Hospital

YORK GENERAL HEALTH CARE SERVICES

York, NE · CCN 281336 · Rates published

3,771 distinct procedures filed

12 distinct payers

61,265 rate rows

2026-02-10 last MRF observed

Data quality

61,199 of 61,265 rate rows are consumer-grade (99.9%)

66 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
per-diem day rate — not a per-procedure price	38
percent-of-charges filed in the dollar field — excluded from medians	24
exceeds 10× this hospital's gross charge — excluded from medians	4

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

Source MRF file	https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbYGHYORKNE&type=CDMWithoutLabel&fileType=CSV
Found on page	https://apps.para-hcfs.com/PTT/FinalLinks/York_V2.aspx
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-13
Content fingerprint	98f62c39267b4184… · 24,540,968 bytes · first seen 2026-05-14

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
J2350 HCPCS	Injection, Ocrelizumab, 1 Mg	12	$15,358.20	$33,159.75	$24,258.97	nat. median $133 outlier · 182.5×
J9228 HCPCS	Injection, Ipilimumab, 1 Mg	12	$7,787.21	$55,169.35	$21,182.71	nat. median $6,073 outlier · 3.5×
J1303 HCPCS	Injection, Ravulizumab-cwvz, 10 Mg	12	$6,240.65	$47,916.05	$17,833.42	nat. median $504 outlier · 35.4×
J3357 HCPCS	Ustekinumab, For Subcutaneous Injection, 1 Mg	12	$9,727.32	$21,002.17	$15,364.74	nat. median $20,264 0.8× median
J9144 HCPCS	Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj	12	$7,907.50	$17,073.02	$12,490.26	nat. median $114 outlier · 109.1×
J2323 HCPCS	Injection, Natalizumab, 1 Mg	12	$7,612.81	$16,436.76	$12,024.78	nat. median $50 outlier · 238.4×
J3380 HCPCS	Injection, Vedolizumab, Intravenous, 1 Mg	12	$7,478.04	$16,145.77	$11,811.90	nat. median $59 outlier · 200.9×
J9022 HCPCS	Injection, Atezolizumab, 10 Mg	12	$5,617.85	$20,098.25	$10,719.06	nat. median $1,229 outlier · 8.7×
J3101 HCPCS	Injection, Tenecteplase, 1 Mg	12	$6,735.85	$14,543.31	$10,639.58	nat. median $498 outlier · 21.4×
J2506 HCPCS	Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg	12	$6,253.87	$13,502.68	$9,878.27	nat. median $916 outlier · 10.8×
6200992 CDM	Strattice 10 X 20 Cm Lifecell Tissue	12	$5,923.50	$12,789.38	$9,356.44	—
J9303 HCPCS	Injection, Panitumumab, 10 Mg	12	$5,790.84	$12,502.95	$9,146.90	nat. median $869 outlier · 10.5×
J9306 HCPCS	Injection, Pertuzumab, 1 Mg	12	$5,759.20	$12,434.65	$9,096.92	nat. median $43 outlier · 213.2×
J9302 HCPCS	Injection, Ofatumumab, 10 Mg	12	$5,724.60	$12,359.93	$9,042.26	nat. median $239 outlier · 37.9×
J0896 HCPCS	Injection, Luspatercept-aamt, 0.25 Mg	12	$3,640.01	$21,066.20	$8,808.05	nat. median $228 outlier · 38.7×
J0517 HCPCS	Injection, Benralizumab, 1 Mg	12	$5,245.33	$11,325.14	$8,285.24	nat. median $404 outlier · 20.5×
6210030 CDM	Mesh Phasix St 8x10	12	$5,193.76	$11,213.80	$8,203.78	—
J9271 HCPCS	Injection, Pembrolizumab, 1 Mg	12	$5,137.75	$11,092.87	$8,115.31	nat. median $127 outlier · 63.9×
J2783 HCPCS	Injection, Rasburicase, 0.5 Mg	12	$4,973.43	$10,738.09	$7,855.76	nat. median $1,129 outlier · 7.0×
J2353 HCPCS	Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg	12	$4,218.81	$13,437.70	$7,666.28	nat. median $1,956 outlier · 3.9×
6200299 CDM	Hip Prosthesis	12	$4,254.80	$9,186.50	$6,720.65	—
J9354 HCPCS	Injection, Ado-trastuzumab Emtansine, 1 Mg	12	$3,508.96	$11,878.18	$6,538.82	nat. median $4,004 1.6× median
Q5111 HCPCS	Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg	12	$4,133.98	$8,925.63	$6,529.80	nat. median $665 outlier · 9.8×
Q5108 HCPCS	Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg	12	$4,133.98	$8,925.63	$6,529.80	nat. median $418 outlier · 15.6×
J0135 HCPCS	Injection, Adalimumab, 20 Mg	12	$3,974.41	$8,581.11	$6,277.76	nat. median $3,520 1.8× median
50590 HCPCS	Shock Wave Crushing Of Kidney Stones	12	$3,575.99	$7,720.89	$5,648.44	nat. median $4,399 1.3× median
J0717 HCPCS	Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm…	12	$2,598.02	$10,812.57	$5,308.65	nat. median $29 outlier · 182.9×
5410106 CDM	Drsg Dermal Regeneration 4x10	12	$3,305.61	$7,137.11	$5,221.36	—
J3590 HCPCS	Unclassified Biologics	12	$3,297.45	$7,119.49	$5,208.47	nat. median $1,549 outlier · 3.4×
J2182 HCPCS	Injection, Mepolizumab, 1 Mg	12	$3,271.75	$7,064.01	$5,167.88	nat. median $80 outlier · 64.9×
J1602 HCPCS	Injection, Golimumab, 1 Mg, For Intravenous Use	12	$2,077.59	$11,776.63	$4,970.07	nat. median $55 outlier · 91.0×
6210085 CDM	Mesh Phasix St 15x20	12	$3,103.98	$6,701.78	$4,902.88	—
J7168 HCPCS	Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity	12	$3,094.06	$6,680.35	$4,887.20	nat. median $589 outlier · 8.3×
J9299 HCPCS	Injection, Nivolumab, 1 Mg	12	$1,299.14	$14,798.96	$4,829.61	nat. median $1,811 outlier · 2.7×
78814 HCPCS	Nuclear Medicine Study Limited Area With CT Scan	12	$2,993.76	$6,463.80	$4,728.78	nat. median $1,613 outlier · 2.9×
78815 HCPCS	Nuclear Medicine Study From Skull Base To Mid-thigh With CT Scan	12	$2,993.76	$6,463.80	$4,728.78	nat. median $1,679 outlier · 2.8×
78816 HCPCS	Nuclear Medicine Study Whole Body With CT Scan	12	$2,993.76	$6,463.80	$4,728.78	nat. median $1,696 outlier · 2.8×
78459 HCPCS	Nuclear Medicine Study Of Heart Muscle With Metabolic Evaluation	12	$2,993.76	$6,463.80	$4,728.78	nat. median $1,344 outlier · 3.5×
78608 HCPCS	Nuclear Medicine Study Of Brain With Metabolic Evaluation	12	$2,993.76	$6,463.80	$4,728.78	nat. median $1,613 outlier · 2.9×
78813 HCPCS	Nuclear Medicine Study Whole Body	12	$2,993.76	$6,463.80	$4,728.78	nat. median $1,497 outlier · 3.2×
J2796 HCPCS	Injection, Romiplostim, 10 Micrograms	12	$2,316.62	$9,597.38	$4,723.45	nat. median $2,653 1.8× median
5401064 CDM	Primatrix-10cm X 12cm	12	$2,939.53	$6,346.71	$4,643.12	—
5401063 CDM	Primatrix - 8cm X 12cm	12	$2,713.48	$5,858.65	$4,286.06	—
6210111 CDM	Mesh Phasix 6x8	12	$2,684.88	$5,796.90	$4,240.89	—
58573 HCPCS	Removal Of Uterus, Tubes, And/or Ovaries Through Abdomen Using An Endoscope, Mor…	8	$998.12	$4,278.75	$4,171.78	nat. median $10,411 outlier · 0.4×
J9358 HCPCS	Injection, Fam-trastuzumab Deruxtecan-nxki, 1 Mg	12	$2,583.81	$5,578.69	$4,081.25	nat. median $67 outlier · 60.8×
6202600 CDM	Lithotripsy Supply	12	$2,536.49	$5,476.51	$4,006.50	—
49406 HCPCS	Drainage Of Fluid Collection Of Abdominal Cavity By Tube Using Imaging Guidance	12	$2,454.54	$5,299.58	$3,877.06	nat. median $1,917 outlier · 2.0×
58572 HCPCS	Removal Of Uterus Through Abdomen Using An Endoscope, More Than 250.0 G	8	$854.02	$3,724.25	$3,631.14	nat. median $10,125 outlier · 0.4×
58571 HCPCS	Removal Of Uterus, Tubes, And/or Ovaries Through Abdomen Using An Endoscope, 250…	8	$748.43	$3,677.25	$3,585.32	nat. median $10,013 outlier · 0.4×

Other procedures at this hospital

Browse this hospital's 3,771 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

J2350	HCPCS	Injection, Ocrelizumab, 1 Mg	12	12	$34,905.00	$34,905.00	$15,358.20	$33,159.75	$24,258.97	2026-02-10
J9228	HCPCS	Injection, Ipilimumab, 1 Mg	24	12	$37,885.60	$37,885.60	$7,787.21	$55,169.35	$21,182.71	2026-02-10
J1303	HCPCS	Injection, Ravulizumab-cwvz, 10 Mg	24	12	$32,310.62	$32,310.62	$6,240.65	$47,916.05	$17,833.42	2026-02-10
J3357	HCPCS	Ustekinumab, For Subcutaneous Injection, 1 Mg	12	12	$22,107.55	$22,107.55	$9,727.32	$21,002.17	$15,364.74	2026-02-10
J9144	HCPCS	Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj	12	12	$17,971.60	$17,971.60	$7,907.50	$17,073.02	$12,490.26	2026-02-10
J2323	HCPCS	Injection, Natalizumab, 1 Mg	12	12	$17,301.85	$17,301.85	$7,612.81	$16,436.76	$12,024.78	2026-02-10
J3380	HCPCS	Injection, Vedolizumab, Intravenous, 1 Mg	12	12	$16,995.55	$16,995.55	$7,478.04	$16,145.77	$11,811.90	2026-02-10
J9022	HCPCS	Injection, Atezolizumab, 10 Mg	24	12	$16,961.95	$16,961.95	$5,617.85	$20,098.25	$10,719.06	2026-02-10
J3101	HCPCS	Injection, Tenecteplase, 1 Mg	12	12	$15,308.75	$15,308.75	$6,735.85	$14,543.31	$10,639.58	2026-02-10
J2506	HCPCS	Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg	12	12	$14,213.35	$14,213.35	$6,253.87	$13,502.68	$9,878.27	2026-02-10
6200992	CDM	Strattice 10 X 20 Cm Lifecell Tissue	12	12	$13,462.50	$13,462.50	$5,923.50	$12,789.38	$9,356.44	2026-02-10
J9303	HCPCS	Injection, Panitumumab, 10 Mg	12	12	$13,161.00	$13,161.00	$5,790.84	$12,502.95	$9,146.90	2026-02-10
J9306	HCPCS	Injection, Pertuzumab, 1 Mg	12	12	$13,089.10	$13,089.10	$5,759.20	$12,434.65	$9,096.92	2026-02-10
J9302	HCPCS	Injection, Ofatumumab, 10 Mg	12	12	$13,010.45	$13,010.45	$5,724.60	$12,359.93	$9,042.26	2026-02-10
J0896	HCPCS	Injection, Luspatercept-aamt, 0.25 Mg	24	12	$15,223.85	$15,223.85	$3,640.01	$21,066.20	$8,808.05	2026-02-10
J0517	HCPCS	Injection, Benralizumab, 1 Mg	12	12	$11,921.20	$11,921.20	$5,245.33	$11,325.14	$8,285.24	2026-02-10
6210030	CDM	Mesh Phasix St 8x10	12	12	$11,804.00	$11,804.00	$5,193.76	$11,213.80	$8,203.78	2026-02-10
J9271	HCPCS	Injection, Pembrolizumab, 1 Mg	12	12	$11,676.70	$11,676.70	$5,137.75	$11,092.87	$8,115.31	2026-02-10
J2783	HCPCS	Injection, Rasburicase, 0.5 Mg	12	12	$11,303.25	$11,303.25	$4,973.43	$10,738.09	$7,855.76	2026-02-10
J2353	HCPCS	Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg	24	12	$11,866.58	$11,866.58	$4,218.81	$13,437.70	$7,666.28	2026-02-10
6200299	CDM	Hip Prosthesis	12	12	$9,670.00	$9,670.00	$4,254.80	$9,186.50	$6,720.65	2026-02-10
J9354	HCPCS	Injection, Ado-trastuzumab Emtansine, 1 Mg	24	12	$10,239.12	$10,239.12	$3,508.96	$11,878.18	$6,538.82	2026-02-10
Q5108	HCPCS	Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg	12	12	$9,395.40	$9,395.40	$4,133.98	$8,925.63	$6,529.80	2026-02-10
Q5111	HCPCS	Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg	12	12	$9,395.40	$9,395.40	$4,133.98	$8,925.63	$6,529.80	2026-02-10
J0135	HCPCS	Injection, Adalimumab, 20 Mg	12	12	$9,032.75	$9,032.75	$3,974.41	$8,581.11	$6,277.76	2026-02-10
50590	HCPCS	Shock Wave Crushing Of Kidney Stones	12	12	$8,127.25	$8,127.25	$3,575.99	$7,720.89	$5,648.44	2026-02-10
J0717	HCPCS	Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm…	24	12	$8,643.12	$8,643.12	$2,598.02	$10,812.57	$5,308.65	2026-02-10
5410106	CDM	Drsg Dermal Regeneration 4x10	12	12	$7,512.75	$7,512.75	$3,305.61	$7,137.11	$5,221.36	2026-02-10
J3590	HCPCS	Unclassified Biologics	12	12	$7,494.20	$7,494.20	$3,297.45	$7,119.49	$5,208.47	2026-02-10
J2182	HCPCS	Injection, Mepolizumab, 1 Mg	12	12	$7,435.80	$7,435.80	$3,271.75	$7,064.01	$5,167.88	2026-02-10
J1602	HCPCS	Injection, Golimumab, 1 Mg, For Intravenous Use	24	12	$8,559.12	$8,559.12	$2,077.59	$11,776.63	$4,970.07	2026-02-10
6210085	CDM	Mesh Phasix St 15x20	12	12	$7,054.50	$7,054.50	$3,103.98	$6,701.78	$4,902.88	2026-02-10
J7168	HCPCS	Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity	12	12	$7,031.95	$7,031.95	$3,094.06	$6,680.35	$4,887.20	2026-02-10
J9299	HCPCS	Injection, Nivolumab, 1 Mg	24	12	$9,265.23	$9,265.23	$1,299.14	$14,798.96	$4,829.61	2026-02-10
78815	HCPCS	Nuclear Medicine Study From Skull Base To Mid-thigh With CT Scan	12	12	$6,804.00	$6,804.00	$2,993.76	$6,463.80	$4,728.78	2026-02-10
78608	HCPCS	Nuclear Medicine Study Of Brain With Metabolic Evaluation	12	12	$6,804.00	$6,804.00	$2,993.76	$6,463.80	$4,728.78	2026-02-10
78459	HCPCS	Nuclear Medicine Study Of Heart Muscle With Metabolic Evaluation	12	12	$6,804.00	$6,804.00	$2,993.76	$6,463.80	$4,728.78	2026-02-10
78816	HCPCS	Nuclear Medicine Study Whole Body With CT Scan	12	12	$6,804.00	$6,804.00	$2,993.76	$6,463.80	$4,728.78	2026-02-10
78814	HCPCS	Nuclear Medicine Study Limited Area With CT Scan	12	12	$6,804.00	$6,804.00	$2,993.76	$6,463.80	$4,728.78	2026-02-10
78813	HCPCS	Nuclear Medicine Study Whole Body	12	12	$6,804.00	$6,804.00	$2,993.76	$6,463.80	$4,728.78	2026-02-10
J2796	HCPCS	Injection, Romiplostim, 10 Micrograms	24	12	$7,683.77	$7,683.77	$2,316.62	$9,597.38	$4,723.45	2026-02-10
5401064	CDM	Primatrix-10cm X 12cm	12	12	$6,680.75	$6,680.75	$2,939.53	$6,346.71	$4,643.12	2026-02-10
5401063	CDM	Primatrix - 8cm X 12cm	12	12	$6,167.00	$6,167.00	$2,713.48	$5,858.65	$4,286.06	2026-02-10
6210111	CDM	Mesh Phasix 6x8	12	12	$6,102.00	$6,102.00	$2,684.88	$5,796.90	$4,240.89	2026-02-10
58573	HCPCS	Removal Of Uterus, Tubes, And/or Ovaries Through Abdomen Using An Endoscope, Mor…	8	8	$4,278.75	$4,278.75	$998.12	$4,278.75	$4,171.78	2026-02-10
J9358	HCPCS	Injection, Fam-trastuzumab Deruxtecan-nxki, 1 Mg	12	12	$5,872.30	$5,872.30	$2,583.81	$5,578.69	$4,081.25	2026-02-10
6202600	CDM	Lithotripsy Supply	12	12	$5,764.75	$5,764.75	$2,536.49	$5,476.51	$4,006.50	2026-02-10
49406	HCPCS	Drainage Of Fluid Collection Of Abdominal Cavity By Tube Using Imaging Guidance	12	12	$5,578.50	$5,578.50	$2,454.54	$5,299.58	$3,877.06	2026-02-10
58572	HCPCS	Removal Of Uterus Through Abdomen Using An Endoscope, More Than 250.0 G	8	8	$3,724.25	$3,724.25	$854.02	$3,724.25	$3,631.14	2026-02-10
58571	HCPCS	Removal Of Uterus, Tubes, And/or Ovaries Through Abdomen Using An Endoscope, 250…	8	8	$3,677.25	$3,677.25	$748.43	$3,677.25	$3,585.32	2026-02-10
6202501	CDM	Laser Turp Supply Pack	12	12	$5,147.25	$5,147.25	$2,264.79	$4,889.89	$3,577.34	2026-02-10
74174	HCPCS	CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast	12	12	$5,138.75	$5,138.75	$2,261.05	$4,881.81	$3,571.43	2026-02-10
J9312	HCPCS	Injection, Rituximab, 10 Mg	24	12	$6,481.77	$6,481.77	$1,076.06	$9,992.05	$3,475.61	2026-02-10
J0401	HCPCS	Injection, Aripiprazole (abilify Maintena), 1 Mg	24	12	$5,226.40	$5,226.40	$1,997.97	$5,616.35	$3,457.54	2026-02-10
J3111	HCPCS	Injection, Romosozumab-aqqg, 1 Mg	12	12	$4,955.75	$4,955.75	$2,180.53	$4,707.96	$3,444.24	2026-02-10
J9400	HCPCS	Injection, Ziv-aflibercept, 1 Mg	24	12	$5,582.70	$5,582.70	$1,700.29	$6,936.05	$3,441.78	2026-02-10
6200975	CDM	Trinity Bone Graft 5cc	12	12	$4,935.75	$4,935.75	$2,171.73	$4,688.96	$3,430.35	2026-02-10
58544	HCPCS	Partial Removal Of Uterus, Tubes, And/or Ovaries With Retention Of Cervix Using …	8	8	$3,515.25	$3,515.25	$731.45	$3,515.25	$3,427.37	2026-02-10
58293	HCPCS	Vaginal Hysterectomy, For Uterus Greater Than 250 G; With Colpo-urethrocystopexy…	5	5	$3,380.75	$3,380.75	$3,211.71	$3,380.75	$3,380.75	2026-02-10
5410181	CDM	Drsg Stravix 3cmx6cm	12	12	$4,836.00	$4,836.00	$2,127.84	$4,594.20	$3,361.02	2026-02-10
58152	HCPCS	Removal Of Uterus And Cervix Through Abdomen With Repair Of Vagina	8	8	$3,352.75	$3,352.75	$992.99	$3,352.75	$3,268.93	2026-02-10
58554	HCPCS	Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, More…	8	8	$3,328.25	$3,328.25	$1,055.18	$3,328.25	$3,245.05	2026-02-10
J9395	HCPCS	Injection, Fulvestrant, 25 Mg	12	12	$4,592.60	$4,592.60	$2,020.74	$4,362.97	$3,191.86	2026-02-10
58292	HCPCS	Removal Of Uterus, Tubes, And/or Ovaries With Repair Of Herniated Bowel Through …	8	8	$3,252.00	$3,252.00	$1,047.99	$3,252.00	$3,170.70	2026-02-10
64561	HCPCS	Insertion Of Sacral Nerve Neurostimulator Electrode Array	8	8	$3,212.25	$3,212.25	$250.31	$3,212.25	$3,131.94	2026-02-10
58294	HCPCS	Removal Of Uterus With Repair Of Herniated Bowel Through Vagina. 250.0 G Or More	8	8	$3,203.00	$3,203.00	$974.19	$3,203.00	$3,122.93	2026-02-10
58552	HCPCS	Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, 250.…	8	8	$3,199.25	$3,199.25	$797.31	$3,199.25	$3,119.27	2026-02-10
58543	HCPCS	Partial Removal Of Uterus With Retention Of Cervix Using An Endoscope, More Than…	8	8	$3,192.75	$3,192.75	$676.45	$3,192.75	$3,112.93	2026-02-10
J0897	HCPCS	Injection, Denosumab, 1 Mg	24	12	$4,932.20	$4,932.20	$1,584.20	$5,950.75	$3,088.28	2026-02-10
58291	HCPCS	Removal Of Uterus, Tubes, And/or Ovaries Through Vagina, More Than 250.0 G	8	8	$3,167.00	$3,167.00	$995.11	$3,167.00	$3,087.82	2026-02-10
J3358	HCPCS	Ustekinumab, For Intravenous Injection, 1 Mg	12	12	$4,409.80	$4,409.80	$1,940.31	$4,189.31	$3,064.81	2026-02-10
J9330	HCPCS	Injection, Temsirolimus, 1 Mg	12	12	$4,400.45	$4,400.45	$1,936.20	$4,180.43	$3,058.32	2026-02-10
58542	HCPCS	Partial Removal Of Uterus, Tubes, And/or Ovaries With Retention Of Cervix Using …	8	8	$3,134.75	$3,134.75	$669.56	$3,134.75	$3,056.38	2026-02-10
J9305	HCPCS	Injection, Pemetrexed, Not Otherwise Specified, 10 Mg	24	12	$5,638.15	$5,638.15	$952.34	$8,656.31	$3,032.71	2026-02-10
70553	HCPCS	MRI Scan Of Brain Before And After Contrast	12	12	$4,348.50	$4,348.50	$1,913.34	$4,131.08	$3,022.21	2026-02-10
71275	HCPCS	CT Scan Of Blood Vessels Of Chest With Contrast	12	12	$4,322.25	$4,322.25	$1,901.79	$4,106.14	$3,003.97	2026-02-10
J9217	HCPCS	Leuprolide Acetate (for Depot Suspension), 7.5 Mg	96	12	$4,089.80	$4,089.80	$16.41	$15,539.67	$2,960.40	2026-02-10
58553	HCPCS	Removal Of Uterus Through Vagina Using An Endoscope, More Than 250.0	8	8	$3,006.00	$3,006.00	$897.63	$3,006.00	$2,930.85	2026-02-10
58570	HCPCS	Removal Of Uterus Through Abdomen Using An Endoscope, 250.0 G Or Less	8	8	$2,994.00	$2,994.00	$659.51	$2,994.00	$2,919.15	2026-02-10
J1568	HCPCS	Injection, Immune Globulin, (octagam), Intravenous, Non-lyophilized (e.g., Liqui…	24	12	$5,249.80	$5,249.80	$1,036.84	$7,735.99	$2,910.81	2026-02-10
58150	HCPCS	Removal Of Uterus And Cervix Through Abdomen	8	8	$2,966.00	$2,966.00	$842.70	$2,966.00	$2,891.85	2026-02-10
72156	HCPCS	MRI Scan Of Upper Spinal Canal Before And After Contrast	12	12	$4,113.50	$4,113.50	$1,809.94	$3,907.83	$2,858.89	2026-02-10
5401062	CDM	Primatrix - 8cm X 8cm	12	12	$4,111.50	$4,111.50	$1,809.06	$3,905.93	$2,857.49	2026-02-10
74178	HCPCS	CT Scan Of Abdomen And Pelvis Before And After Contrast	12	12	$5,995.75	$5,995.75	$2,638.13	$5,695.96	$2,841.39	2026-02-10
J2426	HCPCS	Injection, Paliperidone Palmitate Extended Release (invega Sustenna), 1 Mg	48	12	$4,310.30	$4,310.30	$1,164.33	$6,729.52	$2,815.36	2026-02-10
58550	HCPCS	Removal Of Uterus Through Vagina Using An Endoscope, 250.0 G Or Less	8	8	$2,877.00	$2,877.00	$716.19	$2,877.00	$2,805.07	2026-02-10
J0875	HCPCS	Injection, Dalbavancin, 5 Mg	12	12	$4,029.70	$4,029.70	$1,773.07	$3,828.22	$2,800.64	2026-02-10
58290	HCPCS	Removal Of Uterus Through Vagina, More Than 250.0 G	8	8	$2,845.75	$2,845.75	$921.47	$2,845.75	$2,774.61	2026-02-10
6200622	CDM	Nails-titanium Ctf/11mm Distal/sterile	12	12	$3,978.75	$3,978.75	$1,750.65	$3,779.81	$2,765.23	2026-02-10
6200623	CDM	Nails-titanium Ctf/12mm Distal/sterile	12	12	$3,978.75	$3,978.75	$1,750.65	$3,779.81	$2,765.23	2026-02-10
6200621	CDM	Nails-titanium Ctf/10mm Distal/sterile	12	12	$3,978.75	$3,978.75	$1,750.65	$3,779.81	$2,765.23	2026-02-10
J1438	HCPCS	Injection, Etanercept, 25 Mg (code May Be Used For Medicare When Drug Administer…	12	12	$3,952.20	$3,952.20	$1,738.97	$3,754.59	$2,746.78	2026-02-10
58541	HCPCS	Partial Removal Of Uterus With Retention Of Cervix Using An Endoscope, 250.0 G O…	8	8	$2,812.50	$2,812.50	$593.83	$2,812.50	$2,742.19	2026-02-10
Q5119	HCPCS	Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg	24	12	$5,046.57	$5,046.57	$865.57	$7,719.65	$2,722.13	2026-02-10
6200592	CDM	Wrist Jack / External Fixation Device	12	12	$3,883.75	$3,883.75	$1,708.85	$3,689.56	$2,699.20	2026-02-10
58267	HCPCS	Removal Of Uterus With Repair For Incontinence, 250.0 G Or Less	8	8	$2,751.75	$2,751.75	$856.59	$2,751.75	$2,682.95	2026-02-10
58263	HCPCS	Removal Of Uterus, Tubes, And/or Ovaries With Repair Of Herniated Bowel Through …	8	8	$2,751.75	$2,751.75	$799.93	$2,751.75	$2,682.95	2026-02-10
6210319	CDM	Implant Endomaxx 19x70 Maxx197	12	12	$3,837.75	$3,837.75	$1,688.61	$3,645.86	$2,667.24	2026-02-10
J1459	HCPCS	Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui…	36	12	$3,919.95	$3,919.95	$956.45	$7,041.78	$2,663.26	2026-02-10
74262	HCPCS	Diagnostic CT Scan Of Large Intestine With Contrast	12	12	$3,826.00	$3,826.00	$1,683.44	$3,634.70	$2,659.07	2026-02-10
J9264	HCPCS	Injection, Paclitaxel Protein-bound Particles, 1 Mg	12	12	$3,821.50	$3,821.50	$1,681.46	$3,630.43	$2,655.94	2026-02-10
6200613	CDM	Plate-3.5mm Lcp Proximal Humerus/long	12	12	$3,813.50	$3,813.50	$1,677.94	$3,622.83	$2,650.39	2026-02-10
74175	HCPCS	CT Scan Of Blood Vessels Of Abdomen With Contrast	12	12	$3,812.00	$3,812.00	$1,677.28	$3,621.40	$2,649.34	2026-02-10
77047	HCPCS	MRI Scan Of Both Breasts Without Contrast	12	12	$3,812.00	$3,812.00	$1,677.28	$3,621.40	$2,649.34	2026-02-10
75635	HCPCS	CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast	12	12	$3,812.00	$3,812.00	$1,677.28	$3,621.40	$2,649.34	2026-02-10
6210102	CDM	Catheter Spyglass	12	12	$3,790.00	$3,790.00	$1,667.60	$3,600.50	$2,634.05	2026-02-10
72149	HCPCS	MRI Scan Of Lower Spinal Canal With Contrast	12	12	$3,789.25	$3,789.25	$1,667.27	$3,599.79	$2,633.53	2026-02-10
J9355	HCPCS	Injection, Trastuzumab, Excludes Biosimilar, 10 Mg	12	12	$3,775.00	$3,775.00	$1,661.00	$3,586.25	$2,623.62	2026-02-10
J9035	HCPCS	Injection, Bevacizumab, 10 Mg	24	12	$4,707.10	$4,707.10	$941.31	$6,911.11	$2,616.65	2026-02-10
95808	HCPCS	Sleep Study In Sleep Lab	12	12	$3,744.25	$3,744.25	$1,647.47	$3,557.04	$2,602.26	2026-02-10
95812	HCPCS	Measurement Of Brain Wave Activity (eeg), 41-60 Minutes	12	12	$3,744.25	$3,744.25	$1,647.47	$3,557.04	$2,602.26	2026-02-10
95827	HCPCS	Electroencephalogram (eeg); All Night Recording	12	12	$3,744.25	$3,744.25	$1,647.47	$3,557.04	$2,602.26	2026-02-10
95813	HCPCS	Measurement Of Brain Wave Activity (eeg), 61-119 Minutes	12	12	$3,744.25	$3,744.25	$1,647.47	$3,557.04	$2,602.26	2026-02-10
95807	HCPCS	Sleep Study Including Heart Rate And Breathing Attended By Technician	12	12	$3,744.25	$3,744.25	$1,647.47	$3,557.04	$2,602.26	2026-02-10
J9214	HCPCS	Injection, Interferon, Alfa-2b, Recombinant, 1 Million Units	12	12	$3,727.95	$3,727.95	$1,640.30	$3,541.55	$2,590.93	2026-02-10
74261	HCPCS	Diagnostic CT Scan Of Large Intestine Without Contrast	12	12	$3,698.75	$3,698.75	$1,627.45	$3,513.81	$2,570.63	2026-02-10
71552	HCPCS	MRI Scan Of Chest Before And After Contrast	12	12	$3,693.00	$3,693.00	$1,624.92	$3,508.35	$2,566.64	2026-02-10
81163	HCPCS	Gene Analysis (breast Cancer 1 And 2) Of Full Sequence	12	12	$3,655.75	$3,655.75	$1,608.53	$3,472.96	$2,540.74	2026-02-10
81211	HCPCS	Brca1&2 Seq & Com Dup/del	12	12	$3,655.75	$3,655.75	$1,608.53	$3,472.96	$2,540.74	2026-02-10
72197	HCPCS	MRI Scan Of Pelvis Before And After Contrast	12	12	$3,648.25	$3,648.25	$1,605.23	$3,465.84	$2,535.53	2026-02-10
200012	CDM	Intensive Care Unit - General Classification	6	6	$2,658.00	$2,658.00	$2,525.10	$2,525.10	$2,525.10	2026-02-10
70546	HCPCS	MRI Scan Of Blood Vessels Of Head Before And After Contrast	12	12	$3,623.50	$3,623.50	$1,594.34	$3,442.33	$2,518.34	2026-02-10
74183	HCPCS	MRI Scan Of Abdomen Before And After Contrast	12	12	$3,620.00	$3,620.00	$1,592.80	$3,439.00	$2,515.90	2026-02-10
59514	HCPCS	Cesarean Delivery	8	8	$2,579.25	$2,579.25	$710.53	$2,579.25	$2,514.77	2026-02-10
71270	HCPCS	CT Scan Of Chest Before And After Contrast	12	12	$3,593.00	$3,593.00	$1,580.92	$3,413.35	$2,497.14	2026-02-10
74177	HCPCS	CT Scan Of Abdomen And Pelvis With Contrast	12	12	$5,138.75	$5,138.75	$2,261.05	$4,881.81	$2,491.05	2026-02-10
J1448	HCPCS	Injection, Trilaciclib, 1mg	12	12	$3,578.65	$3,578.65	$1,574.61	$3,399.72	$2,487.16	2026-02-10
74263	HCPCS	Screening CT Scan Of Large Intestine	12	12	$3,569.00	$3,569.00	$1,570.36	$3,390.55	$2,480.45	2026-02-10
72157	HCPCS	MRI Scan Of Middle Spinal Canal Before And After Contrast	12	12	$3,554.75	$3,554.75	$1,564.09	$3,377.01	$2,470.55	2026-02-10
73723	HCPCS	MRI Scan Of Leg Joint Before And After Contrast	12	12	$3,542.75	$3,542.75	$1,558.81	$3,365.61	$2,462.21	2026-02-10
73220	HCPCS	MRI Scan Of Arm Before And After Contrast	12	12	$3,542.75	$3,542.75	$1,558.81	$3,365.61	$2,462.21	2026-02-10
73720	HCPCS	MRI Scan Of Leg Before And After Contrast	12	12	$3,542.75	$3,542.75	$1,558.81	$3,365.61	$2,462.21	2026-02-10
73223	HCPCS	MRI Scan Of Arm Joint Before And After Contrast	12	12	$3,542.75	$3,542.75	$1,558.81	$3,365.61	$2,462.21	2026-02-10
J9033	HCPCS	Injection, Bendamustine Hydrochloride, 1 Mg	24	12	$4,417.17	$4,417.17	$890.30	$6,470.40	$2,459.53	2026-02-10
58180	HCPCS	Removal Of Uterus Through Abdomen	8	8	$2,518.50	$2,518.50	$786.50	$2,518.50	$2,455.54	2026-02-10
6210031	CDM	Mesh Ventralight 12x14	12	12	$3,524.75	$3,524.75	$1,550.89	$3,348.51	$2,449.70	2026-02-10
58262	HCPCS	Removal Of Uterus, Tubes, And/or Ovaries Through Vagina, 250.0 G Or Less	8	8	$2,501.75	$2,501.75	$746.80	$2,501.75	$2,439.20	2026-02-10
58270	HCPCS	Removal Of Uterus With Repair Of Herniated Bowel Through Vagina, 250.0 G Or Less	8	8	$2,501.75	$2,501.75	$722.63	$2,501.75	$2,439.20	2026-02-10
27222	HCPCS	Closed Treatment Of Broken Hip Socket With Manipulation	8	8	$2,496.75	$2,496.75	$826.35	$2,496.75	$2,434.33	2026-02-10
72142	HCPCS	MRI Scan Of Upper Spinal Canal With Contrast	12	12	$3,498.25	$3,498.25	$1,539.23	$3,323.34	$2,431.28	2026-02-10
19081	HCPCS	Biopsy Of Breast And Placement Of Locating Device Using X-ray With Needle, First…	12	12	$3,457.75	$3,457.75	$1,521.41	$3,284.86	$2,403.14	2026-02-10
72147	HCPCS	MRI Scan Of Middle Spinal Canal With Contrast	12	12	$3,451.25	$3,451.25	$1,518.55	$3,278.69	$2,398.62	2026-02-10
6200612	CDM	Plate-3.5mm Lcp Proximal Humerus/stnrd	12	12	$3,450.75	$3,450.75	$1,518.33	$3,278.21	$2,398.27	2026-02-10
70552	HCPCS	MRI Scan Of Brain With Contrast	12	12	$3,447.25	$3,447.25	$1,516.79	$3,274.89	$2,395.84	2026-02-10
19083	HCPCS	Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth	12	12	$3,422.00	$3,422.00	$1,505.68	$3,250.90	$2,378.29	2026-02-10
Q5107	HCPCS	Injection, Bevacizumab-awwb, Biosimilar, (mvasi), 10 Mg	24	12	$4,174.30	$4,174.30	$847.55	$6,101.23	$2,327.89	2026-02-10
58260	HCPCS	Removal Of Uterus Through Vagina, 250.0 G Or Less	8	8	$2,376.75	$2,376.75	$676.52	$2,376.75	$2,317.33	2026-02-10
57280	HCPCS	Attachment Of Vagina To Rear Pelvic Bone	8	8	$2,367.25	$2,367.25	$783.72	$2,367.25	$2,308.07	2026-02-10
74170	HCPCS	CT Scan Of Abdomen Before And After Contrast	12	12	$3,303.25	$3,303.25	$1,453.43	$3,138.09	$2,295.76	2026-02-10
72194	HCPCS	CT Scan Of Pelvis Before And After Contrast	12	12	$3,303.25	$3,303.25	$1,453.43	$3,138.09	$2,295.76	2026-02-10
6210011	CDM	Mesh Phasix St Ops 11cm	12	12	$3,279.25	$3,279.25	$1,442.87	$3,115.29	$2,279.08	2026-02-10
71551	HCPCS	MRI Scan Of Chest With Contrast	12	12	$3,267.50	$3,267.50	$1,437.70	$3,104.13	$2,270.91	2026-02-10
73219	HCPCS	MRI Scan Of Arm With Contrast	12	12	$3,266.50	$3,266.50	$1,437.26	$3,103.18	$2,270.22	2026-02-10
59151	HCPCS	Removal Of Ovarian Or Tubal Pregnancy With Removal Of Ovary And/or Tube Using An…	8	8	$2,321.25	$2,321.25	$602.50	$2,321.25	$2,263.22	2026-02-10
6210015	CDM	Mesh Phasix St Echo 2 4.5'	12	12	$3,249.00	$3,249.00	$1,429.56	$3,086.55	$2,258.06	2026-02-10
74182	HCPCS	MRI Scan Of Abdomen With Contrast	12	12	$3,230.50	$3,230.50	$1,421.42	$3,068.98	$2,245.20	2026-02-10
J0129	HCPCS	Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere…	12	12	$3,224.20	$3,224.20	$1,418.65	$3,062.99	$2,240.82	2026-02-10
70549	HCPCS	MRI Scan Of Blood Vessels Of Neck Before And After Contrast	12	12	$3,222.25	$3,222.25	$1,417.79	$3,061.14	$2,239.47	2026-02-10
J1439	HCPCS	Injection, Ferric Carboxymaltose, 1 Mg	12	12	$3,214.00	$3,214.00	$1,414.16	$3,053.30	$2,233.73	2026-02-10
70543	HCPCS	MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast	12	12	$3,211.50	$3,211.50	$1,413.06	$3,050.93	$2,231.99	2026-02-10
70548	HCPCS	MRI Scan Of Blood Vessels Of Neck With Contrast	12	12	$3,184.50	$3,184.50	$1,401.18	$3,025.28	$2,213.23	2026-02-10
3900160	CDM	MRA Renal Arteries W/contrast	12	12	$3,184.50	$3,184.50	$1,401.18	$3,025.28	$2,213.23	2026-02-10
57284	HCPCS	Repair Of Vaginal Wall Defect Through Abdomen	8	8	$2,256.75	$2,256.75	$672.47	$2,256.75	$2,200.33	2026-02-10
6202020	CDM	Tfna Nail 04.037.161s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
6202012	CDM	Tfna Nail 04.037.157s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
6202015	CDM	Tfna Nail 04.037.159s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
6210050	CDM	Tfna Nail 04.037.154s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
6202010	CDM	Tfna Nail 04.037.155s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
6210018	CDM	Tfna Nail 04.037.164s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
6210034	CDM	Tfna Nail 04.037.152s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
6200625	CDM	Tfna Nail 04.037.160s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
6210071	CDM	Tfna Nail 04.037.162s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
6202011	CDM	Tfna Nail 04.037.156s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
6202025	CDM	Tfna Nail 04.037.165s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
6202021	CDM	Tfna Nail 04.037.163s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
6210049	CDM	Tfna Nail 04.037.153s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
6202013	CDM	Tfna Nail 04.037.158s	12	12	$3,164.50	$3,164.50	$1,392.38	$3,006.28	$2,199.33	2026-02-10
78452	HCPCS	Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect	12	12	$4,549.50	$4,549.50	$2,001.78	$4,322.03	$2,180.72	2026-02-10
73218	HCPCS	MRI Scan Of Arm Without Contrast	24	12	$3,120.12	$3,120.12	$1,372.69	$2,964.48	$2,168.39	2026-02-10
72191	HCPCS	CT Scan Of Blood Vessels Of Pelvis With Contrast	12	12	$3,119.75	$3,119.75	$1,372.69	$2,963.76	$2,168.23	2026-02-10
72146	HCPCS	MRI Scan Of Middle Spinal Canal Without Contrast	12	12	$3,081.25	$3,081.25	$1,355.75	$2,927.19	$2,141.47	2026-02-10
72141	HCPCS	MRI Scan Of Upper Spinal Canal Without Contrast	12	12	$3,081.25	$3,081.25	$1,355.75	$2,927.19	$2,141.47	2026-02-10
5410180	CDM	Drsg Stravix 2cmx4cm	12	12	$3,062.50	$3,062.50	$1,347.50	$2,909.38	$2,128.44	2026-02-10
74176	HCPCS	CT Scan Of Abdomen And Pelvis Without Contrast	12	12	$4,625.00	$4,625.00	$2,035.00	$4,393.75	$2,126.41	2026-02-10
58740	HCPCS	Removal Of Scar Tissue Of Ovaries Or Fallopian Tubes	8	8	$2,172.75	$2,172.75	$745.69	$2,172.75	$2,118.43	2026-02-10
5410099	CDM	Allograft 8x8	12	12	$3,032.00	$3,032.00	$1,334.08	$2,880.40	$2,107.24	2026-02-10
72195	HCPCS	MRI Scan Of Pelvis Without Contrast	12	12	$3,026.75	$3,026.75	$1,331.77	$2,875.41	$2,103.59	2026-02-10
6200626	CDM	Nails-titanium Ctf/235mm Length/sterile	12	12	$3,019.00	$3,019.00	$1,328.36	$2,868.05	$2,098.20	2026-02-10
5409433	CDM	Apligraf	12	12	$3,010.00	$3,010.00	$1,324.40	$2,859.50	$2,091.95	2026-02-10
C8929	HCPCS	Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi…	12	12	$3,009.75	$3,009.75	$1,324.29	$2,859.26	$2,091.78	2026-02-10
J9145	HCPCS	Injection, Daratumumab, 10 Mg	24	12	$3,723.62	$3,723.62	$768.22	$5,416.24	$2,083.61	2026-02-10
6210009	CDM	Mesh Phasix Mesh 4x6	12	12	$2,981.00	$2,981.00	$1,311.64	$2,831.95	$2,071.80	2026-02-10
58285	HCPCS	Removal Of Uterus, Vagina, And Pelvic Lymph Nodes Through Vagina	8	8	$2,047.50	$2,047.50	$1,189.09	$2,116.58	$2,047.50	2026-02-10
J1745	HCPCS	Injection, Infliximab, Excludes Biosimilar, 10 Mg	12	12	$2,936.00	$2,936.00	$1,291.84	$2,789.20	$2,040.52	2026-02-10
73222	HCPCS	MRI Scan Of Arm Joint With Contrast	12	12	$2,904.25	$2,904.25	$1,277.87	$2,759.04	$2,018.45	2026-02-10
73722	HCPCS	MRI Scan Of Leg Joint With Contrast	12	12	$2,904.25	$2,904.25	$1,277.87	$2,759.04	$2,018.45	2026-02-10
73719	HCPCS	MRI Scan Of Leg With Contrast	12	12	$2,903.50	$2,903.50	$1,277.54	$2,758.33	$2,017.93	2026-02-10
95811	HCPCS	Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older)	32	12	$3,744.25	$3,744.25	$118.91	$4,353.38	$2,016.30	2026-02-10
57260	HCPCS	Plastic Repair Of Vagina And Tissue Separating Vagina, Rectum, And Bladder	8	8	$2,067.25	$2,067.25	$628.19	$2,067.25	$2,015.57	2026-02-10
J7326	HCPCS	Hyaluronan Or Derivative, Gel-one, For Intra-articular Injection, Per Dose	12	12	$2,897.70	$2,897.70	$1,274.99	$2,752.82	$2,013.91	2026-02-10
70542	HCPCS	MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast	12	12	$2,881.75	$2,881.75	$1,267.97	$2,737.66	$2,002.82	2026-02-10
72193	HCPCS	CT Scan Of Pelvis With Contrast	12	12	$2,879.00	$2,879.00	$1,266.76	$2,735.05	$2,000.91	2026-02-10
72127	HCPCS	CT Scan Of Upper Spine Before And After Contrast	12	12	$2,855.50	$2,855.50	$1,256.42	$2,712.73	$1,984.58	2026-02-10
70492	HCPCS	CT Scan Of Soft Tissue Of Neck Before And After Contrast	12	12	$2,845.75	$2,845.75	$1,252.13	$2,703.46	$1,977.80	2026-02-10
93312	HCPCS	Ultrasound Of Heart With Probe In Esophagus, With Report	12	12	$2,844.50	$2,844.50	$1,251.58	$2,702.28	$1,976.93	2026-02-10
3900070	CDM	Mr Heart For Morphology Without	12	12	$2,842.00	$2,842.00	$1,250.48	$2,699.90	$1,975.19	2026-02-10
74181	HCPCS	MRI Scan Of Abdomen Without Contrast	12	12	$2,842.00	$2,842.00	$1,250.48	$2,699.90	$1,975.19	2026-02-10
71550	HCPCS	MRI Scan Of Chest Without Contrast	12	12	$2,842.00	$2,842.00	$1,250.48	$2,699.90	$1,975.19	2026-02-10
70540	HCPCS	MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast	12	12	$2,842.00	$2,842.00	$1,250.48	$2,699.90	$1,975.19	2026-02-10
70482	HCPCS	CT Scan Of Cranial Cavity Before And After Contrast	12	12	$2,839.50	$2,839.50	$1,249.38	$2,697.53	$1,973.46	2026-02-10
70545	HCPCS	MRI Scan Of Blood Vessels Of Head With Contrast	24	12	$2,954.88	$2,954.88	$1,161.16	$3,107.21	$1,973.09	2026-02-10
72158	HCPCS	MRI Scan Of Lower Spinal Canal Before And After Contrast	24	12	$3,280.75	$3,280.75	$904.86	$4,279.75	$1,967.94	2026-02-10
70547	HCPCS	MRI Scan Of Blood Vessels Of Neck Without Contrast	12	12	$2,828.50	$2,828.50	$1,244.54	$2,687.08	$1,965.81	2026-02-10
3900161	CDM	MRA Renal Arteries Without Contrast	12	12	$2,826.50	$2,826.50	$1,243.66	$2,685.18	$1,964.42	2026-02-10
77046	HCPCS	MRI Scan Of 1 Breast Without Contrast	12	12	$2,813.50	$2,813.50	$1,237.94	$2,672.83	$1,955.38	2026-02-10
J9202	HCPCS	Goserelin Acetate Implant, Per 3.6 Mg	24	12	$3,218.42	$3,218.42	$928.71	$4,109.84	$1,954.34	2026-02-10
74160	HCPCS	CT Scan Of Abdomen With Contrast	24	12	$2,815.75	$2,815.75	$1,211.10	$2,735.05	$1,940.82	2026-02-10
19082	HCPCS	Biopsy Of Breast And Placement Of Locating Device Using X-ray With Needle, Each …	12	12	$2,790.00	$2,790.00	$1,227.60	$2,650.50	$1,939.05	2026-02-10
72126	HCPCS	CT Scan Of Upper Spine With Contrast	12	12	$2,789.50	$2,789.50	$1,227.38	$2,650.03	$1,938.71	2026-02-10
J2407	HCPCS	Injection, Oritavancin (orbactiv), 10 Mg	12	12	$2,778.15	$2,778.15	$1,222.39	$2,639.24	$1,930.82	2026-02-10
J7307	HCPCS	Etonogestrel (contraceptive) Implant System, Including Implant And Supplies	12	12	$2,774.20	$2,774.20	$1,220.65	$2,635.49	$1,928.07	2026-02-10
57270	HCPCS	Repair Of Protrusion Of Intestine Into Rectum Or Vagina Through Abdomen	8	8	$1,974.25	$1,974.25	$657.71	$1,974.25	$1,924.89	2026-02-10
64581	HCPCS	Insertion Of Sacral Nerve Neurostimulator Electrode	8	8	$1,970.25	$1,970.25	$541.70	$1,970.25	$1,920.99	2026-02-10
51840	HCPCS	Simple Suture Of Bladder Neck To Vaginal Wall And Pubic Bone With Urethra Suspen…	8	8	$1,934.25	$1,934.25	$573.17	$1,934.25	$1,885.89	2026-02-10
70491	HCPCS	CT Scan Of Soft Tissue Of Neck With Contrast	12	12	$2,701.50	$2,701.50	$1,188.66	$2,566.43	$1,877.55	2026-02-10
70551	HCPCS	MRI Scan Of Brain Without Contrast	24	12	$2,821.75	$2,821.75	$1,097.14	$2,992.50	$1,877.41	2026-02-10
72125	HCPCS	CT Scan Of Upper Spine Without Contrast	12	12	$2,688.75	$2,688.75	$1,183.05	$2,554.31	$1,868.68	2026-02-10
59121	HCPCS	Removal Of Ovarian Or Tubal Pregnancy	8	8	$1,915.00	$1,915.00	$638.04	$1,915.00	$1,867.12	2026-02-10
59120	HCPCS	Removal Of Ovarian Or Tubal Pregnancy With Removal Of Ovaries	8	8	$1,912.25	$1,912.25	$638.10	$1,912.25	$1,864.45	2026-02-10
72130	HCPCS	CT Scan Of Middle Spine Before And After Contrast	12	12	$2,675.25	$2,675.25	$1,177.11	$2,541.49	$1,859.30	2026-02-10
72133	HCPCS	CT Scan Of Lower Spine Before And After Contrast	12	12	$2,675.25	$2,675.25	$1,177.11	$2,541.49	$1,859.30	2026-02-10
72132	HCPCS	CT Scan Of Lower Spine With Contrast	12	12	$2,675.25	$2,675.25	$1,177.11	$2,541.49	$1,859.30	2026-02-10
58661	HCPCS	Removal Of Ovaries And/or Tubes Using An Endoscope	8	8	$1,876.00	$1,876.00	$530.75	$1,876.00	$1,829.10	2026-02-10
58563	HCPCS	Exam Of Uterus With Destruction Of Lining Of Uterus Using An Endoscope	8	8	$1,869.75	$1,869.75	$197.40	$1,869.75	$1,823.01	2026-02-10
3000474	CDM	Cytogenetics Medicare Ip Only	12	12	$2,622.00	$2,622.00	$1,153.68	$2,490.90	$1,822.29	2026-02-10
73202	HCPCS	CT Scan Of Arm Before And After Contrast	24	12	$2,621.50	$2,621.50	$1,153.46	$2,490.43	$1,821.94	2026-02-10
5400032	CDM	Drsg Dermal Regeneration 2x2	12	12	$2,613.50	$2,613.50	$1,149.94	$2,482.83	$1,816.38	2026-02-10
59150	HCPCS	Removal Of Ovarian Or Tubal Pregnancy Using An Endoscope	8	8	$1,854.25	$1,854.25	$619.11	$1,854.25	$1,807.89	2026-02-10
57288	HCPCS	Creation Of Sling Around Urethra In Female To Control Leakage	8	8	$1,851.75	$1,851.75	$608.23	$1,851.75	$1,805.45	2026-02-10
58925	HCPCS	Removal Of Cysts Of Ovaries	8	8	$1,835.25	$1,835.25	$631.63	$1,835.25	$1,789.37	2026-02-10
70460	HCPCS	CT Scan Head Or Brain With Contrast	12	12	$2,564.25	$2,564.25	$1,128.27	$2,436.04	$1,782.15	2026-02-10
77049	HCPCS	MRI Scan Of Both Breasts	24	12	$3,040.12	$3,040.12	$755.48	$4,145.09	$1,775.49	2026-02-10
70496	HCPCS	CT Scan Of Blood Vessels Of Head With Contrast	12	12	$2,550.00	$2,550.00	$1,122.00	$2,422.50	$1,772.25	2026-02-10
70498	HCPCS	CT Scan Of Blood Vessels Of Neck With Contrast	12	12	$2,550.00	$2,550.00	$1,122.00	$2,422.50	$1,772.25	2026-02-10
58561	HCPCS	Removal Of Growth Of Muscle Of Uterus Using An Endoscope	8	8	$1,814.25	$1,814.25	$285.42	$1,814.25	$1,768.89	2026-02-10
27301	HCPCS	Drainage Of Deep Abscess Or Blood Accumulation Of Thigh Or Knee	8	8	$1,809.50	$1,809.50	$438.42	$1,809.50	$1,764.26	2026-02-10
57282	HCPCS	Repair Of Pelvic Ligaments Through Vagina	8	8	$1,805.50	$1,805.50	$563.00	$1,805.50	$1,760.37	2026-02-10
58662	HCPCS	Destruction Or Removal Of Ovary Or Growth Of Pelvis Using An Endoscope	8	8	$1,805.50	$1,805.50	$585.46	$1,805.50	$1,760.37	2026-02-10
58720	HCPCS	Removal Of Uterine Tubes And Ovaries	8	8	$1,802.50	$1,802.50	$630.90	$1,802.50	$1,757.44	2026-02-10
5409441	CDM	Allograft 4x8	12	12	$2,496.50	$2,496.50	$1,098.46	$2,371.68	$1,735.07	2026-02-10
J9055	HCPCS	Injection, Cetuximab, 10 Mg	24	12	$2,774.75	$2,774.75	$876.63	$3,379.29	$1,728.94	2026-02-10
58660	HCPCS	Removal Of Scar Tissue Of Ovaries Or Fallopian Tubes Using An Endoscope	8	8	$1,773.00	$1,773.00	$565.20	$1,773.00	$1,728.67	2026-02-10
Q5103	HCPCS	Injection, Infliximab-dyyb, Biosimilar, (inflectra), 10 Mg	12	12	$2,460.15	$2,460.15	$1,082.47	$2,337.14	$1,709.80	2026-02-10
72129	HCPCS	CT Scan Of Middle Spine With Contrast	12	12	$2,453.50	$2,453.50	$1,079.54	$2,330.83	$1,705.18	2026-02-10
74150	HCPCS	CT Scan Of Abdomen Without Contrast	12	12	$2,451.00	$2,451.00	$1,078.44	$2,328.45	$1,703.44	2026-02-10
78227	HCPCS	Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs	12	12	$2,427.25	$2,427.25	$1,067.99	$2,305.89	$1,686.94	2026-02-10
J7298	HCPCS	Levonorgestrel-releasing Intrauterine Contraceptive System (mirena), 52 Mg	12	12	$2,388.80	$2,388.80	$1,051.07	$2,269.36	$1,660.22	2026-02-10
1500039	CDM	Operating Room Services - General Classification	12	12	$2,373.25	$2,373.25	$1,044.23	$2,254.59	$1,649.41	2026-02-10
Q0138	HCPCS	Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd …	12	12	$2,372.20	$2,372.20	$1,043.77	$2,253.59	$1,648.68	2026-02-10
95806	HCPCS	Sleep Study Including Heart Rate, Breathing, Airflow, And Effort	20	12	$3,744.25	$3,744.25	$42.92	$3,557.04	$1,647.47	2026-02-10
70544	HCPCS	MRI Scan Of Blood Vessels Of Head Without Contrast	36	12	$2,639.00	$2,639.00	$869.88	$3,025.28	$1,639.66	2026-02-10
58700	HCPCS	Removal Of Uterine Tubes	8	8	$1,681.00	$1,681.00	$661.39	$1,681.00	$1,638.97	2026-02-10
6200195	CDM	Advantage Fit-transvaginal Sling 850-211	12	12	$2,353.75	$2,353.75	$1,035.65	$2,236.06	$1,635.86	2026-02-10
6200451	CDM	Monarc + Subfacial Hammock	12	12	$2,352.00	$2,352.00	$1,034.88	$2,234.40	$1,634.64	2026-02-10
57250	HCPCS	Repair Of Herniated Rectum Into Vaginal Wall	8	8	$1,676.50	$1,676.50	$498.68	$1,676.50	$1,634.59	2026-02-10
57240	HCPCS	Repair Of Bladder Hernia Into Vaginal Wall	8	8	$1,666.00	$1,666.00	$499.10	$1,666.00	$1,624.35	2026-02-10
72192	HCPCS	CT Scan Of Pelvis Without Contrast	24	12	$2,360.00	$2,360.00	$998.36	$2,328.45	$1,617.00	2026-02-10
70481	HCPCS	CT Scan Of Cranial Cavity With Contrast	12	12	$2,326.25	$2,326.25	$1,023.55	$2,209.94	$1,616.74	2026-02-10
200008	CDM	Room & Board - Private (one Bed) - Obstetrics (ob)	6	6	$1,694.00	$1,694.00	$1,609.30	$1,609.30	$1,609.30	2026-02-10
73201	HCPCS	CT Scan Of Arm With Contrast	24	12	$2,314.50	$2,314.50	$1,018.38	$2,198.78	$1,608.58	2026-02-10
5401061	CDM	Primatrix - 6cm X 6cm	12	12	$2,313.50	$2,313.50	$1,017.94	$2,197.83	$1,607.88	2026-02-10
13160	HCPCS	Extensive Or Complicated Repair Of Surface Wound Reopening	8	8	$1,642.00	$1,642.00	$675.75	$1,642.00	$1,600.95	2026-02-10
72131	HCPCS	CT Scan Of Lower Spine Without Contrast	12	12	$2,281.25	$2,281.25	$1,003.75	$2,167.19	$1,585.47	2026-02-10
90376	HCPCS	Rabies Immune Globulin For Injection Beneath The Skin And/or Into Muscle, Heat-t…	12	12	$2,279.15	$2,279.15	$1,002.83	$2,165.19	$1,584.01	2026-02-10
6210070	CDM	Tfna Nail 04.037.212s	12	12	$2,258.00	$2,258.00	$993.52	$2,145.10	$1,569.31	2026-02-10
6210064	CDM	Tfna Nail 04.037.242s	12	12	$2,258.00	$2,258.00	$993.52	$2,145.10	$1,569.31	2026-02-10
6210063	CDM	Tfna Nail 04.037.142s	12	12	$2,258.00	$2,258.00	$993.52	$2,145.10	$1,569.31	2026-02-10
6210067	CDM	Tfna Nail 04.037.012s	12	12	$2,258.00	$2,258.00	$993.52	$2,145.10	$1,569.31	2026-02-10
6210069	CDM	Tfna Nail 04.037.112s	12	12	$2,258.00	$2,258.00	$993.52	$2,145.10	$1,569.31	2026-02-10
6210068	CDM	Tfna Nail 04.037.042s	12	12	$2,258.00	$2,258.00	$993.52	$2,145.10	$1,569.31	2026-02-10
6200980	CDM	Ventralight St Mesh 7x9	12	12	$2,256.00	$2,256.00	$992.64	$2,143.20	$1,567.92	2026-02-10
72128	HCPCS	CT Scan Of Middle Spine Without Contrast	12	12	$2,253.50	$2,253.50	$991.54	$2,140.83	$1,566.18	2026-02-10
6207290	CDM	Premium Plus Ceea 28 Stapler	12	12	$2,253.50	$2,253.50	$991.54	$2,140.83	$1,566.18	2026-02-10
6207300	CDM	Premium Plus Ceea 31 Stapler	12	12	$2,253.50	$2,253.50	$991.54	$2,140.83	$1,566.18	2026-02-10
6200109	CDM	Premium Plus Ceea 25	12	12	$2,253.50	$2,253.50	$991.54	$2,140.83	$1,566.18	2026-02-10
73701	HCPCS	CT Scan Of Leg With Contrast Material	36	12	$2,229.50	$2,229.50	$980.98	$2,182.39	$1,564.41	2026-02-10
Q5115	HCPCS	Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg	12	12	$2,243.75	$2,243.75	$987.25	$2,131.56	$1,559.40	2026-02-10
5410179	CDM	Drsg Grafix 3cm X 4cm	12	12	$2,241.75	$2,241.75	$986.37	$2,129.66	$1,558.01	2026-02-10
70488	HCPCS	CT Scan Of Face Before And After Contrast	12	12	$2,229.50	$2,229.50	$980.98	$2,118.03	$1,549.51	2026-02-10
43771	HCPCS	Adjustment Of Stomach Reduction Device Using An Endoscope	8	8	$1,543.50	$1,543.50	$1,066.71	$1,898.74	$1,543.50	2026-02-10
19286	HCPCS	Placement Of Locating Device In Breast Using Ultrasound Guidance, Each Additiona…	12	12	$2,205.75	$2,205.75	$970.53	$2,095.46	$1,532.99	2026-02-10
81503	HCPCS	Genetic Profiling On Oncology Biopsy Of Ovarian Lesions, Assays Of Five Proteins	12	12	$2,189.50	$2,189.50	$963.38	$2,080.03	$1,521.70	2026-02-10
77048	HCPCS	MRI Scan Of 1 Breast	24	12	$2,563.12	$2,563.12	$678.04	$3,405.99	$1,520.73	2026-02-10
J9155	HCPCS	Injection, Degarelix, 1 Mg	24	12	$2,589.07	$2,589.07	$649.75	$3,516.38	$1,515.76	2026-02-10
200009	CDM	Room & Board - Private (one Bed) - Medical/surgical/gyn	6	6	$1,584.00	$1,584.00	$1,504.80	$1,504.80	$1,504.80	2026-02-10
J0881	HCPCS	Injection, Darbepoetin Alfa, 1 Microgram (non-esrd Use)	84	12	$2,090.10	$2,090.10	$352.84	$8,303.29	$1,502.49	2026-02-10
70470	HCPCS	CT Scan Of Head Or Brain Before And After Contrast	12	12	$2,862.25	$2,862.25	$1,259.39	$2,719.14	$1,498.02	2026-02-10
J2357	HCPCS	Injection, Omalizumab, 5 Mg	24	12	$2,394.78	$2,394.78	$765.16	$2,898.02	$1,497.14	2026-02-10
72148	HCPCS	MRI Scan Of Lower Spinal Canal Without Contrast	24	12	$2,418.62	$2,418.62	$643.39	$3,206.25	$1,485.00	2026-02-10
J3262	HCPCS	Injection, Tocilizumab, 1 Mg	24	12	$3,093.15	$3,093.15	$212.94	$5,417.23	$1,484.39	2026-02-10

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