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

BOONE COUNTY HEALTH CENTER

Albion, NE · CCN 281334 · Rates published

Your selected procedure

You selected 59400 (CPT)

Obstetric care, planned vaginal delivery

This hospital’s price: $4,218 across 7 payers · range $2,535-$5,070

Source: https://secure.claraprice.net/price-transparency/AWJB-1737999041661/machine-readable/476000611_boone-county-health-center_standardcharges.json · observed 2025-09-11

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.

2,951 distinct procedures filed
7 distinct payers
24,976 rate rows
2025-09-11 last MRF observed
Data quality

24,973 of 24,976 rate rows are consumer-grade (100.0%)

3 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
exceeds 10× this hospital's gross charge — excluded from medians 3
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://secure.claraprice.net/price-transparency/AWJB-1737999041661/machine-readable/476000611_boone-county-health-center_standardcharges.json
Found on page https://boonecohealth.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch success · 2026-08-10
Content fingerprint 35573b7abe3b9bce… · 142,363 bytes · first seen 2026-05-19

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
23660035
CDM 		Ocrelizumab 300 Mg/10 Ml Inj [Bchc] 7 $15,483.00 $30,966.00 $25,760.50 nat. median
$25,760
1.0× median
27339318
CDM 		Tildrakizumab 100 Mg/ml Sol [Bchc] 7 $14,282.00 $28,565.00 $23,763.00 nat. median
$23,763
1.0× median
27752207
CDM 		Efgartigimod Alfa-hyaluronidase Qvfc 180 Mg-2000 Units/ml Sol [Bchc] 7 $13,723.00 $27,446.00 $22,832.00 nat. median
$22,832
1.0× median
24222520
CDM 		Cabazitaxel 60 Mg/1.5 Ml Sol [Bchc] 7 $10,343.00 $20,685.00 $17,208.00 nat. median
$17,208
1.0× median
28012127
CDM 		Risankizumab Rzaa 60 Mg/ml Sol 7 $9,024.00 $18,048.00 $15,014.50 nat. median
$15,014
1.0× median
24705656
CDM 		Daratumumab-hyaluronidase 1800 Mg-30,000 Units/15 Ml Sol [Bchc] 7 $7,933.00 $15,866.00 $13,199.50 nat. median
$13,200
1.0× median
9216935
CDM 		Natalizumab 300 Mg/15 Ml IV Inj [Bchc] 7 $7,428.00 $14,856.00 $12,359.00 nat. median
$12,359
1.0× median
C1771
HCPCS 		Advance Xp Male Sling System 7 $7,384.00 $14,768.00 $12,285.50 nat. median
$2,420
outlier · 5.1×
8597428
CDM 		Alteplase 100 Mg IV Inj [Bchc] 7 $6,886.00 $13,772.00 $11,456.50 nat. median
$11,456
1.0× median
23768950
CDM 		Immune Globulin Intravenous ***Privigen**40 Gm/400 Ml [Bchc] 7 $6,813.00 $13,627.00 $11,336.00 nat. median
$11,336
1.0× median
8597955
CDM 		Leuprolide 45 Mg/6 Months IM Inj, ER [Bchc] 7 $6,773.00 $13,546.00 $11,269.50 nat. median
$11,270
1.0× median
24293415
CDM 		Ecallantide 10 Mg/ml Inj [Bchc] 7 $6,364.00 $12,728.00 $10,588.00 nat. median
$10,588
1.0× median
23664973
CDM 		Vedolizumab 300 Mg Rec Inj [Bchc] 7 $6,069.00 $12,137.00 $10,096.50 nat. median
$10,096
1.0× median
9476600
CDM 		Digoxin Immune Fab 40 Mg Rec [Bchc] 7 $6,004.00 $12,007.00 $9,988.50 nat. median
$9,988
1.0× median
24034581
CDM 		Nivolumab 240 Mg/24 Ml Inj [Bchc] 7 $5,954.00 $11,907.00 $9,905.50 nat. median
$9,906
1.0× median
27508297
CDM 		Pegfilgrastim Bmez 6 Mg/0.6 Ml Sol [Bchc] 7 $5,919.00 $11,839.00 $9,849.00 nat. median
$9,849
1.0× median
24339467
CDM 		Tenecteplase 50 Mg Rec 7 $5,880.00 $11,760.00 $9,783.00 nat. median
$9,783
1.0× median
8598180
CDM 		Pegfilgrastim 6 Mg/0.6 Ml Subq Inj [Bchc] 7 $5,841.00 $11,682.00 $9,718.50 nat. median
$9,718
1.0× median
22553987
CDM 		Pegfilgrastim 6 Mg/0.6 Ml ***Autoinjection** [Bchc] 7 $5,841.00 $11,682.00 $9,718.50 nat. median
$9,718
1.0× median
22172114
CDM 		Octreotide 30 Mg Depot Inj [Bchc] 7 $5,778.00 $11,556.00 $9,613.50 nat. median
$9,614
1.0× median
27445578
CDM 		Pertuzumab 420 Mg/14 Ml Sol [Bchc] 7 $5,733.00 $11,467.00 $9,539.00 nat. median
$12,855
0.7× median
23286570
CDM 		Leuprolide 22.5 Mg/3 Months IM Inj [Bchc] 7 $5,232.00 $10,463.00 $8,704.00 nat. median
$8,704
1.0× median
A9604
HCPCS 		A9604 Nm Bchc Samarium Sm-153 7 $5,191.00 $10,382.00 $8,637.00 nat. median
$12,945
0.7× median
22714995
CDM 		Pembrolizumab 100 Mg/4 Ml Inj [Bchc] 7 $5,130.00 $10,259.00 $8,534.50 nat. median
$8,534
1.0× median
23808510
CDM 		Benralizumab 30 Mg/ml Inj [Bchc] 7 $4,987.00 $9,974.00 $8,297.00 nat. median
$8,297
1.0× median
22281343
CDM 		Obinutuzumab 1000 Mg/40 Ml Inj [Bchc] 7 $4,669.00 $9,338.00 $7,768.50 nat. median
$7,768
1.0× median
22364331
CDM 		Panitumumab 400 Mg/20 Ml Inj [Bchc] 7 $4,643.00 $9,287.00 $7,726.00 nat. median
$7,726
1.0× median
8597954
CDM 		Leuprolide 30 Mg/4 Months IM Inj, ER [Bchc] 7 $4,515.00 $9,031.00 $7,512.50 nat. median
$7,512
1.0× median
78816
CPT 		PET Whole Body 7 $4,452.00 $8,904.00 $7,407.50 nat. median
$2,751
outlier · 2.7×
C9740
HCPCS 		Urolift 2 Implant Cartridge Bx/4 (As Of 2/5/2024 Always Orde 7 $4,208.00 $8,417.00 $7,002.00 nat. median
$9,732
0.7× median
22514
CPT 		22514 Or Lumbar Vertebra Augmentation 1 Body 7 $4,138.00 $8,277.00 $6,885.50 nat. median
$8,313
0.8× median
27849535
CDM 		Ferric Derisomaltose 1000 Mg/10 Ml Inj [Bchc] 7 $4,079.00 $8,158.00 $6,787.00 nat. median
$6,787
1.0× median
27833268
CDM 		Eflapegrastim Xnst 13.2 Mg/0.6 Ml Sol [Bchc] 7 $4,072.00 $8,143.00 $6,774.00 nat. median
$6,774
1.0× median
28025265
CDM 		Alteplase 50 Mg Rec 7 $3,981.00 $7,962.00 $6,623.50 nat. median
$6,624
1.0× median
36475
CPT 		US Endovenous Ablation 1st Vein 7 $3,961.00 $7,923.00 $6,591.00 nat. median
$4,061
1.6× median
24069516
CDM 		Rituximab Abbs **500 Mg/50 Ml** Inj [Bchc] 7 $3,825.00 $7,650.00 $6,364.00 nat. median
$6,364
1.0× median
9097088
CDM 		Herceptin 440 Mg Solr [Bchc] 7 $3,785.00 $7,570.00 $6,297.50 nat. median
$6,298
1.0× median
22207044
CDM 		Rituximab 500 Mg/50 Ml Inj [Bchc] 7 $3,779.00 $7,557.00 $6,287.00 nat. median
$6,287
1.0× median
27746661
CDM 		Pegfilgrastim Cbqv 6 Mg/0.6 Ml Sol [Bchc] 7 $3,778.00 $7,555.00 $6,285.00 nat. median
$6,285
1.0× median
22513
CPT 		22513 Or Thoracic Vertebra Augmentation 1 Body 7 $3,772.00 $7,545.00 $6,276.50 nat. median
$8,294
0.8× median
27796994
CDM 		Darbepoetin Alfa 500 Mcg/ml Sol [Bchc] 7 $3,771.00 $7,542.00 $6,274.50 nat. median
$6,274
1.0× median
59510
CPT 		Obstetric Care, Planned Cesarean Delivery 7 $2,776.00 $13,654.00 $6,189.50 nat. median
$3,552
1.7× median
23766068
CDM 		Immune Globulin Intravenous ***Privigen**20 Gm/200 Ml Inj [Bchc] 7 $3,668.00 $7,337.00 $6,103.50 nat. median
$6,104
1.0× median
78815
CPT 		PET Skullmid Thigh 7 $3,632.00 $7,264.00 $6,043.00 nat. median
$2,791
outlier · 2.2×
24409344
CDM 		Antihemophilic Factor Recombinant Inj ***1900 Units***[bchc] 7 $3,631.00 $7,263.00 $6,042.00 nat. median
$6,042
1.0× median
8598141
CDM 		Octreotide 20 Mg Depot IM Inj [Bchc] 7 $3,614.00 $7,228.00 $6,013.00 nat. median
$6,013
1.0× median
27436016
CDM 		Rituximab Pvvr 500 Mg/50 Ml Inj [Bchc] 7 $3,492.00 $6,984.00 $5,810.00 nat. median
$5,810
1.0× median
23239637
CDM 		Leuprolide 45 Mg/6 Month ***Subq Inj*** [Bchc] 7 $3,407.00 $6,814.00 $5,668.50 nat. median
$5,668
1.0× median
8597670
CDM 		Denosumab 120 Mg/1.7 Ml Sol [Bchc] 7 $3,362.00 $6,723.00 $5,593.00 nat. median
$5,593
1.0× median
23604327
CDM 		Immune Globulin Iv/sq 10% Sol ***30 Gm/300 Ml*** Inj [Bchc] 7 $3,359.00 $6,719.00 $5,589.00 nat. median
$5,589
1.0× median

Other procedures at this hospital

Browse this hospital's 2,951 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
             
23660035 CDM Ocrelizumab 300 Mg/10 Ml Inj [Bchc] 8 7 $26,695.00 $26,695.00 $15,483.00 $30,966.00 $25,760.50 2025-09-11
27339318 CDM Tildrakizumab 100 Mg/ml Sol [Bchc] 8 7 $24,625.00 $24,625.00 $14,282.00 $28,565.00 $23,763.00 2025-09-11
27752207 CDM Efgartigimod Alfa-hyaluronidase Qvfc 180 Mg-2000 Units/ml Sol [Bchc] 8 7 $23,660.00 $23,660.00 $13,723.00 $27,446.00 $22,832.00 2025-09-11
24222520 CDM Cabazitaxel 60 Mg/1.5 Ml Sol [Bchc] 8 7 $17,832.00 $17,832.00 $10,343.00 $20,685.00 $17,208.00 2025-09-11
28012127 CDM Risankizumab Rzaa 60 Mg/ml Sol 8 7 $15,559.00 $15,559.00 $9,024.00 $18,048.00 $15,014.50 2025-09-11
24705656 CDM Daratumumab-hyaluronidase 1800 Mg-30,000 Units/15 Ml Sol [Bchc] 8 7 $13,678.00 $13,678.00 $7,933.00 $15,866.00 $13,199.50 2025-09-11
9216935 CDM Natalizumab 300 Mg/15 Ml IV Inj [Bchc] 8 7 $12,807.00 $12,807.00 $7,428.00 $14,856.00 $12,359.00 2025-09-11
C1771 HCPCS Advance Xp Male Sling System 8 7 $12,731.00 $12,731.00 $7,384.00 $14,768.00 $12,285.50 2025-09-11
8597428 CDM Alteplase 100 Mg IV Inj [Bchc] 8 7 $11,872.00 $11,872.00 $6,886.00 $13,772.00 $11,456.50 2025-09-11
23768950 CDM Immune Globulin Intravenous ***Privigen**40 Gm/400 Ml [Bchc] 8 7 $11,747.00 $11,747.00 $6,813.00 $13,627.00 $11,336.00 2025-09-11
8597955 CDM Leuprolide 45 Mg/6 Months IM Inj, ER [Bchc] 8 7 $11,678.00 $11,678.00 $6,773.00 $13,546.00 $11,269.50 2025-09-11
24293415 CDM Ecallantide 10 Mg/ml Inj [Bchc] 8 7 $10,972.00 $10,972.00 $6,364.00 $12,728.00 $10,588.00 2025-09-11
23664973 CDM Vedolizumab 300 Mg Rec Inj [Bchc] 8 7 $10,463.00 $10,463.00 $6,069.00 $12,137.00 $10,096.50 2025-09-11
9476600 CDM Digoxin Immune Fab 40 Mg Rec [Bchc] 8 7 $10,351.00 $10,351.00 $6,004.00 $12,007.00 $9,988.50 2025-09-11
24034581 CDM Nivolumab 240 Mg/24 Ml Inj [Bchc] 8 7 $10,265.00 $10,265.00 $5,954.00 $11,907.00 $9,905.50 2025-09-11
27508297 CDM Pegfilgrastim Bmez 6 Mg/0.6 Ml Sol [Bchc] 8 7 $10,206.00 $10,206.00 $5,919.00 $11,839.00 $9,849.00 2025-09-11
24339467 CDM Tenecteplase 50 Mg Rec 8 7 $10,138.00 $10,138.00 $5,880.00 $11,760.00 $9,783.00 2025-09-11
8598180 CDM Pegfilgrastim 6 Mg/0.6 Ml Subq Inj [Bchc] 8 7 $10,071.00 $10,071.00 $5,841.00 $11,682.00 $9,718.50 2025-09-11
22553987 CDM Pegfilgrastim 6 Mg/0.6 Ml ***Autoinjection** [Bchc] 8 7 $10,071.00 $10,071.00 $5,841.00 $11,682.00 $9,718.50 2025-09-11
22172114 CDM Octreotide 30 Mg Depot Inj [Bchc] 8 7 $9,962.00 $9,962.00 $5,778.00 $11,556.00 $9,613.50 2025-09-11
27445578 CDM Pertuzumab 420 Mg/14 Ml Sol [Bchc] 8 7 $9,885.00 $9,885.00 $5,733.00 $11,467.00 $9,539.00 2025-09-11
23286570 CDM Leuprolide 22.5 Mg/3 Months IM Inj [Bchc] 8 7 $9,020.00 $9,020.00 $5,232.00 $10,463.00 $8,704.00 2025-09-11
A9604 HCPCS A9604 Nm Bchc Samarium Sm-153 8 7 $8,950.00 $8,950.00 $5,191.00 $10,382.00 $8,637.00 2025-09-11
22714995 CDM Pembrolizumab 100 Mg/4 Ml Inj [Bchc] 8 7 $8,844.00 $8,844.00 $5,130.00 $10,259.00 $8,534.50 2025-09-11
23808510 CDM Benralizumab 30 Mg/ml Inj [Bchc] 8 7 $8,598.00 $8,598.00 $4,987.00 $9,974.00 $8,297.00 2025-09-11
22281343 CDM Obinutuzumab 1000 Mg/40 Ml Inj [Bchc] 8 7 $8,050.00 $8,050.00 $4,669.00 $9,338.00 $7,768.50 2025-09-11
22364331 CDM Panitumumab 400 Mg/20 Ml Inj [Bchc] 8 7 $8,006.00 $8,006.00 $4,643.00 $9,287.00 $7,726.00 2025-09-11
8597954 CDM Leuprolide 30 Mg/4 Months IM Inj, ER [Bchc] 8 7 $7,785.00 $7,785.00 $4,515.00 $9,031.00 $7,512.50 2025-09-11
78816 CPT PET Whole Body 8 7 $7,676.00 $7,676.00 $4,452.00 $8,904.00 $7,407.50 2025-09-11
C9740 HCPCS Urolift 2 Implant Cartridge Bx/4 (As Of 2/5/2024 Always Orde 8 7 $7,256.00 $7,256.00 $4,208.00 $8,417.00 $7,002.00 2025-09-11
22514 CPT 22514 Or Lumbar Vertebra Augmentation 1 Body 8 7 $7,135.00 $7,135.00 $4,138.00 $8,277.00 $6,885.50 2025-09-11
27849535 CDM Ferric Derisomaltose 1000 Mg/10 Ml Inj [Bchc] 8 7 $7,033.00 $7,033.00 $4,079.00 $8,158.00 $6,787.00 2025-09-11
27833268 CDM Eflapegrastim Xnst 13.2 Mg/0.6 Ml Sol [Bchc] 8 7 $7,020.00 $7,020.00 $4,072.00 $8,143.00 $6,774.00 2025-09-11
28025265 CDM Alteplase 50 Mg Rec 8 7 $6,864.00 $6,864.00 $3,981.00 $7,962.00 $6,623.50 2025-09-11
36475 CPT US Endovenous Ablation 1st Vein 8 7 $6,830.00 $6,830.00 $3,961.00 $7,923.00 $6,591.00 2025-09-11
24069516 CDM Rituximab Abbs **500 Mg/50 Ml** Inj [Bchc] 8 7 $6,595.00 $6,595.00 $3,825.00 $7,650.00 $6,364.00 2025-09-11
9097088 CDM Herceptin 440 Mg Solr [Bchc] 8 7 $6,526.00 $6,526.00 $3,785.00 $7,570.00 $6,297.50 2025-09-11
22207044 CDM Rituximab 500 Mg/50 Ml Inj [Bchc] 8 7 $6,515.00 $6,515.00 $3,779.00 $7,557.00 $6,287.00 2025-09-11
27746661 CDM Pegfilgrastim Cbqv 6 Mg/0.6 Ml Sol [Bchc] 8 7 $6,513.00 $6,513.00 $3,778.00 $7,555.00 $6,285.00 2025-09-11
22513 CPT 22513 Or Thoracic Vertebra Augmentation 1 Body 8 7 $6,504.00 $6,504.00 $3,772.00 $7,545.00 $6,276.50 2025-09-11
27796994 CDM Darbepoetin Alfa 500 Mcg/ml Sol [Bchc] 8 7 $6,502.00 $6,502.00 $3,771.00 $7,542.00 $6,274.50 2025-09-11
59510 CPT Obstetric Care, Planned Cesarean Delivery 16 7 $8,278.50 $8,278.50 $2,776.00 $13,654.00 $6,189.50 2025-09-11
23766068 CDM Immune Globulin Intravenous ***Privigen**20 Gm/200 Ml Inj [Bchc] 8 7 $6,325.00 $6,325.00 $3,668.00 $7,337.00 $6,103.50 2025-09-11
78815 CPT PET Skullmid Thigh 8 7 $6,262.00 $6,262.00 $3,632.00 $7,264.00 $6,043.00 2025-09-11
24409344 CDM Antihemophilic Factor Recombinant Inj ***1900 Units***[bchc] 8 7 $6,261.00 $6,261.00 $3,631.00 $7,263.00 $6,042.00 2025-09-11
8598141 CDM Octreotide 20 Mg Depot IM Inj [Bchc] 8 7 $6,231.00 $6,231.00 $3,614.00 $7,228.00 $6,013.00 2025-09-11
27436016 CDM Rituximab Pvvr 500 Mg/50 Ml Inj [Bchc] 8 7 $6,021.00 $6,021.00 $3,492.00 $6,984.00 $5,810.00 2025-09-11
23239637 CDM Leuprolide 45 Mg/6 Month ***Subq Inj*** [Bchc] 8 7 $5,874.00 $5,874.00 $3,407.00 $6,814.00 $5,668.50 2025-09-11
8597670 CDM Denosumab 120 Mg/1.7 Ml Sol [Bchc] 8 7 $5,796.00 $5,796.00 $3,362.00 $6,723.00 $5,593.00 2025-09-11
23604327 CDM Immune Globulin Iv/sq 10% Sol ***30 Gm/300 Ml*** Inj [Bchc] 8 7 $5,792.00 $5,792.00 $3,359.00 $6,719.00 $5,589.00 2025-09-11
C1763 HCPCS Flexpatch 6x9cm 8 7 $5,765.00 $5,765.00 $3,344.00 $6,687.00 $5,563.00 2025-09-11
C1734 HCPCS V92, Cellular Bone Matrix, 2.5cc 8 7 $5,738.00 $5,738.00 $3,328.00 $6,656.00 $5,537.00 2025-09-11
27447117 CDM Trastuzumab Qyyp 420 Mg Rec [Bchc] 8 7 $5,697.00 $5,697.00 $3,304.00 $6,609.00 $5,497.50 2025-09-11
23071057 CDM Ixabepilone 45 Mg Vial Inj [Bchc] 8 7 $5,664.00 $5,664.00 $3,285.00 $6,570.00 $5,465.50 2025-09-11
22034224 CDM Octreotide 10 Mg Depot Inj [Bchc] 8 7 $5,469.00 $5,469.00 $3,172.00 $6,344.00 $5,277.50 2025-09-11
18461118 CDM C1 Esterase Inhibitor 500 Units Kit [Bchc] 8 7 $5,460.00 $5,460.00 $3,167.00 $6,334.00 $5,269.00 2025-09-11
74178 CPT CT Abdomen/pelvis W + Without Contrast 8 7 $5,418.00 $5,418.00 $3,142.00 $6,285.00 $5,228.00 2025-09-11
74174 CPT CT Angiography Abdomen/pelvis 8 7 $5,418.00 $5,418.00 $3,142.00 $6,285.00 $5,228.00 2025-09-11
23326379 CDM Carfilzomib 60 Mg Rec Inj [Bchc] 8 7 $5,005.00 $5,005.00 $2,903.00 $5,806.00 $4,830.00 2025-09-11
8597527 CDM Bevacizumab 400 Mg/16 Ml IV Inj [Bchc] 8 7 $4,985.00 $4,985.00 $2,891.00 $5,783.00 $4,810.50 2025-09-11
23634055 CDM Goserelin 10.8 Mg Subq Imp [Bchc] 8 7 $4,906.00 $4,906.00 $2,845.00 $5,691.00 $4,734.50 2025-09-11
49406 CPT US Guided Abscess Drain Peritoneal/retro 8 7 $4,700.00 $4,700.00 $2,726.00 $5,452.00 $4,535.50 2025-09-11
95811 CPT 95811 Rt Polysomnography Sleep Study With Cpap 8 7 $4,700.00 $4,700.00 $2,726.00 $5,452.00 $4,535.50 2025-09-11
49405 CPT US Guided Abscess Drainage Visceral 8 7 $4,700.00 $4,700.00 $2,726.00 $5,452.00 $4,535.50 2025-09-11
23739616 CDM Romiplostim 250 Mcg Rec Inj [Bchc] 8 7 $4,625.00 $4,625.00 $2,683.00 $5,365.00 $4,463.00 2025-09-11
74177 CPT CT Scan Of Abdomen And Pelvis With Contrast 8 7 $4,616.00 $4,616.00 $2,677.00 $5,355.00 $4,454.50 2025-09-11
22314549 CDM Nivolumab 100 Mg/10 Ml Inj [Bchc] 8 7 $4,606.00 $4,606.00 $2,671.00 $5,343.00 $4,445.00 2025-09-11
16943373 CDM Certolizumab 200 Mg/ml Sq Kit [Bchc] 8 7 $4,536.00 $4,536.00 $2,631.00 $5,262.00 $4,377.50 2025-09-11
19541486 CDM Doxorubicin Liposomal 50 Mg/25 Ml Inj [Bchc] 8 7 $4,527.00 $4,527.00 $2,626.00 $5,251.00 $4,368.50 2025-09-11
22515 CPT 22515 Or Addl Lumbar/thoracic Vertebral Body 8 7 $4,463.00 $4,463.00 $2,589.00 $5,177.00 $4,306.50 2025-09-11
24469944 CDM Tocilizumab 400 Mg/20 Ml Inj [Bchc] 8 7 $4,462.00 $4,462.00 $2,588.00 $5,176.00 $4,306.00 2025-09-11
59400 CPT Obstetric Care, Planned Vaginal Delivery 8 7 $4,371.00 $4,371.00 $2,535.00 $5,070.00 $4,218.00 2025-09-11
C9739 HCPCS Urolift 2 Implant Cartridge Bx/4 (1-3 Implants) For HCPCS Co 8 7 $4,354.00 $4,354.00 $2,525.00 $5,051.00 $4,201.50 2025-09-11
21052352 CDM Pemetrexed 500 Mg Vial [Bchc] 8 7 $4,330.00 $4,330.00 $2,511.00 $5,023.00 $4,178.50 2025-09-11
72156 CPT MRI Spine Cervical With + Without Contrast 8 7 $4,315.00 $4,315.00 $2,503.00 $5,005.00 $4,164.00 2025-09-11
72158 CPT MRI Spine Lumbar With + Without Contrast 8 7 $4,215.00 $4,215.00 $2,445.00 $4,889.00 $4,067.50 2025-09-11
78452 CPT Nm Myocardial Spect Multi Rest/stress 8 7 $4,214.00 $4,214.00 $2,444.00 $4,888.00 $4,066.50 2025-09-11
23838012 CDM Ivig 10% Gamunex-c 20 Gm/200 Ml Inj [Bchc] 8 7 $4,200.00 $4,200.00 $2,436.00 $4,872.00 $4,053.00 2025-09-11
72157 CPT MRI Spine Thoracic With + Without Contrast 8 7 $4,165.00 $4,165.00 $2,416.00 $4,831.00 $4,019.00 2025-09-11
24159700 CDM Bevacizumab Bvzr 400 Mg/16 Ml Inj [Bchc] 8 7 $4,122.00 $4,122.00 $2,391.00 $4,782.00 $3,977.50 2025-09-11
74183 CPT MRI Abdomen With + Without Contrast 8 7 $4,115.00 $4,115.00 $2,387.00 $4,773.00 $3,971.00 2025-09-11
72197 CPT MRI Pelvis With + Without Contrast 8 7 $4,115.00 $4,115.00 $2,387.00 $4,773.00 $3,971.00 2025-09-11
70553 CPT MRI Scan 8 7 $4,115.00 $4,115.00 $2,387.00 $4,773.00 $3,971.00 2025-09-11
95810 CPT Sleep Study 8 7 $4,100.00 $4,100.00 $2,378.00 $4,756.00 $3,956.50 2025-09-11
42820 CPT Removal Of Tonsils And Adenoid Glands, Patient Younger Than Age 12 8 7 $4,065.00 $4,065.00 $2,358.00 $4,715.00 $3,922.50 2025-09-11
27268141 CDM Ustekinumab 130 Mg/26 Ml Sol [Bchc] 8 7 $4,025.00 $4,025.00 $2,335.00 $4,669.00 $3,884.00 2025-09-11
71552 CPT MRI Chest With + Without Contrast 8 7 $4,015.00 $4,015.00 $2,329.00 $4,657.00 $3,874.50 2025-09-11
24307895 CDM Immune Globulin 10% ***Octagam 30 Gm/300 Ml ***[Bchc] 8 7 $3,998.00 $3,998.00 $2,319.00 $4,638.00 $3,858.00 2025-09-11
77049 CPT MRI Breast With + Without Contrast Bilateral. 8 7 $3,915.00 $3,915.00 $2,271.00 $4,541.00 $3,778.00 2025-09-11
74176 CPT CT Abdomen/pelvis Without Contrast 8 7 $3,913.00 $3,913.00 $2,270.00 $4,539.00 $3,776.00 2025-09-11
22853677 CDM Bendamustine 100 Mg/4 Ml Inj Vial [Bchc] 8 7 $3,907.00 $3,907.00 $2,266.00 $4,532.00 $3,770.50 2025-09-11
8597667 CDM Darbepoetin Alfa 300 Mcg/0.6 Ml Inj [Bchc] 8 7 $3,901.00 $3,901.00 $2,263.00 $4,525.00 $3,764.50 2025-09-11
22015586 CDM Dantrolene 250 Mg Vial For Inj [Bchc] 8 7 $3,864.00 $3,864.00 $2,241.00 $4,482.00 $3,728.50 2025-09-11
23856453 CDM Dalbavancin 500 Mg Rec [Bchc] 8 7 $3,863.00 $3,863.00 $2,241.00 $4,481.00 $3,727.50 2025-09-11
24397278 CDM Thyrotropin Alfa 1.1 Mg Rec [Bchc] 8 7 $3,854.00 $3,854.00 $2,235.00 $4,471.00 $3,719.00 2025-09-11
74185 CPT MRA Abdomen With + Without Contrast 8 7 $3,815.00 $3,815.00 $2,213.00 $4,425.00 $3,681.50 2025-09-11
73223 CPT MRI Ue Joint With + Without Contrast Left 8 7 $3,815.00 $3,815.00 $2,213.00 $4,425.00 $3,681.50 2025-09-11
70549 CPT MRA Neck With + Without Contrast 8 7 $3,815.00 $3,815.00 $2,213.00 $4,425.00 $3,681.50 2025-09-11
70543 CPT MRI Face Neck Orbit With + Without Contrast 8 7 $3,815.00 $3,815.00 $2,213.00 $4,425.00 $3,681.50 2025-09-11
23825085 CDM Adalimumab 40 Mg/0.8 Ml Kit [Bchc] 8 7 $3,812.00 $3,812.00 $2,211.00 $4,422.00 $3,679.00 2025-09-11
27986442 CDM Inclisiran 284 Mg/1.5 Ml Sol 8 7 $3,778.00 $3,778.00 $2,191.00 $4,382.00 $3,646.00 2025-09-11
21550 CPT Bchc Xr Bx Of Neck/thorax So 8 7 $3,756.00 $3,756.00 $2,178.00 $4,357.00 $3,624.50 2025-09-11
72147 CPT MRI Spine Thoracic With Contrast 8 7 $3,715.00 $3,715.00 $2,155.00 $4,309.00 $3,585.00 2025-09-11
72142 CPT MRI Spine Cervical With Contrast 8 7 $3,660.00 $3,660.00 $2,123.00 $4,246.00 $3,532.00 2025-09-11
72196 CPT MRI Pelvis With Contrast 8 7 $3,660.00 $3,660.00 $2,123.00 $4,246.00 $3,532.00 2025-09-11
23571776 CDM Immune Globulin Iv/subq 10% Sol 20 Gm/200 Ml [Bchc] 8 7 $3,634.00 $3,634.00 $2,108.00 $4,215.00 $3,507.00 2025-09-11
24155753 CDM Leuprolide 7.5 Mg/month Kit [Bchc] 8 7 $3,615.00 $3,615.00 $2,097.00 $4,193.00 $3,488.50 2025-09-11
70552 CPT MRI Brain With Contrast 8 7 $3,615.00 $3,615.00 $2,097.00 $4,193.00 $3,488.50 2025-09-11
73723 CPT MRI Le Joint With + Without Contrast Left 8 7 $3,615.00 $3,615.00 $2,097.00 $4,193.00 $3,488.50 2025-09-11
78451 CPT Nm Myocardial Spect Single Rest/stress 8 7 $3,612.00 $3,612.00 $2,095.00 $4,190.00 $3,486.00 2025-09-11
23358072 CDM Golimumab 50 Mg/4 Ml Inj Vial [Bchc] 8 7 $3,599.00 $3,599.00 $2,087.00 $4,175.00 $3,473.00 2025-09-11
75635 CPT CT Angiography Aorta With Runoff 8 7 $3,562.00 $3,562.00 $2,066.00 $4,132.00 $3,437.50 2025-09-11
47562 CPT Removal Of Gallbladder Using An Endoscope 16 7 $5,336.00 $5,336.00 $670.00 $11,039.00 $3,430.00 2025-09-11
27963739 CDM Secukinumab 25 Mg/ml Sol 8 7 $3,553.00 $3,553.00 $2,061.00 $4,121.00 $3,428.50 2025-09-11
70551 CPT MRI Brain Without Contrast 8 7 $3,515.00 $3,515.00 $2,039.00 $4,077.00 $3,392.00 2025-09-11
71550 CPT MRI Chest Without Contrast 8 7 $3,515.00 $3,515.00 $2,039.00 $4,077.00 $3,392.00 2025-09-11
72149 CPT MRI Spine Lumbar With Contrast 8 7 $3,510.00 $3,510.00 $2,036.00 $4,072.00 $3,387.50 2025-09-11
27649102 CDM Pegfilgrastim Jmdb 6 Mg/0.6 Ml Inj ***Fulphila** [Bchc] 8 7 $3,507.00 $3,507.00 $2,034.00 $4,068.00 $3,384.50 2025-09-11
C1762 HCPCS Flexigraft Quadlink Fql 9x70 8 7 $3,502.00 $3,502.00 $2,031.00 $4,062.00 $3,379.50 2025-09-11
19081 CPT Ma Stereotactic Localization Left 8 7 $3,485.00 $3,485.00 $2,021.00 $4,043.00 $3,363.00 2025-09-11
72146 CPT MRI Spine Thoracic Without Contrast 8 7 $3,460.00 $3,460.00 $2,007.00 $4,014.00 $3,339.00 2025-09-11
23912817 CDM Immune Globulin Intravenous 20 Gm/200 Ml **Octagam***[bchc] 8 7 $3,447.00 $3,447.00 $1,999.00 $3,999.00 $3,326.50 2025-09-11
70544 CPT MRA Head Without Contrast 8 7 $3,415.00 $3,415.00 $1,981.00 $3,961.00 $3,295.50 2025-09-11
73222 CPT MRI Shoulder With Contrast Left 8 7 $3,415.00 $3,415.00 $1,981.00 $3,961.00 $3,295.50 2025-09-11
72141 CPT MRI Spine Cervical Without Contrast 8 7 $3,415.00 $3,415.00 $1,981.00 $3,961.00 $3,295.50 2025-09-11
28058153 CDM Trilaciclib 300 Mg Rec 8 7 $3,398.00 $3,398.00 $1,971.00 $3,942.00 $3,279.00 2025-09-11
23766069 CDM Immune Globulin Intravenous **Privigen**10 Gm/100 Ml Inj [Bchc} 8 7 $3,389.00 $3,389.00 $1,966.00 $3,931.00 $3,270.00 2025-09-11
49505 CPT Repair Of Groin Hernia Patient Age 5 Years Or Older 16 7 $5,149.00 $5,149.00 $562.00 $10,822.00 $3,267.50 2025-09-11
8597671 CDM Denosumab 60 Mg/ml Sol [Bchc] 8 7 $3,376.00 $3,376.00 $1,958.00 $3,916.00 $3,258.00 2025-09-11
62305 CPT Xr Myelogram 2 Or More Regions 8 7 $3,374.00 $3,374.00 $1,957.00 $3,914.00 $3,256.00 2025-09-11
27556421 CDM Darbepoetin Alfa 200 Mcg/ml Sol [Bchc] 8 7 $3,364.00 $3,364.00 $1,951.00 $3,902.00 $3,246.00 2025-09-11
71275 CPT CT Angiography Chest W/wo Contrast 8 7 $3,311.00 $3,311.00 $1,920.00 $3,841.00 $3,195.50 2025-09-11
74175 CPT CT Angiography Abdomen With + Without Contrast 8 7 $3,311.00 $3,311.00 $1,920.00 $3,841.00 $3,195.50 2025-09-11
72148 CPT MRI Scan Of Lower Spinal Canal 8 7 $3,310.00 $3,310.00 $1,920.00 $3,840.00 $3,194.50 2025-09-11
73720 CPT MRI Foot With + Without Contrast Left 8 7 $3,310.00 $3,310.00 $1,920.00 $3,840.00 $3,194.50 2025-09-11
27567875 CDM Hyaluronan 88 Mg/4 Ml Sol [Bchc] 8 7 $3,260.00 $3,260.00 $1,891.00 $3,782.00 $3,146.00 2025-09-11
27694330 CDM Antihemophilic Factor Recombinant Albumin-free **973**rec [Bchc] 8 7 $3,226.00 $3,226.00 $1,871.00 $3,742.00 $3,113.00 2025-09-11
74181 CPT MRI Abdomen Without Contrast 8 7 $3,210.00 $3,210.00 $1,862.00 $3,724.00 $3,098.00 2025-09-11
27660560 CDM Etanercept 50 Mg/ml Inj [Bchc] 8 7 $3,172.00 $3,172.00 $1,840.00 $3,680.00 $3,061.00 2025-09-11
23587959 CDM Antihemophilic Factor Recombinant **992 Iu***rec[bchc] 8 7 $3,136.00 $3,136.00 $1,819.00 $3,638.00 $3,026.50 2025-09-11
10278190 CDM Decitabine 50 Mg [Bchc] 8 7 $3,121.00 $3,121.00 $1,810.00 $3,620.00 $3,011.50 2025-09-11
23587942 CDM Antihemophilic Factor Recombinant ***1652 Iu***rec Inj [Bchc] 8 7 $3,119.00 $3,119.00 $1,809.00 $3,618.00 $3,009.50 2025-09-11
73220 CPT MRI Humerus With + Without Contrast Left 24 7 $3,400.00 $3,400.00 $1,389.00 $3,961.00 $3,004.00 2025-09-11
74170 CPT CT Abdomen With + Without Contrast 8 7 $3,111.00 $3,111.00 $1,804.00 $3,609.00 $3,002.50 2025-09-11
72195 CPT MRI Pelvis Without Contrast 8 7 $3,110.00 $3,110.00 $1,804.00 $3,608.00 $3,001.50 2025-09-11
44394 CPT 44394 Or Minor Colonoscopy Thru Stoma, With Snare Removal 8 7 $3,102.00 $3,102.00 $1,799.00 $3,598.00 $2,993.50 2025-09-11
8597536 CDM Bortezomib 3.5 Mg IV Inj [Bchc] 8 7 $3,078.00 $3,078.00 $1,785.00 $3,570.00 $2,970.50 2025-09-11
867367 CDM Room/bed: Isolation 8 7 $3,040.00 $3,040.00 $1,763.00 $3,526.00 $2,933.50 2025-09-11
73702 CPT CT Femur With + Without Contrast Left 8 7 $3,010.00 $3,010.00 $1,746.00 $3,492.00 $2,905.00 2025-09-11
70498 CPT CT Angiography Neck W/wo Contrast 8 7 $3,010.00 $3,010.00 $1,746.00 $3,492.00 $2,905.00 2025-09-11
70496 CPT CT Angiography Head With + Without Contrast 8 7 $3,010.00 $3,010.00 $1,746.00 $3,492.00 $2,905.00 2025-09-11
8597887 CDM Hylan G-f 20 8 Mg/ml Intra-articular Inj [Bchc] 8 7 $2,978.00 $2,978.00 $1,727.00 $3,454.00 $2,874.00 2025-09-11
24317736 CDM Interferon Alfa-2b 50000000 Intl Units Rec [Bchc] 8 7 $2,950.00 $2,950.00 $1,711.00 $3,422.00 $2,847.00 2025-09-11
24155440 CDM Leuprolide 22.5 Mg/3 Months Pwd [Bchc] 8 7 $2,947.00 $2,947.00 $1,709.00 $3,419.00 $2,844.00 2025-09-11
71270 CPT CT Chest W/wo Contrast 8 7 $2,910.00 $2,910.00 $1,688.00 $3,376.00 $2,808.50 2025-09-11
72194 CPT CT Pelvis With + Without Contrast 8 7 $2,910.00 $2,910.00 $1,688.00 $3,376.00 $2,808.50 2025-09-11
72133 CPT CT Spine Lumbar With + Without Contrast 8 7 $2,900.00 $2,900.00 $1,682.00 $3,364.00 $2,798.50 2025-09-11
27811430 CDM Eptinezumab Jjmr 100 Mg/ml Sol [Bchc] 8 7 $2,870.00 $2,870.00 $1,665.00 $3,329.00 $2,769.50 2025-09-11
27465754 CDM Carfilzomib 30 Mg Rec [Bchc] 8 7 $2,860.00 $2,860.00 $1,659.00 $3,318.00 $2,760.00 2025-09-11
16405400 CDM Omalizumab 150 Mg Inj [Bchc] 8 7 $2,842.00 $2,842.00 $1,648.00 $3,297.00 $2,742.50 2025-09-11
10617466 CDM L&d Delivery Room Charge 8 7 $2,820.00 $2,820.00 $1,636.00 $3,271.00 $2,721.00 2025-09-11
22989938 CDM Trastuzumab Vial For Injection 150 Mg [Bchc] 8 7 $2,820.00 $2,820.00 $1,636.00 $3,271.00 $2,721.00 2025-09-11
27502 CPT 27502 Ed Clsd Tx Femoral Shaft Fx With Manip 8 7 $2,815.00 $2,815.00 $1,633.00 $3,265.00 $2,716.50 2025-09-11
77048 CPT MRI Breast With + Without Contrast Left. 8 7 $2,810.00 $2,810.00 $1,630.00 $3,260.00 $2,712.00 2025-09-11
27816125 CDM Abatacept 250 Mg Rec [Bchc] 8 7 $2,808.00 $2,808.00 $1,629.00 $3,257.00 $2,710.00 2025-09-11
22176951 CDM Ferric Carboxymaltose (As Elemental Iron) 750 Mg/15 Ml Inj [Bchc] 8 7 $2,791.00 $2,791.00 $1,619.00 $3,238.00 $2,693.00 2025-09-11
22272132 CDM Paclitaxel Protein-bound 100 Mg Vial [Bchc] 8 7 $2,778.00 $2,778.00 $1,611.00 $3,222.00 $2,681.00 2025-09-11
36476 CPT US Endovenous Ablation Incompetent Vein Rf, Add On 8 7 $2,756.00 $2,756.00 $1,598.00 $3,197.00 $2,659.50 2025-09-11
28025091 CDM Omalizumab 150 Mg/ml Sol 8 7 $2,719.00 $2,719.00 $1,577.00 $3,154.00 $2,623.50 2025-09-11
70547 CPT MRA Neck Without Contrast 8 7 $2,710.00 $2,710.00 $1,572.00 $3,144.00 $2,615.50 2025-09-11
73218 CPT MRI Ue Non Joint Without Contrast Left 8 7 $2,710.00 $2,710.00 $1,572.00 $3,144.00 $2,615.50 2025-09-11
73718 CPT MRI Femur Without Contrast Left 8 7 $2,710.00 $2,710.00 $1,572.00 $3,144.00 $2,615.50 2025-09-11
70492 CPT CT Soft Tissue Neck With + Without Contrast 8 7 $2,709.00 $2,709.00 $1,571.00 $3,142.00 $2,614.50 2025-09-11
45384 CPT 45384 Or Minor Colonoscopy, Flex With Hot Biopsy Forceps 8 7 $2,679.00 $2,679.00 $1,554.00 $3,108.00 $2,585.50 2025-09-11
10030 CPT US Guided Abscess Drainage Soft Tissue 8 7 $2,675.00 $2,675.00 $1,552.00 $3,103.00 $2,581.50 2025-09-11
72132 CPT CT Spine Lumbar With Contrast 8 7 $2,659.00 $2,659.00 $1,542.00 $3,084.00 $2,566.00 2025-09-11
72127 CPT CT Spine Cervical With + Without Contrast 8 7 $2,659.00 $2,659.00 $1,542.00 $3,084.00 $2,566.00 2025-09-11
76080 CPT Xr Fistula Or Sinus Tract Abscess Study 8 7 $2,644.00 $2,644.00 $1,534.00 $3,067.00 $2,551.50 2025-09-11
29881 CPT Removal Of One Knee Cartilage Using An Endoscope 16 7 $3,885.00 $3,885.00 $595.00 $7,824.00 $2,550.50 2025-09-11
28003486 CDM Romiplostim 125 Mcg Rec 8 7 $2,643.00 $2,643.00 $1,533.00 $3,066.00 $2,550.50 2025-09-11
72130 CPT CT Spine Thoracic With + Without Contrast 8 7 $2,640.00 $2,640.00 $1,531.00 $3,062.00 $2,547.50 2025-09-11
73721 CPT MRI Scan Of Leg Joint 8 7 $2,610.00 $2,610.00 $1,514.00 $3,028.00 $2,519.00 2025-09-11
73221 CPT MRI Ue Joint Without Contrast Left 8 7 $2,610.00 $2,610.00 $1,514.00 $3,028.00 $2,519.00 2025-09-11
72193 CPT CT Scan Of Pelvis With Contrast 8 7 $2,609.00 $2,609.00 $1,513.00 $3,026.00 $2,518.00 2025-09-11
74160 CPT CT Abdomen With Contrast 8 7 $2,609.00 $2,609.00 $1,513.00 $3,026.00 $2,518.00 2025-09-11
70482 CPT CT Orbit Sella Etc. With + Without Contrast 8 7 $2,609.00 $2,609.00 $1,513.00 $3,026.00 $2,518.00 2025-09-11
70470 CPT CT Head Or Brain With + Without Contrast 8 7 $2,609.00 $2,609.00 $1,513.00 $3,026.00 $2,518.00 2025-09-11
71260 CPT CT Chest W/contrast 8 7 $2,600.00 $2,600.00 $1,508.00 $3,016.00 $2,509.00 2025-09-11
23925292 CDM Calcitonin 200 Intl Units/ml Inj [Bchc] 8 7 $2,595.00 $2,595.00 $1,505.00 $3,010.00 $2,504.00 2025-09-11
22784876 CDM Antihemophilic Factor-von Willebrand Factor Complex (Human) 965 Iu Viii Inj [Bch… 8 7 $2,560.00 $2,560.00 $1,485.00 $2,970.00 $2,470.50 2025-09-11
23838011 CDM Ivig 10% Gamunex-c 10 Gm/100 Ml Inj [Bchc] 8 7 $2,550.00 $2,550.00 $1,479.00 $2,958.00 $2,461.00 2025-09-11
27913186 CDM Tocilizumab 200 Mg/10 Ml Inj [Bchc] 8 7 $2,550.00 $2,550.00 $1,479.00 $2,958.00 $2,461.00 2025-09-11
8597665 CDM Darbepoetin Alfa 200 Mcg/0.4 Ml Inj [Bchc] 8 7 $2,538.00 $2,538.00 $1,472.00 $2,944.00 $2,449.00 2025-09-11
23301607 CDM Darbepoetin Alfa 150 Mcg/0.3 Ml Inj [Bchc] 8 7 $2,528.00 $2,528.00 $1,466.00 $2,932.00 $2,439.50 2025-09-11
24131924 CDM Romosozumab 105 Mg/1.17 Ml Sol[bchc] 8 7 $2,524.00 $2,524.00 $1,464.00 $2,928.00 $2,435.50 2025-09-11
27649044 CDM Jada System Hemorrhage Control System 8 7 $2,511.00 $2,511.00 $1,456.00 $2,913.00 $2,423.50 2025-09-11
77047 CPT MRI Breast Without Contrast Bilateral. 8 7 $2,510.00 $2,510.00 $1,456.00 $2,912.00 $2,422.50 2025-09-11
70336 CPT MRI Tmj 8 7 $2,510.00 $2,510.00 $1,456.00 $2,912.00 $2,422.50 2025-09-11
23571775 CDM Immune Globulin Iv/sq 10% Sol 10 Gm/100 Ml [Bchc] 8 7 $2,509.00 $2,509.00 $1,455.00 $2,910.00 $2,421.50 2025-09-11
24296567 CDM Gel-one Inj [Bchc] 8 7 $2,504.00 $2,504.00 $1,452.00 $2,905.00 $2,416.50 2025-09-11
44388 CPT 44388 Or Minor Diag Colonoscopy Thru Stoma, With Spec Collect 8 7 $2,503.00 $2,503.00 $1,452.00 $2,903.00 $2,415.50 2025-09-11
23277649 CDM Docetaxel 80mg/4 Ml Inj [Bchc] 8 7 $2,483.00 $2,483.00 $1,440.00 $2,880.00 $2,396.50 2025-09-11
70481 CPT CT Orbit Sella Etc. With Contrast 8 7 $2,483.00 $2,483.00 $1,440.00 $2,880.00 $2,396.50 2025-09-11
45379 CPT 45379 Or Minor Colonoscopy, Flex With Fb Removal 8 7 $2,479.00 $2,479.00 $1,438.00 $2,876.00 $2,392.50 2025-09-11
G0121 HCPCS G0121 Or Minor Colonoscopy, Low Risk, Mdcr 8 7 $2,468.00 $2,468.00 $1,431.00 $2,863.00 $2,381.50 2025-09-11
22364332 CDM Panitumumab 100 Mg/5 Ml Inj [Bchc] 8 7 $2,463.00 $2,463.00 $1,429.00 $2,857.00 $2,376.50 2025-09-11
72125 CPT CT Spine Cervical Without Contrast 8 7 $2,433.00 $2,433.00 $1,411.00 $2,822.00 $2,348.00 2025-09-11
19083 CPT US Breast Biopsy Perc Ndl Core Lt 8 7 $2,415.00 $2,415.00 $1,401.00 $2,801.00 $2,330.50 2025-09-11
72131 CPT CT Spine Lumbar Without Contrast 8 7 $2,408.00 $2,408.00 $1,397.00 $2,793.00 $2,324.00 2025-09-11
70488 CPT CT Maxillofacial With + Without Contrast 8 7 $2,408.00 $2,408.00 $1,397.00 $2,793.00 $2,324.00 2025-09-11
72128 CPT CT Spine Thoracic Without Contrast 8 7 $2,408.00 $2,408.00 $1,397.00 $2,793.00 $2,324.00 2025-09-11
70491 CPT CT Soft Tissue Neck With Contrast 8 7 $2,408.00 $2,408.00 $1,397.00 $2,793.00 $2,324.00 2025-09-11
73701 CPT CT Knee With Contrast Right 8 7 $2,408.00 $2,408.00 $1,397.00 $2,793.00 $2,324.00 2025-09-11
24025544 CDM Mitomycin 40 Mg Rec [Bchc] 8 7 $2,407.00 $2,407.00 $1,396.00 $2,792.00 $2,323.00 2025-09-11
45398 CPT 45398 Or Minor Colonoscopy, Flex, With Band Ligation 8 7 $2,374.00 $2,374.00 $1,377.00 $2,754.00 $2,291.00 2025-09-11
27842 CPT 27842 Ed Clsd Tx Ankle Disloc With Anes, W/without Fixation 8 7 $2,345.00 $2,345.00 $1,360.00 $2,720.00 $2,263.00 2025-09-11
23639419 CDM Immune Globulin Intravenous 10 Gm Powder Rec [Bchc] 8 7 $2,336.00 $2,336.00 $1,355.00 $2,710.00 $2,254.50 2025-09-11
23748698 CDM Cetuximab ***200 Mg/100 Ml*** Inj [Bchc] 8 7 $2,317.00 $2,317.00 $1,344.00 $2,688.00 $2,235.50 2025-09-11
73201 CPT CT Upper Extremity With Contrast Left 8 7 $2,308.00 $2,308.00 $1,339.00 $2,677.00 $2,227.50 2025-09-11
70480 CPT CT Orbit Sella Etc. Without Contrast 8 7 $2,308.00 $2,308.00 $1,339.00 $2,677.00 $2,227.50 2025-09-11
71250 CPT CT Chest Without Contrast 8 7 $2,308.00 $2,308.00 $1,339.00 $2,677.00 $2,227.50 2025-09-11
72192 CPT CT Pelvis Without Contrast 8 7 $2,308.00 $2,308.00 $1,339.00 $2,677.00 $2,227.50 2025-09-11
70460 CPT CT Head Or Brain With Contrast 8 7 $2,308.00 $2,308.00 $1,339.00 $2,677.00 $2,227.50 2025-09-11
74150 CPT CT Abdomen Without Contrast 8 7 $2,308.00 $2,308.00 $1,339.00 $2,677.00 $2,227.50 2025-09-11
77012 CPT CT Guided Needle Placement 8 7 $2,308.00 $2,308.00 $1,339.00 $2,677.00 $2,227.50 2025-09-11
78582 CPT Nm Lung Ventilation Perfusion 8 7 $2,308.00 $2,308.00 $1,339.00 $2,677.00 $2,227.50 2025-09-11
G0105 HCPCS G0105 Or Minor Colonoscopy, Hi Risk Screen, Mdcr 8 7 $2,303.00 $2,303.00 $1,336.00 $2,671.00 $2,222.50 2025-09-11
23071056 CDM Ixabepilone 15 Mg Vial Inj [Bchc] 8 7 $2,293.00 $2,293.00 $1,330.00 $2,660.00 $2,212.50 2025-09-11
8597761 CDM Epoetin Alfa 40,000 Units/ml Inj [Bchc] 8 7 $2,263.00 $2,263.00 $1,313.00 $2,625.00 $2,183.50 2025-09-11
45380 CPT Biopsy Exam Of Large Bowel Using An Endoscope 24 7 $2,503.00 $2,503.00 $502.00 $3,908.00 $2,166.00 2025-09-11
45337 CPT 45337 Or Minor Sigmoidoscopy, Flex With Decompression 8 7 $2,244.00 $2,244.00 $1,302.00 $2,603.00 $2,165.50 2025-09-11
22314546 CDM Nivolumab 40 Mg/4 Ml Inj [Bchc] 8 7 $2,237.00 $2,237.00 $1,297.00 $2,595.00 $2,159.00 2025-09-11
45386 CPT 45386 Or Minor Colonoscopy, Flex; With Balloon Dilation 8 7 $2,233.00 $2,233.00 $1,295.00 $2,590.00 $2,155.00 2025-09-11
43247 CPT 43247 Or Minor Transoral Egd, Flex With Fb Removal 8 7 $2,221.00 $2,221.00 $1,288.00 $2,576.00 $2,143.00 2025-09-11
70487 CPT CT Maxillofacial With Contrast 8 7 $2,207.00 $2,207.00 $1,280.00 $2,560.00 $2,130.00 2025-09-11
73700 CPT CT Lower Extremity Without Contrast Left 8 7 $2,207.00 $2,207.00 $1,280.00 $2,560.00 $2,130.00 2025-09-11
27401241 CDM Rasburicase 1.5 Mg Rec [Bchc] 8 7 $2,207.00 $2,207.00 $1,280.00 $2,560.00 $2,130.00 2025-09-11
78018 CPT Nm Thyroid Ca Mets Imaging Whole Body 8 7 $2,206.00 $2,206.00 $1,279.00 $2,559.00 $2,129.00 2025-09-11
93306 CPT 93306 Cc Echocardiogram Transthoracic 2d, With Doppler 8 7 $2,200.00 $2,200.00 $1,276.00 $2,552.00 $2,123.00 2025-09-11
45385 CPT Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope 24 7 $2,421.00 $2,421.00 $521.00 $3,851.00 $2,113.00 2025-09-11
27383770 CDM Sodium Hyaluronate 60 Mg/3 Ml Inj [Bchc] 8 7 $2,189.00 $2,189.00 $1,270.00 $2,539.00 $2,112.00 2025-09-11
45388 CPT 45388 Or Minor Colonoscopy, Flex, With Ablation 8 7 $2,188.00 $2,188.00 $1,269.00 $2,538.00 $2,111.00 2025-09-11
43255 CPT 43255 Or Minor Transoral Egd, Flex, With Bleeding Control 8 7 $2,150.00 $2,150.00 $1,247.00 $2,494.00 $2,075.00 2025-09-11
8597953 CDM Leuprolide 3.75 Mg/month IM Inj, ER [Bchc] 8 7 $2,136.00 $2,136.00 $1,239.00 $2,478.00 $2,061.50 2025-09-11
78315 CPT Nm Bone Three Phase Study 8 7 $2,122.00 $2,122.00 $1,231.00 $2,462.00 $2,047.50 2025-09-11
43251 CPT 43251 Or Minor Transoral Egd, Flex, With Snare Removal 8 7 $2,115.00 $2,115.00 $1,227.00 $2,453.00 $2,041.00 2025-09-11
73200 CPT CT Upper Extremity Without Contrast Left 8 7 $2,107.00 $2,107.00 $1,222.00 $2,444.00 $2,033.50 2025-09-11
70490 CPT CT Soft Tissue Neck Without Contrast 8 7 $2,107.00 $2,107.00 $1,222.00 $2,444.00 $2,033.50 2025-09-11
78709 CPT Nm Kidney Imaging With Flow With + Without Pharm 8 7 $2,107.00 $2,107.00 $1,222.00 $2,444.00 $2,033.50 2025-09-11
70450 CPT CT Scan 8 7 $2,107.00 $2,107.00 $1,222.00 $2,444.00 $2,033.50 2025-09-11
45990 CPT 45990 Or Minor Anorectal Surg Exam, With Anes 8 7 $2,100.00 $2,100.00 $1,218.00 $2,436.00 $2,026.50 2025-09-11
43239 CPT Biopsy Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope 24 7 $2,350.00 $2,350.00 $436.00 $3,598.00 $2,016.00 2025-09-11
25565 CPT 25565 Ed Clsd Tx Radial And Ulnar Fx With Manip 8 7 $2,085.00 $2,085.00 $1,209.00 $2,419.00 $2,012.00 2025-09-11
44389 CPT 44389 Or Minor Diag Colonoscopy Thru Stoma, With Biopsy 8 7 $2,079.00 $2,079.00 $1,206.00 $2,412.00 $2,006.50 2025-09-11
75989 CPT Xr Guidance For Percutaneous Drainage 8 7 $2,078.00 $2,078.00 $1,205.00 $2,410.00 $2,005.50 2025-09-11
23626615 CDM Immune Globulin Intravenous 5% 10 Gm/200 Ml Inj[bchc] 8 7 $2,074.00 $2,074.00 $1,203.00 $2,406.00 $2,001.50 2025-09-11
8597966 CDM Levonorgestrel 52 Mg Intrauteral Dev [Bchc] 8 7 $2,039.00 $2,039.00 $1,183.00 $2,365.00 $1,967.50 2025-09-11
45331 CPT 45331 Or Minor Sigmoidoscopy, Flex, With Biopsy 8 7 $2,030.00 $2,030.00 $1,177.00 $2,355.00 $1,959.00 2025-09-11
45382 CPT 45382 Or Minor Colonoscopy, Flex With Control Of Bleeding 8 7 $2,027.00 $2,027.00 $1,176.00 $2,351.00 $1,956.00 2025-09-11
45378 CPT Diagnostic Exam Of Large Bowel Using An Endoscope 24 7 $2,303.00 $2,303.00 $388.00 $3,448.00 $1,956.00 2025-09-11
73719 CPT MRI Foot With Contrast Left 8 7 $2,010.00 $2,010.00 $1,166.00 $2,332.00 $1,940.00 2025-09-11
64493 CPT Xr Spine Lumb Or Sac Facet Sngl Lvl 8 7 $2,007.00 $2,007.00 $1,164.00 $2,328.00 $1,937.00 2025-09-11
32408 CPT CT Guided Lung Biopsy 8 7 $2,000.00 $2,000.00 $1,160.00 $2,320.00 $1,930.00 2025-09-11
73725 CPT MRA Lower Extremity Left 16 7 $2,037.50 $2,037.50 $1,143.00 $2,442.00 $1,921.00 2025-09-11
43249 CPT 43249 Or Minor Transoral Egd, Flex, With Balloon Dilation 8 7 $1,986.00 $1,986.00 $1,152.00 $2,304.00 $1,916.50 2025-09-11
8597655 CDM Cyclophosphamide 1 G IV Inj [Bchc] 8 7 $1,984.00 $1,984.00 $1,151.00 $2,301.00 $1,914.50 2025-09-11
22562996 CDM Doxorubicin Liposomal **20 Mg/10 Ml** Inj [Bchc] 8 7 $1,977.00 $1,977.00 $1,147.00 $2,293.00 $1,908.00 2025-09-11
C1889 HCPCS Urolift System Bx/4 8 7 $1,950.00 $1,950.00 $1,131.00 $2,262.00 $1,882.00 2025-09-11
43246 CPT 43246 Or Minor Transoral Egd, Flex, With G-tube 8 7 $1,945.00 $1,945.00 $1,128.00 $2,256.00 $1,877.00 2025-09-11
8597820 CDM Fulvestrant 50 Mg/ml IM Inj [Bchc] 8 7 $1,929.00 $1,929.00 $1,119.00 $2,238.00 $1,861.50 2025-09-11
23767742 CDM Immune Globulin Intravenous **Privigen**5 Gm/50 Ml Inj[bchc] 8 7 $1,920.00 $1,920.00 $1,114.00 $2,227.00 $1,852.50 2025-09-11
78306 CPT Nm Bone Imaging Whole Body 8 7 $1,920.00 $1,920.00 $1,114.00 $2,227.00 $1,852.50 2025-09-11
78264 CPT Nm Gastric Emptying Study 8 7 $1,906.00 $1,906.00 $1,105.00 $2,211.00 $1,839.50 2025-09-11
78278 CPT Nm Gi Bleed Scan 8 7 $1,906.00 $1,906.00 $1,105.00 $2,211.00 $1,839.50 2025-09-11
78803 CPT Nm Bone Spect 8 7 $1,906.00 $1,906.00 $1,105.00 $2,211.00 $1,839.50 2025-09-11
64479 CPT Xr Spine Trans Inj Cerv Or Thor Sngl Lvl 8 7 $1,906.00 $1,906.00 $1,105.00 $2,211.00 $1,839.50 2025-09-11
70486 CPT CT Sinus Without Contrast 8 7 $1,906.00 $1,906.00 $1,105.00 $2,211.00 $1,839.50 2025-09-11
78227 CPT Nm Hida Scan With Cck 8 7 $1,906.00 $1,906.00 $1,105.00 $2,211.00 $1,839.50 2025-09-11
22819925 CDM Eribulin 1 Mg/2 Ml Inj [Bchc] 8 7 $1,901.00 $1,901.00 $1,103.00 $2,205.00 $1,834.50 2025-09-11
43235 CPT Diagnostic Exam Of Esophagus, Stomach Or Small Bowel Using An Endoscope 24 7 $2,127.00 $2,127.00 $339.00 $3,145.00 $1,796.50 2025-09-11
G0104 HCPCS G0104 Or Minor Sigmoidoscopy, Flex, Screening 8 7 $1,857.00 $1,857.00 $1,077.00 $2,154.00 $1,792.00 2025-09-11
78226 CPT Nm Hepatobiliary Duct System Imaging 8 7 $1,806.00 $1,806.00 $1,047.00 $2,095.00 $1,743.00 2025-09-11
78707 CPT Nm Kidney Imaging With Flow Without Pharm 8 7 $1,806.00 $1,806.00 $1,047.00 $2,095.00 $1,743.00 2025-09-11
78195 CPT Nm Lymphoscintigraphy 8 7 $1,806.00 $1,806.00 $1,047.00 $2,095.00 $1,743.00 2025-09-11
62284 CPT Bchc Xr Injection Myelogrict 8 7 $1,806.00 $1,806.00 $1,047.00 $2,095.00 $1,743.00 2025-09-11
29826 CPT Shaving Of Shoulder Bone Using Endoscope 16 7 $2,513.50 $2,513.50 $568.00 $4,696.00 $1,742.00 2025-09-11
15277 CPT 15277 Wnd Graft To Face/scalp/feet>100sqcm For 1st 100sqcm 8 7 $1,800.00 $1,800.00 $1,044.00 $2,088.00 $1,737.00 2025-09-11
15273 CPT 15273 Wnd Graft To Trunk/arms/legs>100sqcm For 1st 100sqcm 8 7 $1,800.00 $1,800.00 $1,044.00 $2,088.00 $1,737.00 2025-09-11
45335 CPT 45335 Or Minor Sigmoidoscopy, Flex, With Submucosal Inj 8 7 $1,798.00 $1,798.00 $1,043.00 $2,086.00 $1,735.00 2025-09-11
45381 CPT 45381 Or Minor Colonoscopy, Flex With Submucosal Inj 8 7 $1,786.00 $1,786.00 $1,036.00 $2,072.00 $1,723.50 2025-09-11
27752 CPT 27752 Ed Clsd Tx Tibial Shaft Fx With Manip 8 7 $1,775.00 $1,775.00 $1,030.00 $2,059.00 $1,713.00 2025-09-11
43250 CPT 43250 Or Minor Transoral Egd, Flex, With Hot Biopsy Forceps 8 7 $1,771.00 $1,771.00 $1,027.00 $2,054.00 $1,709.00 2025-09-11
27436017 CDM Rituximab Pvvr 100 Mg/10 Ml Inj [Bchc] 8 7 $1,770.00 $1,770.00 $1,027.00 $2,053.00 $1,708.00 2025-09-11
99291 CPT 99291 Facil Ed Critical Care, 1st Hour 8 7 $1,755.00 $1,755.00 $1,018.00 $2,036.00 $1,693.50 2025-09-11
64490 CPT Xr Spine Cerv Or Thor Facet Sngl Lvl 8 7 $1,738.00 $1,738.00 $1,008.00 $2,016.00 $1,677.00 2025-09-11
24122345 CDM Immune Globulin 10 Gm/100 Ml Inj **Octagam**[bchc] 8 7 $1,734.00 $1,734.00 $1,006.00 $2,011.00 $1,673.50 2025-09-11
47000 CPT Bchc Bx Of Liver Needle P 8 7 $1,731.00 $1,731.00 $1,004.00 $2,008.00 $1,670.50 2025-09-11
24069517 CDM Rituximab Abbs ***100 Mg/10 Ml***inj [Bchc] 8 7 $1,725.00 $1,725.00 $1,000.00 $2,001.00 $1,664.50 2025-09-11
19285 CPT US Breast Ndl Loc Lt 8 7 $1,720.00 $1,720.00 $998.00 $1,995.00 $1,659.50 2025-09-11
8597850 CDM Goserelin 3.6 Mg Subq Imp [Bchc] 8 7 $1,713.00 $1,713.00 $994.00 $1,987.00 $1,653.00 2025-09-11
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