Price Transparency Hospital negotiated rates

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

BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC

Beatrice, NE · CCN 281364 · Rates published

3,640 distinct procedures filed
9 distinct payers
38,757 rate rows
2025-11-07 last MRF observed
Data quality

38,757 of 38,757 rate rows are consumer-grade (100.0%)

Every filed rate row passes our consumer-grade checks — none are excluded from the medians.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://secure.claraprice.net/price-transparency/RNAV-1731102747513/machine-readable/470379834_beatrice-community-hospital_standardcharges.json
Found on page https://secure.claraprice.net/price-transparency/beatrice-community-hospital-ne
Discovered viaDiscovered by HANK
Last fetch success · 2026-06-16
Content fingerprint 5a034ffd95d70d33… · 6,721,207 bytes · first seen 2026-06-16

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
119469
CDM 		Ustekinumab 90 Mg/ml Subcutaneous Syringe 9 $15,079.00 $54,435.00 $53,868.00 nat. median
$160
outlier · 337.5×
180349
CDM 		Ocrelizumab 30 Mg/ml Intravenous Solution 9 $11,157.00 $40,277.00 $39,857.00 nat. median
$39,857
1.0× median
78073
CPT 		Canakinumab (Pf) 150 Mg/ml Subcutaneous Solution 9 $6,578.00 $39,473.00 $39,062.00 nat. median
$12,966
outlier · 3.0×
C1767
HCPCS 		Interstim X Neurostimulator 9 $6,113.00 $36,684.00 $36,301.00 nat. median
$22,478
1.6× median
187610
CDM 		Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe 9 $9,735.00 $35,144.00 $34,778.00 nat. median
$2,773
outlier · 12.5×
CP17624571377121553
CDM 		Uterine And Adnexa Procedures For Non-malignancy Without Cc Or Mcc 9 $2,917.00 $32,074.00 $31,740.00 nat. median
$31,740
1.0× median
C1820
HCPCS 		Interstim Ii Neurostimulator 9 $4,671.00 $28,032.00 $27,740.00 nat. median
$22,013
1.3× median
181954
CDM 		Guselkumab 100 Mg/ml Subcutaneous Syringe 9 $7,636.00 $27,565.00 $27,278.00 nat. median
$27,278
1.0× median
Q4196
HCPCS 		Puraply Am 8cm X 16cm 9 $4,400.00 $26,400.00 $26,125.00 nat. median
$286
outlier · 91.4×
74347
CPT 		Leuprolide Acetate (6 Month) 45 Mg Intramuscular Syringe Kit 9 $4,075.00 $24,455.00 $24,200.00 nat. median
$810
outlier · 29.9×
194061
CDM 		Luspatercept-aamt 75 Mg Subcutaneous Solution 9 $6,623.00 $23,909.00 $23,660.00 nat. median
$23,660
1.0× median
Q4186
HCPCS 		Epifix 7cm X 7cm 9 $3,737.00 $22,426.00 $22,192.00 nat. median
$398
outlier · 55.7×
207144
CDM 		Ublituximab-xiiy 25 Mg/ml Intravenous Solution 9 $6,099.00 $22,017.00 $21,787.00 nat. median
$15,817
1.4× median
C1776
HCPCS 		Femoral Tc3 Cemented Size 4 Ri 9 $3,600.00 $21,605.00 $21,380.00 nat. median
$3,432
outlier · 6.2×
196736
CDM 		Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 9 $5,785.00 $20,884.00 $20,666.00 nat. median
$20,666
1.0× median
74501
CPT 		Risankizumab-rzaa 60 Mg/ml Intravenous Solution 9 $3,434.00 $20,604.00 $20,389.00 nat. median
$25,502
0.8× median
168531
CDM 		Vedolizumab 300 Mg Intravenous Solution 9 $5,170.00 $18,663.00 $18,469.00 nat. median
$18,469
1.0× median
C1781
HCPCS 		Mesh Phasix St 15cm X 20cm 9 $3,048.00 $18,293.00 $18,102.00 nat. median
$1,362
outlier · 13.3×
C1762
HCPCS 		Amniotic Allograft Liquid 2ml 9 $3,038.00 $18,228.00 $18,039.00 nat. median
$2,935
outlier · 6.1×
Q4278
HCPCS 		Epieffect 3x5 Cm 9 $3,000.00 $18,000.00 $17,813.00 nat. median
$357
outlier · 49.9×
40120
CDM 		Natalizumab 300 Mg/15 Ml Intravenous Solution 9 $4,789.00 $17,287.00 $17,107.00 nat. median
$118
outlier · 145.1×
74368
CPT 		Leuprolide 30 Mg (4 Month) Intramuscular Syringe Kit 9 $2,757.00 $16,547.00 $16,374.00 nat. median
$89
outlier · 183.1×
33734
CPT 		Nivolumab 240 Mg/24 Ml Intravenous Solution 9 $2,608.00 $15,651.00 $15,488.00 nat. median
$13,054
1.2× median
A2019
HCPCS 		Kerecis Shield Spiral 30mm 9 $2,361.00 $14,170.00 $14,022.00 nat. median
$552
outlier · 25.4×
119619
CDM 		Kit For Preparation Of Tc-99m-medronate Sodium 20 Mg IV Solution 9 $3,888.00 $14,034.00 $13,888.00 nat. median
$62
outlier · 222.2×
159381
CDM 		Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution 9 $3,822.00 $13,798.00 $13,654.00 nat. median
$13,654
1.0× median
78082
CPT 		Octreotide,microspheres ER 30 Mg Intramuscular Susp, Extended Release 9 $2,223.00 $13,338.00 $13,199.00 nat. median
$13,130
1.0× median
198520
CDM 		Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 9 $3,669.00 $13,245.00 $13,107.00 nat. median
$13,107
1.0× median
81696
CDM 		Eculizumab 300 Mg/30 Ml Intravenous Solution 9 $3,664.00 $13,228.00 $13,090.00 nat. median
$1,997
outlier · 6.6×
172818
CDM 		Paliperidone Palmitate (3 Month) 819 Mg/2.63 Ml Intramuscular Syringe 9 $3,658.00 $13,207.00 $13,069.00 nat. median
$10,584
1.2× median
74334
CPT 		Leuprolide Acetate 22.5 Mg (3 Month) Intramuscular Syringe Kit 9 $2,098.00 $12,592.00 $12,461.00 nat. median
$9,998
1.2× median
202803
CDM 		Efgartigimod Alfa-fcab 20 Mg/ml Intravenous Solution 9 $3,488.00 $12,591.00 $12,460.00 nat. median
$12,329
1.0× median
91495
CDM 		Certolizumab Pegol 400 Mg (200 Mg X 2 Vials) Subcutaneous Kit 9 $3,386.00 $12,225.00 $12,097.00 nat. median
$25
outlier · 490.8×
63026
CPT 		Pembrolizumab 25 Mg/ml Intravenous Solution 9 $1,968.00 $11,809.00 $11,686.00 nat. median
$1,968
outlier · 5.9×
97853
CDM 		Certolizumab Pegol 400 Mg/2 Ml (200 Mg/ml X2) Subcutaneous Syringe Kit 9 $3,218.00 $11,617.00 $11,496.00 nat. median
$29
outlier · 398.9×
9002
CDM 		Alteplase 100 Mg Intravenous Solution 9 $3,038.00 $10,967.00 $10,853.00 nat. median
$192
outlier · 56.5×
C1897
HCPCS 		Lead Kit Is2 28cm 9 $1,821.00 $10,930.00 $10,816.00 nat. median
$1,137
outlier · 9.5×
74366
CPT 		Leuprolide Acetate 11.25 Mg (3 Month) Intramuscular Syringe Kit 9 $1,781.00 $10,685.00 $10,574.00 nat. median
$89
outlier · 118.2×
31017
CPT 		Benralizumab 30 Mg/ml Subcutaneous Syringe 9 $1,774.00 $10,644.00 $10,534.00 nat. median
$4,323
outlier · 2.4×
C1777
HCPCS 		Actis Collared High Size 8 9 $1,760.00 $10,560.00 $10,450.00 nat. median
$5,141
outlier · 2.0×
184667
CDM 		Tenecteplase 50 Mg Intravenous Solution 9 $2,868.00 $10,353.00 $10,245.00 nat. median
$16
outlier · 640.3×
364SU278
CDM 		Femoral Stem Sz 9 Std Collar C 9 $1,680.00 $10,080.00 $9,975.00 nat. median
$9,975
1.0× median
66984
CPT 		Removal Of Cataract With Insertion Of Lens 9 $1,607.00 $9,643.00 $9,543.00 nat. median
$2,924
outlier · 3.3×
172799
CDM 		Immune Glob,gamm(igg) 10 %-pro-iga 0 To 50 Mcg/ml Intravenous Solution 9 $2,627.00 $9,482.00 $9,383.00 nat. median
$3,812
outlier · 2.5×
Q4100
HCPCS 		Allo Adi Dermal Matrix Meshed 9 $1,558.00 $9,348.00 $9,251.00 nat. median
$1,878
outlier · 4.9×
120051
CDM 		Kit Preparation Of Tc 99m-sestamibi Combo No.1 IV Solution 9 $2,553.00 $9,216.00 $9,120.00 nat. median
$93
outlier · 98.5×
101010
CDM 		Collagenase Clostridium Histolyticum 0.9 Mg Solution For Injection 9 $2,441.00 $8,812.00 $8,720.00 nat. median
$261
outlier · 33.4×
206169
CDM 		Eflapegrastim-xnst 13.2 Mg/0.6 Ml Subcutaneous Syringe 9 $2,418.00 $8,727.00 $8,636.00 nat. median
$1,904
outlier · 4.5×
32267
CDM 		Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe 9 $2,397.00 $8,652.00 $8,562.00 nat. median
$1,344
outlier · 6.4×
171445
CDM 		Pegfilgrastim 6 Mg/0.6 Ml (Deliverable) Wearable Subcutaneous Injector 9 $2,397.00 $8,652.00 $8,562.00 nat. median
$8
outlier · 1057.0×

Other procedures at this hospital

Browse this hospital's 3,640 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
             
119469 CDM Ustekinumab 90 Mg/ml Subcutaneous Syringe 9 9 $56,703.00 $56,703.00 $15,079.00 $54,435.00 $53,868.00 2025-11-07
180349 CDM Ocrelizumab 30 Mg/ml Intravenous Solution 9 9 $41,955.00 $41,955.00 $11,157.00 $40,277.00 $39,857.00 2025-11-07
78073 CPT Canakinumab (Pf) 150 Mg/ml Subcutaneous Solution 9 9 $41,118.00 $41,118.00 $6,578.00 $39,473.00 $39,062.00 2025-11-07
C1767 HCPCS Interstim X Neurostimulator 9 9 $38,212.00 $38,212.00 $6,113.00 $36,684.00 $36,301.00 2025-11-07
187610 CDM Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe 9 9 $36,608.00 $36,608.00 $9,735.00 $35,144.00 $34,778.00 2025-11-07
CP17624571377121553 CDM Uterine And Adnexa Procedures For Non-malignancy Without Cc Or Mcc 9 9 $33,410.00 $33,410.00 $2,917.00 $32,074.00 $31,740.00 2025-11-07
C1820 HCPCS Interstim Ii Neurostimulator 9 9 $29,200.00 $29,200.00 $4,671.00 $28,032.00 $27,740.00 2025-11-07
181954 CDM Guselkumab 100 Mg/ml Subcutaneous Syringe 9 9 $28,714.00 $28,714.00 $7,636.00 $27,565.00 $27,278.00 2025-11-07
Q4196 HCPCS Puraply Am 8cm X 16cm 9 9 $27,500.00 $27,500.00 $4,400.00 $26,400.00 $26,125.00 2025-11-07
74347 CPT Leuprolide Acetate (6 Month) 45 Mg Intramuscular Syringe Kit 9 9 $25,474.00 $25,474.00 $4,075.00 $24,455.00 $24,200.00 2025-11-07
194061 CDM Luspatercept-aamt 75 Mg Subcutaneous Solution 9 9 $24,905.00 $24,905.00 $6,623.00 $23,909.00 $23,660.00 2025-11-07
Q4186 HCPCS Epifix 7cm X 7cm 9 9 $23,360.00 $23,360.00 $3,737.00 $22,426.00 $22,192.00 2025-11-07
207144 CDM Ublituximab-xiiy 25 Mg/ml Intravenous Solution 9 9 $22,934.00 $22,934.00 $6,099.00 $22,017.00 $21,787.00 2025-11-07
C1776 HCPCS Femoral Tc3 Cemented Size 4 Ri 9 9 $22,505.00 $22,505.00 $3,600.00 $21,605.00 $21,380.00 2025-11-07
196736 CDM Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 9 9 $21,754.00 $21,754.00 $5,785.00 $20,884.00 $20,666.00 2025-11-07
74501 CPT Risankizumab-rzaa 60 Mg/ml Intravenous Solution 9 9 $21,462.00 $21,462.00 $3,434.00 $20,604.00 $20,389.00 2025-11-07
168531 CDM Vedolizumab 300 Mg Intravenous Solution 9 9 $19,441.00 $19,441.00 $5,170.00 $18,663.00 $18,469.00 2025-11-07
C1781 HCPCS Mesh Phasix St 15cm X 20cm 9 9 $19,055.00 $19,055.00 $3,048.00 $18,293.00 $18,102.00 2025-11-07
C1762 HCPCS Amniotic Allograft Liquid 2ml 9 9 $18,988.00 $18,988.00 $3,038.00 $18,228.00 $18,039.00 2025-11-07
Q4278 HCPCS Epieffect 3x5 Cm 9 9 $18,750.00 $18,750.00 $3,000.00 $18,000.00 $17,813.00 2025-11-07
40120 CDM Natalizumab 300 Mg/15 Ml Intravenous Solution 9 9 $18,007.00 $18,007.00 $4,789.00 $17,287.00 $17,107.00 2025-11-07
74368 CPT Leuprolide 30 Mg (4 Month) Intramuscular Syringe Kit 9 9 $17,236.00 $17,236.00 $2,757.00 $16,547.00 $16,374.00 2025-11-07
33734 CPT Nivolumab 240 Mg/24 Ml Intravenous Solution 9 9 $16,303.00 $16,303.00 $2,608.00 $15,651.00 $15,488.00 2025-11-07
A2019 HCPCS Kerecis Shield Spiral 30mm 9 9 $14,760.00 $14,760.00 $2,361.00 $14,170.00 $14,022.00 2025-11-07
119619 CDM Kit For Preparation Of Tc-99m-medronate Sodium 20 Mg IV Solution 9 9 $14,619.00 $14,619.00 $3,888.00 $14,034.00 $13,888.00 2025-11-07
159381 CDM Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution 9 9 $14,373.00 $14,373.00 $3,822.00 $13,798.00 $13,654.00 2025-11-07
78082 CPT Octreotide,microspheres ER 30 Mg Intramuscular Susp, Extended Release 9 9 $13,894.00 $13,894.00 $2,223.00 $13,338.00 $13,199.00 2025-11-07
198520 CDM Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 9 9 $13,797.00 $13,797.00 $3,669.00 $13,245.00 $13,107.00 2025-11-07
81696 CDM Eculizumab 300 Mg/30 Ml Intravenous Solution 9 9 $13,779.00 $13,779.00 $3,664.00 $13,228.00 $13,090.00 2025-11-07
172818 CDM Paliperidone Palmitate (3 Month) 819 Mg/2.63 Ml Intramuscular Syringe 9 9 $13,757.00 $13,757.00 $3,658.00 $13,207.00 $13,069.00 2025-11-07
74334 CPT Leuprolide Acetate 22.5 Mg (3 Month) Intramuscular Syringe Kit 9 9 $13,117.00 $13,117.00 $2,098.00 $12,592.00 $12,461.00 2025-11-07
202803 CDM Efgartigimod Alfa-fcab 20 Mg/ml Intravenous Solution 9 9 $13,116.00 $13,116.00 $3,488.00 $12,591.00 $12,460.00 2025-11-07
91495 CDM Certolizumab Pegol 400 Mg (200 Mg X 2 Vials) Subcutaneous Kit 9 9 $12,734.00 $12,734.00 $3,386.00 $12,225.00 $12,097.00 2025-11-07
63026 CPT Pembrolizumab 25 Mg/ml Intravenous Solution 9 9 $12,301.00 $12,301.00 $1,968.00 $11,809.00 $11,686.00 2025-11-07
97853 CDM Certolizumab Pegol 400 Mg/2 Ml (200 Mg/ml X2) Subcutaneous Syringe Kit 9 9 $12,101.00 $12,101.00 $3,218.00 $11,617.00 $11,496.00 2025-11-07
9002 CDM Alteplase 100 Mg Intravenous Solution 9 9 $11,424.00 $11,424.00 $3,038.00 $10,967.00 $10,853.00 2025-11-07
C1897 HCPCS Lead Kit Is2 28cm 9 9 $11,385.00 $11,385.00 $1,821.00 $10,930.00 $10,816.00 2025-11-07
74366 CPT Leuprolide Acetate 11.25 Mg (3 Month) Intramuscular Syringe Kit 9 9 $11,130.00 $11,130.00 $1,781.00 $10,685.00 $10,574.00 2025-11-07
31017 CPT Benralizumab 30 Mg/ml Subcutaneous Syringe 9 9 $11,088.00 $11,088.00 $1,774.00 $10,644.00 $10,534.00 2025-11-07
C1777 HCPCS Actis Collared High Size 8 9 9 $11,000.00 $11,000.00 $1,760.00 $10,560.00 $10,450.00 2025-11-07
184667 CDM Tenecteplase 50 Mg Intravenous Solution 9 9 $10,784.00 $10,784.00 $2,868.00 $10,353.00 $10,245.00 2025-11-07
364SU278 CDM Femoral Stem Sz 9 Std Collar C 9 9 $10,500.00 $10,500.00 $1,680.00 $10,080.00 $9,975.00 2025-11-07
66984 CPT Removal Of Cataract With Insertion Of Lens 9 9 $10,045.00 $10,045.00 $1,607.00 $9,643.00 $9,543.00 2025-11-07
172799 CDM Immune Glob,gamm(igg) 10 %-pro-iga 0 To 50 Mcg/ml Intravenous Solution 9 9 $9,877.00 $9,877.00 $2,627.00 $9,482.00 $9,383.00 2025-11-07
Q4100 HCPCS Allo Adi Dermal Matrix Meshed 9 9 $9,738.00 $9,738.00 $1,558.00 $9,348.00 $9,251.00 2025-11-07
120051 CDM Kit Preparation Of Tc 99m-sestamibi Combo No.1 IV Solution 9 9 $9,600.00 $9,600.00 $2,553.00 $9,216.00 $9,120.00 2025-11-07
101010 CDM Collagenase Clostridium Histolyticum 0.9 Mg Solution For Injection 9 9 $9,179.00 $9,179.00 $2,441.00 $8,812.00 $8,720.00 2025-11-07
206169 CDM Eflapegrastim-xnst 13.2 Mg/0.6 Ml Subcutaneous Syringe 9 9 $9,091.00 $9,091.00 $2,418.00 $8,727.00 $8,636.00 2025-11-07
171445 CDM Pegfilgrastim 6 Mg/0.6 Ml (Deliverable) Wearable Subcutaneous Injector 9 9 $9,013.00 $9,013.00 $2,397.00 $8,652.00 $8,562.00 2025-11-07
32267 CDM Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe 9 9 $9,013.00 $9,013.00 $2,397.00 $8,652.00 $8,562.00 2025-11-07
87861 CDM Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe 9 9 $9,005.00 $9,005.00 $2,395.00 $8,645.00 $8,555.00 2025-11-07
364SU270 CDM Kit Lead Tined, 28cm 9 9 $8,888.00 $8,888.00 $1,422.00 $8,532.00 $8,444.00 2025-11-07
364SU272 CDM Tibial Tray Rtng Pltfm Mbt Kee 9 9 $8,805.00 $8,805.00 $1,409.00 $8,453.00 $8,365.00 2025-11-07
63025 CPT Bezlotoxumab 25 Mg/ml Intravenous Solution 9 9 $8,345.00 $8,345.00 $1,335.00 $8,011.00 $7,928.00 2025-11-07
78063 CPT Secukinumab 150 Mg/ml Subcutaneous Pen Injector 9 9 $8,125.00 $8,125.00 $1,300.00 $7,800.00 $7,719.00 2025-11-07
188807 CDM Kit For The Prep Of Tc-99m-tilmanocept 250 Mcg Solution For Injection 9 9 $7,987.00 $7,987.00 $2,124.00 $7,668.00 $7,588.00 2025-11-07
170626 CDM Immune Glob G 40 Gram/400 Ml(10%)-gly-iga Ave 46 Mcg/ml Injection Soln 9 9 $7,725.00 $7,725.00 $2,054.00 $7,416.00 $7,339.00 2025-11-07
208591 CDM Aripiprazole ER (2 Month) 960 Mg/3.2 Ml Susp, Extended Rel IM Syringe 9 9 $7,526.00 $7,526.00 $2,001.00 $7,225.00 $7,150.00 2025-11-07
106804 CDM Denosumab 120 Mg/1.7 Ml (70 Mg/ml) Subcutaneous Solution 9 9 $7,443.00 $7,443.00 $1,979.00 $7,145.00 $7,071.00 2025-11-07
78081 CPT Octreotide,microspheres ER 10 Mg Intramuscular Susp, Extended Release 27 9 $7,455.00 $7,455.00 $84.00 $9,150.00 $7,008.00 2025-11-07
42820 CPT Removal Of Tonsils And Adenoid Glands, Patient Younger Than Age 12 9 9 $7,114.00 $7,114.00 $1,138.00 $6,829.00 $6,758.00 2025-11-07
74174 CPT Hc CT Angio, Abdomen And Pelvis W Contrast 9 9 $7,033.00 $7,033.00 $1,125.00 $6,752.00 $6,681.00 2025-11-07
94427 CPT Immune Glob,gamma (Igg) 10 %-gly-iga Over 50 Mcg/ml Injection Solution 9 9 $6,960.00 $6,960.00 $1,113.00 $6,682.00 $6,612.00 2025-11-07
96987 CDM Degarelix 120 Mg Subcutaneous Solution 9 9 $6,395.00 $6,395.00 $1,701.00 $6,139.00 $6,075.00 2025-11-07
93566 CDM Romiplostim 250 Mcg Subcutaneous Solution 9 9 $6,243.00 $6,243.00 $1,660.00 $5,993.00 $5,931.00 2025-11-07
7060003100 CDM Cc Surgery E <Base Rate> 9 9 $6,145.00 $6,145.00 $1,634.00 $5,899.00 $5,838.00 2025-11-07
28224 CDM Linezolid 600 Mg Tablet 9 9 $5,860.00 $5,860.00 $1,558.00 $5,626.00 $5,567.00 2025-11-07
9003 CDM Alteplase 50 Mg Intravenous Solution 9 9 $5,827.00 $5,827.00 $1,550.00 $5,594.00 $5,536.00 2025-11-07
C1787 HCPCS Smart Programmer Kit X 9 9 $5,800.00 $5,800.00 $928.00 $5,568.00 $5,510.00 2025-11-07
59510 CPT Obstetric Care, Planned Cesarean Delivery 18 9 $16,457.50 $16,457.50 $906.00 $26,161.00 $5,437.00 2025-11-07
74178 CPT Hc CT Abd And Pelv Without And With Contrast 9 9 $5,700.00 $5,700.00 $912.00 $5,472.00 $5,415.00 2025-11-07
211259 CDM Pegfilgrastim-cbqv 6 Mg/0.6 Ml (Deliverable) Wearable Subcut Injector 9 9 $5,453.00 $5,453.00 $1,450.00 $5,235.00 $5,180.00 2025-11-07
28124 CPT Hc Part Remv Phalanx Of Toe 9 9 $5,400.00 $5,400.00 $864.00 $5,184.00 $5,130.00 2025-11-07
C1771 HCPCS Solyx Blue Sling System 9 9 $5,399.00 $5,399.00 $864.00 $5,183.00 $5,129.00 2025-11-07
59610 CPT Obstetric Care, Planned Vaginal Delivery (post Delivery By Cesarean Section) 18 9 $9,295.50 $9,295.50 $853.00 $12,727.00 $5,121.00 2025-11-07
116631 CDM Darbepoetin Alfa 300 Mcg/0.6 Ml In Polysorbate Injection Syringe 9 9 $5,164.00 $5,164.00 $1,373.00 $4,957.00 $4,906.00 2025-11-07
181491 CDM Aripiprazole Lauroxil ER 1,064 Mg/3.9 Ml Suspension,ext.rel IM Syringe 9 9 $5,020.00 $5,020.00 $1,335.00 $4,819.00 $4,769.00 2025-11-07
178685 CDM Ustekinumab 130 Mg/26 Ml Intravenous Solution 9 9 $4,931.00 $4,931.00 $1,311.00 $4,734.00 $4,684.00 2025-11-07
74177 CPT CT Scan Of Abdomen And Pelvis With Contrast 9 9 $4,900.00 $4,900.00 $784.00 $4,704.00 $4,655.00 2025-11-07
7050003100 CDM Cc Surgery D <Base Rate> 9 9 $4,826.00 $4,826.00 $1,283.00 $4,633.00 $4,585.00 2025-11-07
C8908 HCPCS Hc MRI Breast MRI Without & With Contrast Bilateral 9 9 $4,734.00 $4,734.00 $757.00 $4,545.00 $4,497.00 2025-11-07
77049 CPT Hc MRI Breast W&without Contrast W/cad Bilat 9 9 $4,734.00 $4,734.00 $757.00 $4,545.00 $4,497.00 2025-11-07
Q4160 HCPCS Nushield 4cm X 6cm 24 Sq Cm 9 9 $4,688.00 $4,688.00 $750.00 $4,500.00 $4,454.00 2025-11-07
119135 CDM Paliperidone Palmitate 234 Mg/1.5 Ml Intramuscular Syringe 9 9 $4,677.00 $4,677.00 $1,244.00 $4,490.00 $4,443.00 2025-11-07
72156 CPT Hc MRI Cervical Spine MRI Without & With Contrast 9 9 $4,664.00 $4,664.00 $746.00 $4,477.00 $4,431.00 2025-11-07
71552 CPT Hc MRI Chest Without And With Contrast 9 9 $4,664.00 $4,664.00 $746.00 $4,477.00 $4,431.00 2025-11-07
69032 CPT Pegfilgrastim-apgf 6 Mg/0.6 Ml Subcutaneous Syringe 9 9 $4,646.00 $4,646.00 $743.00 $4,460.00 $4,414.00 2025-11-07
95811 CPT Hc Comp Sleep Disorder Study W/init Cpap/bipap 9 9 $4,643.00 $4,643.00 $743.00 $4,457.00 $4,411.00 2025-11-07
78452 CPT Hc Myocardial Perfusion Spect Multi W/wm&ej 9 9 $4,638.00 $4,638.00 $742.00 $4,452.00 $4,406.00 2025-11-07
72157 CPT Hc MRI Thoracic Spine Without & With Contrast 9 9 $4,588.00 $4,588.00 $734.00 $4,404.00 $4,359.00 2025-11-07
75635 CPT Hc CT Angio Lower Ext Runoff 9 9 $4,586.00 $4,586.00 $734.00 $4,403.00 $4,357.00 2025-11-07
165470 CDM Golimumab 12.5 Mg/ml Intravenous Solution 9 9 $4,557.00 $4,557.00 $1,212.00 $4,375.00 $4,329.00 2025-11-07
78100 CPT Inclisiran 284 Mg/1.5 Ml Subcutaneous Syringe 9 9 $4,526.00 $4,526.00 $724.00 $4,345.00 $4,300.00 2025-11-07
41675 CDM Palivizumab 100 Mg/ml Intramuscular Solution 9 9 $4,511.00 $4,511.00 $1,200.00 $4,331.00 $4,285.00 2025-11-07
59400 CPT Obstetric Care, Planned Vaginal Delivery 18 9 $9,120.50 $9,120.50 $712.00 $13,239.00 $4,272.00 2025-11-07
104604 CDM Rifaximin 550 Mg Tablet 9 9 $4,424.00 $4,424.00 $1,176.00 $4,247.00 $4,203.00 2025-11-07
72158 CPT Hc MRI Lumbar Spine Without & With Contrast 9 9 $4,420.00 $4,420.00 $707.00 $4,243.00 $4,199.00 2025-11-07
95810 CPT Sleep Study 9 9 $4,388.00 $4,388.00 $702.00 $4,212.00 $4,169.00 2025-11-07
78815 CPT Hc PET W/ctskull Base To Mid Thigh 18 9 $5,003.50 $5,003.50 $681.00 $5,520.00 $4,087.00 2025-11-07
29313 CDM Crotalidae Polyval Immune Fab Solution For Injection 9 9 $4,297.00 $4,297.00 $1,143.00 $4,125.00 $4,082.00 2025-11-07
73223 CPT Hc MRI Upper Extremity Joint Without & With Contrast 18 9 $5,828.50 $5,828.50 $678.00 $7,121.00 $4,069.00 2025-11-07
105502 CDM Denosumab 60 Mg/ml Subcutaneous Syringe 9 9 $4,265.00 $4,265.00 $1,134.00 $4,094.00 $4,052.00 2025-11-07
78816 CPT Hc PET W/diagnostic CT Whole Body 9 9 $4,257.00 $4,257.00 $681.00 $4,087.00 $4,044.00 2025-11-07
Q4197 HCPCS Puraply Xt 4.91x4.91 Extra Fen 9 9 $4,250.00 $4,250.00 $680.00 $4,080.00 $4,038.00 2025-11-07
26070 CPT Cc Fb Hand 9 9 $4,249.00 $4,249.00 $680.00 $4,079.00 $4,037.00 2025-11-07
20240 CPT Hc Biopsy Bone Open Superficial 9 9 $4,238.00 $4,238.00 $678.00 $4,068.00 $4,026.00 2025-11-07
168835 CDM Hum Prothrombin Cplx, 4-factor 1,000 Unit (800-1,240 Unit) IV Solution 9 9 $4,222.00 $4,222.00 $1,123.00 $4,053.00 $4,011.00 2025-11-07
15240 CPT Hc Full Thick Grft Head,fac,hand <20sqc 9 9 $4,205.00 $4,205.00 $673.00 $4,037.00 $3,995.00 2025-11-07
74176 CPT Hc CT Abdomen And Pelvis Without Contrast 9 9 $4,200.00 $4,200.00 $672.00 $4,032.00 $3,990.00 2025-11-07
72142 CPT Hc MRI Cervical Spine MRI With Contrast 9 9 $4,197.00 $4,197.00 $671.00 $4,029.00 $3,987.00 2025-11-07
177927 CDM Carfilzomib 30 Mg Intravenous Solution 9 9 $4,191.00 $4,191.00 $1,114.00 $4,023.00 $3,981.00 2025-11-07
C8902 HCPCS Hc MRA Without Fol W/contrast Abdomen 9 9 $4,189.00 $4,189.00 $670.00 $4,021.00 $3,980.00 2025-11-07
174447 CDM Aripiprazole Lauroxil ER 882 Mg/3.2 Ml Suspension, Ext.rel. IM Syringe 9 9 $4,185.00 $4,185.00 $1,113.00 $4,018.00 $3,976.00 2025-11-07
74364 CPT Leuprolide 3.75 Mg Intramuscular Syringe Kit 18 9 $4,465.00 $4,465.00 $658.00 $4,624.00 $3,948.00 2025-11-07
81404 CPT Hc Molecular Path Proc Lvl 5 Sgdd4 9 9 $4,153.00 $4,153.00 $664.00 $3,987.00 $3,945.00 2025-11-07
25270 CPT Hc Reforearm Tend/musc,exten,prim,ea 9 9 $4,146.00 $4,146.00 $663.00 $3,980.00 $3,939.00 2025-11-07
25260 CPT Hc Repair Muscle,flexor, Forearm/wrist,single 9 9 $4,146.00 $4,146.00 $663.00 $3,980.00 $3,939.00 2025-11-07
189951 CDM Pegfilgrastim-cbqv 6 Mg/0.6 Ml Subcutaneous Syringe 9 9 $4,132.00 $4,132.00 $1,099.00 $3,967.00 $3,925.00 2025-11-07
9347 CDM Calcitonin (Salmon) 200 Unit/ml Injection Solution 9 9 $4,122.00 $4,122.00 $1,096.00 $3,957.00 $3,916.00 2025-11-07
27337 CPT Hc Exc Tumor,soft Tissue Thigh Or Knee 3cm Or Greater 9 9 $4,098.00 $4,098.00 $656.00 $3,934.00 $3,893.00 2025-11-07
107754 CDM Immune Glob G 20 Gram/200 Ml(10%)-gly-iga Ave 46 Mcg/ml Injection Soln 9 9 $4,081.00 $4,081.00 $1,085.00 $3,918.00 $3,877.00 2025-11-07
74181 CPT Hc MRI Abdomen Without Contrast 9 9 $4,044.00 $4,044.00 $647.00 $3,882.00 $3,842.00 2025-11-07
205769 CDM Pegfilgrastim-pbbk 6 Mg/0.6 Ml Subcutaneous Syringe 9 9 $4,030.00 $4,030.00 $1,072.00 $3,869.00 $3,829.00 2025-11-07
77048 CPT Hc MRI Breast W&without Contrast W/cad Unilat 9 9 $4,006.00 $4,006.00 $641.00 $3,846.00 $3,806.00 2025-11-07
38500 CPT Hc Biopsy/excision, Lymph Node(s) 9 9 $4,000.00 $4,000.00 $640.00 $3,840.00 $3,800.00 2025-11-07
74185 CPT Cc Mra; Abdomen W/wo Contrast 9 9 $3,990.00 $3,990.00 $638.00 $3,830.00 $3,791.00 2025-11-07
64624 CPT Hc Destruct Neurolytic Agt Genicular Nrv W/img 18 9 $5,427.00 $5,427.00 $631.00 $6,631.00 $3,789.00 2025-11-07
72191 CPT Hc CT Angio Pelvis 9 9 $3,962.00 $3,962.00 $634.00 $3,804.00 $3,764.00 2025-11-07
52234 CPT Cc Fac Cysto W/fulg Sm Bladder Tumor 9 9 $3,877.00 $3,877.00 $620.00 $3,722.00 $3,683.00 2025-11-07
52235 CPT Cc Np Cysto W/fulg, Treat Med Les 9 9 $3,877.00 $3,877.00 $620.00 $3,722.00 $3,683.00 2025-11-07
45382 CPT Cc Colonoscopy W/control Bleeding 9 9 $3,859.00 $3,859.00 $617.00 $3,705.00 $3,666.00 2025-11-07
70553 CPT MRI Scan 27 9 $3,900.00 $3,900.00 $518.00 $3,753.00 $3,666.00 2025-11-07
74175 CPT Hc CT Angio Abdomen 9 9 $3,856.00 $3,856.00 $617.00 $3,702.00 $3,663.00 2025-11-07
170553 CDM Bortezomib 3.5 Mg Injection Powder For Solution (2.5 Mg/ml) 9 9 $3,839.00 $3,839.00 $1,021.00 $3,685.00 $3,647.00 2025-11-07
35839 CDM Bortezomib 3.5 Mg Injection Powder For Solution 9 9 $3,839.00 $3,839.00 $1,021.00 $3,685.00 $3,647.00 2025-11-07
171410 CDM Aripiprazole ER 400 Mg Suspension, Extended Rel.intramuscular Syringe 9 9 $3,832.00 $3,832.00 $1,019.00 $3,679.00 $3,640.00 2025-11-07
72146 CPT Hc MRI Thoracic Spine Without Contrast 9 9 $3,788.00 $3,788.00 $606.00 $3,636.00 $3,599.00 2025-11-07
186452 CDM Pegfilgrastim-jmdb 6 Mg/0.6 Ml Subcutaneous Syringe 9 9 $3,772.00 $3,772.00 $1,003.00 $3,621.00 $3,583.00 2025-11-07
C8901 HCPCS Hc Mra; Abdomen Wo Contrast 9 9 $3,770.00 $3,770.00 $603.00 $3,619.00 $3,582.00 2025-11-07
73723 CPT Hc MRI Lower Extremity Joint Without & With Contrast 18 9 $5,223.50 $5,223.50 $597.00 $6,447.00 $3,582.00 2025-11-07
73720 CPT Hc MRI Lower Extrem Oth/thn Jt Without & W/contr Matr 18 9 $5,130.00 $5,130.00 $597.00 $6,268.00 $3,582.00 2025-11-07
73220 CPT Hc MRI Upper Extremity Without & With Contrast 18 9 $5,130.00 $5,130.00 $597.00 $6,268.00 $3,582.00 2025-11-07
Q4159 HCPCS Affinity 2.5 X 2.5 9 9 $3,750.00 $3,750.00 $600.00 $3,600.00 $3,563.00 2025-11-07
181188 CDM Trastuzumab 150 Mg Intravenous Solution 9 9 $3,745.00 $3,745.00 $996.00 $3,595.00 $3,558.00 2025-11-07
54001 CPT Cc Hc Slitting Of Prepuce 9 9 $3,733.00 $3,733.00 $597.00 $3,584.00 $3,546.00 2025-11-07
72197 CPT Hc MRI Pelvis Without & With Contrast 9 9 $3,716.00 $3,716.00 $594.00 $3,567.00 $3,530.00 2025-11-07
70546 CPT Hc MRA Head Without Contrast Follow With Contrast 9 9 $3,707.00 $3,707.00 $593.00 $3,559.00 $3,522.00 2025-11-07
71555 CPT Cc Mra; Chest W Or Wo Contrast 9 9 $3,702.00 $3,702.00 $592.00 $3,554.00 $3,517.00 2025-11-07
71270 CPT Hc CT Thorax Without & With Contrast 9 9 $3,701.00 $3,701.00 $592.00 $3,553.00 $3,516.00 2025-11-07
70549 CPT Hc MRA Neck Without & With Contrast 9 9 $3,693.00 $3,693.00 $591.00 $3,545.00 $3,508.00 2025-11-07
70543 CPT Hc MRI Soft Tissue Neck Without And With Contrast 9 9 $3,693.00 $3,693.00 $591.00 $3,545.00 $3,508.00 2025-11-07
74183 CPT Cc MRI Pancreas With Contrast 18 9 $4,145.00 $4,145.00 $580.00 $4,477.00 $3,481.00 2025-11-07
40475 CDM Paclitaxel Protein-bound 100 Mg Intravenous Suspension 9 9 $3,661.00 $3,661.00 $974.00 $3,515.00 $3,478.00 2025-11-07
36556 CPT Hc An Insert Non Tunneled Cv Cath 9 9 $3,650.00 $3,650.00 $584.00 $3,504.00 $3,468.00 2025-11-07
A2001 HCPCS IM Ac Placental Ecm 5x5 9 9 $3,648.00 $3,648.00 $584.00 $3,502.00 $3,466.00 2025-11-07
72147 CPT Hc MRI Thoracic Spine With Contrast 9 9 $3,627.00 $3,627.00 $580.00 $3,482.00 $3,446.00 2025-11-07
74182 CPT Hc MRI Abdomen W/contrast 9 9 $3,627.00 $3,627.00 $580.00 $3,482.00 $3,446.00 2025-11-07
C8920 HCPCS Hc MRA Pelvis With & Without Contrast 9 9 $3,627.00 $3,627.00 $580.00 $3,482.00 $3,446.00 2025-11-07
71275 CPT Hc CT Angio Chest 9 9 $3,600.00 $3,600.00 $576.00 $3,456.00 $3,420.00 2025-11-07
116630 CDM Darbepoetin Alfa 200 Mcg/0.4 Ml In Polysorbate Injection Syringe 9 9 $3,591.00 $3,591.00 $955.00 $3,447.00 $3,411.00 2025-11-07
72194 CPT Hc CT Pelvis Without & With Contrast 9 9 $3,546.00 $3,546.00 $567.00 $3,404.00 $3,369.00 2025-11-07
24182 CPT Baricitinib 2 Mg Tablet 9 9 $3,539.00 $3,539.00 $566.00 $3,397.00 $3,362.00 2025-11-07
70552 CPT Hc MRI Brain MRI With Contrast 9 9 $3,536.00 $3,536.00 $566.00 $3,395.00 $3,359.00 2025-11-07
70545 CPT Hc MRA Head With Contrast 9 9 $3,533.00 $3,533.00 $565.00 $3,392.00 $3,356.00 2025-11-07
71551 CPT Hc MRI Chest With Contrast 9 9 $3,525.00 $3,525.00 $564.00 $3,384.00 $3,349.00 2025-11-07
32187 CPT Abatacept (With Maltose) 250 Mg Intravenous Solution 9 9 $3,523.00 $3,523.00 $564.00 $3,382.00 $3,347.00 2025-11-07
52310 CPT Hc Remove Foreigh Body/stent Via Bladder, 9 9 $3,523.00 $3,523.00 $564.00 $3,382.00 $3,347.00 2025-11-07
72141 CPT Hc MRI Cervical Spine MRI Without Contrast 9 9 $3,500.00 $3,500.00 $560.00 $3,360.00 $3,325.00 2025-11-07
72198 CPT Cc Mra; Pelvis W Or Wo Contrast 18 9 $3,540.50 $3,540.50 $553.00 $3,482.00 $3,316.00 2025-11-07
175183 CDM Bendamustine 25 Mg/ml Intravenous Solution 9 9 $3,491.00 $3,491.00 $928.00 $3,351.00 $3,316.00 2025-11-07
10631 CDM Mitomycin 40 Mg Intravenous Solution 9 9 $3,474.00 $3,474.00 $924.00 $3,335.00 $3,300.00 2025-11-07
77047 CPT Hc MRI Breast Without Contrast Bilat 9 9 $3,472.00 $3,472.00 $555.00 $3,333.00 $3,298.00 2025-11-07
73719 CPT Hc MRI Lower Ext Other Than Joint With Contrast 18 9 $4,705.50 $4,705.50 $547.00 $5,749.00 $3,285.00 2025-11-07
90ROOM31 CDM Hc Room Nurs Tele Private 9 9 $3,458.00 $3,458.00 $553.00 $3,320.00 $3,285.00 2025-11-07
73222 CPT Hc MRI Upper Extremity Joint With Contrast 18 9 $4,705.50 $4,705.50 $547.00 $5,749.00 $3,285.00 2025-11-07
73722 CPT Hc MRI Lower Extremity Joint With Contrast 18 9 $4,789.00 $4,789.00 $547.00 $5,910.00 $3,285.00 2025-11-07
72149 CPT Hc MRI Lumbar Spine With Contrast 9 9 $3,447.00 $3,447.00 $551.00 $3,309.00 $3,275.00 2025-11-07
189520 CDM Omalizumab 150 Mg/ml Subcutaneous Syringe 9 9 $3,438.00 $3,438.00 $914.00 $3,300.00 $3,266.00 2025-11-07
36151 CDM Omalizumab 150 Mg Subcutaneous Solution 9 9 $3,438.00 $3,438.00 $914.00 $3,300.00 $3,266.00 2025-11-07
73718 CPT Hc MRI Lower Ext Other Than Joint Without Contrast 18 9 $4,664.00 $4,664.00 $543.00 $5,699.00 $3,256.00 2025-11-07
31032 CPT Factor Xa,inactivated-zhzo (Recombinant) 200 Mg Intravenous Solution 9 9 $3,410.00 $3,410.00 $546.00 $3,274.00 $3,240.00 2025-11-07
45334 CPT Cc Fac Sigmoidoscopy 9 9 $3,393.00 $3,393.00 $543.00 $3,257.00 $3,223.00 2025-11-07
44394 CPT Cc Fac Col/stoma Rem Tum/polyp By Snare 9 9 $3,393.00 $3,393.00 $543.00 $3,257.00 $3,223.00 2025-11-07
15275 CPT Hc Appl Skin Subs Scalp,mouth 1st 25 Sq Cm 9 9 $3,377.00 $3,377.00 $540.00 $3,242.00 $3,208.00 2025-11-07
15271 CPT Hc Appl Skin Subs Trunk, 1st 25 Sq Cm 9 9 $3,377.00 $3,377.00 $540.00 $3,242.00 $3,208.00 2025-11-07
15115 CPT Cc Epi Autogrft Fce Hnd Ft 1s 100 9 9 $3,377.00 $3,377.00 $540.00 $3,242.00 $3,208.00 2025-11-07
15110 CPT Cc Epi Auto Trnk,arm,leg 1st 100 9 9 $3,377.00 $3,377.00 $540.00 $3,242.00 $3,208.00 2025-11-07
72196 CPT Hc MRI Pelvis With Contrast 9 9 $3,370.00 $3,370.00 $539.00 $3,235.00 $3,202.00 2025-11-07
70551 CPT Hc MRI Brain MRI Without Contrast 9 9 $3,370.00 $3,370.00 $539.00 $3,235.00 $3,202.00 2025-11-07
70542 CPT Hc MRI Orbit Face Neck MRI With Contrast 9 9 $3,370.00 $3,370.00 $539.00 $3,235.00 $3,202.00 2025-11-07
72133 CPT Hc CT Lumbar Spine Without & With Contrast 9 9 $3,359.00 $3,359.00 $537.00 $3,225.00 $3,191.00 2025-11-07
70544 CPT Hc MRA Head Without Contrast 9 9 $3,357.00 $3,357.00 $537.00 $3,223.00 $3,189.00 2025-11-07
194093 CDM Romiplostim 125 Mcg Subcutaneous Solution 9 9 $3,352.00 $3,352.00 $891.00 $3,218.00 $3,184.00 2025-11-07
71550 CPT Hc MRI Chest Without Contrast 9 9 $3,348.00 $3,348.00 $536.00 $3,214.00 $3,181.00 2025-11-07
74170 CPT Hc CT Abdomen Without & With Contrast 9 9 $3,339.00 $3,339.00 $534.00 $3,205.00 $3,172.00 2025-11-07
72130 CPT Hc CT Thoracic Spine Without & With Contrast 9 9 $3,332.00 $3,332.00 $533.00 $3,199.00 $3,165.00 2025-11-07
70548 CPT Hc MRA Neck With Contrast 9 9 $3,235.00 $3,235.00 $518.00 $3,106.00 $3,073.00 2025-11-07
186480 CDM Aripiprazole Lauroxil,submic. ER 675 Mg/2.4 Ml Susp,ext.rel.im Syringe 9 9 $3,235.00 $3,235.00 $860.00 $3,106.00 $3,073.00 2025-11-07
C8929 HCPCS Hc Echo Complete W/color Flow Doppler With Cont 9 9 $3,226.00 $3,226.00 $516.00 $3,097.00 $3,065.00 2025-11-07
7040003100 CDM Cc Surgery C <Base Rate> 9 9 $3,226.00 $3,226.00 $858.00 $3,097.00 $3,065.00 2025-11-07
191214 CDM Romosozumab-aqqg 210 Mg/2.34 Ml(105 Mg/1.17 Ml X2)subcutaneous Syringe 9 9 $3,217.00 $3,217.00 $855.00 $3,088.00 $3,056.00 2025-11-07
191219 CDM Romosozumab-aqqg 105 Mg/1.17 Ml Subcutaneous Syringe 9 9 $3,217.00 $3,217.00 $855.00 $3,088.00 $3,056.00 2025-11-07
70540 CPT Hc MRI Orbit Face Neck MRI Without Contrast 9 9 $3,202.00 $3,202.00 $512.00 $3,074.00 $3,042.00 2025-11-07
72148 CPT MRI Scan Of Lower Spinal Canal 9 9 $3,200.00 $3,200.00 $512.00 $3,072.00 $3,040.00 2025-11-07
Q4101 HCPCS Apligraf 9 9 $3,188.00 $3,188.00 $510.00 $3,060.00 $3,029.00 2025-11-07
33772 CPT Nivolumab 40 Mg/4 Ml Intravenous Solution 9 9 $3,181.00 $3,181.00 $509.00 $3,054.00 $3,022.00 2025-11-07
174445 CDM Aripiprazole Lauroxil ER 662 Mg/2.4 Ml Suspension, Ext.rel. IM Syringe 9 9 $3,175.00 $3,175.00 $844.00 $3,048.00 $3,016.00 2025-11-07
70496 CPT Hc CT Angio Head 9 9 $3,167.00 $3,167.00 $507.00 $3,040.00 $3,009.00 2025-11-07
119134 CDM Paliperidone Palmitate 156 Mg/ml Intramuscular Syringe 9 9 $3,164.00 $3,164.00 $841.00 $3,037.00 $3,006.00 2025-11-07
119445 CDM Tocilizumab 200 Mg/10 Ml (20 Mg/ml) Intravenous Solution 9 9 $3,162.00 $3,162.00 $841.00 $3,036.00 $3,004.00 2025-11-07
72193 CPT CT Scan Of Pelvis With Contrast 9 9 $3,160.00 $3,160.00 $506.00 $3,034.00 $3,002.00 2025-11-07
C8914 HCPCS Hc MRA Lower Extremity Without & With Contrast 18 9 $4,277.50 $4,277.50 $498.00 $5,226.00 $2,987.00 2025-11-07
73218 CPT Hc MRI Upper Extremity Without Contrast 18 9 $4,275.00 $4,275.00 $497.00 $5,223.00 $2,985.00 2025-11-07
78451 CPT Hc Myocardial Perfusion Spect Single W/wm&ej 9 9 $3,075.00 $3,075.00 $492.00 $2,952.00 $2,921.00 2025-11-07
70547 CPT Hc MRA Neck Without Contrast 9 9 $3,072.00 $3,072.00 $491.00 $2,949.00 $2,918.00 2025-11-07
73706 CPT Hc CT Angio Lower Extremity 18 9 $4,050.00 $4,050.00 $480.00 $4,896.00 $2,880.00 2025-11-07
47562 CPT Removal Of Gallbladder Using An Endoscope 18 9 $12,066.00 $12,066.00 $374.00 $20,920.00 $2,866.00 2025-11-07
21552 CPT Hc Exc Tumor Soft Tissue Neck/ant Thorax Subq +3cm 9 9 $3,000.00 $3,000.00 $480.00 $2,880.00 $2,850.00 2025-11-07
11044 CPT Hc Debride Skin,sq,muscle,bone,full 20 1st 20 Sqcm Or Less 9 9 $2,999.00 $2,999.00 $480.00 $2,879.00 $2,849.00 2025-11-07
73725 CPT Cc Hc Mra/mrv Lwr Ext W Or Without Contrast 18 9 $3,036.50 $3,036.50 $474.00 $2,987.00 $2,844.00 2025-11-07
44202 CPT Pr Laps Enterect Rescj 1 Small Intest Rescj & Ana 9 9 $2,979.00 $2,979.00 $477.00 $2,860.00 $2,830.00 2025-11-07
72129 CPT Hc CT Thoracic Spine With Contrast 9 9 $2,979.00 $2,979.00 $477.00 $2,860.00 $2,830.00 2025-11-07
72132 CPT Hc CT Lumbar Spine With Contrast 9 9 $2,973.00 $2,973.00 $476.00 $2,854.00 $2,824.00 2025-11-07
72195 CPT Hc MRI Pelvis Without Contrast 9 9 $2,954.00 $2,954.00 $473.00 $2,836.00 $2,806.00 2025-11-07
1030000021 CDM Cc Lens Procedure Operating Room 9 9 $2,943.00 $2,943.00 $783.00 $2,825.00 $2,796.00 2025-11-07
73202 CPT Hc CT Upper Extremity Without & With Contrast 18 9 $4,000.00 $4,000.00 $465.00 $4,887.00 $2,793.00 2025-11-07
73702 CPT Hc CT Lower Extremity Without & With Contrast 18 9 $3,999.00 $3,999.00 $465.00 $4,885.00 $2,793.00 2025-11-07
77046 CPT Hc MRI Breast Without Contrast Unilat 9 9 $2,938.00 $2,938.00 $470.00 $2,820.00 $2,791.00 2025-11-07
Q4106 HCPCS Dermagraft 9 9 $2,938.00 $2,938.00 $470.00 $2,820.00 $2,791.00 2025-11-07
70470 CPT Hc CT Head Without & With Contrast 9 9 $2,933.00 $2,933.00 $469.00 $2,816.00 $2,786.00 2025-11-07
41805 CPT Cc Removal Foreign Body, Gum 9 9 $2,926.00 $2,926.00 $468.00 $2,809.00 $2,780.00 2025-11-07
70482 CPT Hc CT Orbit,sella,po-fos, Ear Without & With Contrast 9 9 $2,909.00 $2,909.00 $465.00 $2,793.00 $2,764.00 2025-11-07
72127 CPT Hc CT Cervical Spine Without & With Contrast 9 9 $2,909.00 $2,909.00 $465.00 $2,793.00 $2,764.00 2025-11-07
164460 CDM Aripiprazole ER 300 Mg Intramuscular Suspension,extended Release 9 9 $2,908.00 $2,908.00 $773.00 $2,792.00 $2,763.00 2025-11-07
171408 CDM Aripiprazole ER 300 Mg Suspension, Extended Rel. Intramuscular Syringe 9 9 $2,908.00 $2,908.00 $773.00 $2,792.00 $2,763.00 2025-11-07
54150 CPT Hc Circumcision Clamp Newborn 9 9 $2,896.00 $2,896.00 $463.00 $2,780.00 $2,751.00 2025-11-07
44388 CPT Cc Fac Colonoscopy Thru Stoma; Diagnostic 9 9 $2,885.00 $2,885.00 $462.00 $2,770.00 $2,741.00 2025-11-07
73219 CPT Hc MRI Upper Extremity With Contrast 18 9 $3,921.50 $3,921.50 $456.00 $4,791.00 $2,738.00 2025-11-07
35207 CPT Cc Fac Repair Blood Vessel Hand 9 9 $2,862.00 $2,862.00 $458.00 $2,748.00 $2,719.00 2025-11-07
73221 CPT Hc MRI Upper Extremity Joint 27 9 $2,884.00 $2,884.00 $417.00 $4,927.00 $2,711.00 2025-11-07
70336 CPT Hc MRI Temporomandibular Joint 9 9 $2,852.00 $2,852.00 $456.00 $2,738.00 $2,709.00 2025-11-07
19283 CPT Hc Plcmt Breast Local Device First Lesion Incl Stertac Guid 9 9 $2,838.00 $2,838.00 $454.00 $2,724.00 $2,696.00 2025-11-07
19081 CPT Hc Biop Breast With Dvce Plcmt First Lesion Incl Stertac Guid 9 9 $2,838.00 $2,838.00 $454.00 $2,724.00 $2,696.00 2025-11-07
78473 CPT Hc Gated Heart Muga Exercise Study 9 9 $2,825.00 $2,825.00 $452.00 $2,712.00 $2,684.00 2025-11-07
11438 CDM Succimer 100 Mg Capsule 9 9 $2,822.00 $2,822.00 $750.00 $2,709.00 $2,681.00 2025-11-07
78320 CPT Hc Bone Imaging Spect 9 9 $2,807.00 $2,807.00 $449.00 $2,695.00 $2,667.00 2025-11-07
23796 CDM Infliximab 100 Mg Intravenous Solution 9 9 $2,800.00 $2,800.00 $745.00 $2,688.00 $2,660.00 2025-11-07
70488 CPT Hc CT Maxillofacial Without & W Contrast 9 9 $2,796.00 $2,796.00 $447.00 $2,684.00 $2,656.00 2025-11-07
70498 CPT Hc CT Angio Neck 9 9 $2,796.00 $2,796.00 $447.00 $2,684.00 $2,656.00 2025-11-07
71260 CPT Hc CT Thorax With Contrast 9 9 $2,794.00 $2,794.00 $447.00 $2,682.00 $2,654.00 2025-11-07
73721 CPT MRI Scan Of Leg Joint 45 9 $2,823.00 $2,823.00 $301.00 $5,006.00 $2,654.00 2025-11-07
74160 CPT Hc CT Abdomen With Contrast 9 9 $2,786.00 $2,786.00 $446.00 $2,675.00 $2,647.00 2025-11-07
72128 CPT Hc CT Thoracic Spine Without Contrast 9 9 $2,767.00 $2,767.00 $443.00 $2,656.00 $2,629.00 2025-11-07
49187 CPT Pr Open Exc/dstrj Intra-abdl Tumor/cst 5.1-10 Cm 18 9 $3,171.00 $3,171.00 $435.00 $3,479.00 $2,609.00 2025-11-07
72126 CPT Hc CT Cervical Spine With Contrast 9 9 $2,728.00 $2,728.00 $436.00 $2,619.00 $2,592.00 2025-11-07
72192 CPT Hc CT Pelvis Without Contrast 9 9 $2,725.00 $2,725.00 $436.00 $2,616.00 $2,589.00 2025-11-07
74150 CPT Hc CT Abdomen Without Contrast 9 9 $2,725.00 $2,725.00 $436.00 $2,616.00 $2,589.00 2025-11-07
29826 CPT Shaving Of Shoulder Bone Using Endoscope 18 9 $12,400.00 $12,400.00 $239.00 $22,371.00 $2,582.50 2025-11-07
45331 CPT Cc Fac Sigmoidoscopy Flexible With Biopsy 9 9 $2,689.00 $2,689.00 $430.00 $2,581.00 $2,555.00 2025-11-07
28232 CPT Cc Incision Of Toe Tendon 9 9 $2,680.00 $2,680.00 $429.00 $2,573.00 $2,546.00 2025-11-07
27762 CPT Hc Closed Tx Medial Malleolus Fx W/manip 9 9 $2,680.00 $2,680.00 $429.00 $2,573.00 $2,546.00 2025-11-07
72125 CPT Hc CT Cervical Spine Without Contrast 9 9 $2,670.00 $2,670.00 $427.00 $2,563.00 $2,537.00 2025-11-07
60227 CPT Raltegravir 400 Mg Tablet 9 9 $2,669.00 $2,669.00 $427.00 $2,562.00 $2,536.00 2025-11-07
27327 CPT Hc Exc Tumor,soft Tissue Thigh Or Knee,sq Less Than 3cm 9 9 $2,662.00 $2,662.00 $426.00 $2,556.00 $2,529.00 2025-11-07
71250 CPT Hc CT Thorax Without Contrast 9 9 $2,638.00 $2,638.00 $422.00 $2,532.00 $2,506.00 2025-11-07
72131 CPT Hc CT Lumbar Spine Without Contrast 9 9 $2,635.00 $2,635.00 $422.00 $2,530.00 $2,503.00 2025-11-07
52281 CPT Cc Cystoscopy,dil Urethral Stricture 9 9 $2,627.00 $2,627.00 $420.00 $2,522.00 $2,496.00 2025-11-07
70460 CPT Hc CT Head With Contrast 9 9 $2,612.00 $2,612.00 $418.00 $2,508.00 $2,481.00 2025-11-07
78608 CPT Hc PET Brain Metabolism 9 9 $2,607.00 $2,607.00 $417.00 $2,503.00 $2,477.00 2025-11-07
93306 CPT Hc Echo Av Opt 9 9 $2,581.00 $2,581.00 $413.00 $2,478.00 $2,452.00 2025-11-07
73201 CPT Hc CT Clavicle With Contrast 18 9 $3,571.00 $3,571.00 $408.00 $4,407.00 $2,449.00 2025-11-07
43281 CPT Pr Laps Rpr Paraesphgl Hrna Incl Fundplsty Without Mesh 18 9 $2,958.50 $2,958.50 $406.00 $3,246.00 $2,435.00 2025-11-07
36569 CPT Hc Insert Periph Inserted Cv Cath 5yrs Or Older 9 9 $2,561.00 $2,561.00 $410.00 $2,459.00 $2,433.00 2025-11-07
31045 CPT Durvalumab 50 Mg/ml Intravenous Solution 9 9 $2,558.00 $2,558.00 $409.00 $2,456.00 $2,430.00 2025-11-07
10778 CDM Ondansetron Hcl 4 Mg Tablet 9 9 $2,557.00 $2,557.00 $680.00 $2,455.00 $2,429.00 2025-11-07
151693 CDM Rivaroxaban 10 Mg Tablet 9 9 $2,555.00 $2,555.00 $679.00 $2,453.00 $2,427.00 2025-11-07
27266 CPT Hc Closed Tx Post Hip Athro Disloc W/anes 9 9 $2,555.00 $2,555.00 $409.00 $2,453.00 $2,427.00 2025-11-07
154556 CDM Rivaroxaban 15 Mg Tablet 9 9 $2,555.00 $2,555.00 $679.00 $2,453.00 $2,427.00 2025-11-07
33009 CDM Voriconazole 200 Mg Tablet 9 9 $2,548.00 $2,548.00 $678.00 $2,446.00 $2,421.00 2025-11-07
168716 CDM Dalbavancin 500 Mg Intravenous Solution 9 9 $2,493.00 $2,493.00 $663.00 $2,393.00 $2,368.00 2025-11-07
28011 CPT Hc Incision Subcut Toe Multiple Tendon 9 9 $2,490.00 $2,490.00 $398.00 $2,390.00 $2,366.00 2025-11-07
70492 CPT Hc CT Soft Tissue Neck Without & With Contrast 9 9 $2,489.00 $2,489.00 $398.00 $2,389.00 $2,365.00 2025-11-07
58280 CPT Pr Vag Hyster W/tot/prtl Vaginect W/rpr Enterocele 9 9 $2,473.00 $2,473.00 $396.00 $2,374.00 $2,349.00 2025-11-07
23655 CPT Hc Closed Tx Shoulder Disloc W/manip W/anes 9 9 $2,470.00 $2,470.00 $395.00 $2,371.00 $2,347.00 2025-11-07
30371 CPT Belatacept 250 Mg Intravenous Solution 9 9 $2,468.00 $2,468.00 $395.00 $2,369.00 $2,345.00 2025-11-07
38724 CPT Pr Cervical Lymphadec Modified Radical Neck Dsj 18 9 $2,843.00 $2,843.00 $390.00 $3,119.00 $2,340.00 2025-11-07
28192 CPT Hc Removal Fb Foot, Deep 9 9 $2,462.00 $2,462.00 $394.00 $2,364.00 $2,339.00 2025-11-07
10121 CPT Cc Remove Foreign Body Complicatd 9 9 $2,462.00 $2,462.00 $394.00 $2,364.00 $2,339.00 2025-11-07
G0121 HCPCS Cc Hc Colon Ca Scrn Not Hi Rsk Ind 9 9 $2,460.00 $2,460.00 $394.00 $2,362.00 $2,337.00 2025-11-07
G0105 HCPCS Cc Hc Colorectal Scrn; Hi Risk Ind 9 9 $2,460.00 $2,460.00 $394.00 $2,362.00 $2,337.00 2025-11-07
45330 CPT Cc Flexible Sigmoidoscopy Procedure 9 9 $2,460.00 $2,460.00 $394.00 $2,362.00 $2,337.00 2025-11-07
87903 CPT Cc Pheno Infect Agent Drug Resist 1-10 9 9 $2,454.00 $2,454.00 $393.00 $2,356.00 $2,331.00 2025-11-07
115944 CDM Palivizumab 50 Mg/0.5 Ml Intramuscular Solution 9 9 $2,453.00 $2,453.00 $652.00 $2,355.00 $2,330.00 2025-11-07
50200 CPT Hc Renal Biopsy,perq Needle 9 9 $2,440.00 $2,440.00 $390.00 $2,342.00 $2,318.00 2025-11-07
73701 CPT Hc CT Lower Extremity With Contrast 18 9 $3,313.50 $3,313.50 $386.00 $4,048.00 $2,314.00 2025-11-07
45378 CPT Diagnostic Exam Of Large Bowel Using An Endoscope 27 9 $2,460.00 $2,460.00 $149.00 $5,445.00 $2,312.00 2025-11-07
41010 CPT Hc Incision Of Tongue Fold 9 9 $2,418.00 $2,418.00 $387.00 $2,321.00 $2,297.00 2025-11-07
70491 CPT Hc CT Soft Tissue Neck With Contrast 9 9 $2,414.00 $2,414.00 $386.00 $2,317.00 $2,293.00 2025-11-07
70481 CPT Hc CT Orbit, Sella, Po-fos, Ear With Contrast 9 9 $2,410.00 $2,410.00 $386.00 $2,314.00 $2,290.00 2025-11-07
119133 CDM Paliperidone Palmitate 117 Mg/0.75 Ml Intramuscular Syringe 9 9 $2,407.00 $2,407.00 $640.00 $2,311.00 $2,287.00 2025-11-07
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