Hospital

CHOCTAW MEMORIAL HOSPITAL

Hugo, OK · CCN 370100 · Rates published

1,506 distinct procedures filed

5 distinct payers

17,463 rate rows

2026-04-01 last MRF observed

Data quality

12,801 of 17,463 rate rows are consumer-grade (73.3%)

4,662 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	4,372
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	278
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	8
exceeds 10× this hospital's gross charge — excluded from medians	4

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

Source MRF file	https://choctawmemorial.com/wp-content/uploads/2026/04/736060815_choctaw-county-city-of-hugo-hospital-trust-authority-_standardcharges.csv
Found on page	https://choctawmemorial.com/financial/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-09-21
Content fingerprint	627a3a79fc6a3e9c… · 164,286 bytes · first seen 2026-05-09

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
314 MS_DRG	Other Circulatory System Diagnoses With Mcc	2	$2,945.00	$4,415.00	$4,415.00	nat. median $15,450 outlier · 0.3×
315 MS_DRG	Other Circulatory System Diagnoses With Cc	2	$2,540.00	$3,605.00	$3,605.00	nat. median $7,244 outlier · 0.5×
391 MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Dis	2	$2,496.50	$3,518.00	$3,518.00	nat. median $9,511 outlier · 0.4×
813 MS_DRG	Coagulation Disorders	3	$1,475.00	$5,204.00	$3,339.50	nat. median $11,108 outlier · 0.3×
190 MS_DRG	Blood Bank Forms	3	$1,475.00	$4,900.00	$3,284.00	nat. median $8,303 outlier · 0.4×
394 MS_DRG	Other Diestive System Diagnoses With Mcc	2	$2,332.50	$3,190.00	$3,190.00	nat. median $7,016 outlier · 0.5×
840 MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	3	$1,475.00	$4,760.00	$3,117.50	nat. median $22,339 outlier · 0.1×
313 MS_DRG	Chest Pain	3	$1,475.00	$4,224.00	$2,849.50	nat. median $5,565 0.5× median
595 MS_DRG	Major Skin Disorers With Mcc	3	$1,475.00	$4,169.00	$2,822.00	nat. median $14,481 outlier · 0.2×
640 MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And	3	$1,475.00	$3,846.00	$2,660.50	nat. median $9,697 outlier · 0.3×
637 MS_DRG	Diabetes With Mcc	3	$1,475.00	$3,802.00	$2,638.50	nat. median $10,515 outlier · 0.3×
204 MS_DRG	Respiratory Signs And Symptoms	3	$1,475.00	$3,770.00	$2,622.50	nat. median $6,018 outlier · 0.4×
896 MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation The	3	$1,475.00	$3,689.00	$2,582.00	nat. median $9,938 outlier · 0.3×
206 MS_DRG	Other Resiratory System Diagnoses Without Mcc	3	$1,475.00	$3,688.00	$2,581.50	nat. median $6,811 outlier · 0.4×
562 MS_DRG	Fracture, Sprain, Strain And Dislocation Except Femur Hip	3	$1,475.00	$3,649.00	$2,562.00	nat. median $10,412 outlier · 0.2×
947 MS_DRG	Signs And Symptoms With Mcc	3	$1,475.00	$3,630.00	$2,552.50	nat. median $8,698 outlier · 0.3×
149 MS_DRG	Dysequilibrium	3	$1,475.00	$3,630.00	$2,552.50	nat. median $5,582 outlier · 0.5×
312 MS_DRG	Syncope And Collapse	3	$1,475.00	$3,592.00	$2,533.50	nat. median $6,528 outlier · 0.4×
308 MS_DRG	Cardiac Arrhythmia And Conduction Disorders With Mcc	3	$1,475.00	$3,573.00	$2,524.00	nat. median $8,963 outlier · 0.3×
305 MS_DRG	Hypertension Without Mcc	3	$1,475.00	$3,565.00	$2,520.00	nat. median $5,752 outlier · 0.4×
291 MS_DRG	Heart Failure And Shock With Mcc	3	$1,475.00	$3,550.00	$2,512.50	nat. median $9,572 outlier · 0.3×
918 MS_DRG	Poisoning And Toxic Effects Of Drugs Without Mcc	3	$1,475.00	$3,530.00	$2,502.50	nat. median $5,899 outlier · 0.4×
177 MS_DRG	Respiratory Infections And Inflammations With Mcc	3	$1,475.00	$3,515.00	$2,495.00	nat. median $11,701 outlier · 0.2×
812 MS_DRG	Red Blood Cell Disorders Without Mcc	3	$1,475.00	$3,413.00	$2,444.00	nat. median $6,771 outlier · 0.4×
687 MS_DRG	Kidney And Urinary Tract Neoplasms With Cc	3	$1,475.00	$3,398.00	$2,436.50	nat. median $7,501 outlier · 0.3×
605 MS_DRG	Trauma To The Skin, Subcutaneous Tissue And Breast Without M	3	$1,475.00	$3,391.00	$2,433.00	nat. median $6,761 outlier · 0.4×
378 MS_DRG	Gastroinestinal Hemorrhage With Cc	3	$1,475.00	$3,388.00	$2,431.50	nat. median $7,364 outlier · 0.3×
159 MS_DRG	Dental And Oral Diseases Without Cc/mcc	3	$1,475.00	$3,313.00	$2,394.00	nat. median $5,008 outlier · 0.5×
193 MS_DRG	Simple Pneumonia And Pleurisy With Mcc	3	$1,475.00	$3,303.00	$2,389.00	nat. median $9,802 outlier · 0.2×
155 MS_DRG	Other Ear, Nose, Mouth And Throat Diagnoses With Cc	3	$1,475.00	$3,238.00	$2,356.50	nat. median $6,927 outlier · 0.3×
699 MS_DRG	Other Kidnwy And Urinary Tract Diagnoses With Cc	3	$1,475.00	$3,237.00	$2,356.00	nat. median $7,611 outlier · 0.3×
191 MS_DRG	Chronic Obstructive Pulmonary Disease With Cc	3	$1,475.00	$3,205.00	$2,340.00	nat. median $6,349 outlier · 0.4×
310 MS_DRG	Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc	3	$1,475.00	$3,205.00	$2,340.00	nat. median $4,383 0.5× median
203 MS_DRG	Bronchitis And Asthma Without Cc/mcc	3	$1,475.00	$3,182.00	$2,328.50	nat. median $5,105 outlier · 0.5×
884 MS_DRG	Organic Disturbances And Intellectual Disability	3	$1,475.00	$3,181.00	$2,328.00	nat. median $7,732 outlier · 0.3×
638 MS_DRG	Diabetes With Cc	3	$1,475.00	$3,177.00	$2,326.00	nat. median $6,741 outlier · 0.3×
816 MS_DRG	Reticuloendothelial & Immunity Disorders Without Cc/mcc	3	$1,475.00	$3,167.00	$2,321.00	nat. median $4,806 outlier · 0.5×
556 MS_DRG	Signs And Symptoms Of Musculoskeletal System And Connective	3	$1,475.00	$3,123.00	$2,299.00	nat. median $6,105 outlier · 0.4×
178 MS_DRG	Respiratory Infections And Inflammations With Cc	3	$1,475.00	$3,116.00	$2,295.50	nat. median $7,418 outlier · 0.3×
641 MS_DRG	Miscellaneous Disorders Of Nutrition, Metablosim, Fluids And	3	$1,475.00	$3,106.00	$2,290.50	nat. median $5,850 outlier · 0.4×
948 MS_DRG	Signs And Symptoms Without Mcc	3	$1,475.00	$3,097.00	$2,286.00	nat. median $5,562 outlier · 0.4×
683 MS_DRG	Renal Failure With Cc	3	$1,475.00	$3,048.00	$2,261.50	nat. median $6,692 outlier · 0.3×
392 MS_DRG	Esophagitis, Gastroenteritis And Misc Digestive Dis	3	$1,475.00	$3,044.00	$2,259.50	nat. median $5,890 outlier · 0.4×
863 MS_DRG	Postoperative And Post-traumatic Infections Without Mcc	3	$1,475.00	$3,028.00	$2,251.50	nat. median $7,491 outlier · 0.3×
49205 HCPCS	Excision Endometrioma >10.0cm	5	$2,235.54	$2,235.54	$2,235.54	nat. median $5,477 outlier · 0.4×
689 MS_DRG	Kidney And Urinary Tract Infections With Mcc	3	$1,475.00	$2,996.00	$2,235.50	nat. median $8,710 outlier · 0.3×
563 MS_DRG	Fracture, Sprain, Strain And Dislocation Except Femur, Hip	3	$1,475.00	$2,971.00	$2,223.00	nat. median $6,710 outlier · 0.3×
194 MS_DRG	Simple Pneumonia And Pleurisy With Cc	3	$1,475.00	$2,971.00	$2,223.00	nat. median $6,156 outlier · 0.4×
292 MS_DRG	Heart Failure And Shock With Cc	3	$1,475.00	$2,965.00	$2,220.00	nat. median $6,415 outlier · 0.3×
179 MS_DRG	Respiratory Infectins And Inflammations Without Cc/mcc	3	$1,475.00	$2,961.00	$2,218.00	nat. median $5,691 outlier · 0.4×

Other procedures at this hospital

Browse this hospital's 1,506 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

314	MS_DRG	Other Circulatory System Diagnoses With Mcc	3	2	$11,348.61	$5,674.31 50% off	$2,945.00	$4,415.00	$4,415.00	2026-04-01
315	MS_DRG	Other Circulatory System Diagnoses With Cc	3	2	$7,791.23	$3,895.62 50% off	$2,540.00	$3,605.00	$3,605.00	2026-04-01
391	MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Dis	3	2	$7,893.45	$3,946.73 50% off	$2,496.50	$3,518.00	$3,518.00	2026-04-01
813	MS_DRG	Coagulation Disorders	5	3	$12,224.13	$6,112.07 50% off	$1,475.00	$5,204.00	$3,339.50	2026-04-01
190	MS_DRG	Blood Bank Forms	6	3	$8,028.03	$4,014.02 50% off	$1,475.00	$4,900.00	$3,284.00	2026-04-01
394	MS_DRG	Other Diestive System Diagnoses With Mcc	3	2	$7,601.76	$3,800.88 50% off	$2,332.50	$3,190.00	$3,190.00	2026-04-01
840	MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	5	3	$21,851.07	$10,925.54 50% off	$1,475.00	$4,760.00	$3,117.50	2026-04-01
313	MS_DRG	Chest Pain	5	3	$5,970.07	$2,985.04 50% off	$1,475.00	$4,224.00	$2,849.50	2026-04-01
595	MS_DRG	Major Skin Disorers With Mcc	5	3	$14,938.20	$7,469.10 50% off	$1,475.00	$4,169.00	$2,822.00	2026-04-01
640	MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And	5	3	$8,428.53	$4,214.27 50% off	$1,475.00	$3,846.00	$2,660.50	2026-04-01
637	MS_DRG	Diabetes With Mcc	5	3	$5,798.41	$2,899.21 50% off	$1,475.00	$3,802.00	$2,638.50	2026-04-01
204	MS_DRG	Respiratory Signs And Symptoms	5	3	$7,262.53	$3,631.27 50% off	$1,475.00	$3,770.00	$2,622.50	2026-04-01
896	MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation The	5	3	$2,906.78	$1,453.39 50% off	$1,475.00	$3,689.00	$2,582.00	2026-04-01
206	MS_DRG	Other Resiratory System Diagnoses Without Mcc	5	3	$6,210.10	$3,105.05 50% off	$1,475.00	$3,688.00	$2,581.50	2026-04-01
562	MS_DRG	Fracture, Sprain, Strain And Dislocation Except Femur Hip	5	3	$11,940.86	$5,970.43 50% off	$1,475.00	$3,649.00	$2,562.00	2026-04-01
149	MS_DRG	Dysequilibrium	5	3	$4,636.87	$2,318.44 50% off	$1,475.00	$3,630.00	$2,552.50	2026-04-01
947	MS_DRG	Signs And Symptoms With Mcc	5	3	$8,904.11	$4,452.06 50% off	$1,475.00	$3,630.00	$2,552.50	2026-04-01
312	MS_DRG	Syncope And Collapse	5	3	$6,014.73	$3,007.37 50% off	$1,475.00	$3,592.00	$2,533.50	2026-04-01
308	MS_DRG	Cardiac Arrhythmia And Conduction Disorders With Mcc	5	3	$9,363.78	$4,681.89 50% off	$1,475.00	$3,573.00	$2,524.00	2026-04-01
305	MS_DRG	Hypertension Without Mcc	5	3	$6,135.03	$3,067.52 50% off	$1,475.00	$3,565.00	$2,520.00	2026-04-01
291	MS_DRG	Heart Failure And Shock With Mcc	5	3	$5,026.41	$2,513.21 50% off	$1,475.00	$3,550.00	$2,512.50	2026-04-01
918	MS_DRG	Poisoning And Toxic Effects Of Drugs Without Mcc	5	3	$5,102.75	$2,551.38 50% off	$1,475.00	$3,530.00	$2,502.50	2026-04-01
177	MS_DRG	Respiratory Infections And Inflammations With Mcc	5	3	$11,054.76	$5,527.38 50% off	$1,475.00	$3,515.00	$2,495.00	2026-04-01
812	MS_DRG	Red Blood Cell Disorders Without Mcc	5	3	$3,784.69	$1,892.35 50% off	$1,475.00	$3,413.00	$2,444.00	2026-04-01
687	MS_DRG	Kidney And Urinary Tract Neoplasms With Cc	5	3	$6,753.00	$3,376.50 50% off	$1,475.00	$3,398.00	$2,436.50	2026-04-01
605	MS_DRG	Trauma To The Skin, Subcutaneous Tissue And Breast Without M	5	3	$5,730.10	$2,865.05 50% off	$1,475.00	$3,391.00	$2,433.00	2026-04-01
378	MS_DRG	Gastroinestinal Hemorrhage With Cc	5	3	$6,345.82	$3,172.91 50% off	$1,475.00	$3,388.00	$2,431.50	2026-04-01
159	MS_DRG	Dental And Oral Diseases Without Cc/mcc	5	3	$4,598.97	$2,299.49 50% off	$1,475.00	$3,313.00	$2,394.00	2026-04-01
193	MS_DRG	Simple Pneumonia And Pleurisy With Mcc	5	3	$8,676.71	$4,338.36 50% off	$1,475.00	$3,303.00	$2,389.00	2026-04-01
155	MS_DRG	Other Ear, Nose, Mouth And Throat Diagnoses With Cc	5	3	$7,425.66	$3,712.83 50% off	$1,475.00	$3,238.00	$2,356.50	2026-04-01
699	MS_DRG	Other Kidnwy And Urinary Tract Diagnoses With Cc	5	3	$7,092.07	$3,546.04 50% off	$1,475.00	$3,237.00	$2,356.00	2026-04-01
310	MS_DRG	Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc	5	3	$3,059.28	$1,529.64 50% off	$1,475.00	$3,205.00	$2,340.00	2026-04-01
191	MS_DRG	Chronic Obstructive Pulmonary Disease With Cc	5	3	$7,016.25	$3,508.13 50% off	$1,475.00	$3,205.00	$2,340.00	2026-04-01
203	MS_DRG	Bronchitis And Asthma Without Cc/mcc	5	3	$4,132.55	$2,066.28 50% off	$1,475.00	$3,182.00	$2,328.50	2026-04-01
884	MS_DRG	Organic Disturbances And Intellectual Disability	5	3	$10,169.22	$5,084.61 50% off	$1,475.00	$3,181.00	$2,328.00	2026-04-01
638	MS_DRG	Diabetes With Cc	5	3	$7,103.92	$3,551.96 50% off	$1,475.00	$3,177.00	$2,326.00	2026-04-01
816	MS_DRG	Reticuloendothelial & Immunity Disorders Without Cc/mcc	5	3	$2,722.23	$1,361.12 50% off	$1,475.00	$3,167.00	$2,321.00	2026-04-01
556	MS_DRG	Signs And Symptoms Of Musculoskeletal System And Connective	5	3	$6,598.67	$3,299.34 50% off	$1,475.00	$3,123.00	$2,299.00	2026-04-01
178	MS_DRG	Respiratory Infections And Inflammations With Cc	5	3	$7,103.72	$3,551.86 50% off	$1,475.00	$3,116.00	$2,295.50	2026-04-01
641	MS_DRG	Miscellaneous Disorders Of Nutrition, Metablosim, Fluids And	5	3	$3,650.56	$1,825.28 50% off	$1,475.00	$3,106.00	$2,290.50	2026-04-01
948	MS_DRG	Signs And Symptoms Without Mcc	5	3	$4,804.79	$2,402.40 50% off	$1,475.00	$3,097.00	$2,286.00	2026-04-01
683	MS_DRG	Renal Failure With Cc	5	3	$5,676.37	$2,838.19 50% off	$1,475.00	$3,048.00	$2,261.50	2026-04-01
392	MS_DRG	Esophagitis, Gastroenteritis And Misc Digestive Dis	5	3	$6,447.10	$3,223.55 50% off	$1,475.00	$3,044.00	$2,259.50	2026-04-01
863	MS_DRG	Postoperative And Post-traumatic Infections Without Mcc	5	3	$6,679.61	$3,339.81 50% off	$1,475.00	$3,028.00	$2,251.50	2026-04-01
49205	HCPCS	Excision Endometrioma >10.0cm	10	5	$5,662.00	$2,831.00 50% off	$2,235.54	$2,235.54	$2,235.54	2026-04-01
689	MS_DRG	Kidney And Urinary Tract Infections With Mcc	5	3	$7,550.27	$3,775.14 50% off	$1,475.00	$2,996.00	$2,235.50	2026-04-01
194	MS_DRG	Simple Pneumonia And Pleurisy With Cc	5	3	$6,869.92	$3,434.96 50% off	$1,475.00	$2,971.00	$2,223.00	2026-04-01
563	MS_DRG	Fracture, Sprain, Strain And Dislocation Except Femur, Hip	5	3	$5,449.55	$2,724.78 50% off	$1,475.00	$2,971.00	$2,223.00	2026-04-01
292	MS_DRG	Heart Failure And Shock With Cc	5	3	$7,005.84	$3,502.92 50% off	$1,475.00	$2,965.00	$2,220.00	2026-04-01
179	MS_DRG	Respiratory Infectins And Inflammations Without Cc/mcc	5	3	$1,641.50	$820.75 50% off	$1,475.00	$2,961.00	$2,218.00	2026-04-01
684	MS_DRG	Renal Failure Without Cc/mcc	5	3	$2,769.73	$1,384.87 50% off	$1,475.00	$2,958.00	$2,216.50	2026-04-01
443	MS_DRG	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic	5	3	$4,144.54	$2,072.27 50% off	$1,475.00	$2,939.00	$2,207.00	2026-04-01
538	MS_DRG	Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh	5	3	$4,199.97	$2,099.99 50% off	$1,475.00	$2,929.00	$2,202.00	2026-04-01
293	MS_DRG	Heart Failure And Shock Without Cc/mcc	5	3	$4,693.84	$2,346.92 50% off	$1,475.00	$2,917.00	$2,196.00	2026-04-01
558	MS_DRG	Tendonitis, Myositis And Buristis Without Mcc	5	3	$5,483.93	$2,741.97 50% off	$1,475.00	$2,898.00	$2,186.50	2026-04-01
690	MS_DRG	Kidney And Urinary Tract Infections Without Mcc	5	3	$5,722.53	$2,861.27 50% off	$1,475.00	$2,867.00	$2,171.00	2026-04-01
195	MS_DRG	Simple Pneumonia And Pleurisy Without Cc/mcc	5	3	$3,795.77	$1,897.89 50% off	$1,475.00	$2,846.00	$2,160.50	2026-04-01
603	MS_DRG	Cellulitis Without Mcc	5	3	$6,047.75	$3,023.88 50% off	$1,475.00	$2,789.00	$2,132.00	2026-04-01
758	MS_DRG	Infections, Female Reproductive System W Cc	5	3	$3,320.86	$1,660.43 50% off	$1,475.00	$2,784.00	$2,129.50	2026-04-01
440	MS_DRG	Disorders Of Pancreas Except Malignancy Without Cc/mcc	5	3	$2,863.79	$1,431.90 50% off	$1,475.00	$2,763.00	$2,119.00	2026-04-01
536	MS_DRG	Fractures Of Hip And Pelvis Without Mcc	5	3	$4,801.07	$2,400.54 50% off	$1,475.00	$2,722.00	$2,098.50	2026-04-01
389	MS_DRG	Gastrointestinal Obstruction With Cc	5	3	$3,101.80	$1,550.90 50% off	$1,475.00	$2,718.00	$2,096.50	2026-04-01
27364	HCPCS	Resection Tumor Thigh/knee 5cm Or More	10	5	$6,447.00	$3,223.50 50% off	$1,995.01	$1,995.01	$1,995.01	2026-04-01
885	MS_DRG	Psychoses	5	3	$10,220.93	$5,110.47 50% off	$1,475.00	$2,190.00	$1,832.50	2026-04-01
44160	HCPCS	Colectomy Partial Removal Terminal Ileum	10	5	$4,021.00	$2,010.50 50% off	$1,584.49	$1,584.49	$1,584.49	2026-04-01
44320	HCPCS	Colostomy Or Skin Level Cecostomy	10	5	$3,796.00	$1,898.00 50% off	$1,529.91	$1,529.91	$1,529.91	2026-04-01
42420	HCPCS	Excision Parotid Tumor W/preserv. Facial	10	5	$12,393.00	$6,196.50 50% off	$1,527.20	$1,527.20	$1,527.20	2026-04-01
58290	HCPCS	Hysterectomy Vag. 250g> Uterus	10	5	$17,599.00	$8,799.50 50% off	$1,487.76	$1,487.76	$1,487.76	2026-04-01
101	MS_DRG	Seizures Without Mcc	3	2	$5,725.40	$2,862.70 50% off	$1,475.00	$1,475.00	$1,475.00	2026-04-01
69	MS_DRG	Transient Ischemia Without Thrombolytic	3	2	$4,955.62	$2,477.81 50% off	$1,475.00	$1,475.00	$1,475.00	2026-04-01
174	MS_DRG	G.i. Hemorrhage W Cc	3	2	$3,737.24	$1,868.62 50% off	$1,475.00	$1,475.00	$1,475.00	2026-04-01
552	MS_DRG	Medical Back Problems Without Mcc	3	2	$6,053.47	$3,026.74 50% off	$1,475.00	$1,475.00	$1,475.00	2026-04-01
446	MS_DRG	Disorders Of The Biliary Tract Without Cc/mcc	3	2	$6,532.93	$3,266.47 50% off	$1,475.00	$1,475.00	$1,475.00	2026-04-01
47600	HCPCS	Cholecystectomy Open	10	5	$3,450.00	$1,725.00 50% off	$1,366.68	$1,366.68	$1,366.68	2026-04-01
58150	HCPCS	Hysterectomy Total Abdominal	10	5	$7,035.00	$3,517.50 50% off	$1,305.05	$1,305.05	$1,305.05	2026-04-01
21016	HCPCS	Excision Tumor Facial Radical >2cm	10	5	$6,447.00	$3,223.50 50% off	$1,287.97	$1,287.97	$1,287.97	2026-04-01
44180	HCPCS	Lap Surgical Enterolysis	10	5	$12,598.00	$6,299.00 50% off	$1,174.77	$1,174.77	$1,174.77	2026-04-01
58571	HCPCS	Lap Surgical Total Hyst W/tube Removal	10	5	$20,910.00	$10,455.00 50% off	$1,167.59	$1,167.59	$1,167.59	2026-04-01
0120	RC	—	1	1	$348.00	$174.00 50% off	$1,153.73	$1,153.73	$1,153.73	2026-04-01
27880	HCPCS	Amputation Leg Thru Tibia And Fibula	10	5	$2,855.00	$1,427.50 50% off	$1,147.28	$1,147.28	$1,147.28	2026-04-01
58260	HCPCS	Hysterectomy Vag. 250g Or Less Uterus	10	5	$5,993.00	$2,996.50 50% off	$1,082.93	$1,082.93	$1,082.93	2026-04-01
15260	HCPCS	Skin Graft Full Thick Nose <20sq. Cm	10	5	$4,284.00	$2,142.00 50% off	$1,070.18	$1,070.18	$1,070.18	2026-04-01
49900	HCPCS	Abdominal Wall Repair -dehiscence/evisc.	10	5	$2,607.00	$1,303.50 50% off	$1,045.52	$1,045.52	$1,045.52	2026-04-01
58570	HCPCS	Lap Surgical Total Hyst	10	5	$20,910.00	$10,455.00 50% off	$1,039.61	$1,039.61	$1,039.61	2026-04-01
13160	HCPCS	Secondary Closure Of Surgical Wound Comp	10	5	$4,784.00	$2,392.00 50% off	$1,014.42	$1,014.42	$1,014.42	2026-04-01
15240	HCPCS	Skin Graft Full Thick Neck <20sq. Cm	10	5	$4,284.00	$2,142.00 50% off	$1,004.60	$1,004.60	$1,004.60	2026-04-01
27590	HCPCS	Amputation Thigh Thru Femur Any Level	10	5	$2,314.00	$1,157.00 50% off	$999.95	$999.95	$999.95	2026-04-01
58925	HCPCS	Cystectomy Ovarian	10	5	$12,158.00	$6,079.00 50% off	$987.68	$987.68	$987.68	2026-04-01
11005	HCPCS	Debridement Necrotizing Tissue Abd Wall	10	5	$2,450.00	$1,225.00 50% off	$986.41	$986.41	$986.41	2026-04-01
49000	HCPCS	Laparotomy Exploratory	10	5	$2,492.00	$1,246.00 50% off	$981.72	$981.72	$981.72	2026-04-01
57288	HCPCS	Sling Operation For Stress Incontinence	10	5	$3,026.00	$1,513.00 50% off	$955.31	$955.31	$955.31	2026-04-01
57287	HCPCS	Removal Or Revision Bladder Sling	10	5	$6,880.00	$3,440.00 50% off	$951.66	$951.66	$951.66	2026-04-01
47563	HCPCS	Lap Cholecystectomy With Cholangio	10	5	$12,598.00	$6,299.00 50% off	$919.00	$919.00	$919.00	2026-04-01
57285	HCPCS	Paravaginal Defect Repair - Vag Approach	10	5	$17,599.00	$8,799.50 50% off	$892.85	$892.85	$892.85	2026-04-01
23073	HCPCS	Excision Soft Tissue Shoulder IM 5cm+	10	5	$6,447.00	$3,223.50 50% off	$890.14	$890.14	$890.14	2026-04-01
24073	HCPCS	Excision Tumor Soft Up. Arm >5cm Subfas	10	5	$6,447.00	$3,223.50 50% off	$885.49	$885.49	$885.49	2026-04-01
43999	HCPCS	Removal Of Peg Tube	1	1	$3,000.00	$1,500.00 50% off	$879.90	$879.90	$879.90	2026-04-01
26952	HCPCS	Amputation Finger With Local Adv. Flaps	10	5	$4,243.00	$2,121.50 50% off	$871.29	$871.29	$871.29	2026-04-01
G0121	HCPCS	Colonoscopy Screening Low Risk Pt	1	1	$1,965.00	$982.50 50% off	$858.57	$858.57	$858.57	2026-04-01
22901	HCPCS	Excision Tumor Abdominal Wall Subfa >5cm	10	5	$6,447.00	$3,223.50 50% off	$850.67	$850.67	$850.67	2026-04-01
47562	HCPCS	Lap Cholecystectomy	10	5	$12,598.00	$6,299.00 50% off	$842.93	$842.93	$842.93	2026-04-01
19301	HCPCS	Mastectomy Partial - Lumpectomy	10	5	$7,499.00	$3,749.50 50% off	$842.32	$842.32	$842.32	2026-04-01
58661	HCPCS	Lap Oophorectomy	10	5	$12,598.00	$6,299.00 50% off	$842.08	$842.08	$842.08	2026-04-01
44950	HCPCS	Appendectomy - Open	10	5	$8,589.00	$4,294.50 50% off	$821.42	$821.42	$821.42	2026-04-01
49553	HCPCS	Hernia Repair Femoral Initial I/s	10	5	$8,589.00	$4,294.50 50% off	$809.83	$809.83	$809.83	2026-04-01
57250	HCPCS	Rectocele Repair With/without Peri.	10	5	$11,433.00	$5,716.50 50% off	$793.82	$793.82	$793.82	2026-04-01
14040	HCPCS	Tissue Transfer/rearrangement Neck <10cm	10	5	$4,284.00	$2,142.00 50% off	$789.75	$789.75	$789.75	2026-04-01
45171	HCPCS	Excision Rectal Tumor Transanal Approach	10	5	$6,672.00	$3,336.00 50% off	$785.14	$785.14	$785.14	2026-04-01
15220	HCPCS	Skin Graft Full Thick Extrem <20sq. Cm	10	5	$4,284.00	$2,142.00 50% off	$770.81	$770.81	$770.81	2026-04-01
49507	HCPCS	Hernia Repair Inguinal Initial Incar.	10	5	$8,589.00	$4,294.50 50% off	$752.16	$752.16	$752.16	2026-04-01
11772	HCPCS	Excision Pilonidal Cyst Complicated	10	5	$6,447.00	$3,223.50 50% off	$734.31	$734.31	$734.31	2026-04-01
11004	HCPCS	Debridement Necrotizing Tissue Genitalia	10	5	$1,853.00	$926.50 50% off	$727.08	$727.08	$727.08	2026-04-01
49651	HCPCS	Lap Hernia Repair Recurrent Inguinal	10	5	$12,598.00	$6,299.00 50% off	$721.62	$721.62	$721.62	2026-04-01
24076	HCPCS	Excision Tumor Soft Up. Arm <5cm Subfas	10	5	$6,447.00	$3,223.50 50% off	$699.73	$699.73	$699.73	2026-04-01
59409	HCPCS	Delivery - Vaginal (er Only)	12	5	$6,257.00	$3,128.50 50% off	$300.00	$1,080.03	$690.01	2026-04-01
25073	HCPCS	Excision Tumor Forearm/wrist Subfa >3cm	10	5	$6,447.00	$3,223.50 50% off	$686.11	$686.11	$686.11	2026-04-01
21556	HCPCS	Excision Tumor Neck/thorax Subfa <5cm	10	5	$6,447.00	$3,223.50 50% off	$679.44	$679.44	$679.44	2026-04-01
49505	HCPCS	Hernia Repair Inguinal Initial Reduc.	10	5	$8,589.00	$4,294.50 50% off	$668.17	$668.17	$668.17	2026-04-01
87903	HCPCS	Charge Component For HIV-1 Phenosense 1	10	5	$1,467.00	$733.50 50% off	$614.45	$614.45	$614.45	2026-04-01
46280	HCPCS	Fistulotomy Anal Suprasphincteric	10	5	$6,503.00	$3,251.50 50% off	$612.89	$612.89	$612.89	2026-04-01
21931	HCPCS	Excision Tumor Soft Tissue Back Sq >3cm	10	5	$4,115.00	$2,057.50 50% off	$599.72	$599.72	$599.72	2026-04-01
37722	HCPCS	Ligation/stripping Long Saphenous Vein	10	5	$7,082.00	$3,541.00 50% off	$587.48	$587.48	$587.48	2026-04-01
21552	HCPCS	Excision Tumor Soft Tissue Neck 3cm Or >	10	5	$6,447.00	$3,223.50 50% off	$571.10	$571.10	$571.10	2026-04-01
22903	HCPCS	Excision Tumor Abdominal Wall Subq >3cm	10	5	$6,447.00	$3,223.50 50% off	$562.65	$562.65	$562.65	2026-04-01
64721	HCPCS	Carpal Tunnel Release	10	5	$4,691.00	$2,345.50 50% off	$555.53	$555.53	$555.53	2026-04-01
49650	HCPCS	Lap Hernia Repair Initial Inguinal	10	5	$12,598.00	$6,299.00 50% off	$552.30	$552.30	$552.30	2026-04-01
19300	HCPCS	Mastectomy For Gynecomastia - Male Only	10	5	$7,499.00	$3,749.50 50% off	$549.39	$549.39	$549.39	2026-04-01
64774	HCPCS	Excision Neuroma Surgical Identified	10	5	$4,691.00	$2,345.50 50% off	$544.74	$544.74	$544.74	2026-04-01
46040	HCPCS	I & D Abcess Perirectal Or Ischiorectal	10	5	$1,673.00	$836.50 50% off	$539.99	$539.99	$539.99	2026-04-01
28810	HCPCS	Amputation Metatarsal With Toe - Single	10	5	$7,316.00	$3,658.00 50% off	$539.52	$539.52	$539.52	2026-04-01
27337	HCPCS	Excision Tumor Thigh/knee Subq 3cm Or >	10	5	$6,447.00	$3,223.50 50% off	$535.50	$535.50	$535.50	2026-04-01
24071	HCPCS	Excision Tumor Soft Up. Arm >3cm Subq	10	5	$3,300.00	$1,650.00 50% off	$517.67	$517.67	$517.67	2026-04-01
87633	HCPCS	Respiratory Virus Profile,pcr	10	5	$1,876.00	$938.00 50% off	$515.62	$515.62	$515.62	2026-04-01
87507	HCPCS	Gastrointestinal Profile Stool Pcr	10	5	$1,697.00	$848.50 50% off	$510.46	$510.46	$510.46	2026-04-01
0202U	OTHER	Respiratory Pathogen Panel	10	5	$1,251.00	$625.50 50% off	$500.14	$500.14	$500.14	2026-04-01
11646	HCPCS	Excision Skin Lesion Face Malig >4.0cm	10	5	$6,447.00	$3,223.50 50% off	$496.40	$496.40	$496.40	2026-04-01
46947	HCPCS	Hemorrhoidopexy By Stapling	10	5	$7,112.00	$3,556.00 50% off	$495.93	$495.93	$495.93	2026-04-01
21925	HCPCS	Biopsy Soft Tissue Back/flank Deep	10	5	$3,771.00	$1,885.50 50% off	$479.34	$479.34	$479.34	2026-04-01
58670	HCPCS	Laparoscopic Tubal Ligation W/wo Trans.	10	5	$12,729.00	$6,364.50 50% off	$478.76	$478.76	$478.76	2026-04-01
58600	HCPCS	Ligation Of Tubes Abd Or Vag Approach	10	5	$7,569.00	$3,784.50 50% off	$477.96	$477.96	$477.96	2026-04-01
21930	HCPCS	Excision Tumor Soft Tissue Back Sq <3cm	10	5	$1,772.00	$886.00 50% off	$463.74	$463.74	$463.74	2026-04-01
24105	HCPCS	Excision Olecranon Bursa	10	5	$7,316.00	$3,658.00 50% off	$459.72	$459.72	$459.72	2026-04-01
27550	HCPCS	Closed Tx Knee Dislocation Without Anesth.	10	5	$966.00	$483.00 50% off	$300.00	$609.21	$454.61	2026-04-01
90675	HCPCS	Rabies Vac 2.5un Kit	10	5	$1,158.00	$579.00 50% off	$452.40	$452.40	$452.40	2026-04-01
25505	HCPCS	Closed Tx Radial Fracture With Manip.	10	5	$1,428.00	$714.00 50% off	$300.00	$595.18	$447.59	2026-04-01
25660	HCPCS	Closed Tx Radiocarpal/intercarpal Disloc	10	5	$1,402.00	$701.00 50% off	$300.00	$576.48	$438.24	2026-04-01
21012	HCPCS	Excision Tumor Facial Subq >2cm	10	5	$3,834.00	$1,917.00 50% off	$431.84	$431.84	$431.84	2026-04-01
55040	HCPCS	Exicision Hydrocele Unilateral	10	5	$8,589.00	$4,294.50 50% off	$431.10	$431.10	$431.10	2026-04-01
22902	HCPCS	Excision Tumor Abd Wall Subq <3cm	10	5	$3,834.00	$1,917.00 50% off	$424.34	$424.34	$424.34	2026-04-01
36561	HCPCS	Bard Port Insertion > 5 Yrs Old (or)	10	5	$7,338.00	$3,669.00 50% off	$422.89	$422.89	$422.89	2026-04-01
49320	HCPCS	Laparoscopy Diagnostic Abdomen/peri	10	5	$12,598.00	$6,299.00 50% off	$419.75	$419.75	$419.75	2026-04-01
12057	HCPCS	Wound Repair Inter. Face >30.0cm	12	5	$660.00	$330.00 50% off	$300.00	$532.16	$416.08	2026-04-01
69110	HCPCS	Excision External Ear Partial Simple	10	5	$6,447.00	$3,223.50 50% off	$415.68	$415.68	$415.68	2026-04-01
25111	HCPCS	Excision Ganglion Wrist Primary	10	5	$3,375.00	$1,687.50 50% off	$415.49	$415.49	$415.49	2026-04-01
56740	HCPCS	Excision Bartholin's Cyst/gland	10	5	$7,569.00	$3,784.50 50% off	$405.29	$405.29	$405.29	2026-04-01
74174	HCPCS	CTA Abdomen / Pelvis W/wo Contrast	10	5	$1,850.00	$925.00 50% off	$275.00	$532.85	$403.93	2026-04-01
11446	HCPCS	Excision Skin Lesion Face Benign >4.0cm	10	5	$6,447.00	$3,223.50 50% off	$402.74	$402.74	$402.74	2026-04-01
11606	HCPCS	Excision Skin Lesion Leg Malig >4.0cm	10	5	$4,257.00	$2,128.50 50% off	$402.35	$402.35	$402.35	2026-04-01
99291	HCPCS	Critical Care 30-74 Minutes	12	5	$2,062.00	$1,031.00 50% off	$300.00	$401.14	$401.14	2026-04-01
27327	HCPCS	Excision Tumor Thigh Subq <3cm	10	5	$5,210.00	$2,605.00 50% off	$400.88	$400.88	$400.88	2026-04-01
28192	HCPCS	Foreign Body Removal Foot - Deep	12	5	$3,834.00	$1,917.00 50% off	$300.00	$396.20	$396.20	2026-04-01
26641	HCPCS	Closed Tx Thumb Dislocation With Manip.	10	5	$587.00	$293.50 50% off	$300.00	$491.54	$395.77	2026-04-01
12056	HCPCS	Wound Repair Inter. Face 20.1cm-30.0cm	12	5	$878.00	$439.00 50% off	$300.00	$487.40	$393.70	2026-04-01
42821	HCPCS	Tonsil & Adenoid Removal >12yrs Old	10	5	$6,522.00	$3,261.00 50% off	$391.19	$391.19	$391.19	2026-04-01
21555	HCPCS	Excision Tumor Soft Tissue Neck <3cm	10	5	$3,834.00	$1,917.00 50% off	$390.93	$1,516.28	$390.93	2026-04-01
24201	HCPCS	Removal Of Foreign Body-upper Arm Deep	12	5	$1,125.00	$562.50 50% off	$300.00	$468.84	$384.42	2026-04-01
74178	HCPCS	CT Abdomen W/wo & Pelvis W Contrast	10	5	$3,152.00	$1,576.00 50% off	$275.00	$479.22	$377.11	2026-04-01
37195	HCPCS	Admin. Thrombolysis Cerebral IV Inf - ER	10	5	$839.00	$419.50 50% off	$374.71	$374.71	$374.71	2026-04-01
42820	HCPCS	Tonsil & Adenoid Removal <12yrs Old	10	5	$12,393.00	$6,196.50 50% off	$373.68	$373.68	$373.68	2026-04-01
12047	HCPCS	Wound Repair Inter. Neck >30.0cm	12	5	$4,284.00	$2,142.00 50% off	$300.00	$447.19	$373.60	2026-04-01
24600	HCPCS	Closed Tx Elbow Dislocation Without Anesth.	10	5	$966.00	$483.00 50% off	$300.00	$444.00	$372.00	2026-04-01
11626	HCPCS	Excision Skin Lesion Hand Malig >4.0cm	10	5	$6,447.00	$3,223.50 50% off	$371.03	$371.03	$371.03	2026-04-01
13152	HCPCS	Wound Repair Complex Eyelid 2.6cm-7.5cm	12	5	$1,360.00	$680.00 50% off	$300.00	$426.97	$363.49	2026-04-01
11644	HCPCS	Excision Skin Lesion Face Malig 3.1-4.0c	10	5	$3,710.00	$1,855.00 50% off	$358.10	$358.10	$358.10	2026-04-01
12037	HCPCS	Wound Repair Inter. Scalp >30.0cm	12	5	$7,515.00	$3,757.50 50% off	$300.00	$415.67	$357.83	2026-04-01
26670	HCPCS	Closed Tx Finger Dislocation With Manip.	10	5	$900.00	$450.00 50% off	$300.00	$404.16	$352.08	2026-04-01
74177	HCPCS	CT Abdomen/pelvis With Contrast	10	5	$3,004.00	$1,502.00 50% off	$275.00	$428.06	$351.53	2026-04-01
12046	HCPCS	Wound Repair Inter. Neck 20.1cm-30.0cm	12	5	$878.00	$439.00 50% off	$300.00	$401.64	$350.82	2026-04-01
G0379	HCPCS	Observation-direct Admit	10	5	$1,467.00	$733.50 50% off	$350.00	$1,443.53	$350.00	2026-04-01
G0378	HCPCS	Observation Per Hour	8	4	$17.00	$8.50 50% off	$16.73	$350.00	$350.00	2026-04-01
23650	HCPCS	Closed Tx Shoulder Disloc W/man Without Anes	12	5	$558.00	$279.00 50% off	$300.00	$387.77	$343.88	2026-04-01
11426	HCPCS	Excision Skin Lesion Scalp Benign >4.0cm	10	5	$6,447.00	$3,223.50 50% off	$343.66	$343.66	$343.66	2026-04-01
13132	HCPCS	Wound Repair Complex Forehead 2.6cm-7.5c	12	5	$1,360.00	$680.00 50% off	$300.00	$385.24	$342.62	2026-04-01
12055	HCPCS	Wound Repair Inter. Face 12.6cm-20.0cm	12	5	$878.00	$439.00 50% off	$300.00	$381.49	$340.75	2026-04-01
75635	HCPCS	CTA Aorto-iliofemoral Runoff	10	5	$1,963.00	$981.50 50% off	$275.00	$398.73	$336.87	2026-04-01
36558	HCPCS	Central Line Placement	12	5	$7,082.00	$3,541.00 50% off	$300.00	$330.50	$330.50	2026-04-01
12036	HCPCS	Wound Repair Inter. Scalp 20.1cm-30.0cm	12	5	$1,360.00	$680.00 50% off	$300.00	$357.36	$328.68	2026-04-01
42826	HCPCS	Tonsil Removal >12yrs Old	10	5	$6,522.00	$3,261.00 50% off	$327.60	$327.60	$327.60	2026-04-01
13151	HCPCS	Wound Repair Complex Eyelid 1.1cm-2.5cm	12	5	$1,360.00	$680.00 50% off	$300.00	$353.89	$326.94	2026-04-01
57522	HCPCS	Conization Cervix Leep	10	5	$6,257.00	$3,128.50 50% off	$326.76	$326.76	$326.76	2026-04-01
38500	HCPCS	Biopsy/excision Lymph Node Open Super.	10	5	$7,499.00	$3,749.50 50% off	$325.38	$325.38	$325.38	2026-04-01
12045	HCPCS	Wound Repair Inter. Neck 12.6cm-20.0cm	12	5	$1,360.00	$680.00 50% off	$300.00	$347.87	$323.94	2026-04-01
73706	HCPCS	CTA Lower Ext W/wo Contrast	10	5	$1,411.00	$705.50 50% off	$275.00	$366.95	$320.98	2026-04-01
71275	HCPCS	CTA Chest W/wo Contrast	10	5	$1,570.00	$785.00 50% off	$275.00	$362.10	$318.55	2026-04-01
74175	HCPCS	CTA Abdomen W/wo Contrast	10	5	$1,531.00	$765.50 50% off	$275.00	$361.67	$318.33	2026-04-01
72191	HCPCS	CTA Pelvis W/wo Contrast	10	5	$1,531.00	$765.50 50% off	$275.00	$360.29	$317.64	2026-04-01
73206	HCPCS	CTA Upper Ext W/wo Contrast	10	5	$1,411.00	$705.50 50% off	$275.00	$360.29	$317.64	2026-04-01
58563	HCPCS	Endometrial Ablation With Hysterocscopy	10	5	$11,433.00	$5,716.50 50% off	$316.57	$316.57	$316.57	2026-04-01
70498	HCPCS	CTA Neck W/wo Contrast	10	5	$1,381.00	$690.50 50% off	$275.00	$357.75	$316.38	2026-04-01
70496	HCPCS	CTA Head W/wo Contrast	10	5	$1,381.00	$690.50 50% off	$275.00	$357.75	$316.38	2026-04-01
90377	HCPCS	Rabies Immune Globulin 300iu/2ml	10	5	$2,021.00	$1,010.50 50% off	$314.94	$314.94	$314.94	2026-04-01
11406	HCPCS	Excision Skin Lesion Trunk Benign >4.0cm	10	5	$4,040.00	$2,020.00 50% off	$314.82	$314.82	$314.82	2026-04-01
11462	HCPCS	Excision Skin Hidradenitis Inguinal Reg	10	5	$6,447.00	$3,223.50 50% off	$313.74	$313.74	$313.74	2026-04-01
13121	HCPCS	Wound Repair Complex Scalp 2.6cm-7.5cm	12	5	$1,360.00	$680.00 50% off	$300.00	$327.06	$313.53	2026-04-01
62264	HCPCS	Epidural Lysis Bilat On Single Day,bilateral Procedure	20	5	$2,229.00	$1,114.50 50% off	$313.08	$313.08	$313.08	2026-04-01
13101	HCPCS	Wound Repair Complex Trunk 2.6cm-7.5cm	12	5	$1,360.00	$680.00 50% off	$300.00	$313.26	$306.63	2026-04-01
74170	HCPCS	CT Abdomen W/wo Contrast	10	5	$2,059.00	$1,029.50 50% off	$167.65	$333.98	$304.49	2026-04-01
13131	HCPCS	Wound Repair Complex Forehead 1.1cm-2.5c	12	5	$1,162.00	$581.00 50% off	$300.00	$307.06	$303.53	2026-04-01
12035	HCPCS	Wound Repair Inter. Scalp 12.6cm-20.0cm	12	5	$878.00	$439.00 50% off	$300.00	$305.86	$302.93	2026-04-01
11624	HCPCS	Excision Skin Lesion Scalp Malig 3.1-4.0	10	5	$4,040.00	$2,020.00 50% off	$302.16	$302.16	$302.16	2026-04-01
74160	HCPCS	CT Abdomen With Contrast	10	5	$2,059.00	$1,029.50 50% off	$275.00	$325.77	$300.38	2026-04-01
99499	HCPCS	Emergency Room Assessment	10	5	$75.00	$37.50 50% off	$300.00	$300.00	$300.00	2026-04-01
0450	RC	—	10	5	$171.00	$85.50 50% off	$300.00	$300.00	$300.00	2026-04-01
P9612	HCPCS	Insertion Cath - Ua Only ER	13	5	$46.00	$23.00 50% off	$2.70	$300.00	$300.00	2026-04-01
58120	HCPCS	Dilation & Curettage Non-OB	10	5	$6,257.00	$3,128.50 50% off	$299.67	$299.67	$299.67	2026-04-01
73202	HCPCS	CT Upper Ext Lt W/wo Contrast,procedure Performed On The Lt Side Of The Body	20	5	$1,324.00	$662.00 50% off	$275.00	$322.02	$298.51	2026-04-01
72194	HCPCS	CT Pelvis W/wo Contrast	10	5	$2,159.00	$1,079.50 50% off	$275.00	$322.02	$298.51	2026-04-01
58353	HCPCS	Endometrial Ablation Without Hysterocscopy	10	5	$9,527.00	$4,763.50 50% off	$297.69	$297.69	$297.69	2026-04-01
13120	HCPCS	Wound Repair Complex Scalp 1.1cm-2.5cm	12	5	$1,360.00	$680.00 50% off	$293.71	$300.00	$296.86	2026-04-01
72193	HCPCS	CT Pelvis With Contrast	10	5	$2,059.00	$1,029.50 50% off	$275.00	$318.17	$296.58	2026-04-01
70492	HCPCS	CT Soft Tissue Neck W/wo Contrast	10	5	$1,700.00	$850.00 50% off	$275.00	$311.46	$293.23	2026-04-01
55250	HCPCS	Vasectomy Unilateral Or Bilateral	10	5	$5,207.00	$2,603.50 50% off	$290.79	$290.79	$290.79	2026-04-01
87902	HCPCS	Hepatitis C Genotype	10	5	$1,159.00	$579.50 50% off	$257.45	$323.72	$290.58	2026-04-01
87901	HCPCS	Charge Component For CPT Code 87901	10	5	$243.00	$121.50 50% off	$257.45	$323.72	$290.58	2026-04-01
12054	HCPCS	Wound Repair Inter. Face 7.6cm-12.5cm	12	5	$878.00	$439.00 50% off	$280.40	$300.00	$290.20	2026-04-01
11643	HCPCS	Excision Skin Lesion Nose Malig 2.1-3.0c	10	5	$3,710.00	$1,855.00 50% off	$288.48	$288.48	$288.48	2026-04-01
12053	HCPCS	Wound Repair Inter. Face 5.1cm-7.5cm	12	5	$878.00	$439.00 50% off	$273.54	$300.00	$286.77	2026-04-01
11444	HCPCS	Excision Skin Lesion Face Benign 3.1-4.0	10	5	$3,710.00	$1,855.00 50% off	$286.46	$286.46	$286.46	2026-04-01
99285	HCPCS	Emergency Room Level V	20	5	$1,213.00	$606.50 50% off	$286.31	$300.00	$286.31	2026-04-01
12044	HCPCS	Wound Repair Inter. Neck 7.6cm-12.5cm	12	5	$1,360.00	$680.00 50% off	$271.52	$300.00	$285.76	2026-04-01
70482	HCPCS	CT Orb/sella/ear W/wo Contrast	10	5	$1,482.00	$741.00 50% off	$275.00	$295.02	$285.01	2026-04-01
19101	HCPCS	Biopsy Breast Incisional Left,procedure Performed On The Lt Side Of The Body	20	5	$7,499.00	$3,749.50 50% off	$284.94	$284.94	$284.94	2026-04-01
12034	HCPCS	Wound Repair Inter. Scalp 7.6cm-12.5cm	12	5	$878.00	$439.00 50% off	$260.42	$300.00	$280.21	2026-04-01
73201	HCPCS	CT Upper Ext Lt With Contrast,procedure Performed On The Lt Side Of The Body	20	5	$1,166.00	$583.00 50% off	$275.00	$282.14	$278.57	2026-04-01
54162	HCPCS	Lysis Penile Post-circumcision Adhesion	12	5	$5,207.00	$2,603.50 50% off	$255.77	$300.00	$277.88	2026-04-01
13100	HCPCS	Wound Repair Complex Trunk 1.1cm-2.5cm	12	5	$3,826.00	$1,913.00 50% off	$254.64	$300.00	$277.32	2026-04-01
72130	HCPCS	CT T-spine W/wo Contrast	10	5	$1,645.00	$822.50 50% off	$275.00	$279.20	$277.10	2026-04-01
12052	HCPCS	Wound Repair Inter. Face 2.6cm-5cm	12	5	$878.00	$439.00 50% off	$253.23	$300.00	$276.62	2026-04-01
72133	HCPCS	CT L-spine W/wo Contrast	10	5	$1,645.00	$822.50 50% off	$275.00	$277.44	$276.22	2026-04-01
72127	HCPCS	CT C-spine W/wo Contrast	10	5	$1,876.00	$938.00 50% off	$275.00	$276.57	$275.79	2026-04-01
71270	HCPCS	CT Thorax W/wo Contrast	10	5	$1,755.00	$877.50 50% off	$275.00	$407.04	$275.09	2026-04-01
75571	HCPCS	CT Calcium Scoring	10	5	$180.00	$90.00 50% off	$275.00	$275.00	$275.00	2026-04-01
73702	HCPCS	CT Low Ext Lt W/wo Contrast,procedure Performed On The Lt Side Of The Body	20	5	$1,315.00	$657.50 50% off	$273.26	$275.00	$274.13	2026-04-01
12042	HCPCS	Wound Repair Inter. Neck 2.6cm-7.5cm	12	5	$878.00	$439.00 50% off	$247.72	$300.00	$273.86	2026-04-01
11604	HCPCS	Excision Skin Lesion Arm Malig 3.1-4.0cm	10	5	$1,747.00	$873.50 50% off	$270.27	$270.27	$270.27	2026-04-01
12032	HCPCS	Wound Repair Inter. Scalp 2.6cm-7.5cm	12	5	$878.00	$439.00 50% off	$239.93	$300.00	$269.96	2026-04-01
45386	HCPCS	Colonoscopy With Balloon Dilation	10	5	$1,876.00	$938.00 50% off	$268.74	$268.74	$268.74	2026-04-01
70491	HCPCS	CT Soft Tissue Neck With Contrast	10	5	$1,240.00	$620.00 50% off	$259.61	$275.00	$267.31	2026-04-01
70488	HCPCS	CT Maxillofacial W/wo Contrast	10	5	$1,466.00	$733.00 50% off	$259.43	$275.00	$267.21	2026-04-01
74176	HCPCS	CT Renal For Calculi	10	5	$2,642.00	$1,321.00 50% off	$225.33	$275.00	$266.94	2026-04-01
11623	HCPCS	Excision Skin Lesion Neck Malig 2.1 - 3.	10	5	$3,771.00	$1,885.50 50% off	$266.00	$266.00	$266.00	2026-04-01
30310	HCPCS	Removal Foreign Body Intranasal W/anest	10	5	$6,522.00	$3,261.00 50% off	$264.04	$264.04	$264.04	2026-04-01
70481	HCPCS	CT Orb/sella/ear With Contrast	10	5	$1,240.00	$620.00 50% off	$252.98	$275.00	$263.99	2026-04-01
12018	HCPCS	Wound Repair Simple Face >30.0cm	12	5	$690.00	$345.00 50% off	$224.35	$300.00	$262.18	2026-04-01
37609	HCPCS	Biopsy/ligation Temporal Artery	10	5	$2,887.00	$1,443.50 50% off	$259.83	$259.83	$259.83	2026-04-01
70470	HCPCS	CT Head W/wo Contrast	10	5	$1,580.00	$790.00 50% off	$243.62	$275.00	$259.31	2026-04-01
36578	HCPCS	Replacement Of Picc Line - Cath Only	10	5	$7,082.00	$3,541.00 50% off	$257.85	$257.85	$257.85	2026-04-01
12051	HCPCS	Wound Repair Inter. Face <2.5cm	12	5	$660.00	$330.00 50% off	$214.65	$300.00	$257.32	2026-04-01
72129	HCPCS	CT T-spine With Contrast	10	5	$1,480.00	$740.00 50% off	$238.50	$275.00	$256.75	2026-04-01
27086	HCPCS	Foreign Body Removal Pelivs/hip Subq	12	5	$1,728.00	$864.00 50% off	$213.40	$300.00	$256.70	2026-04-01
72132	HCPCS	CT L-spine With Contrast	10	5	$1,680.00	$840.00 50% off	$237.23	$275.00	$256.12	2026-04-01
72126	HCPCS	CT C-spine With Contrast	10	5	$1,362.00	$681.00 50% off	$236.78	$275.00	$255.89	2026-04-01
45380	HCPCS	Colonoscopy With Biopsy	10	5	$2,130.00	$1,065.00 50% off	$254.84	$1,099.13	$254.84	2026-04-01
43246	HCPCS	Placement Of Peg Tube	10	5	$4,005.00	$2,002.50 50% off	$254.43	$254.43	$254.43	2026-04-01
73701	HCPCS	CT Low Ext Lt With Contrast,procedure Performed On The Lt Side Of The Body	20	5	$1,209.00	$604.50 50% off	$233.81	$275.00	$254.41	2026-04-01
71260	HCPCS	CT Thorax With Contrast	10	5	$1,430.00	$715.00 50% off	$233.81	$405.61	$254.41	2026-04-01
54161	HCPCS	Circumcision Surgical Excis >28 Days Old	10	5	$5,207.00	$2,603.50 50% off	$251.73	$251.73	$251.73	2026-04-01
88309	HCPCS	Pathology Surgical 88309	10	5	$1,363.00	$681.50 50% off	$31.34	$470.39	$250.87	2026-04-01
12017	HCPCS	Wound Repair Simple Face 20.1cm-30.0cm	12	5	$878.00	$439.00 50% off	$198.62	$300.00	$249.31	2026-04-01
70480	HCPCS	CT Orb/sella/ear Without Contrast	10	5	$1,061.00	$530.50 50% off	$223.07	$275.00	$249.03	2026-04-01
12031	HCPCS	Wound Repair Inter. Scalp <2.5cm	12	5	$878.00	$439.00 50% off	$191.71	$300.00	$245.85	2026-04-01
11603	HCPCS	Excision Skin Lesion Arm Malig 2.1 - 3.0	10	5	$1,588.00	$794.00 50% off	$245.28	$245.28	$245.28	2026-04-01
64635	HCPCS	Destruct Bilat Paravert F Jnt L/s W/imag,bilateral Procedure	22	5	$4,691.00	$2,345.50 50% off	$244.85	$1,850.18	$244.85	2026-04-01
64633	HCPCS	Destruct Bilat Paravert F Jnt C/t W/imag,bilateral Procedure	21	5	$4,691.00	$2,345.50 50% off	$244.45	$1,850.18	$244.45	2026-04-01
70487	HCPCS	CT Maxillofacial With Contrast	10	5	$1,240.00	$620.00 50% off	$213.47	$275.00	$244.24	2026-04-01
46221	HCPCS	Hemorrhoidectomy Internal Band Ligation	10	5	$2,004.00	$1,002.00 50% off	$244.11	$244.11	$244.11	2026-04-01
12007	HCPCS	Wound Repair Simple Scalp >30.0cm	12	5	$612.00	$306.00 50% off	$186.66	$300.00	$243.33	2026-04-01
70490	HCPCS	CT Soft Tissue Neck Without Contrast	10	5	$1,061.00	$530.50 50% off	$99.13	$275.00	$243.32	2026-04-01
12041	HCPCS	Wound Repair Inter. Neck <2.5cm	12	5	$878.00	$439.00 50% off	$184.46	$300.00	$242.23	2026-04-01
73200	HCPCS	CT Upper Ext Lt Without Contrast,procedure Performed On The Lt Side Of The Body	20	5	$1,054.00	$527.00 50% off	$98.06	$275.00	$241.93	2026-04-01
70460	HCPCS	CT Head With Contrast	10	5	$1,580.00	$790.00 50% off	$207.75	$275.00	$241.38	2026-04-01
36590	HCPCS	Removal Of Port	10	5	$2,549.00	$1,274.50 50% off	$241.13	$241.13	$241.13	2026-04-01
57135	HCPCS	Excision Vaginal Cyst Or Tumor	10	5	$6,257.00	$3,128.50 50% off	$241.07	$241.07	$241.07	2026-04-01
13153	HCPCS	Wound Repair Complex Eyelid Ea Add'l 5cm	12	5	$577.00	$288.50 50% off	$174.64	$300.00	$237.32	2026-04-01
45378	HCPCS	Colonoscopy W/suction Diagnostic	10	5	$1,965.00	$982.50 50% off	$234.37	$1,670.25	$234.37	2026-04-01
0710	RC	—	1	1	$275.00	$137.50 50% off	$233.75	$233.75	$233.75	2026-04-01
74150	HCPCS	CT Abdomen Without Contrast	10	5	$2,059.00	$1,029.50 50% off	$99.53	$275.00	$233.65	2026-04-01
40812	HCPCS	Excision Mucosa/sub. Vestible Simple	10	5	$6,522.00	$3,261.00 50% off	$233.61	$233.61	$233.61	2026-04-01
12016	HCPCS	Wound Repair Simple Face 12.6cm-20.0cm	12	5	$460.00	$230.00 50% off	$165.50	$300.00	$232.75	2026-04-01
10061	HCPCS	I & D Abcess Complicated/multiple	13	5	$878.00	$439.00 50% off	$232.65	$383.57	$232.65	2026-04-01
46500	HCPCS	Injection Sclerosing Sol. Hemorrhoids	10	5	$2,004.00	$1,002.00 50% off	$232.35	$232.35	$232.35	2026-04-01
72192	HCPCS	CT Pelvis Without Contrast	10	5	$1,959.00	$979.50 50% off	$187.32	$275.00	$231.16	2026-04-01
71250	HCPCS	CT Thorax Without Contrast	10	5	$1,399.00	$699.50 50% off	$100.14	$275.00	$231.13	2026-04-01
42809	HCPCS	Foreign Body Removal Pharynx	12	5	$789.00	$394.50 50% off	$161.71	$300.00	$230.85	2026-04-01
46924	HCPCS	Destruction Of Lesion(s) Anus Surg Exten	10	5	$7,309.00	$3,654.50 50% off	$230.76	$230.76	$230.76	2026-04-01
11642	HCPCS	Excision Skin Lesion Face Malig 1.1-2.0c	10	5	$1,922.00	$961.00 50% off	$230.27	$230.27	$230.27	2026-04-01
28820	HCPCS	Amputation Toe Metatarsophalangeal Joint	10	5	$7,316.00	$3,658.00 50% off	$230.00	$230.00	$230.00	2026-04-01
13133	HCPCS	Wound Repair Complex Forehead Ea Addl 5c	12	5	$489.00	$244.50 50% off	$159.47	$300.00	$229.74	2026-04-01
72125	HCPCS	CT C-spine Without Contrast	10	5	$1,329.00	$664.50 50% off	$99.13	$275.00	$228.53	2026-04-01
72128	HCPCS	CT T-spine Without Contrast	10	5	$1,476.00	$738.00 50% off	$181.62	$275.00	$228.31	2026-04-01

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