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

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Hospital

HOWARD COUNTY MEDICAL CENTER

St Paul, NE · CCN 281338 · Rates published

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You selected 59510 (CPT)

This facility hasn’t published a payer-negotiated rate for this exact code. See its full rate list below.

1,314 distinct procedures filed
22 distinct payers
373,268 rate rows
2026-10-14 last MRF observed
Data quality

64,418 of 373,268 rate rows are consumer-grade (17.3%)

308,850 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
professional (physician) fee — not the facility price 307,029
placeholder amount (≤ $0.02) — excluded from medians 1,686
percent-of-charges filed in the dollar field — excluded from medians 66
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 39
per-diem day rate — not a per-procedure price 30
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8107/470681056_howard-county-medical-center_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/HowardCountyMedicalCenter/8107
Discovered viaDiscovered by HANK
Last fetch success · 2026-10-15
Content fingerprint 6a76f00bb0b58a1d… · 107,990,877 bytes · first seen 2026-10-15

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
J3245
HCPCS 		Tildrakizumab-asmn 100 Mg/ml Syringe 22 $13,749.51 $22,915.85 $20,051.37 nat. median
$256
outlier · 78.3×
J2327
HCPCS 		Risankizumab-rzaa 600 Mg/10 Ml Vial 22 $13,409.73 $22,349.55 $19,555.85 nat. median
$2,076
outlier · 9.4×
J9334
HCPCS 		Efgartigimod-hyaluronidas-qvfc 1,008 Mg/5.6 Ml Vial 22 $12,316.68 $20,527.80 $17,961.83 nat. median
$83
outlier · 216.9×
J3380
HCPCS 		Vedolizumab 300 Mg/5 Ml Vial 18 $23.75 $18,319.60 $16,029.65 nat. median
$162
outlier · 98.9×
J9144
HCPCS 		Daratumumab-hyaluronidase-fihj 15 Ml Vial 22 $8,437.44 $14,062.40 $12,304.60 nat. median
$211
outlier · 58.2×
J2406
HCPCS 		Oritavancin Diphosphate 1,200 Mg Vial 22 $7,873.05 $13,121.75 $11,481.53 nat. median
$60
outlier · 190.3×
0278
RC 		Anchor/screw Bn/bn,tis/bn 22 $7,643.40 $12,739.00 $11,146.62 nat. median
$1,467
outlier · 7.6×
C1713
HCPCS 		Anchor/screw Bn/bn,tis/bn 22 $7,643.40 $12,739.00 $11,146.62 nat. median
$863
outlier · 12.9×
J0717
HCPCS 		Certolizumab Pegol 400 Mg/2 Ml Syringekit 18 $4.29 $11,038.95 $9,659.08 nat. median
$1,598
outlier · 6.0×
J3101
HCPCS 		Tenecteplase 50 Mg/10 Ml Kit 22 $6,609.00 $11,015.00 $9,638.12 nat. median
$3,820
outlier · 2.5×
J0517
HCPCS 		Benralizumab 30 Mg/ml Syringe 20 $184.94 $10,554.35 $9,235.06 nat. median
$919
outlier · 10.1×
J1449
HCPCS 		Eflapegrastim-xnst 13.2 Mg/0.6 Ml Syringe 22 $5,154.00 $8,590.00 $7,516.25 nat. median
$30
outlier · 248.3×
J2356
HCPCS 		Tezepelumab-ekko 210 Mg/1.91 Ml Syringe 22 $4,825.80 $8,043.00 $7,037.62 nat. median
$81
outlier · 86.6×
J2278
HCPCS 		Ziconotide Acetate 25 Mcg/ml Vial 22 $4,819.68 $8,032.80 $7,028.70 nat. median
$16
outlier · 433.3×
Q5115
HCPCS 		Rituximab-abbs 500 Mg/50 Ml Vial 22 $4,450.50 $7,417.50 $6,490.31 nat. median
$840
outlier · 7.7×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml Syringe 22 $4,392.75 $7,321.25 $6,406.10 nat. median
$1,982
outlier · 3.2×
J2997
HCPCS 		Alteplase 100mg/100ml Via 22 $271.50 $10,132.00 $6,079.20 nat. median
$500
outlier · 12.1×
J3315
HCPCS 		Triptorelin Pamoate 22.5 Mg/2 Ml Syr 22 $3,031.26 $10,089.20 $6,053.52 nat. median
$933
outlier · 6.5×
J1306
HCPCS 		Inclisiran Sodium 284 Mg/1.5 Ml Syringe 22 $4,083.54 $6,805.90 $5,955.16 nat. median
$44
outlier · 134.9×
36475
CPT 		Ir Endovenous Rf 1st Vein 22 $3,987.00 $6,645.00 $5,814.38 nat. median
$4,061
1.4× median
J2182
HCPCS 		Mepolizumab--nucala 100 Mg Vial 21 $36.03 $6,574.70 $5,752.86 nat. median
$2,791
outlier · 2.1×
J2353
HCPCS 		Octreotide Acetate,mi-spheres 10 Mg Vial 22 $3,856.59 $8,416.70 $5,736.68 nat. median
$5,573
1.0× median
J1942
HCPCS 		Aripiprazole Lauroxil 882 Mg/3.2 Ml Suser.syr 22 $3,550.56 $5,917.60 $5,177.90 nat. median
$1,407
outlier · 3.7×
J9310
HCPCS 		Rituximab 500 Mg/50 Ml Vial 22 $995.52 $8,235.80 $4,941.48 nat. median
$1,659
outlier · 3.0×
74174
CPT 		CT Angio Abd&pelv W/O&with Contrast 22 $3,343.20 $5,572.00 $4,875.50 nat. median
$988
outlier · 4.9×
C1889
HCPCS 		Mild Kit 22 $4.20 $8,050.00 $4,830.00 nat. median
$2,369
outlier · 2.0×
J2505
HCPCS 		Pegfilgrastim 6mg/0.6ml S 22 $3,306.00 $5,510.00 $4,821.25 nat. median
$6,278
0.8× median
J2357
HCPCS 		Omalizumab 300 Mg/2 Ml Syringe 19 $47.35 $5,453.20 $4,771.55 nat. median
$1,245
outlier · 3.8×
95811
CPT 		Polysom 6/>yrs Cpap 4/> Parm 22 $2,991.60 $4,986.00 $4,362.75 nat. median
$1,894
outlier · 2.3×
78452
CPT 		Ht Muscle Image Spect Mult 22 $2,479.05 $5,482.26 $4,333.88 nat. median
$1,816
outlier · 2.4×
Q5120
HCPCS 		Pegfilgrastim-bmez 6 Mg/0.6 Ml Syringe 22 $2,944.17 $4,906.95 $4,293.58 nat. median
$371
outlier · 11.6×
74178
CPT 		CT Abd & Pelv 1/> Regns 22 $2,923.80 $4,873.00 $4,263.88 nat. median
$1,024
outlier · 4.2×
J3111
HCPCS 		Romosozumab-aqqg 210 Mg/2.34 Ml Kit 22 $2,907.39 $4,845.65 $4,239.94 nat. median
$681
outlier · 6.2×
70553
CPT 		MRI Brain Stem Without & With Contrast 22 $2,859.60 $7,916.43 $4,170.25 nat. median
$1,133
outlier · 3.7×
72157
CPT 		MRI Chest Spine Without & With Contrast 22 $2,856.60 $4,761.00 $4,165.88 nat. median
$1,105
outlier · 3.8×
72158
CPT 		MRI Lumbar Spine Without & With Contrast 22 $2,831.40 $7,839.51 $4,129.12 nat. median
$1,093
outlier · 3.8×
72156
CPT 		MRI Neck Spine Without & With Contrast 22 $2,815.20 $4,692.00 $4,105.50 nat. median
$1,103
outlier · 3.7×
63650
CPT 		Implant Neuroelectrodes 22 $2,799.60 $4,666.00 $4,082.75 nat. median
$7,279
0.6× median
J3032
HCPCS 		Eptinezumab-jjmr 100 Mg/ml Vial 17 $23.26 $4,658.00 $4,075.75 nat. median
$76
outlier · 53.9×
74177
CPT 		CT Abd & Pelv W/contrast 22 $2,759.40 $4,599.00 $4,024.12 nat. median
$974
outlier · 4.1×
73223
CPT 		MRI Joint Upr Extr W/O&with Contrast 22 $2,661.60 $4,569.00 $3,997.88 nat. median
$1,158
outlier · 3.5×
74183
CPT 		MRI Abdomen Without & With Contrast 22 $2,723.40 $4,539.00 $3,971.62 nat. median
$1,100
outlier · 3.6×
64635
CPT 		Bilat Rfa Lumbar Or Sacral 22 $2,388.62 $6,396.00 $3,880.24 nat. median
$2,392
1.6× median
J1569
HCPCS 		Immun Glob G(igg)/gly/iga 50+ 30 Gm/300 Ml Vial 22 $53.25 $12,207.60 $3,871.44 nat. median
$1,070
outlier · 3.6×
64628
CPT 		Trml Dstrj Ios Bvn 1st 2 L/s 22 $2,635.20 $4,392.00 $3,843.00 nat. median
$12,701
outlier · 0.3×
J2426
HCPCS 		Paliperidone Palmitate 156 Mg/ml Disp.syrin 22 $1,927.77 $6,410.95 $3,744.17 nat. median
$2,498
1.5× median
72197
CPT 		MRI Pelvis Without & With Contrast 22 $2,559.00 $4,265.00 $3,731.88 nat. median
$1,063
outlier · 3.5×
Q4316
HCPCS 		Amchoplast, Per Square Cm 22 $123.00 $6,210.00 $3,726.00 nat. median
$483
outlier · 7.7×
64633
CPT 		Bilat Rfa Cervical Or Thoracic 22 $1,860.60 $6,203.00 $3,721.80 nat. median
$2,325
1.6× median
70543
CPT 		MRI Orbt/fac/nck Without &with Contrast 22 $2,543.40 $4,239.00 $3,709.12 nat. median
$1,083
outlier · 3.4×

Other procedures at this hospital

Browse this hospital's 1,314 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
             
J3245 HCPCS Tildrakizumab-asmn 100 Mg/ml Syringe 35 22 $22,915.85 $22,915.85 $13,749.51 $22,915.85 $20,051.37 2026-10-14
J2327 HCPCS Risankizumab-rzaa 600 Mg/10 Ml Vial 35 22 $22,349.55 $22,349.55 $13,409.73 $22,349.55 $19,555.85 2026-10-14
J9334 HCPCS Efgartigimod-hyaluronidas-qvfc 1,008 Mg/5.6 Ml Vial 35 22 $20,527.80 $20,527.80 $12,316.68 $20,527.80 $17,961.83 2026-10-14
J3380 HCPCS Vedolizumab 300 Mg/5 Ml Vial 32 18 $18,319.60 $18,319.60 $23.75 $18,319.60 $16,029.65 2026-10-14
J9144 HCPCS Daratumumab-hyaluronidase-fihj 15 Ml Vial 35 22 $14,062.40 $14,062.40 $8,437.44 $14,062.40 $12,304.60 2026-10-14
J2406 HCPCS Oritavancin Diphosphate 1,200 Mg Vial 35 22 $13,121.75 $13,121.75 $7,873.05 $13,121.75 $11,481.53 2026-10-14
0278 RC Anchor/screw Bn/bn,tis/bn 35 22 $12,739.00 $12,739.00 $7,643.40 $12,739.00 $11,146.62 2026-10-14
C1713 HCPCS Anchor/screw Bn/bn,tis/bn 35 22 $12,739.00 $12,739.00 $7,643.40 $12,739.00 $11,146.62 2026-10-14
J0717 HCPCS Certolizumab Pegol 400 Mg/2 Ml Syringekit 32 18 $11,038.95 $11,038.95 $4.29 $11,038.95 $9,659.08 2026-10-14
J3101 HCPCS Tenecteplase 50 Mg/10 Ml Kit 35 22 $11,015.00 $11,015.00 $6,609.00 $11,015.00 $9,638.12 2026-10-14
J0517 HCPCS Benralizumab 30 Mg/ml Syringe 34 20 $10,554.35 $10,554.35 $184.94 $10,554.35 $9,235.06 2026-10-14
J1449 HCPCS Eflapegrastim-xnst 13.2 Mg/0.6 Ml Syringe 35 22 $8,590.00 $8,590.00 $5,154.00 $8,590.00 $7,516.25 2026-10-14
J2356 HCPCS Tezepelumab-ekko 210 Mg/1.91 Ml Syringe 35 22 $8,043.00 $8,043.00 $4,825.80 $8,043.00 $7,037.62 2026-10-14
J2278 HCPCS Ziconotide Acetate 25 Mcg/ml Vial 33 22 $8,032.80 $8,032.80 $4,819.68 $8,032.80 $7,028.70 2026-10-14
Q5115 HCPCS Rituximab-abbs 500 Mg/50 Ml Vial 35 22 $7,417.50 $7,417.50 $4,450.50 $7,417.50 $6,490.31 2026-10-14
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6 Ml Syringe 35 22 $7,321.25 $7,321.25 $4,392.75 $7,321.25 $6,406.10 2026-10-14
J2997 HCPCS Alteplase 100mg/100ml Via 54 22 $10,132.00 $10,132.00 $271.50 $10,132.00 $6,079.20 2026-10-14
J3315 HCPCS Triptorelin Pamoate 22.5 Mg/2 Ml Syr 54 22 $10,089.20 $10,089.20 $3,031.26 $10,089.20 $6,053.52 2026-10-14
J1306 HCPCS Inclisiran Sodium 284 Mg/1.5 Ml Syringe 35 22 $6,805.90 $6,805.90 $4,083.54 $6,805.90 $5,955.16 2026-10-14
36475 CPT Ir Endovenous Rf 1st Vein 35 22 $6,645.00 $6,645.00 $3,987.00 $6,645.00 $5,814.38 2026-10-14
J2182 HCPCS Mepolizumab--nucala 100 Mg Vial 36 21 $6,574.70 $6,574.70 $36.03 $6,574.70 $5,752.86 2026-10-14
J2353 HCPCS Octreotide Acetate,mi-spheres 10 Mg Vial 54 22 $6,427.65 $6,427.65 $3,856.59 $8,416.70 $5,736.68 2026-10-14
J1942 HCPCS Aripiprazole Lauroxil 882 Mg/3.2 Ml Suser.syr 35 22 $5,917.60 $5,917.60 $3,550.56 $5,917.60 $5,177.90 2026-10-14
J9310 HCPCS Rituximab 500 Mg/50 Ml Vial 54 22 $8,235.80 $8,235.80 $995.52 $8,235.80 $4,941.48 2026-10-14
74174 CPT CT Angio Abd&pelv W/O&with Contrast 35 22 $5,572.00 $5,572.00 $3,343.20 $5,572.00 $4,875.50 2026-10-14
C1889 HCPCS Mild Kit 55 22 $8,050.00 $8,050.00 $4.20 $8,050.00 $4,830.00 2026-10-14
J2505 HCPCS Pegfilgrastim 6mg/0.6ml S 35 22 $5,510.00 $5,510.00 $3,306.00 $5,510.00 $4,821.25 2026-10-14
J2357 HCPCS Omalizumab 300 Mg/2 Ml Syringe 33 19 $5,453.20 $5,453.20 $47.35 $5,453.20 $4,771.55 2026-10-14
95811 CPT Polysom 6/>yrs Cpap 4/> Parm 35 22 $4,986.00 $4,986.00 $2,991.60 $4,986.00 $4,362.75 2026-10-14
78452 CPT Ht Muscle Image Spect Mult 39 22 $4,953.00 $4,953.00 $2,479.05 $5,482.26 $4,333.88 2026-10-14
Q5120 HCPCS Pegfilgrastim-bmez 6 Mg/0.6 Ml Syringe 35 22 $4,906.95 $4,906.95 $2,944.17 $4,906.95 $4,293.58 2026-10-14
74178 CPT CT Abd & Pelv 1/> Regns 37 22 $4,873.00 $4,873.00 $2,923.80 $4,873.00 $4,263.88 2026-10-14
J3111 HCPCS Romosozumab-aqqg 210 Mg/2.34 Ml Kit 35 22 $4,845.65 $4,845.65 $2,907.39 $4,845.65 $4,239.94 2026-10-14
70553 CPT MRI Brain Stem Without & With Contrast 39 22 $4,766.00 $4,766.00 $2,859.60 $7,916.43 $4,170.25 2026-10-14
72157 CPT MRI Chest Spine Without & With Contrast 35 22 $4,761.00 $4,761.00 $2,856.60 $4,761.00 $4,165.88 2026-10-14
72158 CPT MRI Lumbar Spine Without & With Contrast 36 22 $4,719.00 $4,719.00 $2,831.40 $7,839.51 $4,129.12 2026-10-14
72156 CPT MRI Neck Spine Without & With Contrast 35 22 $4,692.00 $4,692.00 $2,815.20 $4,692.00 $4,105.50 2026-10-14
63650 CPT Implant Neuroelectrodes 34 22 $4,666.00 $4,666.00 $2,799.60 $4,666.00 $4,082.75 2026-10-14
J3032 HCPCS Eptinezumab-jjmr 100 Mg/ml Vial 31 17 $4,658.00 $4,658.00 $23.26 $4,658.00 $4,075.75 2026-10-14
74177 CPT CT Abd & Pelv W/contrast 44 22 $4,599.00 $4,599.00 $2,759.40 $4,599.00 $4,024.12 2026-10-14
73223 CPT MRI Joint Upr Extr W/O&with Contrast 54 22 $4,569.00 $4,569.00 $2,661.60 $4,569.00 $3,997.88 2026-10-14
74183 CPT MRI Abdomen Without & With Contrast 35 22 $4,539.00 $4,539.00 $2,723.40 $4,539.00 $3,971.62 2026-10-14
64635 CPT Bilat Rfa Lumbar Or Sacral 55 22 $4,264.00 $4,264.00 $2,388.62 $6,396.00 $3,880.24 2026-10-14
J1569 HCPCS Immun Glob G(igg)/gly/iga 50+ 30 Gm/300 Ml Vial 113 22 $4,075.20 $4,075.20 $53.25 $12,207.60 $3,871.44 2026-10-14
64628 CPT Trml Dstrj Ios Bvn 1st 2 L/s 34 22 $4,392.00 $4,392.00 $2,635.20 $4,392.00 $3,843.00 2026-10-14
J2426 HCPCS Paliperidone Palmitate 156 Mg/ml Disp.syrin 73 22 $4,279.05 $4,279.05 $1,927.77 $6,410.95 $3,744.17 2026-10-14
72197 CPT MRI Pelvis Without & With Contrast 35 22 $4,265.00 $4,265.00 $2,559.00 $4,265.00 $3,731.88 2026-10-14
Q4316 HCPCS Amchoplast, Per Square Cm 54 22 $6,210.00 $6,210.00 $123.00 $6,210.00 $3,726.00 2026-10-14
64633 CPT Bilat Rfa Cervical Or Thoracic 56 22 $6,203.00 $6,203.00 $1,860.60 $6,203.00 $3,721.80 2026-10-14
70543 CPT MRI Orbt/fac/nck Without &with Contrast 35 22 $4,239.00 $4,239.00 $2,543.40 $4,239.00 $3,709.12 2026-10-14
75635 CPT CT Angio Abdominal Arteries 36 22 $4,223.00 $4,223.00 $2,533.80 $4,631.85 $3,695.12 2026-10-14
70551 CPT MRI Brain Stem Without Contrast 36 22 $4,192.00 $4,192.00 $2,515.20 $6,964.06 $3,668.00 2026-10-14
72146 CPT MRI Chest Spine Without Contrast 35 22 $4,168.00 $4,168.00 $2,500.80 $4,168.00 $3,647.00 2026-10-14
70549 CPT Mr Angiograph Neck W/O&with Contrast 35 22 $4,129.00 $4,129.00 $2,477.40 $4,129.00 $3,612.88 2026-10-14
72141 CPT MRI Neck Spine Without Contrast 35 22 $4,122.00 $4,122.00 $2,473.20 $4,122.00 $3,606.75 2026-10-14
74185 CPT MRI Angio Abdom W Orw/o Dye 35 22 $4,077.00 $4,077.00 $2,446.20 $4,077.00 $3,567.38 2026-10-14
72148 CPT MRI Lumbar Spine Without Contrast 37 22 $4,042.00 $4,042.00 $2,053.00 $4,042.00 $3,536.75 2026-10-14
95810 CPT Polysom 6/> Yrs 4/> Param 35 22 $3,989.00 $3,989.00 $2,393.40 $3,989.00 $3,490.38 2026-10-14
71275 CPT CT Angiography Chest 36 22 $3,977.00 $3,977.00 $2,386.20 $4,362.02 $3,479.88 2026-10-14
74175 CPT CT Angio Abdom Without & With Contrast 35 22 $3,936.00 $3,936.00 $2,361.60 $3,936.00 $3,444.00 2026-10-14
70544 CPT Mr Angiography Head Without Contrast 35 22 $3,864.00 $3,864.00 $2,318.40 $3,864.00 $3,381.00 2026-10-14
74181 CPT MRI Abdomen Without Contrast 36 22 $3,853.00 $3,853.00 $2,311.80 $6,405.87 $3,371.38 2026-10-14
73723 CPT MRI Joint Lwr Extr W/O&with Contrast 36 22 $3,825.00 $3,825.00 $2,295.00 $3,825.00 $3,346.88 2026-10-14
73722 CPT MRI Joint Of Lwr Extr With Contrast 35 22 $3,815.00 $3,815.00 $2,289.00 $3,815.00 $3,338.12 2026-10-14
64636 CPT Bilat Rfa Lumbar Or Sacral Add 54 22 $4,524.00 $4,524.00 $1,809.60 $6,032.00 $3,317.60 2026-10-14
70471 CPT Other Professional Services 36 22 $3,734.00 $3,734.00 $2,046.30 $3,734.00 $3,267.25 2026-10-14
J0897 HCPCS Denosumab 60 Mg/ml Syringe 54 21 $3,395.50 $3,395.50 $32.01 $6,233.20 $3,259.68 2026-10-14
73202 CPT CT Uppr Extremity W/O&with Contrast 35 22 $3,711.00 $3,711.00 $2,226.60 $3,711.00 $3,247.12 2026-10-14
73720 CPT MRI Lwr Extremity W/O&with Contrast 36 22 $3,676.00 $3,676.00 $2,205.60 $6,126.59 $3,216.50 2026-10-14
Q5108 HCPCS Pegfilgrastim-jmdb 6 Mg/0.6 Ml Syringe 35 22 $3,668.15 $3,668.15 $2,200.89 $3,668.15 $3,209.63 2026-10-14
81162 CPT Brca1&2 Gen Full Seq Dup/del 35 22 $3,628.00 $3,628.00 $2,176.80 $3,628.00 $3,174.50 2026-10-14
73220 CPT MRI Uppr Extremity W/O&with Contrast 35 22 $3,624.00 $3,624.00 $2,174.40 $3,624.00 $3,171.00 2026-10-14
71270 CPT CT Thorax Dx C-/c+ 36 22 $3,535.00 $3,535.00 $2,121.00 $3,535.00 $3,093.12 2026-10-14
74170 CPT CT Abdomen Without & With Contrast 35 22 $3,532.00 $3,532.00 $2,119.20 $3,532.00 $3,090.50 2026-10-14
J9355 HCPCS Trastuzumab 150 Mg Vial 35 22 $3,531.50 $3,531.50 $2,118.90 $3,531.50 $3,090.07 2026-10-14
J9217 HCPCS Leuprolide Acetate 30 Mg 111 22 $3,958.90 $3,958.90 $1,016.31 $11,846.45 $3,090.00 2026-10-14
J1602 HCPCS Golimumab 50 Mg/4 Ml Vial 32 18 $3,513.60 $3,513.60 $12.78 $3,513.60 $3,074.40 2026-10-14
J2802 HCPCS Romiplostim 125 Mcg Vial 54 22 $5,073.70 $5,073.70 $1,454.37 $5,073.70 $3,044.22 2026-10-14
70547 CPT Mr Angiography Neck Without Contrast 35 22 $3,458.00 $3,458.00 $2,074.80 $3,458.00 $3,025.75 2026-10-14
72195 CPT MRI Pelvis Without Contrast 35 22 $3,456.00 $3,456.00 $2,073.60 $3,456.00 $3,024.00 2026-10-14
64721 CPT Carpal Tunnel Surgery 35 21 $3,355.00 $3,355.00 $2,013.00 $3,355.00 $2,935.62 2026-10-14
73702 CPT CT Lwr Extremity W/O&with Contrast 35 22 $3,342.00 $3,342.00 $2,005.20 $3,342.00 $2,924.25 2026-10-14
J1950 HCPCS Leuprolide Acetate 3.75 Mg Syringekit 35 22 $3,324.55 $3,324.55 $1,994.73 $3,324.55 $2,908.98 2026-10-14
70496 CPT CT Angiography Head 38 22 $3,307.00 $3,307.00 $1,984.20 $3,599.05 $2,893.62 2026-10-14
74176 CPT CT Abd & Pelvis Without Contrast 41 22 $3,268.00 $3,268.00 $1,960.80 $8,015.06 $2,859.50 2026-10-14
38505 CPT Needle Biopsy Lymph Nodes 35 22 $3,258.00 $3,258.00 $1,954.80 $3,258.00 $2,850.75 2026-10-14
70492 CPT CT Sft Tsue Nck Without & With Contrast 35 22 $3,255.00 $3,255.00 $1,953.00 $3,255.00 $2,848.12 2026-10-14
70498 CPT CT Angiography Neck 38 22 $3,255.00 $3,255.00 $1,953.00 $3,599.05 $2,848.12 2026-10-14
G0390 HCPCS Trauma Activation With Hosp Cc 35 22 $3,214.00 $3,214.00 $1,928.40 $3,214.00 $2,812.25 2026-10-14
74160 CPT CT Abdomen With Contrast 35 22 $3,209.00 $3,209.00 $1,925.40 $3,209.00 $2,807.88 2026-10-14
J0875 HCPCS Dalbavancin Hcl 500 Mg Vial 35 22 $3,128.50 $3,128.50 $1,877.10 $3,128.50 $2,737.44 2026-10-14
64629 CPT Trml Dstrj Ios Bvn Ea Addl 33 21 $3,106.00 $3,106.00 $1,863.60 $3,106.00 $2,717.75 2026-10-14
73721 CPT MRI Jnt Of Lwr Extre Without Contrast 38 22 $3,054.00 $3,054.00 $1,559.62 $3,054.00 $2,672.25 2026-10-14
72193 CPT CT Pelvis With Contrast 37 22 $3,043.00 $3,043.00 $1,825.80 $3,357.87 $2,662.62 2026-10-14
73221 CPT MRI Joint Upr Extrem Without Contrast 35 22 $3,032.00 $3,032.00 $1,819.20 $3,032.00 $2,653.00 2026-10-14
71260 CPT CT Thorax Dx C+ 41 22 $3,030.00 $3,030.00 $1,550.78 $4,016.95 $2,651.25 2026-10-14
73218 CPT MRI Upper Extremity Without Contrast 35 22 $3,024.00 $3,024.00 $1,814.40 $3,024.00 $2,646.00 2026-10-14
73718 CPT MRI Lower Extremity Without Contrast 35 22 $3,024.00 $3,024.00 $1,814.40 $3,024.00 $2,646.00 2026-10-14
70470 CPT CT Head/brain Without & With Contrast 37 22 $3,011.00 $3,011.00 $1,806.60 $3,011.00 $2,634.62 2026-10-14
J1439 HCPCS Ferric Carboxymaltose 750 Mg/15 Ml Vial 35 22 $2,998.25 $2,998.25 $1,798.95 $2,998.25 $2,623.47 2026-10-14
65235 CPT Ed Rmv Foreign Body From Eye 34 22 $2,865.00 $2,865.00 $1,719.00 $2,865.00 $2,506.88 2026-10-14
73701 CPT CT Lower Extremity With Contrast 35 22 $2,857.00 $2,857.00 $1,714.20 $2,857.00 $2,499.88 2026-10-14
70491 CPT CT Soft Tissue Neck With Contrast 36 22 $2,825.00 $2,825.00 $1,695.00 $2,825.00 $2,471.88 2026-10-14
Q5136 HCPCS Denosumab-bbdz 60 Mg/ml Syringe 37 22 $2,822.25 $2,822.25 $1,693.35 $2,822.25 $2,469.47 2026-10-14
70488 CPT CT Maxillofacial Without & With Contrast 35 22 $2,817.00 $2,817.00 $1,690.20 $2,817.00 $2,464.88 2026-10-14
70482 CPT CT Orbit/ear/fossa W/O&with Contrast 35 22 $2,804.00 $2,804.00 $1,682.40 $2,804.00 $2,453.50 2026-10-14
74150 CPT CT Abdomen Without Contrast 35 22 $2,777.00 $2,777.00 $1,666.20 $2,777.00 $2,429.88 2026-10-14
72131 CPT CT Lumbar Spine Without Contrast 36 22 $2,776.00 $2,776.00 $1,665.60 $4,365.57 $2,429.00 2026-10-14
Q4275 HCPCS Esano Aca, Per Square Cm 54 22 $2,700.00 $2,700.00 $1,620.00 $3,570.00 $2,409.75 2026-10-14
64530 CPT Nerve Block Inj Celiac Pelus 35 22 $2,753.00 $2,753.00 $1,651.80 $2,753.00 $2,408.88 2026-10-14
72128 CPT CT Chest Spine Without Contrast 36 22 $2,731.00 $2,731.00 $1,638.60 $4,353.86 $2,389.62 2026-10-14
70481 CPT CT Orbit/ear/fossa With Contrast 35 22 $2,730.00 $2,730.00 $1,638.00 $2,730.00 $2,388.75 2026-10-14
73201 CPT CT Upper Extremity With Contrast 35 22 $2,728.00 $2,728.00 $1,636.80 $2,728.00 $2,387.00 2026-10-14
71250 CPT CT Thorax Dx C- 38 22 $2,723.00 $2,723.00 $1,633.80 $4,476.78 $2,382.62 2026-10-14
72192 CPT CT Pelvis Without Contrast 36 22 $2,723.00 $2,723.00 $1,633.80 $4,282.94 $2,382.62 2026-10-14
72125 CPT CT Neck Spine Without Contrast 38 22 $2,720.00 $2,720.00 $1,632.00 $4,177.84 $2,380.00 2026-10-14
73700 CPT CT Lower Extremity Without Contrast 36 22 $2,652.00 $2,652.00 $1,591.20 $4,235.69 $2,320.50 2026-10-14
64624 CPT Dstrj Nulyt Agt Gnclr Nrv 34 22 $2,592.00 $2,592.00 $1,555.20 $2,592.00 $2,268.00 2026-10-14
19083 CPT Bx Breast 1st Lesion US Imag 35 22 $2,588.00 $2,588.00 $1,552.80 $2,588.00 $2,264.50 2026-10-14
93306 CPT Tte W/doppler Complete 36 22 $2,550.00 $2,550.00 $1,530.00 $3,999.69 $2,231.25 2026-10-14
73200 CPT CT Upper Extremity Without Contrast 35 22 $2,533.00 $2,533.00 $1,519.80 $2,533.00 $2,216.38 2026-10-14
70490 CPT CT Soft Tissue Neck Without Contrast 35 22 $2,478.00 $2,478.00 $1,486.80 $2,478.00 $2,168.25 2026-10-14
64493 CPT Mbb Lumbar Or Sacral 1st Lev 55 22 $3,609.00 $3,609.00 $1,114.80 $3,609.00 $2,165.40 2026-10-14
Q0138 HCPCS Ferumoxytol 510 Mg/17 Ml Vial 35 22 $2,453.45 $2,453.45 $1,472.07 $2,453.45 $2,146.77 2026-10-14
70487 CPT CT Maxillofacial With Contrast 35 22 $2,445.00 $2,445.00 $1,467.00 $2,445.00 $2,139.38 2026-10-14
70450 CPT CT Head/brain Without Contrast 42 22 $2,433.00 $2,433.00 $1,440.40 $4,083.86 $2,128.88 2026-10-14
J7325 HCPCS Hylan G-f 20 48 Mg/6 Ml Syr 35 22 $2,411.85 $2,411.85 $1,447.11 $2,411.85 $2,110.37 2026-10-14
29882 CPT Arthrs Kne Srg Mnisc Rpr M/l 35 22 $2,384.00 $2,384.00 $1,430.40 $2,384.00 $2,086.00 2026-10-14
70480 CPT CT Orbit/ear/fossa Without Contrast 35 22 $2,377.00 $2,377.00 $1,426.20 $2,377.00 $2,079.88 2026-10-14
64517 CPT Nerve Block Inj Hypogas Plxs 34 21 $2,298.00 $2,298.00 $1,378.80 $2,298.00 $2,010.75 2026-10-14
36590 CPT Removal Tunneled Cv Cath 35 22 $2,271.00 $2,271.00 $1,362.60 $2,271.00 $1,987.12 2026-10-14
99292 CPT Critical Care, Addl 30 Min 35 22 $2,250.00 $2,250.00 $1,350.00 $2,250.00 $1,968.75 2026-10-14
78227 CPT Hepatobil Syst Image W/drug 35 22 $2,205.00 $2,205.00 $1,323.00 $2,205.00 $1,929.38 2026-10-14
J3240 HCPCS Thyrotropin Alfa 0.9mg/ml 35 22 $2,198.00 $2,198.00 $1,318.80 $2,198.00 $1,923.25 2026-10-14
70460 CPT CT Head/brain With Contrast 35 22 $2,188.00 $2,188.00 $1,312.80 $2,188.00 $1,914.50 2026-10-14
64520 CPT Nerve Block Lumbar/thoracic 35 22 $2,184.00 $2,184.00 $1,310.40 $2,184.00 $1,911.00 2026-10-14
64490 CPT Bilat Mbb Cerv Or Thor 1st Lev 54 22 $3,172.00 $3,172.00 $980.40 $3,172.00 $1,903.20 2026-10-14
70486 CPT CT Maxillofacial Without Contrast 38 22 $2,139.00 $2,139.00 $1,283.40 $3,797.91 $1,871.62 2026-10-14
Q5102 HCPCS Infliximab-dyyb 100 Mg Vial 35 22 $2,138.15 $2,138.15 $1,282.89 $2,138.15 $1,870.88 2026-10-14
64479 CPT Transforaminal Cervical/thorac 34 21 $2,095.00 $2,095.00 $1,257.00 $2,095.00 $1,833.12 2026-10-14
J9202 HCPCS Goserelin Acetate 3.6 Mg Implant 35 22 $2,078.30 $2,078.30 $1,246.98 $2,078.30 $1,818.52 2026-10-14
78315 CPT Bone Imaging 3 Phase 35 22 $2,045.00 $2,045.00 $1,227.00 $2,045.00 $1,789.38 2026-10-14
25605 CPT Ed Frac Distl Rad & Ulna W/man 35 22 $1,976.00 $1,976.00 $1,185.60 $1,976.00 $1,729.00 2026-10-14
J7318 HCPCS Hyaluronate Sodium Stabilized 60 Mg/3 Ml Syringe 35 22 $1,966.25 $1,966.25 $1,179.75 $1,966.25 $1,720.47 2026-10-14
99291 CPT ER - Critical Care 38 22 $1,960.00 $1,960.00 $1,176.00 $1,960.00 $1,715.00 2026-10-14
27301 CPT Ed I&d Dp Absc Burs/hemt Th/kn 34 21 $1,918.00 $1,918.00 $1,150.80 $1,918.00 $1,678.25 2026-10-14
36569 CPT Op Insert Picc Cath 35 22 $1,910.00 $1,910.00 $1,146.00 $1,910.00 $1,671.25 2026-10-14
J3487 HCPCS Zoledronic Acid 4 Mg/5ml 35 22 $1,899.00 $1,899.00 $1,139.40 $1,899.00 $1,661.62 2026-10-14
J1561 HCPCS Immune Glob,gam Caprylate(igg) 1 Gm/10 Ml Ml 93 21 $2,214.25 $2,214.25 $56.29 $6,903.00 $1,645.88 2026-10-14
27752 CPT Treatment Of Tibia Fracture 34 21 $1,881.00 $1,881.00 $1,128.60 $1,881.00 $1,645.88 2026-10-14
24605 CPT Ed Trt Elbow Dislctn, W/anths 33 22 $1,844.00 $1,844.00 $1,106.40 $1,844.00 $1,613.50 2026-10-14
78306 CPT Bone Imaging Whole Body 35 22 $1,832.00 $1,832.00 $1,099.20 $1,832.00 $1,603.00 2026-10-14
64634 CPT Rfa-cervical Or Thoracic Add 52 22 $1,650.00 $1,650.00 $990.00 $3,301.00 $1,584.00 2026-10-14
25565 CPT Ed Treat Fractre Radius & Ulna 34 21 $1,796.00 $1,796.00 $1,077.60 $1,796.00 $1,571.50 2026-10-14
J0630 HCPCS Calcitonin,salmon,synthetic 400 Unit/2 Ml Vial 35 22 $1,765.00 $1,765.00 $1,059.00 $1,765.00 $1,544.38 2026-10-14
93880 CPT Extracranial Bilat Study 55 22 $1,736.00 $1,736.00 $1,031.40 $2,853.99 $1,504.12 2026-10-14
J9395 HCPCS Fulvestrant 250 Mg/5 Ml Syringe 35 22 $1,711.70 $1,711.70 $1,027.02 $1,711.70 $1,497.74 2026-10-14
64494 CPT Mbb Lumbar Or Sacral 2nd Lev 54 22 $1,560.00 $1,560.00 $936.00 $3,120.00 $1,497.60 2026-10-14
27818 CPT Ed Treat Ankle Fracture 35 22 $1,698.00 $1,698.00 $1,018.80 $1,698.00 $1,485.75 2026-10-14
10005 CPT Ir Fine Needle Bx W/us 1st Les 35 22 $1,681.00 $1,681.00 $1,008.60 $1,681.00 $1,470.88 2026-10-14
64483 CPT Transforamil Lumbar/sacral 37 22 $1,673.00 $1,673.00 $146.59 $1,673.00 $1,463.88 2026-10-14
J3262 HCPCS Tocilizumab 200 Mg/10 Ml Vial 75 22 $1,659.90 $1,659.90 $6.26 $5,984.60 $1,452.41 2026-10-14
27810 CPT Ed Treat Ankle Fracture 35 22 $1,655.00 $1,655.00 $993.00 $1,655.00 $1,448.12 2026-10-14
36572 CPT Op Insj Picc Rs&i <5 Yr 35 22 $1,645.00 $1,645.00 $987.00 $1,645.00 $1,439.38 2026-10-14
J0585 HCPCS Onabotulinumtoxina 200 Unit Vial 54 22 $2,293.50 $2,293.50 $887.85 $2,293.50 $1,420.56 2026-10-14
J0248 HCPCS Remdesivir 100 Mg Vial 35 22 $1,609.45 $1,609.45 $965.67 $1,609.45 $1,408.27 2026-10-14
23655 CPT Ed Trt Shldr Dislction,w/anths 33 21 $1,578.00 $1,578.00 $946.80 $1,578.00 $1,380.75 2026-10-14
90375 CPT Rabies Immune Globulin/pf 300 Unit/ml Vial 73 22 $1,555.60 $1,555.60 $397.05 $3,659.10 $1,361.15 2026-10-14
93970 CPT Extremity Study 35 22 $1,543.00 $1,543.00 $925.80 $1,543.00 $1,350.12 2026-10-14
G0378 HCPCS Room/board H&o 1 Hr 1,129 22 $1,682.00 $1,682.00 $450.60 $3,315.00 $1,334.75 2026-10-14
27788 CPT Ed Treat Ankle Fx 35 22 $1,500.00 $1,500.00 $900.00 $1,500.00 $1,312.50 2026-10-14
78300 CPT Bone Imaging Limited Area 35 22 $1,466.00 $1,466.00 $879.60 $1,466.00 $1,282.75 2026-10-14
36589 CPT Removal Tunneled Cv Cath 35 22 $1,462.00 $1,462.00 $877.20 $1,462.00 $1,279.25 2026-10-14
55250 CPT Vasectomy 34 21 $1,449.00 $1,449.00 $869.40 $1,449.00 $1,267.88 2026-10-14
99285 CPT Emergency Service-level 5 42 22 $1,447.00 $1,447.00 $868.20 $1,591.91 $1,266.12 2026-10-14
27830 CPT Ed Treat Lower Leg Dislocation 35 22 $1,407.00 $1,407.00 $844.20 $1,407.00 $1,231.12 2026-10-14
71271 CPT CT Thorax Lung Cancer Scr C- 37 22 $1,401.00 $1,401.00 $840.60 $1,401.00 $1,225.88 2026-10-14
31237 CPT Sc Nasal/sinus Endoscopy Surg 35 22 $1,401.00 $1,401.00 $840.60 $1,401.00 $1,225.88 2026-10-14
93925 CPT Lower Extremity Study 36 22 $1,345.00 $1,345.00 $807.00 $1,805.38 $1,176.88 2026-10-14
36584 CPT Op Replace Picc Without Port 35 22 $1,339.00 $1,339.00 $803.40 $1,339.00 $1,171.62 2026-10-14
93975 CPT Vascular Study 35 22 $1,338.00 $1,338.00 $802.80 $1,338.00 $1,170.75 2026-10-14
64421 CPT Nerve Block Inj Intercost Mult 35 22 $1,335.00 $1,335.00 $801.00 $1,335.00 $1,168.12 2026-10-14
64495 CPT Mbb Lumbar Or Sacral 3rd Lev 54 22 $1,899.00 $1,899.00 $570.00 $1,899.00 $1,167.88 2026-10-14
27560 CPT Ed Treat Kneecap Dislocation 35 22 $1,332.00 $1,332.00 $799.20 $1,332.00 $1,165.50 2026-10-14
24600 CPT Ed Tx Elbw Disl Without Anes 35 22 $1,327.00 $1,327.00 $796.20 $1,327.00 $1,161.12 2026-10-14
73222 CPT MRI Joint Upr Extrem With Contrast 35 22 $1,292.00 $1,292.00 $775.20 $1,292.00 $1,130.50 2026-10-14
64425 CPT Nerve Block Inj Ilio-ing/hypo 35 22 $1,289.00 $1,289.00 $773.40 $1,289.00 $1,127.88 2026-10-14
64640 CPT Rf Of S1/s2/s3 Lateral Branch 54 22 $1,779.00 $1,779.00 $708.60 $1,779.00 $1,121.95 2026-10-14
93307 CPT Tte Without Doppler Complete 35 22 $1,258.00 $1,258.00 $754.80 $1,258.00 $1,100.75 2026-10-14
64454 CPT Njx Aa&/strd Gnclr Nrv Brnch 34 22 $1,238.00 $1,238.00 $742.80 $1,238.00 $1,083.25 2026-10-14
95874 CPT Guide Nerv Destr Needle EMG 33 22 $1,236.00 $1,236.00 $741.60 $1,236.00 $1,081.50 2026-10-14
93971 CPT Extremity Study 55 22 $1,235.00 $1,235.00 $734.40 $2,032.86 $1,080.62 2026-10-14
93017 CPT Stress Test 37 22 $1,217.00 $1,217.00 $730.20 $1,321.26 $1,064.88 2026-10-14
93978 CPT Vascular Study 35 22 $1,200.00 $1,200.00 $720.00 $1,200.00 $1,050.00 2026-10-14
26725 CPT Ed Treat Finger Fracture Each 35 22 $1,198.00 $1,198.00 $718.80 $1,198.00 $1,048.25 2026-10-14
64420 CPT Nerve Block Inj Intercost Sing 35 22 $1,196.00 $1,196.00 $717.60 $1,196.00 $1,046.50 2026-10-14
23650 CPT Ed Treat Shldr Dislocation 35 22 $1,176.00 $1,176.00 $705.60 $1,176.00 $1,029.00 2026-10-14
J0588 HCPCS Incobotulinumtoxina 200 Unit Vial 73 22 $1,164.75 $1,164.75 $395.10 $1,803.50 $1,019.15 2026-10-14
13132 CPT ER Cmplx Rpr F/c/c/m/n/ax/g/h 35 22 $1,163.00 $1,163.00 $697.80 $1,163.00 $1,017.62 2026-10-14
J0881 HCPCS Darbepoetin Alfa In Polysorbat 25 Mcg/0.42 Ml Syr 130 22 $1,059.90 $1,059.90 $270.24 $4,837.50 $1,017.50 2026-10-14
Q5121 HCPCS Infliximab-axxq 100 Mg/10 Ml Vial 34 20 $1,134.00 $1,134.00 $31.74 $1,134.00 $992.25 2026-10-14
64491 CPT Bilat Mbb Cerv Or Thor 2nd Lev 54 22 $1,006.00 $1,006.00 $603.60 $2,011.00 $985.88 2026-10-14
92950 CPT Ed Heart/lung Resus Cpr 35 22 $1,110.00 $1,110.00 $666.00 $1,110.00 $971.25 2026-10-14
62323 CPT Interlaminar Lmbr/sac 35 21 $1,109.00 $1,109.00 $82.81 $1,109.00 $970.38 2026-10-14
62321 CPT Interlaminar Crv/thrc 36 22 $1,109.00 $1,109.00 $665.40 $1,109.00 $970.38 2026-10-14
64492 CPT Mbb Cervical Or Thoracic 3rd L 53 21 $1,006.00 $1,006.00 $603.60 $2,011.00 $965.76 2026-10-14
93926 CPT Lower Extremity Study 54 22 $1,096.00 $1,096.00 $657.60 $1,106.00 $959.00 2026-10-14
27093 CPT Injection For Hip X-ray 35 22 $1,092.00 $1,092.00 $655.20 $1,092.00 $955.50 2026-10-14
J0185 HCPCS Aprepitant 130 Mg/18 Ml Vial 35 22 $1,073.15 $1,073.15 $643.89 $1,073.15 $939.00 2026-10-14
41120 CPT Sc Partial Removal Of Tongue 35 22 $1,073.00 $1,073.00 $643.80 $1,073.00 $938.88 2026-10-14
13151 CPT Ed Cmplx Rpr E/n/e/l 1.1-2.5cm 36 22 $1,065.00 $1,065.00 $639.00 $1,065.00 $931.88 2026-10-14
93931 CPT Upper Extremity Study 35 22 $1,060.00 $1,060.00 $636.00 $1,060.00 $927.50 2026-10-14
93990 CPT Doppler Flow Testing 35 22 $1,056.00 $1,056.00 $633.60 $1,056.00 $924.00 2026-10-14
73525 CPT Contrast X-ray Of Hip 35 22 $1,047.00 $1,047.00 $628.20 $1,047.00 $916.12 2026-10-14
12036 CPT Ed Rpr Intmd S/a/t/ex 20.1-30 35 22 $1,043.00 $1,043.00 $625.80 $1,043.00 $912.62 2026-10-14
J2325 HCPCS Nesiritide 1.5mg/1ml Vl 35 22 $1,039.00 $1,039.00 $623.40 $1,039.00 $909.12 2026-10-14
26770 CPT Ed Tx Ip Jt Disl W/manp Wo Ane 35 22 $1,036.00 $1,036.00 $621.60 $1,036.00 $906.50 2026-10-14
64510 CPT N Block Stellate Ganglion 34 21 $1,030.00 $1,030.00 $618.00 $1,030.00 $901.25 2026-10-14
92960 CPT Op Cardioversion 54 22 $1,500.00 $1,500.00 $252.60 $1,500.00 $900.00 2026-10-14
77002 CPT Needle Localization By Xray 34 22 $1,022.00 $1,022.00 $613.20 $1,022.00 $894.25 2026-10-14
77003 CPT Fluoroguide For Spine Inject 34 22 $1,021.00 $1,021.00 $612.60 $1,021.00 $893.38 2026-10-14
64488 CPT Tap Block Bi Injection 35 22 $1,018.00 $1,018.00 $610.80 $1,018.00 $890.75 2026-10-14
62320 CPT Njx Interlaminar Crv/thrc 34 22 $1,007.00 $1,007.00 $604.20 $1,007.00 $881.12 2026-10-14
76700 CPT US Exam Abdom Complete 41 22 $1,006.00 $1,006.00 $603.60 $1,674.05 $880.25 2026-10-14
13121 CPT Ed Cmplx Rpr S/a/l 2.6-7.5 Cm 35 22 $991.00 $991.00 $594.60 $991.00 $867.12 2026-10-14
93308 CPT Tte F-up Or Lmtd 35 22 $975.00 $975.00 $585.00 $975.00 $853.12 2026-10-14
M0249 HCPCS IV Tcz Hp Pt 2&> Covd-19 Inf&mon Fd 2 2 — — $852.09 $852.09 $852.09 2026-10-14
M0250 HCPCS IV Tcz Hp 2&>covid-19 Inf&mon 2nd D 2 2 — — $852.09 $852.09 $852.09 2026-10-14
62270 CPT Spinal Fluid Tap Diagnostic 35 22 $973.00 $973.00 $583.80 $973.00 $851.38 2026-10-14
73040 CPT Contrast X-ray Of Shoulder 35 22 $970.00 $970.00 $582.00 $970.00 $848.75 2026-10-14
14061 CPT Sc Tis Trfr E/n/e/l10.1-30sqcm 35 22 $969.00 $969.00 $581.40 $969.00 $847.88 2026-10-14
76770 CPT US Exam Abdo Back Wall Comp 36 22 $965.00 $965.00 $579.00 $1,602.27 $844.38 2026-10-14
J0666 HCPCS Bupivacaine Liposome/pf 13.3 Mg/ml 20 Ml Vial 35 22 $956.90 $956.90 $574.14 $956.90 $837.29 2026-10-14
64418 CPT Nerve Block Inj Suprascapular 35 22 $954.00 $954.00 $572.40 $954.00 $834.75 2026-10-14
13101 CPT Ed Cmplx Rpr Trunk 2.6-7.5 Cm 35 22 $951.00 $951.00 $570.60 $951.00 $832.12 2026-10-14
99284 CPT Emergency Service-level 4 41 22 $942.00 $942.00 $565.20 $1,407.09 $824.25 2026-10-14
76856 CPT US Exam Pelvic Complete 38 22 $936.00 $936.00 $561.60 $936.00 $819.00 2026-10-14
94660 CPT Rt Initiat&mgt Cpap Bipap 35 22 $934.00 $934.00 $560.40 $934.00 $817.25 2026-10-14
76776 CPT US Exam K Transpl W/doppler 35 22 $920.00 $920.00 $552.00 $920.00 $805.00 2026-10-14
77075 CPT X-rays Bone Survey Complete 35 22 $916.00 $916.00 $549.60 $916.00 $801.50 2026-10-14
J1447 HCPCS Tbo-filgrastim 480 Mcg/0.8 Ml Syr 35 22 $914.80 $914.80 $548.88 $914.80 $800.45 2026-10-14
12035 CPT Ed Rpr Intmd S/a/t/ex 12.6-20 35 22 $906.00 $906.00 $543.60 $906.00 $792.75 2026-10-14
23350 CPT Injection For Shoulder X-ray 35 22 $899.00 $899.00 $539.40 $899.00 $786.62 2026-10-14
29848 CPT Or Wrist Endoscopy/surgery 36 22 $896.00 $896.00 $537.60 $896.00 $784.00 2026-10-14
26116 CPT Or Exc Hand Tum Deep < 1.5 Cm 35 22 $895.00 $895.00 $537.00 $895.00 $783.12 2026-10-14
64480 CPT Tranforamil Cervical/thor Add 34 21 $887.00 $887.00 $532.20 $887.00 $776.12 2026-10-14
76942 CPT Echo Guide For Biopsy 33 22 $883.00 $883.00 $529.80 $883.00 $772.62 2026-10-14
13152 CPT Ed Cmplx Rpr E/n/e/l 2.6-7.5cm 56 22 $1,282.00 $1,282.00 $278.40 $1,282.00 $769.20 2026-10-14
0003M CPT Liver Dis 10 Assays W/nash 35 22 $877.00 $877.00 $526.20 $877.00 $767.38 2026-10-14
93923 CPT Upr/lxtr Art Stdy 3+ Lvls 54 22 $859.00 $859.00 $515.40 $867.00 $751.62 2026-10-14
88262 CPT Chromo.analysis 15-20 Cel 35 22 $848.00 $848.00 $508.80 $848.00 $742.00 2026-10-14
93979 CPT Vascular Study 35 22 $846.00 $846.00 $507.60 $846.00 $740.25 2026-10-14
J2469 HCPCS Palonosetron 0.25mg/5ml V 35 22 $841.00 $841.00 $504.60 $841.00 $735.88 2026-10-14
62322 CPT Inject Spine Lumbar/sacral 35 22 $840.00 $840.00 $504.00 $840.00 $735.00 2026-10-14
87154 CPT Cul Typ Id Bld Pthgn 6+ Trgt 35 22 $837.00 $837.00 $502.20 $837.00 $732.38 2026-10-14
36430 CPT Ed Blood Transfusion 54 22 $1,018.00 $1,018.00 $459.60 $1,116.46 $731.53 2026-10-14
76805 CPT OB US >/= 14 Wks Sngl Fetus 35 22 $836.00 $836.00 $501.60 $836.00 $731.50 2026-10-14
12044 CPT Ed Layr Clsre Of Wd 7.6-12.5cm 35 22 $832.00 $832.00 $499.20 $832.00 $728.00 2026-10-14
12053 CPT Ed Layr Clsre Of Wnd 5.1-7.5cm 35 22 $828.00 $828.00 $496.80 $828.00 $724.50 2026-10-14
49082 CPT Abdominal Paracentesis 34 22 $812.00 $812.00 $487.20 $1,474.57 $710.50 2026-10-14
J0637 HCPCS Caspofungin Acetate 70 Mg Vial 54 22 $798.50 $798.50 $461.31 $798.50 $698.69 2026-10-14
86052 CPT Aqp4 (nmo-igg) Autoantibody 35 22 $794.00 $794.00 $476.40 $794.00 $694.75 2026-10-14
12051 CPT Ed Layr Clsre Of Wnd 2.5 Cmor< 34 21 $789.00 $789.00 $473.40 $789.00 $690.38 2026-10-14
12034 CPT Ed Rpr Intmd S/a/t/ex 7.6-12.5 35 22 $787.00 $787.00 $472.20 $787.00 $688.62 2026-10-14
64486 CPT Tap Block Unil By Injection 35 22 $786.00 $786.00 $471.60 $786.00 $687.75 2026-10-14
36573 CPT Ed Insj Picc Rs&i 5 Yr+ 34 22 $783.00 $783.00 $469.80 $783.00 $685.12 2026-10-14
86362 CPT Mog-igg1 Antb Cba Each 35 22 $779.00 $779.00 $467.40 $779.00 $681.62 2026-10-14
J1327 HCPCS Eptifibatide 0.75mg/ml 10 73 22 $770.00 $770.00 $135.00 $1,836.00 $673.75 2026-10-14
12052 CPT Ed Rpr Intm F/e/e/n/l/mm 2.6-5 35 22 $770.00 $770.00 $462.00 $770.00 $673.75 2026-10-14
37195 CPT Ed Thrombolytic Therapy Stroke 32 21 $768.00 $768.00 $460.80 $768.00 $672.00 2026-10-14
12042 CPT Ed Rpr Intmd N/h/f/eg 2.6-7.5 35 22 $757.00 $757.00 $454.20 $757.00 $662.38 2026-10-14
76705 CPT Echo Exam Of Abdomen 38 22 $757.00 $757.00 $454.20 $1,242.73 $662.38 2026-10-14
14040 CPT Sc Tis Trnfr F/c/c/m/n/a/g/h/f 35 22 $749.00 $749.00 $449.40 $749.00 $655.38 2026-10-14
94060 CPT Evaluation Of Wheezing 36 22 $747.00 $747.00 $448.20 $801.01 $653.62 2026-10-14
12032 CPT Ed Rpr Intmd S/a/t/ext 2.6-7.5 35 22 $738.00 $738.00 $442.80 $738.00 $645.75 2026-10-14
81270 CPT Jak2 V617f 35 22 $738.00 $738.00 $442.80 $738.00 $645.75 2026-10-14
76536 CPT US Exam Of Head And Neck 38 22 $735.00 $735.00 $441.00 $1,242.73 $643.12 2026-10-14
76706 CPT US Abdl Aorta Screen Aaa 36 22 $732.00 $732.00 $439.20 $732.00 $640.50 2026-10-14
76000 CPT Fluoroscopy <1 Hr Phys/qhp 35 22 $732.00 $732.00 $439.20 $732.00 $640.50 2026-10-14
14060 CPT Sc Tis Trnfr E/n/e/l 10 Sq Cm< 35 22 $726.00 $726.00 $435.60 $726.00 $635.25 2026-10-14
64405 CPT Nerve Block Inj Occipital 34 21 $720.00 $720.00 $432.00 $720.00 $630.00 2026-10-14
0202U CPT Nfct Ds 22 Trgt Sars-cov-2 2 2 — — $624.40 $624.40 $624.40 2026-10-14
76376 CPT 3d Render W/intrp Postproces 35 22 $710.00 $710.00 $426.00 $710.00 $621.25 2026-10-14
64400 CPT Nerve Block Inj Trigeminal 35 22 $707.00 $707.00 $424.20 $707.00 $618.62 2026-10-14
36593 CPT Op Declot Vascular Device 35 22 $695.00 $695.00 $417.00 $695.00 $608.12 2026-10-14
64642 CPT Chemodenerv 1 Extremity 1-4 33 22 $694.00 $694.00 $416.40 $694.00 $607.25 2026-10-14
72052 CPT X-ray Exam Neck Spine 6/>vws 35 22 $679.00 $679.00 $407.40 $679.00 $594.12 2026-10-14
76882 CPT US Lmtd Jt/nonvasc Xtr Strux 35 22 $677.00 $677.00 $406.20 $677.00 $592.38 2026-10-14
76775 CPT US Exam Abdo Back Wall Lim 35 22 $676.00 $676.00 $405.60 $676.00 $591.50 2026-10-14
76870 CPT US Exam Scrotum 35 22 $670.00 $670.00 $402.00 $670.00 $586.25 2026-10-14
76830 CPT Transvaginal US Non-OB 35 22 $670.00 $670.00 $402.00 $670.00 $586.25 2026-10-14
J9214 HCPCS Interferon Alfa-2b Recomb 54 22 $607.00 $607.00 $364.20 $1,671.00 $582.72 2026-10-14
A9562 HCPCS Nm Tc99m Mertiatide 35 22 $665.00 $665.00 $399.00 $665.00 $581.88 2026-10-14
A9500 HCPCS Nm Tc99 Sestamibi 36 22 $665.00 $665.00 $399.00 $736.44 $581.88 2026-10-14
88230 CPT Tissue Culture-lymphocyte 35 22 $659.00 $659.00 $395.40 $659.00 $576.62 2026-10-14
93976 CPT Vascular Study 54 22 $658.00 $658.00 $391.20 $658.00 $575.75 2026-10-14
J1554 HCPCS Inj. Asceniv 2 2 — — $567.10 $567.10 $567.10 2026-10-14
93226 CPT ECG Monit/reprt Up To 48 Hrs 35 22 $647.00 $647.00 $388.20 $647.00 $566.12 2026-10-14
J1610 HCPCS Glucagon,human Recombinant 1 Mg Kit 35 22 $645.00 $645.00 $387.00 $645.00 $564.38 2026-10-14
36410 CPT Ed Non-routine Bl Draw 3/> Yrs 33 19 $639.00 $639.00 $20.00 $639.00 $559.12 2026-10-14
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