|
J3357
|
HCPCS
|
Ustekinumab 90 Mg/ml Subq Sosy
|
48
|
43
|
$70,198.00
|
$70,198.00
|
$11,223.00
|
$73,481.00
|
$69,806.95
|
2026-01-01
|
|
J2350
|
HCPCS
|
Ocrelizumab 300 Mg/10ml IV Soln
|
46
|
41
|
$53,405.00
|
$53,405.00
|
$14,106.00
|
$56,479.00
|
$54,502.24
|
2026-01-01
|
|
Q4309
|
HCPCS
|
Via Matrix Per Sq Cm
|
47
|
42
|
$52,000.00
|
$52,000.00
|
$12,750.40
|
$52,000.00
|
$49,400.00
|
2026-01-01
|
|
J3241
|
HCPCS
|
Teprotumumab-trbw 500 Mg IV Solr
|
48
|
43
|
$50,201.00
|
$50,201.00
|
$12,309.29
|
$50,201.00
|
$47,690.95
|
2026-01-01
|
|
J9334
|
HCPCS
|
Efgartigimod Alfa-hyalur-qvfc 180-2000 Mg-unit/ml Subq Soln
|
46
|
41
|
$43,376.00
|
$43,376.00
|
$13,345.92
|
$46,605.00
|
$44,973.82
|
2026-01-01
|
|
Q4283
|
HCPCS
|
Biovance 3l Tri-layer Human Amniotic Mem
|
46
|
41
|
$32,000.00
|
$32,000.00
|
$957.55
|
$32,000.00
|
$30,880.00
|
2026-01-01
|
|
J1950
|
HCPCS
|
Leuprolide Acetate (ped)(3mon) 11.25 Mg IM Kit
|
47
|
42
|
$29,757.00
|
$29,757.00
|
$4,000.26
|
$29,757.00
|
$28,269.15
|
2026-01-01
|
|
J3380
|
HCPCS
|
Vedolizumab 300 Mg IV Solr
|
46
|
41
|
$23,714.00
|
$23,714.00
|
$5,202.00
|
$26,077.00
|
$25,164.31
|
2026-01-01
|
|
SUP-ABS-2090-10
|
CDM
|
Arthrocell Plus Allograft, 10cc
|
43
|
38
|
$25,000.00
|
$25,000.00
|
$7,784.00
|
$25,000.00
|
$24,500.00
|
2026-01-01
|
|
J2327
|
HCPCS
|
Risankizumab-rzaa 600 Mg/10ml IV Soln
|
46
|
41
|
$23,122.00
|
$23,122.00
|
$6,232.46
|
$23,122.00
|
$22,312.73
|
2026-01-01
|
|
J2323
|
HCPCS
|
Natalizumab 300 Mg/15ml IV Conc
|
46
|
41
|
$22,576.00
|
$22,576.00
|
$5,730.00
|
$21,571.00
|
$20,816.01
|
2026-01-01
|
|
J3101
|
HCPCS
|
Tenecteplase 50 Mg IV Kit
|
90
|
40
|
$20,922.00
|
$20,922.00
|
$6,497.00
|
$21,911.00
|
$20,503.56
|
2026-01-01
|
|
SUP-ABS-4200-038
|
CDM
|
Amnion Thick 3x8
|
43
|
38
|
$18,335.00
|
$18,335.00
|
$5,708.79
|
$18,335.00
|
$17,968.30
|
2026-01-01
|
|
J2353
|
HCPCS
|
Octreotide Acetate 30 Mg IM Kit
|
46
|
41
|
$17,254.00
|
$17,254.00
|
$5,241.00
|
$17,570.00
|
$16,955.05
|
2026-01-01
|
|
J0717
|
HCPCS
|
Certolizumab Pegol 200 Mg/ml Subq Pskt
|
46
|
41
|
$7,102.00
|
$7,102.00
|
$1,248.00
|
$15,876.00
|
$15,320.34
|
2026-01-01
|
|
J0491
|
HCPCS
|
Anifrolumab-fnia 300 Mg/2ml IV Soln
|
46
|
41
|
$14,887.00
|
$14,887.00
|
$4,096.46
|
$14,887.00
|
$14,365.95
|
2026-01-01
|
|
J1932
|
HCPCS
|
Lanreotide Acetate 120 Mg/0.5ml Subq Soln
|
46
|
41
|
$15,380.00
|
$15,380.00
|
$2,938.46
|
$13,055.00
|
$12,598.08
|
2026-01-01
|
|
Q4282
|
HCPCS
|
Cygnus Dual Amniotic Allograft 2x3cm
|
144
|
43
|
$18,500.00
|
$18,500.00
|
$486.78
|
$28,125.00
|
$12,178.13
|
2026-01-01
|
|
J1162
|
HCPCS
|
Digoxin Immune Fab 40 Mg IV Solr
|
48
|
43
|
$12,059.00
|
$12,059.00
|
$3,075.30
|
$12,542.00
|
$11,914.90
|
2026-01-01
|
|
J0565
|
HCPCS
|
Bezlotoxumab 1000 Mg/40ml IV Soln
|
46
|
41
|
$10,398.00
|
$10,398.00
|
$3,190.00
|
$10,398.00
|
$10,034.07
|
2026-01-01
|
|
J1306
|
HCPCS
|
Inclisiran Sodium 284 Mg/1.5ml Subq Sosy
|
46
|
41
|
$9,253.00
|
$9,253.00
|
$2,962.28
|
$9,514.00
|
$9,181.01
|
2026-01-01
|
|
SUP-AR-8942W-1808
|
CDM
|
Biosync Evans Wedge, 18 X 18 X 8 Mm
|
43
|
38
|
$9,147.50
|
$9,147.50
|
$2,848.17
|
$9,147.50
|
$8,964.55
|
2026-01-01
|
|
J2182
|
HCPCS
|
Mepolizumab 100 Mg Subq Solr
|
92
|
41
|
$9,034.00
|
$9,034.00
|
$2,455.00
|
$10,692.00
|
$8,853.32
|
2026-01-01
|
|
73220
|
CPT
|
MRI Scan Of Arm Before And After Contrast
|
50
|
43
|
$7,567.00
|
$7,567.00
|
$343.53
|
$7,945.00
|
$7,547.75
|
2026-01-01
|
|
73223
|
CPT
|
MRI Scan Of Arm Joint Before And After Contrast
|
50
|
43
|
$7,346.00
|
$7,346.00
|
$316.88
|
$7,713.00
|
$7,327.35
|
2026-01-01
|
|
70553
|
CPT
|
MRI Scan Of Brain Before And After Contrast
|
50
|
43
|
$7,317.00
|
$7,317.00
|
$236.92
|
$7,683.00
|
$7,298.85
|
2026-01-01
|
|
70543
|
CPT
|
MRI Scan Of Bone Of Eye Socket, Face, And/or Neck
|
50
|
43
|
$7,313.00
|
$7,313.00
|
$266.26
|
$7,679.00
|
$7,295.05
|
2026-01-01
|
|
71552
|
CPT
|
MRI Scan Of Chest Before And After Contrast
|
50
|
43
|
$7,273.00
|
$7,273.00
|
$405.51
|
$7,637.00
|
$7,255.15
|
2026-01-01
|
|
70546
|
CPT
|
MRI Scan Of Blood Vessels Of Head Before And After Contrast
|
50
|
43
|
$7,273.00
|
$7,273.00
|
$291.44
|
$7,637.00
|
$7,255.15
|
2026-01-01
|
|
74174
|
CPT
|
CT Scan Of Blood Vessels Of Abdomen And Pelvis W/contrast
|
50
|
43
|
$7,216.00
|
$7,216.00
|
$310.15
|
$7,577.00
|
$7,198.15
|
2026-01-01
|
|
73720
|
CPT
|
MRI Scan Of Leg Before And After Contrast
|
50
|
43
|
$6,995.00
|
$6,995.00
|
$263.70
|
$7,345.00
|
$6,977.75
|
2026-01-01
|
|
J3111
|
HCPCS
|
Romosozumab-aqqg 105 Mg/1.17ml Subq Sosy
|
46
|
41
|
$6,851.00
|
$6,851.00
|
$2,239.61
|
$7,193.00
|
$6,941.25
|
2026-01-01
|
|
72158
|
CPT
|
MRI Scan Of Lower Spinal Canal Before And After Contrast
|
50
|
43
|
$6,865.00
|
$6,865.00
|
$236.92
|
$7,208.00
|
$6,847.60
|
2026-01-01
|
|
72197
|
CPT
|
MRI Scan Of Pelvis Before And After Contrast
|
50
|
43
|
$6,826.00
|
$6,826.00
|
$261.13
|
$7,167.00
|
$6,808.65
|
2026-01-01
|
|
J0401
|
HCPCS
|
Aripiprazole ER 400 Mg IM Prsy
|
46
|
41
|
$7,029.00
|
$7,029.00
|
$2,188.55
|
$7,029.00
|
$6,782.99
|
2026-01-01
|
|
44141
|
CPT
|
Hc Pr 44141 Partial Removal Of Colon, With Skin Level Cecostomy Or Colos
|
48
|
42
|
$6,659.00
|
$6,659.00
|
$1,886.98
|
$6,992.00
|
$6,642.40
|
2026-01-01
|
|
70549
|
CPT
|
MRI Scan Of Blood Vessels Of Neck Before And After Contrast
|
50
|
43
|
$6,461.00
|
$6,461.00
|
$292.54
|
$6,784.00
|
$6,444.80
|
2026-01-01
|
|
Q4194
|
HCPCS
|
Novachor 1 Sq Cm
|
48
|
43
|
$6,750.00
|
$6,750.00
|
$858.92
|
$6,750.00
|
$6,412.50
|
2026-01-01
|
|
73723
|
CPT
|
MRI Scan Of Leg Joint Before And After Contrast
|
50
|
43
|
$6,262.00
|
$6,262.00
|
$315.78
|
$6,575.00
|
$6,246.25
|
2026-01-01
|
|
44626
|
CPT
|
Hc Pr 44626 Repair Bowel Opening, Hartmann Method
|
48
|
42
|
$5,971.00
|
$5,971.00
|
$1,654.78
|
$6,270.00
|
$5,956.50
|
2026-01-01
|
|
49020
|
CPT
|
Hc Pr 49020 Drain Abdominal Abscess, Open
|
48
|
42
|
$5,938.00
|
$5,938.00
|
$1,668.54
|
$6,235.00
|
$5,923.25
|
2026-01-01
|
|
74178
|
CPT
|
CT Scan Of Abdomen And Pelvis Before And After Contrast
|
50
|
43
|
$5,932.00
|
$5,932.00
|
$273.23
|
$6,229.00
|
$5,917.55
|
2026-01-01
|
|
44143
|
CPT
|
Hc Pr 44143 Partial Removal Of Colon, Hartmann Procedure
|
48
|
42
|
$5,926.00
|
$5,926.00
|
$1,719.39
|
$6,222.00
|
$5,910.90
|
2026-01-01
|
|
44204
|
CPT
|
Hc Pr 44204 Laparoscopy Partial Colectomy
|
48
|
42
|
$5,634.00
|
$5,634.00
|
$1,602.79
|
$5,916.00
|
$5,620.20
|
2026-01-01
|
|
J1459
|
HCPCS
|
Privigen 10 Gm/100ml IV Soln
|
138
|
41
|
$3,154.00
|
$3,154.00
|
$788.40
|
$12,615.00
|
$5,462.30
|
2026-01-01
|
|
44202
|
CPT
|
Laparoscopy, Surgical; Enterectomy, Resection Of Small Intestine
|
48
|
42
|
$5,197.00
|
$5,197.00
|
$1,448.54
|
$5,457.00
|
$5,184.15
|
2026-01-01
|
|
J1602
|
HCPCS
|
Golimumab 50 Mg/4ml IV Soln
|
46
|
41
|
$5,038.00
|
$5,038.00
|
$332.96
|
$5,367.00
|
$5,179.15
|
2026-01-01
|
|
J3032
|
HCPCS
|
Eptinezumab-jjmr 100 Mg/ml IV Soln
|
46
|
41
|
$5,309.00
|
$5,309.00
|
$1,543.46
|
$5,309.00
|
$5,123.18
|
2026-01-01
|
|
43840
|
CPT
|
Hc Pr 43840 Repair Of Stomach Lesion
|
48
|
42
|
$5,070.00
|
$5,070.00
|
$1,422.43
|
$5,324.00
|
$5,057.80
|
2026-01-01
|
|
75635
|
CPT
|
CT Scan Of Abdominal Aorta And Both Leg Arteries W/contrast
|
50
|
43
|
$5,064.00
|
$5,064.00
|
$335.82
|
$5,317.00
|
$5,051.15
|
2026-01-01
|
|
58554
|
CPT
|
Hc Pr 58554 Laparo-vaginal Hysterectomy With Tubes/Ovary(S) Complex
|
48
|
42
|
$4,929.00
|
$4,929.00
|
$1,378.41
|
$5,175.00
|
$4,916.25
|
2026-01-01
|
|
74183
|
CPT
|
MRI Scan Of Abdomen Before And After Contrast
|
50
|
43
|
$4,929.00
|
$4,929.00
|
$262.60
|
$5,175.00
|
$4,916.25
|
2026-01-01
|
|
J0897
|
HCPCS
|
Denosumab 60 Mg/ml Subq Sosy
|
46
|
41
|
$4,504.00
|
$4,504.00
|
$1,327.80
|
$5,039.00
|
$4,862.64
|
2026-01-01
|
|
74177
|
CPT
|
CT Scan Of Abdomen And Pelvis With Contrast
|
50
|
43
|
$4,863.00
|
$4,863.00
|
$242.18
|
$5,106.00
|
$4,850.70
|
2026-01-01
|
|
44140
|
CPT
|
Hc Pr 44140 Partial Removal Of Colon With Anastomosis
|
48
|
42
|
$4,786.00
|
$4,786.00
|
$1,402.77
|
$5,025.00
|
$4,773.75
|
2026-01-01
|
|
72157
|
CPT
|
MRI Scan Of Middle Spinal Canal Before And After Contrast
|
50
|
43
|
$4,778.00
|
$4,778.00
|
$238.39
|
$5,017.00
|
$4,766.15
|
2026-01-01
|
|
72127
|
CPT
|
CT Scan Of Upper Spine Before And After Contrast
|
50
|
43
|
$4,578.00
|
$4,578.00
|
$153.79
|
$4,807.00
|
$4,566.65
|
2026-01-01
|
|
J0180
|
HCPCS
|
Agalsidase Beta 35 Mg IV Solr
|
92
|
41
|
$11,316.50
|
$11,316.50
|
$880.84
|
$19,804.00
|
$4,497.59
|
2026-01-01
|
|
44160
|
CPT
|
Hc Pr 44160 Removal Of Colon, Partial
|
48
|
42
|
$4,456.00
|
$4,456.00
|
$1,299.28
|
$4,679.00
|
$4,445.05
|
2026-01-01
|
|
27130
|
CPT
|
Hc Pr 27130 Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft
|
48
|
42
|
$4,434.00
|
$4,434.00
|
$1,364.97
|
$4,656.00
|
$4,423.20
|
2026-01-01
|
|
27447
|
CPT
|
Hc Pr 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments
|
48
|
42
|
$4,434.00
|
$4,434.00
|
$1,363.28
|
$4,656.00
|
$4,423.20
|
2026-01-01
|
|
44120
|
CPT
|
Hc Pr 44120 Removal Of Small Intestine, Single Resection
|
48
|
42
|
$4,413.00
|
$4,413.00
|
$1,275.91
|
$4,634.00
|
$4,402.30
|
2026-01-01
|
|
38100
|
CPT
|
Hc Pr 38100 Removal Of Spleen Total
|
48
|
42
|
$4,344.00
|
$4,344.00
|
$1,201.70
|
$4,561.00
|
$4,332.95
|
2026-01-01
|
|
44188
|
CPT
|
Hc Pr 44188 Laparoscopy Colostomy
|
48
|
42
|
$4,306.00
|
$4,306.00
|
$1,271.16
|
$4,521.00
|
$4,294.95
|
2026-01-01
|
|
C1886
|
HCPCS
|
System Thermoablation W/bipolar Electrode Novasure Strl (1bx/3ea)
|
45
|
40
|
$4,382.40
|
$4,382.40
|
$1,364.50
|
$4,382.40
|
$4,294.75
|
2026-01-01
|
|
72149
|
CPT
|
MRI Scan Of Lower Spinal Canal With Contrast
|
50
|
43
|
$4,301.00
|
$4,301.00
|
$208.68
|
$4,516.00
|
$4,290.20
|
2026-01-01
|
|
72196
|
CPT
|
MRI Scan Of Pelvis With Contrast
|
50
|
43
|
$4,249.00
|
$4,249.00
|
$210.15
|
$4,461.00
|
$4,237.95
|
2026-01-01
|
|
37616
|
CPT
|
Hc Pr 37616 Ligation Of Chest Artery
|
48
|
42
|
$4,216.00
|
$4,216.00
|
$1,184.09
|
$4,427.00
|
$4,205.65
|
2026-01-01
|
|
73222
|
CPT
|
MRI Scan Of Arm Joint With Contrast
|
50
|
43
|
$4,149.00
|
$4,149.00
|
$262.23
|
$4,356.00
|
$4,138.20
|
2026-01-01
|
|
74176
|
CPT
|
CT Scan Of Abdomen And Pelvis Without Contrast
|
50
|
43
|
$4,147.00
|
$4,147.00
|
$114.91
|
$4,354.00
|
$4,136.30
|
2026-01-01
|
|
Q5111
|
HCPCS
|
Pegfilgrastim-cbqv 6 Mg/0.6ml Subq Sosy
|
46
|
41
|
$4,287.00
|
$4,287.00
|
$1,334.49
|
$4,286.00
|
$4,135.99
|
2026-01-01
|
|
72156
|
CPT
|
MRI Scan Of Upper Spinal Canal Before And After Contrast
|
50
|
43
|
$4,128.00
|
$4,128.00
|
$237.66
|
$4,334.00
|
$4,117.30
|
2026-01-01
|
|
35226
|
CPT
|
Hc Ed Rpr Blood Vessel Direct Lower Extremity Cdm
|
48
|
43
|
$4,056.00
|
$4,056.00
|
$1,106.54
|
$4,259.00
|
$4,046.05
|
2026-01-01
|
|
27245
|
CPT
|
Hc Pr 27245 Tx Inter/PR/Subtrchntric Fem Fx Imed Implt Screw Cdm
|
48
|
42
|
$4,048.00
|
$4,048.00
|
$1,307.74
|
$4,250.00
|
$4,037.50
|
2026-01-01
|
|
19306
|
CPT
|
Hc Pr 19306 Mast Rad Urban Type
|
48
|
42
|
$4,043.00
|
$4,043.00
|
$1,286.78
|
$4,245.00
|
$4,032.75
|
2026-01-01
|
|
27244
|
CPT
|
Tx Femoral Fracture W/Plate/Screw Type Implant
|
48
|
42
|
$4,040.00
|
$4,040.00
|
$1,309.31
|
$4,242.00
|
$4,029.90
|
2026-01-01
|
|
71275
|
CPT
|
CT Blood Vessels Chest With Contrast
|
50
|
43
|
$4,036.00
|
$4,036.00
|
$220.42
|
$4,238.00
|
$4,026.10
|
2026-01-01
|
|
J0129
|
HCPCS
|
Abatacept 250 Mg IV Solr
|
46
|
41
|
$3,688.00
|
$3,688.00
|
$876.00
|
$4,165.00
|
$4,019.22
|
2026-01-01
|
|
73202
|
CPT
|
CT Scan Of Arm Before And After Contrast
|
50
|
43
|
$3,927.00
|
$3,927.00
|
$211.98
|
$4,123.00
|
$3,916.85
|
2026-01-01
|
|
74175
|
CPT
|
CT Scan Of Blood Vessels Of Arm With Contrast
|
50
|
43
|
$3,926.00
|
$3,926.00
|
$247.19
|
$4,122.00
|
$3,915.90
|
2026-01-01
|
|
44005
|
CPT
|
Hc Pr 44005 Freeing Of Bowel Adhesion
|
48
|
42
|
$3,913.00
|
$3,913.00
|
$1,140.99
|
$4,109.00
|
$3,903.55
|
2026-01-01
|
|
19307
|
CPT
|
Hc Pr 19307 Mast Mod Rad
|
48
|
42
|
$3,901.00
|
$3,901.00
|
$1,241.52
|
$4,096.00
|
$3,891.20
|
2026-01-01
|
|
73702
|
CPT
|
CT Scan Of Leg Before And After Contrast
|
50
|
43
|
$3,899.00
|
$3,899.00
|
$155.26
|
$4,094.00
|
$3,889.30
|
2026-01-01
|
|
44187
|
CPT
|
Hc Pr 44187 Lap Ileo/jejuno-stomy
|
48
|
42
|
$3,865.00
|
$3,865.00
|
$1,146.56
|
$4,058.00
|
$3,855.10
|
2026-01-01
|
|
Q4196
|
HCPCS
|
Hc Dressing Biological Puraply Am-com Sheet 5x5cm 25sqcm
|
144
|
43
|
$9,041.00
|
$9,041.00
|
$103.77
|
$9,180.00
|
$3,846.25
|
2026-01-01
|
|
50020
|
CPT
|
Hc Pr 50020 Drainage Perirenal/Renal Abscess Open Cdm
|
48
|
42
|
$3,791.00
|
$3,791.00
|
$1,081.71
|
$3,981.00
|
$3,781.95
|
2026-01-01
|
|
J1439
|
HCPCS
|
Ferric Carboxymaltose 750 Mg/15ml IV Soln
|
46
|
41
|
$3,511.00
|
$3,511.00
|
$1.14
|
$3,919.00
|
$3,781.84
|
2026-01-01
|
|
70492
|
CPT
|
CT Scan Of Soft Tissue Of Neck Before And After Contrast
|
50
|
43
|
$3,790.00
|
$3,790.00
|
$162.96
|
$3,980.00
|
$3,781.00
|
2026-01-01
|
|
27236
|
CPT
|
Hc Pr 27236 Optx Fem Fx Prox End Nck Int Fixj/Prostc Rplcmt
|
48
|
42
|
$3,770.00
|
$3,770.00
|
$1,232.67
|
$3,959.00
|
$3,761.05
|
2026-01-01
|
|
44310
|
CPT
|
Hc Pr 44310 Ileostomy/Jejunostomy
|
48
|
42
|
$3,752.00
|
$3,752.00
|
$1,090.00
|
$3,940.00
|
$3,743.00
|
2026-01-01
|
|
C1052
|
HCPCS
|
Endoclot Phs Powder 3g Vial With Applicator
|
135
|
40
|
$3,875.00
|
$3,875.00
|
$1,158.26
|
$6,000.00
|
$3,720.00
|
2026-01-01
|
|
47600
|
CPT
|
Hc Pr 47600 Cholecystectomy
|
48
|
42
|
$3,729.00
|
$3,729.00
|
$1,124.19
|
$3,915.00
|
$3,719.25
|
2026-01-01
|
|
73219
|
CPT
|
MRI Scan Of Arm With Contrast
|
50
|
43
|
$3,729.00
|
$3,729.00
|
$283.87
|
$3,915.00
|
$3,719.25
|
2026-01-01
|
|
73722
|
CPT
|
MRI Scan Of Leg Joint With Contrast
|
50
|
43
|
$3,729.00
|
$3,729.00
|
$264.06
|
$3,915.00
|
$3,719.25
|
2026-01-01
|
|
70482
|
CPT
|
CT Scan Of Cranial Cavity Before And After Contrast
|
50
|
43
|
$3,729.00
|
$3,729.00
|
$168.83
|
$3,915.00
|
$3,719.25
|
2026-01-01
|
|
72147
|
CPT
|
MRI Scan Of Middle Spinal Canal With Contrast
|
50
|
43
|
$3,729.00
|
$3,729.00
|
$211.61
|
$3,915.00
|
$3,719.25
|
2026-01-01
|
|
71551
|
CPT
|
MRI Scan Of Chest With Contrast
|
50
|
43
|
$3,729.00
|
$3,729.00
|
$326.78
|
$3,915.00
|
$3,719.25
|
2026-01-01
|
|
47605
|
CPT
|
Hc Pr 47605 Cholecystectomy With Cholangiography
|
48
|
42
|
$3,729.00
|
$3,729.00
|
$1,181.33
|
$3,915.00
|
$3,719.25
|
2026-01-01
|
|
72142
|
CPT
|
MRI Scan Of Upper Spinal Canal With Contrast
|
50
|
43
|
$3,729.00
|
$3,729.00
|
$213.82
|
$3,915.00
|
$3,719.25
|
2026-01-01
|
|
44180
|
CPT
|
Hc Pr 44180 Laparoscopy Enterolysis
|
48
|
42
|
$3,724.00
|
$3,724.00
|
$964.58
|
$3,910.00
|
$3,714.50
|
2026-01-01
|
|
SUP-FANT-SL
|
CDM
|
All Inside Ant Tib Ten Sl Frozen
|
43
|
38
|
$3,759.90
|
$3,759.90
|
$1,170.68
|
$3,759.90
|
$3,684.70
|
2026-01-01
|
|
44345
|
CPT
|
Hc Pr 44345 Revision Of Colostomy, Complicated
|
48
|
42
|
$3,686.00
|
$3,686.00
|
$1,105.62
|
$3,870.00
|
$3,676.50
|
2026-01-01
|
|
70488
|
CPT
|
CT Scan Of Face Before And After Contrast
|
50
|
43
|
$3,673.00
|
$3,673.00
|
$139.85
|
$3,857.00
|
$3,664.15
|
2026-01-01
|
|
PX-75010318
|
CDM
|
Hc Endoscopy/Gastrointestinal Procedure Level 4
|
45
|
40
|
$3,560.00
|
$3,560.00
|
$729.66
|
$3,738.00
|
$3,663.24
|
2026-01-01
|
|
PX-75010319
|
CDM
|
Hc Endoscopy/Gastrointestinal Procedure Level 5
|
45
|
40
|
$3,560.00
|
$3,560.00
|
$729.66
|
$3,738.00
|
$3,663.24
|
2026-01-01
|
|
PX-75010272
|
CDM
|
Hc Endoscopy/Gastrointestinal Procedure Level 6
|
45
|
40
|
$3,560.00
|
$3,560.00
|
$729.66
|
$3,738.00
|
$3,663.24
|
2026-01-01
|
|
15830
|
CPT
|
Hc Pr 15830 Exc Skin Abd
|
48
|
42
|
$3,662.00
|
$3,662.00
|
$1,197.18
|
$3,845.00
|
$3,652.75
|
2026-01-01
|
|
Q4159
|
HCPCS
|
Hc Allograft Tissue Affinity 2.5x2.5cm
|
48
|
43
|
$6,623.00
|
$6,623.00
|
$175.45
|
$3,825.00
|
$3,633.75
|
2026-01-01
|
|
Q4101
|
HCPCS
|
Hc Allograft Tissue Apligraf 3x3in
|
48
|
43
|
$3,245.00
|
$3,245.00
|
$30.36
|
$3,825.00
|
$3,633.75
|
2026-01-01
|
|
74182
|
CPT
|
MRI Scan Of Abdomen With Contrast
|
50
|
43
|
$3,639.00
|
$3,639.00
|
$247.56
|
$3,821.00
|
$3,629.95
|
2026-01-01
|
|
58552
|
CPT
|
Hc Pr 58552 Laparo-vaginal Hysterectomy Incl Tubes/Ovary(S)
|
48
|
42
|
$3,607.00
|
$3,607.00
|
$1,040.72
|
$3,787.00
|
$3,597.65
|
2026-01-01
|
|
70496
|
CPT
|
CT Scan Of Blood Vessels Of Head With Contrast
|
50
|
43
|
$3,599.00
|
$3,599.00
|
$218.22
|
$3,779.00
|
$3,590.05
|
2026-01-01
|
|
70552
|
CPT
|
MRI Scan Of Brain With Contrast
|
49
|
42
|
$3,538.00
|
$3,538.00
|
$209.78
|
$3,715.00
|
$3,529.25
|
2026-01-01
|
|
58180
|
CPT
|
Hc Pr 58180 Partial Hysterectomy
|
48
|
42
|
$3,520.00
|
$3,520.00
|
$1,019.03
|
$3,696.00
|
$3,511.20
|
2026-01-01
|
|
44050
|
CPT
|
Hc Pr 44050 Reduce Bowel Obstruction
|
47
|
42
|
$3,693.00
|
$3,693.00
|
$981.14
|
$3,693.00
|
$3,508.35
|
2026-01-01
|
|
73719
|
CPT
|
MRI Scan Of Leg With Contrast
|
50
|
43
|
$3,472.00
|
$3,472.00
|
$209.05
|
$3,646.00
|
$3,463.70
|
2026-01-01
|
|
76390
|
CPT
|
MRI Study For Measuring Biochemical Changes In The Brain
|
45
|
40
|
$3,359.00
|
$3,359.00
|
$1,098.17
|
$3,527.00
|
$3,456.46
|
2026-01-01
|
|
70545
|
CPT
|
MRI Scan Of Blood Vessels Of Head With Contrast
|
50
|
43
|
$3,458.00
|
$3,458.00
|
$192.18
|
$3,631.00
|
$3,449.45
|
2026-01-01
|
|
19318
|
CPT
|
Hc Pr 19318 Reduction Of Large Breast
|
48
|
42
|
$3,433.00
|
$3,433.00
|
$1,122.45
|
$3,605.00
|
$3,424.75
|
2026-01-01
|
|
58150
|
CPT
|
Remove Uterus Cervix Via Abdomen W/wo Tubes Or Ovaries
|
48
|
42
|
$3,398.00
|
$3,398.00
|
$1,080.45
|
$3,568.00
|
$3,389.60
|
2026-01-01
|
|
77021
|
CPT
|
Review By Radiologist Of MRI Guidance For Needle Placement
|
50
|
43
|
$3,395.00
|
$3,395.00
|
$379.96
|
$3,565.00
|
$3,386.75
|
2026-01-01
|
|
19303
|
CPT
|
Hc Pr 19303 Mast Simple Complete
|
48
|
42
|
$3,394.00
|
$3,394.00
|
$1,009.90
|
$3,564.00
|
$3,385.80
|
2026-01-01
|
|
70336
|
CPT
|
MRI Scan Of Jaw Joint
|
49
|
42
|
$3,388.00
|
$3,388.00
|
$216.02
|
$3,557.00
|
$3,379.15
|
2026-01-01
|
|
72148
|
CPT
|
MRI Scan Of Lower Spinal Canal Without Contrast
|
50
|
43
|
$3,382.00
|
$3,382.00
|
$136.55
|
$3,551.00
|
$3,373.45
|
2026-01-01
|
|
57265
|
CPT
|
Hc Pr 57265 Extensive Repair Of Vagina
|
48
|
42
|
$3,378.00
|
$3,378.00
|
$923.25
|
$3,547.00
|
$3,369.65
|
2026-01-01
|
|
71555
|
CPT
|
MRI Scan Of Blood Vessels Of Chest
|
48
|
43
|
$3,359.00
|
$3,359.00
|
$377.71
|
$3,527.00
|
$3,350.65
|
2026-01-01
|
|
72198
|
CPT
|
MRI Scan Of Blood Vessels Of Pelvis
|
48
|
43
|
$3,359.00
|
$3,359.00
|
$379.61
|
$3,527.00
|
$3,350.65
|
2026-01-01
|
|
74185
|
CPT
|
MRI Scan Of Blood Vessels Of Abdomen
|
48
|
43
|
$3,359.00
|
$3,359.00
|
$545.56
|
$3,527.00
|
$3,350.65
|
2026-01-01
|
|
50940
|
CPT
|
Hc Pr 50940 Deligation Ureter Cdm
|
48
|
42
|
$3,347.00
|
$3,347.00
|
$945.88
|
$3,514.00
|
$3,338.30
|
2026-01-01
|
|
73218
|
CPT
|
MRI Scan Of Arm Without Contrast
|
50
|
43
|
$3,329.00
|
$3,329.00
|
$265.53
|
$3,495.00
|
$3,320.25
|
2026-01-01
|
|
73718
|
CPT
|
MRI Scan Of Leg Without Contrast
|
50
|
43
|
$3,329.00
|
$3,329.00
|
$178.37
|
$3,495.00
|
$3,320.25
|
2026-01-01
|
|
27502
|
CPT
|
Closed Treatment Of Broken Thigh Bone At Midportion
|
48
|
43
|
$3,326.00
|
$3,326.00
|
$670.63
|
$3,492.00
|
$3,317.40
|
2026-01-01
|
|
J3424
|
HCPCS
|
Hydroxocobalamin 5 G IV Solr
|
46
|
41
|
$3,431.00
|
$3,431.00
|
$160.46
|
$3,431.00
|
$3,310.91
|
2026-01-01
|
|
70498
|
CPT
|
CT Scan Of Blood Vessels Of Neck With Contrast
|
50
|
43
|
$3,297.00
|
$3,297.00
|
$217.85
|
$3,462.00
|
$3,288.90
|
2026-01-01
|
|
72191
|
CPT
|
CT Blood Vessels Pelvis With/without Contrast
|
50
|
43
|
$3,295.00
|
$3,295.00
|
$246.82
|
$3,460.00
|
$3,287.00
|
2026-01-01
|
|
29827
|
CPT
|
Hc Pr 29827 Shldr Arthroscop,Surg,W/Rotat Cuff Repr
|
48
|
42
|
$3,273.00
|
$3,273.00
|
$1,070.14
|
$3,437.00
|
$3,265.15
|
2026-01-01
|
|
27827
|
CPT
|
Hc Pr 27827 Open Treatment Fracture Distal Tibia Only Cdm
|
48
|
42
|
$3,167.00
|
$3,167.00
|
$1,035.27
|
$7,007.06
|
$3,258.50
|
2026-01-01
|
|
78452
|
CPT
|
Nuclear Medicine Myocardial Perfuse Spect
|
50
|
43
|
$3,243.00
|
$3,243.00
|
$380.92
|
$3,405.00
|
$3,234.75
|
2026-01-01
|
|
72195
|
CPT
|
MRI Scan Of Pelvis Without Contrast
|
50
|
43
|
$3,235.00
|
$3,235.00
|
$178.73
|
$3,397.00
|
$3,227.15
|
2026-01-01
|
|
44960
|
CPT
|
Hc Pr 44960 Appendectomy, Ruptured
|
48
|
42
|
$3,228.00
|
$3,228.00
|
$918.64
|
$3,389.00
|
$3,219.55
|
2026-01-01
|
|
73221
|
CPT
|
MRI Scan Of Arm Joint Without Contrast
|
50
|
43
|
$3,223.00
|
$3,223.00
|
$156.96
|
$3,384.00
|
$3,214.80
|
2026-01-01
|
|
58550
|
CPT
|
Hc Pr 58550 Laparo-asst Vaginal Hysterectomy
|
48
|
42
|
$3,221.00
|
$3,221.00
|
$936.37
|
$3,382.00
|
$3,212.90
|
2026-01-01
|
|
70551
|
CPT
|
MRI Scan Of Brain Without Contrast
|
50
|
43
|
$3,220.00
|
$3,220.00
|
$142.79
|
$3,381.00
|
$3,211.95
|
2026-01-01
|
|
74181
|
CPT
|
MRI Scan Of Abdomen Without Contrast
|
50
|
43
|
$3,217.00
|
$3,217.00
|
$142.79
|
$3,378.00
|
$3,209.10
|
2026-01-01
|
|
72146
|
CPT
|
MRI Scan Of Middle Spinal Canal Without Contrast
|
50
|
43
|
$3,217.00
|
$3,217.00
|
$136.19
|
$3,378.00
|
$3,209.10
|
2026-01-01
|
|
52601
|
CPT
|
Hc Pr 52601 Trurl Electrosurg Rescj Prostate Bleed Complete Cdm
|
48
|
42
|
$3,209.00
|
$3,209.00
|
$775.72
|
$3,369.00
|
$3,200.55
|
2026-01-01
|
|
PX-36010147
|
CDM
|
Hc Operating Room Services Level 2 1st 30 Mins
|
45
|
40
|
$3,094.00
|
$3,094.00
|
$634.20
|
$3,249.00
|
$3,184.02
|
2026-01-01
|
|
PX-36010151
|
CDM
|
Hc Operating Room Services Level 6 1st 30 Mins
|
45
|
40
|
$3,094.00
|
$3,094.00
|
$634.20
|
$3,249.00
|
$3,184.02
|
2026-01-01
|
|
PX-36010146
|
CDM
|
Hc Operating Room Services Level 1 1st 30 Mins
|
45
|
40
|
$3,094.00
|
$3,094.00
|
$634.20
|
$3,249.00
|
$3,184.02
|
2026-01-01
|
|
PX-36010148
|
CDM
|
Hc Operating Room Services Level 3 1st 30 Mins
|
45
|
40
|
$3,094.00
|
$3,094.00
|
$634.20
|
$3,249.00
|
$3,184.02
|
2026-01-01
|
|
PX-36010149
|
CDM
|
Hc Operating Room Services Level 4 1st 30 Mins
|
45
|
40
|
$3,094.00
|
$3,094.00
|
$634.20
|
$3,249.00
|
$3,184.02
|
2026-01-01
|
|
PX-36010153
|
CDM
|
Hc Operating Room Services Level 8 1st 30 Mins
|
45
|
40
|
$3,094.00
|
$3,094.00
|
$634.20
|
$3,249.00
|
$3,184.02
|
2026-01-01
|
|
PX-36010152
|
CDM
|
Hc Operating Room Services Level 7 1st 30 Mins
|
45
|
40
|
$3,094.00
|
$3,094.00
|
$634.20
|
$3,249.00
|
$3,184.02
|
2026-01-01
|
|
PX-36010150
|
CDM
|
Hc Operating Room Services Level 5 1st 30 Mins
|
45
|
40
|
$3,094.00
|
$3,094.00
|
$634.20
|
$3,249.00
|
$3,184.02
|
2026-01-01
|
|
25609
|
CPT
|
Hc Pr 25609 Open Rx Distal Radius Fx, Intra-articular, 3+ Frag [25609] Cdm
|
48
|
42
|
$3,079.00
|
$3,079.00
|
$1,006.63
|
$3,831.79
|
$3,168.34
|
2026-01-01
|
|
71550
|
CPT
|
MRI Scan Of Chest Without Contrast
|
50
|
43
|
$3,166.00
|
$3,166.00
|
$297.81
|
$3,324.00
|
$3,157.80
|
2026-01-01
|
|
70544
|
CPT
|
MRI Scan Of Blood Vessels Of Head Without Contrast
|
50
|
43
|
$3,156.00
|
$3,156.00
|
$178.60
|
$3,314.00
|
$3,148.30
|
2026-01-01
|
|
J7298
|
HCPCS
|
Hc Pr Rx Levonorgestrel IUD (Mirena) IUD 5 Yr 52 Mg
|
96
|
43
|
$3,258.00
|
$3,258.00
|
$798.86
|
$3,298.00
|
$3,133.10
|
2026-01-01
|
|
49402
|
CPT
|
Hc Pr 49402 Remove Foreign Body Adbomen
|
48
|
42
|
$3,131.00
|
$3,131.00
|
$898.80
|
$3,288.00
|
$3,123.60
|
2026-01-01
|
|
J3262
|
HCPCS
|
Tocilizumab 80 Mg/4ml IV Soln
|
138
|
41
|
$2,435.00
|
$2,435.00
|
$382.40
|
$7,133.00
|
$3,088.59
|
2026-01-01
|
|
71270
|
CPT
|
CT Scan Of Chest Before And After Contrast
|
50
|
43
|
$3,083.00
|
$3,083.00
|
$154.16
|
$3,237.00
|
$3,075.15
|
2026-01-01
|
|
72141
|
CPT
|
MRI Scan Of Upper Spinal Canal Without Contrast
|
50
|
43
|
$3,080.00
|
$3,080.00
|
$135.82
|
$3,234.00
|
$3,072.30
|
2026-01-01
|
|
Q4197
|
HCPCS
|
Hc Puraply Mz 500mg
|
96
|
43
|
$3,132.00
|
$3,132.00
|
$72.64
|
$4,250.00
|
$3,069.36
|
2026-01-01
|
|
70548
|
CPT
|
MRI Scan Of Blood Vessels Of Neck With Contrast
|
50
|
43
|
$3,062.00
|
$3,062.00
|
$197.31
|
$3,215.00
|
$3,054.25
|
2026-01-01
|
|
57260
|
CPT
|
Hc Pr 57260 Repair Of Vagina, Combined Anteroposterior Colporrhaphy
|
48
|
42
|
$3,062.00
|
$3,062.00
|
$826.02
|
$3,215.00
|
$3,054.25
|
2026-01-01
|
|
78227
|
CPT
|
Nuclear Medicine Study Of Liver And Bile Duct System
|
50
|
43
|
$3,036.00
|
$3,036.00
|
$381.78
|
$3,188.00
|
$3,028.60
|
2026-01-01
|
|
59426
|
CPT
|
Hc Pr 59426 Antepartum Care Only 7/> Visits Rhc
|
55
|
42
|
$3,316.00
|
$3,316.00
|
$820.42
|
$3,316.00
|
$3,017.56
|
2026-01-01
|
|
74170
|
CPT
|
CT Scan Of Abdomen Before And After Contrast
|
50
|
43
|
$3,000.00
|
$3,000.00
|
$217.24
|
$3,150.00
|
$2,992.50
|
2026-01-01
|
|
49594
|
CPT
|
Hc Pr 49594 Rpr Aa Hernia 1st 3-10 Cm Ncrc8/Strangulated Cdm
|
48
|
42
|
$2,997.00
|
$2,997.00
|
$774.59
|
$3,147.00
|
$2,989.65
|
2026-01-01
|
|
19302
|
CPT
|
Mastectomy Partial W/Axillary Lymphadenectomy
|
48
|
42
|
$2,995.00
|
$2,995.00
|
$955.36
|
$3,145.00
|
$2,987.75
|
2026-01-01
|
|
27759
|
CPT
|
Hc Pr 27759 Tx Tibl Shft Fx Imed Implt W/wo Screws&/Cercla
|
48
|
42
|
$2,896.00
|
$2,896.00
|
$946.85
|
$7,053.77
|
$2,980.18
|
2026-01-01
|
|
47480
|
CPT
|
Hc Pr 47480 Incision Of Gallbladder
|
48
|
42
|
$2,950.00
|
$2,950.00
|
$926.87
|
$3,098.00
|
$2,943.10
|
2026-01-01
|
|
72194
|
CPT
|
CT Scan Of Pelvis Before And After Contrast
|
50
|
43
|
$2,936.00
|
$2,936.00
|
$216.51
|
$3,083.00
|
$2,928.85
|
2026-01-01
|
|
35206
|
CPT
|
Hc Pr 35206 Repair Blood Vessel Lesion, Upper Extremity
|
95
|
42
|
$3,046.00
|
$3,046.00
|
$820.73
|
$3,082.00
|
$2,927.90
|
2026-01-01
|
|
23420
|
CPT
|
Hc Pr 23420 Repair Of Shoulder
|
48
|
42
|
$2,897.00
|
$2,897.00
|
$947.16
|
$3,042.00
|
$2,921.38
|
2026-01-01
|
|
77049
|
CPT
|
MRI Scan Of Both Breasts
|
48
|
43
|
$2,879.00
|
$2,879.00
|
$154.19
|
$3,023.00
|
$2,871.85
|
2026-01-01
|
|
70547
|
CPT
|
MRI Scan Of Blood Vessels Of Neck Without Contrast
|
50
|
43
|
$2,871.00
|
$2,871.00
|
$178.97
|
$3,015.00
|
$2,864.25
|
2026-01-01
|
|
54360
|
CPT
|
Hc Pr 54360 Plastic Rpr Penis Correct Angulation Cdm
|
48
|
42
|
$2,840.00
|
$2,840.00
|
$770.26
|
$2,982.00
|
$2,832.90
|
2026-01-01
|
|
J7165
|
HCPCS
|
Prothrombin Complex Human-lans 500 Units IV Solr
|
46
|
41
|
$2,872.00
|
$2,872.00
|
$720.00
|
$2,933.00
|
$2,830.35
|
2026-01-01
|
|
23615
|
CPT
|
Hc Pr 23615 Treat Humerus Fracture Open
|
48
|
42
|
$2,738.00
|
$2,738.00
|
$895.16
|
$7,218.59
|
$2,817.50
|
2026-01-01
|
|
28805
|
CPT
|
Hc Pr 28805 Amputation Foot Transmetarsal
|
48
|
42
|
$2,823.00
|
$2,823.00
|
$755.32
|
$2,964.00
|
$2,815.80
|
2026-01-01
|
|
27822
|
CPT
|
Hc Pr 27822 Open Tx Of Ankle Fracture Without Fixation Of Posterior
|
47
|
42
|
$2,870.00
|
$2,870.00
|
$893.60
|
$3,686.63
|
$2,812.60
|
2026-01-01
|
|
49659
|
CPT
|
Hc Pr 49659 Laparoscopy Procedure Hernia Repair
|
38
|
34
|
$2,868.00
|
$2,868.00
|
$892.98
|
$2,868.00
|
$2,810.64
|
2026-01-01
|
|
44800
|
CPT
|
Hc Pr 44800 Excision Of Bowel Pouch
|
48
|
42
|
$2,817.00
|
$2,817.00
|
$817.68
|
$2,958.00
|
$2,810.10
|
2026-01-01
|
|
73706
|
CPT
|
CT Scan Of Blood Vessels Of Neck With Contrast
|
50
|
43
|
$2,773.00
|
$2,773.00
|
$262.47
|
$2,912.00
|
$2,766.40
|
2026-01-01
|
|
58700
|
CPT
|
Hc Pr 58700 Removal Of Fallopian Tube
|
47
|
42
|
$2,904.00
|
$2,904.00
|
$850.26
|
$2,904.00
|
$2,758.80
|
2026-01-01
|
|
36573
|
CPT
|
Insert Tube For IVw/imaging Guidance =>5yrs
|
48
|
43
|
$2,736.00
|
$2,736.00
|
$241.08
|
$2,873.00
|
$2,729.35
|
2026-01-01
|
|
27438
|
CPT
|
Hc Pr 27438 Revise Kneecap With Implant
|
47
|
42
|
$2,758.00
|
$2,758.00
|
$858.73
|
$6,780.42
|
$2,702.84
|
2026-01-01
|
|
52648
|
CPT
|
Hc Pr 52648 Laser Vaporization Of Prostate For Urine Flow Cdm
|
48
|
42
|
$2,701.00
|
$2,701.00
|
$740.62
|
$2,836.00
|
$2,694.20
|
2026-01-01
|
|
73721
|
CPT
|
MRI Scan Of Leg Joint Without Contrast
|
50
|
43
|
$2,689.00
|
$2,689.00
|
$156.60
|
$2,823.00
|
$2,681.85
|
2026-01-01
|
|
J7168
|
HCPCS
|
Prothrombin Complex Conc Human 500 Units IV Kit
|
46
|
41
|
$2,777.00
|
$2,777.00
|
$864.65
|
$2,777.00
|
$2,679.81
|
2026-01-01
|
|
27641
|
CPT
|
Hc Pr 27641 Partial Removal Of Fibula
|
48
|
42
|
$2,671.00
|
$2,671.00
|
$708.72
|
$2,805.00
|
$2,664.75
|
2026-01-01
|
|
27266
|
CPT
|
Closed Treat Dislocated Hip Prosthesis Under Anesthesia
|
48
|
43
|
$2,657.00
|
$2,657.00
|
$670.63
|
$2,790.00
|
$2,650.50
|
2026-01-01
|
|
49521
|
CPT
|
Hc Pr 49521 Rpr Recrt Ingun Hernia Any Age Incarcerated Cdm Cdm
|
48
|
42
|
$2,655.00
|
$2,655.00
|
$756.63
|
$2,788.00
|
$2,648.60
|
2026-01-01
|
|
23412
|
CPT
|
Hc Pr 23412 Repair Rotator Cuff Chronic
|
48
|
42
|
$2,553.00
|
$2,553.00
|
$834.76
|
$2,808.67
|
$2,627.38
|
2026-01-01
|
|
27814
|
CPT
|
Hc Pr 27814 Open Treatment Of Ankle Fracture
|
48
|
42
|
$2,552.00
|
$2,552.00
|
$822.33
|
$3,653.92
|
$2,626.40
|
2026-01-01
|
|
SUP-AR-3210-0044
|
CDM
|
Nanoneedle Scope, 180mm
|
43
|
38
|
$2,676.00
|
$2,676.00
|
$833.20
|
$2,676.00
|
$2,622.48
|
2026-01-01
|
|
23675
|
CPT
|
Hc Pr 23675 Cltx Shoulder Dislc W/Surg/Antmcl Neck Fx W/Manj Cdm
|
48
|
42
|
$2,619.00
|
$2,619.00
|
$549.81
|
$2,750.00
|
$2,612.50
|
2026-01-01
|
|
J2357
|
HCPCS
|
Omalizumab 150 Mg/ml Subq Sosy
|
92
|
41
|
$2,642.00
|
$2,642.00
|
$612.86
|
$3,875.00
|
$2,589.16
|
2026-01-01
|
|
58662
|
CPT
|
Hc Pr 58662 Laparoscopy Excise Lesions
|
48
|
42
|
$2,593.00
|
$2,593.00
|
$756.19
|
$2,723.00
|
$2,586.85
|
2026-01-01
|
|
SUP-AR-3210-0043
|
CDM
|
Nanoneedle Scope, 125mm
|
43
|
38
|
$2,625.00
|
$2,625.00
|
$817.32
|
$2,625.00
|
$2,572.50
|
2026-01-01
|
|
13160
|
CPT
|
Late Closure Of Wound Extensive Or Complicated
|
48
|
42
|
$2,577.00
|
$2,577.00
|
$784.87
|
$2,706.00
|
$2,570.70
|
2026-01-01
|
|
47563
|
CPT
|
Hc Pr 47563 Laparoscopy Cholecystectomy/Graph
|
48
|
42
|
$2,569.00
|
$2,569.00
|
$756.73
|
$2,697.00
|
$2,562.15
|
2026-01-01
|
|
27698
|
CPT
|
Hc Pr 27698 Repair Secondary Disrupted Ligament Ankle Coltrl Cdm
|
47
|
42
|
$2,588.00
|
$2,588.00
|
$689.52
|
$3,664.10
|
$2,536.24
|
2026-01-01
|
|
28737
|
CPT
|
Hc Pr 28737 Arthrd W/Tdn Lngth&Advmnt Tarsl Nvclr-cuneifor
|
48
|
42
|
$2,450.00
|
$2,450.00
|
$741.41
|
$8,105.45
|
$2,521.54
|
2026-01-01
|
|
J0490
|
HCPCS
|
Belimumab 120 Mg IV Solr
|
92
|
41
|
$4,266.00
|
$4,266.00
|
$527.16
|
$6,013.00
|
$2,519.00
|
2026-01-01
|
|
27252
|
CPT
|
Closed Treatment Of Dislocated Hip Under Anesthesia
|
96
|
43
|
$3,317.00
|
$3,317.00
|
$656.63
|
$3,483.00
|
$2,514.68
|
2026-01-01
|
|
27540
|
CPT
|
Hc Pr 27540 Treat Knee Fracture
|
48
|
42
|
$2,516.00
|
$2,516.00
|
$822.61
|
$2,642.00
|
$2,509.90
|
2026-01-01
|
|
23410
|
CPT
|
Hc Pr 23410 Open Repair Of Rotator Cuff Acute Cdm
|
48
|
42
|
$2,438.00
|
$2,438.00
|
$797.08
|
$2,808.67
|
$2,508.80
|
2026-01-01
|
|
70470
|
CPT
|
CT Scan Of Head Or Brain Before And After Contrast
|
50
|
43
|
$2,507.00
|
$2,507.00
|
$127.75
|
$2,632.00
|
$2,500.40
|
2026-01-01
|
|
21554
|
CPT
|
Hc Pr 21554 Exc Neck Tum Deep 5+ Cm
|
48
|
42
|
$2,479.00
|
$2,479.00
|
$778.48
|
$2,603.00
|
$2,472.85
|
2026-01-01
|
|
73725
|
CPT
|
MRI Scan Of Blood Vessels Of Leg
|
48
|
43
|
$2,478.00
|
$2,478.00
|
$378.07
|
$2,602.00
|
$2,471.90
|
2026-01-01
|
|
27045
|
CPT
|
Hc Pr 27045 Exc Hip/Pelv Tum Deep 5 Cm/>
|
48
|
42
|
$2,475.00
|
$2,475.00
|
$782.46
|
$2,599.00
|
$2,469.05
|
2026-01-01
|
|
21933
|
CPT
|
Hc Pr 21933 Exc Tumor Soft Tiss Back/Flank Subfascial 5 Cm/> Cdm Cdm
|
48
|
42
|
$2,475.00
|
$2,475.00
|
$783.07
|
$2,599.00
|
$2,469.05
|
2026-01-01
|
|
74160
|
CPT
|
CT Scan Of Abdomen With Contrast
|
50
|
43
|
$2,471.00
|
$2,471.00
|
$191.57
|
$2,595.00
|
$2,465.25
|
2026-01-01
|
|
78803
|
CPT
|
Nuclear Medicine Spect 1 Area/single Acquisition
|
49
|
42
|
$2,471.00
|
$2,471.00
|
$317.12
|
$2,595.00
|
$2,465.25
|
2026-01-01
|
|
72126
|
CPT
|
CT Scan Of Upper Spine With Contrast
|
50
|
43
|
$2,470.00
|
$2,470.00
|
$125.18
|
$2,594.00
|
$2,464.30
|
2026-01-01
|
|
71260
|
CPT
|
CT Scan Of Chest With Contrast
|
50
|
43
|
$2,468.00
|
$2,468.00
|
$125.92
|
$2,591.00
|
$2,461.45
|
2026-01-01
|
|
49000
|
CPT
|
Hc Pr 49000 Exploration Of Abdomen
|
48
|
42
|
$2,463.00
|
$2,463.00
|
$805.18
|
$2,586.00
|
$2,456.70
|
2026-01-01
|
|
57240
|
CPT
|
Hc Pr 57240 Repair Bladder & Vagina
|
48
|
42
|
$2,454.00
|
$2,454.00
|
$653.26
|
$2,577.00
|
$2,448.15
|
2026-01-01
|
|
28730
|
CPT
|
Hc Pr 28730 Fusion Foot Bones,Midtarsal,Multi
|
48
|
42
|
$2,377.00
|
$2,377.00
|
$777.15
|
$7,884.30
|
$2,446.08
|
2026-01-01
|
|
28615
|
CPT
|
Hc Pr 28615 Open Treatment Tarsometatarsal Joint Dislocation Cdm
|
48
|
42
|
$2,377.00
|
$2,377.00
|
$777.15
|
$3,588.49
|
$2,446.08
|
2026-01-01
|
|
72132
|
CPT
|
CT Scan Of Lower Spine With Contrast
|
50
|
43
|
$2,449.00
|
$2,449.00
|
$125.92
|
$2,571.00
|
$2,442.45
|
2026-01-01
|
|
25608
|
CPT
|
Hc Pr 25608 Open Rx Distal Radius Fx, Intra-articular, 2 Frag [25608] Cdm
|
48
|
42
|
$2,371.00
|
$2,371.00
|
$775.29
|
$3,811.43
|
$2,440.20
|
2026-01-01
|
|
J7325
|
HCPCS
|
Hylan G-f 20 48 Mg/6ml Intra-articu Sosy
|
94
|
43
|
$2,486.00
|
$2,486.00
|
$9.09
|
$2,607.00
|
$2,436.28
|
2026-01-01
|
|
23140
|
CPT
|
Hc Pr 23140 Excision Or Curettage Of Bone
|
48
|
42
|
$2,438.00
|
$2,438.00
|
$604.15
|
$2,560.00
|
$2,432.00
|
2026-01-01
|
|
93306
|
CPT
|
Ultrasound Heart W/color Blood Flow, Rate, Direction
|
48
|
43
|
$2,429.00
|
$2,429.00
|
$257.26
|
$2,550.00
|
$2,422.50
|
2026-01-01
|
|
58661
|
CPT
|
Hc Pr 58661 Laparoscopy Remove Adnexa
|
48
|
42
|
$2,423.00
|
$2,423.00
|
$691.02
|
$2,544.00
|
$2,416.80
|
2026-01-01
|
|
57250
|
CPT
|
Hc Pr 57250 Repair Rectum & Vagina
|
48
|
42
|
$2,423.00
|
$2,423.00
|
$654.80
|
$2,544.00
|
$2,416.80
|
2026-01-01
|
|
72193
|
CPT
|
CT Scan Of Pelvis With Contrast
|
50
|
43
|
$2,395.00
|
$2,395.00
|
$193.04
|
$2,515.00
|
$2,389.25
|
2026-01-01
|
|
24575
|
CPT
|
Hc Pr 24575 Open Tx Humeral Epicondylar Fracture Cdm
|
47
|
42
|
$2,427.00
|
$2,427.00
|
$755.67
|
$6,792.79
|
$2,378.46
|
2026-01-01
|
|
27230
|
CPT
|
Hc Pr 27230 Cltx Fem Fx Prox End Nck Without Manj Cdm
|
48
|
42
|
$2,381.00
|
$2,381.00
|
$103.14
|
$2,500.00
|
$2,375.00
|
2026-01-01
|
|
47562
|
CPT
|
Hc Pr 47562 Laparoscopic Cholecystectomy
|
48
|
42
|
$2,370.00
|
$2,370.00
|
$696.45
|
$2,489.00
|
$2,364.55
|
2026-01-01
|
|
27339
|
CPT
|
Hc Pr 27339 Exc Thigh/Knee Tum Dep 5cm/>
|
48
|
42
|
$2,360.00
|
$2,360.00
|
$771.55
|
$2,478.00
|
$2,354.10
|
2026-01-01
|
|
44950
|
CPT
|
Hc Pr 44950 Appendectomy
|
48
|
42
|
$2,355.00
|
$2,355.00
|
$674.05
|
$2,473.00
|
$2,349.35
|
2026-01-01
|
|
J0248
|
HCPCS
|
Remdesivir 100 Mg IV Solr
|
46
|
41
|
$2,237.00
|
$2,237.00
|
$231.46
|
$2,429.00
|
$2,343.99
|
2026-01-01
|
|
15839
|
CPT
|
Hc Pr 15839 Excise Excessive Skin Tissue Other Area
|
48
|
42
|
$2,332.00
|
$2,332.00
|
$762.52
|
$2,449.00
|
$2,326.55
|
2026-01-01
|
|
26123
|
CPT
|
Hc Pr 26123 Fasct Prtl Palmar 1 Dgt Prox Iphal Jt W/wo Rpr Cdm
|
48
|
42
|
$2,256.00
|
$2,256.00
|
$737.61
|
$2,529.38
|
$2,321.62
|
2026-01-01
|
|
78451
|
CPT
|
Nuclear Medicine Myocardial Perfuse Spect
|
50
|
43
|
$2,318.00
|
$2,318.00
|
$240.09
|
$2,434.00
|
$2,312.30
|
2026-01-01
|
|
73201
|
CPT
|
CT Scan Of Arm With Contrast
|
50
|
43
|
$2,313.00
|
$2,313.00
|
$162.96
|
$2,429.00
|
$2,307.55
|
2026-01-01
|
|
27524
|
CPT
|
Hc Pr 27524 Open Tx Patllr Fx W/Int Fixj/Patllc&Soft Tiss Repair Cdm
|
48
|
42
|
$2,305.00
|
$2,305.00
|
$753.49
|
$2,420.00
|
$2,299.00
|
2026-01-01
|
|
53235
|
CPT
|
Hc Pr 53235 Exc Urethral Diverticulum Spx Male Cdm
|
48
|
42
|
$2,303.00
|
$2,303.00
|
$679.58
|
$2,418.00
|
$2,297.10
|
2026-01-01
|
|
27784
|
CPT
|
Hc Pr 27784 Open Treatment Proximal Fibula/Shaft Fracture
|
47
|
42
|
$2,338.00
|
$2,338.00
|
$727.96
|
$2,808.67
|
$2,291.24
|
2026-01-01
|
|
49614
|
CPT
|
Hc Pr 49614 Rpr Aa Hernia Recr < 3 Cm Ncrc8/Strangulated Cdm
|
48
|
42
|
$2,282.00
|
$2,282.00
|
$594.25
|
$2,396.00
|
$2,288.26
|
2026-01-01
|
|
19371
|
CPT
|
Hc Pr 19371 Removal Of Breast Capsule
|
48
|
42
|
$2,274.00
|
$2,274.00
|
$743.53
|
$2,388.00
|
$2,268.60
|
2026-01-01
|
|
29880
|
CPT
|
Hc Pr 29880 Arthrs Knee W/Meniscectomy Med&Lat W/Shaving
|
48
|
42
|
$2,274.00
|
$2,274.00
|
$608.26
|
$2,388.00
|
$2,268.60
|
2026-01-01
|
|
78278
|
CPT
|
Nuclear Medicine Study To Assess Blood Loss
|
50
|
43
|
$2,267.00
|
$2,267.00
|
$234.87
|
$2,380.00
|
$2,261.00
|
2026-01-01
|
|
78315
|
CPT
|
Nuclear Medicine Bone/joint 3 Phase
|
50
|
43
|
$2,265.00
|
$2,265.00
|
$237.22
|
$2,378.00
|
$2,259.10
|
2026-01-01
|
|
15120
|
CPT
|
Hc Pr 15120 Skn Splt A-grft Fac/Nck/Hf/G 1st 100 Sq Cm
|
48
|
42
|
$2,256.00
|
$2,256.00
|
$737.61
|
$2,369.00
|
$2,250.55
|
2026-01-01
|
|
27634
|
CPT
|
Hc Pr 27634 Exc Leg/Ankle Tum Deep 5 Cm/>
|
48
|
42
|
$2,255.00
|
$2,255.00
|
$717.32
|
$2,368.00
|
$2,249.60
|
2026-01-01
|
|
24073
|
CPT
|
Hc Pr 24073 Ex Arm/Elbow Tum Deep > 5 Cm
|
48
|
42
|
$2,253.00
|
$2,253.00
|
$736.68
|
$2,366.00
|
$2,247.70
|
2026-01-01
|
|
23073
|
CPT
|
Hc Pr 23073 Exc Shoulder Tum Deep 5 Cm/>
|
48
|
42
|
$2,253.00
|
$2,253.00
|
$736.68
|
$2,366.00
|
$2,247.70
|
2026-01-01
|
|
22901
|
CPT
|
Hc Pr 22901 Exc Back Tum Deep 5+ Cm
|
48
|
42
|
$2,248.00
|
$2,248.00
|
$708.05
|
$2,360.00
|
$2,242.00
|
2026-01-01
|
|
Q5108
|
HCPCS
|
Pegfilgrastim-jmdb 6 Mg/0.6ml Subq Sosy
|
46
|
41
|
$5,261.00
|
$5,261.00
|
$722.67
|
$2,321.00
|
$2,239.76
|
2026-01-01
|
|
24538
|
CPT
|
Hc Pr 24538 Percutaneous Fixation Humeral
|
48
|
42
|
$2,176.00
|
$2,176.00
|
$711.46
|
$2,808.67
|
$2,239.30
|
2026-01-01
|
|
J7300
|
HCPCS
|
Paragard Intrauterine Copper Intrauterine IUD
|
96
|
43
|
$2,273.00
|
$2,273.00
|
$557.34
|
$3,160.00
|
$2,227.54
|
2026-01-01
|
|
23515
|
CPT
|
Hc Pr 23515 Open Tx Clavicular Fracture Internal Fixation
|
48
|
42
|
$2,158.00
|
$2,158.00
|
$705.54
|
$3,688.33
|
$2,220.68
|
2026-01-01
|
|
Q5103
|
HCPCS
|
Infliximab-dyyb 100 Mg IV Solr
|
46
|
41
|
$2,270.00
|
$2,270.00
|
$92.40
|
$2,295.00
|
$2,214.68
|
2026-01-01
|
|
78226
|
CPT
|
Nuclear Medicine Study Of Liver And Bile Duct System
|
50
|
43
|
$2,220.00
|
$2,220.00
|
$280.81
|
$2,331.00
|
$2,214.45
|
2026-01-01
|
|
28005
|
CPT
|
Hc Pr 28005 Incision Bone Cortex Foot
|
47
|
42
|
$2,331.00
|
$2,331.00
|
$619.95
|
$2,331.00
|
$2,214.45
|
2026-01-01
|
|
29826
|
CPT
|
Hc Pr 29826 Arthroscopy Shoulder W/Coracoacrm Ligmnt Release
|
48
|
42
|
$2,207.00
|
$2,207.00
|
$179.99
|
$2,317.00
|
$2,201.15
|
2026-01-01
|
|
49553
|
CPT
|
Hc Pr 49553 Repair Femoral Hernia Initial Blocked
|
48
|
42
|
$2,206.00
|
$2,206.00
|
$668.71
|
$2,316.00
|
$2,200.20
|
2026-01-01
|
|
45171
|
CPT
|
Hc Pr 45171 Excise Rectal Tumor Transanal Approach
|
47
|
42
|
$2,314.00
|
$2,314.00
|
$660.10
|
$2,314.00
|
$2,198.30
|
2026-01-01
|
|
25607
|
CPT
|
Hc Pr 25607 Optx Dstl Radl X-artic Fx/Epiphysl Sep Cdm
|
48
|
42
|
$2,129.00
|
$2,129.00
|
$695.89
|
$3,807.56
|
$2,190.30
|
2026-01-01
|
|
J7296
|
HCPCS
|
Levonorgestrel 19.5 Mg Intrauterine IUD
|
54
|
24
|
$3,008.00
|
$3,008.00
|
$1,026.87
|
$3,369.00
|
$2,189.85
|
2026-01-01
|
|
90375
|
HCPCS
|
Rabies Immune Globulin 300 Unit/ml Injection Soln (wrapper)
|
81
|
24
|
$2,231.00
|
$2,231.00
|
$537.34
|
$8,921.00
|
$2,186.38
|
2026-01-01
|
|
27818
|
CPT
|
Closed Treatment Of 3 Broken Lower Leg Bones At Ankle
|
48
|
43
|
$2,189.00
|
$2,189.00
|
$542.04
|
$2,298.00
|
$2,183.10
|
2026-01-01
|
|
26121
|
CPT
|
Hc Pr 26121 Fasct Palm W/wo Z-plasty Tissue Reargmt/Skn Grft Cdm
|
47
|
42
|
$2,293.00
|
$2,293.00
|
$654.03
|
$2,293.00
|
$2,178.35
|
2026-01-01
|
|
21932
|
CPT
|
Hc Pr 21932 Exc Back Tum Deep < 5 Cm Subq
|
48
|
42
|
$2,184.00
|
$2,184.00
|
$708.47
|
$2,293.00
|
$2,178.35
|
2026-01-01
|
|
58660
|
CPT
|
Hc Pr 58660 Laparoscopy Lysis
|
47
|
42
|
$2,210.00
|
$2,210.00
|
$688.11
|
$2,288.26
|
$2,165.80
|
2026-01-01
|
|
72129
|
CPT
|
CT Scan Of Middle Spine With Contrast
|
50
|
43
|
$2,170.00
|
$2,170.00
|
$126.65
|
$2,279.00
|
$2,165.05
|
2026-01-01
|
|
19301
|
CPT
|
Hc Pr 19301 Mastectomy Partial Cdm Cdm
|
48
|
42
|
$2,170.00
|
$2,170.00
|
$695.85
|
$2,279.00
|
$2,165.05
|
2026-01-01
|
|
29898
|
CPT
|
Hc Pr 29898 Arthroscopy Ankle Surgical Debridement Extensive Cdm
|
48
|
42
|
$2,168.00
|
$2,168.00
|
$605.58
|
$2,276.00
|
$2,162.20
|
2026-01-01
|
|
SUP-ABS-2012-02
|
CDM
|
Allosync Dbm Putty, 2.5cc
|
43
|
38
|
$2,202.00
|
$2,202.00
|
$685.61
|
$2,202.00
|
$2,157.96
|
2026-01-01
|
|
77047
|
CPT
|
MRI Scan Of Both Breasts Without Contrast
|
50
|
43
|
$2,160.00
|
$2,160.00
|
$161.13
|
$2,268.00
|
$2,154.60
|
2026-01-01
|
|
50590
|
CPT
|
Shock Wave Crushing Of Kidney Stones
|
96
|
43
|
$14,265.00
|
$14,265.00
|
$612.89
|
$14,978.00
|
$2,148.00
|
2026-01-01
|
|
27752
|
CPT
|
Closed Treatment Of Middle Part Of Broken Shin Bone
|
48
|
43
|
$2,153.00
|
$2,153.00
|
$566.81
|
$2,261.00
|
$2,147.95
|
2026-01-01
|
|
J1561
|
HCPCS
|
Gamunex-c 1 Gm/10ml Injection Soln
|
276
|
41
|
$2,188.00
|
$2,188.00
|
$78.42
|
$12,498.00
|
$2,144.24
|
2026-01-01
|
|
J1745
|
HCPCS
|
Infliximab 100 Mg IV Solr
|
46
|
41
|
$2,394.00
|
$2,394.00
|
$244.20
|
$2,221.00
|
$2,143.26
|
2026-01-01
|
|
J0881
|
HCPCS
|
Darbepoetin Alfa 200 Mcg/ml Injection Soln
|
92
|
41
|
$3,899.00
|
$3,899.00
|
$142.80
|
$3,899.00
|
$2,127.00
|
2026-01-01
|
|
49507
|
CPT
|
Hc Pr 49507 Repair Inguinal Hernia Initial Block >5 Yr
|
48
|
42
|
$2,131.00
|
$2,131.00
|
$622.07
|
$2,238.00
|
$2,126.10
|
2026-01-01
|
|
15100
|
CPT
|
Hc Pr 15100 Skin Splt Grft Trnk/Arm/Leg First 100 Sq Cm Or Less
|
48
|
42
|
$2,122.00
|
$2,122.00
|
$693.71
|
$2,228.00
|
$2,124.64
|
2026-01-01
|
|
28297
|
CPT
|
Hc Pr 28297 Corrj Hallux Valgus W/Sesmdc W/1metar Medial Cnf
|
48
|
42
|
$2,065.00
|
$2,065.00
|
$649.14
|
$7,855.92
|
$2,124.64
|
2026-01-01
|
|
28740
|
CPT
|
Hc Pr 28740 Arthrodesis Midtarsometatarsal Single Joint
|
48
|
42
|
$2,064.00
|
$2,064.00
|
$665.28
|
$4,037.04
|
$2,123.66
|
2026-01-01
|
|
28299
|
CPT
|
Hc Pr 28299 Corrj Hallux Valgus W/Sesmdc W/2 Osteot Cdm
|
48
|
42
|
$2,064.00
|
$2,064.00
|
$647.34
|
$3,581.46
|
$2,123.66
|
2026-01-01
|
|
53850
|
CPT
|
Hc Pr 53850 Prostatic Microwave Thermotx
|
48
|
42
|
$2,120.00
|
$2,120.00
|
$384.76
|
$2,226.00
|
$2,114.70
|
2026-01-01
|
|
72131
|
CPT
|
CT Scan Of Lower Spine Without Contrast
|
50
|
43
|
$2,118.00
|
$2,118.00
|
$93.03
|
$2,224.00
|
$2,112.80
|
2026-01-01
|
|
23655
|
CPT
|
Closed Treatment Of Dislocated Shoulder
|
48
|
43
|
$2,118.00
|
$2,118.00
|
$305.09
|
$2,224.00
|
$2,112.80
|
2026-01-01
|
|
27562
|
CPT
|
Closed Treatment Of Dislocated Kneecap Under Anesthesia
|
48
|
43
|
$2,115.00
|
$2,115.00
|
$103.14
|
$2,221.00
|
$2,109.95
|
2026-01-01
|
|
72125
|
CPT
|
CT Scan Of Upper Spine Without Contrast
|
50
|
43
|
$2,114.00
|
$2,114.00
|
$93.77
|
$2,220.00
|
$2,109.00
|
2026-01-01
|
|
72192
|
CPT
|
CT Scan Of Pelvis Without Contrast
|
50
|
43
|
$2,111.00
|
$2,111.00
|
$92.30
|
$2,217.00
|
$2,106.15
|
2026-01-01
|
|
73701
|
CPT
|
CT Scan Of Leg With Contrast Material
|
50
|
43
|
$2,100.00
|
$2,100.00
|
$125.92
|
$2,205.00
|
$2,094.75
|
2026-01-01
|
|
26113
|
CPT
|
Hc Pr 26113 Ex Tum/Vasc Mal Sft Tis Hand/Fngr Subfsc 1.5cm/> Cd
|
47
|
42
|
$2,199.00
|
$2,199.00
|
$597.12
|
$2,199.00
|
$2,089.05
|
2026-01-01
|
|
Q5118
|
HCPCS
|
Bevacizumab-bvzr 100 Mg/4ml IV Soln
|
46
|
41
|
$2,164.00
|
$2,164.00
|
$199.16
|
$2,164.00
|
$2,088.26
|
2026-01-01
|
|
27792
|
CPT
|
Hc Pr 27792 Open Tx Distal Fibular Fracture Lat Malleolus
|
48
|
42
|
$2,026.00
|
$2,026.00
|
$662.26
|
$3,676.94
|
$2,084.46
|
2026-01-01
|
|
71250
|
CPT
|
CT Scan Of Chest Without Contrast
|
50
|
43
|
$2,081.00
|
$2,081.00
|
$92.67
|
$2,185.00
|
$2,075.75
|
2026-01-01
|
|
72128
|
CPT
|
CT Scan Of Middle Spine Without Contrast
|
50
|
43
|
$2,066.00
|
$2,066.00
|
$93.40
|
$2,169.00
|
$2,060.55
|
2026-01-01
|
|
52240
|
CPT
|
Hc Pr 52240 Cystourethroscopy W/Dest &/Rmvl Tumor Large Cdm
|
48
|
42
|
$2,061.00
|
$2,061.00
|
$411.33
|
$2,164.00
|
$2,055.80
|
2026-01-01
|
|
70487
|
CPT
|
CT Scan Of Face With Contrast
|
50
|
43
|
$2,044.00
|
$2,044.00
|
$111.25
|
$2,146.00
|
$2,038.70
|
2026-01-01
|
|
70491
|
CPT
|
CT Scan Of Soft Tissue Of Neck With Contrast
|
50
|
43
|
$2,044.00
|
$2,044.00
|
$133.99
|
$2,146.00
|
$2,038.70
|
2026-01-01
|