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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

PROVIDENCE MEDICAL CENTER

Wayne, NE · CCN 281345 · Rates published

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 — reasonRows
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://search.hospitalpriceindex.com/hpi2/machineReadable/ProvidenceMedicalCenter/10169
Found on page https://providencemedical.com/
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-11-11

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
$714
outlier · 52.6×
J1303
HCPCS 		Ravulizumab 1100 Mg/11 Ml Inj [pmc] 10 $249.42 $44,749.25 $26,940.87 nat. median
$6,519
outlier · 4.1×
J1628
HCPCS 		Guselkumab 100 mg/mL Inj [pmc] 10 $16,784.47 $27,879.29 $26,741.36 nat. median
$227
outlier · 117.6×
J2327
HCPCS 		Risankizumab-rzaa 60 mg/mL Sol [pmc] 10 $11,959.27 $19,864.55 $19,053.75 nat. median
$2,512
outlier · 7.6×
J3380
HCPCS 		Vedolizumab 300 Mg Pow Inj [pmc] 10 $23.96 $18,426.14 $17,486.03 nat. median
$204
outlier · 85.8×
J2323
HCPCS 		Natalizumab 300 Mg/15 Ml IV Conc [pmc] 10 $27.59 $16,185.04 $15,359.27 nat. median
$252
outlier · 61.0×
C1820
HCPCS 		Neurostimulator F15 10 $8,955.32 $14,874.93 $14,267.79 nat. median
$22,950
0.6× median
C1767
HCPCS 		Implant Interstim Internal Neurostimulator Bladder/bowel 10 $8,278.44 $13,750.63 $13,189.38 nat. median
$23,834
0.6× median
J3101
HCPCS 		Tenecteplase 25 Mg IV Inj Stroke [pmc] 10 $7,857.50 $15,577.98 $12,918.26 nat. median
$4,042
outlier · 3.2×
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
$1,662
outlier · 7.2×
J0717
HCPCS 		Certolizumab 200 mg/mL Syringe Kit [pmc] 10 $7,358.96 $12,223.36 $11,724.44 nat. median
$1,753
outlier · 6.7×
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
$323
outlier · 33.3×
J1950
HCPCS 		Leuprolide 11.25 Mg/3 Months IM Inj [pmc] 10 $6,627.83 $11,008.94 $10,559.59 nat. median
$3,916
outlier · 2.7×
J0517
HCPCS 		Benralizumab 30 mg/mL Sol [pmc] 10 $184.87 $11,015.17 $10,453.17 nat. median
$969
outlier · 10.8×
62330
CPT 		Mild; 1 Interspace 10 $6,032.16 $10,019.52 $9,610.56 nat. median
$8,165
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
$1,697
outlier · 5.5×
63650
CPT 		Spinal Cord Stimulator Trial 10 $5,794.39 $9,624.58 $9,231.74 nat. median
$7,236
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
$1,109
outlier · 7.9×
J2356
HCPCS 		Tezepelumab-ekko 210 Mg/1.91 Ml Syr [pmc] 10 $5,103.82 $8,477.53 $8,131.51 nat. median
$85
outlier · 95.8×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml Inj [pmc] 10 $4,877.24 $8,101.17 $7,770.51 nat. median
$2,014
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
$637
outlier · 12.2×
L8699
HCPCS 		Implant Denovo Nt Graft 10 $4,813.52 $7,995.33 $7,668.99 nat. median
$2,013
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
$164
outlier · 45.8×
J2182
HCPCS 		Mepolizumab 100 Mg Pow Inj [pmc] 10 $34.57 $7,562.90 $7,177.04 nat. median
$2,892
outlier · 2.5×
Q5123
HCPCS 		Rituximab-arrx 10 mg/mL Inj Sol 50 Ml [pmc] 10 $4,440.58 $7,375.87 $7,074.81 nat. median
$1,030
outlier · 6.9×
Q5119
HCPCS 		Rituximab-pvvr 10 mg/mL Inj Sol 50 Ml [pmc] 10 $4,440.58 $7,375.87 $7,074.81 nat. median
$818
outlier · 8.7×
J1725
HCPCS 		Hydroxyprogesterone 250 mg/mL Sol 5 Ml [pmc] 10 $4,274.55 $7,100.10 $6,810.30 nat. median
$51
outlier · 134.5×
C1768
HCPCS 		Alitply Lite 4cm X 4cm 10 $2,124.00 $10,143.00 $6,545.00 nat. median
$2,049
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 · 140.9×
78815
CPT 		PET Skull Base To Midthigh With CT Scan 10 $3,879.84 $6,444.48 $6,181.44 nat. median
$2,810
outlier · 2.2×
75635
CPT 		CT Angio Abdomen Aorta +Iliofemoral 10 $3,824.97 $6,353.34 $6,094.02 nat. median
$725
outlier · 8.4×
78816
CPT 		PET Whole Body With CT Scan 10 $3,729.98 $6,195.56 $5,942.68 nat. median
$2,784
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
$1,956
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
$2,359
outlier · 2.5×
70549
CPT 		MRA Neck With + Without Cont 10 $3,519.94 $5,846.68 $5,608.04 nat. median
$1,042
outlier · 5.4×
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
$1,944
outlier · 2.7×
J3111
HCPCS 		Romosozumab-aqqg 210 Mg/2.34 Ml Inj Kit [pmc] 10 $3,257.23 $5,410.32 $5,189.49 nat. median
$734
outlier · 7.1×
13160
CPT 		13160 Secondary Closure Of Surgical Wound/dehiscence 10 $3,207.83 $5,328.26 $5,110.78 nat. median
$2,718
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
$859
outlier · 5.9×
74178
CPT 		Pmc CT Abdomen +Pelvis With + Without Cont 10 $3,197.21 $5,310.62 $5,039.67 nat. median
$1,023
outlier · 4.9×
Q4100
HCPCS 		Active Barrier 200 Amniotic Membrane Allograft 4x8 10 $2,284.63 $8,225.14 $5,032.13 nat. median
$1,909
outlier · 2.6×
52601
CPT 		Prostate Resection Transurethral 10 $3,156.50 $5,243.00 $5,029.00 nat. median
$5,343
0.9× median
73723
CPT 		MRI Ankle With + Without Cont Lt 10 $3,123.46 $5,188.12 $4,976.36 nat. median
$1,191
outlier · 4.2×
20240
CPT 		20240 Biopsy, Bone, Open; Superficial 10 $3,105.76 $5,158.72 $4,948.16 nat. median
$2,906
1.7× median
C1762
HCPCS 		Altiply Lite 4cm X 7cm 10 $1,585.63 $14,406.00 $4,829.92 nat. median
$2,937
1.6× median
74174
CPT 		Pmc CT Angio Abdomen Pelvis 10 $3,031.42 $5,035.24 $4,829.72 nat. median
$980
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.

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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
             
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
78452 CPT Cardiolite 33m 15 10 $2,765.00 $2,350.25 $1,631.35 $2,709.70 $2,543.80 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
51715 CPT Cystoscopy With Implant 34 10 $2,250.00 $1,912.50 $838.98 $2,469.60 $2,025.00 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
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
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
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
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
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
0722 RC Delivery Only 34 10 $2,273.00 $1,932.05 $1,152.27 $3,599.54 $1,979.82 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
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
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
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
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
93306 CPT Echo Complete 15 10 $2,917.00 $2,479.45 $1,721.03 $2,858.66 $2,741.98 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
55041 CPT Hydrocelectomy Bilateral 14 10 $3,774.00 $3,207.90 $2,226.66 $3,698.52 $3,547.56 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
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
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
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
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
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
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
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
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
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
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
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
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
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
C2625 HCPCS Implant Propel 24 10 $2,850.00 $2,422.50 $1,615.13 $2,793.00 $2,611.32 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
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
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
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
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
65400 CPT Keratectomy 14 10 $2,750.00 $2,337.50 $1,622.50 $2,695.00 $2,585.00 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
0684 RC Trauma Activation 14 10 $1,951.00 $1,658.35 $1,151.09 $1,911.98 $1,833.94 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
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
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
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
55250 CPT Vasectomy 15 10 $3,348.00 $2,845.80 $1,975.32 $3,281.04 $3,147.12 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
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
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