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

BAYAMON MEDICAL CENTER

Bayamon, PR · CCN 400032 · Rates published

1,817 distinct procedures filed
16 distinct payers
23,829 rate rows
2026-03-31 last MRF observed
Data quality

1,749 of 23,829 rate rows are consumer-grade (7.3%)

22,080 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 21,895
exceeds 10× this hospital's gross charge — excluded from medians 106
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 68
placeholder amount (≤ $0.02) — excluded from medians 11
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://bayamonmedical.com/wp-content/price-transparency/BMC%20Price%20Transparency.csv
Found on page https://bayamonmedical.com/wp-content/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-12
Content fingerprint d9663a5e78587ecc… · 5,028,372 bytes · first seen 2026-05-05

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
7015097
LOCAL 		Insert Vent Assist Dev Impella 4 $14,250.00 $56,000.00 $38,806.00 —
57059738
LOCAL 		Impella Cp Set 3 $25,000.00 $25,000.00 $25,000.00 —
57059981
LOCAL 		Navitor Transcath Heart Valve 1 $22,500.00 $22,500.00 $22,500.00 —
4444000517
LOCAL 		Aortic Valve Replace Avr W/Cc 1 $20,997.11 $20,997.11 $20,997.11 —
480000051
LOCAL 		Repair Aberrant Anatomy: Aorta 1 $18,865.00 $18,865.00 $18,865.00 —
480000081
LOCAL 		Cabg W/Non Vasc Procedure 4 $15,710.00 $20,947.50 $18,628.33 —
480000083
LOCAL 		Cardiovasc Mult Valve Replacem 4 $16,500.00 $19,845.00 $18,572.60 —
480000087
LOCAL 		Mediastinotomy W Exploration 1 $17,420.00 $17,420.00 $17,420.00 —
480000076
LOCAL 		Cabg W Prev Cardiovasc Surgery 6 $15,710.00 $19,500.00 $17,374.58 —
480000042
LOCAL 		Mitral Valve Replac W Conco 9 $15,000.00 $21,498.75 $17,321.39 —
480000084
LOCAL 		Cardiovas Valve Repair W Ccb 4 $15,200.00 $19,500.00 $17,081.67 —
480000041
LOCAL 		Mitral Valve Replac W Pre Card 2 $16,000.00 $18,000.00 $17,000.00 —
480000074
LOCAL 		Excision Proc Of Cardiac Tumor 1 $16,985.00 $16,985.00 $16,985.00 —
480000086
LOCAL 		Removal Venous Access Device 1 $16,985.00 $16,985.00 $16,985.00 —
480000044
LOCAL 		Aortic Valve Replac With Cab 8 $15,000.00 $25,000.00 $16,888.75 —
480000035
LOCAL 		Cab And Valve Surg With Cath 5 $15,600.00 $18,434.90 $16,876.98 —
480000043
LOCAL 		Aortic Valve Replacement 6 $15,000.00 $19,045.00 $16,843.33 —
480000050
LOCAL 		Tapvd-total Anomalous 6 $15,710.00 $19,000.00 $16,756.50 —
480000079
LOCAL 		Arterial Explor Postoper Comp 1 $16,617.00 $16,617.00 $16,617.00 —
480000077
LOCAL 		Cabg With Cath 5 $15,710.00 $17,772.30 $16,551.83 —
480000040
LOCAL 		Mitral Valve Replac With Cath 9 $15,000.00 $20,396.25 $16,510.64 —
480000049
LOCAL 		Av-canal-ant Ventricular 6 $15,500.00 $17,640.00 $16,508.12 —
480000055
LOCAL 		Arch Of Aorta Without Cardiopulmo 7 $7,500.00 $20,396.25 $16,410.31 —
480000045
LOCAL 		Mitral Valve Replac With Cab 6 $15,000.00 $19,500.00 $16,362.80 —
480000031
LOCAL 		Cab Without Catheterization 8 $13,000.00 $17,900.00 $16,061.17 —
4444000544
LOCAL 		Idiopat Hyp Sub Aort Sten Ihss 1 $16,000.00 $16,000.00 $16,000.00 —
480000094
LOCAL 		Partial Anomal Venous Drainage 1 $16,000.00 $16,000.00 $16,000.00 —
480000032
LOCAL 		Cabgs: Arterial Grafts 9 $13,000.00 $18,000.00 $15,774.35 —
480000038
LOCAL 		Tricuspid Valve Procedures 4 $11,892.00 $25,000.00 $15,735.20 —
480000039
LOCAL 		Aortic Valve Replac With Cath. 9 $10,000.00 $20,990.00 $15,712.79 —
480000048
LOCAL 		Vsd-ventricular Septal Defect 7 $9,000.00 $17,640.00 $15,673.89 —
480000047
LOCAL 		Ads-atrial Septal Defect 7 $9,000.00 $17,900.00 $15,526.14 —
4444000525
LOCAL 		Valve Replacement Multiple 2 $15,000.00 $16,537.00 $15,512.33 —
480000075
LOCAL 		Proc For Injury Of The Heart 1 $15,178.00 $15,178.00 $15,178.00 —
480000085
LOCAL 		Placement Venous Access Device 1 $15,178.00 $15,178.00 $15,178.00 —
480000053
LOCAL 		Abdominal Aorta And Branches 9 $12,000.00 $18,350.00 $15,000.30 —
480000099
LOCAL 		Thoracic Aorta Surgery 3 $14,000.00 $16,000.00 $15,000.00 —
4444000623
LOCAL 		Watchman Implants 1 $15,000.00 $15,000.00 $15,000.00 —
2009995
LOCAL 		Fg Watchman Laa Device 24mm 8 $14,000.00 $15,000.00 $14,933.33 —
480000034
LOCAL 		Endarterectomy With Cabg 3 $7,500.00 $18,395.00 $14,631.67 —
33502
CPT 		Tapvc 5 $13,430.00 $14,806.58 $14,153.24 nat. median
$3,682
outlier · 3.8×
4444000526
LOCAL 		Thoracic Abd Aneurism Taa 1 $14,000.00 $14,000.00 $14,000.00 —
480000056
LOCAL 		Arch Of Aorta With Cardiopulmo 4 $8,269.00 $18,300.00 $13,761.50 —
480000054
LOCAL 		Endov Repair Aortic Aneu Thora 8 $7,500.00 $18,865.00 $13,534.93 —
480000082
LOCAL 		Thoracotomy 5 $5,500.00 $15,710.00 $13,162.84 —
480000046
LOCAL 		Pulmonary Valvotomy 1 $13,000.00 $13,000.00 $13,000.00 —
33361
CPT 		Tvar Replacement 6 $1,214.60 $16,120.00 $12,636.51 nat. median
$2,550
outlier · 5.0×
480000052
LOCAL 		Tetralogy Of Fallot Shunt 6 $8,000.00 $15,710.00 $12,517.76 —
480000063
LOCAL 		Evar Endovascular Implantation 3 $11,000.00 $17,000.00 $12,500.00 —
35301
CPT 		Paquete Periferovascular 1 $12,012.00 $12,012.00 $12,012.00 nat. median
$3,873
outlier · 3.1×

Other procedures at this hospital

Browse this hospital's 1,817 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
             
7015097 LOCAL Insert Vent Assist Dev Impella 6 4 $15,000.00 $15,000.00 $14,250.00 $56,000.00 $38,806.00 2026-03-31
57059738 LOCAL Impella Cp Set 4 3 $37,500.00 $37,500.00 $25,000.00 $25,000.00 $25,000.00 2026-03-31
57059981 LOCAL Navitor Transcath Heart Valve 2 1 $30,937.50 $30,937.50 $22,500.00 $22,500.00 $22,500.00 2026-03-31
4444000517 LOCAL Aortic Valve Replace Avr W/Cc 2 1 $7,000.00 $7,000.00 $20,997.11 $20,997.11 $20,997.11 2026-03-31
480000051 LOCAL Repair Aberrant Anatomy: Aorta 2 1 $1.00 $1.00 $18,865.00 $18,865.00 $18,865.00 2026-03-31
480000081 LOCAL Cabg W/Non Vasc Procedure 7 4 $1.00 $1.00 $15,710.00 $20,947.50 $18,628.33 2026-03-31
480000083 LOCAL Cardiovasc Mult Valve Replacem 7 4 $1.00 $1.00 $16,500.00 $19,845.00 $18,572.60 2026-03-31
480000087 LOCAL Mediastinotomy W Exploration 2 1 $1.00 $1.00 $17,420.00 $17,420.00 $17,420.00 2026-03-31
480000076 LOCAL Cabg W Prev Cardiovasc Surgery 10 6 $1.00 $1.00 $15,710.00 $19,500.00 $17,374.58 2026-03-31
480000042 LOCAL Mitral Valve Replac W Conco 17 9 $1.00 $1.00 $15,000.00 $21,498.75 $17,321.39 2026-03-31
480000084 LOCAL Cardiovas Valve Repair W Ccb 7 4 $1.00 $1.00 $15,200.00 $19,500.00 $17,081.67 2026-03-31
480000041 LOCAL Mitral Valve Replac W Pre Card 3 2 $1.00 $1.00 $16,000.00 $18,000.00 $17,000.00 2026-03-31
480000074 LOCAL Excision Proc Of Cardiac Tumor 2 1 $1.00 $1.00 $16,985.00 $16,985.00 $16,985.00 2026-03-31
480000086 LOCAL Removal Venous Access Device 2 1 $1.00 $1.00 $16,985.00 $16,985.00 $16,985.00 2026-03-31
480000044 LOCAL Aortic Valve Replac With Cab 13 8 $1.00 $1.00 $15,000.00 $25,000.00 $16,888.75 2026-03-31
480000035 LOCAL Cab And Valve Surg With Cath 10 5 $1.00 $1.00 $15,600.00 $18,434.90 $16,876.98 2026-03-31
480000043 LOCAL Aortic Valve Replacement 10 6 $1.00 $1.00 $15,000.00 $19,045.00 $16,843.33 2026-03-31
480000050 LOCAL Tapvd-total Anomalous 11 6 $1.00 $1.00 $15,710.00 $19,000.00 $16,756.50 2026-03-31
480000079 LOCAL Arterial Explor Postoper Comp 2 1 $1.00 $1.00 $16,617.00 $16,617.00 $16,617.00 2026-03-31
480000077 LOCAL Cabg With Cath 9 5 $1.00 $1.00 $15,710.00 $17,772.30 $16,551.83 2026-03-31
480000040 LOCAL Mitral Valve Replac With Cath 16 9 $1.00 $1.00 $15,000.00 $20,396.25 $16,510.64 2026-03-31
480000049 LOCAL Av-canal-ant Ventricular 9 6 $1.00 $1.00 $15,500.00 $17,640.00 $16,508.12 2026-03-31
480000055 LOCAL Arch Of Aorta Without Cardiopulmo 13 7 $1.00 $1.00 $7,500.00 $20,396.25 $16,410.31 2026-03-31
480000045 LOCAL Mitral Valve Replac With Cab 11 6 $1.00 $1.00 $15,000.00 $19,500.00 $16,362.80 2026-03-31
480000031 LOCAL Cab Without Catheterization 15 8 $1.00 $1.00 $13,000.00 $17,900.00 $16,061.17 2026-03-31
4444000544 LOCAL Idiopat Hyp Sub Aort Sten Ihss 4 1 $5,500.00 $5,500.00 $16,000.00 $16,000.00 $16,000.00 2026-03-31
480000094 LOCAL Partial Anomal Venous Drainage 4 1 $1.00 $1.00 $16,000.00 $16,000.00 $16,000.00 2026-03-31
480000032 LOCAL Cabgs: Arterial Grafts 17 9 $12,000.00 $12,000.00 $13,000.00 $18,000.00 $15,774.35 2026-03-31
480000038 LOCAL Tricuspid Valve Procedures 6 4 $1.00 $1.00 $11,892.00 $25,000.00 $15,735.20 2026-03-31
480000039 LOCAL Aortic Valve Replac With Cath. 17 9 $1.00 $1.00 $10,000.00 $20,990.00 $15,712.79 2026-03-31
480000048 LOCAL Vsd-ventricular Septal Defect 10 7 $1.00 $1.00 $9,000.00 $17,640.00 $15,673.89 2026-03-31
480000047 LOCAL Ads-atrial Septal Defect 12 7 $1.00 $1.00 $9,000.00 $17,900.00 $15,526.14 2026-03-31
4444000525 LOCAL Valve Replacement Multiple 4 2 $7,000.00 $7,000.00 $15,000.00 $16,537.00 $15,512.33 2026-03-31
480000085 LOCAL Placement Venous Access Device 2 1 $1.00 $1.00 $15,178.00 $15,178.00 $15,178.00 2026-03-31
480000075 LOCAL Proc For Injury Of The Heart 2 1 $1.00 $1.00 $15,178.00 $15,178.00 $15,178.00 2026-03-31
480000053 LOCAL Abdominal Aorta And Branches 16 9 $1.00 $1.00 $12,000.00 $18,350.00 $15,000.30 2026-03-31
4444000623 LOCAL Watchman Implants 4 1 $15,742.50 $15,742.50 $15,000.00 $15,000.00 $15,000.00 2026-03-31
480000099 LOCAL Thoracic Aorta Surgery 7 3 $1.00 $1.00 $14,000.00 $16,000.00 $15,000.00 2026-03-31
2009995 LOCAL Fg Watchman Laa Device 24mm 16 8 $20,000.00 $20,000.00 $14,000.00 $15,000.00 $14,933.33 2026-03-31
480000034 LOCAL Endarterectomy With Cabg 4 3 $1.00 $1.00 $7,500.00 $18,395.00 $14,631.67 2026-03-31
33502 CPT Tapvc 10 5 $1.00 $1.00 $13,430.00 $14,806.58 $14,153.24 2026-03-31
4444000526 LOCAL Thoracic Abd Aneurism Taa 2 1 $6,000.00 $6,000.00 $14,000.00 $14,000.00 $14,000.00 2026-03-31
480000056 LOCAL Arch Of Aorta With Cardiopulmo 7 4 $1.00 $1.00 $8,269.00 $18,300.00 $13,761.50 2026-03-31
480000054 LOCAL Endov Repair Aortic Aneu Thora 16 8 $1.00 $1.00 $7,500.00 $18,865.00 $13,534.93 2026-03-31
480000082 LOCAL Thoracotomy 8 5 $1.00 $1.00 $5,500.00 $15,710.00 $13,162.84 2026-03-31
480000046 LOCAL Pulmonary Valvotomy 2 1 $1.00 $1.00 $13,000.00 $13,000.00 $13,000.00 2026-03-31
33361 CPT Tvar Replacement 14 6 $1,849.25 $1,849.25 $1,214.60 $16,120.00 $12,636.51 2026-03-31
480000052 LOCAL Tetralogy Of Fallot Shunt 11 6 $1.00 $1.00 $8,000.00 $15,710.00 $12,517.76 2026-03-31
480000063 LOCAL Evar Endovascular Implantation 7 3 $1.00 $1.00 $11,000.00 $17,000.00 $12,500.00 2026-03-31
35301 CPT Paquete Periferovascular 2 1 $1.00 $1.00 $12,012.00 $12,012.00 $12,012.00 2026-03-31
480000072 LOCAL Congenital Cardio Surgery 10 5 $355.00 $355.00 $6,000.00 $16,400.00 $11,413.56 2026-03-31
480000062 LOCAL Pericadiotomy 6 4 $1.00 $1.00 $5,900.00 $16,985.00 $10,974.25 2026-03-31
480000058 LOCAL Peripheral Vascular Surgery 14 7 $1.00 $1.00 $7,500.00 $18,395.00 $10,837.09 2026-03-31
33430 CPT Mitral Valve Replacement 30 10 $16,000.00 $16,000.00 $1,422.00 $20,396.25 $10,498.00 2026-03-31
480000057 LOCAL Vascular Angioplasty 3 2 $1.00 $1.00 $4,800.00 $16,170.00 $10,485.00 2026-03-31
33510 CPT Cabgs: Art Grafts W Concomit 25 10 $2,600.00 $2,600.00 $1,415.97 $18,301.50 $10,254.18 2026-03-31
33405 CPT Rplcmet Prost Aortic Valve 29 11 $3,000.00 $3,000.00 $1,104.72 $19,500.00 $10,035.79 2026-03-31
480000098 LOCAL Ptc With Device 4 1 $1.00 $1.00 $10,000.00 $10,000.00 $10,000.00 2026-03-31
L8699 HCPCS Inspiris Resilia Aortic Val29M 44 9 $30,000.00 $30,000.00 $1,980.00 $20,600.00 $9,635.27 2026-03-31
39545 CPT Diafragma 7 4 $3,000.00 $3,000.00 $9,000.00 $9,923.00 $9,511.33 2026-03-31
93580 CPT Perc-trns Closure Procedure 3 2 $1.00 $1.00 $5,900.00 $12,030.00 $8,965.00 2026-03-31
93656 CPT Eps St W/Ablat&3d (without Defib) 16 8 $1.00 $1.00 $4,200.00 $11,025.00 $8,712.58 2026-03-31
C1786 HCPCS Pacemacker Micra Generator 10 6 $10,000.00 $10,000.00 $8,300.00 $8,755.00 $8,378.22 2026-03-31
3360000574 LOCAL Arteriovenous Fistula (Avf) 4 2 $1.00 $1.00 $6,375.00 $9,500.00 $8,125.00 2026-03-31
3360000565 LOCAL Eps W Ablation 3d Map 2 1 $1.00 $1.00 $7,600.00 $7,600.00 $7,600.00 2026-03-31
J3101 HCPCS Tenecteplase 50 Mg Kit 17 9 $14,801.46 $14,801.46 $6,927.94 $7,654.50 $7,455.33 2026-03-31
32220 CPT Pulmonary Decortation 8 5 $1.00 $1.00 $900.00 $8,820.00 $7,380.00 2026-03-31
480000097 LOCAL Ptca For Chronic Total Occlus 7 3 $1.00 $1.00 $6,000.00 $8,000.00 $7,333.33 2026-03-31
92943 CPT Ptca Cto 17 9 $1.00 $1.00 $4,741.00 $8,662.00 $7,192.19 2026-03-31
61867 CPT Implant Brain Neurostimulator 2 1 $16,250.00 $16,250.00 $6,500.00 $6,500.00 $6,500.00 2026-03-31
61886 CPT Cranial Neurostimu Pulse Gene 2 1 $16,250.00 $16,250.00 $6,500.00 $6,500.00 $6,500.00 2026-03-31
430000529 LOCAL Amplatz 4 3 $134.80 $134.80 $6,400.00 $6,400.00 $6,400.00 2026-03-31
3360000532 LOCAL Ptca/Angioplasty W Catheterism 3 2 $1.00 $1.00 $5,250.00 $7,470.00 $6,360.00 2026-03-31
33967 CPT Ptca And Cath W/Ffr Wire 6 3 $1.00 $1.00 $5,000.00 $6,800.00 $6,160.00 2026-03-31
4444000618 LOCAL Valvuloplasty Percutaneous 2 1 $5,000.00 $5,000.00 $6,000.00 $6,000.00 $6,000.00 2026-03-31
7770000333 LOCAL Laser Atherectomy 4 1 $1.00 $1.00 $6,000.00 $6,000.00 $6,000.00 2026-03-31
4444000507 LOCAL Electrophysiology Study 2 1 $5,000.00 $5,000.00 $6,000.00 $6,000.00 $6,000.00 2026-03-31
480000071 LOCAL Valvuloplasty Aortic Valve 12 7 $355.00 $355.00 $4,500.00 $6,615.00 $5,994.09 2026-03-31
92941 CPT Coronary Occlusion (Cto) 4 3 $9,750.00 $9,750.00 $5,200.00 $6,500.00 $5,900.00 2026-03-31
100000000 LOCAL Semi Private (Case Rate) 2 1 $450.00 $450.00 $5,890.00 $5,890.00 $5,890.00 2026-03-31
93650 CPT Electrophisiology: Eps W Ablat 18 10 $355.00 $355.00 $4,961.25 $7,500.00 $5,771.40 2026-03-31
A9515 HCPCS Choline C-11 Up To 20 Mci 2 1 $1.00 $1.00 $5,700.00 $5,700.00 $5,700.00 2026-03-31
4444000509 LOCAL Ptca W/Cath 9 5 $1.00 $1.00 $4,500.00 $6,300.00 $5,612.50 2026-03-31
37241 CPT Vasc Embolization/Ocl Incl Rad 3 1 $656.96 $656.96 $5,500.00 $5,500.00 $5,500.00 2026-03-31
34101 CPT Embolectomy Ax/Br/Inn/Sub Arm 2 1 $910.43 $910.43 $5,500.00 $5,500.00 $5,500.00 2026-03-31
480000064 LOCAL Cryosurgal Ablation Prostate 4 2 $1.00 $1.00 $4,800.00 $5,800.00 $5,466.67 2026-03-31
92928 CPT Ptca With Cardiac Cath 19 11 $6,475.00 $6,475.00 $4,000.00 $6,615.00 $5,414.85 2026-03-31
55873 CPT Cryosurgical Ablat Prostate 2 1 $5,500.00 $5,500.00 $5,292.00 $5,292.00 $5,292.00 2026-03-31
92924 CPT Ptca Rotablator 12 7 $750.00 $750.00 $4,150.00 $8,000.00 $5,288.36 2026-03-31
4444000578 LOCAL Cabg W N Va Pr Or F Ptc W Car 2 1 $19,000.00 $19,000.00 $5,250.00 $5,250.00 $5,250.00 2026-03-31
3360000504 LOCAL Atherectomy 4 2 $1.00 $1.00 $4,500.00 $5,500.00 $5,097.33 2026-03-31
4444000006 LOCAL Artherectomy 6 3 $5,000.00 $5,000.00 $4,800.00 $5,513.00 $5,085.10 2026-03-31
4444000648 LOCAL Cystourethroscopy 4 1 $1,100.00 $1,100.00 $5,000.00 $5,000.00 $5,000.00 2026-03-31
7015103 LOCAL Davinci Operating Room Use Nep 4 3 $1,000.00 $1,000.00 $5,000.00 $5,000.00 $5,000.00 2026-03-31
4444000594 LOCAL Post Mastec-mammoplas And Abd 4 1 $5,000.00 $5,000.00 $5,000.00 $5,000.00 $5,000.00 2026-03-31
4444000508 LOCAL Ptca 9 5 $1.00 $1.00 $4,360.00 $5,733.00 $4,992.21 2026-03-31
7770000342 LOCAL Extracorporeal Shock Wave Lith 4 2 $500.00 $500.00 $4,725.00 $5,200.00 $4,975.00 2026-03-31
430000634 LOCAL Edwards Magna Ease Mitral27mm 3 2 $6,125.00 $6,125.00 $4,900.00 $5,047.00 $4,973.50 2026-03-31
3360000573 LOCAL Chemoembolization 2 1 $1.00 $1.00 $4,961.25 $4,961.25 $4,961.25 2026-03-31
480000089 LOCAL Ptca With Ffr Wire 5 2 $1.00 $1.00 $4,800.00 $5,400.00 $4,950.00 2026-03-31
3360000511 LOCAL Eps W Ablation 2 1 $1.00 $1.00 $4,932.00 $4,932.00 $4,932.00 2026-03-31
7015102 LOCAL Davinci Operating Room Use Uro 9 5 $1,000.00 $1,000.00 $3,936.00 $5,250.00 $4,898.25 2026-03-31
7015104 LOCAL Davinci Operating Room Use H/n 7 4 $1,000.00 $1,000.00 $4,095.00 $5,246.00 $4,890.17 2026-03-31
7049422 LOCAL Removal Tunneled Intrap Cath 2 1 $511.20 $511.20 $4,800.00 $4,800.00 $4,800.00 2026-03-31
7770001481 LOCAL Peritoneal Cath Revision �lap 4 1 $1.00 $1.00 $4,800.00 $4,800.00 $4,800.00 2026-03-31
34812 CPT Opn Fem Art Expos Dlvr Evasc 4 1 $500.00 $500.00 $4,800.00 $4,800.00 $4,800.00 2026-03-31
49422 CPT Rmvl Tunn Intraperitoneal Cath 4 1 $349.34 $349.34 $4,800.00 $4,800.00 $4,800.00 2026-03-31
480000102 LOCAL Endov Repair Abd Aor-iliac Art 2 1 $12,000.00 $12,000.00 $4,800.00 $4,800.00 $4,800.00 2026-03-31
480000103 LOCAL Endovascular Revascularization 2 1 $12,000.00 $12,000.00 $4,800.00 $4,800.00 $4,800.00 2026-03-31
480000093 LOCAL Repair Centralvenous Ac-device 4 1 $1.00 $1.00 $4,800.00 $4,800.00 $4,800.00 2026-03-31
37246 CPT As Endovascular Revascularizat 4 1 $500.00 $500.00 $4,800.00 $4,800.00 $4,800.00 2026-03-31
480000091 LOCAL Contrast Inj Asses Of Abcess 4 1 $1.00 $1.00 $4,800.00 $4,800.00 $4,800.00 2026-03-31
321000074 LOCAL Biliary Dilation Wo Stent 4 1 $1.00 $1.00 $4,800.00 $4,800.00 $4,800.00 2026-03-31
7770000418 LOCAL Peritoneal Cannula Insertion 4 1 $1.00 $1.00 $4,800.00 $4,800.00 $4,800.00 2026-03-31
480000092 LOCAL Rev Of Peritoneal-venous Shunt 4 1 $1.00 $1.00 $4,800.00 $4,800.00 $4,800.00 2026-03-31
7770000417 LOCAL Peritoneal Cannula Removal 4 1 $1.00 $1.00 $4,800.00 $4,800.00 $4,800.00 2026-03-31
7036589 LOCAL Removal Tuneled Cv Cath 4 1 $286.90 $286.90 $4,800.00 $4,800.00 $4,800.00 2026-03-31
7015101 LOCAL Davinci Operating Room Use GYN 12 6 $1,000.00 $1,000.00 $3,161.00 $5,250.00 $4,773.27 2026-03-31
C1721 HCPCS Cardioverter Dual Desfibrilato 3 2 $1.00 $1.00 $0.01 $9,500.00 $4,750.01 2026-03-31
57059999 LOCAL Shockwave C2+ivl 3.5x12mm 2 1 $9,400.00 $9,400.00 $4,700.00 $4,700.00 $4,700.00 2026-03-31
4444000505 LOCAL Electrophysiology Ablat 4 2 $5,000.00 $5,000.00 $4,698.00 $4,698.00 $4,698.00 2026-03-31
33340 CPT Watchman 15 8 $4,060.00 $4,060.00 $3,307.00 $7,718.00 $4,695.36 2026-03-31
92920 CPT Ptca 15 8 $5,000.00 $5,000.00 $3,850.00 $5,733.00 $4,596.84 2026-03-31
4444000573 LOCAL Colectomy Thru Laparacopy 11 6 $4,700.00 $4,700.00 $1,365.00 $7,166.25 $4,571.91 2026-03-31
7015106 LOCAL Davinci Operating Room Use Gen 5 3 $1,000.00 $1,000.00 $3,125.00 $5,000.00 $4,531.25 2026-03-31
3360000527 LOCAL Litotripsia Facility 10 5 $1.00 $1.00 $3,500.00 $5,200.00 $4,469.44 2026-03-31
480000028 LOCAL Intra-aortic Ballon 14 7 $1.00 $1.00 $3,000.00 $5,513.00 $4,325.54 2026-03-31
50590 CPT Lithotrp Xtrcorp Shock Wave 21 8 $4,500.00 $4,500.00 $1,500.00 $6,120.00 $4,214.49 2026-03-31
430000563 LOCAL Onxaap Ascending Aortic Prosth 9 6 $8,625.00 $8,625.00 $4,050.00 $4,285.00 $4,171.25 2026-03-31
430000553 LOCAL Mitral Valve On-x 2 1 $6,000.00 $6,000.00 $4,150.00 $4,150.00 $4,150.00 2026-03-31
430000552 LOCAL Aortic Valve On-x 2 1 $6,000.00 $6,000.00 $4,150.00 $4,150.00 $4,150.00 2026-03-31
430000638 LOCAL Mosaic Mitral Bio Valve 27mm 2 1 $9,750.00 $9,750.00 $4,000.00 $4,000.00 $4,000.00 2026-03-31
3360000557 LOCAL Intervencional Radiology Cat 6 15 7 $355.00 $355.00 $3,000.00 $4,961.25 $3,926.52 2026-03-31
430000639 LOCAL Mosaic Mitral Bio Valve 29mm 3 2 $9,750.00 $9,750.00 $3,900.00 $3,900.00 $3,900.00 2026-03-31
250002048 LOCAL Hemabate 250mcg/Ml Inj 16 8 $1,275.90 $1,275.90 $3,828.00 $3,828.00 $3,828.00 2026-03-31
57057139 LOCAL Graft Vascular Propaten 2 1 $5,040.00 $5,040.00 $3,758.00 $3,758.00 $3,758.00 2026-03-31
3360000508 LOCAL Criocirugia 6 5 $1.00 $1.00 $2,450.00 $5,292.00 $3,668.40 2026-03-31
4444000633 LOCAL Abd/Mammo Recon Post Bariatric 5 3 $8,212.00 $8,212.00 $3,285.00 $4,300.00 $3,579.75 2026-03-31
3360000509 LOCAL Cryoablation 7 4 $1.00 $1.00 $2,500.00 $5,513.00 $3,568.83 2026-03-31
7770000004 LOCAL Ablation 9 4 $1.00 $1.00 $2,600.00 $5,250.00 $3,546.50 2026-03-31
33249 CPT Insertion Or Reposition Desfri 8 5 $3,000.00 $3,000.00 $1,800.00 $10,300.00 $3,510.71 2026-03-31
J9310 HCPCS Rituximab 500 Mg/50 Ml Vial 4 3 $240.93 $240.93 $627.18 $5,811.71 $3,338.80 2026-03-31
4444000599 LOCAL Eus 4 2 $7,800.00 $7,800.00 $2,625.00 $4,750.00 $3,333.33 2026-03-31
19302 CPT Mastectomy Reconstruction 9 5 $1.00 $1.00 $1,500.00 $4,600.00 $3,272.25 2026-03-31
33858 CPT Asc Aorta Graft W Cp Bypass 2 1 $5,333.94 $5,333.94 $3,262.28 $3,262.28 $3,262.28 2026-03-31
7037242 LOCAL Vasc Embolize/Occlude Artery 4 1 $5,652.94 $5,652.94 $3,200.00 $3,200.00 $3,200.00 2026-03-31
19316 CPT Breast Recostruction 9 6 $1,200.00 $1,200.00 $1,323.00 $4,100.00 $3,084.88 2026-03-31
93619 CPT Electrophisiology: Eps 17 9 $1.00 $1.00 $1,488.00 $5,000.00 $3,031.78 2026-03-31
4444000650 LOCAL Neurosurgery 5 4 $5,500.00 $5,500.00 $2,200.00 $3,750.00 $3,018.75 2026-03-31
7770000517 LOCAL Transurethral Resection Of Pro 3 2 $1.00 $1.00 $3,000.00 $3,000.00 $3,000.00 2026-03-31
4444000646 LOCAL Craniotomy Neurosurgery 2 1 $2,500.00 $2,500.00 $3,000.00 $3,000.00 $3,000.00 2026-03-31
3360000543 LOCAL Defibrillator Facility Fee 4 1 $1.00 $1.00 $3,000.00 $3,000.00 $3,000.00 2026-03-31
4444000029 LOCAL Chemoembolization 5 3 $6,000.00 $6,000.00 $2,000.00 $4,500.00 $2,925.00 2026-03-31
3360000556 LOCAL Intervencional Radiology Cat 5 17 9 $355.00 $355.00 $1,200.00 $5,775.00 $2,916.56 2026-03-31
7770000147 LOCAL Cystourethroscopy 11 5 $1.00 $1.00 $1,800.00 $4,500.00 $2,891.40 2026-03-31
C1785 HCPCS Pacemaker Implants 4 2 $8,000.00 $8,000.00 $0.01 $8,500.00 $2,833.34 2026-03-31
A9584 HCPCS 1-123 Ioflupane Up To 5 Mci 4 2 $2,708.64 $2,708.64 $2,813.44 $2,813.52 $2,813.47 2026-03-31
3360000502 LOCAL Abd Reconst Post Bariatrica 2 1 $1.00 $1.00 $2,756.38 $2,756.38 $2,756.38 2026-03-31
3360000571 LOCAL Neurology Facility Use 8 6 $1.00 $1.00 $2,200.00 $3,500.00 $2,732.14 2026-03-31
480000088 LOCAL Facility Use Micra 6 3 $1.00 $1.00 $1,500.00 $3,000.00 $2,700.00 2026-03-31
36818 CPT Arv Anast Opn Uprarmcep Ve Trp 3 1 $1,853.52 $1,853.52 $2,687.06 $2,687.06 $2,687.06 2026-03-31
61680 CPT Embolization 8 3 $355.00 $355.00 $1,500.00 $3,859.00 $2,662.91 2026-03-31
33516 CPT Cabg 6-vein 10 5 $3,500.00 $3,500.00 $1,980.96 $4,250.00 $2,629.75 2026-03-31
7052601 LOCAL Prostatectomy (Turp) 3 1 $2,200.00 $2,200.00 $2,250.00 $3,000.00 $2,625.00 2026-03-31
33863 CPT W/Coronary Reconstruction (Be 3 2 $4,200.00 $4,200.00 $2,232.83 $3,014.50 $2,623.66 2026-03-31
4444000574 LOCAL Cath W Ffr 2 1 $2,850.00 $2,850.00 $2,590.00 $2,590.00 $2,590.00 2026-03-31
4444000572 LOCAL Abd Recostruct Bariatric Sur 13 6 $2,500.00 $2,500.00 $2,402.00 $2,756.25 $2,576.44 2026-03-31
7770000436 LOCAL Radiogrequency Ablation 2 1 $1.00 $1.00 $2,572.00 $2,572.00 $2,572.00 2026-03-31
430000636 LOCAL Tri-ad 2.0adams Tricuspid 28mm 4 3 $3,500.00 $3,500.00 $1,400.00 $4,900.00 $2,566.67 2026-03-31
33427 CPT Vlvp Mitral Valve W Bypass Ra 2 1 $3,200.00 $3,200.00 $2,554.30 $2,554.30 $2,554.30 2026-03-31
33514 CPT Cabg 5-vein 10 5 $3,500.00 $3,500.00 $1,911.67 $4,050.00 $2,543.63 2026-03-31
4444000579 LOCAL Desfibrilator Facility 9 5 $3,000.00 $3,000.00 $1,654.00 $3,307.50 $2,493.00 2026-03-31
4444000583 LOCAL Diskectomy & Vertebroplasty 4 2 $1.00 $1.00 $2,205.00 $2,600.00 $2,468.33 2026-03-31
480000073 LOCAL Cardiac Cath With Ffr 8 4 $2,000.00 $2,000.00 $1,500.00 $3,142.13 $2,456.73 2026-03-31
15830 CPT Surgery Abdominoplasty 6 2 $1,900.00 $1,900.00 $1,900.00 $2,756.25 $2,413.50 2026-03-31
4444000565 LOCAL Artero Ven Embololiz Malforma 2 1 $2,179.00 $2,179.00 $2,402.34 $2,402.34 $2,402.34 2026-03-31
33536 CPT Cabg W/Arterial Graft 4/+ Arte 10 5 $3,483.00 $3,483.00 $1,933.50 $3,675.00 $2,377.14 2026-03-31
33513 CPT Cabg 4-vein 10 5 $3,500.00 $3,500.00 $1,816.83 $3,675.00 $2,367.16 2026-03-31
61710 CPT Embolization 7 3 $1.00 $1.00 $1,346.00 $3,859.00 $2,358.66 2026-03-31
J2997 HCPCS Alteplase 50 Mg Vial 4 3 $12,442.77 $12,442.77 $36.93 $6,927.94 $2,339.92 2026-03-31
33410 CPT Replacement Aortic Valve Opn 3 2 $4,416.27 $4,416.27 $1,766.51 $2,850.00 $2,308.26 2026-03-31
33535 CPT Cabg W/Arterial Graft 3 Arter 12 6 $2,600.00 $2,600.00 $1,552.14 $3,360.00 $2,277.78 2026-03-31
4444000611 LOCAL Pacemaker Facility 13 7 $2,250.00 $2,250.00 $1,000.00 $3,000.00 $2,263.46 2026-03-31
480000024 LOCAL Cardiac Cath Inpatient 17 9 $2,100.00 $2,100.00 $1,852.00 $2,976.75 $2,256.86 2026-03-31
33512 CPT Cabg 3-vein 10 5 $3,500.00 $3,500.00 $1,770.15 $3,300.00 $2,233.63 2026-03-31
A9547 HCPCS In- 111 Oxyquinoli Per 0.5 Mci 4 2 $4,076.93 $4,076.93 $2,211.73 $2,221.92 $2,215.13 2026-03-31
A9600 HCPCS Sr-89 Chloride Therap Per Mci 2 1 $1,471.54 $1,471.54 $2,200.10 $2,200.10 $2,200.10 2026-03-31
33534 CPT Cabg 2-arterial Graft 12 6 $3,000.00 $3,000.00 $1,608.96 $3,180.00 $2,169.87 2026-03-31
52648 CPT Laser Vaporization Prostate 18 8 $2,500.00 $2,500.00 $1,575.00 $5,250.00 $2,105.87 2026-03-31
L8670 HCPCS Stretch Vascular Graft Ringed 2 1 $2,541.25 $2,541.25 $2,093.99 $2,093.99 $2,093.99 2026-03-31
4444000593 LOCAL Mammoplasty-post Bariatric Sur 12 6 $3,000.00 $3,000.00 $1,856.00 $2,205.00 $2,043.82 2026-03-31
430000624 LOCAL Physio Flex Mit Annu Ring30mm 2 1 $2,970.00 $2,970.00 $2,039.40 $2,039.40 $2,039.40 2026-03-31
7770000405 LOCAL Partial Thyroidectomy 8 6 $1.00 $1.00 $1,100.00 $3,500.00 $2,011.43 2026-03-31
480000095 LOCAL Arteriograma Periferovaculares 4 1 $1.00 $1.00 $2,000.00 $2,000.00 $2,000.00 2026-03-31
480000096 LOCAL A Or V Mechanical Thrombectomy 4 1 $1.00 $1.00 $2,000.00 $2,000.00 $2,000.00 2026-03-31
480000101 LOCAL Intravas Dis Blo Flow Velocity 2 1 $1.00 $1.00 $2,000.00 $2,000.00 $2,000.00 2026-03-31
430000626 LOCAL Physio Flex Mit Annu Ring34mm 2 1 $2,970.00 $2,970.00 $1,980.00 $1,980.00 $1,980.00 2026-03-31
430000607 LOCAL Physio Mit Annuloplasty R#24 2 1 $2,970.00 $2,970.00 $1,980.00 $1,980.00 $1,980.00 2026-03-31
430000646 LOCAL Annuloplasty Ring Edwards 2 1 $2,970.00 $2,970.00 $1,980.00 $1,980.00 $1,980.00 2026-03-31
430000623 LOCAL Physio Flex Mit Annu Ring28mm 4 2 $2,970.00 $2,970.00 $1,980.00 $1,980.00 $1,980.00 2026-03-31
430000625 LOCAL Physio Flex Mit Annu Ring32mm 4 2 $2,970.00 $2,970.00 $1,980.00 $1,980.00 $1,980.00 2026-03-31
430000609 LOCAL Physio Mit Annuloplasty R#28 3 2 $2,970.00 $2,970.00 $1,980.00 $1,980.00 $1,980.00 2026-03-31
730000005 LOCAL G Tilt Table Test 2 1 $1.00 $1.00 $1,974.22 $1,974.22 $1,974.22 2026-03-31
4444000564 LOCAL Artero Venous Embolization 3 1 $1,401.00 $1,401.00 $1,544.60 $2,402.35 $1,973.47 2026-03-31
33511 CPT Cabg 2-vein 10 5 $2,800.00 $2,800.00 $1,476.16 $2,925.00 $1,933.74 2026-03-31
3360000537 LOCAL Thyroidectomy 6 2 $355.00 $355.00 $1,653.75 $2,205.00 $1,928.75 2026-03-31
93458 CPT Cardiac Cath Outpatient 21 10 $2,500.00 $2,500.00 $760.00 $2,976.75 $1,882.64 2026-03-31
3360000555 LOCAL Intervencional Radiology Cat 4 17 9 $355.00 $355.00 $1,200.00 $3,859.00 $1,868.55 2026-03-31
33533 CPT Cabg 1-arterial Graft 13 7 $2,500.00 $2,500.00 $1,302.29 $3,060.00 $1,858.81 2026-03-31
33425 CPT Valvuloplasty Mitral Valve 3 2 $3,600.00 $3,600.00 $1,422.00 $2,271.50 $1,846.75 2026-03-31
33426 CPT Mitral Valve Repair With Ring 3 2 $3,200.00 $3,200.00 $1,655.49 $1,977.44 $1,816.46 2026-03-31
7770000562 LOCAL Ercp Therapeutic 16 8 $1.00 $1.00 $700.00 $3,600.00 $1,803.72 2026-03-31
52356 CPT Cysto/Uret W/Lito Ind Stnt Ins 3 1 $2,000.00 $2,000.00 $1,800.00 $1,800.00 $1,800.00 2026-03-31
4444000658 LOCAL Each 24hrs EEG Monitoring 2 1 $4,500.00 $4,500.00 $1,800.00 $1,800.00 $1,800.00 2026-03-31
4444000631 LOCAL Percutaneous Vertebral 5 3 $2,700.00 $2,700.00 $1,080.00 $2,500.00 $1,790.00 2026-03-31
7019379 LOCAL Excise Excess Skin Other Area 4 2 $355.00 $355.00 $1,175.00 $2,624.00 $1,755.67 2026-03-31
7770000498 LOCAL Total Thyroidectomy 5 4 $1.00 $1.00 $1,100.00 $2,200.00 $1,725.00 2026-03-31
7019318 LOCAL Reduction Mammaplasty 4 2 $3,000.00 $3,000.00 $1,500.00 $2,100.00 $1,700.00 2026-03-31
A9507 HCPCS In-111 Capromab Up To 10 Mci 5 4 $3,568.78 $3,568.78 $1,670.48 $1,670.48 $1,670.48 2026-03-31
81162 CPT Molecular Pathology Brac 1/2 3 2 $150.00 $150.00 $1,419.40 $1,824.88 $1,622.14 2026-03-31
C1768 HCPCS Stent Graft Fluency Plus 12 6 $2,970.00 $2,970.00 $1,400.00 $1,980.00 $1,558.18 2026-03-31
53854 CPT Rezum Facility Use 7 5 $355.00 $355.00 $801.00 $2,200.00 $1,552.83 2026-03-31
4444000009 LOCAL Ercp 16 8 $1,500.00 $1,500.00 $725.00 $2,300.00 $1,551.77 2026-03-31
33418 CPT Transcath Mitral Valve Repair 8 4 $3,914.00 $3,914.00 $1,318.18 $1,883.11 $1,514.88 2026-03-31
19301 CPT Mastectomy Facility Fee 11 6 $1.00 $1.00 $1,100.00 $2,350.00 $1,510.58 2026-03-31
7770001974 LOCAL Breast Reconstr W/Other Tech 3 1 $3,750.00 $3,750.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
7770000348 LOCAL Mastectomy Gynecomastia 2 1 $1.00 $1.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
19396 CPT Design Custom Breast Implant 3 1 $3,750.00 $3,750.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
19355 CPT Correct Of Inverted Nipples 3 1 $3,750.00 $3,750.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
19328 CPT Removal Intact Mammary Implant 3 1 $3,750.00 $3,750.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
7019370 LOCAL Open Periprosthetic Cap Breast 3 1 $1,800.00 $1,800.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
7019371 LOCAL Removal Of Breast Capsule 3 1 $2,888.15 $2,888.15 $1,500.00 $1,500.00 $1,500.00 2026-03-31
19300 CPT Mastectomy Procedures 3 1 $2,500.00 $2,500.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
60254 CPT Extensive Thyroid Surgery 2 1 $1,000.00 $1,000.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
480000067 LOCAL Pacemaker Insertion Or Replac 3 1 $1.00 $1.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
7019342 LOCAL Dly Ins Br Pro Flwg Ma Ma/Rcns 3 1 $3,500.00 $3,500.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
7019350 LOCAL Nipple/Areola Reconstruction 3 1 $1,500.00 $1,500.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
7770000870 LOCAL Biopsy Thyroid 3 1 $1.00 $1.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
7019380 LOCAL Revision Reconstructed Breast 3 1 $3,000.00 $3,000.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
7019357 LOCAL Brs Rcn Immt/Olyd W/Tiss Ex Sb 3 1 $5,000.00 $5,000.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
7770000012 LOCAL Angioplasty Renal 2 1 $1.00 $1.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
3360000544 LOCAL Litotripsy Re-treatment Facili 3 1 $1.00 $1.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
3360000541 LOCAL Mastopexy Facility Fee 3 1 $1.00 $1.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
60252 CPT Removal Of Thyroid 2 1 $1,200.00 $1,200.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
19499 CPT Breast Surgery Procedure 3 1 $3,750.00 $3,750.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
7019340 LOCAL Immediate Breast Prosthesis 3 1 $3,978.77 $3,978.77 $1,500.00 $1,500.00 $1,500.00 2026-03-31
7019330 LOCAL Removal Mammary Implant Mat 3 1 $1,800.00 $1,800.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
7770001072 LOCAL Thyroid 3 1 $1.00 $1.00 $1,500.00 $1,500.00 $1,500.00 2026-03-31
7770000403 LOCAL Sentinel Node Biopsy 6 4 $1.00 $1.00 $800.00 $2,600.00 $1,498.82 2026-03-31
92978 CPT Ivus 92978 16 8 $1,200.00 $1,200.00 $1,170.00 $1,800.00 $1,498.25 2026-03-31
47562 CPT Laparoscopy Surgery 21 8 $1,500.00 $1,500.00 $367.00 $2,205.00 $1,492.49 2026-03-31
4444000567 LOCAL Epilepcy Monitori For Seizures 5 4 $1,886.90 $1,886.90 $875.00 $1,981.25 $1,464.06 2026-03-31
J1569 HCPCS Immunoglobulina 5Gm 50Ml Vial 6 4 $4,742.25 $4,742.25 $38.53 $2,331.21 $1,421.84 2026-03-31
92979 CPT Ivus) 92979 16 8 $1,200.00 $1,200.00 $1,155.00 $1,800.00 $1,414.87 2026-03-31
430000633 LOCAL Edwards Magna Ease Mitral25mm 2 1 $6,125.00 $6,125.00 $1,400.00 $1,400.00 $1,400.00 2026-03-31
430000650 LOCAL Tri-ad2.0 Adams Tricuspid 34mm 2 1 $3,500.00 $3,500.00 $1,400.00 $1,400.00 $1,400.00 2026-03-31
4444000522 LOCAL Tricuspide Valve Replace 2 1 $6,500.00 $6,500.00 $1,400.00 $1,400.00 $1,400.00 2026-03-31
38525 CPT Biopsy/Removal Lymph Nodes 4 2 $500.00 $500.00 $1,139.00 $1,500.00 $1,379.67 2026-03-31
33641 CPT Heart Septum Repair 2 1 $1,400.00 $1,400.00 $1,356.14 $1,356.14 $1,356.14 2026-03-31
7770000674 LOCAL Simple Mastectomy 2 1 $1.00 $1.00 $1,350.00 $1,350.00 $1,350.00 2026-03-31
3360000523 LOCAL Laparoscopy Orthopedic 3 1 $1.00 $1.00 $1,300.00 $1,400.00 $1,350.00 2026-03-31
7019374 LOCAL Excision Excessive Skin Hip 3 1 $355.00 $355.00 $1,190.00 $1,488.00 $1,339.00 2026-03-31
7019375 LOCAL Excision Excess Skin Buttock 3 1 $355.00 $355.00 $1,190.00 $1,488.00 $1,339.00 2026-03-31
7019373 LOCAL Excision Excessive Skin Leg 3 1 $355.00 $355.00 $1,190.00 $1,488.00 $1,339.00 2026-03-31
7019378 LOCAL Excise Excess Skin Fat Pad 3 1 $355.00 $355.00 $1,190.00 $1,488.00 $1,339.00 2026-03-31
3360000554 LOCAL Intervencional Radiology Cat 3 17 9 $355.00 $355.00 $1,080.00 $1,929.38 $1,333.21 2026-03-31
7019377 LOCAL Excise Exces Skin Forearm/Hand 3 1 $355.00 $355.00 $1,185.00 $1,481.00 $1,333.00 2026-03-31
33365 CPT Replace Aortic Valve Open 3 1 $3,250.00 $3,250.00 $1,300.00 $1,364.83 $1,332.41 2026-03-31
7019372 LOCAL Excision Excessive Skin Thigh 3 1 $355.00 $355.00 $1,183.00 $1,478.00 $1,330.50 2026-03-31
7019376 LOCAL Excision Excessive Skin Arm 3 1 $355.00 $355.00 $1,160.00 $1,450.00 $1,305.00 2026-03-31
3360000542 LOCAL Mammaplasty Facility Fee 5 2 $355.00 $355.00 $1,100.00 $1,500.00 $1,300.00 2026-03-31
4444000024 LOCAL Laparascopy Surgical 3 7 2 $850.00 $850.00 $850.00 $2,215.50 $1,295.37 2026-03-31
J0630 HCPCS Miacalcin 400 Units/2ml Vial 4 2 $3,425.25 $3,425.25 $677.40 $2,448.45 $1,267.75 2026-03-31
740000003 LOCAL G Sleep Study 2 1 $1.00 $1.00 $1,257.10 $1,257.10 $1,257.10 2026-03-31
7770001054 LOCAL Stereotactic Brain Biopsy 2 1 $1.00 $1.00 $1,255.75 $1,255.75 $1,255.75 2026-03-31
38500 CPT Biopsy/Removal Lymph Nodes 3 1 $3,125.00 $3,125.00 $1,250.00 $1,250.00 $1,250.00 2026-03-31
J1561 HCPCS Immunoglobulina 10gm 100 Ml Vi 30 8 $4,186.74 $4,186.74 $37.62 $2,331.20 $1,237.56 2026-03-31
A9568 HCPCS Tc-99m Arcitumoma Up To 45 Mci 4 2 $1,235.00 $1,235.00 $1,235.00 $1,235.00 $1,235.00 2026-03-31
36245 CPT Slctv Cathj Ea 1st Ord Abdl P 5 3 $1,600.00 $1,600.00 $694.00 $1,929.37 $1,232.09 2026-03-31
4444000560 LOCAL Laparascopy Surgical Iii Ipd 7 2 $867.00 $867.00 $850.00 $2,205.00 $1,218.64 2026-03-31
19081 CPT Stereotactic Loc Lt 11 5 $770.00 $770.00 $770.00 $2,384.55 $1,205.81 2026-03-31
7015111 LOCAL Rezum Delivery Device 6 3 $3,000.00 $3,000.00 $1,200.00 $1,200.00 $1,200.00 2026-03-31
3360000530 LOCAL Pacemaker Facility 2 1 $1.00 $1.00 $1,200.00 $1,200.00 $1,200.00 2026-03-31
33507 CPT Rpr An Aortic Or Cor Art U/t 2 1 $2,701.02 $2,701.02 $1,197.44 $1,197.44 $1,197.44 2026-03-31
7770001949 LOCAL Angiogram 2 1 $1.00 $1.00 $1,190.00 $1,190.00 $1,190.00 2026-03-31
A9521 HCPCS Tc-99m Exametazin Up To 25 Mci 22 9 $1,867.65 $1,867.65 $10.35 $1,742.80 $1,188.93 2026-03-31
250002106 LOCAL Curosurf 240mg/3ml Vial 4 1 $1,296.98 $1,296.98 $1,106.52 $1,295.82 $1,176.08 2026-03-31
4444000014 LOCAL Surgery Orthopedic 13 6 $1,500.00 $1,500.00 $1,050.00 $1,300.00 $1,167.08 2026-03-31
250002096 LOCAL Gamunex-c 10 Gm/100 Ml 3 2 $2,093.38 $2,093.38 $1,165.61 $1,165.61 $1,165.61 2026-03-31
7770000751 LOCAL Excision Breast Lesion 4 2 $1.00 $1.00 $131.04 $2,300.00 $1,160.35 2026-03-31
4444000632 LOCAL Desc Perc Of Nucl Pulp Interve 2 1 $2,877.50 $2,877.50 $1,151.00 $1,151.00 $1,151.00 2026-03-31
3360000534 LOCAL Surgery Orthopedic 10 6 $1.00 $1.00 $760.00 $1,300.00 $1,148.86 2026-03-31
49320 CPT Orthopedic Laparascopy 5 2 $1,500.00 $1,500.00 $825.00 $1,500.00 $1,137.50 2026-03-31
21602 CPT Exc Chest W Tumor Ribs Wo Ml 2 1 $2,394.89 $2,394.89 $1,133.07 $1,133.07 $1,133.07 2026-03-31
J3262 HCPCS Tocilizumab 400mg/20ml Vial 16 8 $3,458.70 $3,458.70 $520.00 $2,519.46 $1,129.51 2026-03-31
33285 CPT Insertion Subq Car Rhythm Mntr 3 1 $2,750.00 $2,750.00 $1,100.00 $1,100.00 $1,100.00 2026-03-31
4444000550 LOCAL Surgery Mammoplasty 2 1 $1,500.00 $1,500.00 $1,100.00 $1,100.00 $1,100.00 2026-03-31
19085 CPT Guided Breast Biopsy Rt MRI 13 6 $765.00 $765.00 $1.00 $1,986.47 $1,087.62 2026-03-31
3360000525 LOCAL Laparoscopy Diagnostic 4 1 $1.00 $1.00 $825.00 $1,500.00 $1,050.00 2026-03-31
4444000013 LOCAL Surgery One Day 6 4 $1,500.00 $1,500.00 $830.00 $1,425.00 $1,049.80 2026-03-31
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