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

LAKE DISTRICT HOSPITAL

Lakeview, OR · CCN 381309 · Rates published

Your selected procedure

You selected 93350 (HCPCS)

Ultrasound of heart during rest, exercise and/or drug-induced stress with report

This hospital’s price: $822 across 13 payers · range $67-$2,138

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbLakeDistrict2&type=CDMWithoutLabel&fileType=CSV · observed 2026-06-19

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.

3,785 distinct procedures filed
18 distinct payers
81,113 rate rows
2026-06-19 last MRF observed
Data quality

80,874 of 81,113 rate rows are consumer-grade (99.7%)

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

Excluded — reasonRows
percent-of-charges filed in the dollar field — excluded from medians 167
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 40
per-diem day rate — not a per-procedure price 30
exceeds 10× this hospital's gross charge — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbLakeDistrict2&type=CDMWithoutLabel&fileType=CSV
Found on page https://lakehealthdistrict.org/price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-20
Content fingerprint 4323bc41343d2c65… · 31,201,274 bytes · first seen 2026-07-17

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
8693206_1
CDM 		32909-0168-02 - Barium Sulfate 105% Rectal Susp 1900 Ml [lake] 12 $39,902.00 $79,804.00 $75,813.80 nat. median
$75,814
1.0× median
J2350
HCPCS 		Injection, Ocrelizumab, 1 Mg 13 $24,406.50 $63,456.90 $46,372.35 nat. median
$414
outlier · 111.9×
J3241
HCPCS 		Injection, Teprotumumab-trbw, 10 Mg 13 $22,381.50 $58,191.90 $42,524.85 nat. median
$718
outlier · 59.2×
J9119
HCPCS 		Injection, Cemiplimab-rwlc, 1 Mg 13 $15,941.64 $41,448.26 $30,289.12 nat. median
$91
outlier · 332.7×
J1930
HCPCS 		Injection, Lanreotide, 1 Mg 13 $13,370.25 $34,762.65 $25,403.48 nat. median
$5,088
outlier · 5.0×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 13 $11,772.90 $30,609.54 $22,368.51 nat. median
$3,787
outlier · 5.9×
J9299
HCPCS 		Injection, Nivolumab, 1 Mg 13 $10,822.94 $28,139.64 $20,563.59 nat. median
$2,849
outlier · 7.2×
J3380
HCPCS 		Injection, Vedolizumab, Intravenous, 1 Mg 13 $9,734.85 $25,310.61 $18,496.22 nat. median
$155
outlier · 119.7×
9793226_1
CDM 		Phasix Sterile Mesh 8x10 12 $9,539.55 $19,079.10 $18,125.15 nat. median
$18,125
1.0× median
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 13 $9,378.09 $24,383.03 $17,818.37 nat. median
$1,659
outlier · 10.7×
J2323
HCPCS 		Injection, Natalizumab, 1 Mg 13 $9,301.50 $24,183.90 $17,672.85 nat. median
$180
outlier · 98.4×
29807
HCPCS 		Repair Of Shoulder Socket Using An Endoscope 13 $9,152.50 $23,796.50 $17,389.75 nat. median
$7,094
outlier · 2.5×
27447
HCPCS 		Replacement Of Knee Joint, Both Sides Of Knee 13 $297.84 $41,915.90 $16,121.50 nat. median
$12,739
1.3× median
J0717
HCPCS 		Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 13 $8,132.34 $21,144.08 $15,451.45 nat. median
$1,635
outlier · 9.5×
J9271
HCPCS 		Injection, Pembrolizumab, 1 Mg 13 $8,044.14 $20,914.76 $15,283.87 nat. median
$275
outlier · 55.7×
49654
HCPCS 		Laparoscopy, Surgical, Repair, Incisional Hernia (includes Mesh Insertion, When… 13 $1,638.00 $30,288.70 $15,144.35 nat. median
$4,638
outlier · 3.3×
J9306
HCPCS 		Injection, Pertuzumab, 1 Mg 13 $7,550.34 $19,630.88 $14,345.65 nat. median
$75
outlier · 191.1×
49566
HCPCS 		Repair Recurrent Incisional Or Ventral Hernia; Incarcerated Or Strangulated 13 $7,394.00 $19,224.40 $14,048.60 nat. median
$4,344
outlier · 3.2×
58660
HCPCS 		Removal Of Scar Tissue Of Ovaries Or Fallopian Tubes Using An Endoscope 13 $280.71 $19,224.40 $13,609.70 nat. median
$5,906
outlier · 2.3×
49650
HCPCS 		Repair Of Groin Hernia Using An Endoscope 13 $264.71 $17,981.60 $12,741.49 nat. median
$5,840
outlier · 2.2×
Q5111
HCPCS 		Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 13 $6,294.00 $16,364.40 $11,958.60 nat. median
$1,984
outlier · 6.0×
8765437_1
CDM 		Allomax 4x8 Surgical Graft 12 $5,847.66 $11,695.32 $11,110.55 nat. median
$11,111
1.0× median
J0565
HCPCS 		Injection, Bezlotoxumab, 10 Mg 13 $5,731.50 $14,901.90 $10,889.85 nat. median
$159
outlier · 68.6×
50230
HCPCS 		Removal Of Kidney, Lymph Nodes, And/or Blood Clot From Major Vein With Partial R… 13 $207.74 $26,587.60 $10,226.00 nat. median
$2,952
outlier · 3.5×
J2182
HCPCS 		Injection, Mepolizumab, 1 Mg 13 $4,998.98 $12,997.34 $9,498.05 nat. median
$2,791
outlier · 3.4×
J0840
HCPCS 		Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 13 $4,828.50 $12,554.10 $9,174.15 nat. median
$3,452
outlier · 2.7×
29827
HCPCS 		Repair Of Shoulder Rotator Cuff Using An Endoscope 13 $493.96 $23,796.50 $9,152.50 nat. median
$7,187
1.3× median
25607
HCPCS 		Treatment Of Broken Forearm Bone On Thumb Side Of Wrist, Above Wrist, With Place… 13 $115.86 $23,796.50 $9,152.50 nat. median
$7,088
1.3× median
49565
HCPCS 		Repair Recurrent Incisional Or Ventral Hernia; Reducible 13 $1,489.80 $17,981.60 $8,990.80 nat. median
$3,073
outlier · 2.9×
49652
HCPCS 		Laparoscopy, Surgical, Repair, Ventral, Umbilical, Spigelian Or Epigastric Herni… 13 $1,442.35 $17,981.60 $8,990.80 nat. median
$5,038
1.8× median
47480
HCPCS 		Drainage Or Removal Of Stone From Gallbladder 13 $4,651.00 $12,092.60 $8,836.90 nat. median
$2,506
outlier · 3.5×
23430
HCPCS 		Anchoring Of Biceps Tendon 13 $101.27 $22,722.70 $8,739.50 nat. median
$6,937
1.3× median
8766295_1
CDM 		Summit Cemented Stem Std 3 12 $4,558.64 $9,117.27 $8,661.41 nat. median
$8,661
1.0× median
8766730_1
CDM 		Alloderm 8x16 12 $4,556.34 $9,112.68 $8,657.05 nat. median
$8,657
1.0× median
27698
HCPCS 		Secondary Repair Of Disrupted Collateral Ligament Of Ankle 13 $581.06 $22,297.60 $8,576.00 nat. median
$6,559
1.3× median
27236
HCPCS 		Treatment Of Upper End Of Broken Thigh Bone With Placement Of Stabilizing Device… 13 $180.57 $22,297.60 $8,576.00 nat. median
$4,896
1.8× median
49592
HCPCS 		Initial Repair Of Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length 13 $415.10 $16,939.00 $8,469.50 nat. median
$5,879
1.4× median
27880
HCPCS 		Amputation Of Both Lower Leg Bones 13 $4,232.00 $11,003.20 $8,040.80 nat. median
$3,647
outlier · 2.2×
58180
HCPCS 		Removal Of Uterus Through Abdomen 13 $4,207.50 $10,939.50 $7,994.25 nat. median
$3,293
outlier · 2.4×
J9217
HCPCS 		Leuprolide Acetate (for Depot Suspension), 7.5 Mg 13 $2,433.38 $30,299.43 $7,783.73 nat. median
$1,573
outlier · 4.9×
29879
HCPCS 		Repair Of Knee Joint With Drilling And Or Scraping Of Joint Using An Endoscope 13 $3,948.00 $10,264.80 $7,501.20 nat. median
$3,748
outlier · 2.0×
29875
HCPCS 		Partial Removal Of Knee Joint Lining Using An Endoscope 13 $3,948.00 $10,264.80 $7,501.20 nat. median
$3,607
outlier · 2.1×
26615
HCPCS 		Treatment Of Broken Midhand Bone 13 $3,948.00 $10,264.80 $7,501.20 nat. median
$3,818
2.0× median
25120
HCPCS 		Removal Of Cyst Or Growth Of Lower Forearm Bone 13 $3,948.00 $10,264.80 $7,501.20 nat. median
$3,512
outlier · 2.1×
8766309_1
CDM 		Summit Por Taper Sz5 Std Off 12 $3,926.79 $7,853.57 $7,460.89 nat. median
$7,461
1.0× median
8766273_1
CDM 		Summit Por Taper Sz7 Hi Off 12 $3,926.79 $7,853.57 $7,460.89 nat. median
$7,461
1.0× median
59510
HCPCS 		Cesarean Delivery With Care Before And After Delivery 12 $1,390.97 $7,877.00 $7,412.25 nat. median
$3,631
outlier · 2.0×
19307
HCPCS 		Removal Of Breast And Underarm Lymph Nodes 13 $919.31 $19,232.20 $7,397.00 nat. median
$6,795
1.1× median
59151
HCPCS 		Removal Of Ovarian Or Tubal Pregnancy With Removal Of Ovary And/or Tube Using An… 13 $656.21 $19,224.40 $7,394.00 nat. median
$6,193
1.2× median
58661
HCPCS 		Removal Of Ovaries And/or Tubes Using An Endoscope 13 $97.79 $19,224.40 $7,394.00 nat. median
$5,947
1.2× median

Other procedures at this hospital

Browse this hospital's 3,785 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
             
8693206_1 CDM 32909-0168-02 - Barium Sulfate 105% Rectal Susp 1900 Ml [lake] 12 12 $79,804.00 $67,833.40 $39,902.00 $79,804.00 $75,813.80 2026-06-19
J2350 HCPCS Injection, Ocrelizumab, 1 Mg 13 13 $48,813.00 $41,491.05 $24,406.50 $63,456.90 $46,372.35 2026-06-19
J3241 HCPCS Injection, Teprotumumab-trbw, 10 Mg 13 13 $44,763.00 $38,048.55 $22,381.50 $58,191.90 $42,524.85 2026-06-19
J9119 HCPCS Injection, Cemiplimab-rwlc, 1 Mg 13 13 $31,883.28 $27,100.79 $15,941.64 $41,448.26 $30,289.12 2026-06-19
J1930 HCPCS Injection, Lanreotide, 1 Mg 13 13 $26,740.50 $22,729.43 $13,370.25 $34,762.65 $25,403.48 2026-06-19
J3101 HCPCS Injection, Tenecteplase, 1 Mg 13 13 $23,545.80 $20,013.93 $11,772.90 $30,609.54 $22,368.51 2026-06-19
J9299 HCPCS Injection, Nivolumab, 1 Mg 13 13 $21,645.88 $18,399.00 $10,822.94 $28,139.64 $20,563.59 2026-06-19
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 13 13 $19,469.70 $16,549.25 $9,734.85 $25,310.61 $18,496.22 2026-06-19
9793226_1 CDM Phasix Sterile Mesh 8x10 12 12 $19,079.10 $16,217.24 $9,539.55 $19,079.10 $18,125.15 2026-06-19
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 13 13 $18,756.18 $15,942.75 $9,378.09 $24,383.03 $17,818.37 2026-06-19
J2323 HCPCS Injection, Natalizumab, 1 Mg 13 13 $18,603.00 $15,812.55 $9,301.50 $24,183.90 $17,672.85 2026-06-19
29807 HCPCS Repair Of Shoulder Socket Using An Endoscope 13 13 $18,305.00 $15,559.25 $9,152.50 $23,796.50 $17,389.75 2026-06-19
27447 HCPCS Replacement Of Knee Joint, Both Sides Of Knee 25 13 $32,243.00 $27,406.55 $297.84 $41,915.90 $16,121.50 2026-06-19
J0717 HCPCS Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 13 13 $16,264.68 $13,824.98 $8,132.34 $21,144.08 $15,451.45 2026-06-19
J9271 HCPCS Injection, Pembrolizumab, 1 Mg 13 13 $16,088.28 $13,675.04 $8,044.14 $20,914.76 $15,283.87 2026-06-19
49654 HCPCS Laparoscopy, Surgical, Repair, Incisional Hernia (includes Mesh Insertion, When … 23 13 $23,299.00 $19,804.15 $1,638.00 $30,288.70 $15,144.35 2026-06-19
J9306 HCPCS Injection, Pertuzumab, 1 Mg 13 13 $15,100.68 $12,835.58 $7,550.34 $19,630.88 $14,345.65 2026-06-19
49566 HCPCS Repair Recurrent Incisional Or Ventral Hernia; Incarcerated Or Strangulated 13 13 $14,788.00 $12,569.80 $7,394.00 $19,224.40 $14,048.60 2026-06-19
58660 HCPCS Removal Of Scar Tissue Of Ovaries Or Fallopian Tubes Using An Endoscope 38 13 $14,331.00 $12,181.35 $280.71 $19,224.40 $13,609.70 2026-06-19
49650 HCPCS Repair Of Groin Hernia Using An Endoscope 38 13 $13,429.00 $11,414.65 $264.71 $17,981.60 $12,741.49 2026-06-19
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 13 13 $12,588.00 $10,699.80 $6,294.00 $16,364.40 $11,958.60 2026-06-19
8765437_1 CDM Allomax 4x8 Surgical Graft 12 12 $11,695.32 $9,941.02 $5,847.66 $11,695.32 $11,110.55 2026-06-19
J0565 HCPCS Injection, Bezlotoxumab, 10 Mg 13 13 $11,463.00 $9,743.55 $5,731.50 $14,901.90 $10,889.85 2026-06-19
50230 HCPCS Removal Of Kidney, Lymph Nodes, And/or Blood Clot From Major Vein With Partial R… 25 13 $20,452.00 $17,384.20 $207.74 $26,587.60 $10,226.00 2026-06-19
J2182 HCPCS Injection, Mepolizumab, 1 Mg 13 13 $9,997.95 $8,498.26 $4,998.98 $12,997.34 $9,498.05 2026-06-19
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 13 13 $9,657.00 $8,208.45 $4,828.50 $12,554.10 $9,174.15 2026-06-19
25607 HCPCS Treatment Of Broken Forearm Bone On Thumb Side Of Wrist, Above Wrist, With Place… 25 13 $18,305.00 $15,559.25 $115.86 $23,796.50 $9,152.50 2026-06-19
29827 HCPCS Repair Of Shoulder Rotator Cuff Using An Endoscope 25 13 $18,305.00 $15,559.25 $493.96 $23,796.50 $9,152.50 2026-06-19
49565 HCPCS Repair Recurrent Incisional Or Ventral Hernia; Reducible 23 13 $13,832.00 $11,757.20 $1,489.80 $17,981.60 $8,990.80 2026-06-19
49652 HCPCS Laparoscopy, Surgical, Repair, Ventral, Umbilical, Spigelian Or Epigastric Herni… 23 13 $13,832.00 $11,757.20 $1,442.35 $17,981.60 $8,990.80 2026-06-19
47480 HCPCS Drainage Or Removal Of Stone From Gallbladder 13 13 $9,302.00 $7,906.70 $4,651.00 $12,092.60 $8,836.90 2026-06-19
23430 HCPCS Anchoring Of Biceps Tendon 25 13 $17,479.00 $14,857.15 $101.27 $22,722.70 $8,739.50 2026-06-19
8766295_1 CDM Summit Cemented Stem Std 3 12 12 $9,117.27 $7,749.68 $4,558.64 $9,117.27 $8,661.41 2026-06-19
8766730_1 CDM Alloderm 8x16 12 12 $9,112.68 $7,745.78 $4,556.34 $9,112.68 $8,657.05 2026-06-19
27698 HCPCS Secondary Repair Of Disrupted Collateral Ligament Of Ankle 25 13 $17,152.00 $14,579.20 $581.06 $22,297.60 $8,576.00 2026-06-19
27236 HCPCS Treatment Of Upper End Of Broken Thigh Bone With Placement Of Stabilizing Device… 25 13 $17,152.00 $14,579.20 $180.57 $22,297.60 $8,576.00 2026-06-19
49592 HCPCS Initial Repair Of Entrapped Hernia Of Abdomen, Less Than 3 Cm In Length 23 13 $13,030.00 $11,075.50 $415.10 $16,939.00 $8,469.50 2026-06-19
27880 HCPCS Amputation Of Both Lower Leg Bones 13 13 $8,464.00 $7,194.40 $4,232.00 $11,003.20 $8,040.80 2026-06-19
58180 HCPCS Removal Of Uterus Through Abdomen 13 13 $8,415.00 $7,152.75 $4,207.50 $10,939.50 $7,994.25 2026-06-19
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 65 13 $8,193.40 $6,964.39 $2,433.38 $30,299.43 $7,783.73 2026-06-19
25120 HCPCS Removal Of Cyst Or Growth Of Lower Forearm Bone 13 13 $7,896.00 $6,711.60 $3,948.00 $10,264.80 $7,501.20 2026-06-19
29879 HCPCS Repair Of Knee Joint With Drilling And Or Scraping Of Joint Using An Endoscope 13 13 $7,896.00 $6,711.60 $3,948.00 $10,264.80 $7,501.20 2026-06-19
26615 HCPCS Treatment Of Broken Midhand Bone 13 13 $7,896.00 $6,711.60 $3,948.00 $10,264.80 $7,501.20 2026-06-19
29875 HCPCS Partial Removal Of Knee Joint Lining Using An Endoscope 13 13 $7,896.00 $6,711.60 $3,948.00 $10,264.80 $7,501.20 2026-06-19
8766309_1 CDM Summit Por Taper Sz5 Std Off 12 12 $7,853.57 $6,675.53 $3,926.79 $7,853.57 $7,460.89 2026-06-19
8766273_1 CDM Summit Por Taper Sz7 Hi Off 12 12 $7,853.57 $6,675.53 $3,926.79 $7,853.57 $7,460.89 2026-06-19
59510 HCPCS Cesarean Delivery With Care Before And After Delivery 12 12 $7,877.00 $6,695.45 $1,390.97 $7,877.00 $7,412.25 2026-06-19
19307 HCPCS Removal Of Breast And Underarm Lymph Nodes 25 13 $14,794.00 $12,574.90 $919.31 $19,232.20 $7,397.00 2026-06-19
58661 HCPCS Removal Of Ovaries And/or Tubes Using An Endoscope 25 13 $14,788.00 $12,569.80 $97.79 $19,224.40 $7,394.00 2026-06-19
44180 HCPCS Release Of Small Bowel Scar Tissue Using An Endoscope 25 13 $14,788.00 $12,569.80 $135.89 $19,224.40 $7,394.00 2026-06-19
58662 HCPCS Destruction Or Removal Of Ovary Or Growth Of Pelvis Using An Endoscope 25 13 $14,788.00 $12,569.80 $305.66 $19,224.40 $7,394.00 2026-06-19
59151 HCPCS Removal Of Ovarian Or Tubal Pregnancy With Removal Of Ovary And/or Tube Using An… 25 13 $14,788.00 $12,569.80 $656.21 $19,224.40 $7,394.00 2026-06-19
44144 HCPCS Partial Removal Of Large Bowel With Creation Of 2 Openings From Small Or Large B… 25 13 $14,726.00 $12,517.10 $843.26 $19,143.80 $7,363.00 2026-06-19
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 26 13 $13,706.93 $11,650.89 $474.89 $34,403.30 $7,233.38 2026-06-19
58150 HCPCS Removal Of Uterus And Cervix Through Abdomen 25 13 $14,445.00 $12,278.25 $810.72 $18,778.50 $7,222.50 2026-06-19
21235 HCPCS Obtaining Ear Cartilage For Grafting 25 13 $14,172.00 $12,046.20 $101.27 $18,423.60 $7,086.00 2026-06-19
26910 HCPCS Amputation Of Finger Or Thumb 13 13 $7,442.00 $6,325.70 $3,721.00 $9,674.60 $7,069.90 2026-06-19
J3315 HCPCS Injection, Triptorelin Pamoate, 3.75 Mg 13 13 $7,382.15 $6,274.83 $3,691.08 $9,596.80 $7,013.04 2026-06-19
58550 HCPCS Removal Of Uterus Through Vagina Using An Endoscope, 250.0 G Or Less 25 13 $13,832.00 $11,757.20 $584.73 $17,981.60 $6,916.00 2026-06-19
49320 HCPCS Diagnostic Exam Of Abdomen Using An Endoscope 25 13 $13,832.00 $11,757.20 $46.91 $17,981.60 $6,916.00 2026-06-19
60240 HCPCS Removal Of Thyroid 25 13 $13,832.00 $11,757.20 $134.77 $17,981.60 $6,916.00 2026-06-19
44970 HCPCS Removal Of Appendix Using An Endoscope 25 13 $13,565.00 $11,530.25 $54.73 $17,634.50 $6,782.50 2026-06-19
47562 HCPCS Removal Of Gallbladder Using An Endoscope 25 13 $13,565.00 $11,530.25 $466.12 $17,634.50 $6,782.50 2026-06-19
46275 HCPCS Repair Of Abnormal Drainage Tract In Anal Sphincter 13 13 $7,139.00 $6,068.15 $3,569.50 $9,280.70 $6,782.05 2026-06-19
58558 HCPCS Biopsy Of Lining Of Uterus And/or Removal Of Polyp Using An Endoscope 38 13 $6,900.00 $5,865.00 $175.32 $9,240.40 $6,547.18 2026-06-19
57522 HCPCS Removal Or Destruction Of Cervix Using Loop Electrode 38 13 $6,900.00 $5,865.00 $224.47 $9,240.40 $6,547.18 2026-06-19
49322 HCPCS Aspiration Of Abdominal Cavity Or Cyst Using An Endoscope 25 13 $13,030.00 $11,075.50 $51.75 $16,939.00 $6,515.00 2026-06-19
J1451 HCPCS Injection, Fomepizole, 15 Mg 13 13 $6,813.00 $5,791.05 $3,406.50 $8,856.90 $6,472.35 2026-06-19
9551662_1 CDM 11/130 Deg Ti Cann Tfna 340/right Sile 12 12 $6,705.99 $5,700.09 $3,353.00 $6,705.99 $6,370.69 2026-06-19
7634784_1 CDM Operating Room Services - General Classification 12 12 $6,679.25 $5,677.36 $3,339.63 $6,679.25 $6,345.29 2026-06-19
24201 HCPCS Removal Of Foreign Body, Upper Arm Or Elbow Area 13 13 $6,458.00 $5,489.30 $3,229.00 $8,395.40 $6,135.10 2026-06-19
44604 HCPCS Suture Of Tear Or Hole In Large Bowel 25 13 $11,980.00 $10,183.00 $684.29 $15,574.00 $5,990.00 2026-06-19
J7168 HCPCS Prothrombin Complex Concentrate (human), Kcentra, Per I.u. Of Factor Ix Activity 26 13 $7,389.72 $6,281.27 $3,001.95 $11,408.22 $5,943.86 2026-06-19
44208 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum And Creation Of Openin… 25 13 $10,233.00 $8,698.05 $202.21 $13,302.90 $5,915.00 2026-06-19
49560 HCPCS Repair Initial Incisional Or Ventral Hernia; Reducible 23 13 $9,086.00 $7,723.10 $1,430.65 $11,811.80 $5,905.90 2026-06-19
J9312 HCPCS Injection, Rituximab, 10 Mg 26 13 $8,856.90 $7,528.37 $1,779.01 $18,402.54 $5,851.65 2026-06-19
J1602 HCPCS Injection, Golimumab, 1 Mg, For Intravenous Use 13 13 $6,060.58 $5,151.49 $3,030.29 $7,878.75 $5,757.55 2026-06-19
49591 HCPCS Initial Repair Of Sliding Hernia Of Abdomen, Less Than 3 Cm In Length 23 13 $8,855.00 $7,526.75 $300.57 $11,511.50 $5,755.75 2026-06-19
44960 HCPCS Removal Of Ruptured Infected Appendix 25 13 $11,454.00 $9,735.90 $505.96 $14,890.20 $5,727.00 2026-06-19
J9041 HCPCS Injection, Bortezomib, 0.1 Mg 13 13 $5,959.20 $5,065.32 $2,979.60 $7,746.96 $5,661.24 2026-06-19
J9355 HCPCS Injection, Trastuzumab, Excludes Biosimilar, 10 Mg 13 13 $5,860.30 $4,981.26 $2,930.15 $7,618.39 $5,567.29 2026-06-19
66984 HCPCS Removal Of Cataract With Insertion Of Prosthetic Lens 13 13 $5,771.00 $4,905.35 $2,885.50 $7,502.30 $5,482.45 2026-06-19
8766231_1 CDM Sigma Ps Cem Rem Sz 4 R 12 12 $5,688.54 $4,835.26 $2,844.27 $5,688.54 $5,404.11 2026-06-19
8766316_1 CDM Sigma Ps Cem Fem Sz5 L 12 12 $5,688.54 $4,835.26 $2,844.27 $5,688.54 $5,404.11 2026-06-19
8766314_1 CDM Sigma Ps Cem Fem Sz6 L 12 12 $5,688.54 $4,835.26 $2,844.27 $5,688.54 $5,404.11 2026-06-19
8766279_1 CDM Sigma Ps Cem Fem Sz3 L 12 12 $5,688.54 $4,835.26 $2,844.27 $5,688.54 $5,404.11 2026-06-19
8766302_1 CDM Sigma Ps Cem Fem Sz 4 L 12 12 $5,688.54 $4,835.26 $2,844.27 $5,688.54 $5,404.11 2026-06-19
8766312_1 CDM Sigma Ps Cem Fem Sz 4n L 12 12 $5,688.54 $4,835.26 $2,844.27 $5,688.54 $5,404.11 2026-06-19
8766227_1 CDM Sigma Ps Cem Rem Sz 5 R 12 12 $5,688.54 $4,835.26 $2,844.27 $5,688.54 $5,404.11 2026-06-19
8766322_1 CDM Summit Cemented Stem Sz6 Std 12 12 $5,667.66 $4,817.51 $2,833.83 $5,667.66 $5,384.28 2026-06-19
8766277_1 CDM Summit Cemented Stem Sz4 Std 12 12 $5,667.66 $4,817.51 $2,833.83 $5,667.66 $5,384.28 2026-06-19
8766300_1 CDM Summit Cemented Stem Std 5 12 12 $5,667.66 $4,817.51 $2,833.83 $5,667.66 $5,384.28 2026-06-19
J9047 HCPCS Injection, Carfilzomib, 1 Mg 13 13 $5,664.70 $4,815.00 $2,832.35 $7,364.11 $5,381.47 2026-06-19
8693808_1 CDM 60574-4114-01 - Palivizumab 100 mg/mL IM Sol [lake] 12 12 $5,631.59 $4,786.85 $2,815.80 $5,631.59 $5,350.01 2026-06-19
Q5115 HCPCS Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg 26 13 $7,977.35 $6,780.74 $1,604.23 $16,570.13 $5,272.06 2026-06-19
J0875 HCPCS Injection, Dalbavancin, 5 Mg 13 13 $5,449.39 $4,631.98 $2,724.70 $7,084.21 $5,176.92 2026-06-19
J3240 HCPCS Injection, Thyrotropin Alpha, 0.9 Mg, Provided In 1.1 Mg Vial 13 13 $5,388.09 $4,579.88 $2,694.05 $7,004.52 $5,118.69 2026-06-19
J3358 HCPCS Ustekinumab, For Intravenous Injection, 1 Mg 13 13 $5,339.87 $4,538.89 $2,669.94 $6,941.83 $5,072.88 2026-06-19
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 38 13 $5,359.00 $4,555.15 $100.15 $7,112.30 $5,062.18 2026-06-19
J0897 HCPCS Injection, Denosumab, 1 Mg 26 13 $5,471.30 $4,650.60 $2,530.18 $7,646.90 $5,009.75 2026-06-19
52204 HCPCS Biopsy Of Bladder Using An Endoscope 13 13 $5,240.00 $4,454.00 $2,620.00 $6,812.00 $4,978.00 2026-06-19
59414 HCPCS Delivery Of Placenta 38 13 $5,200.00 $4,420.00 $18.02 $9,240.40 $4,940.00 2026-06-19
J0129 HCPCS Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere… 13 13 $5,196.23 $4,416.80 $2,598.12 $6,755.10 $4,936.42 2026-06-19
35840 HCPCS Exploration Of Abdomen For Bleeding, Blood Clot, Or Infection After Surgery 25 13 $9,692.00 $8,238.20 $502.98 $12,599.60 $4,846.00 2026-06-19
8766230_1 CDM Mbt Cem Keel Tib Sz 3 12 12 $5,100.79 $4,335.67 $2,550.40 $5,100.79 $4,845.75 2026-06-19
8766311_1 CDM Mbt Cem Keel Tib Tray Sz 2.5 12 12 $5,100.79 $4,335.67 $2,550.40 $5,100.79 $4,845.75 2026-06-19
8766301_1 CDM Mbt Cem Deel Tib Sz 4 12 12 $5,100.79 $4,335.67 $2,550.40 $5,100.79 $4,845.75 2026-06-19
8766286_1 CDM Mbt Cem Keel Tib Sz 5 12 12 $5,100.79 $4,335.67 $2,550.40 $5,100.79 $4,845.75 2026-06-19
11006 HCPCS Removal Of Infected Skin, Tissue Or Muscle Of Genitals, Perineum, Or Abdomen 13 13 $4,914.00 $4,176.90 $2,457.00 $6,388.20 $4,668.30 2026-06-19
64718 HCPCS Release And/or Relocation Of Elbow Nerve 25 13 $4,910.00 $4,173.50 $89.35 $6,383.00 $4,664.50 2026-06-19
49507 HCPCS Repair Of Trapped Groin Hernia (5 Years Or Older) 25 13 $9,302.00 $7,906.70 $83.02 $12,092.60 $4,651.00 2026-06-19
49520 HCPCS Repair Of Groin Hernia That Is Not Trapped 25 13 $9,302.00 $7,906.70 $421.82 $12,092.60 $4,651.00 2026-06-19
J2357 HCPCS Injection, Omalizumab, 5 Mg 13 13 $4,832.82 $4,107.90 $2,416.41 $6,282.67 $4,591.18 2026-06-19
8987116_1 CDM Prevena Dressing Kits 35cm 9 9 $4,790.89 $4,072.26 $3,114.08 $4,790.89 $4,551.35 2026-06-19
49550 HCPCS Repair Of Femoral Groin Hernia 25 13 $9,086.00 $7,723.10 $375.28 $11,811.80 $4,543.00 2026-06-19
26951 HCPCS Amputation Of Finger Or Thumb With Direct Closure 24 13 $7,896.00 $6,711.60 $685.95 $10,264.80 $4,540.20 2026-06-19
49900 HCPCS Suture Of Postsurgical Opening In Abdominal Wall 13 13 $4,749.00 $4,036.65 $2,374.50 $6,173.70 $4,511.55 2026-06-19
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 13 13 $4,718.00 $4,010.30 $2,359.00 $6,133.40 $4,482.10 2026-06-19
8766324_1 CDM Pinn Sector W/gription 58mm 12 12 $4,675.14 $3,973.87 $2,337.57 $4,675.14 $4,441.38 2026-06-19
8766319_1 CDM Pinn Sector W/gription 54mm 12 12 $4,675.14 $3,973.87 $2,337.57 $4,675.14 $4,441.38 2026-06-19
8766305_1 CDM Pinn Sector 52mm W/gription 12 12 $4,675.14 $3,973.87 $2,337.57 $4,675.14 $4,441.38 2026-06-19
8766270_1 CDM Pinn Sector W/gription 60mm 12 12 $4,675.14 $3,973.87 $2,337.57 $4,675.14 $4,441.38 2026-06-19
44950 HCPCS Removal Of Appendix 25 13 $8,872.00 $7,541.20 $400.59 $11,533.60 $4,436.00 2026-06-19
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 38 13 $4,718.00 $4,010.30 $82.66 $6,133.40 $4,397.18 2026-06-19
23930 HCPCS Drainage Of Deep Abscess Or Blood Accumulation Of Upper Arm Or Elbow 13 13 $4,611.00 $3,919.35 $2,305.50 $5,994.30 $4,380.45 2026-06-19
44205 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 25 13 $8,740.00 $7,429.00 $1,004.84 $11,362.00 $4,370.00 2026-06-19
15731 HCPCS Creation Of Flap Graft To Nose, Forehead, Temple, Or Scalp 25 13 $8,700.00 $7,395.00 $854.86 $11,310.00 $4,350.00 2026-06-19
15730 HCPCS Creation Of Flap Graft To Midface 25 13 $8,700.00 $7,395.00 $766.30 $11,310.00 $4,350.00 2026-06-19
15120 HCPCS Partial Thickness Self Skin Graft To Face, Scalp, Eyelids, Mouth, Neck, Ears, Ar… 25 13 $8,700.00 $7,395.00 $92.70 $11,310.00 $4,350.00 2026-06-19
14301 HCPCS Repair Of Wound By Transferring Skin, 30.1-60.0 Sq Cm 25 13 $8,700.00 $7,395.00 $177.59 $11,310.00 $4,350.00 2026-06-19
15733 HCPCS Creation Of Flap Graft To Head And/or Neck 25 13 $8,700.00 $7,395.00 $881.33 $11,310.00 $4,350.00 2026-06-19
43246 HCPCS Insertion Of Stomach Tube Using A Flexible Endoscope 38 13 $4,552.00 $3,869.20 $172.92 $7,419.10 $4,324.40 2026-06-19
19120 HCPCS Removal Of Growth And Tissue Of Breast, Duct, Or Nipple 25 13 $8,595.00 $7,305.75 $210.72 $11,173.50 $4,297.50 2026-06-19
Q0138 HCPCS Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd … 13 13 $4,503.25 $3,827.76 $2,251.63 $5,854.23 $4,278.09 2026-06-19
8775062_1 CDM Intensive Care Unit - General Classification 11 11 $4,503.00 $3,827.55 $3,467.31 $4,503.00 $4,277.85 2026-06-19
2120844_1 CDM Intensive Care Unit - Medical 11 11 $4,503.00 $3,827.55 $3,467.31 $4,503.00 $4,277.85 2026-06-19
8775063_1 CDM Intensive Care Unit - Pediatric 11 11 $4,503.00 $3,827.55 $3,467.31 $4,503.00 $4,277.85 2026-06-19
8775061_1 CDM Nursery - Newborn - Level Ii 11 11 $4,464.00 $3,794.40 $3,437.28 $4,464.00 $4,240.80 2026-06-19
J1745 HCPCS Injection, Infliximab, Excludes Biosimilar, 10 Mg 13 13 $4,456.29 $3,787.85 $2,228.15 $5,793.18 $4,233.48 2026-06-19
J1439 HCPCS Injection, Ferric Carboxymaltose, 1 Mg 13 13 $4,429.75 $3,765.29 $2,214.88 $5,758.68 $4,208.26 2026-06-19
90375 HCPCS Rabies Immune Globulin For Injection 26 13 $5,850.50 $4,972.93 $1,579.18 $11,105.45 $4,188.60 2026-06-19
31622 HCPCS Diagnostic Exam Of Lung Airway Using An Endoscope 13 13 $4,373.00 $3,717.05 $2,186.50 $5,684.90 $4,154.35 2026-06-19
28820 HCPCS Amputation Of Toe At Joint Between Forefoot And Toes 25 13 $8,270.00 $7,029.50 $157.36 $10,751.00 $4,135.00 2026-06-19
49505 HCPCS Repair Of Groin Hernia (5 Years Or Older) 25 13 $8,202.00 $6,971.70 $344.01 $10,662.60 $4,101.00 2026-06-19
42825 HCPCS Removal Of Tonsils (younger Than 12 Years) 25 13 $8,181.00 $6,953.85 $168.65 $10,635.30 $4,090.50 2026-06-19
59412 HCPCS Turning Of Fetus Through External Manipulation 24 13 $7,107.00 $6,040.95 $88.76 $9,239.10 $4,086.53 2026-06-19
28810 HCPCS Amputation Of Toe And Midfoot Bone 25 13 $7,999.00 $6,799.15 $253.16 $10,398.70 $3,999.50 2026-06-19
29883 HCPCS Repair Of Inside And Outside Knee Joint Cartilage Using An Endoscope 25 13 $7,999.00 $6,799.15 $583.39 $10,398.70 $3,999.50 2026-06-19
26565 HCPCS Incision Or Removal Of Hand Bone 25 13 $7,999.00 $6,799.15 $337.30 $10,398.70 $3,999.50 2026-06-19
28825 HCPCS Amputation Of Toe At Toe Joint 25 13 $7,667.00 $6,516.95 $152.32 $9,967.10 $3,833.50 2026-06-19
42826 HCPCS Removal Of Tonsils (12 Years Or Older) 25 13 $7,654.00 $6,505.90 $202.53 $9,950.20 $3,827.00 2026-06-19
30120 HCPCS Removal Or Scraping Of Skin On Nose 25 13 $7,654.00 $6,505.90 $366.29 $9,950.20 $3,827.00 2026-06-19
J7325 HCPCS Hyaluronan Or Derivative, Synvisc Or Synvisc-one, For Intra-articular Injection,… 39 13 $4,002.00 $3,401.70 $962.84 $6,705.56 $3,801.90 2026-06-19
J2325 HCPCS Injection, Nesiritide, 0.1 Mg 13 13 $4,000.66 $3,400.56 $2,000.33 $5,200.86 $3,800.63 2026-06-19
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 37 13 $4,068.00 $3,457.80 $407.81 $5,289.70 $3,792.31 2026-06-19
26200 HCPCS Removal Of Cyst Or Growth From Hand Bone 13 13 $3,955.00 $3,361.75 $1,977.50 $5,141.50 $3,757.25 2026-06-19
27825 HCPCS Closed Treatment Of Broken Shin Bone At Lower Weight Bearing Joint With Manipula… 13 13 $3,952.00 $3,359.20 $1,976.00 $5,137.60 $3,754.40 2026-06-19
J3262 HCPCS Injection, Tocilizumab, 1 Mg 39 13 $3,946.25 $3,354.31 $883.31 $8,224.16 $3,748.94 2026-06-19
8765436_1 CDM Ventralight St Mesh 7x9 Composix 12 12 $3,930.00 $3,340.50 $1,965.00 $3,930.00 $3,733.50 2026-06-19
8765433_1 CDM Mesh Composix E/x 8x10 12 12 $3,930.00 $3,340.50 $1,965.00 $3,930.00 $3,733.50 2026-06-19
8769615_1 CDM Mesh Duel Gore 18x24 12 12 $3,930.00 $3,340.50 $1,965.00 $3,930.00 $3,733.50 2026-06-19
8766287_1 CDM Sig Rp Aox Stb Ins Sz 5 10 12 12 $3,930.00 $3,340.50 $1,965.00 $3,930.00 $3,733.50 2026-06-19
8766315_1 CDM Sig Rp Aox Stb Ins Sz6 10 12 12 $3,930.00 $3,340.50 $1,965.00 $3,930.00 $3,733.50 2026-06-19
9016675_1 CDM Phasix St 7cm X 10cm Rectangle 9 9 $3,930.00 $3,340.50 $2,554.50 $3,930.00 $3,733.50 2026-06-19
8765852_1 CDM Closurefast Cath 100cm Cfp 12 12 $3,930.00 $3,340.50 $1,965.00 $3,930.00 $3,733.50 2026-06-19
8766296_1 CDM Sig Rp Aox Stb Ins Sz 4 10 12 12 $3,930.00 $3,340.50 $1,965.00 $3,930.00 $3,733.50 2026-06-19
8766326_1 CDM Dlt Ts Cer Hd 12/14 40mm +1.5 12 12 $3,930.00 $3,340.50 $1,965.00 $3,930.00 $3,733.50 2026-06-19
8766280_1 CDM Sig Rp Aox Stb Ins Sz3 10 12 12 $3,930.00 $3,340.50 $1,965.00 $3,930.00 $3,733.50 2026-06-19
9246584_1 CDM Minerva Es Disp. Handpiece Min9770 9 9 $3,930.00 $3,340.50 $2,554.50 $3,930.00 $3,733.50 2026-06-19
8766325_1 CDM Altrx Neut 40idx58od 12 12 $3,920.32 $3,332.27 $1,960.16 $3,920.32 $3,724.30 2026-06-19
25270 HCPCS Primary Repair Of Tendon Or Muscle Of Top Side Of Forearm Or Wrist 25 13 $7,301.00 $6,205.85 $65.15 $9,491.30 $3,650.50 2026-06-19
59160 HCPCS Scraping Of Lining Of Uterus After Delivery 25 13 $7,300.00 $6,205.00 $158.85 $9,490.00 $3,650.00 2026-06-19
59821 HCPCS Treatment Of Miscarriage During Second Trimester 25 13 $7,300.00 $6,205.00 $327.76 $9,490.00 $3,650.00 2026-06-19
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 26 13 $3,813.00 $3,241.05 $1,860.00 $5,077.80 $3,616.95 2026-06-19
20205 HCPCS Deep Biopsy Of Muscle 25 13 $7,157.00 $6,083.45 $109.08 $9,304.10 $3,578.50 2026-06-19
24071 HCPCS Removal Of Growth Under Skin Of Upper Arm Or Elbow, 3.0 Cm Or More 25 13 $7,157.00 $6,083.45 $67.01 $9,304.10 $3,578.50 2026-06-19
8998361_1 CDM Tru Clear Dense Tissue Shaver Mini 9 9 $3,744.34 $3,182.69 $2,433.82 $3,744.34 $3,557.12 2026-06-19
Q5103 HCPCS Injection, Infliximab-dyyb, Biosimilar, (inflectra), 10 Mg 13 13 $3,632.17 $3,087.34 $1,816.09 $4,721.82 $3,450.56 2026-06-19
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 47 13 $5,286.00 $4,493.10 $97.58 $6,988.80 $3,435.90 2026-06-19
46060 HCPCS Incision And Drainage Of Abscess In Wall Of Rectum Or Between Rectum And Muscle … 25 13 $6,822.00 $5,798.70 $353.69 $8,868.60 $3,411.00 2026-06-19
25111 HCPCS Removal Of First Cyst Of Wrist 13 13 $3,586.00 $3,048.10 $1,793.00 $4,661.80 $3,406.70 2026-06-19
69110 HCPCS Partial Removal Of External Ear With Simple Repair 25 13 $6,777.00 $5,760.45 $126.58 $8,810.10 $3,388.50 2026-06-19
10180 HCPCS Complex Drainage Of Wound Infection After Surgery 25 13 $6,777.00 $5,760.45 $117.65 $8,810.10 $3,388.50 2026-06-19
11470 HCPCS Removal Of Skin And Tissue Of Anus Or Navel For Inflamed Sweat Glands With Simpl… 25 13 $6,777.00 $5,760.45 $135.52 $8,810.10 $3,388.50 2026-06-19
22900 HCPCS Removal Of Growth Of Muscle Of Abdomen, Less Than 5.0 Cm 25 13 $6,777.00 $5,760.45 $403.95 $8,810.10 $3,388.50 2026-06-19
59410 HCPCS Vaginal Delivery With Post Delivery Care 11 11 $3,560.00 $3,026.00 $922.65 $3,560.00 $3,382.00 2026-06-19
8766243_1 CDM 4.5mm Curved Plate 10 Holes 12 12 $3,559.55 $3,025.62 $1,779.78 $3,559.55 $3,381.57 2026-06-19
27245 HCPCS Treatment Of Broken Neck Of Thigh Bone With Bone Implant 12 12 $3,555.00 $3,021.75 $186.89 $3,555.00 $3,345.26 2026-06-19
8766272_1 CDM Delta Cer Head 12/14 36mm 12 12 $3,483.73 $2,961.17 $1,741.87 $3,483.73 $3,309.54 2026-06-19
8766308_1 CDM Delta Cer Head 12/14 36mm +1.5 12 12 $3,483.73 $2,961.17 $1,741.87 $3,483.73 $3,309.54 2026-06-19
10026854_1 CDM 00093-4127-73-thp - Thp Penicillin V Potassium 250 Mg/5 Ml Oral 100ml [lake] 12 12 $3,479.85 $2,957.87 $1,739.93 $3,479.85 $3,305.86 2026-06-19
8765248_1 CDM Gel Port 120mm 12 12 $3,392.50 $2,883.63 $1,696.25 $3,392.50 $3,222.88 2026-06-19
9467612_1 CDM Swvlk Teno Bio-comp 7x 9 9 $3,327.75 $2,828.59 $2,163.04 $3,327.75 $3,161.36 2026-06-19
43332 HCPCS Repair Of Paraesophageal Hernia Through Abdomen 12 12 $3,346.00 $2,844.10 $973.33 $3,346.00 $3,148.59 2026-06-19
9566739_1 CDM Infasurf 35 Mg/ml Vial 12 12 $3,302.20 $2,806.87 $1,651.10 $3,302.20 $3,137.09 2026-06-19
95807 HCPCS Sleep Study Including Heart Rate And Breathing Attended By Technician 13 13 $3,300.00 $2,805.00 $1,650.00 $4,290.00 $3,135.00 2026-06-19
95805 HCPCS Sleep Study, Multiple Trials 13 13 $3,300.00 $2,805.00 $1,650.00 $4,290.00 $3,135.00 2026-06-19
59514 HCPCS Cesarean Delivery 25 13 $5,299.00 $4,504.15 $771.01 $6,888.70 $3,134.00 2026-06-19
8766271_1 CDM Altrx +4 Neut 36idx60od 12 12 $3,286.82 $2,793.80 $1,643.41 $3,286.82 $3,122.48 2026-06-19
8766307_1 CDM Altrx +4 Neut 36idx52od 12 12 $3,286.82 $2,793.80 $1,643.41 $3,286.82 $3,122.48 2026-06-19
36568 HCPCS Insertion Of Tube For Infusion (younger Than 5 Years) 13 13 $3,267.00 $2,776.95 $1,633.50 $4,247.10 $3,103.65 2026-06-19
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 13 13 $3,267.00 $2,776.95 $1,633.50 $4,247.10 $3,103.65 2026-06-19
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 38 13 $3,257.00 $2,768.45 $91.57 $7,358.00 $3,094.15 2026-06-19
8766731_1 CDM Alloderm 4x12 Thick 12 12 $3,232.89 $2,747.96 $1,616.45 $3,232.89 $3,071.25 2026-06-19
66982 HCPCS Complex Removal Of Cataract With Insertion Of Prosthetic Lens 25 13 $6,121.00 $5,202.85 $201.04 $7,957.30 $3,060.50 2026-06-19
29826 HCPCS Shaving Of Part Of Shoulder Bone And Repair Of Ligament Using An Endoscope 25 13 $6,102.00 $5,186.70 $141.76 $7,932.60 $3,051.00 2026-06-19
9467611_1 CDM Dbl Loaded 4.75mm Bio-comp Swvlk 9 9 $3,190.05 $2,711.54 $2,073.53 $3,190.05 $3,030.55 2026-06-19
Q5104 HCPCS Injection, Infliximab-abda, Biosimilar, (renflexis), 10 Mg 13 13 $3,185.84 $2,707.96 $1,592.92 $4,141.59 $3,026.55 2026-06-19
8768410_1 CDM Tacker 5mm 12 12 $3,181.42 $2,704.21 $1,590.71 $3,181.42 $3,022.35 2026-06-19
46608 HCPCS Removal Of Foreign Body In Anus Using An Endoscope 13 13 $3,176.00 $2,699.60 $1,588.00 $4,128.80 $3,017.20 2026-06-19
8766246_1 CDM 10mm Ti Cann Tibial Nail-ex W/bend 345mm 12 12 $3,153.33 $2,680.33 $1,576.67 $3,153.33 $2,995.66 2026-06-19
40654 HCPCS Repair Of Vertical Lip Wound Extending To Over Half Of Lip 13 13 $3,117.00 $2,649.45 $1,558.50 $4,052.10 $2,961.15 2026-06-19
31605 HCPCS Emergent Incision Of Windpipe For Insertion Of Breathing Tube 13 13 $3,103.00 $2,637.55 $1,551.50 $4,033.90 $2,947.85 2026-06-19
31603 HCPCS Emergent Incision Of Windpipe Through Neck For Insertion Of Breathing Tube 13 13 $3,103.00 $2,637.55 $1,551.50 $4,033.90 $2,947.85 2026-06-19
57105 HCPCS Biopsy Of Extensive Area Of Vaginal Mucous Membrane 25 13 $5,841.00 $4,964.85 $132.06 $7,593.30 $2,920.50 2026-06-19
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 25 13 $5,794.00 $4,924.90 $104.15 $7,532.20 $2,897.00 2026-06-19
J7296 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System, (kyleena), 19.5 Mg 26 13 $3,499.61 $2,974.67 $1,446.00 $5,339.39 $2,863.08 2026-06-19
J7298 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System (mirena), 52 Mg 26 13 $3,298.61 $2,803.82 $1,435.50 $4,844.10 $2,842.29 2026-06-19
8766320_1 CDM Altrx Neut 36idx54od 12 12 $2,983.50 $2,535.98 $1,491.75 $2,983.50 $2,834.33 2026-06-19
67975 HCPCS Reconstruction Of Eyelid By Transfer Of Eyelid Tissue From Opposite Eyelid 25 13 $5,656.00 $4,807.60 $286.30 $7,352.80 $2,828.00 2026-06-19
46040 HCPCS Drainage Of Deep Abscess In Rectum 38 13 $2,950.00 $2,507.50 $178.70 $6,992.70 $2,802.50 2026-06-19
8860131_1 CDM Labor Room/delivery - Labor 12 12 $2,918.00 $2,480.30 $1,459.00 $2,918.00 $2,772.10 2026-06-19
J9155 HCPCS Injection, Degarelix, 1 Mg 26 13 $3,894.42 $3,310.26 $1,027.94 $7,452.85 $2,769.56 2026-06-19
45100 HCPCS Biopsy Of Anal And/or Rectal Wall Through Anus 25 13 $5,480.00 $4,658.00 $168.65 $7,124.00 $2,740.00 2026-06-19
46924 HCPCS Extensive Destruction Of Growth Of Anus 25 13 $5,480.00 $4,658.00 $167.48 $7,124.00 $2,740.00 2026-06-19
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 38 13 $2,875.00 $2,443.75 $82.33 $4,171.70 $2,731.25 2026-06-19
15200 HCPCS Full Thickness Skin Graft To Trunk, 20.0 Sq Cm Or Less 24 13 $4,742.00 $4,030.70 $589.32 $6,164.60 $2,726.65 2026-06-19
J0490 HCPCS Injection, Belimumab, 10 Mg 26 13 $3,887.39 $3,304.28 $978.34 $7,563.53 $2,726.36 2026-06-19
43245 HCPCS Dilation Of Stomach Outlet Using A Flexible Endoscope 25 13 $5,445.00 $4,628.25 $152.65 $7,078.50 $2,722.50 2026-06-19
21501 HCPCS Drainage Of Deep Abscess Or Blood Accumulation In Soft Tissue Of Neck Or Chest 25 13 $5,423.00 $4,609.55 $51.01 $7,049.90 $2,711.50 2026-06-19
8775066_1 CDM Room & Board - Semi-private (two Beds) - General Classification 11 11 $2,849.00 $2,421.65 $2,193.73 $2,849.00 $2,706.55 2026-06-19
8848693_1 CDM Room & Board - Semi-private (two Beds) - Obstetrics (ob) 11 11 $2,849.00 $2,421.65 $2,193.73 $2,849.00 $2,706.55 2026-06-19
40652 HCPCS Repair Of Vertical Lip Wound Extending To Half Of Lip 13 13 $2,834.00 $2,408.90 $1,417.00 $3,684.20 $2,692.30 2026-06-19
41252 HCPCS Repair Of Lacerated Tongue Or Floor Of Mouth, More Than 2.6 Cm 13 13 $2,834.00 $2,408.90 $1,417.00 $3,684.20 $2,692.30 2026-06-19
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 25 13 $5,359.00 $4,555.15 $104.15 $6,966.70 $2,679.50 2026-06-19
54700 HCPCS Incision And Drainage Of Sperm Reservoir, Testis, And/or Scrotal Area 25 13 $5,332.00 $4,532.20 $195.03 $6,931.60 $2,666.00 2026-06-19
71552 HCPCS MRI Scan Of Chest Before And After Contrast 25 13 $5,323.00 $4,524.55 $102.48 $6,919.90 $2,661.50 2026-06-19
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 25 13 $5,323.00 $4,524.55 $100.15 $6,919.90 $2,661.50 2026-06-19
70553 HCPCS MRI Scan Of Brain Before And After Contrast 25 13 $5,286.00 $4,493.10 $103.82 $6,871.80 $2,643.00 2026-06-19
54520 HCPCS Simple Removal Of Testicle 25 13 $5,238.00 $4,452.30 $253.16 $6,809.40 $2,619.00 2026-06-19
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 38 13 $2,739.00 $2,328.15 $79.19 $4,171.70 $2,602.05 2026-06-19
64421 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Multiple Rib Nerves For Region… 13 13 $2,732.00 $2,322.20 $1,366.00 $3,551.60 $2,595.40 2026-06-19
45382 HCPCS Control Of Bleeding Of Upper Large Bowel Using A Flexible Endoscope 13 13 $2,707.00 $2,300.95 $1,353.50 $3,519.10 $2,571.65 2026-06-19
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 25 13 $5,137.00 $4,366.45 $107.96 $6,678.10 $2,568.50 2026-06-19
8987103_1 CDM Speedbrg Imp Sys W/bio-comp Swvl 12 12 $2,662.20 $2,262.87 $1,331.10 $2,662.20 $2,529.09 2026-06-19
81420 HCPCS Test For Detecting Genes Associated With Fetal Disease, Aneuploidy Genomic Seque… 13 13 $2,655.00 $2,256.75 $1,327.50 $2,655.00 $2,522.25 2026-06-19
99291 HCPCS Critical Care, First 30-74 Minutes 25 13 $5,035.00 $4,279.75 $121.60 $6,545.50 $2,517.50 2026-06-19
94002 HCPCS Initial Hospital Inpatient Or Observation Ventilation Assistance And Management 13 13 $2,636.00 $2,240.60 $1,318.00 $3,426.80 $2,504.20 2026-06-19
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 25 13 $4,975.00 $4,228.75 $104.15 $6,467.50 $2,487.50 2026-06-19
64721 HCPCS Release And/or Relocation Of Hand Nerve 25 13 $4,910.00 $4,173.50 $63.29 $6,383.00 $2,455.00 2026-06-19
15260 HCPCS Full Thickness Skin Graft To Nose, Ears, Eyelids, Or Lips, 20.0 Sq Cm Or Less 25 13 $4,742.00 $4,030.70 $84.51 $6,164.60 $2,455.00 2026-06-19
44204 HCPCS Partial Removal Of Large Bowel Using An Endoscope 25 13 $2,493.00 $2,119.05 $218.17 $4,594.00 $2,443.14 2026-06-19
J1670 HCPCS Injection, Tetanus Immune Globulin, Human, Up To 250 Units 13 13 $2,559.55 $2,175.62 $1,279.78 $3,327.42 $2,431.57 2026-06-19
A0434 HCPCS Specialty Care Transport (sct) 26 13 $2,562.50 $2,178.12 $1,250.00 $3,412.50 $2,430.75 2026-06-19
1370882_1 CDM Trauma Team Activated 9 9 $2,554.00 $2,170.90 $1,660.10 $2,554.00 $2,426.30 2026-06-19
G0390 HCPCS Trauma Response Team Associated With Hospital Critical Care Service 13 13 $2,554.00 $2,170.90 $1,277.00 $3,320.20 $2,426.30 2026-06-19
15740 HCPCS Creation Of Skin And Tissue Graft 25 13 $4,742.00 $4,030.70 $101.27 $6,164.60 $2,424.00 2026-06-19
8766264_1 CDM 2.7mm 3.5mm Va-lcp 75mm Short 12 12 $2,550.20 $2,167.67 $1,275.10 $2,550.20 $2,422.69 2026-06-19
8765434_1 CDM Mesh Composix E/x 10x14 12 12 $2,524.50 $2,145.83 $1,262.25 $2,524.50 $2,398.28 2026-06-19
8766132_1 CDM 3.5mm Lcp Proximal Humerus Plate 114mm 12 12 $2,517.17 $2,139.59 $1,258.59 $2,517.17 $2,391.31 2026-06-19
27503 HCPCS Closed Treatment Of Broken Thigh Bone At Far End With Manipulation 25 13 $3,961.00 $3,366.85 $93.08 $5,149.30 $2,385.00 2026-06-19
14061 HCPCS Repair Of Wound Of Eyelids, Nose, Ears, Or Lips By Transferring Skin, 10.1-30.0 … 25 13 $4,742.00 $4,030.70 $684.43 $6,164.60 $2,377.00 2026-06-19
43249 HCPCS Balloon Dilation Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexibl… 25 13 $4,749.00 $4,036.65 $133.14 $6,173.70 $2,374.50 2026-06-19
15650 HCPCS Transfer Of Skin Flap 25 13 $4,742.00 $4,030.70 $176.86 $6,164.60 $2,371.00 2026-06-19
15630 HCPCS Transfer Of Skin Flap To Eyelids, Nose, Ears, Or Lips 25 13 $4,742.00 $4,030.70 $50.63 $6,164.60 $2,371.00 2026-06-19
15620 HCPCS Transfer Of Skin Flap To Forehead, Cheeks, Chin, Neck, Underarms, Genitals, Hand… 25 13 $4,742.00 $4,030.70 $253.16 $6,164.60 $2,371.00 2026-06-19
15610 HCPCS Transfer Of Skin Flap To Scalp, Arms, Or Legs 25 13 $4,742.00 $4,030.70 $37.23 $6,164.60 $2,371.00 2026-06-19
15576 HCPCS Creation Of Flap Graft To Eyelids, Nose, Ears, Lips, Or Mouth 25 13 $4,742.00 $4,030.70 $63.29 $6,164.60 $2,371.00 2026-06-19
15275 HCPCS Application Of Skin Substitute Graft To Wound Of Face, Scalp, Eyelids, Mouth, Ne… 25 13 $4,742.00 $4,030.70 $82.11 $6,164.60 $2,371.00 2026-06-19
15271 HCPCS Application Of Skin Substitute Graft To Wound Of Trunk, Arms, Or Legs, 25.0 Sq C… 25 13 $4,742.00 $4,030.70 $72.20 $6,164.60 $2,371.00 2026-06-19
15240 HCPCS Full Thickness Skin Graft To Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Gen… 25 13 $4,742.00 $4,030.70 $67.39 $6,164.60 $2,371.00 2026-06-19
15220 HCPCS Full Thickness Skin Graft To Scalp, Arms, Or Legs, 20.0 Sq Cm Or Less 25 13 $4,742.00 $4,030.70 $58.82 $6,164.60 $2,371.00 2026-06-19
15100 HCPCS Partial Thickness Self Skin Graft To Trunk, Arms, Or Legs, 100.0 Sq Cm Or 1% Bod… 25 13 $4,742.00 $4,030.70 $265.45 $6,164.60 $2,371.00 2026-06-19
14302 HCPCS Repair Of Wound By Transferring Skin, Each Additional 30.0 Sq Cm 25 13 $4,742.00 $4,030.70 $176.00 $6,164.60 $2,371.00 2026-06-19
14060 HCPCS Repair Of Wound Of Eyelids, Nose, Ears, Or Lips By Transferring Skin, 10.0 Sq Cm… 25 13 $4,742.00 $4,030.70 $84.51 $6,164.60 $2,371.00 2026-06-19
14041 HCPCS Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Han… 25 13 $4,742.00 $4,030.70 $421.82 $6,164.60 $2,371.00 2026-06-19
14040 HCPCS Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Han… 25 13 $4,742.00 $4,030.70 $67.39 $6,164.60 $2,371.00 2026-06-19
14021 HCPCS Repair Of Wound Of Scalp, Arms, Or Legs By Transferring Skin, 10.1-30.0 Sq Cm 25 13 $4,742.00 $4,030.70 $337.30 $6,164.60 $2,371.00 2026-06-19
14020 HCPCS Repair Of Wound Of Scalp, Arms, Or Legs By Transferring Skin, 10.0 Sq Cm Or Less 25 13 $4,742.00 $4,030.70 $50.63 $6,164.60 $2,371.00 2026-06-19
14001 HCPCS Repair Of Wound Of Trunk By Transferring Skin, 10.1-30.0 Sq Cm 25 13 $4,742.00 $4,030.70 $291.88 $6,164.60 $2,371.00 2026-06-19
14000 HCPCS Repair Of Wound Of Trunk By Transferring Skin, 10.0 Sq Cm Or Less 25 13 $4,742.00 $4,030.70 $44.68 $6,164.60 $2,371.00 2026-06-19
13160 HCPCS Extensive Or Complicated Repair Of Surface Wound Reopening 25 13 $4,742.00 $4,030.70 $548.40 $6,164.60 $2,371.00 2026-06-19
8775065_1 CDM Room & Board - Semi-private (two Beds) - Pediatric 11 11 $2,476.00 $2,104.60 $1,906.52 $2,476.00 $2,352.20 2026-06-19
9527049_1 CDM Room & Board - Other - Sterile Environment 11 11 $2,476.00 $2,104.60 $1,906.52 $2,476.00 $2,352.20 2026-06-19
8528543_1 CDM Room & Board - Semi-private (two Beds) - General Classification 11 11 $2,476.00 $2,104.60 $1,906.52 $2,476.00 $2,352.20 2026-06-19
8766262_1 CDM 2.7mm 3.5mm Va-lcp Humerus 108mm 12 12 $2,471.72 $2,100.96 $1,235.86 $2,471.72 $2,348.13 2026-06-19
24505 HCPCS Closed Treatment Of Broken Middle Part Of Upper Arm Bone With Manipulation 24 13 $4,081.00 $3,468.85 $460.79 $5,305.30 $2,346.57 2026-06-19
73720 HCPCS MRI Scan Of Leg Before And After Contrast 25 13 $4,686.00 $3,983.10 $97.91 $6,091.80 $2,343.00 2026-06-19
20102 HCPCS Exploration Of Wound Of Abdomen, Back, Or Flank 25 13 $4,662.00 $3,962.70 $135.52 $6,060.60 $2,331.00 2026-06-19
J7307 HCPCS Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 26 13 $2,993.94 $2,544.86 $1,072.50 $4,995.76 $2,321.44 2026-06-19
8766131_1 CDM 3.5mm Lcp Proximal Humerus Plate 90mm 3h 12 12 $2,439.85 $2,073.87 $1,219.93 $2,439.85 $2,317.86 2026-06-19
27517 HCPCS Closed Treatment Of Growth Plate Broken At End Of Thigh Bone With Manipulation 24 13 $3,961.00 $3,366.85 $633.63 $5,149.30 $2,310.82 2026-06-19
8766222_1 CDM 8mm Ti Cannulated Tibial Nail 405mm 12 12 $2,401.18 $2,041.00 $1,200.59 $2,401.18 $2,281.12 2026-06-19
43215 HCPCS Removal Of Foreign Bodies In Esophagus Using A Flexible Endoscope 25 13 $4,552.00 $3,869.20 $123.88 $5,917.60 $2,276.00 2026-06-19
27752 HCPCS Closed Treatment Of Middle Part Of Broken Shin Bone With Manipulation 24 13 $3,955.00 $3,361.75 $486.38 $5,141.50 $2,274.12 2026-06-19
49000 HCPCS Exploration Of Abdominal Cavity 25 13 $3,495.00 $2,970.75 $421.82 $4,543.50 $2,271.75 2026-06-19
73725 HCPCS MRI Scan Of Blood Vessels Of Leg 25 13 $4,531.00 $3,851.35 $81.66 $5,890.30 $2,265.50 2026-06-19
8765941_1 CDM 2.4/2.7mm Va-lcp Fusion Deg/right 12 12 $2,383.74 $2,026.18 $1,191.87 $2,383.74 $2,264.55 2026-06-19
94003 HCPCS Follow-up Inpatient Or Observation Ventilation Assistance And Management 13 13 $2,383.00 $2,025.55 $1,191.50 $3,097.90 $2,263.85 2026-06-19
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 25 13 $4,504.00 $3,828.40 $81.52 $5,855.20 $2,252.00 2026-06-19
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