3,080.00
|
$1,540.00
|
$3,018.40
|
$2,074.96
|
2026-05-01
|
|
58120
|
HCPCS
|
D And C (non Ob)
|
16
|
13
|
$3,100.00
|
$3,100.00
|
$1,550.00
|
$3,038.00
|
$2,088.43
|
2026-05-01
|
|
70498
|
HCPCS
|
CT Angiography Neck
|
16
|
13
|
$3,100.00
|
$3,100.00
|
$1,550.00
|
$3,038.00
|
$2,088.43
|
2026-05-01
|
|
46614
|
HCPCS
|
Anoscopy; Control Of Bleeding
|
16
|
13
|
$3,130.00
|
$3,130.00
|
$1,565.00
|
$3,067.40
|
$2,108.64
|
2026-05-01
|
|
70496
|
HCPCS
|
CT Angiography Head
|
16
|
13
|
$3,150.00
|
$3,150.00
|
$1,575.00
|
$3,087.00
|
$2,122.12
|
2026-05-01
|
|
J3111
|
HCPCS
|
Romosozumab-aqqg Syr [210 Mg / 2.34 Ml]
|
16
|
13
|
$3,163.00
|
$3,163.00
|
$1,581.50
|
$3,099.74
|
$2,130.87
|
2026-05-01
|
|
42820
|
HCPCS
|
Tonsillectomy Adenoidectomy Under Age 12
|
16
|
13
|
$3,165.00
|
$3,165.00
|
$1,582.50
|
$3,101.70
|
$2,132.22
|
2026-05-01
|
|
73719
|
HCPCS
|
MRI Lower Extremity W/cont Nonjoint
|
16
|
13
|
$3,175.00
|
$3,175.00
|
$1,587.50
|
$3,111.50
|
$2,138.96
|
2026-05-01
|
|
72195
|
HCPCS
|
MRI Pelvis Without Contrast
|
16
|
13
|
$3,195.00
|
$3,195.00
|
$1,597.50
|
$3,131.10
|
$2,152.43
|
2026-05-01
|
|
28124
|
HCPCS
|
Partial Excision Bone, Phalanx Of Toe
|
16
|
13
|
$3,211.00
|
$3,211.00
|
$1,605.50
|
$3,146.78
|
$2,163.21
|
2026-05-01
|
|
74170
|
HCPCS
|
Cat Scan Abdomen W/wo Contrast
|
16
|
13
|
$3,215.00
|
$3,215.00
|
$1,607.50
|
$3,150.70
|
$2,165.91
|
2026-05-01
|
|
64718
|
HCPCS
|
Transposition;ulnar Nerve At Elbow
|
16
|
13
|
$3,225.00
|
$3,225.00
|
$1,612.50
|
$3,160.50
|
$2,172.64
|
2026-05-01
|
|
64721
|
HCPCS
|
Neuroplasty/transposition Median Nerve
|
16
|
13
|
$3,225.00
|
$3,225.00
|
$1,612.50
|
$3,160.50
|
$2,172.64
|
2026-05-01
|
|
74181
|
HCPCS
|
MRI Abdomen, Without Contrast
|
16
|
13
|
$3,270.00
|
$3,270.00
|
$1,635.00
|
$3,204.60
|
$2,202.96
|
2026-05-01
|
|
73220
|
HCPCS
|
MRI Upper Extremity W/wo Cont Non-joint
|
16
|
13
|
$3,300.00
|
$3,300.00
|
$1,650.00
|
$3,234.00
|
$2,223.17
|
2026-05-01
|
|
38500
|
HCPCS
|
Biopsy/excision Lymph Node, Open Sprf
|
16
|
13
|
$3,300.00
|
$3,300.00
|
$1,650.00
|
$3,234.00
|
$2,223.17
|
2026-05-01
|
|
30520
|
HCPCS
|
Septoplasty
|
16
|
13
|
$3,300.00
|
$3,300.00
|
$1,650.00
|
$3,234.00
|
$2,223.17
|
2026-05-01
|
|
28820
|
HCPCS
|
Amputation Toe Metatarsophalangeal Joint
|
16
|
13
|
$3,300.00
|
$3,300.00
|
$1,650.00
|
$3,234.00
|
$2,223.17
|
2026-05-01
|
|
23073
|
HCPCS
|
Excision Tumor Soft Tiss Shoulder 5cm <
|
16
|
13
|
$3,326.00
|
$3,326.00
|
$1,663.00
|
$3,259.48
|
$2,240.68
|
2026-05-01
|
|
27698
|
HCPCS
|
Repair, 2ndary, Ligamt Ankle Collateral
|
16
|
13
|
$3,337.00
|
$3,337.00
|
$1,668.50
|
$3,270.26
|
$2,248.09
|
2026-05-01
|
|
73720
|
HCPCS
|
MRI Lwr Extremity W/wo Cont Nonjoint
|
16
|
13
|
$3,350.00
|
$3,350.00
|
$1,675.00
|
$3,283.00
|
$2,256.85
|
2026-05-01
|
|
72148
|
HCPCS
|
MRI Lumbar Spne Without Contrast
|
16
|
13
|
$3,350.00
|
$3,350.00
|
$1,675.00
|
$3,283.00
|
$2,256.85
|
2026-05-01
|
|
28825
|
HCPCS
|
Amputation Toe Interphalangeal Joint
|
16
|
13
|
$3,355.00
|
$3,355.00
|
$1,677.50
|
$3,287.90
|
$2,260.22
|
2026-05-01
|
|
73723
|
HCPCS
|
MRI Of Lower Joint W/wout Contrast
|
16
|
13
|
$3,400.00
|
$3,400.00
|
$1,700.00
|
$3,332.00
|
$2,290.54
|
2026-05-01
|
|
57288
|
HCPCS
|
Sling Operation For Stress Incontinence
|
16
|
13
|
$3,405.00
|
$3,405.00
|
$1,702.50
|
$3,336.90
|
$2,293.91
|
2026-05-01
|
|
42821
|
HCPCS
|
Tonsillectomy And Adenoid. Over Age 12
|
16
|
13
|
$3,410.00
|
$3,410.00
|
$1,705.00
|
$3,341.80
|
$2,297.27
|
2026-05-01
|
|
28120
|
HCPCS
|
Partial Excision Bone; Talus/calcaneus
|
16
|
13
|
$3,425.00
|
$3,425.00
|
$1,712.50
|
$3,356.50
|
$2,307.38
|
2026-05-01
|
|
27385
|
HCPCS
|
Suture Quad/ham Muscle Rupture Primary
|
16
|
13
|
$3,455.00
|
$3,455.00
|
$1,727.50
|
$3,385.90
|
$2,327.59
|
2026-05-01
|
|
74175
|
HCPCS
|
CTA Abdomen W/wo Contrast
|
16
|
13
|
$3,475.00
|
$3,475.00
|
$1,737.50
|
$3,405.50
|
$2,341.06
|
2026-05-01
|
|
70544
|
HCPCS
|
MRA Head Without Contrast
|
16
|
13
|
$3,500.00
|
$3,500.00
|
$1,750.00
|
$3,430.00
|
$2,357.91
|
2026-05-01
|
|
58563
|
HCPCS
|
Hysteroscopy With Endometrial Ablation
|
16
|
13
|
$3,500.00
|
$3,500.00
|
$1,750.00
|
$3,430.00
|
$2,357.91
|
2026-05-01
|
|
27687
|
HCPCS
|
Gastrocnemius Recession
|
16
|
13
|
$3,505.00
|
$3,505.00
|
$1,752.50
|
$3,434.90
|
$2,361.28
|
2026-05-01
|
|
72147
|
HCPCS
|
MRI Thoracic Spine With Contrast
|
16
|
13
|
$3,505.00
|
$2,804.00
20% off
|
$1,752.50
|
$3,434.90
|
$2,361.28
|
2026-05-01
|
|
71275
|
HCPCS
|
CT Angiography Chest W/contract/noncontr
|
16
|
13
|
$3,505.00
|
$3,505.00
|
$1,752.50
|
$3,434.90
|
$2,361.28
|
2026-05-01
|
|
72149
|
HCPCS
|
MRI Lumbar Spine With Contrast
|
16
|
13
|
$3,505.00
|
$3,505.00
|
$1,752.50
|
$3,434.90
|
$2,361.28
|
2026-05-01
|
|
52332
|
HCPCS
|
Cystourethroscopy, W/insert Stent
|
16
|
13
|
$3,510.00
|
$3,510.00
|
$1,755.00
|
$3,439.80
|
$2,364.64
|
2026-05-01
|
|
20900
|
HCPCS
|
Bone Graft Any Donor Site, Minor/small
|
16
|
13
|
$3,510.00
|
$3,510.00
|
$1,755.00
|
$3,439.80
|
$2,364.64
|
2026-05-01
|
|
J0897
|
HCPCS
|
Xgeva 120mg/1.7ml Vial
|
32
|
13
|
$4,504.00
|
$4,504.00
|
$1,259.50
|
$4,413.92
|
$2,365.65
|
2026-05-01
|
|
28315
|
HCPCS
|
Sesamoidectomy First Toe Spx
|
16
|
13
|
$3,540.00
|
$3,540.00
|
$1,770.00
|
$3,469.20
|
$2,384.85
|
2026-05-01
|
|
72142
|
HCPCS
|
MRI Cervical Spine W/contrast
|
16
|
13
|
$3,540.00
|
$2,832.00
20% off
|
$1,770.00
|
$3,469.20
|
$2,384.85
|
2026-05-01
|
|
27680
|
HCPCS
|
Tenolysis, Flex/extens Tendon Leg/ankle
|
16
|
13
|
$3,555.00
|
$3,555.00
|
$1,777.50
|
$3,483.90
|
$2,394.96
|
2026-05-01
|
|
72141
|
HCPCS
|
MRI Cervical Spine Without Contrast
|
16
|
13
|
$3,555.00
|
$3,555.00
|
$1,777.50
|
$3,483.90
|
$2,394.96
|
2026-05-01
|
|
19020
|
HCPCS
|
Mastotomy Explor/drain Abscess; Deep
|
16
|
13
|
$3,565.00
|
$3,565.00
|
$1,782.50
|
$3,493.70
|
$2,401.70
|
2026-05-01
|
|
27650
|
HCPCS
|
Repair Primary Ruptured Achilles Tendon
|
16
|
13
|
$3,585.00
|
$3,585.00
|
$1,792.50
|
$3,513.30
|
$2,415.17
|
2026-05-01
|
|
70543
|
HCPCS
|
MRI Orbit,face,neck Without & W Contrast
|
16
|
13
|
$3,600.00
|
$3,600.00
|
$1,800.00
|
$3,528.00
|
$2,425.28
|
2026-05-01
|
|
72146
|
HCPCS
|
MRI Thoracic Spine Without Contrast
|
16
|
13
|
$3,600.00
|
$3,600.00
|
$1,800.00
|
$3,528.00
|
$2,425.28
|
2026-05-01
|
|
36561
|
HCPCS
|
Insertion Of Tunneled Central Vad
|
16
|
13
|
$3,655.00
|
$3,655.00
|
$1,827.50
|
$3,581.90
|
$2,462.33
|
2026-05-01
|
|
70551
|
HCPCS
|
MRI Brain Without Contrast
|
16
|
13
|
$3,666.00
|
$3,666.00
|
$1,833.00
|
$3,592.68
|
$2,469.74
|
2026-05-01
|
|
27610
|
HCPCS
|
Arthrotomy Ankle, Expl, Drain, Remove Fb
|
16
|
13
|
$3,695.00
|
$3,695.00
|
$1,847.50
|
$3,621.10
|
$2,489.28
|
2026-05-01
|
|
70549
|
HCPCS
|
MRA Neck W & Without Contrast Material
|
16
|
13
|
$3,700.00
|
$3,700.00
|
$1,850.00
|
$3,626.00
|
$2,492.64
|
2026-05-01
|
|
49591
|
HCPCS
|
Repair Abd Hernia Any Approach W/mesh
|
16
|
13
|
$3,780.00
|
$3,780.00
|
$1,890.00
|
$3,704.40
|
$2,546.54
|
2026-05-01
|
|
73223
|
HCPCS
|
MRI Upper Ext Joint W/wo Contrast
|
16
|
13
|
$3,785.00
|
$3,785.00
|
$1,892.50
|
$3,709.30
|
$2,549.91
|
2026-05-01
|
|
70552
|
HCPCS
|
MRI Brain With Contrast
|
16
|
13
|
$3,805.00
|
$3,044.00
20% off
|
$1,902.50
|
$3,728.90
|
$2,563.38
|
2026-05-01
|
|
27658
|
HCPCS
|
Repair Flexor Tendon, Leg Without Grt Each
|
16
|
13
|
$3,840.00
|
$3,840.00
|
$1,920.00
|
$3,763.20
|
$2,586.96
|
2026-05-01
|
|
49651
|
HCPCS
|
Laparoscopic Repr Recur Inguinal Hernia
|
16
|
13
|
$3,855.00
|
$3,855.00
|
$1,927.50
|
$3,777.90
|
$2,597.07
|
2026-05-01
|
|
95810
|
HCPCS
|
Polysomnography >4 Parameters Of Sleep
|
16
|
13
|
$3,865.00
|
$3,865.00
|
$1,932.50
|
$3,787.70
|
$2,603.80
|
2026-05-01
|
|
J0717
|
HCPCS
|
Certolizumab Kit [200 Mg]
|
16
|
13
|
$3,890.00
|
$3,890.00
|
$1,945.00
|
$3,812.20
|
$2,620.64
|
2026-05-01
|
|
28160
|
HCPCS
|
Hemiphalangectomy, Toe, Proximal End Ea
|
16
|
13
|
$3,915.00
|
$3,915.00
|
$1,957.50
|
$3,836.70
|
$2,637.49
|
2026-05-01
|
|
51102
|
HCPCS
|
Drain Bladder W Cath Insertion
|
16
|
13
|
$3,980.00
|
$3,980.00
|
$1,990.00
|
$3,900.40
|
$2,681.28
|
2026-05-01
|
|
74176
|
HCPCS
|
CT Abdomen & Pelvis Without Contrast
|
16
|
13
|
$4,020.00
|
$4,020.00
|
$2,010.00
|
$3,939.60
|
$2,708.22
|
2026-05-01
|
|
70546
|
HCPCS
|
MRA Of The Head W/wo Contrst
|
16
|
13
|
$4,050.00
|
$4,050.00
|
$2,025.00
|
$3,969.00
|
$2,728.43
|
2026-05-01
|
|
46260
|
HCPCS
|
Hemorrhoidectomy Inter/exter 2+ Columns
|
16
|
13
|
$4,075.00
|
$4,075.00
|
$2,037.50
|
$3,993.50
|
$2,745.28
|
2026-05-01
|
|
72197
|
HCPCS
|
MRI Pelvis With/without Contrast
|
16
|
13
|
$4,100.00
|
$4,100.00
|
$2,050.00
|
$4,018.00
|
$2,762.12
|
2026-05-01
|
|
49615
|
HCPCS
|
Repair Recur Abd Hernia, 3-10 Cm Reduc
|
16
|
13
|
$4,110.00
|
$4,110.00
|
$2,055.00
|
$4,027.80
|
$2,768.86
|
2026-05-01
|
|
70553
|
HCPCS
|
MRI Brain W & Without Contrast
|
16
|
13
|
$4,150.00
|
$4,150.00
|
$2,075.00
|
$4,067.00
|
$2,795.80
|
2026-05-01
|
|
27829
|
HCPCS
|
Open Tx Distal Tf Joint, Interanal Fix
|
16
|
13
|
$4,156.00
|
$4,156.00
|
$2,078.00
|
$4,072.88
|
$2,799.84
|
2026-05-01
|
|
27659
|
HCPCS
|
Repair, Flexor Tendon, Leg 2nd W/without Gft
|
16
|
13
|
$4,170.00
|
$4,170.00
|
$2,085.00
|
$4,086.60
|
$2,809.28
|
2026-05-01
|
|
28150
|
HCPCS
|
Phalangectomy, Toe, Each Toe
|
16
|
13
|
$4,200.00
|
$4,200.00
|
$2,100.00
|
$4,116.00
|
$2,829.49
|
2026-05-01
|
|
28297
|
HCPCS
|
Correction, Hallux Valgus, Bunion W/sesa
|
16
|
13
|
$4,230.00
|
$4,230.00
|
$2,115.00
|
$4,145.40
|
$2,849.70
|
2026-05-01
|
|
74183
|
HCPCS
|
MRI Abdomen W & Without Contrast
|
16
|
13
|
$4,285.00
|
$4,285.00
|
$2,142.50
|
$4,199.30
|
$2,886.75
|
2026-05-01
|
|
72158
|
HCPCS
|
MRI Lumbar Spine W/wo Contrast
|
16
|
13
|
$4,300.00
|
$4,300.00
|
$2,150.00
|
$4,214.00
|
$2,896.86
|
2026-05-01
|
|
59400
|
HCPCS
|
Routine OB Care
|
16
|
13
|
$4,300.00
|
$3,440.00
20% off
|
$2,150.00
|
$4,214.00
|
$2,896.86
|
2026-05-01
|
|
72157
|
HCPCS
|
MRI Thoracic Spine W/wout Contrast
|
16
|
13
|
$4,330.00
|
$4,330.00
|
$2,165.00
|
$4,243.40
|
$2,917.07
|
2026-05-01
|
|
78452
|
HCPCS
|
Heart Imaging, Mulitiple Studies
|
16
|
13
|
$4,390.00
|
$4,390.00
|
$2,195.00
|
$4,302.20
|
$2,957.49
|
2026-05-01
|
|
29822
|
HCPCS
|
Arthroscopy, Shldr; Debride 1-2 Struct
|
16
|
13
|
$4,400.00
|
$4,400.00
|
$2,200.00
|
$4,312.00
|
$2,964.22
|
2026-05-01
|
|
27792
|
HCPCS
|
Orif Distal Fibular Fracture
|
16
|
13
|
$4,400.00
|
$4,400.00
|
$2,200.00
|
$4,312.00
|
$2,964.22
|
2026-05-01
|
|
95811
|
HCPCS
|
Polysomnography W/cpap, Attended By Tech
|
16
|
13
|
$4,415.00
|
$4,415.00
|
$2,207.50
|
$4,326.70
|
$2,974.33
|
2026-05-01
|
|
59510
|
HCPCS
|
Routine OB Care W/cesarean Section
|
16
|
13
|
$4,420.00
|
$4,420.00
|
$2,210.00
|
$4,331.60
|
$2,977.70
|
2026-05-01
|
|
28116
|
HCPCS
|
Ostectomy Excision Of Tarsal Coalition
|
16
|
13
|
$4,435.00
|
$4,435.00
|
$2,217.50
|
$4,346.30
|
$2,987.80
|
2026-05-01
|
|
57260
|
HCPCS
|
Combined Anterpost Colporrhaphy With Cysto
|
16
|
13
|
$4,500.00
|
$4,500.00
|
$2,250.00
|
$4,410.00
|
$3,031.59
|
2026-05-01
|
|
72156
|
HCPCS
|
MRI Cervical Spine W/wo Contrast
|
16
|
13
|
$4,500.00
|
$4,500.00
|
$2,250.00
|
$4,410.00
|
$3,031.59
|
2026-05-01
|
|
5726080
|
OTHER
|
Combined Anteroposteior Colporrhaphy
|
16
|
13
|
$4,500.00
|
$4,500.00
|
$2,250.00
|
$4,410.00
|
$3,031.59
|
2026-05-01
|
|
28086
|
HCPCS
|
Synovectomy, Tendon Sheath, Foot; Flexor
|
16
|
13
|
$4,505.00
|
$4,505.00
|
$2,252.50
|
$4,414.90
|
$3,034.96
|
2026-05-01
|
|
29826
|
HCPCS
|
Arthroscopy, Shldr, Subacromial Decomp
|
16
|
13
|
$4,505.00
|
$4,505.00
|
$2,252.50
|
$4,414.90
|
$3,034.96
|
2026-05-01
|
|
49593
|
HCPCS
|
Repair Ant Abd Hernia 3-10cm Reducible
|
16
|
13
|
$4,505.00
|
$4,505.00
|
$2,252.50
|
$4,414.90
|
$3,034.96
|
2026-05-01
|
|
49505
|
HCPCS
|
Repair 1st Inguinal Hernia
|
16
|
13
|
$4,520.00
|
$4,520.00
|
$2,260.00
|
$4,429.60
|
$3,045.07
|
2026-05-01
|
|
27618
|
HCPCS
|
Excision Tumor Leg Or Ankle Subq Tis
|
16
|
13
|
$4,560.00
|
$4,560.00
|
$2,280.00
|
$4,468.80
|
$3,072.01
|
2026-05-01
|
|
27632
|
HCPCS
|
Excision Tumor Leg/ankle Subq 3cm+
|
16
|
13
|
$4,630.00
|
$4,630.00
|
$2,315.00
|
$4,537.40
|
$3,119.17
|
2026-05-01
|
|
29898
|
HCPCS
|
Arthroscopy, Ankle; Debride Extensive
|
16
|
13
|
$4,662.00
|
$4,662.00
|
$2,331.00
|
$4,568.76
|
$3,140.73
|
2026-05-01
|
|
29894
|
HCPCS
|
Arhtoroscopy, Ankle; W/removal Loose/fb
|
16
|
13
|
$4,662.00
|
$4,662.00
|
$2,331.00
|
$4,568.76
|
$3,140.73
|
2026-05-01
|
|
74177
|
HCPCS
|
CT Abdomen & Pelvis W Contrast
|
16
|
13
|
$4,665.00
|
$4,665.00
|
$2,332.50
|
$4,571.70
|
$3,142.75
|
2026-05-01
|
|
27695
|
HCPCS
|
Repair, Prim Ligament Ankle; Collateral
|
16
|
13
|
$4,685.00
|
$4,685.00
|
$2,342.50
|
$4,591.30
|
$3,156.23
|
2026-05-01
|
|
23430
|
HCPCS
|
Tenodesis Long Tendon Biceps
|
16
|
13
|
$4,730.00
|
$4,730.00
|
$2,365.00
|
$4,635.40
|
$3,186.54
|
2026-05-01
|
|
28296
|
HCPCS
|
Bunionectomy W/sesamoid Distal Metatarsa
|
16
|
13
|
$4,805.00
|
$3,844.00
20% off
|
$2,402.50
|
$4,708.90
|
$3,237.07
|
2026-05-01
|
|
44186
|
HCPCS
|
Laparoscopy, Sugical; Jejunostomy
|
16
|
13
|
$4,865.00
|
$4,865.00
|
$2,432.50
|
$4,767.70
|
$3,277.49
|
2026-05-01
|
|
28750
|
HCPCS
|
Arthodesis, Great Toe; Metatarsophalalng
|
16
|
13
|
$4,870.00
|
$4,870.00
|
$2,435.00
|
$4,772.60
|
$3,280.86
|
2026-05-01
|
|
29877
|
HCPCS
|
Arthroscopy Knee; Debride/shave Art Cart
|
16
|
13
|
$4,876.00
|
$4,876.00
|
$2,438.00
|
$4,778.48
|
$3,284.90
|
2026-05-01
|
|
29881
|
HCPCS
|
Arthroscopy Meniscectomy Medial/lateral
|
16
|
13
|
$4,950.00
|
$4,950.00
|
$2,475.00
|
$4,851.00
|
$3,334.75
|
2026-05-01
|
|
28300
|
HCPCS
|
Osteotomy, Calcaneous W/wo Internal Fix
|
16
|
13
|
$5,090.00
|
$5,090.00
|
$2,545.00
|
$4,988.20
|
$3,429.07
|
2026-05-01
|
|
29827
|
HCPCS
|
Arthroscopy, Shoulder; W/rotator Cuff
|
16
|
13
|
$5,250.00
|
$5,250.00
|
$2,625.00
|
$5,145.00
|
$3,536.86
|
2026-05-01
|
|
58260
|
HCPCS
|
Vaginal Hysterectomy
|
16
|
13
|
$5,255.00
|
$5,255.00
|
$2,627.50
|
$5,149.90
|
$3,540.23
|
2026-05-01
|
|
11771
|
HCPCS
|
Excision Of Pilonidal Cyst Or Sinus
|
16
|
13
|
$5,255.00
|
$5,255.00
|
$2,627.50
|
$5,149.90
|
$3,540.23
|
2026-05-01
|
|
49650
|
HCPCS
|
Lap Inguinal Hernia Repair W/mesh
|
16
|
13
|
$5,460.00
|
$5,460.00
|
$2,730.00
|
$5,350.80
|
$3,678.33
|
2026-05-01
|
|
74178
|
HCPCS
|
CT Abdomen & Pelvis W & Without Contrast
|
16
|
13
|
$5,565.00
|
$5,565.00
|
$2,782.50
|
$5,453.70
|
$3,749.07
|
2026-05-01
|
|
47562
|
HCPCS
|
Laparoscopy Cholecystectomy
|
16
|
13
|
$5,740.00
|
$5,740.00
|
$2,870.00
|
$5,625.20
|
$3,866.97
|
2026-05-01
|
|
58262
|
HCPCS
|
Vag. Hysterectomy W/remova
|
16
|
13
|
$5,780.00
|
$5,780.00
|
$2,890.00
|
$5,664.40
|
$3,893.91
|
2026-05-01
|
|
28208
|
HCPCS
|
Repair Tendon Extensor Ft 1/2 Each
|
16
|
13
|
$5,850.00
|
$4,680.00
20% off
|
$2,925.00
|
$5,733.00
|
$3,941.07
|
2026-05-01
|
|
74174
|
HCPCS
|
CT Angiography Abd & Pelvis W Contrast
|
16
|
13
|
$5,965.00
|
$5,965.00
|
$2,982.50
|
$5,845.70
|
$4,018.55
|
2026-05-01
|
|
44970
|
HCPCS
|
Laparoscopy Appendectomy
|
16
|
13
|
$5,990.00
|
$5,990.00
|
$2,995.00
|
$5,870.20
|
$4,035.39
|
2026-05-01
|
|
47563
|
HCPCS
|
Laps Surg Cholecystectomy With Cholangiogr
|
16
|
13
|
$6,000.00
|
$6,000.00
|
$3,000.00
|
$5,880.00
|
$4,042.12
|
2026-05-01
|
|
29806
|
HCPCS
|
Arthroscopy, Shoulder, Surgical
|
16
|
13
|
$6,115.00
|
$6,115.00
|
$3,057.50
|
$5,992.70
|
$4,119.60
|
2026-05-01
|
|
78816
|
HCPCS
|
PET Scan W/ct; Whole Body
|
16
|
13
|
$6,470.00
|
$6,470.00
|
$3,235.00
|
$6,340.60
|
$4,358.76
|
2026-05-01
|
|
78815
|
HCPCS
|
PET Scan W/ct; Skull To Mid-thigh
|
16
|
13
|
$6,480.00
|
$6,480.00
|
$3,240.00
|
$6,350.40
|
$4,365.49
|
2026-05-01
|
|
29882
|
HCPCS
|
Arthroscopy, Knee Medial/lateral Meniscu
|
16
|
13
|
$6,985.00
|
$6,985.00
|
$3,492.50
|
$6,845.30
|
$4,705.71
|
2026-05-01
|
|
44180
|
HCPCS
|
Laparoscopy, Surgical, Enterolysis
|
16
|
13
|
$7,210.00
|
$7,210.00
|
$3,605.00
|
$7,065.80
|
$4,857.29
|
2026-05-01
|
|
58552
|
HCPCS
|
Lapar Assisted Vag Hysterectomy
|
16
|
13
|
$7,250.00
|
$7,250.00
|
$3,625.00
|
$7,105.00
|
$4,884.23
|
2026-05-01
|
|
54600
|
HCPCS
|
Reduce Testis Torsion
|
16
|
13
|
$7,303.00
|
$7,303.00
|
$3,651.50
|
$7,156.94
|
$4,919.94
|
2026-05-01
|
|
27130
|
HCPCS
|
Arthroplasty, Total Hip
|
16
|
13
|
$8,145.00
|
$8,145.00
|
$4,072.50
|
$7,982.10
|
$5,487.19
|
2026-05-01
|
|
29888
|
HCPCS
|
Arthroscopy Acl Repair/aug/reconstruct
|
16
|
13
|
$8,280.00
|
$8,280.00
|
$4,140.00
|
$8,114.40
|
$5,578.13
|
2026-05-01
|
|
27447
|
HCPCS
|
Arthroplasty, Knee; Total Knee
|
16
|
13
|
$8,415.00
|
$8,415.00
|
$4,207.50
|
$8,246.70
|
$5,669.08
|
2026-05-01
|
|
23472
|
HCPCS
|
Arthroplasty, Glenohumeral, Total Shldr
|
16
|
13
|
$9,075.00
|
$9,075.00
|
$4,537.50
|
$8,893.50
|
$6,113.71
|
2026-05-01
|
|
J9173
|
HCPCS
|
Durvalumab Vial [500 Mg/10 Ml]
|
16
|
13
|
$9,500.00
|
$9,500.00
|
$4,750.00
|
$9,310.00
|
$6,400.03
|
2026-05-01
|
|
J3101
|
HCPCS
|
Tnkase 50mg Pwd Vial IV
|
16
|
13
|
$10,716.00
|
$10,716.00
|
$5,358.00
|
$10,501.68
|
$7,219.23
|
2026-05-01
|
|
J9274
|
HCPCS
|
Tebentafusp-tebn Vial [100 Mcg/0.5 Ml]
|
16
|
13
|
$23,652.00
|
$23,652.00
|
$11,826.00
|
$23,178.96
|
$15,934.06
|
2026-05-01
|