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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

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

13,087 of 17,463 rate rows are consumer-grade (74.9%)

4,376 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 4,372
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 viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-17
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
813
MS_DRG 		Coagulation Disorders 5 $1,475.00 $5,204.00 $3,339.50 nat. median
$15,711
outlier · 0.2×
190
MS_DRG 		Blood Bank Forms 5 $1,475.00 $4,900.00 $3,187.50 nat. median
$11,699
outlier · 0.3×
840
MS_DRG 		Lymphoma And Non-acute Leukemia With Mcc 5 $1,475.00 $4,760.00 $3,117.50 nat. median
$31,382
outlier · 0.1×
314
MS_DRG 		Other Circulatory System Diagnoses With Mcc 5 $1,475.00 $4,415.00 $2,945.00 nat. median
$20,752
outlier · 0.1×
313
MS_DRG 		Chest Pain 5 $1,475.00 $4,224.00 $2,849.50 nat. median
$8,214
outlier · 0.3×
595
MS_DRG 		Major Skin Disorers With Mcc 5 $1,475.00 $4,169.00 $2,822.00 nat. median
$21,126
outlier · 0.1×
640
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And 5 $1,475.00 $3,846.00 $2,660.50 nat. median
$13,400
outlier · 0.2×
637
MS_DRG 		Diabetes With Mcc 5 $1,475.00 $3,802.00 $2,638.50 nat. median
$14,787
outlier · 0.2×
204
MS_DRG 		Respiratory Signs And Symptoms 5 $1,475.00 $3,770.00 $2,622.50 nat. median
$8,989
outlier · 0.3×
896
MS_DRG 		Alcohol, Drug Abuse Or Dependence Without Rehabilitation The 5 $1,475.00 $3,689.00 $2,582.00 nat. median
$16,145
outlier · 0.2×
206
MS_DRG 		Other Resiratory System Diagnoses Without Mcc 5 $1,475.00 $3,688.00 $2,581.50 nat. median
$10,000
outlier · 0.3×
562
MS_DRG 		Fracture, Sprain, Strain And Dislocation Except Femur Hip 5 $1,475.00 $3,649.00 $2,562.00 nat. median
$14,855
outlier · 0.2×
149
MS_DRG 		Dysequilibrium 5 $1,475.00 $3,630.00 $2,552.50 nat. median
$8,477
outlier · 0.3×
947
MS_DRG 		Signs And Symptoms With Mcc 5 $1,475.00 $3,630.00 $2,552.50 nat. median
$12,688
outlier · 0.2×
315
MS_DRG 		Other Circulatory System Diagnoses With Cc 5 $1,475.00 $3,605.00 $2,540.00 nat. median
$10,513
outlier · 0.2×
312
MS_DRG 		Syncope And Collapse 5 $1,475.00 $3,592.00 $2,533.50 nat. median
$9,478
outlier · 0.3×
308
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders With Mcc 5 $1,475.00 $3,573.00 $2,524.00 nat. median
$12,751
outlier · 0.2×
305
MS_DRG 		Hypertension Without Mcc 5 $1,475.00 $3,565.00 $2,520.00 nat. median
$8,578
outlier · 0.3×
291
MS_DRG 		Heart Failure And Shock With Mcc 5 $1,475.00 $3,550.00 $2,512.50 nat. median
$13,521
outlier · 0.2×
918
MS_DRG 		Poisoning And Toxic Effects Of Drugs Without Mcc 5 $1,475.00 $3,530.00 $2,502.50 nat. median
$8,831
outlier · 0.3×
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Dis 5 $1,475.00 $3,518.00 $2,496.50 nat. median
$13,245
outlier · 0.2×
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 5 $1,475.00 $3,515.00 $2,495.00 nat. median
$16,234
outlier · 0.2×
812
MS_DRG 		Red Blood Cell Disorders Without Mcc 5 $1,475.00 $3,413.00 $2,444.00 nat. median
$9,870
outlier · 0.2×
687
MS_DRG 		Kidney And Urinary Tract Neoplasms With Cc 5 $1,475.00 $3,398.00 $2,436.50 nat. median
$11,403
outlier · 0.2×
605
MS_DRG 		Trauma To The Skin, Subcutaneous Tissue And Breast Without M 5 $1,475.00 $3,391.00 $2,433.00 nat. median
$9,920
outlier · 0.2×
378
MS_DRG 		Gastroinestinal Hemorrhage With Cc 5 $1,475.00 $3,388.00 $2,431.50 nat. median
$10,712
outlier · 0.2×
159
MS_DRG 		Dental And Oral Diseases Without Cc/mcc 5 $1,475.00 $3,313.00 $2,394.00 nat. median
$7,917
outlier · 0.3×
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 5 $1,475.00 $3,303.00 $2,389.00 nat. median
$13,648
outlier · 0.2×
155
MS_DRG 		Other Ear, Nose, Mouth And Throat Diagnoses With Cc 5 $1,475.00 $3,238.00 $2,356.50 nat. median
$10,037
outlier · 0.2×
699
MS_DRG 		Other Kidnwy And Urinary Tract Diagnoses With Cc 5 $1,475.00 $3,237.00 $2,356.00 nat. median
$10,935
outlier · 0.2×
191
MS_DRG 		Chronic Obstructive Pulmonary Disease With Cc 5 $1,475.00 $3,205.00 $2,340.00 nat. median
$9,406
outlier · 0.2×
310
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 5 $1,475.00 $3,205.00 $2,340.00 nat. median
$6,746
outlier · 0.3×
394
MS_DRG 		Other Diestive System Diagnoses With Mcc 5 $1,475.00 $3,190.00 $2,332.50 nat. median
$10,259
outlier · 0.2×
203
MS_DRG 		Bronchitis And Asthma Without Cc/mcc 5 $1,475.00 $3,182.00 $2,328.50 nat. median
$7,677
outlier · 0.3×
884
MS_DRG 		Organic Disturbances And Intellectual Disability 5 $1,475.00 $3,181.00 $2,328.00 nat. median
$14,858
outlier · 0.2×
638
MS_DRG 		Diabetes With Cc 5 $1,475.00 $3,177.00 $2,326.00 nat. median
$9,824
outlier · 0.2×
816
MS_DRG 		Reticuloendothelial & Immunity Disorders Without Cc/mcc 5 $1,475.00 $3,167.00 $2,321.00 nat. median
$7,565
outlier · 0.3×
556
MS_DRG 		Signs And Symptoms Of Musculoskeletal System And Connective 5 $1,475.00 $3,123.00 $2,299.00 nat. median
$9,145
outlier · 0.3×
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 5 $1,475.00 $3,116.00 $2,295.50 nat. median
$10,873
outlier · 0.2×
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metablosim, Fluids And 5 $1,475.00 $3,106.00 $2,290.50 nat. median
$8,664
outlier · 0.3×
948
MS_DRG 		Signs And Symptoms Without Mcc 5 $1,475.00 $3,097.00 $2,286.00 nat. median
$8,515
outlier · 0.3×
683
MS_DRG 		Renal Failure With Cc 5 $1,475.00 $3,048.00 $2,261.50 nat. median
$9,664
outlier · 0.2×
392
MS_DRG 		Esophagitis, Gastroenteritis And Misc Digestive Dis 5 $1,475.00 $3,044.00 $2,259.50 nat. median
$8,728
outlier · 0.3×
863
MS_DRG 		Postoperative And Post-traumatic Infections Without Mcc 5 $1,475.00 $3,028.00 $2,251.50 nat. median
$10,815
outlier · 0.2×
49205
HCPCS 		Excision Endometrioma >10.0cm 5 $2,235.54 $2,235.54 $2,235.54 nat. median
$4,203
0.5× median
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 5 $1,475.00 $2,996.00 $2,235.50 nat. median
$12,152
outlier · 0.2×
563
MS_DRG 		Fracture, Sprain, Strain And Dislocation Except Femur, Hip 5 $1,475.00 $2,971.00 $2,223.00 nat. median
$9,671
outlier · 0.2×
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 5 $1,475.00 $2,971.00 $2,223.00 nat. median
$9,125
outlier · 0.2×
292
MS_DRG 		Heart Failure And Shock With Cc 5 $1,475.00 $2,965.00 $2,220.00 nat. median
$9,635
outlier · 0.2×
179
MS_DRG 		Respiratory Infectins And Inflammations Without Cc/mcc 5 $1,475.00 $2,961.00 $2,218.00 nat. median
$8,705
outlier · 0.3×

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.

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
             
813 MS_DRG Coagulation Disorders 9 5 $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 10 5 $8,028.03 $4,014.02 50% off $1,475.00 $4,900.00 $3,187.50 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 9 5 $21,851.07 $10,925.54 50% off $1,475.00 $4,760.00 $3,117.50 2026-04-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 9 5 $11,348.61 $5,674.31 50% off $1,475.00 $4,415.00 $2,945.00 2026-04-01
313 MS_DRG Chest Pain 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $11,940.86 $5,970.43 50% off $1,475.00 $3,649.00 $2,562.00 2026-04-01
149 MS_DRG Dysequilibrium 9 5 $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 9 5 $8,904.11 $4,452.06 50% off $1,475.00 $3,630.00 $2,552.50 2026-04-01
315 MS_DRG Other Circulatory System Diagnoses With Cc 9 5 $7,791.23 $3,895.62 50% off $1,475.00 $3,605.00 $2,540.00 2026-04-01
312 MS_DRG Syncope And Collapse 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $5,102.75 $2,551.38 50% off $1,475.00 $3,530.00 $2,502.50 2026-04-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Dis 9 5 $7,893.45 $3,946.73 50% off $1,475.00 $3,518.00 $2,496.50 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $7,016.25 $3,508.13 50% off $1,475.00 $3,205.00 $2,340.00 2026-04-01
394 MS_DRG Other Diestive System Diagnoses With Mcc 9 5 $7,601.76 $3,800.88 50% off $1,475.00 $3,190.00 $2,332.50 2026-04-01
203 MS_DRG Bronchitis And Asthma Without Cc/mcc 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $7,550.27 $3,775.14 50% off $1,475.00 $2,996.00 $2,235.50 2026-04-01
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip 9 5 $5,449.55 $2,724.78 50% off $1,475.00 $2,971.00 $2,223.00 2026-04-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 9 5 $6,869.92 $3,434.96 50% off $1,475.00 $2,971.00 $2,223.00 2026-04-01
292 MS_DRG Heart Failure And Shock With Cc 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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 9 5 $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
69 MS_DRG Transient Ischemia Without Thrombolytic 9 5 $4,955.62 $2,477.81 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 9 5 $6,532.93 $3,266.47 50% off $1,475.00 $1,475.00 $1,475.00 2026-04-01
101 MS_DRG Seizures Without Mcc 9 5 $5,725.40 $2,862.70 50% off $1,475.00 $1,475.00 $1,475.00 2026-04-01
174 MS_DRG G.i. Hemorrhage W Cc 9 5 $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 9 5 $6,053.47 $3,026.74 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 HCPCS 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
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
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
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
P9612 HCPCS Insertion Cath - Ua Only ER 13 5 $46.00 $23.00 50% off $2.70 $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
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
73700 HCPCS CT Low Ext Lt Without Contrast,procedure Performed On The Lt Side Of The Body 20 5 $1,054.00 $527.00 50% off $71.62 $275.00 $228.31 2026-04-01
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