Hospital

SIDNEY REGIONAL MEDICAL CENTER

Sidney, NE · CCN 281357 · Rates published

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You selected 93306 (CPT)

HB ECHO TTE 2-D +/-M MODE CMPLT W DOPPLER

This hospital’s price: $2,910 across 12 payers · range $1,265-$3,100

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/8186/470408242_cheyenne-county-hospital-association-inc_standardcharges.csv · observed 2026-01-09

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

2,772 distinct procedures filed

12 distinct payers

195,916 rate rows

2026-01-09 last MRF observed

Data quality

61,824 of 195,916 rate rows are consumer-grade (31.6%)

134,092 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	133,839
placeholder amount (≤ $0.02) — excluded from medians	93
percent-of-charges filed in the dollar field — excluded from medians	57
per-diem day rate — not a per-procedure price	42
exceeds 10× this hospital's gross charge — excluded from medians	40
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	19
template filing: same amount across many unrelated codes — excluded	2

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

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/8186/470408242_cheyenne-county-hospital-association-inc_standardcharges.csv
Found on page	https://www.sidneyrmc.com/cms-hpt.txt
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-10-03
Content fingerprint	c4631800ca99bce1… · 58,585,604 bytes · first seen 2026-05-15

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
Q2056 HCPCS	Ciltacabtagene Car-pos T	1	$534,747.21	$534,747.21	$534,747.21	nat. median $646,415 0.8× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	1	$493,075.45	$493,075.45	$493,075.45	nat. median $640,950 0.8× median
Q2053 HCPCS	Brexucabtagene Car Pos T	1	$487,597.46	$487,597.46	$487,597.46	nat. median $591,721 0.8× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	1	$487,597.46	$487,597.46	$487,597.46	nat. median $608,239 0.8× median
J1566 HCPCS	Immune Glob,gamma(igg) 10 Gram-gly-gluc-iga 0 To 50 Mcg/ml IV Solution\|discarded…	12	$83.17	$609,579.60	$393,946.00	nat. median $789 outlier · 499.3×
J9223 HCPCS	Lurbinectedin 4 Mg Intravenous Solution	12	$211.49	$84,526.76	$81,939.21	nat. median $617 outlier · 132.7×
J0840 HCPCS	Crotalidae Polyval Immune Fab Solution For Injection	12	$2,098.66	$84,356.73	$81,774.38	nat. median $3,445 outlier · 23.7×
C1820 HCPCS	Implantable Pulse Generator	12	$28,787.28	$70,528.84	$68,369.79	nat. median $22,986 outlier · 3.0×
J9029 HCPCS	Instill Adstiladrin, Tx Dose	1	$67,315.72	$67,315.72	$67,315.72	nat. median $68,423 1.0× median
C1822 HCPCS	Inceptiv	12	$25,935.00	$63,540.75	$61,595.62	nat. median $31,540 2.0× median
Q2043 HCPCS	Sipuleucel-t Auto Cd54+	2	$57,567.44	$58,780.78	$58,174.11	nat. median $65,720 0.9× median
J9226 HCPCS	Supprelin La Implant	2	$47,253.48	$48,985.99	$48,119.74	nat. median $55,159 0.9× median
J0875 HCPCS	Dalbavancin 500 Mg Intravenous Solution	12	$16.03	$56,948.17	$37,190.64	nat. median $390 outlier · 95.4×
J7330 HCPCS	Cultured Chondrocytes Implnt	1	$36,120.26	$36,120.26	$36,120.26	nat. median $75,000 outlier · 0.5×
C1767 HCPCS	Nrstm Axonics Impl Axonics Snm	12	$13,282.14	$32,541.24	$31,545.08	nat. median $23,896 1.3× median
J9266 HCPCS	Pegaspargase Injection	2	$27,328.35	$27,949.69	$27,639.02	nat. median $33,233 0.8× median
J9176 HCPCS	Elotuzumab 300 Mg Intravenous Solution\|discarded Drug Not Administe	12	$7.80	$64,436.33	$23,917.17	nat. median $2,651 outlier · 9.0×
J9144 HCPCS	Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln	12	$51.73	$24,466.31	$23,717.34	nat. median $211 outlier · 112.2×
J1162 HCPCS	Digoxin Immune Fab 40 Mg Intravenous Solution	12	$5,064.09	$24,038.26	$23,302.40	nat. median $7,141 outlier · 3.3×
J2350 HCPCS	Ocrelizumab 30 Mg/ml Intravenous Solution\|discarded Drug Not Administe	12	$62.29	$30,172.30	$19,499.10	nat. median $470 outlier · 41.5×
J7310 HCPCS	Fee Schedule	1	$19,200.42	$19,200.42	$19,200.42	nat. median $18,387 1.0× median
J9600 HCPCS	Porfimer Sodium Injection	1	$19,143.46	$19,143.46	$19,143.46	nat. median $30,131 0.6× median
50590 CPT	Hb Or Lithotripsy	12	$7,959.60	$19,501.02	$18,904.05	nat. median $4,382 outlier · 4.3×
J0565 HCPCS	Bezlotoxumab 25 Mg/ml Intravenous Solution	12	$42.26	$18,562.38	$17,994.14	nat. median $159 outlier · 112.9×
J9358 HCPCS	Fam-trastuzumab Deruxtecan-nxki 100 Mg Intravenous Solution	12	$28.47	$18,120.10	$17,565.40	nat. median $95 outlier · 184.2×
J2427 HCPCS	Paliperidone Palmitate (3 Month) 819 Mg/2.63 Ml Intramuscular Syringe	12	$12.92	$17,616.56	$17,077.28	nat. median $2,599 outlier · 6.6×
J9063 HCPCS	Mirvetuximab Soravtansine-gynx 5 Mg/ml Intravenous Solution	12	$69.62	$16,820.06	$16,305.16	nat. median $210 outlier · 77.5×
J3380 HCPCS	Vedolizumab 300 Mg Intravenous Solution	12	$23.16	$15,627.66	$15,149.26	nat. median $162 outlier · 93.5×
J9307 HCPCS	Pralatrexate 40 Mg/2 Ml (20 Mg/ml) Intravenous Solution\|discarded Drug Not Admin…	12	$317.24	$25,713.46	$13,473.67	nat. median $897 outlier · 15.0×
J0841 HCPCS	Antivenin Crotalidae (equine) Solution For Injection	12	$1,110.13	$13,291.65	$12,884.76	nat. median $1,879 outlier · 6.9×
J3101 HCPCS	Tenecteplase 50 Mg Intravenous Solution (for Stemi)	12	$162.30	$12,780.56	$12,034.94	nat. median $3,820 outlier · 3.2×
Q4122 HCPCS	Decellularized Dermis	12	$4,998.44	$12,246.19	$11,871.31	nat. median $308 outlier · 38.5×
50593 CPT	Hb Radiant Ablation Renal Tumor Unil Perc Cryo	12	$4,422.40	$10,834.88	$10,503.20	nat. median $10,372 1.0× median
C1889 HCPCS	Aquablation	12	$645.24	$22,902.60	$9,273.19	nat. median $2,369 outlier · 3.9×
J1932 HCPCS	Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe	12	$46.66	$9,525.18	$9,233.59	nat. median $113 outlier · 81.6×
J9119 HCPCS	Cemiplimab-rwlc 50 Mg/ml Intravenous Solution	12	$29.21	$17,368.29	$9,196.67	nat. median $91 outlier · 101.0×
27329 CPT	Hb Rad Resect Tumor Soft Tissue Thigh/knee <5cm	12	$3,708.40	$9,085.58	$8,807.45	nat. median $3,169 outlier · 2.8×
J9316 HCPCS	Pertuzumab 600 Mg-trastuzumab 600 Mg-hyaluronid-zzxf/10 Ml Subcut Soln\|discarded…	12	$69.24	$16,742.40	$8,772.91	nat. median $384 outlier · 22.8×
78816 CPT	Hb Radiant Pet/ct Tumor Image Full Body	12	$3,654.80	$8,954.26	$8,680.15	nat. median $2,788 outlier · 3.1×
J9047 HCPCS	Carfilzomib 30 Mg Intravenous Solution\|discarded Drug Not Administe	12	$50.01	$30,112.36	$8,398.69	nat. median $1,607 outlier · 5.2×
J9356 HCPCS	Trastuzumab 600 Mg-hyaluronidase-oysk 10,000 Unit/5 Ml Subcut Solution	12	$69.89	$8,449.94	$8,191.27	nat. median $139 outlier · 59.0×
11770 CPT	Hb Excision Of Pilonidal Cyst	12	$3,365.60	$8,245.72	$7,993.30	nat. median $2,837 outlier · 2.8×
J9228 HCPCS	Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution	12	$182.19	$15,084.20	$7,987.22	nat. median $9,003 0.9× median
78815 CPT	Hb Radiant Pet/ct Tumor Image Skul-thigh	12	$3,360.00	$8,232.00	$7,820.40	nat. median $2,820 outlier · 2.8×
52284 CPT	Hb Cysto W/dilat Rx Balo Cath Urtl Strix/sten Male	12	$3,290.40	$8,061.48	$7,814.70	nat. median $5,405 1.4× median
J9022 HCPCS	Atezolizumab 840 Mg/14 Ml (60 Mg/ml) Intravenous Solution	12	$88.98	$16,460.77	$7,683.24	nat. median $6,785 1.1× median
74174 CPT	Hb Radiant-CT Angio Abd & Pelv Wo & W Contrast	12	$3,284.40	$8,046.78	$7,644.44	nat. median $988 outlier · 7.7×
24655 CPT	Hb Closed Tx Radial Head/neck Fx W Manip	12	$3,204.80	$7,851.76	$7,611.40	nat. median $1,596 outlier · 4.8×
J2323 HCPCS	Natalizumab 300 Mg/15 Ml Intravenous Solution\|discarded Drug Not Administe	12	$25.68	$14,242.64	$7,463.06	nat. median $197 outlier · 37.8×
37609 CPT	Hb Ligation Or Biopsy Temporal Artery	12	$3,134.80	$7,680.26	$7,445.15	nat. median $1,884 outlier · 4.0×

Other procedures at this hospital

Browse this hospital's 2,772 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

Q2056	HCPCS	Ciltacabtagene Car-pos T	1	1	—	—	$534,747.21	$534,747.21	$534,747.21	2026-01-09
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	1	1	—	—	$493,075.45	$493,075.45	$493,075.45	2026-01-09
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	1	1	—	—	$487,597.46	$487,597.46	$487,597.46	2026-01-09
Q2053	HCPCS	Brexucabtagene Car Pos T	1	1	—	—	$487,597.46	$487,597.46	$487,597.46	2026-01-09
J1566	HCPCS	Immune Glob,gamma(igg) 10 Gram-gly-gluc-iga 0 To 50 Mcg/ml IV Solution\|discarded…	33	12	$414,680.00	$414,680.00	$83.17	$609,579.60	$393,946.00	2026-01-09
J9223	HCPCS	Lurbinectedin 4 Mg Intravenous Solution	20	12	$86,251.80	$86,251.80	$211.49	$84,526.76	$81,939.21	2026-01-09
J0840	HCPCS	Crotalidae Polyval Immune Fab Solution For Injection	20	12	$86,078.30	$86,078.30	$2,098.66	$84,356.73	$81,774.38	2026-01-09
C1820	HCPCS	Implantable Pulse Generator	19	12	$71,968.20	$71,968.20	$28,787.28	$70,528.84	$68,369.79	2026-01-09
J9029	HCPCS	Instill Adstiladrin, Tx Dose	1	1	—	—	$67,315.72	$67,315.72	$67,315.72	2026-01-09
C1822	HCPCS	Inceptiv	19	12	$64,837.50	$64,837.50	$25,935.00	$63,540.75	$61,595.62	2026-01-09
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	2	2	—	—	$57,567.44	$58,780.78	$58,174.11	2026-01-09
J9226	HCPCS	Supprelin La Implant	2	2	—	—	$47,253.48	$48,985.99	$48,119.74	2026-01-09
J0875	HCPCS	Dalbavancin 500 Mg Intravenous Solution	33	12	$58,110.38	$58,110.38	$16.03	$56,948.17	$37,190.64	2026-01-09
J7330	HCPCS	Cultured Chondrocytes Implnt	1	1	—	—	$36,120.26	$36,120.26	$36,120.26	2026-01-09
C1767	HCPCS	Nrstm Axonics Impl Axonics Snm	19	12	$33,205.35	$33,205.35	$13,282.14	$32,541.24	$31,545.08	2026-01-09
J9266	HCPCS	Pegaspargase Injection	2	2	—	—	$27,328.35	$27,949.69	$27,639.02	2026-01-09
J9176	HCPCS	Elotuzumab 300 Mg Intravenous Solution\|discarded Drug Not Administe	46	12	$36,985.32	$36,985.32	$7.80	$64,436.33	$23,917.17	2026-01-09
J9144	HCPCS	Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln	20	12	$24,965.62	$24,965.62	$51.73	$24,466.31	$23,717.34	2026-01-09
J1162	HCPCS	Digoxin Immune Fab 40 Mg Intravenous Solution	20	12	$24,528.84	$24,528.84	$5,064.09	$24,038.26	$23,302.40	2026-01-09
J2350	HCPCS	Ocrelizumab 30 Mg/ml Intravenous Solution\|discarded Drug Not Administe	33	12	$20,525.37	$20,525.37	$62.29	$30,172.30	$19,499.10	2026-01-09
J7310	HCPCS	Fee Schedule	1	1	—	—	$19,200.42	$19,200.42	$19,200.42	2026-01-09
J9600	HCPCS	Porfimer Sodium Injection	1	1	—	—	$19,143.46	$19,143.46	$19,143.46	2026-01-09
50590	CPT	Hb Or Lithotripsy	19	12	$19,899.00	$19,899.00	$7,959.60	$19,501.02	$18,904.05	2026-01-09
J0565	HCPCS	Bezlotoxumab 25 Mg/ml Intravenous Solution	20	12	$18,941.20	$18,941.20	$42.26	$18,562.38	$17,994.14	2026-01-09
J9358	HCPCS	Fam-trastuzumab Deruxtecan-nxki 100 Mg Intravenous Solution	20	12	$18,489.90	$18,489.90	$28.47	$18,120.10	$17,565.40	2026-01-09
J2427	HCPCS	Paliperidone Palmitate (3 Month) 819 Mg/2.63 Ml Intramuscular Syringe	20	12	$17,976.08	$17,976.08	$12.92	$17,616.56	$17,077.28	2026-01-09
J9063	HCPCS	Mirvetuximab Soravtansine-gynx 5 Mg/ml Intravenous Solution	20	12	$17,163.33	$17,163.33	$69.62	$16,820.06	$16,305.16	2026-01-09
J3380	HCPCS	Vedolizumab 300 Mg Intravenous Solution	20	12	$15,946.59	$15,946.59	$23.16	$15,627.66	$15,149.26	2026-01-09
J9307	HCPCS	Pralatrexate 40 Mg/2 Ml (20 Mg/ml) Intravenous Solution\|discarded Drug Not Admin…	33	12	$14,182.82	$14,182.82	$317.24	$25,713.46	$13,473.67	2026-01-09
J0841	HCPCS	Antivenin Crotalidae (equine) Solution For Injection	20	12	$13,562.91	$13,562.91	$1,110.13	$13,291.65	$12,884.76	2026-01-09
J3101	HCPCS	Tenecteplase 50 Mg Intravenous Solution (for Stemi)	33	12	$12,668.36	$12,668.36	$162.30	$12,780.56	$12,034.94	2026-01-09
Q4122	HCPCS	Decellularized Dermis	19	12	$12,496.11	$12,496.11	$4,998.44	$12,246.19	$11,871.31	2026-01-09
50593	CPT	Hb Radiant Ablation Renal Tumor Unil Perc Cryo	19	12	$11,056.00	$11,056.00	$4,422.40	$10,834.88	$10,503.20	2026-01-09
C1889	HCPCS	Aquablation	117	12	$10,117.50	$10,117.50	$645.24	$22,902.60	$9,273.19	2026-01-09
J1932	HCPCS	Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe	20	12	$9,719.57	$9,719.57	$46.66	$9,525.18	$9,233.59	2026-01-09
J9119	HCPCS	Cemiplimab-rwlc 50 Mg/ml Intravenous Solution	33	12	$17,722.74	$17,722.74	$29.21	$17,368.29	$9,196.67	2026-01-09
27329	CPT	Hb Rad Resect Tumor Soft Tissue Thigh/knee <5cm	19	12	$9,271.00	$9,271.00	$3,708.40	$9,085.58	$8,807.45	2026-01-09
J9316	HCPCS	Pertuzumab 600 Mg-trastuzumab 600 Mg-hyaluronid-zzxf/10 Ml Subcut Soln\|discarded…	33	12	$9,234.64	$9,234.64	$69.24	$16,742.40	$8,772.91	2026-01-09
78816	CPT	Hb Radiant Pet/ct Tumor Image Full Body	19	12	$9,137.00	$9,137.00	$3,654.80	$8,954.26	$8,680.15	2026-01-09
J9047	HCPCS	Carfilzomib 30 Mg Intravenous Solution\|discarded Drug Not Administe	59	12	$20,484.60	$20,484.60	$50.01	$30,112.36	$8,398.69	2026-01-09
J9356	HCPCS	Trastuzumab 600 Mg-hyaluronidase-oysk 10,000 Unit/5 Ml Subcut Solution	20	12	$8,622.39	$8,622.39	$69.89	$8,449.94	$8,191.27	2026-01-09
11770	CPT	Hb Excision Of Pilonidal Cyst	19	12	$8,414.00	$8,414.00	$3,365.60	$8,245.72	$7,993.30	2026-01-09
J9228	HCPCS	Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution	33	12	$15,392.04	$15,392.04	$182.19	$15,084.20	$7,987.22	2026-01-09
78815	CPT	Hb Radiant Pet/ct Tumor Image Skul-thigh	19	12	$8,400.00	$8,400.00	$3,360.00	$8,232.00	$7,820.40	2026-01-09
52284	CPT	Hb Cysto W/dilat Rx Balo Cath Urtl Strix/sten Male	19	12	$8,226.00	$8,226.00	$3,290.40	$8,061.48	$7,814.70	2026-01-09
J9022	HCPCS	Atezolizumab 840 Mg/14 Ml (60 Mg/ml) Intravenous Solution	59	12	$14,504.08	$14,504.08	$88.98	$16,460.77	$7,683.24	2026-01-09
74174	CPT	Hb Radiant-CT Angio Abd & Pelv Wo & W Contrast	19	12	$8,211.00	$8,211.00	$3,284.40	$8,046.78	$7,644.44	2026-01-09
24655	CPT	Hb Closed Tx Radial Head/neck Fx W Manip	19	12	$8,012.00	$8,012.00	$3,204.80	$7,851.76	$7,611.40	2026-01-09
J2323	HCPCS	Natalizumab 300 Mg/15 Ml Intravenous Solution\|discarded Drug Not Administe	33	12	$7,855.85	$7,855.85	$25.68	$14,242.64	$7,463.06	2026-01-09
37609	CPT	Hb Ligation Or Biopsy Temporal Artery	19	12	$7,837.00	$7,837.00	$3,134.80	$7,680.26	$7,445.15	2026-01-09
78814	CPT	Hb Radiant Pet/ct Tumor Image Limited	19	12	$7,782.00	$7,782.00	$3,112.80	$7,626.36	$7,392.90	2026-01-09
66986	CPT	Hb Exchange Intraocular Lens	19	12	$7,533.00	$7,533.00	$3,013.20	$7,382.34	$7,156.35	2026-01-09
22514	CPT	Hb Perq Vert Agmntj Cavity Crtj Uni/bi Cannulj Lmbr	19	12	$7,385.00	$7,385.00	$2,954.00	$7,237.30	$7,015.75	2026-01-09
J0637	HCPCS	Caspofungin IV Solution 7 Mg/ml	20	12	$7,298.78	$7,298.78	$7.03	$7,152.80	$6,933.84	2026-01-09
J0402	HCPCS	Aripiprazole ER (2 Month) 720 Mg/2.4 Ml Susp, Extended Rel IM Syringe	20	12	$7,246.78	$7,246.78	$6.16	$7,101.84	$6,884.44	2026-01-09
52276	CPT	Hb Cystourethroscopy With Dviu	19	12	$6,998.00	$6,998.00	$2,799.20	$6,858.04	$6,648.10	2026-01-09
21552	CPT	Hb Exc Soft Tumor Neck/chest Perq Eg 3 Cm	19	12	$6,937.00	$6,937.00	$2,774.80	$6,798.26	$6,590.15	2026-01-09
J9306	HCPCS	Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution\|discarded Drug Not Admin…	33	12	$6,787.75	$6,787.75	$16.35	$12,306.18	$6,448.36	2026-01-09
J2353	HCPCS	Octreotide,microspheres ER 10 Mg Intramuscular Susp, Extended Release	46	12	$7,294.09	$7,294.09	$223.19	$10,703.93	$6,432.47	2026-01-09
63650	CPT	Hb Impl. Neurostim Electrode Epid	19	12	$6,712.00	$6,712.00	$2,684.80	$6,577.76	$6,376.40	2026-01-09
J3315	HCPCS	Triptorelin Pamoate 22.5 Mg IM Suspension	20	12	$6,676.34	$6,676.34	$432.90	$6,542.81	$6,342.52	2026-01-09
J1306	HCPCS	Inclisiran 284 Mg/1.5 Ml Subcutaneous Syringe	20	12	$6,600.14	$6,600.14	$12.85	$6,468.14	$6,270.13	2026-01-09
J0600	HCPCS	Edetate Calcium Disodium Inj	2	2	—	—	$6,051.11	$6,462.69	$6,256.90	2026-01-09
20525	CPT	Hb Rmvl Foreign Body Muscle/tendon Sheath Deep/comp	19	12	$6,565.00	$6,565.00	$2,626.00	$6,433.70	$6,236.75	2026-01-09
70546	CPT	Hb Radiant-MRA Head W/o&w Cont	19	12	$6,538.00	$6,538.00	$2,615.20	$6,407.24	$6,211.10	2026-01-09
J2997	HCPCS	Alteplase 2 Mg Intra-catheter Solution	46	12	$8,167.61	$8,167.61	$94.15	$14,807.88	$6,195.13	2026-01-09
74178	CPT	Hb Radiant-CT Abdomen And Pelvis Without W Contrast	19	12	$6,515.00	$6,515.00	$2,606.00	$6,384.70	$6,189.25	2026-01-09
53854	CPT	Hb Gi-trurl Dstrj Prst8 Tiss Rf Wv Thermotherapy	19	12	$6,508.00	$6,508.00	$2,603.20	$6,377.84	$6,182.60	2026-01-09
64635	CPT	Hb Dest L/s Facet Jnt Single Level W Image	19	12	$6,358.00	$6,358.00	$2,543.20	$6,230.84	$6,040.10	2026-01-09
C1763	HCPCS	Novabone Bioactive Strip	89	12	$7,875.00	$7,875.00	$1,978.00	$8,937.60	$6,019.20	2026-01-09
78452	CPT	Hb Radiant-hrt Muscle Image Spect-multiple	19	12	$6,402.00	$6,402.00	$2,560.80	$6,273.96	$5,960.26	2026-01-09
14020	CPT	Hb Tissue Tran Scalp Lt 10 Sq Cm	19	12	$6,237.00	$6,237.00	$2,494.80	$6,112.26	$5,925.15	2026-01-09
J9225	HCPCS	Vantas Implant	1	1	—	—	$5,848.76	$5,848.76	$5,848.76	2026-01-09
72157	CPT	Hb Radiant-mr T-spine With/without Contrast	19	12	$6,139.00	$6,139.00	$1,864.07	$6,016.22	$5,832.05	2026-01-09
95811	CPT	Hb Sleep Study With Cpap	19	12	$6,176.00	$6,176.00	$2,470.40	$6,052.48	$5,749.86	2026-01-09
55500	CPT	Hb Exc Hydrocele Sprmatic Cord Uni Spx	19	12	$6,022.00	$6,022.00	$2,408.80	$5,901.56	$5,720.90	2026-01-09
59414	CPT	Hb Delivery Of Placenta Only (outborn)	19	12	$5,977.00	$5,977.00	$2,390.80	$5,857.46	$5,678.15	2026-01-09
C1747	HCPCS	Ureteroscope Flx Lithovue Std	33	12	$5,940.00	$5,940.00	$2,376.00	$9,761.54	$5,643.00	2026-01-09
J9177	HCPCS	Enfortumab Vedotin-ejfv 20 Mg Intravenous Solution	20	12	$5,932.53	$5,932.53	$36.69	$5,813.88	$5,635.90	2026-01-09
72158	CPT	Hb Radiant-mr L-spine With/without Contrast	19	12	$5,928.00	$5,928.00	$2,371.20	$5,809.44	$5,631.60	2026-01-09
27337	CPT	Hb Exc Tumor Soft Tiss Thigh/knee Subq Eg 3cm	19	12	$5,903.00	$5,903.00	$2,361.20	$5,784.94	$5,607.85	2026-01-09
73223	CPT	Hb Radiant-MRI Any Jt Up Extrem W/o&w/cont	19	12	$5,869.00	$5,869.00	$2,347.60	$5,751.62	$5,575.55	2026-01-09
64633	CPT	Hb Dest Cerv/thor Facet Jnt Single Level W Image	19	12	$5,850.00	$5,850.00	$2,340.00	$5,733.00	$5,557.50	2026-01-09
27328	CPT	Hb Exc Tumor Soft Tissue Thigh/knee Subfasc <5cm	19	12	$5,797.00	$5,797.00	$2,318.80	$5,681.06	$5,507.15	2026-01-09
72156	CPT	Hb Radiant-mr C-spine With/without Contrast	19	12	$5,908.00	$5,908.00	$1,864.07	$5,789.84	$5,500.35	2026-01-09
J0139	HCPCS	Adalimumab 40 Mg/0.4 Ml Subcutaneous Pen Kit	19	12	$5,780.86	$5,780.86	$2,312.34	$5,665.24	$5,491.81	2026-01-09
J9271	HCPCS	Pembrolizumab 25 Mg/ml Intravenous Solution\|discarded Drug Not Administe	33	12	$5,755.48	$5,755.48	$59.46	$10,434.69	$5,467.70	2026-01-09
74183	CPT	Hb Radiant-mr Abdomen W + Without Contrast	19	12	$5,754.00	$5,754.00	$2,301.60	$5,638.92	$5,466.30	2026-01-09
J9219	HCPCS	Leuprolide Acetate Implant	1	1	—	—	$5,456.52	$5,456.52	$5,456.52	2026-01-09
19301	CPT	Hb Mastectomy Partial; Lumpectomy	19	12	$5,738.00	$5,738.00	$2,295.20	$5,623.24	$5,451.10	2026-01-09
72147	CPT	Hb Radiant MRI T-spine With Contrast	19	12	$5,701.00	$5,701.00	$2,280.40	$5,586.98	$5,415.95	2026-01-09
J0225	HCPCS	Inj, Vutrisiran, 1 Mg	2	2	—	—	$5,231.32	$5,593.65	$5,412.48	2026-01-09
J1437	HCPCS	Ferric Derisomaltose 100 Mg Iron/ml Intravenous Solution	20	12	$5,640.82	$5,640.82	$21.14	$5,528.00	$5,358.77	2026-01-09
14021	CPT	Hb Tissue Tran Scalp 10.1-30.0 Sq Cm	19	12	$5,637.00	$5,637.00	$2,254.80	$5,524.26	$5,355.15	2026-01-09
46040	CPT	Hb I&d Perirectal Abscess	19	12	$5,621.00	$5,621.00	$2,248.40	$5,508.58	$5,339.95	2026-01-09
72142	CPT	Hb Radiant MRI C-spine With Contrast	19	12	$5,602.00	$5,602.00	$2,240.80	$5,489.96	$5,321.90	2026-01-09
74177	CPT	Hb Radiant-CT Abdomen And Pelvis W Contrast	19	12	$5,678.00	$5,678.00	$2,271.20	$5,564.44	$5,286.22	2026-01-09
70543	CPT	Hb Radiant-MRI Orbit Face & Nec W/o&w Cont	19	12	$5,521.00	$5,521.00	$2,208.40	$5,410.58	$5,244.95	2026-01-09
70549	CPT	Hb Radiant-MRA Neck W + Without Contrast	19	12	$5,462.00	$5,462.00	$2,184.80	$5,352.76	$5,188.90	2026-01-09
25630	CPT	Hb Closed Tx Wrist Fx Not Without Manip Each Bone	19	12	$5,447.00	$5,447.00	$2,178.80	$5,338.06	$5,174.65	2026-01-09
95810	CPT	Hb Sleep Study	19	12	$5,553.00	$5,553.00	$2,221.20	$5,441.94	$5,169.84	2026-01-09
73220	CPT	Hb Radiant-MRI Up Extrem Not Jt W/o&w/cont	19	12	$5,363.00	$5,363.00	$2,145.20	$5,255.74	$5,094.85	2026-01-09
42808	CPT	Hb Exc/dstrj Les Pharynx Any Meth	19	12	$5,339.00	$5,339.00	$2,135.60	$5,232.22	$5,072.05	2026-01-09
27842	CPT	Hb Cltx Ankle Dislc Req Anes +-prq Skel Fixj	19	12	$5,326.00	$5,326.00	$2,130.40	$5,219.48	$5,059.70	2026-01-09
31622	CPT	Hb Bronchoscopy Diagnostic-resp	19	12	$5,250.00	$5,250.00	$2,100.00	$5,145.00	$4,987.50	2026-01-09
66989	CPT	Hb Xcpsl Ctrc Rmvl Cplx Insj 1+	19	12	$5,229.00	$5,229.00	$2,091.60	$5,124.42	$4,967.55	2026-01-09
C1897	HCPCS	Quattrode Trial Lead Kit, 60cm	19	12	$5,187.60	$5,187.60	$2,075.04	$5,083.85	$4,928.22	2026-01-09
J0517	HCPCS	Benralizumab 30 Mg/ml Subcutaneous Syringe\|discarded Drug Not Administe	33	12	$5,145.66	$5,145.66	$175.17	$9,329.08	$4,888.38	2026-01-09
73723	CPT	Hb Radiant-MRI Any Jt Lw Extrem W/o&w/cont	19	12	$5,128.00	$5,128.00	$2,051.20	$5,025.44	$4,871.60	2026-01-09
J0480	HCPCS	Basiliximab	2	2	—	—	$4,756.22	$4,968.88	$4,862.55	2026-01-09
72149	CPT	Hb Radiant-mr L-spine W Contrast	19	12	$5,093.00	$5,093.00	$2,037.20	$4,991.14	$4,838.35	2026-01-09
70552	CPT	Hb Radiant-mr Imag Brain; With Cont	19	12	$5,045.00	$5,045.00	$2,018.00	$4,944.10	$4,792.75	2026-01-09
73222	CPT	Hb Radiant-MRI Any Jt Up Extrem W/cont	19	12	$4,955.00	$4,955.00	$1,982.00	$4,855.90	$4,707.25	2026-01-09
72132	CPT	Hb Radiant-CT L-spine With Contrast	19	12	$4,941.00	$4,941.00	$1,976.40	$4,842.18	$4,693.95	2026-01-09
73720	CPT	Hb Radiant-MRI Low Extrem Not Jnt W/o&w Cont	19	12	$4,908.00	$4,908.00	$1,963.20	$4,809.84	$4,662.60	2026-01-09
70553	CPT	Hb Radiant-MRI Brain W/o&w Cont	19	12	$4,995.00	$4,995.00	$1,998.00	$4,895.10	$4,650.35	2026-01-09
72146	CPT	Hb Radiant-mr T-spine Without Contrast	19	12	$4,888.00	$4,888.00	$1,782.91	$4,790.24	$4,643.60	2026-01-09
70544	CPT	Hb Radiant-MRA Head Without Cont	19	12	$4,876.00	$4,876.00	$1,950.40	$4,778.48	$4,632.20	2026-01-09
20670	CPT	Hb Removal Int Fixation Dev Superficial	19	12	$4,874.00	$4,874.00	$1,949.60	$4,776.52	$4,630.30	2026-01-09
L8606	HCPCS	Bulkamid Urethral Bulking System	19	12	$4,872.00	$4,872.00	$1,948.80	$4,774.56	$4,628.40	2026-01-09
C1776	HCPCS	Bi-mentum Altrx Liner	551	12	$7,026.00	$7,026.00	$169.80	$43,822.17	$4,547.20	2026-01-09
C1778	HCPCS	16 Lead Tricentrus	131	12	$7,064.88	$7,064.88	$90.56	$13,965.00	$4,540.24	2026-01-09
72197	CPT	Hb Radiant-mr Pelvis W + Without Contrast	19	12	$4,766.00	$4,766.00	$1,906.40	$4,670.68	$4,527.70	2026-01-09
52287	CPT	Hb Cysto Injection(s) Chemodenervation Bladder	19	12	$4,713.00	$4,713.00	$1,885.20	$4,618.74	$4,477.35	2026-01-09
J9055	HCPCS	Cetuximab 100 Mg/50 Ml Intravenous Solution	33	12	$4,704.00	$4,704.00	$77.90	$9,219.84	$4,468.80	2026-01-09
71550	CPT	Hb Radiant Mr Chest Without Contrast	19	12	$4,689.00	$4,689.00	$1,875.60	$4,595.22	$4,454.55	2026-01-09
C1765	HCPCS	Trial Screening Lead Kit	19	12	$4,677.12	$4,677.12	$1,870.85	$4,583.58	$4,443.27	2026-01-09
0200	RC	Hb Room & Board ICU	8	7	$4,606.00	$4,606.00	$4,237.52	$4,513.88	$4,421.76	2026-01-09
73722	CPT	Hb Radiant-MRI Any Jt Low Extrem; W/cont	19	12	$4,646.00	$4,646.00	$1,858.40	$4,553.08	$4,413.70	2026-01-09
74176	CPT	Hb Radiant-CT Abdomen And Pelvis Without Contrast	19	12	$4,727.00	$4,727.00	$1,890.80	$4,632.46	$4,400.84	2026-01-09
C1771	HCPCS	Altis Midurethral Incision Sli	19	12	$4,622.50	$4,622.50	$1,849.00	$4,530.05	$4,391.38	2026-01-09
72195	CPT	Hb Radiant-mr Pelvis Without Contrast	19	12	$4,620.00	$4,620.00	$1,848.00	$4,527.60	$4,389.00	2026-01-09
73706	CPT	Hb Radiant-CT Angio Low Ext W/wo Cont	19	12	$4,611.00	$4,611.00	$1,724.26	$4,518.78	$4,380.45	2026-01-09
54001	CPT	Hb Slitting Of Prepuce - Except Nb	19	12	$4,595.00	$4,595.00	$1,838.00	$4,503.10	$4,365.25	2026-01-09
J7168	HCPCS	Hum Prothrombin Cplx 4 Factor 1000 Units (volume)	61	12	$5,000.04	$5,000.04	$1,039.78	$28,609.14	$4,363.20	2026-01-09
J0401	HCPCS	Aripiprazole ER 400 Mg Suspension, Extended Rel.intramuscular Syringe	33	12	$5,680.82	$5,680.82	$7.22	$5,567.20	$4,359.83	2026-01-09
74181	CPT	Hb Radiant-mr Abdomen Without Contrast	19	12	$4,579.00	$4,579.00	$1,831.60	$4,487.42	$4,350.05	2026-01-09
72191	CPT	Hb Radiant-CT Angiography Pelvis W Without	19	12	$4,555.00	$4,555.00	$1,822.00	$4,463.90	$4,327.25	2026-01-09
J0800	HCPCS	Chemo Drugs	1	1	—	—	$4,324.37	$4,324.37	$4,324.37	2026-01-09
74175	CPT	Hb Radiant-CT Angio Abd W/wo Cont	19	12	$4,535.00	$4,535.00	$1,814.00	$4,444.30	$4,308.25	2026-01-09
52224	CPT	Hb Cysto W/destruct Minor Les Lt 0.5	33	12	$8,332.00	$8,332.00	$1,770.40	$8,165.36	$4,248.96	2026-01-09
95805	CPT	Hb Multi Sleep Latency Test	19	12	$4,398.00	$4,398.00	$1,759.20	$4,310.04	$4,178.10	2026-01-09
72133	CPT	Hb Radiant-CT L-spine With & Without Contrast	19	12	$4,396.00	$4,396.00	$1,758.40	$4,308.08	$4,176.20	2026-01-09
64421	CPT	Hb Inj Intercostal Nerves Multiple	19	12	$4,390.00	$4,390.00	$1,756.00	$4,302.20	$4,170.50	2026-01-09
C8908	HCPCS	Hb Radiant MRI Breast Bilat W And Without Cntrst	19	12	$4,356.00	$4,356.00	$1,742.40	$4,268.88	$4,138.20	2026-01-09
71552	CPT	Hb Radiant-mr Chest W + Without Contrast	19	12	$4,352.00	$4,352.00	$1,740.80	$4,264.96	$4,134.40	2026-01-09
J2356	HCPCS	Tezepelumab-ekko 210 Mg/1.91 Ml (110 Mg/ml) Subcutaneous Syringe\|discarded Drug …	33	12	$4,348.42	$4,348.42	$18.87	$7,883.69	$4,131.00	2026-01-09
15839	CPT	Hb Excise Excess Skin/subq Tissue Other	19	12	$4,345.00	$4,345.00	$1,738.00	$4,258.10	$4,127.75	2026-01-09
14040	CPT	Hb Tissue Tran Forehead Eq Lt 10 Sq Cm	19	12	$4,257.00	$4,257.00	$1,702.80	$4,171.86	$4,044.15	2026-01-09
66982	CPT	Hb Complex Cataract	19	12	$4,248.00	$4,248.00	$1,699.20	$4,163.04	$4,035.60	2026-01-09
G0390	HCPCS	Hb Full Trauma Activation (level Iii Trauma Center)	33	12	$5,034.00	$5,034.00	$1,678.00	$4,933.32	$4,027.20	2026-01-09
27825	CPT	Hb Cls Tx Fx Dist Tibia W/manip	19	12	$4,214.00	$4,214.00	$1,685.60	$4,129.72	$4,003.30	2026-01-09
J9200	HCPCS	Floxuridine Injection	2	2	—	—	$3,952.26	$4,020.09	$3,986.18	2026-01-09
J0348	HCPCS	Anidulafungin 100 Mg Intravenous Solution\|discarded Drug Not Administe	33	12	$4,193.40	$4,193.40	$0.49	$7,602.63	$3,983.73	2026-01-09
74170	CPT	Hb Radiant-CT Abdomen With & Without Contrast	19	12	$4,182.00	$4,182.00	$1,672.80	$4,098.36	$3,972.90	2026-01-09
52281	CPT	Hb Cysto W/urethral Calib/dilation	19	12	$4,153.00	$4,153.00	$1,661.20	$4,069.94	$3,945.35	2026-01-09
27570	CPT	Hb Optime-manipulatn Knee Jt+anesthesia	19	12	$4,145.00	$4,145.00	$1,658.00	$4,062.10	$3,937.75	2026-01-09
75635	CPT	Hb Radiant-CT Angio Abd Art/bil Low Leg W/without Ctrst S&i	19	12	$4,139.00	$4,139.00	$1,655.60	$4,056.22	$3,932.05	2026-01-09
72148	CPT	Hb Radiant-mr L-spine Without Contrast	19	12	$4,176.00	$4,176.00	$1,670.40	$4,092.48	$3,887.86	2026-01-09
78830	CPT	Hb Radiant-rp Loclzj Tum Spect W/ct 1 Area/acquisj 1 Day Imaging	19	12	$4,086.00	$4,086.00	$1,634.40	$4,004.28	$3,881.70	2026-01-09
Q5111	HCPCS	Pegfilgrastim-cbqv 6 Mg/0.6 Ml Subcutaneous Syringe	33	12	$7,472.72	$7,472.72	$141.26	$7,323.27	$3,877.74	2026-01-09
36573	CPT	Hb Insertion Picc W/rs&i 5 Yr/>	19	12	$4,079.00	$4,079.00	$1,631.60	$3,997.42	$3,875.05	2026-01-09
J9371	HCPCS	Chemo Drugs	1	1	—	—	$3,872.67	$3,872.67	$3,872.67	2026-01-09
94003	CPT	Hb Ventilator Subsq Daily	19	12	$4,068.00	$4,068.00	$1,627.20	$3,986.64	$3,864.60	2026-01-09
70481	CPT	Hb Radiant-CT Post Fossa With Contrast	19	12	$4,026.00	$4,026.00	$1,610.40	$3,945.48	$3,824.70	2026-01-09
58999	CPT	Hb Dilitation Of Vagina	19	12	$4,025.00	$4,025.00	$1,610.00	$3,944.50	$3,823.75	2026-01-09
64625	CPT	Hb Radiofrequency Abltj Nrv Nrvtg Si Jt W/img Gdn	19	12	$4,016.00	$4,016.00	$1,606.40	$3,935.68	$3,815.20	2026-01-09
52001	CPT	Hb Csto W/irrg&evac Mlt Obstructing Clots	19	12	$4,014.00	$4,014.00	$1,605.60	$3,933.72	$3,813.30	2026-01-09
36556	CPT	Hb Radiant Insert Nt Cv Cath Eq Or Gt 5 Age	19	12	$4,011.00	$4,011.00	$1,604.40	$3,930.78	$3,810.45	2026-01-09
78451	CPT	Hb Radiant-myocardial Spect Single Study At Rest Or Stress	19	12	$3,999.00	$3,999.00	$1,599.60	$3,919.02	$3,799.05	2026-01-09
72194	CPT	Hb Radiant-CT Pelvis With & Without Contrast	19	12	$3,989.00	$3,989.00	$1,595.60	$3,909.22	$3,789.55	2026-01-09
72141	CPT	Hb Radiant-mr C-spine Without Contrast	19	12	$3,983.00	$3,983.00	$1,593.20	$3,903.34	$3,783.85	2026-01-09
73206	CPT	Hb Radiant-CT Angio Upper Extrem Without W Contrast	19	12	$3,977.00	$3,977.00	$1,590.80	$3,897.46	$3,778.15	2026-01-09
70551	CPT	Hb Radiant-mr Imag Brain; Without Cont	19	12	$4,054.00	$4,054.00	$1,621.60	$3,972.92	$3,774.27	2026-01-09
42104	CPT	Hb Excision Lesion Palate/uvula Wo Closure	19	12	$3,963.00	$3,963.00	$1,585.20	$3,883.74	$3,764.85	2026-01-09
52315	CPT	Hb Scope Bladder, Complex Removal Stone, Stent,fb	19	12	$3,959.00	$3,959.00	$1,583.60	$5,413.35	$3,761.05	2026-01-09
57522	CPT	Hb Cone Cervix Loop Electrode W Without	19	12	$3,948.00	$3,948.00	$1,579.20	$3,869.04	$3,750.60	2026-01-09
71270	CPT	Hb Radiant-CT Chest With & Without Contrast	19	12	$3,931.00	$3,931.00	$1,572.40	$3,852.38	$3,734.45	2026-01-09
J9023	HCPCS	Avelumab 20 Mg/ml Intravenous Solution	20	12	$3,925.28	$3,925.28	$98.08	$3,846.77	$3,729.01	2026-01-09
C1762	HCPCS	Arthrex Cancellous 1-4mm 15.0cc	75	12	$5,973.00	$5,973.00	$931.00	$8,297.86	$3,725.57	2026-01-09
C1787	HCPCS	Axonics Remote Control	19	12	$3,911.52	$3,911.52	$1,564.61	$3,833.29	$3,715.95	2026-01-09
J0897	HCPCS	Denosumab 60 Mg/ml Subcutaneous Syringe	33	12	$3,907.46	$3,907.46	$26.24	$6,691.58	$3,712.09	2026-01-09
73218	CPT	Hb Radiant MRI Up Extrem Not Jt Without Cont	19	12	$3,871.00	$3,871.00	$1,548.40	$3,793.58	$3,677.45	2026-01-09
93351	CPT	Hb Radiant Ccl Stress Echo Complete Pharm	19	12	$3,865.00	$3,865.00	$1,546.00	$3,787.70	$3,671.75	2026-01-09
23700	CPT	Hb Manipulation Shoulder Under Anesthesia	19	12	$3,846.00	$3,846.00	$1,538.40	$3,769.08	$3,653.70	2026-01-09
J2507	HCPCS	Pegloticase Injection	2	2	—	—	$3,595.42	$3,700.21	$3,647.82	2026-01-09
78803	CPT	Hb Radiant-tumor Localization Spect/acquisj Sngl Day Img	19	12	$3,838.00	$3,838.00	$1,535.20	$3,761.24	$3,646.10	2026-01-09
81162	CPT	Hb Brca1/brca2 Gene Analysis Sendout	19	12	$3,831.00	$3,831.00	$1,532.40	$3,754.38	$3,639.45	2026-01-09
14301	CPT	Hb Derm Skin Tissue Trnsfr Defect 30.1 To 60.0 Sq Cm	19	12	$3,824.00	$3,824.00	$1,529.60	$3,747.52	$3,632.80	2026-01-09
Q4310	HCPCS	Procenta, Per 100 Mg	1	1	—	—	$3,614.18	$3,614.18	$3,614.18	2026-01-09
71275	CPT	Hb Radiant-CT Angio Chest Without With Ctrst Noncoronary	19	12	$3,800.00	$3,800.00	$1,520.00	$3,724.00	$3,610.00	2026-01-09
J7504	HCPCS	Lymphocyte Immune Globulin	2	2	—	—	$3,384.35	$3,831.69	$3,608.02	2026-01-09
57135	CPT	Hb Excision Vaginal Cyst Or Tumor	19	12	$3,784.00	$3,784.00	$1,513.60	$3,708.32	$3,594.80	2026-01-09
20680	CPT	Hb Removal Int Fixation Dev Deep	19	12	$3,773.00	$3,773.00	$1,509.20	$3,955.68	$3,584.35	2026-01-09
0278	RC	Mtp Dorsal Plate (right)	565	12	$5,920.20	$5,920.20	$76.80	$44,688.00	$3,573.90	2026-01-09
J0801	HCPCS	Inj. Acthar Gel To 40 Units	1	1	—	—	$3,572.61	$3,572.61	$3,572.61	2026-01-09
J0802	HCPCS	Inj. (ani), Up To 40 Units	1	1	—	—	$3,567.22	$3,567.22	$3,567.22	2026-01-09
72126	CPT	Hb Radiant-CT C-spine With Contrast	19	12	$3,749.00	$3,749.00	$1,499.60	$3,674.02	$3,561.55	2026-01-09
73221	CPT	Hb Radiant Mr Any Jt Up Extrem Without Cont	19	12	$3,742.00	$3,742.00	$1,496.80	$3,667.16	$3,554.90	2026-01-09
73718	CPT	Hb Radiant-MRI Low Extrem Not Jt Without Contrst	19	12	$3,738.00	$3,738.00	$1,439.31	$3,663.24	$3,551.10	2026-01-09
52310	CPT	Hb Cysto W/rem Fb/stone/stent Simple	33	12	$4,245.00	$4,245.00	$1,480.00	$4,160.10	$3,515.00	2026-01-09
C8930	HCPCS	Hb Radiant Ccl-rad Stress Echo W/wo Contr W/ecg	19	12	$3,632.00	$3,632.00	$1,452.80	$3,559.36	$3,450.40	2026-01-09
99291	CPT	Hb E&m Critical Care Ill /injured First 30-74 Minutes	19	12	$3,612.00	$3,612.00	$1,444.80	$3,539.76	$3,431.40	2026-01-09
70496	CPT	Hb Radiant-CT Angiography Head With Without Cont	19	12	$3,601.00	$3,601.00	$1,440.40	$3,528.98	$3,420.95	2026-01-09
A9584	HCPCS	Hb Radiant Ioflupane I-123 Dx Per Study To 5 Mci	19	12	$3,600.00	$3,600.00	$1,440.00	$3,528.00	$3,420.00	2026-01-09
94002	CPT	Hb Ventilator Initial Day	19	12	$3,584.00	$3,584.00	$1,433.60	$3,512.32	$3,404.80	2026-01-09
27266	CPT	Hb Closed Rx Post Hip Fix Disloc,anesth	19	12	$3,583.00	$3,583.00	$1,433.20	$3,511.34	$3,403.85	2026-01-09
73702	CPT	Hb Radiant-CT Lower Extremity W & Without Contrast	19	12	$3,577.00	$3,577.00	$1,430.80	$3,505.46	$3,398.15	2026-01-09
23665	CPT	Hb Closed Tx Shldr Dsloc W/fx W/man	19	12	$3,572.00	$3,572.00	$1,428.80	$3,500.56	$3,393.40	2026-01-09
0722	RC	Hb Vaginal Delivery Level 3	47	12	$4,369.00	$4,369.00	$1,382.00	$5,137.16	$3,385.90	2026-01-09
19120	CPT	Hb Exc Brst Cyst Tumr/les Open 1 Or More	19	12	$3,549.00	$3,549.00	$1,419.60	$3,478.02	$3,371.55	2026-01-09
25622	CPT	Hb Closed Rx Navicular Fx	19	12	$3,537.00	$3,537.00	$1,414.80	$3,466.26	$3,360.15	2026-01-09
J2506	HCPCS	Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe\|discarded Drug Not Administe	46	12	$6,519.77	$6,519.77	$97.03	$7,601.01	$3,347.99	2026-01-09
J2315	HCPCS	Naltrexone ER 380 Mg Intramuscular Suspension,extended Release	20	12	$3,521.81	$3,521.81	$4.21	$3,451.37	$3,345.72	2026-01-09
76498	CPT	Hb Radiant-li-fraumeni Screening	19	12	$3,514.00	$3,514.00	$1,405.60	$3,443.72	$3,338.30	2026-01-09
J1950	HCPCS	Leuprolide 11.25 Mg (3 Month) Intramuscular Syringe Kit\|discarded Drug Not Admin…	59	12	$4,315.23	$4,315.23	$637.08	$7,823.52	$3,336.29	2026-01-09
72129	CPT	Hb Radiant-CT T-spine With Contrast	19	12	$3,496.00	$3,496.00	$1,398.40	$3,426.08	$3,321.20	2026-01-09
70498	CPT	Hb Radiant-CT Angio Neck Without With Cont	19	12	$3,494.00	$3,494.00	$1,397.60	$3,424.12	$3,319.30	2026-01-09
93312	CPT	Echo Transesophageal	19	12	$3,491.00	$3,491.00	$1,396.40	$3,421.18	$3,316.45	2026-01-09
L8699	HCPCS	Stem Accolade C Cs 132 Nk	47	12	$5,643.58	$5,643.58	$710.75	$7,364.70	$3,306.60	2026-01-09
10180	CPT	Hb I/d Post Op Wound Infection	19	12	$3,473.00	$3,473.00	$1,389.20	$3,403.54	$3,299.35	2026-01-09
64634	CPT	Hb Dest Cerv/thor Facet Jnt Each Addl W Image	19	12	$3,462.00	$3,462.00	$1,384.80	$3,392.76	$3,288.90	2026-01-09
J9308	HCPCS	Ramucirumab 10 Mg/ml Intravenous Solution	59	12	$6,578.80	$6,578.80	$73.83	$16,762.78	$3,284.14	2026-01-09
C8929	HCPCS	Hb Radiant Ccl Tte Cmplt W Sp/color Flw Dppler W Cntrst	19	12	$3,454.00	$3,454.00	$1,381.60	$3,384.92	$3,281.30	2026-01-09
24505	CPT	Hb Closed Tx Humeral Shaft Fx W Manip	19	12	$3,435.00	$3,435.00	$1,374.00	$3,366.30	$3,263.25	2026-01-09
23073	CPT	Hb Shoulder Exc Tumor Soft Tissue Subfascial 5+cm	19	12	$3,433.00	$3,433.00	$1,373.20	$3,364.34	$3,261.35	2026-01-09
Q4246	HCPCS	Coretext Or Protext, Per Cc	2	2	—	—	$3,146.08	$3,360.07	$3,253.07	2026-01-09
21930	CPT	Hb Exc Tumor Soft Tissue Back/flank Lt 3 Cm	33	12	$3,424.00	$3,424.00	$1,369.60	$5,119.52	$3,252.80	2026-01-09
70487	CPT	Hb Radiant-CT Maxlofce Area With Contrast	19	12	$3,374.00	$3,374.00	$1,349.60	$3,306.52	$3,205.30	2026-01-09
72130	CPT	Hb Radiant CT T-spine With & Without Contrast	19	12	$3,370.00	$3,370.00	$1,348.00	$3,302.60	$3,201.50	2026-01-09
72131	CPT	Hb Radiant-CT L-spine - Non Contrast	19	12	$3,364.00	$3,364.00	$1,345.60	$3,296.72	$3,195.80	2026-01-09
J3032	HCPCS	Eptinezumab-jjmr 100 Mg/ml Intravenous Solution	20	12	$3,363.75	$3,363.75	$19.13	$3,296.48	$3,195.56	2026-01-09
J9179	HCPCS	Eribulin 1 Mg/2 Ml (0.5 Mg/ml) Intravenous Solution	20	12	$3,359.15	$3,359.15	$139.71	$3,291.97	$3,191.19	2026-01-09
70470	CPT	Hb Radiant-CT Brain W & Wo Contrast	19	12	$3,358.00	$3,358.00	$1,343.20	$3,290.84	$3,190.10	2026-01-09
73701	CPT	Hb Radiant-CT Lower Extremity With Contrast	19	12	$3,354.00	$3,354.00	$1,341.60	$3,286.92	$3,186.30	2026-01-09
74160	CPT	Hb Radiant-CT Abdomen With Contrast	19	12	$3,344.00	$3,344.00	$1,337.60	$3,277.12	$3,176.80	2026-01-09
72127	CPT	Hb Radiant-CT C-spine With & Without Contrast	19	12	$3,333.00	$3,333.00	$1,333.20	$3,266.34	$3,166.35	2026-01-09
72125	CPT	Hb Radiant-CT C-spine Without Contrast	19	12	$3,401.00	$3,401.00	$1,360.40	$3,332.98	$3,166.33	2026-01-09
24605	CPT	Hb Closed Rx Elbow Dislocatn	19	12	$3,330.00	$3,330.00	$1,332.00	$3,263.40	$3,163.50	2026-01-09
49440	CPT	Hb Radiant-insert Perc Gastrostomy W Flouro	19	12	$3,330.00	$3,330.00	$1,332.00	$3,263.40	$3,163.50	2026-01-09
72193	CPT	Hb Radiant-CT Pelvis With Contrast	19	12	$3,321.00	$3,321.00	$1,328.40	$3,254.58	$3,154.95	2026-01-09
21931	CPT	Hb Exc Tumor Soft Tissue Back/flank Eg 3 Cm	19	12	$3,321.00	$3,321.00	$1,328.40	$3,254.58	$3,154.95	2026-01-09
J0129	HCPCS	Abatacept (with Maltose) 250 Mg Intravenous Solution	20	12	$3,320.62	$3,320.62	$45.41	$3,254.21	$3,154.59	2026-01-09
72128	CPT	Hb Radiant-CT T-spine - Non Contrast	19	12	$3,311.00	$3,311.00	$1,324.40	$3,244.78	$3,145.45	2026-01-09
70460	CPT	Hb Radiant-CT Head/brain W/contrast	19	12	$3,291.00	$3,291.00	$1,316.40	$3,225.18	$3,126.45	2026-01-09
71250	CPT	Hb Radiant-CT Chest - Non Contrast	19	12	$3,291.00	$3,291.00	$1,316.40	$3,225.18	$3,063.92	2026-01-09
70488	CPT	Hb Radiant-CT Face W / Wo Contrast	19	12	$3,225.00	$3,225.00	$1,290.00	$3,160.50	$3,063.75	2026-01-09
73721	CPT	Hb Radiant-MRI Any Jt Low Extrem; Without Cont	19	12	$3,283.00	$3,283.00	$1,313.20	$3,217.34	$3,056.47	2026-01-09
24071	CPT	Hb Exc Tumor Upper Arm Subq Eg 3 Cm	19	12	$3,207.00	$3,207.00	$1,282.80	$3,142.86	$3,046.65	2026-01-09
J9299	HCPCS	Nivolumab 40 Mg/4 Ml Intravenous Solution	111	12	$3,874.97	$3,874.97	$32.96	$14,053.50	$3,042.28	2026-01-09
72192	CPT	Hb Radiant-CT Pelvis - Non Contrast	19	12	$3,196.00	$3,196.00	$1,278.40	$3,132.08	$3,036.20	2026-01-09
J2426	HCPCS	Paliperidone Palmitate 156 Mg/ml Intramuscular Syringe	33	12	$4,748.18	$4,748.18	$15.14	$4,653.22	$3,032.05	2026-01-09
42860	CPT	Hb Tonsil Tags Excision	19	12	$3,191.00	$3,191.00	$1,276.40	$3,127.18	$3,031.45	2026-01-09
70491	CPT	Hb Radiant-CT Soft Tissue Neck W/contrst	19	12	$3,189.00	$3,189.00	$1,275.60	$3,125.22	$3,029.55	2026-01-09
J9217	HCPCS	Leuprolide 30 Mg (4 Month) Intramuscular Syringe Kit\|discarded Drug Not Administ…	163	12	$6,064.88	$6,064.88	$140.40	$17,541.15	$3,016.77	2026-01-09
36569	CPT	Hb Insert Picc Without Port/pump Gt 5 Age-default	19	12	$3,169.00	$3,169.00	$1,267.60	$3,105.62	$3,010.55	2026-01-09
78582	CPT	Hb Radiant-lung Ventilat&perfus Imaging	19	12	$3,144.00	$3,144.00	$1,257.60	$3,081.12	$2,986.80	2026-01-09
64530	CPT	Hb Celiac Plexus Block W Or Without Fluoro	19	12	$3,122.00	$3,122.00	$1,248.80	$3,059.56	$2,965.90	2026-01-09
93306	CPT	Tte W/doppler Complete	19	12	$3,163.00	$3,163.00	$1,265.20	$3,099.74	$2,944.75	2026-01-09
70480	CPT	Hb Radiant-CT Post Fossa - Non Contrast	19	12	$3,094.00	$3,094.00	$1,237.60	$3,032.12	$2,939.30	2026-01-09
C9359	HCPCS	Magnet Os 1.5cc	19	12	$3,087.60	$3,087.60	$1,235.04	$3,025.85	$2,933.22	2026-01-09
10081	CPT	Hb Emerg I&d Pilonidal Cyst Complex	19	12	$3,079.00	$3,079.00	$1,231.60	$3,017.42	$2,925.05	2026-01-09
15120	CPT	Hb Split Graft 1st 100 Sq Sm Face	19	12	$3,077.00	$3,077.00	$1,230.80	$3,015.46	$2,923.15	2026-01-09
Q4197	HCPCS	Hb Cc Puraply Xt, Per Sq Cm	20	12	$3,077.00	$3,077.00	$128.93	$3,015.46	$2,923.15	2026-01-09
71260	CPT	Hb Radiant-CT Chest With Contrast	19	12	$3,137.00	$3,137.00	$1,202.43	$3,074.26	$2,920.55	2026-01-09
J9305	HCPCS	Pemetrexed Disodium 100 Mg Intravenous Powder For Solution\|discarded Drug Not Ad…	46	12	$3,153.56	$3,153.56	$4.21	$6,953.60	$2,909.16	2026-01-09
20200	CPT	Hb Biopsy Muscle Superficial	19	12	$3,062.00	$3,062.00	$1,224.80	$3,000.76	$2,908.90	2026-01-09
70490	CPT	Hb Radiant-CT Soft Tiss Neck Without Contrst	19	12	$3,058.00	$3,058.00	$1,223.20	$2,996.84	$2,905.10	2026-01-09
64721	CPT	Hb Revise Median N/carpal Tunnel Surg	19	12	$3,050.00	$3,050.00	$1,220.00	$2,989.00	$2,897.50	2026-01-09
57061	CPT	Hb Destruction Vaginal Lesion Simple	19	12	$3,029.00	$3,029.00	$1,211.60	$2,968.42	$2,877.55	2026-01-09
J9286	HCPCS	Inj Glofitamab Gxbm, 2.5 Mg	1	1	—	—	$2,869.69	$2,869.69	$2,869.69	2026-01-09
0173	RC	Hb Newborn Room/level Iii	8	7	$3,003.00	$3,003.00	$2,762.76	$2,942.94	$2,867.86	2026-01-09
38505	CPT	Hb Radiant-bx Lymph Node Percutaneous	19	12	$3,013.00	$3,013.00	$1,205.20	$2,952.74	$2,862.35	2026-01-09
64490	CPT	Hb Inj Pv Fct Jt C/t W Image Lev 1	19	12	$2,991.00	$2,991.00	$1,196.40	$2,931.18	$2,841.45	2026-01-09
73201	CPT	Hb Radiant-CT Upper Extremity With Contrast	19	12	$2,985.00	$2,985.00	$1,194.00	$2,925.30	$2,835.75	2026-01-09
43235	CPT	Hb Gi-flex Egd +/- Specimen Collection	19	12	$2,985.00	$2,985.00	$1,155.94	$2,925.30	$2,835.75	2026-01-09
78315	CPT	Hb Radiant-3 Phase Bone	19	12	$2,973.00	$2,973.00	$1,189.20	$2,913.54	$2,824.35	2026-01-09
64479	CPT	Hb Inj(s) Foramen Cerv/thor Sngl W Image	19	12	$2,949.00	$2,949.00	$1,179.60	$2,890.02	$2,801.55	2026-01-09
25535	CPT	Hb Closed Rx Ulna Shaft Fx,manipulatn	19	12	$2,941.00	$2,941.00	$1,176.40	$2,882.18	$2,793.95	2026-01-09
23655	CPT	Hb Closed Rx Shldr Disloc,anesthesia	19	12	$2,918.00	$2,918.00	$1,167.20	$2,859.64	$2,772.10	2026-01-09
75989	CPT	Hb Radiant Radiological Guidance Prq DRG W/plmt Cath Rs&i	19	12	$2,901.00	$2,901.00	$1,160.40	$2,842.98	$2,755.95	2026-01-09
47000	CPT	Hb Radiant-biopsy Liver Needle Percutaneous	19	12	$2,897.00	$2,897.00	$1,158.80	$2,839.06	$2,752.15	2026-01-09
J9229	HCPCS	Inj Inotuzumab Ozogam 0.1 Mg	2	2	—	—	$2,734.96	$2,744.31	$2,739.64	2026-01-09
64493	CPT	Hb Inj Pv Fct Jt L/s W Image Lev 1	19	12	$2,862.00	$2,862.00	$1,144.80	$3,191.44	$2,718.90	2026-01-09
Q0222	HCPCS	Fee Schedule	1	1	—	—	$2,710.25	$2,710.25	$2,710.25	2026-01-09
64483	CPT	Hb Inj(s) Foramen/epi Lum/scrl Sngl W Image	19	12	$2,887.00	$2,887.00	$1,154.80	$2,829.26	$2,687.80	2026-01-09
10140	CPT	Hb I&d Hematoma/seroma/fluid Collect	47	12	$3,854.00	$3,854.00	$1,124.80	$4,111.10	$2,671.40	2026-01-09
J3401	HCPCS	Vyjuvek 5x10^9pfu/ml, 0.1 Ml	1	1	—	—	$2,670.24	$2,670.24	$2,670.24	2026-01-09
27372	CPT	Hb Remv Foreign Body,knee/thigh,deep	19	12	$2,809.00	$2,809.00	$1,123.60	$2,752.82	$2,668.55	2026-01-09
10061	CPT	Hb I&d Abscess Complex/multiple	19	12	$2,809.00	$2,809.00	$778.94	$2,752.82	$2,668.55	2026-01-09
21932	CPT	Hb Exc Tumor Soft Tiss Back/flank Subfascial <5cm	19	12	$2,809.00	$2,809.00	$1,123.60	$2,752.82	$2,668.55	2026-01-09
74150	CPT	Hb Radiant-CT Abdomen - Non Contrast	19	12	$2,799.00	$2,799.00	$1,119.60	$2,743.02	$2,659.05	2026-01-09
78227	CPT	Hb Radiant-hepatobil Syst Image W/drug	19	12	$2,787.00	$2,787.00	$1,114.80	$2,731.26	$2,647.65	2026-01-09
51102	CPT	Hb Asp Bladder W/suprapubic Cath	33	12	$2,775.00	$2,775.00	$1,110.00	$5,247.90	$2,636.25	2026-01-09
11446	CPT	Hb Exc Face-mm B9+marg Over 4.0 Cm	19	12	$2,765.00	$2,765.00	$1,106.00	$2,709.70	$2,626.75	2026-01-09
25605	CPT	Hb Closed Tx Dist Rad/ulna Fx Manip	19	12	$2,764.00	$2,764.00	$1,105.60	$2,729.37	$2,625.80	2026-01-09
49320	CPT	Hb Laparoscopy Diagnostic; Abdomen, Peritoneum & Omentum	19	12	$2,763.00	$2,763.00	$1,105.20	$2,707.74	$2,624.85	2026-01-09
40654	CPT	Hb Repair Lip Full Thickness Complex	19	12	$2,753.00	$2,753.00	$1,101.20	$2,697.94	$2,615.35	2026-01-09
J2993	HCPCS	Reteplase Injection	1	1	—	—	$2,605.99	$2,605.99	$2,605.99	2026-01-09
69436	CPT	Hb Bmt Tympanostomy With Tube General Anesthesia Unilateral	19	12	$2,742.00	$2,742.00	$1,027.12	$3,815.46	$2,604.90	2026-01-09

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