Price Transparencybeta 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

MOUNT GRANT GENERAL HOSPITAL

Hawthorne, NV · CCN 291300 · Rates published

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You selected 93306 (HCPCS)

ECHOCARDIOGRAM, COMPLETE

This hospital’s price: $1,444 across 10 payers · range $828-$2,247

Source: https://raw.githubusercontent.com/Mt-Grant-General-Hospital/Pricing-Transparency/d445dd438c/820299396_MtGrantGeneralHospital_standardcharges.JSON · observed 2025-09-10

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

1,828 distinct procedures filed
10 distinct payers
27,924 rate rows
2025-09-10 last MRF observed · ⚠ 13 mo old
Data quality

27,758 of 27,924 rate rows are consumer-grade (99.4%)

166 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
percent-of-charges filed in the dollar field — excluded from medians 166

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 13 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://raw.githubusercontent.com/Mt-Grant-General-Hospital/Pricing-Transparency/d445dd438c/820299396_MtGrantGeneralHospital_standardcharges.JSON
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-10-01
Content fingerprint 7c28d9c0057b7a04… · 40,941,755 bytes · first seen 2026-07-17

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
81432
HCPCS 		Hereditary Comprehensive Cancer Panel 10 $1,715.00 $4,655.00 $2,991.50 nat. median
$1,408
outlier · 2.1×
74178
HCPCS 		CT--abdomen Pelvis Wo/w IV 10 $1,660.00 $4,506.00 $2,895.50 nat. median
$1,027
outlier · 2.8×
70543
HCPCS 		MRI Orbits Face Neck W/wo 10 $1,586.00 $4,305.00 $2,766.50 nat. median
$1,087
outlier · 2.5×
74183
HCPCS 		Abd MRI Wo/w Contrast 10 $1,584.00 $4,301.00 $2,763.50 nat. median
$1,105
outlier · 2.5×
74177,TC
OTHER 		CT--abdomen Pelvis IV Only 10 $1,540.00 $4,180.00 $2,686.00 nat. median
$2,686
1.0× median
74177
HCPCS 		CT--abdomen Pelvis IV And Oral With Contrast 10 $1,540.00 $4,180.00 $2,686.00 nat. median
$976
outlier · 2.8×
70546
HCPCS 		MRA Head Wo/w Contr Cow 10 $1,503.00 $4,078.00 $2,621.00 nat. median
$1,073
outlier · 2.4×
66982,RT
OTHER 		Complex Cataract Surg Rt 10 $1,458.00 $3,959.00 $2,543.50 nat. median
$2,544
1.0× median
66984,LT
OTHER 		Extracap Cataract Remv Lt 10 $1,458.00 $3,959.00 $2,543.50 nat. median
$2,544
1.0× median
66982,LT
OTHER 		Complex Cataract Surg Lt 10 $1,458.00 $3,959.00 $2,543.50 nat. median
$2,544
1.0× median
66984,RT
OTHER 		Extracap Cataract Remv Rt 10 $1,458.00 $3,959.00 $2,543.50 nat. median
$2,544
1.0× median
70553
HCPCS 		Brain Wo/w Contr MRI 10 $1,444.00 $3,919.00 $2,518.50 nat. median
$1,136
outlier · 2.2×
72158
HCPCS 		L Spine Wo/w Contr MRI 10 $1,443.00 $3,918.00 $2,517.50 nat. median
$1,097
outlier · 2.3×
72156
HCPCS 		C Spine Wo/w Contr MRI 10 $1,443.00 $3,918.00 $2,517.50 nat. median
$1,110
outlier · 2.3×
72157
HCPCS 		T Spine Wo/w Contr MRI 10 $1,430.00 $3,882.00 $2,494.50 nat. median
$1,114
outlier · 2.2×
81229
HCPCS 		Chromosomal Microarray, Postnatal, ClariSure(R) Oligo-snp 10 $1,428.00 $3,875.00 $2,490.50 nat. median
$1,323
1.9× median
81162
HCPCS 		Brca1 And Brca2 Comprehensive Analysis 10 $1,260.00 $4,344.00 $2,368.50 nat. median
$1,825
1.3× median
66983,LT
OTHER 		Intracap Cataract Remv Lt 10 $1,337.00 $3,629.00 $2,332.00 nat. median
$2,332
1.0× median
66983,RT
OTHER 		Intracap Cataract Remv Rt 10 $1,337.00 $3,629.00 $2,332.00 nat. median
$2,332
1.0× median
74175
HCPCS 		CTA Abd Wo/w Contrast W/imag 10 $1,297.00 $3,522.00 $2,263.00 nat. median
$718
outlier · 3.2×
73720
HCPCS 		Le Rt Non Jnt Wo/w Contr 10 $1,268.00 $3,441.00 $2,211.50 nat. median
$1,135
1.9× median
0350
RC 		CT Chest/abdomen With IV Contrast 10 $1,125.00 $4,069.00 $2,149.00 nat. median
$1,119
1.9× median
70336
HCPCS 		Temporomandibular Joints 10 $1,186.00 $3,219.00 $2,068.50 nat. median
$756
outlier · 2.7×
74176
HCPCS 		CT Abd Pelvis W / O Contrast 10 $1,165.00 $3,163.00 $2,032.50 nat. median
$694
outlier · 2.9×
74181
HCPCS 		Abdomen MRI 10 $1,152.00 $3,126.00 $2,009.00 nat. median
$820
outlier · 2.4×
72194
HCPCS 		Pelvis Wo/w Contrast 10 $1,141.00 $3,096.00 $1,990.00 nat. median
$672
outlier · 3.0×
71275
HCPCS 		CTA Chest Wo/w Contr W/image 10 $1,133.00 $3,074.00 $1,976.00 nat. median
$759
outlier · 2.6×
72197
HCPCS 		Pelvis Wo/w Contr MRI 10 $1,113.00 $3,020.00 $1,941.00 nat. median
$1,074
1.8× median
71552,TC
OTHER 		MRI Chest Wo/w 10 $1,102.00 $2,992.00 $1,923.00 nat. median
$1,923
1.0× median
71552
HCPCS 		MRI Chest W 10 $1,102.00 $2,992.00 $1,923.00 nat. median
$1,103
1.7× median
72126
HCPCS 		Cervical Spine With Contrast 10 $1,101.00 $2,990.00 $1,921.00 nat. median
$758
outlier · 2.5×
70496
HCPCS 		CT Angio Head Arteries With Contrast 10 $1,093.00 $2,966.00 $1,906.00 nat. median
$752
outlier · 2.5×
73702
HCPCS 		Lower Extremity Rt Wo/w Contr 10 $1,083.00 $2,939.00 $1,889.00 nat. median
$708
outlier · 2.7×
72132
HCPCS 		CT Lumbar With Contrast 10 $1,059.00 $2,875.00 $1,847.50 nat. median
$769
outlier · 2.4×
73221
HCPCS 		Ue Rt Joint Wo Contrast 10 $1,045.00 $2,836.00 $1,822.50 nat. median
$844
outlier · 2.2×
70488
HCPCS 		Maxillofacial Wo/w Contr 10 $1,040.00 $2,823.00 $1,814.50 nat. median
$639
outlier · 2.8×
70540
HCPCS 		MRI Orbits Face/neck Wo 10 $1,035.00 $2,810.00 $1,805.50 nat. median
$799
outlier · 2.3×
70492
HCPCS 		Neck Wo/w Contrast 10 $1,033.00 $2,803.00 $1,801.50 nat. median
$650
outlier · 2.8×
72149
HCPCS 		L Spine W Contrast MRI 10 $1,024.00 $2,780.00 $1,786.50 nat. median
$979
1.8× median
71270
HCPCS 		Chest Wo/w Contrast 10 $1,021.00 $2,770.00 $1,780.50 nat. median
$684
outlier · 2.6×
72129
HCPCS 		Thoracic Spine With Contrast 10 $1,014.00 $2,753.00 $1,769.00 nat. median
$585
outlier · 3.0×
94002
HCPCS 		Ventilator Per Day Unit 10 $1,006.00 $2,731.00 $1,755.00 nat. median
$921
1.9× median
72146
HCPCS 		T Spine Wo Contrast MRI 10 $994.00 $2,697.00 $1,733.50 nat. median
$800
outlier · 2.2×
73701
HCPCS 		Lower Extremity Lt W C 10 $980.00 $2,660.00 $1,709.50 nat. median
$677
outlier · 2.5×
72193
HCPCS 		Pelvis W Contrast 10 $972.00 $2,638.00 $1,695.50 nat. median
$643
outlier · 2.6×
70547
HCPCS 		MRA Neck Wo (carotids) 10 $968.00 $2,627.00 $1,688.00 nat. median
$764
outlier · 2.2×
73220
HCPCS 		Ue Lt Non Jnt Wo/w Contr 10 $894.00 $3,111.00 $1,685.50 nat. median
$1,136
1.5× median
73706
HCPCS 		CTA Bilat Leg W/iv 10 $841.00 $3,410.00 $1,674.00 nat. median
$752
outlier · 2.2×
72148
HCPCS 		L Spine Wo Contrast MRI 10 $948.00 $2,573.00 $1,653.50 nat. median
$807
outlier · 2.1×
70470
HCPCS 		Head Wo/w Contrast 10 $939.00 $2,550.00 $1,638.50 nat. median
$629
outlier · 2.6×

Other procedures at this hospital

Browse this hospital's 1,828 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
81432 HCPCS Hereditary Comprehensive Cancer Panel 10 10 — — $1,715.00 $4,655.00 $2,991.50 2025-09-10
74178 HCPCS CT--abdomen Pelvis Wo/w IV 10 10 — — $1,660.00 $4,506.00 $2,895.50 2025-09-10
70543 HCPCS MRI Orbits Face Neck W/wo 10 10 — — $1,586.00 $4,305.00 $2,766.50 2025-09-10
74183 HCPCS Abd MRI Wo/w Contrast 10 10 — — $1,584.00 $4,301.00 $2,763.50 2025-09-10
74177,TC OTHER CT--abdomen Pelvis IV Only 10 10 — — $1,540.00 $4,180.00 $2,686.00 2025-09-10
74177 HCPCS CT--abdomen Pelvis IV And Oral With Contrast 10 10 — — $1,540.00 $4,180.00 $2,686.00 2025-09-10
70546 HCPCS MRA Head Wo/w Contr Cow 10 10 — — $1,503.00 $4,078.00 $2,621.00 2025-09-10
66982,RT OTHER Complex Cataract Surg Rt 10 10 — — $1,458.00 $3,959.00 $2,543.50 2025-09-10
66984,RT OTHER Extracap Cataract Remv Rt 10 10 — — $1,458.00 $3,959.00 $2,543.50 2025-09-10
66982,LT OTHER Complex Cataract Surg Lt 10 10 — — $1,458.00 $3,959.00 $2,543.50 2025-09-10
66984,LT OTHER Extracap Cataract Remv Lt 10 10 — — $1,458.00 $3,959.00 $2,543.50 2025-09-10
70553 HCPCS Brain Wo/w Contr MRI 10 10 — — $1,444.00 $3,919.00 $2,518.50 2025-09-10
72158 HCPCS L Spine Wo/w Contr MRI 10 10 — — $1,443.00 $3,918.00 $2,517.50 2025-09-10
72156 HCPCS C Spine Wo/w Contr MRI 10 10 — — $1,443.00 $3,918.00 $2,517.50 2025-09-10
72157 HCPCS T Spine Wo/w Contr MRI 10 10 — — $1,430.00 $3,882.00 $2,494.50 2025-09-10
81229 HCPCS Chromosomal Microarray, Postnatal, ClariSure(R) Oligo-snp 10 10 — — $1,428.00 $3,875.00 $2,490.50 2025-09-10
81162 HCPCS Brca1 And Brca2 Comprehensive Analysis 20 10 — — $1,260.00 $4,344.00 $2,368.50 2025-09-10
66983,RT OTHER Intracap Cataract Remv Rt 10 10 — — $1,337.00 $3,629.00 $2,332.00 2025-09-10
66983,LT OTHER Intracap Cataract Remv Lt 10 10 — — $1,337.00 $3,629.00 $2,332.00 2025-09-10
74175 HCPCS CTA Abd Wo/w Contrast W/imag 10 10 — — $1,297.00 $3,522.00 $2,263.00 2025-09-10
73720 HCPCS Le Rt Non Jnt Wo/w Contr 10 10 — — $1,268.00 $3,441.00 $2,211.50 2025-09-10
0350 RC CT Chest/abdomen With IV Contrast 20 10 — — $1,125.00 $4,069.00 $2,149.00 2025-09-10
70336 HCPCS Temporomandibular Joints 10 10 — — $1,186.00 $3,219.00 $2,068.50 2025-09-10
74176 HCPCS CT Abd Pelvis W / O Contrast 10 10 — — $1,165.00 $3,163.00 $2,032.50 2025-09-10
74181 HCPCS Abdomen MRI 10 10 — — $1,152.00 $3,126.00 $2,009.00 2025-09-10
72194 HCPCS Pelvis Wo/w Contrast 10 10 — — $1,141.00 $3,096.00 $1,990.00 2025-09-10
71275 HCPCS CTA Chest Wo/w Contr W/image 10 10 — — $1,133.00 $3,074.00 $1,976.00 2025-09-10
72197 HCPCS Pelvis Wo/w Contr MRI 10 10 — — $1,113.00 $3,020.00 $1,941.00 2025-09-10
71552 HCPCS MRI Chest W 10 10 — — $1,102.00 $2,992.00 $1,923.00 2025-09-10
71552,TC OTHER MRI Chest Wo/w 10 10 — — $1,102.00 $2,992.00 $1,923.00 2025-09-10
72126 HCPCS Cervical Spine With Contrast 10 10 — — $1,101.00 $2,990.00 $1,921.00 2025-09-10
70496 HCPCS CT Angio Head Arteries With Contrast 10 10 — — $1,093.00 $2,966.00 $1,906.00 2025-09-10
73702 HCPCS Lower Extremity Rt Wo/w Contr 10 10 — — $1,083.00 $2,939.00 $1,889.00 2025-09-10
72132 HCPCS CT Lumbar With Contrast 10 10 — — $1,059.00 $2,875.00 $1,847.50 2025-09-10
73221 HCPCS Ue Rt Joint Wo Contrast 10 10 — — $1,045.00 $2,836.00 $1,822.50 2025-09-10
70488 HCPCS Maxillofacial Wo/w Contr 10 10 — — $1,040.00 $2,823.00 $1,814.50 2025-09-10
70540 HCPCS MRI Orbits Face/neck Wo 10 10 — — $1,035.00 $2,810.00 $1,805.50 2025-09-10
70492 HCPCS Neck Wo/w Contrast 10 10 — — $1,033.00 $2,803.00 $1,801.50 2025-09-10
72149 HCPCS L Spine W Contrast MRI 10 10 — — $1,024.00 $2,780.00 $1,786.50 2025-09-10
71270 HCPCS Chest Wo/w Contrast 10 10 — — $1,021.00 $2,770.00 $1,780.50 2025-09-10
72129 HCPCS Thoracic Spine With Contrast 10 10 — — $1,014.00 $2,753.00 $1,769.00 2025-09-10
94002 HCPCS Ventilator Per Day Unit 10 10 — — $1,006.00 $2,731.00 $1,755.00 2025-09-10
72146 HCPCS T Spine Wo Contrast MRI 10 10 — — $994.00 $2,697.00 $1,733.50 2025-09-10
73701 HCPCS Lower Extremity Lt W C 10 10 — — $980.00 $2,660.00 $1,709.50 2025-09-10
72193 HCPCS Pelvis W Contrast 10 10 — — $972.00 $2,638.00 $1,695.50 2025-09-10
70547 HCPCS MRA Neck Wo (carotids) 10 10 — — $968.00 $2,627.00 $1,688.00 2025-09-10
73220 HCPCS Ue Lt Non Jnt Wo/w Contr 20 10 — — $894.00 $3,111.00 $1,685.50 2025-09-10
73706 HCPCS CTA Bilat Leg W/iv 30 10 — — $841.00 $3,410.00 $1,674.00 2025-09-10
72148 HCPCS L Spine Wo Contrast MRI 10 10 — — $948.00 $2,573.00 $1,653.50 2025-09-10
70470 HCPCS Head Wo/w Contrast 10 10 — — $939.00 $2,550.00 $1,638.50 2025-09-10
73218 HCPCS Ue Lt Non Jnt Wo Contr 10 10 — — $933.00 $2,534.00 $1,628.00 2025-09-10
74170 HCPCS Abdomen Wo/w Contrast 10 10 — — $926.00 $2,513.00 $1,615.00 2025-09-10
70551 HCPCS Brain Wo Contrast MRI 10 10 — — $915.00 $2,483.00 $1,596.00 2025-09-10
72141 HCPCS C Spine Wo Contrast MRI 10 10 — — $915.00 $2,482.00 $1,595.50 2025-09-10
25605 HCPCS Closed Treatment Of Distal Radial Fracture 20 10 — — $877.00 $2,688.00 $1,586.50 2025-09-10
93976 HCPCS Renal Doppler US - Limited 10 10 — — $908.00 $2,463.00 $1,583.50 2025-09-10
73721 HCPCS Le Rt Jnt Wo Contr 10 10 — — $905.00 $2,456.00 $1,578.50 2025-09-10
70491 HCPCS Neck Soft Tissue W C 10 10 — — $905.00 $2,456.00 $1,578.50 2025-09-10
73718 HCPCS Le Rt Non Jnt Wo Contrast 10 10 — — $894.00 $2,427.00 $1,559.50 2025-09-10
72125 HCPCS Cervical Spine Without Contrast 10 10 — — $891.00 $2,420.00 $1,554.50 2025-09-10
74160 HCPCS Abdomen With Contrast 10 10 — — $887.00 $2,408.00 $1,547.50 2025-09-10
71260 HCPCS Chest With Contrast 10 10 — — $887.00 $2,406.00 $1,546.50 2025-09-10
72195 HCPCS Pelvis Wo Contrast MRI 10 10 — — $879.00 $2,385.00 $1,533.00 2025-09-10
70544 HCPCS MRA Head Wo Cont Cow 10 10 — — $879.00 $2,385.00 $1,533.00 2025-09-10
P9021 HCPCS Processing And Storage 60 10 — — $307.00 $4,988.00 $1,532.00 2025-09-10
72128 HCPCS Thoracic Spine Without Contrast 10 10 — — $859.00 $2,332.00 $1,498.50 2025-09-10
73201 HCPCS Upper Extremity Rt W C 10 10 — — $859.00 $2,330.00 $1,498.00 2025-09-10
74185 HCPCS MRA Abdomen 10 10 — — $858.00 $2,328.00 $1,496.50 2025-09-10
71550 HCPCS MRI Chest Wo 10 10 — — $845.00 $2,294.00 $1,474.00 2025-09-10
70460 HCPCS Head With Contrast 10 10 — — $834.00 $2,263.00 $1,454.50 2025-09-10
93306 HCPCS Echocardiogram, Complete 10 10 — — $828.00 $2,247.00 $1,444.00 2025-09-10
72131 HCPCS Lumbar Spine Without Contrast 10 10 — — $816.00 $2,215.00 $1,423.50 2025-09-10
70481 HCPCS Orbits W Contrast 10 10 — — $814.00 $2,210.00 $1,420.00 2025-09-10
73202 HCPCS Upper Extremity Lt Wo/w Contr 10 10 — — $787.00 $2,137.00 $1,373.00 2025-09-10
66985 HCPCS Iridectomy 10 10 — — $770.00 $2,090.00 $1,343.00 2025-09-10
70490 HCPCS Neck Soft Tissue Without C 10 10 — — $764.00 $2,075.00 $1,333.00 2025-09-10
86711 HCPCS Stratify Jcv Antibody (with Index) With Reflex To Inhibit -- Quest 10 10 — — $759.00 $2,060.00 $1,324.00 2025-09-10
70482 HCPCS Orbit Wo/w Contrast 10 10 — — $758.00 $2,057.00 $1,322.00 2025-09-10
70486,TC OTHER CT--sinuses--multisection Coronal Sagittal 10 10 — — $754.00 $2,046.00 $1,315.00 2025-09-10
94003 HCPCS Ventilator Per Day Subseq 10 10 — — $746.00 $2,025.00 $1,301.50 2025-09-10
70487 HCPCS Maxillofacial W Contrast 10 10 — — $746.00 $2,024.00 $1,300.50 2025-09-10
73700 HCPCS Lower Extremity Lt Without C 10 10 — — $735.00 $1,995.00 $1,282.00 2025-09-10
72192 HCPCS Pelvis Without Contrast 10 10 — — $729.00 $1,980.00 $1,272.00 2025-09-10
59410 HCPCS Vag Deliv W/postpart Care 10 10 — — $723.00 $1,963.00 $1,261.00 2025-09-10
70486 HCPCS Maxillofacial Without C 10 10 — — $710.00 $1,928.00 $1,238.50 2025-09-10
75733 HCPCS CT Angio-renal Vessals-w And Wo Contrast 10 10 — — $709.00 $1,926.00 $1,237.50 2025-09-10
74150 HCPCS Abdomen Without Contrast 10 10 — — $706.00 $1,916.00 $1,231.50 2025-09-10
0110 RC Med/surg Room (private) 20 10 — — $666.00 $2,154.00 $1,225.50 2025-09-10
73200 HCPCS Upper Extremity Lt Without C 10 10 — — $698.00 $1,895.00 $1,218.00 2025-09-10
35207 HCPCS Pro Fee Repair Blood Vessel Direct Hand Finger 20 10 — — $649.00 $2,212.00 $1,215.00 2025-09-10
70480 HCPCS Orbit Sella Fossa Ear Without 10 10 — — $696.00 $1,890.00 $1,214.00 2025-09-10
99291 HCPCS Critcare, 1st Hr, Ip Pf 20 10 — — $497.00 $3,183.00 $1,205.00 2025-09-10
71250 HCPCS Chest Without Contrast 10 10 — — $659.00 $1,789.00 $1,149.50 2025-09-10
45390 HCPCS Colonscopy, Flexible; With Endoscopic Mucosal Resection 10 10 — — $648.00 $1,759.00 $1,130.50 2025-09-10
59409 HCPCS Vaginal Delivery Only 20 10 — — $641.00 $1,759.00 $1,121.00 2025-09-10
71271 HCPCS Chest, Low Dose, Without Contrast 10 10 — — $638.00 $1,733.00 $1,113.50 2025-09-10
70450 HCPCS Head Without Contrast 10 10 — — $635.00 $1,724.00 $1,108.00 2025-09-10
0160 RC Administrative Room Day 10 10 — — $630.00 $1,710.00 $1,099.00 2025-09-10
G0121 HCPCS Screening Mcare Avg Risk 10 10 — — $608.00 $1,650.00 $1,060.50 2025-09-10
82139 HCPCS Amino Acid Analysis, Lc/ms, Plasma 10 10 — — $608.00 $1,650.00 $1,060.50 2025-09-10
G0105 HCPCS Screening Mcare High Risk 10 10 — — $608.00 $1,650.00 $1,060.50 2025-09-10
0123 RC Pediatric Room 10 10 — — $596.00 $1,618.00 $1,039.50 2025-09-10
0129 RC Swing Bed 10 10 — — $595.00 $1,615.00 $1,038.00 2025-09-10
0550 RC Swing Bed 10 10 — — $595.00 $1,615.00 $1,038.00 2025-09-10
49083 HCPCS Abdominal Paracentesis With Imaging Guidance 20 10 — — $320.00 $3,125.00 $1,010.00 2025-09-10
45378 HCPCS Colonoscopy 10 10 — — $567.00 $1,540.00 $989.50 2025-09-10
76800 HCPCS S.t. Back 10 10 — — $555.00 $1,506.00 $968.00 2025-09-10
93880 HCPCS Doppler Scan Xcranial Bilat (carotid) 10 10 — — $533.00 $1,447.00 $930.00 2025-09-10
A0130 HCPCS Non-emergency Transportation: Wheelchair Van 10 10 — — $525.00 $1,425.00 $915.50 2025-09-10
93925 HCPCS Bilat Doppler Low Ext Artery 10 10 — — $524.00 $1,421.00 $913.50 2025-09-10
44360 HCPCS Small Intestinal Endoscopy, Enteroscopy Beyond Second Portion Of Duodenum, Not … 10 10 — — $507.00 $1,376.00 $884.00 2025-09-10
0636 RC Hydroxocobalamin 5gm Vial Suv 10 10 — — $506.00 $1,372.00 $882.00 2025-09-10
93975 HCPCS Renal Doppler US - Complete 10 10 — — $505.00 $1,370.00 $880.50 2025-09-10
93930 HCPCS Duplex Scan Ue Arteries/artieral 10 10 — — $497.00 $1,349.00 $867.00 2025-09-10
46040 HCPCS I&d Of Ischiorectal And/or Perirectal Abcess - ProFee 20 10 — — $401.00 $1,915.00 $852.00 2025-09-10
93970 HCPCS Cmpl Bilat Venous Stud US 10 10 — — $475.00 $1,288.00 $828.00 2025-09-10
36573 HCPCS Insertion Of Picc With Imaging, Age 5 Or Older 10 10 — — $473.00 $1,282.00 $824.50 2025-09-10
81225 HCPCS Pharmacogenomics Panel 10 10 — — $473.00 $1,282.00 $824.50 2025-09-10
45398 HCPCS Colonoscopy, Flexible, With Band Ligation (hemorrhoids) 20 10 — — $290.00 $2,328.00 $823.00 2025-09-10
81270 HCPCS Jak2 V617f Cascading Reflex To Exon 9,exon 12,mpl And Csf -- Quest 20 10 — — $272.00 $2,422.00 $815.50 2025-09-10
46230 HCPCS Excision Of Multiple External Papillae Or Tags, Anus 20 10 — — $184.00 $2,992.00 $800.50 2025-09-10
43870 HCPCS Closure Of Gastrostomy, Surgical 10 10 — — $454.00 $1,232.00 $792.00 2025-09-10
36430 HCPCS Blood Administration 60 10 — — $234.00 $2,226.00 $761.50 2025-09-10
31605 HCPCS Tracheostomy, Emergency Procedure, Cricothyroid 20 10 — — $373.00 $1,537.00 $747.50 2025-09-10
A6024 HCPCS Collagen Matrix 5cm X 2cm 10 10 — — $426.00 $1,157.00 $743.50 2025-09-10
45350 HCPCS Sigmoidoscopy, Flexible; With Band Ligation(s) 10 10 — — $426.00 $1,155.00 $742.50 2025-09-10
13132 HCPCS Repair Complex,2.6-7.5 Cm 30 10 — — $316.00 $1,866.00 $737.00 2025-09-10
90677 HCPCS Prevnar 20 Syr 10 10 — — $410.00 $1,112.00 $714.50 2025-09-10
93308 HCPCS Echocardiogram, Limited 10 10 — — $408.00 $1,107.00 $711.50 2025-09-10
45331 HCPCS Flex Sig W/biopsy 10 10 — — $405.00 $1,100.00 $707.00 2025-09-10
44380 HCPCS Ileoscopy, Through Stoma; Diagnostic, Inc Collection Of Specimen(s) By Brushing… 10 10 — — $405.00 $1,100.00 $707.00 2025-09-10
P9034 HCPCS Platelet Phoresis, 1 Unit 20 10 — — $327.00 $1,617.00 $704.50 2025-09-10
13160 HCPCS Closure Wound/exten/compl 20 10 — — $308.00 $1,739.00 $704.00 2025-09-10
11771 HCPCS Exc Pilonidal Cyst Xtensv 20 10 — — $297.00 $1,739.00 $690.00 2025-09-10
27562 HCPCS Closed Txt Patel Disloc 20 10 — — $387.00 $1,106.00 $685.00 2025-09-10
92950 HCPCS Cardiopulmonary Resus 20 10 — — $363.00 $1,216.00 $676.00 2025-09-10
15100 HCPCS Split Graft 1st 100 Sq Cm 20 10 — — $284.00 $1,739.00 $673.50 2025-09-10
45333 HCPCS Flex Sigmoid-remove Polyp 10 10 — — $386.00 $1,048.00 $673.50 2025-09-10
99285,PF OTHER ER Visit,comp,pro Fee 10 10 — — $385.00 $1,045.00 $671.50 2025-09-10
43246 HCPCS Peg Tube Placement 10 10 — — $385.00 $1,045.00 $671.50 2025-09-10
59426 HCPCS Antepartum Care;7 Or More 10 10 — — $383.00 $1,039.00 $668.00 2025-09-10
11646 HCPCS Excise Lesion >4 Cm 20 10 — — $267.00 $1,739.00 $653.00 2025-09-10
47000 HCPCS Percutaneous Liver Biopsy 10 10 — — $365.00 $990.00 $636.50 2025-09-10
93926 HCPCS Uni Duplex Low Ext Lt Artery 10 10 — — $364.00 $989.00 $635.50 2025-09-10
36590 HCPCS Removal Of Tunneled Central Venous Access Device, With Subcutaneous Port Or Pump… 20 10 — — $105.00 $2,660.00 $632.00 2025-09-10
87902 HCPCS Hcv RNA Ns3 Genotype 40 10 — — $333.00 $1,147.00 $624.50 2025-09-10
81401 HCPCS Huntington Disease Mutation Analysis 10 10 — — $355.00 $962.00 $618.50 2025-09-10
76805 HCPCS OB U/s Gestation 10 10 — — $355.00 $962.00 $618.50 2025-09-10
11626 HCPCS Excise Lesion >4 Cm 30 10 — — $219.00 $1,739.00 $618.00 2025-09-10
76700 HCPCS Complete Abdomen U S 10 10 — — $350.00 $949.00 $610.00 2025-09-10
26765 HCPCS Open Txt Dist Phalang Fx 20 10 — — $213.00 $1,739.00 $609.50 2025-09-10
V2787 HCPCS Alcon Toric Lens 10 10 — — $348.00 $945.00 $607.50 2025-09-10
33016 HCPCS Pericardiocentesis, Including Imaging Guide, When Performed 20 10 — — $133.00 $2,290.00 $603.00 2025-09-10
43235 HCPCS Egd 10 10 — — $345.00 $936.00 $601.50 2025-09-10
99285 HCPCS Emergency Dept Visit High Severity&threat Funcj 20 10 — — $138.00 $2,232.00 $598.00 2025-09-10
26951 HCPCS Amputation, Finger/thumb 20 10 — — $304.00 $1,106.00 $581.50 2025-09-10
15200 HCPCS Full Thck Graft Trnk<20cm 20 10 — — $302.00 $1,106.00 $579.50 2025-09-10
92960 HCPCS Cardioversion, Ext 10 10 — — $330.00 $896.00 $575.50 2025-09-10
27301 HCPCS Incision,deep Abcess 20 10 — — $298.00 $1,106.00 $574.50 2025-09-10
27550 HCPCS Closed Treatment Of Knee Dislocation: Without Anesthesia 20 10 — — $192.00 $1,692.00 $572.00 2025-09-10
11446 HCPCS Excise,lesion,>4 Cm 20 10 — — $183.00 $1,739.00 $569.50 2025-09-10
36558 HCPCS Insert Tunnel Cath >=5yrs 20 10 — — $183.00 $1,739.00 $568.50 2025-09-10
27786 HCPCS Closed Treatment Of Distal Fibular Fracture; Without Manipulation 20 10 — — $286.00 $1,154.00 $568.50 2025-09-10
45330 HCPCS Flex Sig 10 10 — — $324.00 $880.00 $565.50 2025-09-10
G0104 HCPCS Flex Sig Canc Scrn-mcare 10 10 — — $324.00 $880.00 $565.50 2025-09-10
44388 HCPCS Colonscopy Through Stoma 10 10 — — $324.00 $880.00 $565.50 2025-09-10
94660 HCPCS Cpap, Init&mgmt 10 10 — — $321.00 $872.00 $560.50 2025-09-10
28090 HCPCS Excis Lesion Tendon Foot 20 10 — — $177.00 $1,739.00 $560.50 2025-09-10
93931 HCPCS Right Ue Arterial 10 10 — — $319.00 $866.00 $556.50 2025-09-10
25650 HCPCS Fracture And/or Dislocation Procedure On The Forearm And Wrist 20 10 — — $282.00 $1,087.00 $551.50 2025-09-10
13121 HCPCS Repair Comp. 2.6cm-7.5cm 30 10 — — $203.00 $1,496.00 $550.50 2025-09-10
81220 HCPCS Cystic Fibrosis Screen 10 10 — — $315.00 $855.00 $549.50 2025-09-10
86360 HCPCS Cd4/t-helper Cell Profile (lymphocyte Subset Panel 4) 10 10 — — $315.00 $855.00 $549.50 2025-09-10
11426 HCPCS Excise,lesion,4.0 Cm 20 10 — — $165.00 $1,739.00 $544.00 2025-09-10
27750 HCPCS Fracture And/or Disclocation Procedure On The Leg (tibia & Fibula & Ankle Joint) 10 10 — — $308.00 $837.00 $537.50 2025-09-10
93320 HCPCS Doppler Echocardiography, Pulsed Wave And/or Coninuous Wave With Spectral Display:… 10 10 — — $301.00 $818.00 $525.50 2025-09-10
26755 HCPCS Phalangeal Fracture In A Finger Or A Thumb 20 10 — — $234.00 $1,255.00 $522.50 2025-09-10
87536 HCPCS HIV-1 Rna, Quantitative, Real-time Pcr 10 10 — — $299.00 $812.00 $522.00 2025-09-10
40805 HCPCS Remove F/b Mouth Complex 20 10 — — $147.00 $1,739.00 $520.00 2025-09-10
59160 HCPCS Curettage Postpartum 20 10 — — $147.00 $1,739.00 $520.00 2025-09-10
77074 HCPCS Xr--xxx Bones--views Survey 10 10 — — $298.00 $808.00 $519.00 2025-09-10
76604 HCPCS Chest Ultrasound St Non Breast 10 10 — — $297.00 $806.00 $518.00 2025-09-10
G0438 HCPCS Annual Wellness First Mc 10 10 — — $296.00 $805.00 $517.00 2025-09-10
93971 HCPCS Limited Venous Studies US 10 10 — — $295.00 $802.00 $515.00 2025-09-10
76856 HCPCS Pelvis Non OB Ultra Sound 10 10 — — $290.00 $788.00 $506.50 2025-09-10
11606 HCPCS Excise Lesion >4 Cm 30 10 — — $187.00 $1,361.00 $502.00 2025-09-10
71111 HCPCS Xr--ribs.bilateral--views 4 10 10 — — $287.00 $778.00 $500.00 2025-09-10
76801 HCPCS OB U/s 1st Trimester 10 10 — — $286.00 $775.00 $498.50 2025-09-10
93321 HCPCS Doppler Echocardiography, Pulsed Wave And/or Continuous Wave With Spectral Display… 10 10 — — $285.00 $773.00 $497.00 2025-09-10
20102 HCPCS Expl Wound,abd/flank/back 20 10 — — $129.00 $1,739.00 $496.00 2025-09-10
76536 HCPCS S T Neck 10 10 — — $284.00 $770.00 $495.00 2025-09-10
76830 HCPCS Transvaginal Ultra Sound 10 10 — — $282.00 $766.00 $492.00 2025-09-10
72114 HCPCS Xr--spine.lumbar--views 5^w Flexion & W Extension 10 10 — — $280.00 $759.00 $488.00 2025-09-10
93325 HCPCS Doppler Echocardiography Color Flow Velocity Mapping 10 10 — — $279.00 $758.00 $487.00 2025-09-10
37785 HCPCS Ligation Varicose Vein 20 10 — — $122.00 $1,739.00 $486.00 2025-09-10
86352 HCPCS Immune Cell Function 10 10 — — $278.00 $753.00 $484.50 2025-09-10
11644 HCPCS Excise Lesion 3.1-4 Cm 20 10 — — $224.00 $1,106.00 $482.00 2025-09-10
81332 HCPCS Alpha-1 Antitrypsin (aat) Mutation Analysis 10 10 — — $276.00 $749.00 $481.00 2025-09-10
53020 HCPCS Meatotomy, Cutting Meatus 20 10 — — $116.00 $1,739.00 $477.50 2025-09-10
66821,LT OTHER Yag Laser Lt 10 10 — — $273.00 $742.00 $476.50 2025-09-10
66821,RT OTHER Yag Laser 10 10 — — $273.00 $742.00 $476.50 2025-09-10
12042 HCPCS Layer Closure 2.6-7.5 Cm 30 10 — — $254.00 $866.00 $475.50 2025-09-10
12051 HCPCS Layer Closure <2.5cm 30 10 — — $250.00 $891.00 $474.50 2025-09-10
43249 HCPCS Egd Balln Dil 20 10 — — $162.00 $1,376.00 $473.50 2025-09-10
43248 HCPCS Egd Dil W/guidewire 20 10 — — $162.00 $1,376.00 $473.50 2025-09-10
43244 HCPCS Egd W/banding Varices 20 10 — — $162.00 $1,376.00 $473.50 2025-09-10
76870 HCPCS Scrotum Ultrasound 10 10 — — $271.00 $736.00 $473.00 2025-09-10
45385 HCPCS Colonoscopy, Flexible; With Removal Of Tumor(s), Polyp(s), Or Other Lesion(s) By… 20 10 — — $102.00 $1,815.00 $472.50 2025-09-10
45384 HCPCS Colonoscopy, Flexible; With Removal Of Tumor(s), Polyp(s), Or Other Lesion(s) By… 20 10 — — $102.00 $1,815.00 $472.50 2025-09-10
76770 HCPCS Abdominal Aorta Ultrasound 10 10 — — $270.00 $732.00 $470.50 2025-09-10
99235 HCPCS Adm/dc Same Day-mod Ip 10 10 — — $267.00 $724.00 $465.50 2025-09-10
11642 HCPCS Excise Mal Lesion 1.1-2 15 10 — — $175.00 $475.00 $464.00 2025-09-10
99284,PF OTHER ER Visit,detailed,pro Fee 10 10 — — $264.00 $716.00 $460.50 2025-09-10
46221 HCPCS Hemorrhoidectomy Simple 10 10 — — $264.00 $715.00 $460.00 2025-09-10
41800 HCPCS Drainage Of Abscess, Cyst, Heatoma From Dentoalveolar Structures 20 10 — — $262.00 $717.00 $458.50 2025-09-10
74021 HCPCS Xr--abdomen--views 2 10 10 — — $263.00 $713.00 $458.50 2025-09-10
73521 HCPCS Xr--pelvis+hip.bilateral--views 10 10 — — $263.00 $713.00 $458.50 2025-09-10
J1442 HCPCS Neupogen 300 Mg/0.5ml Inj 10 10 — — $262.00 $712.00 $457.50 2025-09-10
26775 HCPCS Clsd Reduct Finger Disloc 20 10 — — $202.00 $1,106.00 $454.50 2025-09-10
72052 HCPCS Xr--spine.cervical--complete, Incl Oblique Flexion Ext Studies 10 10 — — $260.00 $705.00 $453.00 2025-09-10
36556 HCPCS Insert Centrl Venous Cath 30 10 — — $84.00 $2,255.00 $452.00 2025-09-10
25600 HCPCS Closed T/x,radial Fractur 30 10 — — $177.00 $1,222.00 $450.00 2025-09-10
43251 HCPCS Egd, Flexible, Transoral, With Removal Of Tumor(s), Polyp(s) Or Other Lesion(s) … 20 10 — — $162.00 $1,247.00 $450.00 2025-09-10
12041 HCPCS Layer Closure <2.5cm 20 10 — — $231.00 $844.00 $443.00 2025-09-10
99284 HCPCS Emergency Department Visit High/urgent Severity 20 10 — — $113.00 $1,567.00 $442.50 2025-09-10
23655 HCPCS Clos Tx Shldr Disloc,anes 20 10 — — $192.00 $1,106.00 $442.00 2025-09-10
31500 HCPCS Intubation - Ip 20 10 — — $238.00 $789.00 $441.50 2025-09-10
76857 HCPCS Pelvis Non OB Ultra Sound Limited 10 10 — — $251.00 $682.00 $438.00 2025-09-10
85305 HCPCS Protein S Antigen, Total And Free 10 10 — — $251.00 $681.00 $438.00 2025-09-10
21930 HCPCS Excision Tumor Back/flank 20 10 — — $185.00 $1,106.00 $434.00 2025-09-10
11624 HCPCS Excise Lesion 3.1-4 Cm 30 10 — — $183.00 $1,106.00 $431.50 2025-09-10
31720 HCPCS Naso Tracheal Suction 10 10 — — $247.00 $670.00 $430.50 2025-09-10
76815 HCPCS OB Ultra Sound Limited 10 10 — — $245.00 $666.00 $428.00 2025-09-10
81335 HCPCS Thiopurine S-methyltransferase(tpmt) Genotype -- Quest 10 10 — — $245.00 $664.00 $427.00 2025-09-10
12057 HCPCS Layer Closure >30 Cm 30 10 — — $117.00 $1,449.00 $425.00 2025-09-10
0120 RC Med/surg Room (semi-private) 50 10 — — $1.00 $2,154.00 $424.50 2025-09-10
82671 HCPCS Estrogens, Fractionated, Lc/ms/ms 10 10 — — $243.00 $660.00 $424.00 2025-09-10
27614 HCPCS Biopsy Lower Leg Soft Tis 10 10 — — $243.00 $660.00 $424.00 2025-09-10
82652 HCPCS Vitamin D, 1,25-dihydroxy, Lc/ms/ms 10 10 — — $243.00 $660.00 $424.00 2025-09-10
99292 HCPCS Critcare,add 30min,profee 20 10 — — $205.00 $910.00 $422.50 2025-09-10
12046 HCPCS Layer Closure,20.1-30.0 Cm 20 10 — — $152.00 $1,171.00 $422.00 2025-09-10
87517 HCPCS Hepatitis B Virus Dna, Quantitative, Real-time Pcr 10 10 — — $239.00 $650.00 $417.50 2025-09-10
23650 HCPCS Closed Treatment Shoulder Dislocation 30 10 — — $122.00 $1,149.00 $417.00 2025-09-10
94762 HCPCS Overnight Oximetry 10 10 — — $237.00 $644.00 $414.00 2025-09-10
12056 HCPCS Layer Closure 20.1-30 Cm 30 10 — — $117.00 $1,378.00 $412.00 2025-09-10
59425 HCPCS Antepartum Care Only;4-6 10 10 — — $236.00 $641.00 $412.00 2025-09-10
94618 HCPCS Pulmonary Stress Testing (eg, 6-minute Walk Test), Including Measurement Of Hear… 10 10 — — $236.00 $640.00 $411.50 2025-09-10
45020 HCPCS I&d Deep Supralevator Abs 20 10 — — $167.00 $1,106.00 $411.50 2025-09-10
92977 HCPCS Thrombolysis,iv 10 10 — — $233.00 $634.00 $407.00 2025-09-10
26160 HCPCS Exc Les Of Tendon Sheath 20 10 — — $159.00 $1,106.00 $407.00 2025-09-10
87799 HCPCS Adenovirus Dna, Quantitative Real-time Pcr 30 10 — — $213.00 $769.00 $406.50 2025-09-10
84445 HCPCS Tsi 10 10 — — $232.00 $630.00 $404.50 2025-09-10
72110 HCPCS Xr--spine.lumbar--views 5 10 10 — — $232.00 $630.00 $404.50 2025-09-10
20103 HCPCS Explore Penetrating Wound 20 10 — — $148.00 $1,106.00 $404.00 2025-09-10
59414 HCPCS Deliver Placenta Separate 10 10 — — $231.00 $627.00 $403.00 2025-09-10
45915 HCPCS Remove Rectal Obstruction 20 10 — — $146.00 $1,106.00 $401.50 2025-09-10
76817 HCPCS Transvaginal OB U/s 10 10 — — $229.00 $620.00 $399.00 2025-09-10
11643 HCPCS Excise Lesion 2.1-3 Cm 20 10 — — $203.00 $791.00 $398.00 2025-09-10
45380 HCPCS Colonoscopy, Flexible; With Biopsy, Single Or Multiple 20 10 — — $61.00 $1,704.00 $396.50 2025-09-10
27810 HCPCS Closed Treatment Of Bimalleolar Ankle Fracture With Manipulation 20 10 — — $217.00 $665.00 $392.50 2025-09-10
66761 HCPCS Laser Periph Iridotomy Lt 10 10 — — $225.00 $610.00 $392.00 2025-09-10
65855 HCPCS Trabeculoplasty 10 10 — — $225.00 $610.00 $392.00 2025-09-10
11406 HCPCS Excise,lesion,>4.0cm 20 10 — — $138.00 $1,106.00 $390.50 2025-09-10
74022 HCPCS Xr--abdomen--views 3 10 10 — — $223.00 $605.00 $389.00 2025-09-10
45381 HCPCS Colonoscopy, Flexible; With Directed Submucosal Injection(s), Any Substance 20 10 — — $57.00 $1,694.00 $389.00 2025-09-10
91322 HCPCS Spike-vax 2023-2024 (12^) 10 10 — — $223.00 $604.00 $388.50 2025-09-10
12047 HCPCS Layer Closure >30 Cm 30 10 — — $117.00 $1,270.00 $387.00 2025-09-10
11750 HCPCS Excise,nail Part/complete 20 10 — — $138.00 $1,087.00 $387.00 2025-09-10
76380 HCPCS Sinuses Limited Or Follow Up CT 10 10 — — $221.00 $600.00 $385.50 2025-09-10
27780 HCPCS Closed Treatment Of Proximal Fibula Or Shaft Fracture 10 10 — — $221.00 $598.00 $385.00 2025-09-10
13100 HCPCS Repair,complex 1.1-2.5 Cm 30 10 — — $154.00 $1,038.00 $383.00 2025-09-10
76641 HCPCS Breast Rt Ultra Sound 10 10 — — $219.00 $595.00 $382.00 2025-09-10
70150 HCPCS Xr--facial Bones--views 3 10 10 — — $219.00 $594.00 $381.50 2025-09-10
L0454 HCPCS Lower Spine Support Brace - Vista 464 Tlso 10 10 — — $218.00 $591.00 $380.00 2025-09-10
99236 HCPCS Adm/dc Same Day-high Ip 20 10 — — $168.00 $901.00 $375.50 2025-09-10
11603 HCPCS Excise Lesion 2.1-3 Cm 30 10 — — $178.00 $835.00 $375.50 2025-09-10
70130 HCPCS Xr--mastoid.right--views 3 10 10 — — $215.00 $584.00 $375.50 2025-09-10
87522 HCPCS Hepatitis C Virus Rna, Quantitative, Real-time Pcr 10 10 — — $214.00 $580.00 $372.50 2025-09-10
74250 HCPCS Xr--abdomen--views (sitzmark) 10 10 — — $213.00 $579.00 $371.50 2025-09-10
99395,MP OTHER Scorpio Gold Phys 10 10 — — $212.00 $577.00 $370.50 2025-09-10
87910 HCPCS Cytomegalovirus (cmv) Genotype 10 10 — — $212.00 $577.00 $370.50 2025-09-10
81256 HCPCS Hereditary Hemochromatosis DNA Mutation Analysis 20 10 — — $186.00 $749.00 $369.00 2025-09-10
72050 HCPCS Xr--spine.cervical--views 4 Or 5 10 10 — — $211.00 $574.00 $368.50 2025-09-10
11444 HCPCS Excise,lesion,3.1-4 Cm 20 10 — — $178.00 $791.00 $367.50 2025-09-10
41008 HCPCS Intraoral I&d Of Abscess, Cyst, Or Hematoma Tongue And Mouth 10 10 — — $210.00 $570.00 $366.50 2025-09-10
12037 HCPCS Layer Closure >30.0 Cm 30 10 — — $117.00 $1,478.00 $366.50 2025-09-10
11012 HCPCS Debride Inc Remov Foreign 20 10 — — $175.00 $797.00 $365.00 2025-09-10
76705 HCPCS Limited Abdomen U S 20 10 — — $175.00 $782.00 $361.50 2025-09-10
11424 HCPCS Excise,lesion,3.1-4 Cm 20 10 — — $116.00 $1,106.00 $361.00 2025-09-10
12055 HCPCS Layer Closure 12.6-20 Cm 30 10 — — $117.00 $1,326.00 $359.00 2025-09-10
13101 HCPCS Repair,complex 2.6-7.5 Cm 30 10 — — $112.00 $1,115.00 $357.50 2025-09-10
11622 HCPCS Excise Lesion 1.1-2 Cm 30 10 — — $162.00 $844.00 $357.00 2025-09-10
42330 HCPCS Sialolithotomy Uncomplica 20 10 — — $111.00 $1,106.00 $353.50 2025-09-10
55250 HCPCS Vasectomy 10 10 — — $203.00 $550.00 $353.50 2025-09-10
L8610 HCPCS Ocular Implant 10 10 — — $203.00 $550.00 $353.50 2025-09-10
46945 HCPCS Ligation Of Hemorrhoids 10 10 — — $203.00 $550.00 $353.50 2025-09-10
81226 HCPCS Cytochrome P450 2d6 Genotype -- Quest 10 10 — — $202.00 $548.00 $352.50 2025-09-10
96365 HCPCS Therapeutic 16-60 Min 10 10 — — $202.00 $547.00 $352.00 2025-09-10
11623 HCPCS Excise Lesion 2.1-3 Cm 30 10 — — $153.00 $874.00 $351.50 2025-09-10
12053 HCPCS Layer Closure, 5.1-7.5 Cm 30 10 — — $103.00 $1,001.00 $350.50 2025-09-10
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