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

ASHLEY MEDICAL CENTER

Ashley, ND · CCN 351322 · Rates published

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You selected 93306 (HCPCS)

US ECHOCARDIOGRAM

This hospital’s price: $864 across 14 payers · range $825-$1,230

Source: https://irp.cdn-website.com/5b245649/files/uploaded/450255914_ashley-medical-center_standardcharges.csv · observed 2026-10-09

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.

1,109 distinct procedures filed
14 distinct payers
38,062 rate rows
2026-10-09 last MRF observed
Data quality

35,383 of 38,062 rate rows are consumer-grade (93.0%)

2,679 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
per-diem day rate — not a per-procedure price 1,941
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 516
exceeds 10× this hospital's gross charge — excluded from medians 147
percent-of-charges filed in the dollar field — excluded from medians 75
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://irp.cdn-website.com/5b245649/files/uploaded/450255914_ashley-medical-center_standardcharges.csv
Found on page https://www.amctoday.org/financial
Discovered viaDiscovered by HANK
Last fetch success · 2026-10-17
Content fingerprint 23e455dde577f254… · 13,491,100 bytes · first seen 2026-10-17

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
J3101
HCPCS 		Tenecteplase (tnk) 25 Mg Ivp 14 $11,166.03 $20,743.15 $14,520.20 nat. median
$3,787
outlier · 3.8×
J2997
HCPCS 		Activase (alteplase) 100 Mg IV 14 $12,320.50 $17,600.72 $12,559.87 nat. median
$500
outlier · 25.1×
J3358
HCPCS 		Stelara 390 Mg/78 Ml Vial 14 $10,649.62 $15,213.75 $10,856.53 nat. median
$264
outlier · 41.1×
J2506
HCPCS 		Neulasta Onpro 6 Mg/0.6 Ml Vial 14 $8,985.19 $15,403.18 $10,782.23 nat. median
$1,659
outlier · 6.5×
J2353
HCPCS 		Sandostatin Lar(octreotide) 20mg Vial IM 14 $6,598.73 $17,281.40 $10,761.87 nat. median
$5,623
1.9× median
J9271
HCPCS 		Keytruda Intravenous Solution 25mg/1m 14 $10,527.44 $15,039.20 $10,731.97 nat. median
$275
outlier · 39.1×
J2802
HCPCS 		Nplate (romiplostim) 500 Mcg Vial Sq 14 $9,634.57 $13,763.67 $9,821.75 nat. median
$2,849
outlier · 3.4×
J1569
HCPCS 		Gammagard(immune Globulin)45 Gm Vial 10% 14 $6,362.50 $9,089.28 $6,486.11 nat. median
$1,074
outlier · 6.0×
Q5108
HCPCS 		Fulphila Subcutaneous Solution 6mg/0. 14 $5,228.30 $7,469.00 $5,329.88 nat. median
$1,244
outlier · 4.3×
J3590
HCPCS 		Yusimry SubQ Solution 40mg/0.8ml 14 $4,845.83 $6,922.62 $4,939.98 nat. median
$775
outlier · 6.4×
0110
RC 		8 $4,765.90 $4,765.90 $4,765.90 nat. median
$961
outlier · 5.0×
J0897
HCPCS 		Prolia (denosumab) 60 Mg / Ml Vial 14 $3,355.95 $7,046.96 $4,554.51 nat. median
$1,982
outlier · 2.3×
71552
HCPCS 		MRI Chest W&without Cont 14 $3,953.60 $5,648.00 $4,030.41 nat. median
$1,103
outlier · 3.7×
70553
HCPCS 		MRI Brain W&without Contrast 14 $3,334.10 $4,763.00 $3,429.36 nat. median
$1,136
outlier · 3.0×
72158
HCPCS 		MRI L Spine W&without - Lumbar 14 $3,334.10 $4,763.00 $3,429.36 nat. median
$1,097
outlier · 3.1×
73220
HCPCS 		MRI Ext Upper Lt Non-joint WO/W,Left 14 $3,321.50 $4,745.00 $3,386.03 nat. median
$1,136
outlier · 3.0×
73723
HCPCS 		MRI Ext Lower Lt Joint W&W/O,Left 14 $3,273.90 $4,677.00 $3,337.51 nat. median
$1,199
outlier · 2.8×
74183
HCPCS 		MRI Abdomen W&without 14 $3,285.10 $4,693.00 $3,322.24 nat. median
$1,105
outlier · 3.0×
72157
HCPCS 		MRI T Spine W & Without - Thoracic 14 $3,305.97 $4,736.00 $3,315.20 nat. median
$1,114
outlier · 3.0×
73720
HCPCS 		MRI Ext Lower Lt Non-joint W&W/O,Left 14 $3,273.90 $4,677.00 $3,311.55 nat. median
$1,135
outlier · 2.9×
72197
HCPCS 		MRI Pelvis W&without 14 $3,146.19 $4,693.00 $3,297.17 nat. median
$1,074
outlier · 3.1×
70543
HCPCS 		MRI Orbit/face/neck W&without Contrast 14 $3,273.90 $4,677.00 $3,285.59 nat. median
$1,087
outlier · 3.0×
72156
HCPCS 		MRI C Spine W&without - Cervical 14 $3,080.70 $4,401.00 $3,091.64 nat. median
$1,110
outlier · 2.8×
87507
HCPCS 		Gi Panel By PCR,Ref Lab 14 $3,005.10 $4,293.00 $3,063.48 nat. median
$552
outlier · 5.5×
11646
HCPCS 		Excision Face 4.0 Cm 14 $2,902.90 $4,147.00 $2,959.30 nat. median
$2,852
1.0× median
71550
HCPCS 		MRI Chest Without 14 $2,900.10 $4,143.00 $2,956.44 nat. median
$820
outlier · 3.6×
70548
HCPCS 		MRA Neck W Contrast 14 $2,885.40 $4,122.00 $2,941.46 nat. median
$922
outlier · 3.2×
66920
HCPCS 		Extraction Of Lens Material 14 $2,790.20 $3,986.00 $2,844.41 nat. median
$2,693
1.1× median
70552
HCPCS 		MRI Brain W Contrast 14 $2,678.20 $3,826.00 $2,730.23 nat. median
$965
outlier · 2.8×
70547
HCPCS 		MRA Neck Without Contrast 14 $2,720.69 $3,898.00 $2,728.60 nat. median
$764
outlier · 3.6×
73223
HCPCS 		MRI Ext Upper Lt Joint W&W/O,Left 14 $2,671.90 $3,817.00 $2,723.81 nat. median
$1,158
outlier · 2.4×
72196
HCPCS 		MRI Pelvis W 14 $2,644.60 $3,778.00 $2,695.98 nat. median
$953
outlier · 2.8×
70549
HCPCS 		MRA Neck W&without Contrast 14 $2,544.50 $3,635.00 $2,593.94 nat. median
$1,063
outlier · 2.4×
73218
HCPCS 		MRI Ext Upper Lt Non-joint WO,Left 14 $2,542.40 $3,632.00 $2,591.80 nat. median
$866
outlier · 3.0×
70471
HCPCS 		CT Angio Head & Neck W Contrast 14 $2,461.71 $3,672.00 $2,579.99 nat. median
$815
outlier · 3.2×
70544
HCPCS 		MRA Head Without Contrast 14 $2,497.60 $3,568.00 $2,568.96 nat. median
$829
outlier · 3.1×
49585
HCPCS 		Hernia Repair Umbilical 14 $821.80 $5,603.00 $2,548.05 nat. median
$3,104
0.8× median
72195
HCPCS 		MRI Pelvis Without Contrast 14 $2,467.50 $3,525.00 $2,538.00 nat. median
$811
outlier · 3.1×
73718
HCPCS 		MRI Ext Lower Lt Non-joint WO,Left 14 $2,454.20 $3,506.00 $2,524.32 nat. median
$870
outlier · 2.9×
22901
HCPCS 		Excision Abdl Tum Deep 5 Cm/> 14 $1,304.10 $4,436.00 $2,484.10 nat. median
$3,064
0.8× median
73706
HCPCS 		CT Angio Lower Ext Lt W/WO,Left 14 $2,262.60 $3,477.00 $2,481.19 nat. median
$752
outlier · 3.3×
74174
HCPCS 		CT Angio Abd/pel W 14 $2,447.90 $3,497.00 $2,475.63 nat. median
$998
outlier · 2.5×
J1750
HCPCS 		Infed(iron Dextran 50mg/ml)2g/40 Ml Dose 14 $2,422.66 $3,460.94 $2,469.73 nat. median
$47
outlier · 52.2×
J9217
HCPCS 		Eligard(leuprolide Acetate)3 Mnth 22.5mg 14 $1,784.91 $6,500.43 $2,459.66 nat. median
$1,573
1.6× median
74182
HCPCS 		MRI Abdomen With 14 $2,397.50 $3,425.00 $2,444.08 nat. median
$976
outlier · 2.5×
49561
HCPCS 		Rpr Ventral Hern Init Block 14 $1,548.79 $5,624.00 $2,389.00 nat. median
$3,182
0.8× median
64721
HCPCS 		Carpal Tunnel 14 $860.30 $4,816.00 $2,300.10 nat. median
$2,392
1.0× median
Q5101
HCPCS 		Zarxio (filgtim-sndz)300 Mcg/0.5 Ml Sq 14 $1,561.39 $3,345.84 $2,286.32 nat. median
$329
outlier · 7.0×
73222
HCPCS 		MRI Ext Upper Lt Joint W,Left 14 $2,193.10 $3,133.00 $2,235.71 nat. median
$1,282
1.7× median
74181
HCPCS 		MRI Abdomen Without Contrast 14 $2,122.40 $3,032.00 $2,183.04 nat. median
$820
outlier · 2.7×

Other procedures at this hospital

Browse this hospital's 1,109 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
             
J3101 HCPCS Tenecteplase (tnk) 25 Mg Ivp 34 14 $18,347.31 $18,347.31 $11,166.03 $20,743.15 $14,520.20 2026-10-09
J2997 HCPCS Activase (alteplase) 100 Mg IV 17 14 $17,600.72 $17,600.72 $12,320.50 $17,600.72 $12,559.87 2026-10-09
J3358 HCPCS Stelara 390 Mg/78 Ml Vial 17 14 $15,213.75 $15,213.75 $10,649.62 $15,213.75 $10,856.53 2026-10-09
J2506 HCPCS Neulasta Onpro 6 Mg/0.6 Ml Vial 34 14 $14,119.58 $14,119.58 $8,985.19 $15,403.18 $10,782.23 2026-10-09
J2353 HCPCS Sandostatin Lar(octreotide) 20mg Vial IM 34 14 $13,354.08 $13,354.08 $6,598.73 $17,281.40 $10,761.87 2026-10-09
J9271 HCPCS Keytruda Intravenous Solution 25mg/1m 17 14 $15,039.20 $15,039.20 $10,527.44 $15,039.20 $10,731.97 2026-10-09
J2802 HCPCS Nplate (romiplostim) 500 Mcg Vial Sq 17 14 $13,763.67 $13,763.67 $9,634.57 $13,763.67 $9,821.75 2026-10-09
J1569 HCPCS Gammagard(immune Globulin)45 Gm Vial 10% 17 14 $9,089.28 $9,089.28 $6,362.50 $9,089.28 $6,486.11 2026-10-09
Q5108 HCPCS Fulphila Subcutaneous Solution 6mg/0. 17 14 $7,469.00 $7,469.00 $5,228.30 $7,469.00 $5,329.88 2026-10-09
J3590 HCPCS Yusimry SubQ Solution 40mg/0.8ml 17 14 $6,922.62 $6,922.62 $4,845.83 $6,922.62 $4,939.98 2026-10-09
0110 RC — 8 8 $8.00 $8.00 $4,765.90 $4,765.90 $4,765.90 2026-10-09
J0897 HCPCS Prolia (denosumab) 60 Mg / Ml Vial 51 14 $5,977.35 $5,977.35 $3,355.95 $7,046.96 $4,554.51 2026-10-09
71552 HCPCS MRI Chest W&without Cont 17 14 $5,648.00 $5,648.00 $3,953.60 $5,648.00 $4,030.41 2026-10-09
72158 HCPCS MRI L Spine W&without - Lumbar 17 14 $4,763.00 $4,763.00 $3,334.10 $4,763.00 $3,429.36 2026-10-09
70553 HCPCS MRI Brain W&without Contrast 17 14 $4,763.00 $4,763.00 $3,334.10 $4,763.00 $3,429.36 2026-10-09
73220 HCPCS MRI Ext Upper Lt Non-joint WO/W,Left 34 14 $4,745.00 $4,745.00 $3,321.50 $4,745.00 $3,386.03 2026-10-09
73723 HCPCS MRI Ext Lower Lt Joint W&W/O,Left 34 14 $4,677.00 $4,677.00 $3,273.90 $4,677.00 $3,337.51 2026-10-09
74183 HCPCS MRI Abdomen W&without 17 14 $4,693.00 $4,693.00 $3,285.10 $4,693.00 $3,322.24 2026-10-09
72157 HCPCS MRI T Spine W & Without - Thoracic 17 14 $4,736.00 $4,736.00 $3,305.97 $4,736.00 $3,315.20 2026-10-09
73720 HCPCS MRI Ext Lower Lt Non-joint W&W/O,Left 34 14 $4,677.00 $4,677.00 $3,273.90 $4,677.00 $3,311.55 2026-10-09
72197 HCPCS MRI Pelvis W&without 17 14 $4,693.00 $4,693.00 $3,146.19 $4,693.00 $3,297.17 2026-10-09
70543 HCPCS MRI Orbit/face/neck W&without Contrast 17 14 $4,677.00 $4,677.00 $3,273.90 $4,677.00 $3,285.59 2026-10-09
72156 HCPCS MRI C Spine W&without - Cervical 17 14 $4,401.00 $4,401.00 $3,080.70 $4,401.00 $3,091.64 2026-10-09
87507 HCPCS Gi Panel By PCR,Ref Lab 17 14 $4,293.00 $4,293.00 $3,005.10 $4,293.00 $3,063.48 2026-10-09
11646 HCPCS Excision Face 4.0 Cm 17 14 $4,147.00 $4,147.00 $2,902.90 $4,147.00 $2,959.30 2026-10-09
71550 HCPCS MRI Chest Without 17 14 $4,143.00 $4,143.00 $2,900.10 $4,143.00 $2,956.44 2026-10-09
70548 HCPCS MRA Neck W Contrast 17 14 $4,122.00 $4,122.00 $2,885.40 $4,122.00 $2,941.46 2026-10-09
66920 HCPCS Extraction Of Lens Material 17 14 $3,986.00 $3,986.00 $2,790.20 $3,986.00 $2,844.41 2026-10-09
70552 HCPCS MRI Brain W Contrast 17 14 $3,826.00 $3,826.00 $2,678.20 $3,826.00 $2,730.23 2026-10-09
70547 HCPCS MRA Neck Without Contrast 17 14 $3,898.00 $3,898.00 $2,720.69 $3,898.00 $2,728.60 2026-10-09
73223 HCPCS MRI Ext Upper Lt Joint W&W/O,Left 34 14 $3,817.00 $3,817.00 $2,671.90 $3,817.00 $2,723.81 2026-10-09
72196 HCPCS MRI Pelvis W 17 14 $3,778.00 $3,778.00 $2,644.60 $3,778.00 $2,695.98 2026-10-09
70549 HCPCS MRA Neck W&without Contrast 17 14 $3,635.00 $3,635.00 $2,544.50 $3,635.00 $2,593.94 2026-10-09
73218 HCPCS MRI Ext Upper Lt Non-joint WO,Left 34 14 $3,632.00 $3,632.00 $2,542.40 $3,632.00 $2,591.80 2026-10-09
70471 HCPCS CT Angio Head & Neck W Contrast 17 14 $3,672.00 $3,672.00 $2,461.71 $3,672.00 $2,579.99 2026-10-09
70544 HCPCS MRA Head Without Contrast 17 14 $3,568.00 $3,568.00 $2,497.60 $3,568.00 $2,568.96 2026-10-09
49585 HCPCS Hernia Repair Umbilical 34 14 $3,388.50 $3,388.50 $821.80 $5,603.00 $2,548.05 2026-10-09
72195 HCPCS MRI Pelvis Without Contrast 17 14 $3,525.00 $3,525.00 $2,467.50 $3,525.00 $2,538.00 2026-10-09
73718 HCPCS MRI Ext Lower Lt Non-joint WO,Left 34 14 $3,506.00 $3,506.00 $2,454.20 $3,506.00 $2,524.32 2026-10-09
22901 HCPCS Excision Abdl Tum Deep 5 Cm/> 34 14 $3,149.50 $3,149.50 $1,304.10 $4,436.00 $2,484.10 2026-10-09
73706 HCPCS CT Angio Lower Ext Lt W/WO,Left 34 14 $3,477.00 $3,477.00 $2,262.60 $3,477.00 $2,481.19 2026-10-09
74174 HCPCS CT Angio Abd/pel W 17 14 $3,497.00 $3,497.00 $2,447.90 $3,497.00 $2,475.63 2026-10-09
J1750 HCPCS Infed(iron Dextran 50mg/ml)2g/40 Ml Dose 17 14 $3,460.94 $3,460.94 $2,422.66 $3,460.94 $2,469.73 2026-10-09
J9217 HCPCS Eligard(leuprolide Acetate)3 Mnth 22.5mg 68 14 $3,372.61 $3,372.61 $1,784.91 $6,500.43 $2,459.66 2026-10-09
74182 HCPCS MRI Abdomen With 17 14 $3,425.00 $3,425.00 $2,397.50 $3,425.00 $2,444.08 2026-10-09
49561 HCPCS Rpr Ventral Hern Init Block 35 14 $2,389.00 $2,389.00 $1,548.79 $5,624.00 $2,389.00 2026-10-09
64721 HCPCS Carpal Tunnel 34 14 $3,022.50 $3,022.50 $860.30 $4,816.00 $2,300.10 2026-10-09
Q5101 HCPCS Zarxio (filgtim-sndz)300 Mcg/0.5 Ml Sq 34 14 $2,788.20 $2,788.20 $1,561.39 $3,345.84 $2,286.32 2026-10-09
73222 HCPCS MRI Ext Upper Lt Joint W,Left 34 14 $3,133.00 $3,133.00 $2,193.10 $3,133.00 $2,235.71 2026-10-09
74181 HCPCS MRI Abdomen Without Contrast 17 14 $3,032.00 $3,032.00 $2,122.40 $3,032.00 $2,183.04 2026-10-09
70336 HCPCS MRI Tmj - Temporomandibular Joints 17 14 $3,001.00 $3,001.00 $2,100.70 $3,001.00 $2,141.51 2026-10-09
74178 HCPCS CT Abd/pel W&without Cont 17 14 $2,959.00 $2,959.00 $2,071.30 $2,959.00 $2,130.48 2026-10-09
73721 HCPCS MRI Ext Lower Lt Joint W/O,Left 34 14 $2,990.00 $2,990.00 $1,945.50 $2,990.00 $2,126.49 2026-10-09
70551 HCPCS MRI Brain Without Contrast 17 14 $2,889.00 $2,889.00 $2,022.30 $2,889.00 $2,080.08 2026-10-09
27047 HCPCS Exc Hip/pelvis <3cm 34 14 $2,729.00 $2,729.00 $715.40 $4,436.00 $2,063.60 2026-10-09
43249 HCPCS Esoph Egd Dilation <30mm 59 14 $2,859.00 $2,859.00 $289.80 $3,427.50 $2,058.48 2026-10-09
73221 HCPCS MRI Ext Upper Lt Joint W/O,Left 34 14 $2,914.00 $2,914.00 $2,032.97 $2,914.00 $2,055.12 2026-10-09
72149 HCPCS MRI L Spine W - Lumbar 17 14 $2,826.00 $2,826.00 $1,978.20 $2,826.00 $2,016.63 2026-10-09
73206 HCPCS CT Ang Upper Ext Lt W&without - ANGIO,Left 68 14 $2,708.50 $2,708.50 $1,839.60 $2,789.00 $1,952.30 2026-10-09
72141 HCPCS MRI C Spine Without - Cervical 17 14 $2,776.00 $2,776.00 $1,861.03 $2,776.00 $1,943.20 2026-10-09
J1442 HCPCS Neupogen (filgrastim) 300mcg/ML Vial 34 14 $2,510.09 $2,510.09 $786.65 $3,896.40 $1,925.63 2026-10-09
J0885 HCPCS Procrit 40,000 Units/ml Vial Subcu 17 14 $2,672.50 $2,672.50 $1,870.75 $2,672.50 $1,907.10 2026-10-09
20520 HCPCS Removal Forgein Body 17 14 $2,643.00 $2,643.00 $1,850.10 $2,643.00 $1,886.04 2026-10-09
70498 HCPCS CT Angio Neck W 17 14 $2,572.00 $2,572.00 $1,800.40 $2,525.70 $1,851.84 2026-10-09
23071 HCPCS Exc Shoulder Lesion 3cm> 17 14 $2,566.00 $2,566.00 $1,796.20 $2,566.00 $1,831.10 2026-10-09
27327 HCPCS Excision Thigh/knee <3cm 17 14 $2,566.00 $2,566.00 $1,796.20 $2,566.00 $1,831.10 2026-10-09
21930 HCPCS Excision Back 3cm 17 14 $2,566.00 $2,566.00 $1,796.20 $2,566.00 $1,831.10 2026-10-09
21925 HCPCS Biopsy Soft Tissue Of Neck 17 14 $2,566.00 $2,566.00 $1,796.20 $2,566.00 $1,831.10 2026-10-09
74177 HCPCS CT Abd/pel W Cont 17 14 $2,578.00 $2,578.00 $1,675.33 $2,578.00 $1,824.46 2026-10-09
72146 HCPCS MRI T Spine Without - Thoracic 17 14 $2,513.00 $2,513.00 $1,674.66 $2,467.77 $1,809.36 2026-10-09
72148 HCPCS MRI L Spine Without - Lumbar 17 14 $2,511.00 $2,511.00 $1,757.70 $2,465.80 $1,807.92 2026-10-09
24655 HCPCS Treat Radius Fracture 17 14 $2,524.00 $2,524.00 $1,766.80 $2,524.00 $1,801.13 2026-10-09
73702 HCPCS CT Low Ext Lt W&without CONT,Left 34 14 $2,499.00 $2,499.00 $1,749.30 $2,499.00 $1,783.29 2026-10-09
73202 HCPCS CT Upper Ext Lt W&without CONTRAST,Left 68 14 $2,463.00 $2,463.00 $1,673.00 $2,536.00 $1,775.20 2026-10-09
70482 HCPCS CT Ear/orb/sel W/wo Cont 34 14 $2,381.00 $2,381.00 $1,572.90 $2,515.00 $1,760.50 2026-10-09
88120 HCPCS Urovysion For Detection Of Bladder CANCE,Ref Lab 17 14 $2,443.00 $2,443.00 $1,710.10 $2,443.00 $1,743.32 2026-10-09
72130 HCPCS CT Thoracic Spine W&without 17 14 $2,435.00 $2,435.00 $1,704.50 $2,435.00 $1,737.62 2026-10-09
71275 HCPCS CT Angio Chest W 17 14 $2,468.00 $2,468.00 $1,654.55 $2,468.00 $1,733.98 2026-10-09
70496 HCPCS CT Angio Head W 17 14 $2,403.00 $2,403.00 $1,682.10 $2,359.75 $1,730.16 2026-10-09
46080 HCPCS Inc Anal Sphincter 34 14 $2,376.50 $2,376.50 $305.20 $4,317.00 $1,728.95 2026-10-09
72127 HCPCS CT Cervical Spine W&without 17 14 $2,420.00 $2,420.00 $1,694.00 $2,420.00 $1,726.91 2026-10-09
Q5103 HCPCS Inflectra (infliximab-dyyb) 100 Mg Vial 17 14 $2,416.97 $2,416.97 $1,691.88 $2,416.97 $1,724.75 2026-10-09
74170 HCPCS CT Abd W&without Cont 17 14 $2,411.00 $2,411.00 $1,687.70 $2,411.00 $1,720.49 2026-10-09
72133 HCPCS CT Lumbar Spine W & Without 17 14 $2,409.00 $2,409.00 $1,686.30 $2,409.00 $1,719.06 2026-10-09
71270 HCPCS CT Chest W&without Con 17 14 $2,401.00 $2,401.00 $1,680.70 $2,401.00 $1,713.35 2026-10-09
11624 HCPCS Excision Malignant Lesion 3.1-4.0 17 14 $2,399.00 $2,399.00 $1,679.30 $2,399.00 $1,711.93 2026-10-09
11443 HCPCS Excision Face 2.1-3.0 17 14 $2,399.00 $2,399.00 $1,679.30 $2,399.00 $1,711.93 2026-10-09
70492 HCPCS CT Neck W&without Cont 17 14 $2,394.00 $2,394.00 $1,675.80 $2,394.00 $1,708.36 2026-10-09
23075 HCPCS Excision Shoulder<3cm 34 14 $2,088.50 $2,088.50 $1,127.70 $2,566.00 $1,703.60 2026-10-09
J1745 HCPCS Remicade (infliximab) 100 Mg Vial 17 14 $2,382.36 $2,382.36 $1,667.65 $2,382.36 $1,700.05 2026-10-09
70481 HCPCS CT Ear/orb/sel W Cont 34 14 $2,347.00 $2,347.00 $1,593.90 $2,417.00 $1,691.90 2026-10-09
72194 HCPCS CT Pelvic W&without Contrast 17 14 $2,329.00 $2,329.00 $1,630.30 $2,329.00 $1,661.97 2026-10-09
27618 HCPCS Exc Tumor Leg/ankle >3cm (phy) 34 14 $2,129.50 $2,129.50 $606.20 $3,393.00 $1,620.55 2026-10-09
G0121 HCPCS Colonoscopy (screening) 34 14 $2,090.50 $2,090.50 $177.45 $3,701.00 $1,535.35 2026-10-09
G0105 HCPCS Colonoscopy (screen Hi Risk) 34 14 $2,090.00 $2,090.00 $177.29 $3,701.00 $1,534.85 2026-10-09
J1439 HCPCS Injectafer(ferr Carb)750mg/15ml Im/ivp 17 14 $2,100.00 $2,100.00 $1,470.00 $2,100.00 $1,498.56 2026-10-09
70488 HCPCS CT Face/sin/jaw Wo/w 17 14 $2,033.00 $2,033.00 $1,423.10 $2,033.00 $1,450.75 2026-10-09
70480 HCPCS CT Ear/orb/sel Without Cont 17 14 $1,977.00 $1,977.00 $1,383.90 $1,977.00 $1,410.79 2026-10-09
71260 HCPCS CT Chest W Cont 17 14 $1,951.00 $1,951.00 $1,307.95 $1,951.00 $1,404.72 2026-10-09
72129 HCPCS CT Thoracic Spine W 17 14 $1,966.00 $1,966.00 $1,376.20 $1,966.00 $1,402.94 2026-10-09
72193 HCPCS CT Pelvic W Contrast 17 14 $1,962.00 $1,962.00 $1,373.40 $1,962.00 $1,400.08 2026-10-09
74160 HCPCS CT Abd W/cont 17 14 $1,957.00 $1,957.00 $1,369.90 $1,957.00 $1,396.52 2026-10-09
73701 HCPCS CT Low Ext Lt W CONT,Left 34 14 $1,962.00 $1,962.00 $1,315.32 $1,962.00 $1,395.28 2026-10-09
72126 HCPCS CT Cervical Spine W 17 14 $1,955.00 $1,955.00 $1,368.50 $1,955.00 $1,395.09 2026-10-09
72132 HCPCS CT Lumbar Spine W 17 14 $1,954.00 $1,954.00 $1,367.80 $1,954.00 $1,394.37 2026-10-09
73201 HCPCS CT Upp Ext Lt W CONT,Left 34 14 $1,925.00 $1,925.00 $1,347.50 $1,925.00 $1,373.68 2026-10-09
87632 HCPCS Respiratory Viral Panel 9 By PCR,Ref Lab 17 14 $1,908.50 $1,908.50 $1,335.95 $1,908.50 $1,361.91 2026-10-09
70491 HCPCS CT Neck W Contrast 17 14 $1,937.00 $1,937.00 $1,298.56 $1,937.00 $1,360.56 2026-10-09
21012 HCPCS Exc Face Les Sbq (phy) 34 14 $1,716.00 $1,716.00 $659.40 $2,490.00 $1,342.50 2026-10-09
49560 HCPCS Repair Vental Hernia Reducibl 18 14 $1,898.00 $1,898.00 $1,230.47 $1,898.00 $1,341.51 2026-10-09
32551 HCPCS Chest Tube Insertion (fnp),np Or Pa 34 14 $1,809.00 $1,809.00 $293.30 $3,199.00 $1,329.15 2026-10-09
21555 HCPCS Excision Neck <3cm 34 14 $1,678.00 $1,678.00 $606.20 $2,490.00 $1,304.50 2026-10-09
26160 HCPCS Remove Tendon Sheath Lesion 34 14 $1,657.00 $1,657.00 $625.80 $2,420.00 $1,294.00 2026-10-09
11606 HCPCS Excise Malignant Marg >4cm 34 14 $1,631.00 $1,631.00 $604.10 $2,399.00 $1,271.15 2026-10-09
21931 HCPCS Exc Back Les Sc 3 Cm/> 42 14 $1,317.00 $1,317.00 $827.23 $2,566.00 $1,231.68 2026-10-09
49505 HCPCS Rpr I/hern Init Reduc >5 Yr 59 14 $1,475.00 $1,475.00 $918.97 $5,348.00 $1,230.80 2026-10-09
11644 HCPCS Excision Malignant Marg 3.1-4 Cm 34 14 $1,584.25 $1,584.25 $538.65 $2,399.00 $1,224.40 2026-10-09
J3489 HCPCS Reclast (zoledronic Acid) 5mg/100ml Vial 34 14 $1,460.16 $1,460.16 $802.18 $1,774.36 $1,194.01 2026-10-09
11406 HCPCS Excision B9 >4.0cm 34 14 $1,542.50 $1,542.50 $480.20 $2,399.00 $1,182.65 2026-10-09
26111 HCPCS Exc Hand Lesion 1.5cm> 34 14 $1,559.50 $1,559.50 $371.00 $2,589.00 $1,171.15 2026-10-09
19120 HCPCS Removal Of Breast Lesion 59 14 $1,664.00 $1,664.00 $735.50 $5,051.00 $1,164.80 2026-10-09
70487 HCPCS CT Face/sin/jaw W Cont 17 14 $1,627.00 $1,627.00 $1,138.90 $1,627.00 $1,161.03 2026-10-09
43235 HCPCS Egd Dx Brush Wash 34 14 $1,585.50 $1,585.50 $125.42 $2,839.00 $1,159.65 2026-10-09
36430 HCPCS ER Blood Adm 1 Unit 81 14 $1,649.00 $1,649.00 $771.40 $2,285.00 $1,155.00 2026-10-09
11643 HCPCS Excision Malignant Marg 2 1-3 (phy) 34 14 $1,511.00 $1,511.00 $436.10 $2,399.00 $1,151.15 2026-10-09
70470 HCPCS CT Head W&without Cont 17 14 $1,591.00 $1,591.00 $1,113.70 $1,591.00 $1,135.34 2026-10-09
Q5110 HCPCS Nivestym 300mcg/0.5ml Vial 17 14 $1,580.28 $1,580.28 $1,106.20 $1,580.28 $1,127.69 2026-10-09
11623 HCPCS Exc Malignant Lesion 2.1-3.0cm (phy) 34 14 $1,485.50 $1,485.50 $400.40 $2,399.00 $1,125.65 2026-10-09
45384 HCPCS Colonoscopy/lesion Remove Hot Snare(phy) 51 14 $1,566.50 $1,566.50 $416.50 $3,701.00 $1,117.85 2026-10-09
72125 HCPCS CT Cervical Spine Without 17 14 $1,534.00 $1,534.00 $1,073.80 $1,534.00 $1,114.96 2026-10-09
72128 HCPCS CT Thoracic Spine Without 17 14 $1,527.00 $1,527.00 $1,023.70 $1,527.00 $1,099.44 2026-10-09
72131 HCPCS CT Lumbar Spine Without 17 14 $1,519.00 $1,519.00 $1,063.30 $1,519.00 $1,093.68 2026-10-09
71250 HCPCS CT Chest Without Cont 17 14 $1,510.00 $1,510.00 $1,057.00 $1,510.00 $1,087.20 2026-10-09
73200 HCPCS CT Upp Ext Lt Without CONT,Left 34 14 $1,514.00 $1,514.00 $1,059.80 $1,514.00 $1,085.24 2026-10-09
73700 HCPCS CT Low Ext Lt Without CONT,Left 34 14 $1,519.00 $1,519.00 $1,018.34 $1,519.00 $1,075.35 2026-10-09
70490 HCPCS CT Neck Without Contrast 17 14 $1,503.00 $1,503.00 $1,052.10 $1,503.00 $1,072.54 2026-10-09
11404 HCPCS Excision 3.1-4.0 Cm (fnp),np Or Pa 34 14 $1,428.00 $1,428.00 $319.90 $2,399.00 $1,068.15 2026-10-09
66821 HCPCS Yag Lazer 17 14 $1,494.00 $1,494.00 $1,045.80 $1,494.00 $1,066.12 2026-10-09
24071 HCPCS Exc Arm/elbow Les Sc 3cm/> 42 14 $1,137.50 $1,137.50 $715.72 $4,436.00 $1,064.71 2026-10-09
49587 HCPCS Repair Umbilical Hernia Block 52 14 $1,275.00 $1,275.00 $797.41 $5,624.00 $1,064.62 2026-10-09
87154 HCPCS Blood Culture Id By Pcr 17 14 $1,472.00 $1,472.00 $1,030.40 $1,472.00 $1,059.84 2026-10-09
11423 HCPCS Excision Hand Face 2.1-3.0 Cm (phy) 34 14 $1,418.00 $1,418.00 $305.90 $2,399.00 $1,058.15 2026-10-09
Q5104 HCPCS Renflexis (infliximab-abda) 100 Mg Vial 17 14 $1,468.76 $1,468.76 $1,028.13 $1,468.76 $1,048.11 2026-10-09
45385 HCPCS Colonoscopy W Lesion Removal 59 14 $1,452.00 $1,452.00 $259.45 $3,701.00 $1,036.15 2026-10-09
11422 HCPCS Excision 1.1-2.0cm 34 14 $1,388.00 $1,388.00 $132.94 $2,399.00 $1,028.15 2026-10-09
31500 HCPCS Endotracheal Intubation (fnp),np Or Pa 34 14 $1,377.50 $1,377.50 $270.20 $2,369.00 $1,022.15 2026-10-09
74176 HCPCS CT Abd/pel Without Contrast 17 14 $1,361.00 $1,361.00 $952.70 $1,336.50 $963.27 2026-10-09
70486 HCPCS CT Face/sin/jaw Without 17 14 $1,328.00 $1,328.00 $929.60 $1,328.00 $956.16 2026-10-09
99999 HCPCS Cataract 51 14 $1,320.00 $1,320.00 $317.80 $4,532.00 $941.95 2026-10-09
64450 HCPCS Nerve Block Other Peripheral 17 14 $1,317.00 $1,317.00 $921.90 $1,317.00 $939.81 2026-10-09
72192 HCPCS CT Pelvic Without Cont 17 14 $1,298.00 $1,298.00 $908.60 $1,298.00 $934.56 2026-10-09
70460 HCPCS CT Head W Cont 17 14 $1,274.00 $1,274.00 $891.80 $1,274.00 $909.13 2026-10-09
45380 HCPCS Colonoscopy And Biopsy 76 14 $1,164.00 $1,164.00 $379.40 $2,726.00 $906.77 2026-10-09
93970 HCPCS US Venous Dopp Bilat - Doppler Ven 17 14 $1,269.00 $1,269.00 $850.74 $1,269.00 $905.56 2026-10-09
55250 HCPCS Removal Of Sperm Ducts 42 14 $1,006.50 $1,006.50 $586.06 $3,214.00 $904.92 2026-10-09
74150 HCPCS CT Abd Without Cont 17 14 $1,258.00 $1,258.00 $877.89 $1,258.00 $880.60 2026-10-09
93306 HCPCS US Echocardiogram 17 14 $1,230.00 $1,230.00 $824.59 $1,230.00 $864.09 2026-10-09
23655 HCPCS Reduction Of Dislocation (fnp),np Or Pa 17 14 $1,209.00 $1,209.00 $846.30 $1,209.00 $862.74 2026-10-09
92950 HCPCS Cpr 34 14 $1,118.50 $1,118.50 $346.50 $1,742.00 $857.20 2026-10-09
43239 HCPCS Egd Biopsy Single/multiple 59 14 $1,216.00 $1,216.00 $130.24 $5,210.75 $851.20 2026-10-09
93880 HCPCS US Carotid Duplex Bilateral 17 14 $1,210.00 $1,210.00 $811.18 $1,210.00 $847.00 2026-10-09
24600 HCPCS Elbow Dislocation 42 14 $1,055.50 $1,055.50 $303.10 $1,384.00 $828.57 2026-10-09
43245 HCPCS Egd Dialate Stricture (phy) 34 14 $1,112.00 $1,112.00 $225.40 $1,902.00 $826.70 2026-10-09
25600 HCPCS Distal Radial Fracture 25 14 $1,119.00 $1,119.00 $618.15 $1,119.00 $798.52 2026-10-09
G0379 HCPCS Direct Admit 17 14 $1,101.00 $1,101.00 $770.70 $1,101.00 $792.72 2026-10-09
46221 HCPCS Ligation Of Hemorrhoid 34 14 $1,004.50 $1,004.50 $401.10 $1,436.00 $789.10 2026-10-09
45378 HCPCS Diagnostic Colonoscopy 59 14 $1,098.00 $1,098.00 $187.86 $3,357.00 $776.05 2026-10-09
70450 HCPCS CT Head Without Cont 17 14 $1,045.00 $1,045.00 $731.50 $1,045.00 $739.41 2026-10-09
11600 HCPCS Excision Extr Malig +marg 0.5cm 17 14 $1,012.00 $1,012.00 $708.40 $1,012.00 $722.16 2026-10-09
10080 HCPCS I & D Of Pilonidal Cyst 42 14 $782.50 $782.50 $437.93 $1,028.00 $689.88 2026-10-09
P9016 HCPCS Leukocyte Poor Blood 17 14 $930.00 $930.00 $651.00 $930.00 $669.60 2026-10-09
12020 HCPCS Repair Wound Dehiscence 25 14 $919.50 $919.50 $524.47 $919.50 $656.16 2026-10-09
87153 HCPCS Dna/rna SEQUENCING,Ref Lab 17 14 $916.00 $916.00 $641.20 $916.00 $653.66 2026-10-09
11604 HCPCS Excision Extr 3.-cm (phy) 34 14 $797.00 $797.00 $407.40 $1,012.00 $645.20 2026-10-09
13121 HCPCS Complex Repair 2.5-5.0cm 17 14 $870.00 $870.00 $609.00 $870.00 $620.83 2026-10-09
J0878 HCPCS Cubicin (daptomycin) 500 Mg Im/ivp Only 17 14 $869.15 $869.15 $608.40 $869.15 $620.23 2026-10-09
26755 HCPCS Finger Fracture Reduction (fnp),np Or Pa 17 14 $869.00 $869.00 $608.30 $869.00 $620.12 2026-10-09
93971 HCPCS US Venous Dopp Lt Unilat - DOPPLER,Left 34 14 $839.00 $839.00 $562.47 $839.00 $598.71 2026-10-09
11603 HCPCS Excise Malignant Marg 2.1-3cm 34 14 $743.50 $743.50 $332.50 $1,012.00 $591.70 2026-10-09
11622 HCPCS Excision 0.6-1.0 34 14 $737.50 $737.50 $324.10 $1,012.00 $585.70 2026-10-09
99291 HCPCS Critical Care Eval 30-74 Min 76 14 $733.00 $733.00 $250.00 $2,791.00 $579.00 2026-10-09
G0390 HCPCS ER Level V Trauma Activiation 17 14 $810.00 $810.00 $567.00 $810.00 $578.02 2026-10-09
43762 HCPCS Replacement Of G-tube 17 14 $790.50 $790.50 $553.35 $790.50 $564.10 2026-10-09
74270 HCPCS Xr Colon 17 14 $785.00 $785.00 $549.50 $785.00 $560.18 2026-10-09
11601 HCPCS Excision Malignant +marg 1.2cm 34 14 $709.00 $709.00 $284.90 $1,011.00 $557.35 2026-10-09
0360 RC — 17 14 $777.74 $777.74 $544.42 $777.74 $555.00 2026-10-09
12016 HCPCS Repair Laceration > 12.6 Cm 25 14 $777.00 $777.00 $382.17 $777.00 $543.90 2026-10-09
11640 HCPCS Excision .5cm 34 14 $680.00 $680.00 $243.60 $1,012.00 $528.20 2026-10-09
90677 HCPCS Cln - Prevnar 20 32 14 $386.00 $386.00 $270.20 $917.98 $514.30 2026-10-09
71271 HCPCS CT Low Dose Chest Without Screening 17 14 $710.00 $710.00 $497.00 $697.22 $511.20 2026-10-09
56405 HCPCS I&d Of Vulva/perineum 17 14 $703.00 $703.00 $492.10 $703.00 $501.66 2026-10-09
M0247 HCPCS Infusion Of Sotrovimab 500mg 17 14 $700.00 $700.00 $490.00 $700.00 $499.52 2026-10-09
M0243 HCPCS Infusion Of Casirivimab/imdevimab 17 14 $700.00 $700.00 $490.00 $700.00 $499.52 2026-10-09
11760 HCPCS Repair/excision Nail Bed 42 14 $542.00 $542.00 $323.18 $870.00 $493.15 2026-10-09
45307 HCPCS Proctoscope Foreign Body 25 14 $686.50 $686.50 $372.45 $686.50 $488.32 2026-10-09
81256 HCPCS Hemochromatosis(hfe) MUTATION,HEREDITARY,Ref Lab 17 14 $674.00 $674.00 $471.80 $674.00 $480.97 2026-10-09
12034 HCPCS Repair Laceration 76 14 $568.00 $568.00 $385.70 $972.00 $480.25 2026-10-09
12042 HCPCS Layer Closure/neck/hands Etc 76 14 $568.00 $568.00 $375.90 $885.50 $475.58 2026-10-09
86870 HCPCS Antibody ID,Ref Lab 17 14 $658.50 $658.50 $460.95 $658.50 $469.91 2026-10-09
77066 HCPCS Ma Bilat Diagnostic 17 14 $655.00 $655.00 $458.50 $655.00 $467.41 2026-10-09
74230 HCPCS Pt Speech Swallow Barrium (mbs) Eval 17 14 $640.00 $640.00 $448.00 $640.00 $456.70 2026-10-09
76536 HCPCS US Thyroid B-scan/head 17 14 $623.00 $623.00 $436.10 $611.79 $448.56 2026-10-09
12051 HCPCS Layer Closure Up To 2.5 Cm 76 14 $568.00 $568.00 $324.10 $821.50 $447.60 2026-10-09
76700 HCPCS US Abd Complete - Abdominal 17 14 $634.00 $634.00 $425.03 $622.59 $445.07 2026-10-09
76830 HCPCS US Pelvis Eval Transvaginal 17 14 $618.00 $618.00 $432.60 $618.00 $444.96 2026-10-09
12052 HCPCS Intermediate Repair 93 14 $551.00 $551.00 $382.90 $906.00 $440.80 2026-10-09
43233 HCPCS Egd Balloon Dilation Esophagus 17 14 $616.50 $616.50 $431.55 $616.50 $439.93 2026-10-09
76770 HCPCS US Renal/aorta/nodes 17 14 $622.00 $622.00 $435.40 $622.00 $439.71 2026-10-09
81515 HCPCS Multiplex Vaginal Panel By Pcr(vag PATH),Ref Lab 17 14 $610.00 $610.00 $427.00 $610.00 $439.20 2026-10-09
99345 HCPCS Home Visit-new Patient 25 14 $610.00 $610.00 $349.11 $610.00 $435.30 2026-10-09
80307 HCPCS Drug Screen With Rflx To Quant, S/P,Ref Lab 17 14 $616.50 $616.50 $398.84 $616.50 $431.55 2026-10-09
80428 HCPCS Growth Hormone Stimulation Panel 17 14 $597.50 $597.50 $418.25 $597.50 $426.38 2026-10-09
11642 HCPCS Excision 1-1.2cm 51 14 $500.00 $500.00 $189.58 $1,012.00 $425.00 2026-10-09
12044 HCPCS Layered Closure (fnp),np Or Pa 17 14 $589.50 $589.50 $412.65 $589.50 $420.67 2026-10-09
12007 HCPCS Repair Trunk>30.0cm 34 14 $531.00 $531.00 $223.30 $743.00 $419.55 2026-10-09
76881 HCPCS US Ext Nonvas Complete 17 14 $588.00 $588.00 $409.83 $588.00 $411.60 2026-10-09
45305 HCPCS Procto With Biopsy 25 14 $576.00 $576.00 $316.05 $576.00 $411.03 2026-10-09
90792 HCPCS Psych Diag Eval W/med Srvcs 25 14 $587.00 $587.00 $268.57 $587.00 $410.90 2026-10-09
16030 HCPCS Burn Care Initail Tx Lg 17 14 $574.00 $574.00 $401.80 $574.00 $409.61 2026-10-09
12041 HCPCS Intermediate Repair 76 14 $568.00 $568.00 $263.20 $763.50 $408.96 2026-10-09
12032 HCPCS Intermediate Repair 93 14 $551.00 $551.00 $335.30 $871.00 $408.96 2026-10-09
12017 HCPCS Repair Fe/e/en/l/m 20.1-30.0 Cm 42 14 $448.00 $448.00 $267.10 $598.00 $407.60 2026-10-09
90376 HCPCS Cln - Imovax Rabies Vacc 1 Ml Vial 17 14 $570.00 $570.00 $399.00 $570.00 $406.75 2026-10-09
11403 HCPCS Lesion Excision 2-3 Cm 76 14 $536.00 $536.00 $290.50 $1,012.00 $406.00 2026-10-09
12005 HCPCS Laceration Repair 12.5- 20 Cm 59 14 $568.00 $568.00 $182.70 $613.00 $405.32 2026-10-09
0120 RC — 351 8 $507.45 $507.45 $207.54 $4,765.90 $400.66 2026-10-09
99205 HCPCS Office O/p New Hi 60 Minutes 17 14 $561.00 $561.00 $392.70 $561.00 $400.33 2026-10-09
99306 HCPCS Swing Bed Admit High Care 17 14 $560.50 $560.50 $392.35 $560.50 $399.97 2026-10-09
99350 HCPCS Home Visit-estab Patient 25 14 $560.50 $560.50 $320.58 $560.50 $399.97 2026-10-09
99236 HCPCS Hospital Care-high 59 14 $560.00 $560.00 $182.04 $561.00 $398.88 2026-10-09
81241 HCPCS Factor V Leiden (f5) R506q MUT,Ref Lab 17 14 $558.00 $558.00 $390.60 $558.00 $398.19 2026-10-09
12053 HCPCS Repair Of Face 5.1-7.5 Cm 34 14 $559.50 $559.50 $385.70 $568.00 $397.60 2026-10-09
12031 HCPCS Layer Closure Up To 2.5 Cm 93 14 $551.00 $551.00 $270.90 $754.50 $397.60 2026-10-09
99245 HCPCS Consulation Op-level 5 18 14 $561.00 $561.00 $363.70 $561.00 $396.51 2026-10-09
76801 HCPCS US Obstetrica Fetal Eval 17 14 $555.00 $555.00 $388.50 $555.00 $396.05 2026-10-09
77067 HCPCS Ma Mammo Bilat Screening 34 14 $541.00 $541.00 $87.65 $541.00 $389.52 2026-10-09
11750 HCPCS Excision Of Nail 76 14 $458.00 $458.00 $195.30 $568.00 $385.70 2026-10-09
96373 HCPCS Intra Arterial Infusion 17 14 $540.00 $540.00 $378.00 $540.00 $385.34 2026-10-09
76775 HCPCS US Aorta 17 14 $537.00 $537.00 $375.90 $537.00 $383.20 2026-10-09
76870 HCPCS US Scrotum 17 14 $543.00 $543.00 $378.92 $543.00 $380.10 2026-10-09
76856 HCPCS US Pelvic Complete 17 14 $537.00 $537.00 $374.59 $537.00 $379.91 2026-10-09
82542 HCPCS Thiopurine METABOLITES,Ref Lab 17 14 $529.00 $529.00 $370.30 $529.00 $377.49 2026-10-09
84445 HCPCS Thyroid Stimulating IMMUNOGLOBULIN,Ref Lab 33 14 $456.00 $456.00 $303.88 $523.50 $366.45 2026-10-09
96374 HCPCS ER Ivp Infusion 20 14 $508.00 $508.00 $355.60 $508.00 $365.76 2026-10-09
96360 HCPCS ER IV Hydration 1st Hr 20 14 $508.00 $508.00 $355.60 $508.00 $365.76 2026-10-09
96365 HCPCS ER IV Therapy 1st Hr 21 14 $508.00 $508.00 $355.60 $508.00 $365.76 2026-10-09
77065 HCPCS Ma Uni Diag Lt Dig W/cad - MAMMO,Left 34 14 $511.00 $511.00 $357.70 $511.00 $364.65 2026-10-09
J1610 HCPCS Glucagon Kit 1 Mg Vial Sq 17 14 $508.64 $508.64 $356.05 $508.64 $362.97 2026-10-09
11641 HCPCS Excision Malignant+ Margin 0.6-1 Cm 51 14 $427.00 $427.00 $298.90 $1,012.00 $362.95 2026-10-09
G0402 HCPCS Welcome To Medicare 25 14 $507.00 $507.00 $289.47 $507.00 $361.80 2026-10-09
G0438 HCPCS Annual Wellness Exam 25 14 $506.50 $506.50 $288.82 $506.50 $361.44 2026-10-09
10140 HCPCS I & D Fluid 25 14 $506.50 $506.50 $297.57 $506.50 $361.44 2026-10-09
99285 HCPCS ER Significant THREAT,same Day As Other Service 85 14 $498.00 $498.00 $151.81 $1,548.61 $358.56 2026-10-09
76641 HCPCS US B-scan Lt Complete - Breast SCAN,Left 34 14 $502.00 $502.00 $351.40 $502.00 $358.23 2026-10-09
99255 HCPCS Inpatient Consultation 18 14 $501.00 $501.00 $324.80 $501.00 $354.11 2026-10-09
87522 HCPCS Hcv RNA Quant 33 14 $505.50 $505.50 $42.84 $505.50 $353.85 2026-10-09
11441 HCPCS Lesion Excision 0.5-1.0 Cm 76 14 $471.50 $471.50 $109.05 $1,891.87 $353.15 2026-10-09
99387 HCPCS Prev Med New Pt; 65+ 25 14 $490.00 $490.00 $281.04 $490.00 $349.66 2026-10-09
77080 HCPCS Bd Bone Density 17 14 $497.00 $497.00 $347.90 $497.00 $349.55 2026-10-09
83883 HCPCS Retinol-binding Proteinurinerandom 17 14 $489.50 $489.50 $342.65 $489.50 $349.31 2026-10-09
11442 HCPCS Exc Face 1.1-2cm (fnp),np Or Pa 51 14 $406.00 $406.00 $155.33 $1,012.00 $345.10 2026-10-09
76705 HCPCS US Abd Limited - Abdominal 17 14 $488.00 $488.00 $327.16 $488.00 $341.60 2026-10-09
11402 HCPCS Lesion Excision 1.0-2.0 Cm 76 14 $465.00 $465.00 $92.67 $1,012.00 $341.18 2026-10-09
11602 HCPCS Excision Mal 1.1-2.0 Cm 51 14 $397.00 $397.00 $123.64 $551.00 $337.45 2026-10-09
99220 HCPCS Outpt Observation High 52 14 $480.00 $480.00 $298.22 $480.00 $336.00 2026-10-09
77075 HCPCS Bone Survey Complete 17 14 $466.00 $466.00 $326.20 $466.00 $332.54 2026-10-09
99310 HCPCS Nursing Facility Subs Care - High 17 14 $474.50 $474.50 $269.61 $474.50 $332.15 2026-10-09
97162 HCPCS Pt Eval Moderate Complex 30 Min,physical Therapist Service 17 14 $465.00 $465.00 $325.50 $465.00 $331.82 2026-10-09
99223 HCPCS Admission-hc 59 14 $454.00 $454.00 $152.49 $469.00 $326.88 2026-10-09
10120 HCPCS Removal Foreign Body 93 14 $457.00 $457.00 $207.90 $568.00 $326.12 2026-10-09
99244 HCPCS Consulation Op-level 4 18 14 $460.50 $460.50 $298.54 $460.50 $325.48 2026-10-09
87799 HCPCS Bk Virus Quantitative Naat, PLASMA,Ref Lab 17 14 $456.00 $456.00 $319.20 $456.00 $325.40 2026-10-09
76857 HCPCS US Pelvic Limited 17 14 $453.00 $453.00 $317.10 $453.00 $323.26 2026-10-09
99386 HCPCS Prev Med Visit New Pt 40-64 Yr 25 14 $452.00 $452.00 $259.00 $452.00 $322.55 2026-10-09
M0239 HCPCS Infusion Of Bamlanivimab 17 14 $450.00 $450.00 $315.00 $450.00 $321.12 2026-10-09
29355 HCPCS Long Leg Casting Walker 25 14 $449.00 $449.00 $251.54 $449.00 $320.41 2026-10-09
99215 HCPCS Office O/p Est Hi 40-54 Min 25 14 $456.00 $456.00 $214.74 $456.00 $319.20 2026-10-09
87497 HCPCS Cytomegalovirus By Quantitative NAAT,Ref Lab 17 14 $441.50 $441.50 $294.22 $441.50 $315.05 2026-10-09
11401 HCPCS Lesion Excision 0.5-1.0 Cm 93 14 $450.00 $450.00 $50.58 $29,000.00 $315.00 2026-10-09
97161 HCPCS Pt Evaluation,physical Therapist Service 28 14 $429.00 $429.00 $300.30 $442.00 $313.82 2026-10-09
27824 HCPCS Lower Leg Fracture Tx 17 14 $434.00 $434.00 $303.80 $434.00 $309.70 2026-10-09
29345 HCPCS Long Leg Cast 25 14 $432.50 $432.50 $239.87 $432.50 $308.63 2026-10-09
Q0138 HCPCS Feraheme 510 Mg In 17 Ml Vial Only 17 14 $440.40 $440.40 $0.62 $440.40 $308.28 2026-10-09
43753 HCPCS Gastric Intubation 34 14 $379.50 $379.50 $179.20 $503.00 $304.05 2026-10-09
12014 HCPCS Laceration Repair 5.0- 7.5 Cm 42 14 $385.50 $385.50 $146.30 $500.50 $302.62 2026-10-09
69100 HCPCS Biopsy External Ear 34 14 $373.75 $373.75 $187.95 $479.00 $301.90 2026-10-09
99235 HCPCS Observation Care Sameday Com 59 14 $416.00 $416.00 $274.88 $429.00 $300.30 2026-10-09
99204 HCPCS Office Visit-new Patient 25 14 $420.00 $420.00 $198.89 $420.00 $299.71 2026-10-09
54056 HCPCS Cyrotherapy Lesions 25 14 $418.00 $418.00 $254.46 $418.00 $298.28 2026-10-09
77076 HCPCS Bone Survey Infant 17 14 $417.00 $417.00 $291.90 $417.00 $297.57 2026-10-09
90675 HCPCS Rabies Vaccine Intradermal US 25 14 $410.50 $410.50 $272.29 $420.00 $295.56 2026-10-09
92610 HCPCS Pt Speech Swallow Eval,pt Thru Telehealth 17 14 $413.00 $413.00 $289.10 $413.00 $294.72 2026-10-09
99254 HCPCS Ip Consulation 18 14 $415.50 $415.50 $269.37 $415.50 $293.68 2026-10-09
90670 HCPCS Cln - Prevnar 13 35 14 $292.00 $292.00 $189.30 $587.48 $292.00 2026-10-09
11303 HCPCS Skin Lesion >2.0cm 34 14 $373.00 $373.00 $136.50 $551.00 $290.35 2026-10-09
76817 HCPCS US OB Eval Transvaginal 17 14 $406.00 $406.00 $284.20 $406.00 $289.72 2026-10-09
20610 HCPCS Joint Injection/ Aspiration 93 14 $412.00 $412.00 $86.45 $519.00 $288.40 2026-10-09
G0439 HCPCS Annual Wellness Subsequent 25 14 $400.00 $400.00 $227.23 $400.00 $288.00 2026-10-09
99397 HCPCS Prev Med Eval > 65 Yr 25 14 $403.50 $403.50 $250.25 $403.50 $287.94 2026-10-09
99384 HCPCS Prev Med Adolescent 12-17 25 14 $402.50 $402.50 $231.12 $402.50 $287.22 2026-10-09
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