Hospital

PROVIDENCE MEDICAL CENTER

Wayne, NE · CCN 281345 · Rates published

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This hospital’s price: $2,625 across 10 payers · range $1,721-$2,859

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/10169/470566524_providence-medical-center_standardcharges.csv · observed 2026-10-20

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.

1,862 distinct procedures filed

10 distinct payers

57,404 rate rows

2026-10-20 last MRF observed

Data quality

52,473 of 57,404 rate rows are consumer-grade (91.4%)

4,931 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
professional (physician) fee — not the facility price	4,856
percent-of-charges filed in the dollar field — excluded from medians	72
per-diem day rate — not a per-procedure price	3

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

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/10169/470566524_providence-medical-center_standardcharges.csv
Found on page	https://search.hospitalpriceindex.com/hpi2/machineReadable/ProvidenceMedicalCenter/10169
Discovered via	Discovered by HANK
Last fetch	success · 2026-10-21
Content fingerprint	fb817b75a0e05f9b… · 39,621,236 bytes · first seen 2026-10-21

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	Ocrelizumab 300 Mg/10 Ml Inj [pmc]	10	$65.44	$39,580.81	$37,561.38	nat. median $470 outlier · 80.0×
J1303 HCPCS	Ravulizumab 1100 Mg/11 Ml Inj [pmc]	10	$249.42	$44,749.25	$26,940.87	nat. median $5,977 outlier · 4.5×
J1628 HCPCS	Guselkumab 100 mg/mL Inj [pmc]	10	$16,784.47	$27,879.29	$26,741.36	nat. median $228 outlier · 117.2×
J2327 HCPCS	Risankizumab-rzaa 60 mg/mL Sol [pmc]	10	$11,959.27	$19,864.55	$19,053.75	nat. median $2,076 outlier · 9.2×
J3380 HCPCS	Vedolizumab 300 Mg Pow Inj [pmc]	10	$23.96	$18,426.14	$17,486.03	nat. median $162 outlier · 107.9×
J2323 HCPCS	Natalizumab 300 Mg/15 Ml IV Conc [pmc]	10	$27.59	$16,185.04	$15,359.27	nat. median $197 outlier · 77.9×
C1820 HCPCS	Neurostimulator F15	10	$8,955.32	$14,874.93	$14,267.79	nat. median $22,986 0.6× median
C1767 HCPCS	Implant Interstim Internal Neurostimulator Bladder/bowel	10	$8,278.44	$13,750.63	$13,189.38	nat. median $23,896 0.6× median
J3101 HCPCS	Tenecteplase 25 Mg IV Inj Stroke [pmc]	10	$7,857.50	$15,577.98	$12,918.26	nat. median $3,820 outlier · 3.4×
J2506 HCPCS	Pegfilgrastim Onpro Kit 6 Mg/0.6 Ml SubQ Inj 0.6 Ml [pmc]	10	$7,497.50	$12,453.47	$11,945.17	nat. median $1,646 outlier · 7.3×
J0717 HCPCS	Certolizumab 200 mg/mL Syringe Kit [pmc]	10	$7,358.96	$12,223.36	$11,724.44	nat. median $1,598 outlier · 7.3×
0275T CPT	Minimally Invasive Lumbar Decompression	10	$6,937.22	$11,522.84	$11,052.52	nat. median $8,372 1.3× median
J9271 HCPCS	Pembrolizumab 25 mg/mL Inj 4 Ml [pmc]	10	$6,754.63	$11,219.55	$10,761.61	nat. median $276 outlier · 39.0×
J1950 HCPCS	Leuprolide 11.25 Mg/3 Months IM Inj [pmc]	10	$6,627.83	$11,008.94	$10,559.59	nat. median $3,902 outlier · 2.7×
J0517 HCPCS	Benralizumab 30 mg/mL Sol [pmc]	10	$184.87	$11,015.17	$10,453.17	nat. median $919 outlier · 11.4×
62330 CPT	Mild; 1 Interspace	10	$6,032.16	$10,019.52	$9,610.56	nat. median $8,307 1.2× median
Q4297 HCPCS	Emerge Amnion/chorion Membrane Matrix 2cm X 2cm	10	$5,837.46	$9,696.12	$9,300.36	nat. median $1,748 outlier · 5.3×
63650 CPT	Spinal Cord Stimulator Trial	10	$5,794.39	$9,624.58	$9,231.74	nat. median $7,279 1.3× median
J9312 HCPCS	riTUXimab 10 mg/mL Inj Sol 50 Ml [pmc]	10	$5,487.74	$9,115.22	$8,743.17	nat. median $1,071 outlier · 8.2×
J2356 HCPCS	Tezepelumab-ekko 210 Mg/1.91 Ml Syr [pmc]	10	$5,103.82	$8,477.53	$8,131.51	nat. median $81 outlier · 100.0×
Q5111 HCPCS	Pegfilgrastim-cbqv 6 Mg/0.6 Ml Inj [pmc]	10	$4,877.24	$8,101.17	$7,770.51	nat. median $1,982 outlier · 3.9×
Q5122 HCPCS	Pegfilgrastim-apgf 6 Mg/0.6 Ml Inj [pmc]	10	$4,863.08	$8,077.65	$7,747.95	nat. median $561 outlier · 13.8×
L8699 HCPCS	Implant Denovo Nt Graft	10	$4,813.52	$7,995.33	$7,668.99	nat. median $2,008 outlier · 3.8×
J0565 HCPCS	Bezlotoxumab 25 mg/mL Sol 40 Ml [pmc]	10	$4,708.20	$7,820.40	$7,501.20	nat. median $159 outlier · 47.1×
J2182 HCPCS	Mepolizumab 100 Mg Pow Inj [pmc]	10	$34.57	$7,562.90	$7,177.04	nat. median $2,791 outlier · 2.6×
Q5119 HCPCS	Rituximab-pvvr 10 mg/mL Inj Sol 50 Ml [pmc]	10	$4,440.58	$7,375.87	$7,074.81	nat. median $826 outlier · 8.6×
Q5123 HCPCS	Rituximab-arrx 10 mg/mL Inj Sol 50 Ml [pmc]	10	$4,440.58	$7,375.87	$7,074.81	nat. median $1,006 outlier · 7.0×
J1725 HCPCS	Hydroxyprogesterone 250 mg/mL Sol 5 Ml [pmc]	10	$4,274.55	$7,100.10	$6,810.30	nat. median $50 outlier · 135.2×
C1768 HCPCS	Alitply Lite 4cm X 4cm	10	$2,124.00	$10,143.00	$6,545.00	nat. median $2,052 outlier · 3.2×
J1437 HCPCS	Ferric Derisomaltose 1000 Mg/10 Ml Inj [pmc]	10	$4,022.74	$6,681.85	$6,409.12	nat. median $46 outlier · 140.6×
78815 CPT	PET Skull Base To Midthigh With CT Scan	10	$3,879.84	$6,444.48	$6,181.44	nat. median $2,820 outlier · 2.2×
75635 CPT	CT Angio Abdomen Aorta +Iliofemoral	10	$3,824.97	$6,353.34	$6,094.02	nat. median $722 outlier · 8.4×
78816 CPT	PET Whole Body With CT Scan	10	$3,729.98	$6,195.56	$5,942.68	nat. median $2,788 outlier · 2.1×
58558 CPT	58558 Hysteroscopy With Biopsy, W Or Without D&c	10	$3,720.54	$6,179.88	$5,927.64	nat. median $3,308 1.8× median
J0401 HCPCS	ARIPiprazole 400 Mg IM Kit [pmc]	10	$3,706.55	$6,156.64	$5,905.35	nat. median $1,939 outlier · 3.0×
C1889 HCPCS	Implant Arthroflex 40 X 70 X 3.0mm	10	$3,536.31	$7,519.59	$5,813.94	nat. median $2,369 outlier · 2.5×
70549 CPT	MRA Neck With + Without Cont	10	$3,519.94	$5,846.68	$5,608.04	nat. median $1,055 outlier · 5.3×
C1778 HCPCS	Implant 3889-28 Sns Lead	10	$431.59	$6,002.50	$5,378.63	nat. median $4,400 1.2× median
25608 CPT	25608 Open Tx Of Distal Radial Intra-artic Fx W Internal Fixation; 2 Fragments	10	$3,304.00	$5,488.00	$5,264.00	nat. median $7,110 0.7× median
C9399 HCPCS	Graft, Activi Viable Matrix Plus 2.5cc	10	$3,304.00	$8,575.00	$5,264.00	nat. median $2,003 outlier · 2.6×
J3111 HCPCS	Romosozumab-aqqg 210 Mg/2.34 Ml Inj Kit [pmc]	10	$3,257.23	$5,410.32	$5,189.49	nat. median $681 outlier · 7.6×
13160 CPT	13160 Secondary Closure Of Surgical Wound/dehiscence	10	$3,207.83	$5,328.26	$5,110.78	nat. median $2,657 1.9× median
70471 CPT	CT Angio Head +Angio Neck With + Without Cont	10	$3,229.07	$5,363.54	$5,089.89	nat. median $830 outlier · 6.1×
74178 CPT	Pmc CT Abdomen +Pelvis With + Without Cont	10	$3,197.21	$5,310.62	$5,039.67	nat. median $1,024 outlier · 4.9×
Q4100 HCPCS	Active Barrier 200 Amniotic Membrane Allograft 4x8	10	$2,284.63	$8,225.14	$5,032.13	nat. median $2,016 outlier · 2.5×
52601 CPT	Prostate Resection Transurethral	10	$3,156.50	$5,243.00	$5,029.00	nat. median $5,338 0.9× median
73723 CPT	MRI Ankle With + Without Cont Lt	10	$3,123.46	$5,188.12	$4,976.36	nat. median $1,192 outlier · 4.2×
20240 CPT	20240 Biopsy, Bone, Open; Superficial	10	$3,105.76	$5,158.72	$4,948.16	nat. median $2,902 1.7× median
C1762 HCPCS	Altiply Lite 4cm X 7cm	10	$1,585.63	$14,406.00	$4,829.92	nat. median $2,940 1.6× median
74174 CPT	Pmc CT Angio Abdomen Pelvis	10	$3,031.42	$5,035.24	$4,829.72	nat. median $988 outlier · 4.9×

Other procedures at this hospital

Browse this hospital's 1,862 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	Ocrelizumab 300 Mg/10 Ml Inj [pmc]	14	10	$40,388.58	$34,330.30	$65.44	$39,580.81	$37,561.38	2026-10-20
J1303	HCPCS	Ravulizumab 1100 Mg/11 Ml Inj [pmc]	23	10	$45,662.50	$38,813.13	$249.42	$44,749.25	$26,940.87	2026-10-20
J1628	HCPCS	Guselkumab 100 mg/mL Inj [pmc]	14	10	$28,448.25	$24,181.02	$16,784.47	$27,879.29	$26,741.36	2026-10-20
J2327	HCPCS	Risankizumab-rzaa 60 mg/mL Sol [pmc]	14	10	$20,269.95	$17,229.46	$11,959.27	$19,864.55	$19,053.75	2026-10-20
J3380	HCPCS	Vedolizumab 300 Mg Pow Inj [pmc]	14	10	$18,802.18	$15,981.86	$23.96	$18,426.14	$17,486.03	2026-10-20
J2323	HCPCS	Natalizumab 300 Mg/15 Ml IV Conc [pmc]	14	10	$16,515.35	$14,038.05	$27.59	$16,185.04	$15,359.27	2026-10-20
C1820	HCPCS	Neurostimulator F15	14	10	$15,178.50	$12,901.73	$8,955.32	$14,874.93	$14,267.79	2026-10-20
C1767	HCPCS	Implant Interstim Internal Neurostimulator Bladder/bowel	14	10	$14,031.25	$11,926.57	$8,278.44	$13,750.63	$13,189.38	2026-10-20
J3101	HCPCS	Tenecteplase 25 Mg IV Inj Stroke [pmc]	24	10	$15,895.89	$13,511.52	$7,857.50	$15,577.98	$12,918.26	2026-10-20
J2506	HCPCS	Pegfilgrastim Onpro Kit 6 Mg/0.6 Ml SubQ Inj 0.6 Ml [pmc]	14	10	$12,707.62	$10,801.48	$7,497.50	$12,453.47	$11,945.17	2026-10-20
J0717	HCPCS	Certolizumab 200 mg/mL Syringe Kit [pmc]	14	10	$12,472.81	$10,601.90	$7,358.96	$12,223.36	$11,724.44	2026-10-20
0275T	CPT	Minimally Invasive Lumbar Decompression	14	10	$11,758.00	$9,994.30	$6,937.22	$11,522.84	$11,052.52	2026-10-20
J9271	HCPCS	Pembrolizumab 25 mg/mL Inj 4 Ml [pmc]	14	10	$11,448.52	$9,731.25	$6,754.63	$11,219.55	$10,761.61	2026-10-20
J1950	HCPCS	Leuprolide 11.25 Mg/3 Months IM Inj [pmc]	14	10	$11,233.61	$9,548.57	$6,627.83	$11,008.94	$10,559.59	2026-10-20
J0517	HCPCS	Benralizumab 30 mg/mL Sol [pmc]	14	10	$11,239.97	$9,553.98	$184.87	$11,015.17	$10,453.17	2026-10-20
62330	CPT	Mild; 1 Interspace	14	10	$10,224.00	$8,690.40	$6,032.16	$10,019.52	$9,610.56	2026-10-20
Q4297	HCPCS	Emerge Amnion/chorion Membrane Matrix 2cm X 2cm	14	10	$9,894.00	$8,409.90	$5,837.46	$9,696.12	$9,300.36	2026-10-20
63650	CPT	Spinal Cord Stimulator Trial	14	10	$9,821.00	$8,347.85	$5,794.39	$9,624.58	$9,231.74	2026-10-20
J9312	HCPCS	riTUXimab 10 mg/mL Inj Sol 50 Ml [pmc]	14	10	$9,301.25	$7,906.07	$5,487.74	$9,115.22	$8,743.17	2026-10-20
J2356	HCPCS	Tezepelumab-ekko 210 Mg/1.91 Ml Syr [pmc]	14	10	$8,650.54	$7,352.96	$5,103.82	$8,477.53	$8,131.51	2026-10-20
Q5111	HCPCS	Pegfilgrastim-cbqv 6 Mg/0.6 Ml Inj [pmc]	14	10	$8,266.50	$7,026.53	$4,877.24	$8,101.17	$7,770.51	2026-10-20
Q5122	HCPCS	Pegfilgrastim-apgf 6 Mg/0.6 Ml Inj [pmc]	14	10	$8,242.50	$7,006.13	$4,863.08	$8,077.65	$7,747.95	2026-10-20
L8699	HCPCS	Implant Denovo Nt Graft	14	10	$8,158.50	$6,934.73	$4,813.52	$7,995.33	$7,668.99	2026-10-20
J0565	HCPCS	Bezlotoxumab 25 mg/mL Sol 40 Ml [pmc]	14	10	$7,980.00	$6,783.00	$4,708.20	$7,820.40	$7,501.20	2026-10-20
J2182	HCPCS	Mepolizumab 100 Mg Pow Inj [pmc]	14	10	$7,717.25	$6,559.67	$34.57	$7,562.90	$7,177.04	2026-10-20
Q5123	HCPCS	Rituximab-arrx 10 mg/mL Inj Sol 50 Ml [pmc]	14	10	$7,526.40	$6,397.44	$4,440.58	$7,375.87	$7,074.81	2026-10-20
Q5119	HCPCS	Rituximab-pvvr 10 mg/mL Inj Sol 50 Ml [pmc]	14	10	$7,526.40	$6,397.44	$4,440.58	$7,375.87	$7,074.81	2026-10-20
J1725	HCPCS	Hydroxyprogesterone 250 mg/mL Sol 5 Ml [pmc]	14	10	$7,245.00	$6,158.25	$4,274.55	$7,100.10	$6,810.30	2026-10-20
C1768	HCPCS	Alitply Lite 4cm X 4cm	44	10	$8,700.00	$7,395.00	$2,124.00	$10,143.00	$6,545.00	2026-10-20
J1437	HCPCS	Ferric Derisomaltose 1000 Mg/10 Ml Inj [pmc]	14	10	$6,818.21	$5,795.48	$4,022.74	$6,681.85	$6,409.12	2026-10-20
78815	CPT	PET Skull Base To Midthigh With CT Scan	14	10	$6,576.00	$5,589.60	$3,879.84	$6,444.48	$6,181.44	2026-10-20
75635	CPT	CT Angio Abdomen Aorta +Iliofemoral	14	10	$6,483.00	$5,510.55	$3,824.97	$6,353.34	$6,094.02	2026-10-20
78816	CPT	PET Whole Body With CT Scan	14	10	$6,322.00	$5,373.70	$3,729.98	$6,195.56	$5,942.68	2026-10-20
58558	CPT	58558 Hysteroscopy With Biopsy, W Or Without D&c	14	10	$6,306.00	$5,360.10	$3,720.54	$6,179.88	$5,927.64	2026-10-20
J0401	HCPCS	ARIPiprazole 400 Mg IM Kit [pmc]	14	10	$6,282.29	$5,339.95	$3,706.55	$6,156.64	$5,905.35	2026-10-20
C1889	HCPCS	Implant Arthroflex 40 X 70 X 3.0mm	24	10	$7,673.05	$6,522.10	$3,536.31	$7,519.59	$5,813.94	2026-10-20
70549	CPT	MRA Neck With + Without Cont	14	10	$5,966.00	$5,071.10	$3,519.94	$5,846.68	$5,608.04	2026-10-20
C1778	HCPCS	Implant 3889-28 Sns Lead	34	10	$5,976.25	$5,079.82	$431.59	$6,002.50	$5,378.63	2026-10-20
25608	CPT	25608 Open Tx Of Distal Radial Intra-artic Fx W Internal Fixation; 2 Fragments	14	10	$5,600.00	$4,760.00	$3,304.00	$5,488.00	$5,264.00	2026-10-20
C9399	HCPCS	Graft, Activi Viable Matrix Plus 2.5cc	24	10	$5,600.00	$4,760.00	$3,304.00	$8,575.00	$5,264.00	2026-10-20
J3111	HCPCS	Romosozumab-aqqg 210 Mg/2.34 Ml Inj Kit [pmc]	14	10	$5,520.73	$4,692.63	$3,257.23	$5,410.32	$5,189.49	2026-10-20
13160	CPT	13160 Secondary Closure Of Surgical Wound/dehiscence	14	10	$5,437.00	$4,621.45	$3,207.83	$5,328.26	$5,110.78	2026-10-20
70471	CPT	CT Angio Head +Angio Neck With + Without Cont	16	10	$5,473.00	$4,652.05	$3,229.07	$5,363.54	$5,089.89	2026-10-20
74178	CPT	Pmc CT Abdomen +Pelvis With + Without Cont	14	10	$5,419.00	$4,606.15	$3,197.21	$5,310.62	$5,039.67	2026-10-20
Q4100	HCPCS	Active Barrier 200 Amniotic Membrane Allograft 4x8	104	10	$6,013.00	$5,111.05	$2,284.63	$8,225.14	$5,032.13	2026-10-20
52601	CPT	Prostate Resection Transurethral	14	10	$5,350.00	$4,547.50	$3,156.50	$5,243.00	$5,029.00	2026-10-20
73723	CPT	MRI Ankle With + Without Cont Lt	14	10	$5,294.00	$4,499.90	$3,123.46	$5,188.12	$4,976.36	2026-10-20
20240	CPT	20240 Biopsy, Bone, Open; Superficial	14	10	$5,264.00	$4,474.40	$3,105.76	$5,158.72	$4,948.16	2026-10-20
C1762	HCPCS	Altiply Lite 4cm X 7cm	174	10	$5,262.95	$4,473.51	$1,585.63	$14,406.00	$4,829.92	2026-10-20
74174	CPT	Pmc CT Angio Abdomen Pelvis	14	10	$5,138.00	$4,367.30	$3,031.42	$5,035.24	$4,829.72	2026-10-20
73706	CPT	CT Angio Le Bil	14	10	$5,129.00	$4,359.65	$3,026.11	$5,026.42	$4,821.26	2026-10-20
52224	CPT	Bladder Biopsy With Fulguration	14	10	$4,982.00	$4,234.70	$2,939.38	$4,882.36	$4,683.08	2026-10-20
70546	CPT	MRA Head Venography With + Without Cont	15	10	$4,973.00	$4,227.05	$2,934.07	$4,873.54	$4,674.62	2026-10-20
J1459	HCPCS	Immune Globulin 10 % (Privigen) 10 Gm/100 Ml [pmc]	41	10	$4,861.45	$4,132.24	$55.68	$15,338.47	$4,666.99	2026-10-20
64721	CPT	Carpal Tunnel Release	14	10	$4,891.00	$4,157.35	$2,885.69	$4,793.18	$4,597.54	2026-10-20
J1602	HCPCS	Golimumab 50 Mg/4 Ml Inj Sol [pmc]	14	10	$4,918.01	$4,180.31	$12.19	$4,819.65	$4,573.75	2026-10-20
C9361	HCPCS	Implant Nerve Protector 5mm X 40mm	14	10	$4,863.25	$4,133.77	$2,869.32	$4,765.99	$4,571.46	2026-10-20
64595	CPT	Sacral Nerve Stimulator Removal	14	10	$4,863.00	$4,133.55	$2,869.17	$4,765.74	$4,571.22	2026-10-20
74177	CPT	Pmc CT Abdomen +Pelvis With Cont	18	10	$4,901.00	$4,165.85	$2,858.73	$4,802.98	$4,508.92	2026-10-20
C1763	HCPCS	Implant 10cc Agrix W/mixer	74	10	$5,110.00	$4,343.50	$1,462.95	$5,460.56	$4,508.31	2026-10-20
35206	CPT	35206 Repair Blood Vessel, Direct; Upper Extremity	14	10	$4,788.00	$4,069.80	$2,824.92	$4,692.24	$4,500.72	2026-10-20
J0897	HCPCS	Denosumab 60 mg/mL Sol 1 Ml [pmc]	34	10	$4,751.96	$4,039.17	$2,722.00	$7,312.55	$4,429.02	2026-10-20
J2802	HCPCS	romiPLOStim 125 Mcg Pow Inj [pmc]	34	10	$5,781.34	$4,914.15	$2,192.81	$10,683.88	$4,422.76	2026-10-20
21554	CPT	Excision, Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subfascial (eg, Intramu…	14	10	$4,704.00	$3,998.40	$2,775.36	$4,609.92	$4,421.76	2026-10-20
C1783	HCPCS	Implant Glaukos Trabecular Micro-bypass Stent System	14	10	$4,663.75	$3,964.19	$2,751.61	$4,570.48	$4,383.93	2026-10-20
Q5158	HCPCS	Denosumab-bnht 120 Mg/1.7 Ml Inj Syringe [pmc]	24	10	$7,027.12	$5,973.06	$2,640.34	$6,886.58	$4,340.90	2026-10-20
74175	CPT	CT Angio Abdomen	14	10	$4,555.00	$3,871.75	$2,687.45	$4,463.90	$4,281.70	2026-10-20
C1776	HCPCS	24mm +2 Lat Baseplate, Modular	1,644	10	$4,870.25	$4,139.72	$149.27	$14,822.50	$4,266.85	2026-10-20
74183	CPT	MRI Abdomen With + Without Cont	16	10	$4,583.00	$3,895.55	$2,703.97	$4,491.34	$4,262.19	2026-10-20
72197	CPT	MRI Pelvis With + Without Cont	14	10	$4,524.00	$3,845.40	$2,669.16	$4,433.52	$4,252.56	2026-10-20
Q4148	HCPCS	Amniofill Human Placental Tissue Allograft 1000mg	14	10	$4,500.00	$3,825.00	$2,655.00	$4,410.00	$4,230.00	2026-10-20
Q5108	HCPCS	Pegfilgrastim-jmdb 6 Mg/0.6 Ml Inj [pmc]	24	10	$4,383.75	$3,726.19	$2,586.41	$8,101.17	$4,208.40	2026-10-20
43245	CPT	43245 Egd Dilation Gastric/Duodenal Stricture	14	10	$4,477.00	$3,805.45	$2,641.43	$4,387.46	$4,208.38	2026-10-20
J3358	HCPCS	Ustekinumab 5 mg/mL IV Sol 26 Ml [pmc]	14	10	$4,451.29	$3,783.60	$2,626.26	$4,362.26	$4,184.21	2026-10-20
71275	CPT	CT Angio Chest Pe With Cont	15	10	$4,435.00	$3,769.75	$2,616.65	$4,346.30	$4,168.90	2026-10-20
J0875	HCPCS	Dalbavancin 500 Mg Inj [pmc]	14	10	$4,376.66	$3,720.17	$2,582.23	$4,289.13	$4,114.06	2026-10-20
72191	CPT	CT Angio Pelvis With Cont	14	10	$4,358.00	$3,704.30	$2,571.22	$4,270.84	$4,096.52	2026-10-20
73222	CPT	MRI Elbow With Cont Lt	15	10	$4,349.00	$3,696.65	$2,565.91	$4,262.02	$4,088.06	2026-10-20
70498	CPT	Pmc CT Angio Neck	14	10	$4,344.00	$3,692.40	$2,562.96	$4,257.12	$4,083.36	2026-10-20
Q5136	HCPCS	Denosumab-bbdz 60 mg/mL Inj Sol [pmc]	14	10	$4,331.16	$3,681.49	$2,555.38	$4,244.54	$4,071.29	2026-10-20
70496	CPT	CT Angio Head	14	10	$4,317.00	$3,669.45	$2,547.03	$4,230.66	$4,057.98	2026-10-20
66984	CPT	Cataract Extraction With Intraocular Lens Implantation	34	10	$4,483.00	$3,810.55	$2,513.40	$4,676.56	$4,034.70	2026-10-20
73722	CPT	MRI Ankle With Cont Lt	16	10	$4,333.00	$3,683.05	$2,556.47	$4,246.34	$4,029.69	2026-10-20
70543	CPT	MRI Face Neck Orbit With + Without Cont	15	10	$4,267.00	$3,626.95	$2,517.53	$4,181.66	$4,010.98	2026-10-20
58353	CPT	58353 Endometrial Ablation, Thermal, Without Hysteroscopic Guidance	14	10	$4,181.00	$3,553.85	$2,466.79	$4,097.38	$3,930.14	2026-10-20
J1439	HCPCS	Ferric Carboxymaltose (as Elemental Iron) 50 mg/mL Sol 15 Ml [pmc]	34	10	$4,160.29	$3,536.25	$2,424.64	$4,356.75	$3,862.99	2026-10-20
J2357	HCPCS	Omalizumab 150 mg/mL Prefilled Inj [pmc]	32	10	$4,195.15	$3,565.88	$45.42	$6,395.30	$3,850.23	2026-10-20
74170	CPT	CT Abdomen With + Without Cont	14	10	$4,085.00	$3,472.25	$2,410.15	$4,003.30	$3,839.90	2026-10-20
J7327	HCPCS	Hyaluronan 88 Mg/4 Ml Sol Inj [pmc]	14	10	$4,050.00	$3,442.50	$2,389.50	$3,969.00	$3,807.00	2026-10-20
72157	CPT	MRI Spine Thoracic With + Without Cont	14	10	$4,035.00	$3,429.75	$2,380.65	$3,954.30	$3,792.90	2026-10-20
72156	CPT	MRI Spine Cervical With + Without Cont	14	10	$4,026.00	$3,422.10	$2,375.34	$3,945.48	$3,784.44	2026-10-20
72158	CPT	MRI Spine Lumbar With + Without Cont	14	10	$4,008.00	$3,406.80	$2,364.72	$3,927.84	$3,767.52	2026-10-20
66850	CPT	Removal Of Lens Material; Phacofragmentation Technique, With Aspiration	14	10	$4,000.00	$3,400.00	$2,360.00	$3,920.00	$3,760.00	2026-10-20
45384	CPT	45384 Colonoscopy With Removal Lesion By Hot Biopsy Forcep	14	10	$3,931.00	$3,341.35	$2,319.29	$3,852.38	$3,695.14	2026-10-20
21555	CPT	Excision, Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subcutaneous; Less Than…	14	10	$3,920.00	$3,332.00	$2,312.80	$3,841.60	$3,684.80	2026-10-20
70553	CPT	MRI Brain With + Without Cont	17	10	$3,991.00	$3,392.35	$2,354.69	$3,911.18	$3,671.72	2026-10-20
J9145	HCPCS	Daratumumab 20 mg/mL Inj 20 Ml [pmc]	24	10	$6,176.73	$5,250.23	$1,587.87	$6,053.20	$3,644.27	2026-10-20
45380	CPT	45380 Colonoscopy W/Biopsy Single/Multiple	15	10	$3,847.00	$3,269.95	$2,269.73	$3,770.06	$3,616.18	2026-10-20
70544	CPT	MRA Head Without Cont	14	10	$3,830.00	$3,255.50	$2,259.70	$3,753.40	$3,600.20	2026-10-20
30117	CPT	30117 Excision Or Destruction (eg, Laser), Intranasal Lesion; Internal Approach,…	14	10	$3,808.00	$3,236.80	$2,246.72	$3,731.84	$3,579.52	2026-10-20
55041	CPT	Hydrocelectomy Bilateral	14	10	$3,774.00	$3,207.90	$2,226.66	$3,698.52	$3,547.56	2026-10-20
35221	CPT	35221 Repair Blood Vessel, Direct; Intra-abdominal	14	10	$3,773.00	$3,207.05	$2,226.07	$3,697.54	$3,546.62	2026-10-20
70540	CPT	MRI Face Neck Orbit Without Cont	14	10	$3,742.00	$3,180.70	$2,207.78	$3,667.16	$3,517.48	2026-10-20
J9202	HCPCS	Goserelin 10.8 Mg SubQ Imp [pmc]	44	10	$4,053.65	$3,445.60	$1,080.67	$6,612.17	$3,499.56	2026-10-20
J7325	HCPCS	Hylan G-f 20 48 Mg/6 Ml Sol 6 Ml [pmc]	14	10	$3,697.96	$3,143.27	$2,181.80	$3,624.01	$3,476.09	2026-10-20
32550	CPT	32550 Insertion Of Indwelling Tunneled Pleural Catheter With Cuff	24	10	$3,920.00	$3,332.00	$2,089.74	$3,841.60	$3,435.67	2026-10-20
73718	CPT	MRI Femur Without Cont Lt	14	10	$3,648.00	$3,100.80	$2,152.32	$3,575.04	$3,429.12	2026-10-20
J9217	HCPCS	Leuprolide 22.5 Mg/3 Months Sq Inj [pmc]	44	10	$3,658.69	$3,109.89	$975.38	$5,577.45	$3,402.58	2026-10-20
J9282	HCPCS	mitoMYcin 40 Mg Inj [pmc]	14	10	$3,609.88	$3,068.40	$2,129.83	$3,537.68	$3,393.28	2026-10-20
70552	CPT	MRI Brain With Cont	14	10	$3,609.00	$3,067.65	$2,129.31	$3,536.82	$3,392.46	2026-10-20
43249	CPT	43249 Egd Balloon Dilation Esophagus <30 Mm Diam.	15	10	$3,600.00	$3,060.00	$2,124.00	$3,528.00	$3,384.00	2026-10-20
30801	CPT	30801 Ablation, Soft Tissue Of Inferior Turbinates, Uni Or Bilat, Any Method; Su…	14	10	$3,599.00	$3,059.15	$2,123.41	$3,527.02	$3,383.06	2026-10-20
72193	CPT	CT Pelvis With Cont	14	10	$3,592.00	$3,053.20	$2,119.28	$3,520.16	$3,376.48	2026-10-20
72195	CPT	MRI Pelvis Without Cont	14	10	$3,586.00	$3,048.10	$2,115.74	$3,514.28	$3,370.84	2026-10-20
74160	CPT	Pmc CT Abdomen With Cont	14	10	$3,584.00	$3,046.40	$2,114.56	$3,512.32	$3,368.96	2026-10-20
46220	CPT	46220 Exc Of Single External Papilla Or Tag, Anus	14	10	$3,584.00	$3,046.40	$2,114.56	$3,512.32	$3,368.96	2026-10-20
J0129	HCPCS	Abatacept 250 Mg IV Inj [pmc]	14	10	$3,597.24	$3,057.66	$49.11	$3,525.30	$3,345.43	2026-10-20
72132	CPT	CT Spine Lumbar With Cont	15	10	$3,542.00	$3,010.70	$2,089.78	$3,471.16	$3,329.48	2026-10-20
J1745	HCPCS	inFLIXimab 100 Mg Inj [pmc]	14	10	$3,573.53	$3,037.50	$34.56	$3,502.06	$3,323.39	2026-10-20
67005	CPT	Removal Of Vitreous, Anterior Approach; Partial Removal	14	10	$3,500.00	$2,975.00	$2,065.00	$3,430.00	$3,290.00	2026-10-20
71270	CPT	CT Chest +Abdomen +Pelvis With + Without Cont	14	10	$3,494.00	$2,969.90	$2,061.46	$3,424.12	$3,284.36	2026-10-20
74185	CPT	MRA Abdomen With + Without Cont	14	10	$3,472.00	$2,951.20	$2,048.48	$3,402.56	$3,263.68	2026-10-20
70492	CPT	CT Neck Soft Tissue With + Without Cont	15	10	$3,466.00	$2,946.10	$2,044.94	$3,396.68	$3,258.04	2026-10-20
52332	CPT	Cystoscopy With Stent Exchange	26	10	$4,982.00	$4,234.70	$1,979.45	$4,882.36	$3,254.35	2026-10-20
74181	CPT	MRI Abdomen Without Cont	14	10	$3,458.00	$2,939.30	$2,040.22	$3,388.84	$3,250.52	2026-10-20
70548	CPT	MRA Neck With Cont	14	10	$3,437.00	$2,921.45	$2,027.83	$3,368.26	$3,230.78	2026-10-20
61958-0701-01	NDC	Emtricitabine-tenofovir 200 Mg-300 Mg Tab [pmc]	14	10	$3,426.65	$2,912.65	$2,021.72	$3,358.11	$3,221.05	2026-10-20
73223	CPT	MRI Elbow With + Without Cont Lt	15	10	$3,412.00	$2,900.20	$2,013.08	$3,343.76	$3,207.28	2026-10-20
J7318	HCPCS	Sodium Hyaluronate 60 Mg/3 Ml Inj Sol [pmc]	14	10	$3,411.90	$2,900.12	$2,013.02	$3,343.66	$3,207.18	2026-10-20
93351	CPT	Cardiac Echocardiogram With Stress	15	10	$3,392.00	$2,883.20	$2,001.28	$3,324.16	$3,188.48	2026-10-20
72126	CPT	CT Spine Cervical With Cont	14	10	$3,366.00	$2,861.10	$1,985.94	$3,298.68	$3,164.04	2026-10-20
45338	CPT	45338 Sigmoidoscopy Removal Tumor Polyp/Other Lesions By Snare	14	10	$3,360.00	$2,856.00	$1,982.40	$3,292.80	$3,158.40	2026-10-20
72130	CPT	CT Spine Thoracic With + Without Cont	14	10	$3,356.00	$2,852.60	$1,980.04	$3,288.88	$3,154.64	2026-10-20
52214	CPT	52214 Cystoscopy With Fulguration	14	10	$3,355.00	$2,851.75	$1,979.45	$3,287.90	$3,153.70	2026-10-20
55250	CPT	Vasectomy	15	10	$3,348.00	$2,845.80	$1,975.32	$3,281.04	$3,147.12	2026-10-20
67921	CPT	67921 Repair Of Entropion; Suture	14	10	$3,304.00	$2,808.40	$1,949.36	$3,237.92	$3,105.76	2026-10-20
72149	CPT	MRI Spine Lumbar With Cont	14	10	$3,262.00	$2,772.70	$1,924.58	$3,196.76	$3,066.28	2026-10-20
72147	CPT	MRI Spine Thoracic With Cont	14	10	$3,262.00	$2,772.70	$1,924.58	$3,196.76	$3,066.28	2026-10-20
72142	CPT	MRI Spine Cervical With Cont	14	10	$3,262.00	$2,772.70	$1,924.58	$3,196.76	$3,066.28	2026-10-20
31528	CPT	31528 Laryngoscopy Direct, With Or Without Tracheoscopy; With Dilation, Initial	14	10	$3,248.00	$2,760.80	$1,916.32	$3,183.04	$3,053.12	2026-10-20
A0434	HCPCS	A0434 Specialty Care Transport.	14	10	$3,174.00	$2,697.90	$1,872.66	$3,110.52	$2,983.56	2026-10-20
C8929	HCPCS	Echo With Contrast	24	10	$3,261.00	$2,771.85	$1,832.54	$3,195.78	$2,966.23	2026-10-20
0200	RC	Room/bed: ICU	10	10	$3,152.00	$2,679.20	$2,836.80	$3,088.96	$2,962.88	2026-10-20
27831	CPT	27831 Closed Tx Of Proximal Tibfib Jt Dislocation; Requiring Anesthesia	14	10	$3,115.00	$2,647.75	$1,837.85	$3,052.70	$2,928.10	2026-10-20
30469	CPT	30469 Repair Nasal Valve Collapse With Low Energy, Temp-controlled Subq/submcsl Re…	14	10	$3,108.00	$2,641.80	$1,833.72	$3,045.84	$2,921.52	2026-10-20
45385	CPT	45385 Colonoscopy With Removal Of Tumor Polyp Lesion By Snare	17	10	$3,173.00	$2,697.05	$1,872.07	$3,109.54	$2,919.16	2026-10-20
72196	CPT	MRI Pelvis With Cont	14	10	$3,087.00	$2,623.95	$1,821.33	$3,025.26	$2,901.78	2026-10-20
71552	CPT	MRI Brachial Plexus With + Without Cont Lt	14	10	$3,087.00	$2,623.95	$1,821.33	$3,025.26	$2,901.78	2026-10-20
Q4186	HCPCS	Epifix Amnion/chorion Membrane Allograft 7cm X 7cm	74	10	$3,213.75	$2,731.69	$1,112.23	$13,664.39	$2,892.38	2026-10-20
73220	CPT	MRI Clavicle With + Without Cont Lt	14	10	$3,065.00	$2,605.25	$1,808.35	$3,003.70	$2,881.10	2026-10-20
59412	CPT	59412 External Cephalic Version, With Or Without Tocolysis.	24	10	$3,024.00	$2,570.40	$1,784.16	$3,148.74	$2,842.56	2026-10-20
Q5135	HCPCS	Tocilizumab-aazg 20 mg/mL Inj Sol 10 Ml [pmc]	26	10	$2,996.35	$2,546.90	$1,767.85	$4,721.31	$2,842.42	2026-10-20
78264	CPT	Nm Gastric Emptying Study	14	10	$3,012.00	$2,560.20	$1,777.08	$2,951.76	$2,831.28	2026-10-20
93247	CPT	Holter Monitor, 8-15 Days, Scanning Analysis Report	15	10	$3,012.00	$2,560.20	$1,777.08	$2,951.76	$2,831.28	2026-10-20
37785	CPT	37785 Ligation, Division, And/or Excision Of Varicose Vein Cluster(s), 1 Leg	14	10	$2,979.00	$2,532.15	$1,757.61	$2,919.42	$2,800.26	2026-10-20
36556	CPT	36556 Insert Non-tunneled Central Venous Catheter; Age 5 Years Or Older	14	10	$2,979.00	$2,532.15	$1,757.61	$2,919.42	$2,800.26	2026-10-20
70491	CPT	CT Neck Soft Tissue With Cont	14	10	$2,978.00	$2,531.30	$1,757.02	$2,918.44	$2,799.32	2026-10-20
C1787	HCPCS	Programmer 3037 Patient Interstim Slim	14	10	$2,975.00	$2,528.75	$1,755.25	$2,915.50	$2,796.50	2026-10-20
J1568	HCPCS	Immune Globulin IV 10% Sol 100 Ml [pmc]	23	10	$2,903.60	$2,468.06	$52.13	$4,898.04	$2,787.46	2026-10-20
J3590	HCPCS	idaruCIZUmab 2.5 G/50 Ml Sol Inj [pmc]	34	10	$2,902.50	$2,467.13	$928.24	$5,355.38	$2,771.89	2026-10-20
71260	CPT	CT Chest +Abdomen +Pelvis With Cont	17	10	$2,985.00	$2,537.25	$1,550.78	$2,925.30	$2,746.20	2026-10-20
70547	CPT	MRA Neck Without Cont	14	10	$2,921.00	$2,482.85	$1,723.39	$2,862.58	$2,745.74	2026-10-20
93306	CPT	Echo Complete	15	10	$2,917.00	$2,479.45	$1,721.03	$2,858.66	$2,741.98	2026-10-20
71550	CPT	MRI Brachial Plexus Without Cont Lt	14	10	$2,912.00	$2,475.20	$1,718.08	$2,853.76	$2,737.28	2026-10-20
45308	CPT	45308 Proctosig; With Removal Of Single Tumor, By Hot Biopsy	14	10	$2,912.00	$2,475.20	$1,718.08	$2,853.76	$2,737.28	2026-10-20
52260	CPT	Cystoscopy With Hydrodistention	14	10	$2,911.00	$2,474.35	$1,717.49	$2,852.78	$2,736.34	2026-10-20
52005	CPT	Cystoscopy With Retrograde Pyelogram	14	10	$2,911.00	$2,474.35	$1,717.49	$2,852.78	$2,736.34	2026-10-20
93243	CPT	Holter Monitor, 3-7 Days, Scanning Analysis Report	15	10	$2,893.00	$2,459.05	$1,706.87	$2,835.14	$2,719.42	2026-10-20
73700	CPT	CT Ankle Without Cont Lt	15	10	$2,883.00	$2,450.55	$1,700.97	$2,825.34	$2,710.02	2026-10-20
73720	CPT	MRI Femur With + Without Cont Lt	14	10	$2,875.00	$2,443.75	$1,696.25	$2,817.50	$2,702.50	2026-10-20
55040	CPT	Hydrocelectomy Unilateral	15	10	$2,870.00	$2,439.50	$1,693.30	$2,812.60	$2,697.80	2026-10-20
Q5103	HCPCS	Infliximab-dyyb 100 Mg Pow Inj [pmc]	14	10	$2,895.63	$2,461.29	$18.01	$2,837.71	$2,692.93	2026-10-20
20525	CPT	20525 Removal Of Foreign Body In Muscle Or Tendon Sheath; Deep Or Complicated Pr…	14	10	$2,843.00	$2,416.55	$1,677.37	$2,786.14	$2,672.42	2026-10-20
70488	CPT	CT Maxillofacial With + Without Cont	14	10	$2,836.00	$2,410.60	$1,673.24	$2,779.28	$2,665.84	2026-10-20
25000	CPT	25000 Incision, Extensor Tendon Sheath, Wrist (eg, De Quervains Disease)	14	10	$2,833.00	$2,408.05	$1,671.47	$2,776.34	$2,663.02	2026-10-20
38505	CPT	US Lymph Node Biopsy	14	10	$2,827.00	$2,402.95	$1,667.93	$2,770.46	$2,657.38	2026-10-20
43239	CPT	43239 Egd Transoral Biopsy Single/Multiple	16	10	$2,853.00	$2,425.05	$1,683.27	$2,795.94	$2,653.29	2026-10-20
70470	CPT	CT Head Or Brain With + Without Cont	14	10	$2,843.00	$2,416.55	$1,677.37	$2,786.14	$2,643.99	2026-10-20
52287	CPT	Cystourethroscopy With Bladder Injection	14	10	$2,807.00	$2,385.95	$1,656.13	$2,750.86	$2,638.58	2026-10-20
35226	CPT	35226 Repair Blood Vessel, Direct; Lower Extremity	14	10	$2,800.00	$2,380.00	$1,652.00	$2,744.00	$2,632.00	2026-10-20
72128	CPT	CT Spine Thoracic Without Cont	15	10	$2,794.00	$2,374.90	$1,648.46	$2,738.12	$2,626.36	2026-10-20
72125	CPT	CT Spine Cervical Without Cont	15	10	$2,783.00	$2,365.55	$1,641.97	$2,727.34	$2,616.02	2026-10-20
72131	CPT	CT Spine Lumbar Without Cont	15	10	$2,778.00	$2,361.30	$1,639.02	$2,722.44	$2,611.32	2026-10-20
C2625	HCPCS	Implant Propel	24	10	$2,850.00	$2,422.50	$1,615.13	$2,793.00	$2,611.32	2026-10-20
11044	CPT	11044 Wc Debridement, Bone; First 20 Sq Cm Or Less	14	10	$2,772.00	$2,356.20	$1,635.48	$2,716.56	$2,605.68	2026-10-20
73200	CPT	CT Clavicle Without Cont Lt	15	10	$2,771.00	$2,355.35	$1,634.89	$2,715.58	$2,604.74	2026-10-20
Q0138	HCPCS	Ferumoxytol 30 mg/mL Inj Sol 17 Ml [pmc]	14	10	$2,770.37	$2,354.82	$1,634.52	$2,714.97	$2,604.16	2026-10-20
66982	CPT	Cataract Extraction With Intraocular Lens Implantation, Complex	14	10	$2,766.00	$2,351.10	$1,631.94	$2,710.68	$2,600.04	2026-10-20
65400	CPT	Keratectomy	14	10	$2,750.00	$2,337.50	$1,622.50	$2,695.00	$2,585.00	2026-10-20
53450	CPT	53450 Urethromeatoplasty, With Mucosal Advancement	24	10	$3,205.12	$2,724.36	$1,570.58	$3,141.02	$2,582.14	2026-10-20
72127	CPT	CT Spine Cervical With + Without Cont	14	10	$2,741.00	$2,329.85	$1,617.19	$2,686.18	$2,576.54	2026-10-20
78452	CPT	Cardiolite 33m	15	10	$2,765.00	$2,350.25	$1,631.35	$2,709.70	$2,543.80	2026-10-20
45381	CPT	45381 Colonoscopy, Flexible; With Directed Submucosal Injection(s), Any Substanc…	14	10	$2,705.00	$2,299.25	$1,595.95	$2,650.90	$2,542.70	2026-10-20
27842	CPT	27842 Closed Tx Of Ankle Dislocation; Requiring Anesthesia	14	10	$2,688.00	$2,284.80	$1,585.92	$2,634.24	$2,526.72	2026-10-20
45333	CPT	45333 Sigmoidoscopy With Removal Tumor By Hot Biopsy Forcep	14	10	$2,688.00	$2,284.80	$1,585.92	$2,634.24	$2,526.72	2026-10-20
C1771	HCPCS	Mesh Sling Obtryx Curved	14	10	$2,681.25	$2,279.07	$1,581.94	$2,627.63	$2,520.38	2026-10-20
74176	CPT	Pmc CT Abdomen + Pelvis Without Cont	15	10	$2,716.00	$2,308.60	$1,602.44	$2,661.68	$2,498.72	2026-10-20
64635	CPT	64635 Rf Ablation - Lumbar 1 Level	37	10	$2,759.00	$2,345.15	$1,256.11	$4,214.98	$2,483.10	2026-10-20
66985	CPT	Insertion Of Intraocular Lens Prosthesis, Not Associated With Concurrent Catarac…	14	10	$2,600.00	$2,210.00	$1,534.00	$2,548.00	$2,444.00	2026-10-20
90375	CPT	Rabies Immune Globulin, Human 300 units/mL Inj Sol [pmc]	14	10	$2,599.03	$2,209.18	$1,533.43	$2,547.05	$2,443.09	2026-10-20
Q5162	HCPCS	Denosumab-nxxp 60 mg/mL Inj Sol [pmc]	14	10	$2,582.64	$2,195.25	$1,523.76	$2,530.99	$2,427.68	2026-10-20
11426	CPT	11426 Excision Benign Lesion, Except Skin Tag , Scalp, Neck, Hands, Feet; Diame…	14	10	$2,576.00	$2,189.60	$1,519.84	$2,524.48	$2,421.44	2026-10-20
45305	CPT	45305 Proctosig; With Biopsy, Single Or Multiple	14	10	$2,576.00	$2,189.60	$1,519.84	$2,524.48	$2,421.44	2026-10-20
45307	CPT	45307 Proctosig, Rigid; With Removal Of Foreign Body	14	10	$2,576.00	$2,189.60	$1,519.84	$2,524.48	$2,421.44	2026-10-20
30520	CPT	30520 Septoplasty Or Submucous Resection, With Or Without Cartilage Scoring, Con…	14	10	$2,565.00	$2,180.25	$1,513.35	$2,513.70	$2,411.10	2026-10-20
73221	CPT	MRI Elbow Without Cont Lt	14	10	$2,560.00	$2,176.00	$1,510.40	$2,508.80	$2,406.40	2026-10-20
Q4278	HCPCS	Epieffect 1cm X 2cm	24	10	$2,552.00	$2,169.20	$1,505.68	$3,057.60	$2,398.88	2026-10-20
73721	CPT	MRI Ankle Without Cont Lt	14	10	$2,560.00	$2,176.00	$1,510.40	$2,508.80	$2,380.80	2026-10-20
74280	CPT	Xr Barium Enema With Air Cont	14	10	$2,513.00	$2,136.05	$1,482.67	$2,462.74	$2,362.22	2026-10-20
C1726	HCPCS	Catheter Sinus Balloon 3.5mm	44	10	$2,438.43	$2,072.67	$1,127.64	$4,721.97	$2,340.89	2026-10-20
43247	CPT	43247 Egd, Flexible, Transoral; With Removal Of Foreign Body(s)	14	10	$2,464.00	$2,094.40	$1,453.76	$2,414.72	$2,316.16	2026-10-20
35207	CPT	35207 Repair Blood Vessel, Direct; Hand, Finger	14	10	$2,464.00	$2,094.40	$1,453.76	$2,414.72	$2,316.16	2026-10-20
44389	CPT	44389 Colonoscopy Through Stoma; With Biopsy, Single Or Multiple	14	10	$2,464.00	$2,094.40	$1,453.76	$2,414.72	$2,316.16	2026-10-20
78226	CPT	Nm Hepa Duct System	14	10	$2,463.00	$2,093.55	$1,453.17	$2,413.74	$2,315.22	2026-10-20
72129	CPT	CT Spine Thoracic With Cont	14	10	$2,460.00	$2,091.00	$1,451.40	$2,410.80	$2,312.40	2026-10-20
J3424	HCPCS	Hydroxocobalamin 5 G Pow [pmc]	24	10	$3,206.88	$2,725.85	$1,402.44	$3,142.74	$2,305.71	2026-10-20
72194	CPT	CT Pelvis With + Without Cont	14	10	$2,436.00	$2,070.60	$1,437.24	$2,387.28	$2,289.84	2026-10-20
73702	CPT	CT Ankle With + Without Cont Lt	14	10	$2,426.00	$2,062.10	$1,431.34	$2,377.48	$2,280.44	2026-10-20
70487	CPT	CT Maxillofacial With Cont	14	10	$2,426.00	$2,062.10	$1,431.34	$2,377.48	$2,280.44	2026-10-20
15273	CPT	15273 Wc Application Of Skin Sub Graft To Trunk, Arms, Legs, Total Wound Surface…	14	10	$2,423.00	$2,059.55	$1,429.57	$2,374.54	$2,277.62	2026-10-20
73218	CPT	MRI Clavicle Without Cont Lt	14	10	$2,411.00	$2,049.35	$1,422.49	$2,362.78	$2,266.34	2026-10-20
70490	CPT	CT Neck Soft Tissue Without Cont	14	10	$2,409.00	$2,047.65	$1,421.31	$2,360.82	$2,264.46	2026-10-20
11424	CPT	11424 Excision Benign Lesion, Except Skin Tag , Scalp, Neck, Hands, Feet; 3.1 T…	14	10	$2,408.00	$2,046.80	$1,420.72	$2,359.84	$2,263.52	2026-10-20
70482	CPT	CT Iac With + Without Cont	14	10	$2,388.00	$2,029.80	$1,408.92	$2,340.24	$2,244.72	2026-10-20
J0585	HCPCS	onabotulinumtoxinA 100 Units Inj [pmc]	14	10	$2,382.66	$2,025.27	$1,405.77	$2,335.01	$2,239.70	2026-10-20
27252	CPT	27252 Closed Tx Of Hip Dislocation, Traumatic; Require Anesthesia	14	10	$2,380.00	$2,023.00	$1,404.20	$2,332.40	$2,237.20	2026-10-20
70480	CPT	CT Iac Without Cont	14	10	$2,371.00	$2,015.35	$1,398.89	$2,323.58	$2,228.74	2026-10-20
70551	CPT	MRI Brain Without Cont	14	10	$2,366.00	$2,011.10	$1,395.94	$2,318.68	$2,224.04	2026-10-20
72133	CPT	CT Spine Lumbar With + Without Cont	14	10	$2,359.00	$2,005.15	$1,391.81	$2,311.82	$2,217.46	2026-10-20
11406	CPT	11406 Excision, Benign Lesion Including Margins, Except Skin Trunk, Arms Legs, E…	14	10	$2,352.00	$1,999.20	$1,387.68	$2,304.96	$2,210.88	2026-10-20
45309	CPT	45309 Proctosig; With Removal Of Single Tumor, By Snare Technique	14	10	$2,352.00	$1,999.20	$1,387.68	$2,304.96	$2,210.88	2026-10-20
44388	CPT	44388 Colonoscopy Through Stoma; Diagnostic, Including Collection Of Specimen(s)…	14	10	$2,352.00	$1,999.20	$1,387.68	$2,304.96	$2,210.88	2026-10-20
45378	CPT	45378 Colonoscopy (diagnostic)	30	10	$2,443.00	$2,076.55	$1,414.23	$2,394.14	$2,205.24	2026-10-20
26055	CPT	26055 Tendon Sheath Incision (for Trigger Finger)	14	10	$2,335.00	$1,984.75	$1,377.65	$2,288.30	$2,194.90	2026-10-20
73701	CPT	CT Ankle With Cont Lt	14	10	$2,323.00	$1,974.55	$1,370.57	$2,276.54	$2,183.62	2026-10-20
71250	CPT	CT Chest +Abdomen +Pelvis Without Cont	15	10	$2,299.00	$1,954.15	$1,356.41	$2,253.02	$2,161.06	2026-10-20
0750	RC	Screening: Colonoscopy After Positive Cologuard	14	10	$2,299.00	$1,954.15	$1,356.41	$2,253.02	$2,161.06	2026-10-20
27818	CPT	27818 Closed Tx Of Trimalleolar Ankle Fx; With Manip 981	24	10	$2,297.00	$1,952.45	$1,355.23	$2,441.18	$2,159.18	2026-10-20
27810	CPT	Closed Tx Bimalleolar Ankle Fracture W/Manj 981	24	10	$2,297.00	$1,952.45	$1,355.23	$2,376.50	$2,159.18	2026-10-20
24605	CPT	24605 Treatment Of Closed Elbow Dislocation; With Anesthesia 981	24	10	$2,297.00	$1,952.45	$1,355.23	$2,639.14	$2,159.18	2026-10-20
36573	CPT	36573 Insert Picc Cath, Age 5 Yr And Up With Imaging	14	10	$2,289.00	$1,945.65	$1,350.51	$2,243.22	$2,151.66	2026-10-20
72148	CPT	MRI Spine Lumbar Without Cont	15	10	$2,327.00	$1,977.95	$1,372.93	$2,280.46	$2,140.84	2026-10-20
23655	CPT	Clsd Tx Shoulder Dislc W/Manipulation W Anes 981	24	10	$2,297.00	$1,952.45	$1,355.23	$2,254.98	$2,138.05	2026-10-20
J1212	HCPCS	Dimethyl Sulfoxide 50% Irr Sol 50 Ml [pmc]	14	10	$2,264.04	$1,924.44	$1,335.79	$2,218.76	$2,128.20	2026-10-20
70481	CPT	CT Iac With Cont	14	10	$2,264.00	$1,924.40	$1,335.76	$2,218.72	$2,128.16	2026-10-20
72146	CPT	MRI Spine Thoracic Without Cont	14	10	$2,258.00	$1,919.30	$1,332.22	$2,212.84	$2,122.52	2026-10-20
72141	CPT	MRI Spine Cervical Without Cont	14	10	$2,254.00	$1,915.90	$1,329.86	$2,208.92	$2,118.76	2026-10-20
73202	CPT	CT Clavicle With + Without Cont Lt	14	10	$2,243.00	$1,906.55	$1,323.37	$2,198.14	$2,108.42	2026-10-20
70486	CPT	CT Maxillofacial Without Cont	16	10	$2,266.00	$1,926.10	$1,336.94	$2,220.68	$2,107.38	2026-10-20
J7307	HCPCS	Etonogestrel 68 Mg Imp [pmc]	24	10	$2,525.21	$2,146.44	$1,276.96	$2,474.71	$2,099.41	2026-10-20
45331	CPT	45331 Sigmoidoscopy W/Biopsy Single/Multiple	14	10	$2,228.00	$1,893.80	$1,314.52	$2,183.44	$2,094.32	2026-10-20
64561	CPT	Peripheral Nerve Evaluation	14	10	$2,212.00	$1,880.20	$1,305.08	$2,167.76	$2,079.28	2026-10-20
45100	CPT	45100 Biopsy Of Anorectal Wall, Anal Approach (eg, Congenital Megacolon)	14	10	$2,196.00	$1,866.60	$1,295.64	$2,152.08	$2,064.24	2026-10-20
73201	CPT	CT Clavicle With Cont Lt	14	10	$2,181.00	$1,853.85	$1,286.79	$2,137.38	$2,050.14	2026-10-20
90380	CPT	Nirsevimab-alip 50 Mg/0.5 Ml Inj [pmc]	14	10	$2,177.93	$1,851.24	$1,284.98	$2,134.37	$2,047.25	2026-10-20
19083	CPT	US Breast Biopsy Lt	16	10	$2,199.00	$1,869.15	$1,297.41	$2,155.02	$2,045.07	2026-10-20
0671T	CPT	0376t iStent, Insertion Of Anterior Segment Aqueous Drainage Device, Without Ext…	14	10	$2,160.00	$1,836.00	$1,274.40	$2,116.80	$2,030.40	2026-10-20
51715	CPT	Cystoscopy With Implant	34	10	$2,250.00	$1,912.50	$838.98	$2,469.60	$2,025.00	2026-10-20
93985	CPT	93985 Vein Mapping For Hd Access: Bilateral	14	10	$2,137.00	$1,816.45	$1,260.83	$2,094.26	$2,008.78	2026-10-20
49900	CPT	49900 Suture, Secondary, Of Abdominal Wall For Evisceration Or Dehiscence Pmc	14	10	$2,136.00	$1,815.60	$1,260.24	$2,093.28	$2,007.84	2026-10-20
0722	RC	Delivery Only	34	10	$2,273.00	$1,932.05	$1,152.27	$3,599.54	$1,979.82	2026-10-20
11606	CPT	11606 Excision, Malignant Lesion Including Margins, Trunk, Arms, Or Legs; Excise…	14	10	$2,102.00	$1,786.70	$1,240.18	$2,059.96	$1,975.88	2026-10-20
64633	CPT	Radiofrequency Ablation- C Or T	24	10	$2,057.00	$1,748.45	$1,213.63	$4,031.72	$1,974.72	2026-10-20
70460	CPT	CT Head Or Brain With Cont	14	10	$2,097.00	$1,782.45	$1,237.23	$2,055.06	$1,971.18	2026-10-20
78582	CPT	Nm Pulm Perf With Vent	14	10	$2,087.00	$1,773.95	$1,231.33	$2,045.26	$1,961.78	2026-10-20
J7298	HCPCS	Levonorgestrel 52 Mg Dev [pmc]	14	10	$2,054.47	$1,746.31	$1,212.14	$2,013.38	$1,931.20	2026-10-20
21556	CPT	Excision, Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subfascial (eg, Intramu…	14	10	$2,016.00	$1,713.60	$1,189.44	$1,975.68	$1,895.04	2026-10-20
43246	CPT	Upper Gi Endoscopy Incl Esophagus Stomach Either Duodenum And/or Jejunum W/perc…	24	10	$2,016.00	$1,713.60	$1,189.44	$2,664.62	$1,895.04	2026-10-20
72192	CPT	CT Pelvis Without Cont	14	10	$2,011.00	$1,709.35	$1,186.49	$1,970.78	$1,890.34	2026-10-20
52281	CPT	Cystoscopy Urethral Dilation	24	10	$2,000.00	$1,700.00	$1,180.00	$2,852.78	$1,880.00	2026-10-20
74150	CPT	Pmc CT Abdomen Without Cont	14	10	$1,981.00	$1,683.85	$1,168.79	$1,941.38	$1,862.14	2026-10-20
0272	RC	Crossroads Sterile Instrument Kit 1500-4700	54	10	$2,062.50	$1,753.13	$153.16	$3,691.17	$1,856.25	2026-10-20
11422	CPT	11422 Excision Benign Lesion, Except Skin Tag , Scalp, Neck, Hands, Feet; 1.1 T…	14	10	$1,960.00	$1,666.00	$1,156.40	$1,920.80	$1,842.40	2026-10-20
G0390	HCPCS	G0390 Trauma Team Activation With Critical Care	14	10	$1,951.00	$1,658.35	$1,151.09	$1,911.98	$1,833.94	2026-10-20
0684	RC	Trauma Activation	14	10	$1,951.00	$1,658.35	$1,151.09	$1,911.98	$1,833.94	2026-10-20
78315	CPT	Nm Bone 3 Phase Study	14	10	$1,939.00	$1,648.15	$1,144.01	$1,900.22	$1,822.66	2026-10-20
78071	CPT	Nm Parathyroid With Tomography	14	10	$1,935.00	$1,644.75	$1,141.65	$1,896.30	$1,818.90	2026-10-20
43235	CPT	43235 Egd Transoral Diagnostic	14	10	$1,929.00	$1,639.65	$1,138.11	$1,890.42	$1,813.26	2026-10-20
10121	CPT	Incision & Removal Foreign Body Subq Tiss Compl	14	10	$1,921.00	$1,632.85	$1,133.39	$1,882.58	$1,805.74	2026-10-20
25607	CPT	25607 Open Tx Of Distal Radial Extra-artic Fx W Internal Fixation	14	10	$1,917.00	$1,629.45	$1,131.03	$1,878.66	$1,801.98	2026-10-20
11043	CPT	11043 Wc Debridement, Muscle And/or Fascia; First 20 Sq Cm Or Less	14	10	$1,909.00	$1,622.65	$1,126.31	$1,870.82	$1,794.46	2026-10-20
65235	CPT	65235 Removal Of Fb, Intraocular; From Anterior Chamber Of Eye Or Lens	14	10	$1,899.00	$1,614.15	$1,120.41	$1,861.02	$1,785.06	2026-10-20
57410	CPT	57410 Pelvic Examination Under Anesthesia (other Than Local)	24	10	$3,009.00	$2,557.65	$165.20	$2,948.82	$1,775.31	2026-10-20
28230	CPT	28230 Tenotomy, Open, Tendon Flexor; Foot, Single Or Multiple Tendon(s)	14	10	$1,874.00	$1,592.90	$1,105.66	$1,836.52	$1,761.56	2026-10-20
25339045	CDM	25520 Closed Treatment Of Radial Shaft Fracture And Closed Treatment Of Dislocat…	14	10	$1,857.00	$1,578.45	$1,095.63	$1,819.86	$1,745.58	2026-10-20
J9155	HCPCS	Degarelix 120 Mg Inj [pmc]	24	10	$2,789.26	$2,370.87	$1,054.76	$2,733.47	$1,734.10	2026-10-20
70450	CPT	CT Head Or Brain Without Cont	17	10	$1,884.00	$1,601.40	$1,111.56	$1,846.32	$1,733.28	2026-10-20
78306	CPT	Nm Bone Whole Body	14	10	$1,841.00	$1,564.85	$1,086.19	$1,804.18	$1,730.54	2026-10-20
86790	CPT	Jcv Antibody Up	14	10	$1,820.00	$1,547.00	$1,073.80	$1,783.60	$1,710.80	2026-10-20
A4649	HCPCS	Arthrex Iobp Knee Open Tip Procedure Kit	44	10	$2,041.88	$1,735.60	$1,008.39	$2,519.83	$1,699.60	2026-10-20
L8606	HCPCS	Bulkamid Urethral Bulking System 2ml	24	10	$2,875.00	$2,443.75	$884.26	$2,817.50	$1,696.25	2026-10-20
J0475	HCPCS	Baclofen 2 mg/mL Intrathecal Sol Kit 20 Ml [pmc]	54	10	$2,830.50	$2,405.93	$510.24	$3,322.87	$1,688.18	2026-10-20
11400	CPT	11400 Excision Benign Lesion, Except Skin Tag , Trunk, Arms Or Legs; 0.5 Cm Or …	14	10	$1,792.00	$1,523.20	$1,057.28	$1,756.16	$1,684.48	2026-10-20
45300	CPT	45300 Proctosig; Dx With Or Without Collection Of Specimen By Brushing Or Washin…	14	10	$1,792.00	$1,523.20	$1,057.28	$1,756.16	$1,684.48	2026-10-20
52234	CPT	Transurethral Resection Of Bladder Tumor	14	10	$1,791.00	$1,522.35	$1,056.69	$1,755.18	$1,683.54	2026-10-20
77049	CPT	MRI Breast With + Without Cont Bil	15	10	$1,785.00	$1,517.25	$1,053.15	$1,749.30	$1,677.90	2026-10-20
95805	CPT	Multiple Sleep Latency Test	14	10	$1,779.00	$1,512.15	$1,049.61	$1,743.42	$1,672.26	2026-10-20
27510	CPT	Closed Tx Of Femoral Fracture With Manip	14	10	$1,748.00	$1,485.80	$1,031.32	$1,713.04	$1,643.12	2026-10-20
11421	CPT	11421 Excision Benign Lesion, Except Skin Tag , Scalp, Neck, Hands, Feet; 0.6 T…	14	10	$1,736.00	$1,475.60	$1,024.24	$1,701.28	$1,631.84	2026-10-20
45330	CPT	45330 Sigmoidoscopy With Specimen When Performed	24	10	$2,122.00	$1,803.70	$991.20	$2,079.56	$1,629.60	2026-10-20

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