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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

FALL RIVER HOSPITAL - CAH

Hot Springs, SD · CCN 431322 · Rates published

2,015 distinct procedures filed
19 distinct payers
86,963 rate rows
2026-02-01 last MRF observed
Data quality

86,876 of 86,963 rate rows are consumer-grade (99.9%)

87 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
placeholder amount (≤ $0.02) — excluded from medians 87
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.frhssd.org/docs/460450523_Fall-River-Health-Services_standardcharges.csv
Found on page https://www.frhssd.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-20
Content fingerprint 1d9071519773e664… · 49,594,452 bytes · first seen 2026-05-17

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
J0896
HCPCS 		Luspatercept-aamt 75 Mg Subcutaneous Solution 19 $76,890.65 $92,084.61 $87,480.38 nat. median
$4,569
outlier · 19.1×
J2327
HCPCS 		Risankizumab-rzaa 150 Mg/ml Subcutaneous Syringe 19 $56,770.82 $78,417.22 $65,949.33 nat. median
$1,767
outlier · 37.3×
J3101
HCPCS 		Tenecteplase 50 Mg Intravenous Solution - Mi 19 $24,271.70 $49,500.00 $35,200.21 nat. median
$3,787
outlier · 9.3×
J9312
HCPCS 		Rituximab 10 Mg/ml Concentrate,intravenous 19 $26,702.67 $31,979.25 $30,380.29 nat. median
$1,063
outlier · 28.6×
J1306
HCPCS 		Inclisiran 284 Mg/1.5 Ml Subcutaneous Syringe 19 $21,214.22 $25,406.25 $24,135.94 nat. median
$44
outlier · 551.9×
J1459
HCPCS 		Immune Globulin (human) (privigen) 10% Injection Solution 19 $14,675.13 $17,575.00 $16,696.25 nat. median
$1,371
outlier · 12.2×
J2182
HCPCS 		Mepolizumab 100 Mg Subcutaneous Solution 19 $14,675.13 $17,575.00 $16,696.25 nat. median
$2,791
outlier · 6.0×
49657
CPT 		*No Longer Active 2023 Do Not Use* Hc Lap Inc Hern Recur Comp 19 $13,844.30 $16,580.00 $15,751.00 nat. median
$6,115
outlier · 2.6×
J2506
HCPCS 		Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe 19 $12,885.09 $15,431.25 $14,659.69 nat. median
$1,659
outlier · 8.8×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml Subcutaneous Syringe 19 $12,765.48 $15,288.00 $14,523.60 nat. median
$1,984
outlier · 7.3×
J3111
HCPCS 		Romosozumab-aqqg 210 Mg/2.34 Ml(105 Mg/1.17 Ml X2)subcutaneous Syringe 19 $10,876.24 $13,025.44 $12,374.17 nat. median
$696
outlier · 17.8×
J2997
HCPCS 		Alteplase 100 Mg/100ml IV (wet Solr Vial) 19 $440.70 $28,792.81 $12,284.90 nat. median
$500
outlier · 24.6×
J0717
HCPCS 		Certolizumab Pegol 400 Mg (200 Mg X 2 Vials) Lypholized Powder 19 $7,893.05 $15,639.05 $11,255.69 nat. median
$1,635
outlier · 6.9×
29827
CPT 		Arthroscopy Shoulder Rotator Cuff Repair 19 $9,397.93 $11,255.00 $10,692.25 nat. median
$7,187
1.5× median
90375
HCPCS 		Rabies Immune Globulin (pf) 300 Unit/ml Intramuscular Solution 19 $9,367.26 $11,218.27 $10,657.36 nat. median
$1,052
outlier · 10.1×
43282
CPT 		Hc Pro Laps Rpr Paraesphgl Hrna Incl Fundplsty W/Mesh 19 $5,888.42 $16,137.00 $10,263.20 nat. median
$10,337
1.0× median
J3032
HCPCS 		Eptinezumab-jjmr 100 Mg/ml Intravenous Solution 19 $8,616.78 $10,319.50 $9,803.53 nat. median
$73
outlier · 135.0×
15734
CPT 		Hc Pro Musc Myocutaneous/Fasciocutaneous Flap Trunk 19 $5,148.61 $14,855.00 $9,284.97 nat. median
$3,795
outlier · 2.4×
43281
CPT 		Hc Pro Laps Rpr Paraesphgl Hrna Incl Fundplsty Without Mesh 19 $5,240.46 $14,368.00 $9,136.64 nat. median
$10,128
0.9× median
J0139
HCPCS 		Adalimumab 40 Mg/0.8 Ml Subcutaneous Syringe Kit 19 $7,979.75 $9,556.59 $9,078.76 nat. median
$3,513
outlier · 2.6×
J0630
HCPCS 		Calcitonin (salmon) 200 Unit/ml Injection Solution 19 $7,841.15 $9,390.60 $8,921.07 nat. median
$1,896
outlier · 4.7×
23412
CPT 		Repair Of Ruptured Musculotendinous Cuff (Eg, Rotator Cuff) Open; Chronic 19 $7,419.81 $8,886.00 $8,441.70 nat. median
$6,954
1.2× median
J1950
HCPCS 		Leuprolide 3.75 Mg (lupron) Intramuscular Syringe Kit 19 $7,368.88 $8,825.00 $8,383.75 nat. median
$3,921
outlier · 2.1×
PX-2704000458
CDM 		Hc Frh Supp Glaukos Stent 19 $7,067.44 $8,464.00 $8,040.80 nat. median
$8,041
1.0× median
47563
CPT 		Laps Surg Cholecystectomy W/Cholangiography 19 $7,014.84 $8,401.00 $7,980.95 nat. median
$6,020
1.3× median
J0897
HCPCS 		Denosumab 120 Mg/1.7 Ml (70 Mg/ml) Subcutaneous Solution 19 $6,482.69 $8,426.00 $7,530.79 nat. median
$1,982
outlier · 3.8×
J3262
HCPCS 		Tocilizumab 400 Mg/20 Ml (20 Mg/ml) Intravenous Solution 19 $6,593.21 $7,896.06 $7,501.26 nat. median
$1,413
outlier · 5.3×
64718
CPT 		Neuroplasty &/Transposition Ulnar Nerve Elbow 19 $6,565.61 $7,863.00 $7,469.85 nat. median
$2,512
outlier · 3.0×
J7165
HCPCS 		Prothrombin Complex Conc (pcc) Human-lans 1,000 Unit IV Solution (balfaxar) 19 $4,665.56 $11,100.00 $7,428.00 nat. median
$16
outlier · 453.2×
58660
CPT 		Laparoscopy W/Lysis Of Adhesions 19 $6,413.64 $7,681.00 $7,296.95 nat. median
$5,906
1.2× median
J0401
HCPCS 		Aripiprazole ER 400 Mg Intramuscular Suspension,extended Release 19 $6,022.75 $7,212.87 $6,852.23 nat. median
$1,912
outlier · 3.6×
36561
CPT 		Hc Pro Insj Tunneled Ctr Vad W/Subq Port Age 5 Yr/> 19 $3,766.69 $10,875.00 $6,795.81 nat. median
$3,751
1.8× median
29880
CPT 		Arthrs Knee W/Meniscectomy Med&Lat W/Shaving 19 $5,931.01 $7,103.00 $6,747.85 nat. median
$3,840
1.8× median
58662
CPT 		Laps Fulg/Exc Ovary Viscera/Peritoneal Surface 19 $5,897.61 $7,063.00 $6,709.85 nat. median
$6,065
1.1× median
14301
CPT 		Adjnt Tis Trnsfr/Reargmt Any Area 30.1-60 Sq Cm 19 $3,716.59 $10,630.00 $6,663.52 nat. median
$3,781
1.8× median
49651
CPT 		Hc Pro Laps Surg Rpr Recurrent Inguinal Hernia 19 $1,924.68 $13,179.00 $6,654.73 nat. median
$5,961
1.1× median
74178
CPT 		CT Abdomen & Pelvis Without Contrst Followed By W Contrst 1/> Body Re 19 $5,743.13 $6,878.00 $6,534.10 nat. median
$1,027
outlier · 6.4×
74174
CPT 		CT Angio Abd&Plvis Cntrst Mtrl W/wo Cntrst Img 19 $5,708.90 $6,837.00 $6,495.15 nat. median
$998
outlier · 6.5×
29826
CPT 		Arthroscopy Shoulder W/Coracoacrm Ligmnt Release 19 $5,644.60 $6,760.00 $6,422.00 nat. median
$3,122
outlier · 2.1×
49520
CPT 		Rpr Recrt Inguinal Hernia Any Age Reducible 19 $5,616.21 $6,726.00 $6,389.70 nat. median
$3,788
1.7× median
65426
CPT 		Excision/Transposition Pterygium W/Grafg 19 $5,478.44 $6,561.00 $6,232.95 nat. median
$2,953
outlier · 2.1×
24077
CPT 		Hc Pro Resect Arm/Elbow Tum < 5 Cm 19 $3,270.70 $9,778.00 $6,040.82 nat. median
$3,069
2.0× median
29877
CPT 		Arthroscopy, Knee, Surgical; Debridement/Shaving Of Articular Cartilage 19 $5,245.47 $6,282.00 $5,967.90 nat. median
$3,839
1.6× median
74177
CPT 		CT Abdomen & Pelvis W/Contrast Material 19 $5,242.13 $6,278.00 $5,964.10 nat. median
$976
outlier · 6.1×
49320
CPT 		Laps Abd Prtm&Omentum Dx W/wo Spec Br/Wa Spx 19 $5,241.30 $6,277.00 $5,963.15 nat. median
$5,644
1.1× median
49650
CPT 		Hc Pro Laparoscopy Surg Rpr Initial Inguinal Hernia 19 $1,406.14 $11,886.00 $5,804.40 nat. median
$5,840
1.0× median
Q3027
HCPCS 		Interferon Beta-1a 30 Mcg/0.5 Ml Intramuscular Pen Injector 19 $5,094.91 $6,101.69 $5,796.61 nat. median
$130
outlier · 44.5×
49525
CPT 		Rpr Ingun Hernia Sliding Any Age 19 $5,089.33 $6,095.00 $5,790.25 nat. median
$3,682
1.6× median
J2428
HCPCS 		Paliperidone Palmitate 156 Mg/ml Intramuscular Syringe 19 $5,065.13 $6,066.02 $5,762.72 nat. median
$22
outlier · 265.6×
19303
CPT 		Hc Pro Mastectomy Simple Complete 19 $3,307.44 $9,028.00 $5,749.69 nat. median
$6,253
0.9× median

Other procedures at this hospital

Browse this hospital's 2,015 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
             
J0896 HCPCS Luspatercept-aamt 75 Mg Subcutaneous Solution 29 19 $92,084.61 $92,084.61 $76,890.65 $92,084.61 $87,480.38 2026-02-01
J2327 HCPCS Risankizumab-rzaa 150 Mg/ml Subcutaneous Syringe 58 19 $73,203.11 $73,203.11 $56,770.82 $78,417.22 $65,949.33 2026-02-01
J3101 HCPCS Tenecteplase 50 Mg Intravenous Solution - Mi 58 19 $39,283.96 $39,283.96 $24,271.70 $49,500.00 $35,200.21 2026-02-01
J9312 HCPCS Rituximab 10 Mg/ml Concentrate,intravenous 29 19 $31,979.25 $31,979.25 $26,702.67 $31,979.25 $30,380.29 2026-02-01
J1306 HCPCS Inclisiran 284 Mg/1.5 Ml Subcutaneous Syringe 29 19 $25,406.25 $25,406.25 $21,214.22 $25,406.25 $24,135.94 2026-02-01
J1459 HCPCS Immune Globulin (human) (privigen) 10% Injection Solution 29 19 $17,575.00 $17,575.00 $14,675.13 $17,575.00 $16,696.25 2026-02-01
J2182 HCPCS Mepolizumab 100 Mg Subcutaneous Solution 29 19 $17,575.00 $17,575.00 $14,675.13 $17,575.00 $16,696.25 2026-02-01
49657 CPT *No Longer Active 2023 Do Not Use* Hc Lap Inc Hern Recur Comp 29 19 $16,580.00 $16,580.00 $13,844.30 $16,580.00 $15,751.00 2026-02-01
J2506 HCPCS Pegfilgrastim 6 Mg/0.6 Ml Subcutaneous Syringe 29 19 $15,431.25 $15,431.25 $12,885.09 $15,431.25 $14,659.69 2026-02-01
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6 Ml Subcutaneous Syringe 29 19 $15,288.00 $15,288.00 $12,765.48 $15,288.00 $14,523.60 2026-02-01
J3111 HCPCS Romosozumab-aqqg 210 Mg/2.34 Ml(105 Mg/1.17 Ml X2)subcutaneous Syringe 29 19 $13,025.44 $13,025.44 $10,876.24 $13,025.44 $12,374.17 2026-02-01
J2997 HCPCS Alteplase 100 Mg/100ml IV (wet Solr Vial) 58 19 $14,660.30 $14,660.30 $440.70 $28,792.81 $12,284.90 2026-02-01
J0717 HCPCS Certolizumab Pegol 400 Mg (200 Mg X 2 Vials) Lypholized Powder 58 19 $12,545.90 $12,545.90 $7,893.05 $15,639.05 $11,255.69 2026-02-01
29827 CPT Arthroscopy Shoulder Rotator Cuff Repair 29 19 $11,255.00 $11,255.00 $9,397.93 $11,255.00 $10,692.25 2026-02-01
90375 HCPCS Rabies Immune Globulin (pf) 300 Unit/ml Intramuscular Solution 29 19 $11,218.27 $11,218.27 $9,367.26 $11,218.27 $10,657.36 2026-02-01
43282 CPT Hc Pro Laps Rpr Paraesphgl Hrna Incl Fundplsty W/Mesh 58 19 $11,594.50 $11,594.50 $5,888.42 $16,137.00 $10,263.20 2026-02-01
J3032 HCPCS Eptinezumab-jjmr 100 Mg/ml Intravenous Solution 29 19 $10,319.50 $10,319.50 $8,616.78 $10,319.50 $9,803.53 2026-02-01
15734 CPT Hc Pro Musc Myocutaneous/Fasciocutaneous Flap Trunk 58 19 $10,510.50 $10,510.50 $5,148.61 $14,855.00 $9,284.97 2026-02-01
43281 CPT Hc Pro Laps Rpr Paraesphgl Hrna Incl Fundplsty Without Mesh 58 19 $10,322.00 $10,322.00 $5,240.46 $14,368.00 $9,136.64 2026-02-01
J0139 HCPCS Adalimumab 40 Mg/0.8 Ml Subcutaneous Syringe Kit 29 19 $9,556.59 $9,556.59 $7,979.75 $9,556.59 $9,078.76 2026-02-01
J0630 HCPCS Calcitonin (salmon) 200 Unit/ml Injection Solution 29 19 $9,390.60 $9,390.60 $7,841.15 $9,390.60 $8,921.07 2026-02-01
23412 CPT Repair Of Ruptured Musculotendinous Cuff (Eg, Rotator Cuff) Open; Chronic 29 19 $8,886.00 $8,886.00 $7,419.81 $8,886.00 $8,441.70 2026-02-01
J1950 HCPCS Leuprolide 3.75 Mg (lupron) Intramuscular Syringe Kit 29 19 $8,825.00 $8,825.00 $7,368.88 $8,825.00 $8,383.75 2026-02-01
PX-2704000458 CDM Hc Frh Supp Glaukos Stent 29 19 $8,464.00 $8,464.00 $7,067.44 $8,464.00 $8,040.80 2026-02-01
47563 CPT Laps Surg Cholecystectomy W/Cholangiography 29 19 $8,401.00 $8,401.00 $7,014.84 $8,401.00 $7,980.95 2026-02-01
J0897 HCPCS Denosumab 120 Mg/1.7 Ml (70 Mg/ml) Subcutaneous Solution 58 19 $8,094.85 $8,094.85 $6,482.69 $8,426.00 $7,530.79 2026-02-01
J3262 HCPCS Tocilizumab 400 Mg/20 Ml (20 Mg/ml) Intravenous Solution 29 19 $7,896.06 $7,896.06 $6,593.21 $7,896.06 $7,501.26 2026-02-01
64718 CPT Neuroplasty &/Transposition Ulnar Nerve Elbow 29 19 $7,863.00 $7,863.00 $6,565.61 $7,863.00 $7,469.85 2026-02-01
J7165 HCPCS Prothrombin Complex Conc (pcc) Human-lans 1,000 Unit IV Solution (balfaxar) 58 19 $8,343.75 $8,343.75 $4,665.56 $11,100.00 $7,428.00 2026-02-01
58660 CPT Laparoscopy W/Lysis Of Adhesions 29 19 $7,681.00 $7,681.00 $6,413.64 $7,681.00 $7,296.95 2026-02-01
J0401 HCPCS Aripiprazole ER 400 Mg Intramuscular Suspension,extended Release 29 19 $7,212.87 $7,212.87 $6,022.75 $7,212.87 $6,852.23 2026-02-01
36561 CPT Hc Pro Insj Tunneled Ctr Vad W/Subq Port Age 5 Yr/> 58 19 $7,693.00 $7,693.00 $3,766.69 $10,875.00 $6,795.81 2026-02-01
29880 CPT Arthrs Knee W/Meniscectomy Med&Lat W/Shaving 29 19 $7,103.00 $7,103.00 $5,931.01 $7,103.00 $6,747.85 2026-02-01
58662 CPT Laps Fulg/Exc Ovary Viscera/Peritoneal Surface 29 19 $7,063.00 $7,063.00 $5,897.61 $7,063.00 $6,709.85 2026-02-01
14301 CPT Adjnt Tis Trnsfr/Reargmt Any Area 30.1-60 Sq Cm 58 19 $7,540.50 $7,540.50 $3,716.59 $10,630.00 $6,663.52 2026-02-01
49651 CPT Hc Pro Laps Surg Rpr Recurrent Inguinal Hernia 58 19 $7,742.00 $7,742.00 $1,924.68 $13,179.00 $6,654.73 2026-02-01
74178 CPT CT Abdomen & Pelvis Without Contrst Followed By W Contrst 1/> Body Re 29 19 $6,878.00 $6,878.00 $5,743.13 $6,878.00 $6,534.10 2026-02-01
74174 CPT CT Angio Abd&Plvis Cntrst Mtrl W/wo Cntrst Img 29 19 $6,837.00 $6,837.00 $5,708.90 $6,837.00 $6,495.15 2026-02-01
29826 CPT Arthroscopy Shoulder W/Coracoacrm Ligmnt Release 29 19 $6,760.00 $6,760.00 $5,644.60 $6,760.00 $6,422.00 2026-02-01
49520 CPT Rpr Recrt Inguinal Hernia Any Age Reducible 29 19 $6,726.00 $6,726.00 $5,616.21 $6,726.00 $6,389.70 2026-02-01
65426 CPT Excision/Transposition Pterygium W/Grafg 29 19 $6,561.00 $6,561.00 $5,478.44 $6,561.00 $6,232.95 2026-02-01
24077 CPT Hc Pro Resect Arm/Elbow Tum < 5 Cm 58 19 $6,847.50 $6,847.50 $3,270.70 $9,778.00 $6,040.82 2026-02-01
29877 CPT Arthroscopy, Knee, Surgical; Debridement/Shaving Of Articular Cartilage 29 19 $6,282.00 $6,282.00 $5,245.47 $6,282.00 $5,967.90 2026-02-01
74177 CPT CT Abdomen & Pelvis W/Contrast Material 29 19 $6,278.00 $6,278.00 $5,242.13 $6,278.00 $5,964.10 2026-02-01
49320 CPT Laps Abd Prtm&Omentum Dx W/wo Spec Br/Wa Spx 29 19 $6,277.00 $6,277.00 $5,241.30 $6,277.00 $5,963.15 2026-02-01
49650 CPT Hc Pro Laparoscopy Surg Rpr Initial Inguinal Hernia 58 19 $6,785.00 $6,785.00 $1,406.14 $11,886.00 $5,804.40 2026-02-01
Q3027 HCPCS Interferon Beta-1a 30 Mcg/0.5 Ml Intramuscular Pen Injector 29 19 $6,101.69 $6,101.69 $5,094.91 $6,101.69 $5,796.61 2026-02-01
49525 CPT Rpr Ingun Hernia Sliding Any Age 29 19 $6,095.00 $6,095.00 $5,089.33 $6,095.00 $5,790.25 2026-02-01
J2428 HCPCS Paliperidone Palmitate 156 Mg/ml Intramuscular Syringe 29 19 $6,066.02 $6,066.02 $5,065.13 $6,066.02 $5,762.72 2026-02-01
19303 CPT Hc Pro Mastectomy Simple Complete 58 19 $6,494.50 $6,494.50 $3,307.44 $9,028.00 $5,749.69 2026-02-01
95811 CPT Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd 29 19 $6,042.00 $6,042.00 $5,045.07 $6,042.00 $5,739.90 2026-02-01
36573 CPT Insertion Picc W/Rs&I 5 Yr/> 29 19 $5,987.00 $5,987.00 $4,999.15 $5,987.00 $5,687.65 2026-02-01
26418 CPT Repair Extensor Tendon Finger Without Graft Each 29 19 $5,937.00 $5,937.00 $4,957.40 $5,937.00 $5,640.15 2026-02-01
64721 CPT Neuroplasty And/or Transpos Median Nrv Carpal Tunne 29 19 $5,728.00 $5,728.00 $4,782.88 $5,728.00 $5,441.60 2026-02-01
19302 CPT Hc Pro Mastectomy Partial W/Axillary Lymphadenectomy 58 19 $6,145.50 $6,145.50 $3,127.08 $8,546.00 $5,440.45 2026-02-01
47562 CPT Laparoscopy Surg Cholecystectomy 29 19 $5,676.00 $5,676.00 $4,739.46 $5,676.00 $5,392.20 2026-02-01
11406 CPT Exc B9 Lesion Mrgn Xcp Sk Tg T/a/L >4.0 Cm 29 19 $5,519.00 $5,519.00 $4,608.37 $5,519.00 $5,243.05 2026-02-01
95810 CPT Polysom 6/>Yrs Sleep 4/> Addl Param Attnd 29 19 $5,510.00 $5,510.00 $4,600.85 $5,510.00 $5,234.50 2026-02-01
81162 CPT Ref Brca1/Brca2 Full Gene Analysis 29 19 $5,483.00 $5,483.00 $4,578.31 $5,483.00 $5,208.85 2026-02-01
11444 CPT Exc B9 Les Mrgn Xcp Sk Tg F/e/e/n/l/m 3.1-4.0cm 29 19 $5,467.00 $5,467.00 $4,564.95 $5,467.00 $5,193.65 2026-02-01
74176 CPT CT Abdomen & Pelvis Without Contrast Material 29 19 $5,408.00 $5,408.00 $4,515.68 $5,408.00 $5,137.60 2026-02-01
26160 CPT Exc Lesion Tdn Shth/Jt Capsl Hand/Fngr 29 19 $5,351.00 $5,351.00 $4,468.09 $5,351.00 $5,083.45 2026-02-01
66982 CPT Xcapsular Cataract Rmvl Insj Lens Prosth 1 Stg 29 19 $5,339.00 $5,339.00 $4,458.07 $5,339.00 $5,072.05 2026-02-01
72157 CPT MRI Spinal Canal Thoracic Without & W/Contr Matrl 29 19 $5,245.00 $5,245.00 $4,379.58 $5,245.00 $4,982.75 2026-02-01
J0875 HCPCS Dalbavancin 500 Mg Intravenous Solution 29 19 $5,239.32 $5,239.32 $4,374.83 $5,239.32 $4,977.35 2026-02-01
28080 CPT Excision Interdigital Morton Neuroma Single Each 29 19 $5,194.00 $5,194.00 $4,336.99 $5,194.00 $4,934.30 2026-02-01
28090 CPT Exc Lesion Tendon Sheath/Capsule W/Synvct Foot 29 19 $5,169.00 $5,169.00 $4,316.12 $5,169.00 $4,910.55 2026-02-01
72158 CPT MRI Spinal Canal Lumbar Without & W/Contr Matrl 29 19 $5,137.00 $5,137.00 $4,289.40 $5,137.00 $4,880.15 2026-02-01
72156 CPT MRI Spinal Canal Cervical Without & W/Contr Matrl 29 19 $5,133.00 $5,133.00 $4,286.06 $5,133.00 $4,876.35 2026-02-01
46255 CPT Hemorrhoidectomy Ntrnl & Xtrnl 1 Column/Group 29 19 $5,132.00 $5,132.00 $4,285.22 $5,132.00 $4,875.40 2026-02-01
74183 CPT MRI Abdomen Without & W/Contrast Material 29 19 $5,091.00 $5,091.00 $4,250.99 $5,091.00 $4,836.45 2026-02-01
11403 CPT Exc B9 Lesion Mrgn Xcp Sk Tg T/a/L 2.1-3.0 Cm/< 29 19 $5,069.00 $5,069.00 $4,232.62 $5,069.00 $4,815.55 2026-02-01
70553 CPT MRI Brain Brain Stem Without W/Contrast Material 29 19 $5,066.00 $5,066.00 $4,230.11 $5,066.00 $4,812.70 2026-02-01
J1439 HCPCS Ferric Carboxymaltose 50 Mg Iron/ml Intravenous Solution 29 19 $5,054.38 $5,054.38 $4,220.41 $5,054.38 $4,801.66 2026-02-01
71552 CPT MRI Chest Without & W/Contrast Material 29 19 $5,052.00 $5,052.00 $4,218.42 $5,052.00 $4,799.40 2026-02-01
19316 CPT Hc Pro Mastopexy 58 19 $5,420.50 $5,420.50 $2,703.73 $7,603.00 $4,793.26 2026-02-01
25111 CPT Excision Ganglion Wrist Dorsal/Volar Primary 29 19 $4,917.00 $4,917.00 $4,105.70 $4,917.00 $4,671.15 2026-02-01
73223 CPT MRI Any Jt Upper Extremity Without & W/Contr Matrl 29 19 $4,895.00 $4,895.00 $4,087.33 $4,895.00 $4,650.25 2026-02-01
J1286 HCPCS Interferon Beta-1a 30 Mcg/0.5 Ml Intramuscular Syringe 29 19 $4,887.50 $4,887.50 $4,081.06 $4,887.50 $4,643.13 2026-02-01
74185 CPT MRA Abdomen W Contrast Material 58 19 $4,963.00 $4,963.00 $3,986.29 $5,152.00 $4,630.78 2026-02-01
21501 CPT I&d Deep Absc/Hmtma Soft Tissue Neck/Thorax 29 19 $4,844.00 $4,844.00 $4,044.74 $4,844.00 $4,601.80 2026-02-01
72197 CPT MRI Pelvis Without & W/Contrast Material 29 19 $4,822.00 $4,822.00 $4,026.37 $4,822.00 $4,580.90 2026-02-01
70552 CPT MRI Brain Brain Stem W/Contrast Material 29 19 $4,792.00 $4,792.00 $4,001.32 $4,792.00 $4,552.40 2026-02-01
70543 CPT MRI Orbit Face & Neck Without & W/Contrast Matrl 29 19 $4,764.00 $4,764.00 $3,977.94 $4,764.00 $4,525.80 2026-02-01
11005 CPT Hc Debride Abdom Wall 58 19 $5,038.00 $5,038.00 $2,401.46 $7,200.00 $4,444.00 2026-02-01
73725 CPT MRA Lower Extremity W/wo Contrast Material 29 19 $4,614.00 $4,614.00 $3,852.69 $4,614.00 $4,383.30 2026-02-01
11421 CPT Exc B9 Lesion Mrgn Xcp Sk Tg S/n/h/f/g 0.6-1.0cm 29 19 $4,604.00 $4,604.00 $3,844.34 $4,604.00 $4,373.80 2026-02-01
70549 CPT MRA Neck Without &W/Contrast Material 29 19 $4,602.00 $4,602.00 $3,842.67 $4,602.00 $4,371.90 2026-02-01
Q5130 HCPCS Pegfilgrastim-pbbk 6 Mg/0.6 Ml Subcutaneous Syringe 29 19 $4,550.01 $4,550.01 $3,799.26 $4,550.01 $4,322.51 2026-02-01
J7307 HCPCS Etonogestrel 68 Mg Subdermal Implant 29 19 $4,538.76 $4,538.76 $3,789.86 $4,538.76 $4,311.82 2026-02-01
22900 CPT Exc Tumor Soft Tissue Abdl Wall Subfascial <5cm 29 19 $4,529.00 $4,529.00 $3,781.72 $4,529.00 $4,302.55 2026-02-01
15822 CPT Blepharoplasty Upper Eyelid 29 19 $4,514.00 $4,514.00 $3,769.19 $4,514.00 $4,288.30 2026-02-01
72142 CPT MRI Spinal Canal Cervical W/Contrast Matrl 29 19 $4,458.00 $4,458.00 $3,722.43 $4,458.00 $4,235.10 2026-02-01
73220 CPT MRI Upper Extrem Other Than Jt Without & W/Contras 29 19 $4,447.00 $4,447.00 $3,713.25 $4,447.00 $4,224.65 2026-02-01
28060 CPT Fasciectomy Plantar Fascia Partial Spx 29 19 $4,446.00 $4,446.00 $3,712.41 $4,446.00 $4,223.70 2026-02-01
29881 CPT Arthrs Kne Surg W/Meniscectomy Med/Lat W/Shvg 29 19 $4,437.00 $4,437.00 $3,704.90 $4,437.00 $4,215.15 2026-02-01
46260 CPT Hemorrhoidectomy Int & Xtrnl 2/> Column/Gro 29 19 $4,428.00 $4,428.00 $3,697.38 $4,428.00 $4,206.60 2026-02-01
70548 CPT MRA Neck W/Contrast Material 29 19 $4,427.00 $4,427.00 $3,696.55 $4,427.00 $4,205.65 2026-02-01
73720 CPT MRI Lower Extrem Oth/Thn Jt Without & W/Contr Matr 29 19 $4,416.00 $4,416.00 $3,687.36 $4,416.00 $4,195.20 2026-02-01
72141 CPT MRI Spinal Canal Cervical Without Contrast Matrl 29 19 $4,395.00 $4,395.00 $3,669.83 $4,395.00 $4,175.25 2026-02-01
J0881 HCPCS Darbepoetin Alfa 300 Mcg/0.6 Ml In Polysorbate Injection Syringe 58 19 $4,829.30 $4,829.30 $1,385.91 $7,998.83 $4,169.40 2026-02-01
70551 CPT MRI Brain Brain Stem Without Contrast Material 29 19 $4,367.00 $4,367.00 $3,646.45 $4,367.00 $4,148.65 2026-02-01
72148 CPT MRI Spinal Canal Lumbar Without Contrast Material 29 19 $4,366.00 $4,366.00 $3,645.61 $4,366.00 $4,147.70 2026-02-01
73723 CPT MRI Any Jt Lower Extrem Without & W/Contrast Matrl 29 19 $4,366.00 $4,366.00 $3,645.61 $4,366.00 $4,147.70 2026-02-01
72149 CPT MRI Spinal Canal Lumbar W/Contrast Material 29 19 $4,344.00 $4,344.00 $3,627.24 $4,344.00 $4,126.80 2026-02-01
72146 CPT MRI Spinal Canal Thoracic Without Contrast Matrl 29 19 $4,342.00 $4,342.00 $3,625.57 $4,342.00 $4,124.90 2026-02-01
70545 CPT MRA Head W/Contrast Material 29 19 $4,342.00 $4,342.00 $3,625.57 $4,342.00 $4,124.90 2026-02-01
23073 CPT Exc Tumor Soft Tissue Shoulder Subfascial 5 Cm/> 58 19 $4,656.50 $4,656.50 $2,220.27 $6,654.00 $4,107.55 2026-02-01
J1745 HCPCS Infliximab 100 Mg Intravenous Solution 29 19 $4,259.00 $4,259.00 $3,556.27 $4,259.00 $4,046.05 2026-02-01
72196 CPT MRI Pelvis W/Contrast Material 29 19 $4,229.00 $4,229.00 $3,531.22 $4,229.00 $4,017.55 2026-02-01
28289 CPT Hallux Rigidus Correct W/Cheilectomy 1st Mp Jt 29 19 $4,186.00 $4,186.00 $3,495.31 $4,186.00 $3,976.70 2026-02-01
19301 CPT Hc Pro Mastectomy Partial 58 19 $4,475.00 $4,475.00 $2,277.05 $6,223.00 $3,961.61 2026-02-01
PX-1210000100 CDM Room Semi Private W Tele 29 19 $4,150.00 $4,150.00 $3,465.25 $4,150.00 $3,942.50 2026-02-01
PX-1110000100 CDM Room Private W Tele 30 19 $4,150.00 $4,150.00 $3,465.25 $4,150.00 $3,942.50 2026-02-01
71275 CPT CT Angiography Chest W/Contrast/Noncontrast 29 19 $4,148.00 $4,148.00 $3,463.58 $4,148.00 $3,940.60 2026-02-01
74175 CPT CT Angiography Abdomen W/Contrast/Noncontrast 29 19 $4,148.00 $4,148.00 $3,463.58 $4,148.00 $3,940.60 2026-02-01
70544 CPT MRA Head Without Contrst Material 29 19 $4,124.00 $4,124.00 $3,443.54 $4,124.00 $3,917.80 2026-02-01
75635 CPT CTA Abdl Aorta&Bi Iliofem W/Contrast&Postp 29 19 $4,116.00 $4,116.00 $3,436.86 $4,116.00 $3,910.20 2026-02-01
71550 CPT MRI Chest Without Contrast Material 29 19 $4,043.00 $4,043.00 $3,375.91 $4,043.00 $3,840.85 2026-02-01
J0129 HCPCS Abatacept 250 Mg/10 Ml IV (wet Solr Vial) 29 19 $4,039.13 $4,039.13 $3,372.67 $4,039.13 $3,837.17 2026-02-01
74181 CPT MRI Abdomen Without Contrast Material 29 19 $4,038.00 $4,038.00 $3,371.73 $4,038.00 $3,836.10 2026-02-01
J0841 HCPCS Antivenin Crotalidae (equine) IV (wet Solr Vial) 29 19 $4,015.09 $4,015.09 $3,352.60 $4,015.09 $3,814.34 2026-02-01
28285 CPT Correction Hammertoe 29 19 $3,985.00 $3,985.00 $3,327.48 $3,985.00 $3,785.75 2026-02-01
J7318 HCPCS Hyaluronate Sodium, Stabilized 60 Mg/3 Ml Intra-articular Syringe 29 19 $3,977.51 $3,977.51 $3,321.22 $3,977.51 $3,778.63 2026-02-01
11771 CPT Excision Pilonidal Cyst/Sinus Extensive 58 19 $4,286.00 $4,286.00 $2,022.37 $6,150.00 $3,778.62 2026-02-01
70498 CPT CT Angiography Neck W/Contrast/Noncontrast 29 19 $3,939.00 $3,939.00 $3,289.07 $3,939.00 $3,742.05 2026-02-01
70540 CPT MRI Orbit Face &/Neck Without Contrast 29 19 $3,912.00 $3,912.00 $3,266.52 $3,912.00 $3,716.40 2026-02-01
PX-1210000200 CDM Room Semi Private 29 19 $3,900.00 $3,900.00 $3,256.50 $3,900.00 $3,705.00 2026-02-01
PX-2020000100 CDM Room ICU Medical 29 19 $3,900.00 $3,900.00 $3,256.50 $3,900.00 $3,705.00 2026-02-01
PX-1500000100 CDM Room Ward 5 Or More Per Room 29 19 $3,900.00 $3,900.00 $3,256.50 $3,900.00 $3,705.00 2026-02-01
PX-1300000100 CDM Room Semi-private 3 Or 4 Per Room 29 19 $3,900.00 $3,900.00 $3,256.50 $3,900.00 $3,705.00 2026-02-01
PX-2060000100 CDM Room ICU Intermediate 29 19 $3,900.00 $3,900.00 $3,256.50 $3,900.00 $3,705.00 2026-02-01
PX-1110000200 CDM Room Private 29 19 $3,900.00 $3,900.00 $3,256.50 $3,900.00 $3,705.00 2026-02-01
73222 CPT MRI Any Jt Upper Extremity W/Contrast Matrl 29 19 $3,881.00 $3,881.00 $3,240.64 $3,881.00 $3,686.95 2026-02-01
72195 CPT MRI Pelvis Without Contrast Material 29 19 $3,868.00 $3,868.00 $3,229.78 $3,868.00 $3,674.60 2026-02-01
95805 CPT Mlt Sleep Latency/Maint Of Wakefulness Tstg 29 19 $3,846.00 $3,846.00 $3,211.41 $3,846.00 $3,653.70 2026-02-01
74170 CPT CT Abdomen Without & W/Contrast Material 29 19 $3,822.00 $3,822.00 $3,191.37 $3,822.00 $3,630.90 2026-02-01
66984 CPT Cataract Removal Insertion Of Lens 29 19 $3,798.00 $3,798.00 $3,171.33 $3,798.00 $3,608.10 2026-02-01
28292 CPT Keller/Mcbride/Mayo Procedure 29 19 $3,782.00 $3,782.00 $3,157.97 $3,782.00 $3,592.90 2026-02-01
J9217 HCPCS Leuprolide 22.5 Mg (eligard) Subcutaneous Syringe (3 Month) 232 19 $4,023.45 $4,023.45 $404.56 $32,714.85 $3,568.47 2026-02-01
74182 CPT MRI Abdomen W/Contrast Material 29 19 $3,753.00 $3,753.00 $3,133.76 $3,753.00 $3,565.35 2026-02-01
70496 CPT CT Angiography Head W/Contrast/Noncontrast 29 19 $3,738.00 $3,738.00 $3,121.23 $3,738.00 $3,551.10 2026-02-01
72127 CPT CT Cervical Spine Without &W/Contrast Material 29 19 $3,710.00 $3,710.00 $3,097.85 $3,710.00 $3,524.50 2026-02-01
28810 CPT Amputation Metatarsal W/Toe Single 29 19 $3,676.00 $3,676.00 $3,069.46 $3,676.00 $3,492.20 2026-02-01
21920 CPT Biopsy Soft Tissue Back/Flank Superficial 29 19 $3,614.00 $3,614.00 $3,017.69 $3,614.00 $3,433.30 2026-02-01
PX-1200000200 CDM Room Semi Private Swingbed Skilled 29 19 $3,600.00 $3,600.00 $3,006.00 $3,600.00 $3,420.00 2026-02-01
PX-1100000100 CDM Room Private Swingbed Skilled 29 19 $3,600.00 $3,600.00 $3,006.00 $3,600.00 $3,420.00 2026-02-01
64772 CPT Hc Incision Of Spinal Nerve 58 19 $3,867.00 $3,867.00 $1,928.02 $5,425.00 $3,419.44 2026-02-01
71270 CPT Diagnostic Computed Tomography Thorax C-/c+ 29 19 $3,593.00 $3,593.00 $3,000.16 $3,593.00 $3,413.35 2026-02-01
11004 CPT Hc Debride Genitalia & Perineum 58 19 $3,854.50 $3,854.50 $1,956.41 $5,366.00 $3,411.80 2026-02-01
26055 CPT Tendon Sheath Incision 29 19 $3,575.00 $3,575.00 $2,985.13 $3,575.00 $3,396.25 2026-02-01
72194 CPT CT Pelvis Without & W/Contrast Material 29 19 $3,564.00 $3,564.00 $2,975.94 $3,564.00 $3,385.80 2026-02-01
37609 CPT Ligation/Biopsy Temporal Artery 29 19 $3,544.00 $3,544.00 $2,959.24 $3,544.00 $3,366.80 2026-02-01
70492 CPT CT Soft Tissue Neck Without & W/Contrast Material 29 19 $3,543.00 $3,543.00 $2,958.41 $3,543.00 $3,365.85 2026-02-01
27613 CPT Biopsy Soft Tissue Leg/Ankle Area Superficial 29 19 $3,501.00 $3,501.00 $2,923.34 $3,501.00 $3,325.95 2026-02-01
73218 CPT MRI Upper Extremity Oth Than Jt Without Contr Matrl 29 19 $3,463.00 $3,463.00 $2,891.61 $3,463.00 $3,289.85 2026-02-01
49505 CPT Pro Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible 58 19 $3,720.50 $3,720.50 $1,805.27 $5,279.00 $3,284.99 2026-02-01
49654 CPT Hc Pro Laparoscopy, Repair, Incisional Hernia (Includes Mesh Insertion); Reducib… 29 19 $3,449.00 $3,449.00 $2,879.92 $3,449.00 $3,276.55 2026-02-01
J7298 HCPCS Levonorgestrel 21 Mcg/24 Hr (up To 8 Years) 52 Mg Intrauterine Device 29 19 $3,412.29 $3,412.29 $2,849.26 $3,412.29 $3,241.68 2026-02-01
26115 CPT Exc Tum/Vasc Mal Sft Tiss Hand/Fngr Subq <1.5cm 29 19 $3,403.00 $3,403.00 $2,841.51 $3,403.00 $3,232.85 2026-02-01
70488 CPT CT Maxillofacial Without & W/Contrast Material 29 19 $3,387.00 $3,387.00 $2,828.15 $3,387.00 $3,217.65 2026-02-01
73718 CPT MRI Lower Extrem Oth/Thn Jt Without Contr Matrl 29 19 $3,378.00 $3,378.00 $2,820.63 $3,378.00 $3,209.10 2026-02-01
94002 CPT Ventilation Assist & Mgmt Inpatient 1st Day 29 19 $3,373.00 $3,373.00 $2,816.46 $3,373.00 $3,204.35 2026-02-01
73706 CPT CT Angiography Lower Extremity 29 19 $3,372.00 $3,372.00 $2,815.62 $3,372.00 $3,203.40 2026-02-01
73721 CPT MRI Any Jt Lower Extrem Without Contrast Matrl 29 19 $3,363.00 $3,363.00 $2,808.11 $3,363.00 $3,194.85 2026-02-01
19120 CPT Exc Cyst/Aberrant Breast Tissue Open 1/> Lesion 58 19 $3,608.00 $3,608.00 $1,792.75 $5,069.00 $3,189.81 2026-02-01
87507 CPT Gi Pcr Panel 12-25 Targets 29 19 $3,344.00 $3,344.00 $2,792.24 $3,344.00 $3,176.80 2026-02-01
74160 CPT CT Abdomen W/Contrast Material 29 19 $3,334.00 $3,334.00 $2,783.89 $3,334.00 $3,167.30 2026-02-01
73221 CPT MRI Any Jt Upper Extremity Without Contrast Matrl 29 19 $3,302.00 $3,302.00 $2,757.17 $3,302.00 $3,136.90 2026-02-01
71260 CPT Diagnostic Computed Tomography Thorax W/Contrast 29 19 $3,288.00 $3,288.00 $2,745.48 $3,288.00 $3,123.60 2026-02-01
54161 CPT Circumcision Age >28 Days 29 19 $3,263.00 $3,263.00 $2,724.61 $3,263.00 $3,099.85 2026-02-01
72147 CPT MRI Spinal Canal Thoracic W/Contrast Matrl 29 19 $3,222.00 $3,222.00 $2,690.37 $3,222.00 $3,060.90 2026-02-01
72193 CPT CT Pelvis W/Contrast Material 29 19 $3,218.00 $3,218.00 $2,687.03 $3,218.00 $3,057.10 2026-02-01
72132 CPT CT Lumbar Spine W/Contrast Material 29 19 $3,211.00 $3,211.00 $2,681.19 $3,211.00 $3,050.45 2026-02-01
67904 CPT Rpr Blepharoptosis Levator Rescj/Advmnt Xtrnl 29 19 $3,209.00 $3,209.00 $2,679.52 $3,209.00 $3,048.55 2026-02-01
21930 CPT Excision Tumor Soft Tissue Back/Flank Subq <3cm 58 19 $3,444.50 $3,444.50 $1,619.90 $4,949.00 $3,036.21 2026-02-01
70470 CPT CT Head/Brain Without & W/Contrast Material 29 19 $3,188.00 $3,188.00 $2,661.98 $3,188.00 $3,028.60 2026-02-01
23650 CPT Clsd Tx Shoulder Dislc W/Manipulation Without Anes 58 19 $3,448.00 $3,448.00 $1,504.67 $5,094.00 $3,027.74 2026-02-01
13121 CPT Pro Repair Complex Scalp/Arm/Leg 2.6-7.5 Cm 58 19 $3,366.00 $3,366.00 $1,995.65 $4,342.00 $3,007.78 2026-02-01
J1569 HCPCS Immune Globulin (human) (gammagard) 10% Injection Solution 29 19 $3,147.75 $3,147.75 $2,628.37 $3,147.75 $2,990.36 2026-02-01
25505 CPT Closed Tx Radial Shaft Fracture W/Manipulation 58 19 $3,137.00 $3,137.00 $2,614.39 $3,143.00 $2,985.85 2026-02-01
13132 CPT Pro Repair Complex F/C/C/M/N/Ax/G/H/F 2.6-7.5 Cm 58 19 $3,376.00 $3,376.00 $1,644.12 $4,783.00 $2,981.40 2026-02-01
J0248 HCPCS Remdesivir 100 Mg Intravenous Powder For Solution 29 19 $3,137.50 $3,137.50 $2,619.81 $3,137.50 $2,980.63 2026-02-01
25605 CPT Cltx Dstl Rdl Fx/Epiphysl Sep W/Manj When Perf 58 19 $3,173.50 $3,173.50 $2,537.57 $3,308.00 $2,947.83 2026-02-01
19300 CPT Hc Pro Mastectomy Gynecomastia 58 19 $3,263.00 $3,263.00 $2,012.35 $4,116.00 $2,923.43 2026-02-01
72125 CPT CT Cervical Spine Without Contrast Material 29 19 $3,064.00 $3,064.00 $2,558.44 $3,064.00 $2,910.80 2026-02-01
71250 CPT Diagnostic Computed Tomography Thorax Without Cntrst 29 19 $3,024.00 $3,024.00 $2,525.04 $3,024.00 $2,872.80 2026-02-01
72128 CPT CT Thoracic Spine Without Contrast Material 29 19 $3,016.00 $3,016.00 $2,518.36 $3,016.00 $2,865.20 2026-02-01
70481 CPT CT Orbit Sella/Post Fossa/Ear W/Contrast Matrl 29 19 $2,995.00 $2,995.00 $2,500.83 $2,995.00 $2,845.25 2026-02-01
46946 CPT Hc Pro Hrhc Ntrnl Lig Oth Than Rbbr Band 2/> Col/Grp 58 19 $3,202.00 $3,202.00 $1,725.11 $4,338.00 $2,844.11 2026-02-01
70491 CPT CT Soft Tissue Neck W/Contrast Material 29 19 $2,964.00 $2,964.00 $2,474.94 $2,964.00 $2,815.80 2026-02-01
73701 CPT CT Lower Extremity W/Contrast Material 29 19 $2,947.00 $2,947.00 $2,460.75 $2,947.00 $2,799.65 2026-02-01
72131 CPT CT Lumbar Spine Without Contrast Material 29 19 $2,933.00 $2,933.00 $2,449.06 $2,933.00 $2,786.35 2026-02-01
67917 CPT Repair Ectropion Extensive 29 19 $2,931.00 $2,931.00 $2,447.39 $2,931.00 $2,784.45 2026-02-01
21931 CPT Excision, Tumor, Soft Tissue Of Back Or Flank, Subcutaneous 58 19 $3,133.50 $3,133.50 $1,502.17 $4,468.00 $2,764.89 2026-02-01
74150 CPT CT Abdomen Without Contrast Material 29 19 $2,906.00 $2,906.00 $2,426.51 $2,906.00 $2,760.70 2026-02-01
73201 CPT CT Upper Extremity W/Contrast Material 29 19 $2,897.00 $2,897.00 $2,419.00 $2,897.00 $2,752.15 2026-02-01
28820 CPT Amputation Toe Metatarsophalangeal Joint 29 19 $2,874.00 $2,874.00 $2,399.79 $2,874.00 $2,730.30 2026-02-01
J7301 HCPCS Levonorgestrel 14 Mcg/24 Hr (up To 3 Yrs) 13.5 Mg Intrauterine Device 29 19 $2,853.86 $2,853.86 $2,382.97 $2,853.86 $2,711.17 2026-02-01
PX-2704000508 CDM Hc Frh Supp Mesh Echo 2 Ventralight St 29 19 $2,848.00 $2,848.00 $2,378.08 $2,848.00 $2,705.60 2026-02-01
J2357 HCPCS Omalizumab 150 Mg/ml Subcutaneous Syringe 58 19 $3,037.26 $3,037.26 $1,711.62 $4,024.68 $2,705.23 2026-02-01
72192 CPT CT Pelvis Without Contrast Material 29 19 $2,840.00 $2,840.00 $2,371.40 $2,840.00 $2,698.00 2026-02-01
94003 CPT Ventilation Assist & Mgmt Inpatient Ea Sbsq Da 29 19 $2,822.00 $2,822.00 $2,356.37 $2,822.00 $2,680.90 2026-02-01
70487 CPT CT Maxillofacial W/Contrast Material 29 19 $2,815.00 $2,815.00 $2,350.53 $2,815.00 $2,674.25 2026-02-01
70460 CPT CT Head/Brain W/Contrast Material 29 19 $2,809.00 $2,809.00 $2,345.52 $2,809.00 $2,668.55 2026-02-01
45385 CPT Colsc Flx W/Rmvl Of Tumor Polyp Lesion Snare Tq 29 19 $2,806.00 $2,806.00 $2,343.01 $2,806.00 $2,665.70 2026-02-01
73700 CPT CT Lower Extremity Without Contrast Material 29 19 $2,796.00 $2,796.00 $2,334.66 $2,796.00 $2,656.20 2026-02-01
46606 CPT Anoscopy, W Biopsy, Single Or Multiple 29 19 $2,794.00 $2,794.00 $2,332.99 $2,794.00 $2,654.30 2026-02-01
21555 CPT Exc Tumor Soft Tissue Neck/Ant Thorax Subq <3cm 58 19 $3,005.50 $3,005.50 $1,415.33 $4,316.00 $2,649.43 2026-02-01
38525 CPT Bx/Exc Lymph Node Open Deep Axillary Node 58 19 $2,993.00 $2,993.00 $1,519.70 $4,166.00 $2,649.31 2026-02-01
21552 CPT Exc Tumor Soft Tis Neck/Ant Thorax Subq 3 Cm/> 58 19 $2,979.50 $2,979.50 $1,424.51 $4,253.00 $2,628.63 2026-02-01
PX-4500000300 CDM Trauma Resp W Activation After To Arrival Cah Level 1 29 19 $2,748.00 $2,748.00 $2,294.58 $2,748.00 $2,610.60 2026-02-01
G0390 HCPCS Trauma Resp W Activation Cah 29 19 $2,748.00 $2,748.00 $2,294.58 $2,748.00 $2,610.60 2026-02-01
70480 CPT CT Orbit Sella/Post Fossa/Ear Without Contrast Matrl 29 19 $2,747.00 $2,747.00 $2,293.75 $2,747.00 $2,609.65 2026-02-01
45384 CPT Colsc Flx W/Removal Lesion By Hot Bx Forceps 58 19 $2,847.50 $2,847.50 $2,243.65 $3,008.00 $2,606.39 2026-02-01
27810 CPT Closed Tx Bimalleolar Ankle Fracture W/Manj 58 19 $2,848.50 $2,848.50 $2,143.45 $3,130.00 $2,590.28 2026-02-01
27818 CPT Cltx Trimalleolar Ankle Fx W/Manipulation 58 19 $2,750.50 $2,750.50 $2,223.61 $2,838.00 $2,583.11 2026-02-01
93306 CPT Echo Tthrc R-t 2d W/wom-mode Compl Spec&Colr D 29 19 $2,699.00 $2,699.00 $2,253.67 $2,699.00 $2,564.05 2026-02-01
90377 HCPCS Rabies Immune Globulin (pf) 150 Unit/ml Intramuscular Solution 29 19 $2,678.79 $2,678.79 $2,236.79 $2,678.79 $2,544.85 2026-02-01
73200 CPT CT Upper Extremity Without Contrast Material 29 19 $2,671.00 $2,671.00 $2,230.29 $2,671.00 $2,537.45 2026-02-01
27337 CPT Excison Tumor Soft Tissue Thigh/Knee Subq 3 Cm/> 58 19 $2,867.00 $2,867.00 $1,445.39 $4,003.00 $2,536.76 2026-02-01
70490 CPT CT Soft Tissue Neck Without Contrast Material 29 19 $2,666.00 $2,666.00 $2,226.11 $2,666.00 $2,532.70 2026-02-01
13101 CPT Pro Repair Complex Trunk 2.6-7.5 Cm 58 19 $2,865.00 $2,865.00 $1,394.45 $4,060.00 $2,530.05 2026-02-01
43247 CPT Egd Flexible Foreign Body Removal 58 19 $2,825.00 $2,825.00 $1,577.32 $3,761.00 $2,514.72 2026-02-01
70450 CPT CT Head/Brain Without Contrast Material 29 19 $2,646.00 $2,646.00 $2,209.41 $2,646.00 $2,513.70 2026-02-01
19100 CPT Pro Bx Breast Needle Core Without Imaging Guidance Spx 29 19 $2,625.00 $2,625.00 $2,191.88 $2,625.00 $2,493.75 2026-02-01
23071 CPT Excision Tumor Soft Tissue Shoulder Subq 3 Cm/> 58 19 $2,809.50 $2,809.50 $1,341.85 $4,012.00 $2,478.51 2026-02-01
13131 CPT Pro Repair Complex F/C/C/M/N/Ax/G/H/F 1.1-2.5 Cm 58 19 $2,781.50 $2,781.50 $1,354.37 $3,941.00 $2,456.37 2026-02-01
12053 CPT Repair Intermediate F/E/E/N/L&/Muc 5.1-7.5 Cm 29 19 $2,536.00 $2,536.00 $2,117.56 $2,536.00 $2,409.20 2026-02-01
24071 CPT Exc Tumor Soft Tissue Upper Arm/Elbow Subq 3cm/> 58 19 $2,718.50 $2,718.50 $1,296.76 $3,884.00 $2,398.07 2026-02-01
Q5101 HCPCS Filgrastim-sndz 300 Mcg/0.5 Ml Injection Syringe 58 19 $2,655.01 $2,655.01 $1,816.13 $3,135.01 $2,396.36 2026-02-01
27047 CPT Exc Tumor Soft Tissue Pelvis & Hip Subq <3cm 58 19 $2,680.50 $2,680.50 $1,596.52 $3,449.00 $2,395.96 2026-02-01
70547 CPT MRA Neck Without Contrst Material 29 19 $2,503.00 $2,503.00 $2,090.01 $2,503.00 $2,377.85 2026-02-01
25075 CPT Exc Tumor Soft Tissue Forearm &/Wrist Subq <3cm 58 19 $2,546.00 $2,546.00 $1,695.89 $3,061.00 $2,293.47 2026-02-01
13100 CPT Pro Repair Complex Trunk 1.1-2.5 Cm 58 19 $2,574.00 $2,574.00 $1,394.45 $3,478.00 $2,287.07 2026-02-01
43249 CPT Egd Balloon Dilation Esophagus <30 Mm Diam 58 19 $2,594.00 $2,594.00 $1,191.55 $3,761.00 $2,283.72 2026-02-01
71271 CPT Computed Tomography Thorax Lw Dose Lng Ca Scr C- 29 19 $2,390.00 $2,390.00 $1,995.65 $2,390.00 $2,270.50 2026-02-01
12054 CPT Pro Repair Intermediate F/E/E/N/L&/Muc 7.6-12.5 Cm 58 19 $2,491.50 $2,491.50 $1,859.55 $2,756.00 $2,264.13 2026-02-01
13120 CPT Pro Repair Complex Scalp/Arm/Leg 1.1-2.5 Cm 58 19 $2,552.00 $2,552.00 $1,244.15 $3,614.00 $2,253.85 2026-02-01
11643 CPT Excision Malignant Lesion F/e/e/n/l 2.1-3.0 Cm 29 19 $2,368.00 $2,368.00 $1,977.28 $2,368.00 $2,249.60 2026-02-01
22902 CPT Hc Exc Tumor Soft Tissue Abdominal Wall Subq <3cm 58 19 $2,509.00 $2,509.00 $1,527.22 $3,189.00 $2,245.91 2026-02-01
27327 CPT Excision Tumor Soft Tissue Thigh/Knee Subq <3cm 58 19 $2,483.50 $2,483.50 $1,627.42 $3,018.00 $2,234.52 2026-02-01
90675 HCPCS Rabies Vaccine, Purified Chicken Embryo Cell (pf) 2.5 Unit IM Susp 29 19 $2,350.00 $2,350.00 $1,962.25 $2,350.00 $2,232.50 2026-02-01
G0121 HCPCS Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For … 58 19 $2,331.50 $2,331.50 $1,892.11 $2,397.00 $2,198.02 2026-02-01
27265 CPT Cltx Post Hip Arthrp Dislc Without Anes 58 19 $2,425.50 $2,425.50 $1,859.55 $2,624.00 $2,191.04 2026-02-01
24500 CPT Pro Clsd Tx Humeral Shaft Fracture Without Manipulation 29 19 $2,305.00 $2,305.00 $1,924.68 $2,305.00 $2,189.75 2026-02-01
70486 CPT CT Maxillofacial Without Contrast Material 29 19 $2,301.00 $2,301.00 $1,921.34 $2,301.00 $2,185.95 2026-02-01
76936 CPT US Cmprn Rpr Artl Pseudoarysm/Arven Fstl 29 19 $2,284.00 $2,284.00 $1,907.14 $2,284.00 $2,169.80 2026-02-01
11770 CPT Excision Of Pilonidal Cyst Or Sinus; Simple 58 19 $2,406.00 $2,406.00 $1,126.42 $3,463.00 $2,120.31 2026-02-01
11642 CPT Excision Malignant Lesion F/e/e/n/l 1.1-2.0 Cm 29 19 $2,196.00 $2,196.00 $1,833.66 $2,196.00 $2,086.20 2026-02-01
11622 CPT Pro Excision Malignant Lesion S/n/h/f/g 1.1-2.0 Cm 29 19 $2,196.00 $2,196.00 $1,833.66 $2,196.00 $2,086.20 2026-02-01
24600 CPT Treatment Closed Elbow Dislocation Without Anes 29 19 $2,172.00 $2,172.00 $1,813.62 $2,172.00 $2,063.40 2026-02-01
21012 CPT Excision Tumor Soft Tiss Face/Scalp Subq 2 Cm/> 58 19 $2,326.00 $2,326.00 $1,164.83 $3,257.00 $2,057.30 2026-02-01
45330 CPT Sigmoidoscopy Flx Dx W/Collj Spec Br/Wa If Pfrmd 29 19 $2,135.00 $2,135.00 $1,782.73 $2,135.00 $2,028.25 2026-02-01
45378 CPT Colonoscopy Flx Dx W/Collj Spec When Pfrmd 58 19 $2,194.00 $2,194.00 $1,582.33 $2,493.00 $1,988.33 2026-02-01
25600 CPT Cltx Dstl Radial Fx/Epiphysl Sep Without Manj 58 19 $2,095.00 $2,095.00 $1,703.40 $2,150.00 $1,978.80 2026-02-01
24075 CPT Exc Tumor Soft Tiss Upper Arm/Elbow Subq <3cm 29 19 $2,081.00 $2,081.00 $1,737.64 $2,081.00 $1,976.95 2026-02-01
45380 CPT Colonoscopy, Flexible, W Biopsy, Single Or Multiple 58 19 $2,175.50 $2,175.50 $1,582.33 $2,456.00 $1,972.88 2026-02-01
15820 CPT Blepharoplasty Lower Eyelid 29 19 $2,063.00 $2,063.00 $1,722.61 $2,063.00 $1,959.85 2026-02-01
49591 CPT Hc Rpr Aa Hrn 1st < 3 Cm Rdc 29 19 $2,051.00 $2,051.00 $1,712.59 $2,051.00 $1,948.45 2026-02-01
45331 CPT Sigmoidoscopy Flx W/Biopsy Single/Multiple 29 19 $2,043.00 $2,043.00 $1,705.91 $2,043.00 $1,940.85 2026-02-01
56405 CPT I&d Vulva/Perineal Abscess 29 19 $2,021.00 $2,021.00 $1,687.54 $2,021.00 $1,919.95 2026-02-01
45915 CPT Rmvl Fecal Impaction/FB Spx Under Anes 29 19 $2,003.00 $2,003.00 $1,672.51 $2,003.00 $1,902.85 2026-02-01
43235 CPT Esophagogastroduodenoscopy Transoral Diagnostic 58 19 $2,135.00 $2,135.00 $1,019.54 $3,049.00 $1,883.46 2026-02-01
49587 CPT Hc Pro Rpr Umbilical Hernia Age 5 Yrs/> Incarcerated 29 19 $1,980.00 $1,980.00 $1,653.30 $1,980.00 $1,881.00 2026-02-01
13152 CPT Pro Repair Complex Eyelid/Nose/Ear/Lip 2.6-7.5 Cm 58 19 $1,985.00 $1,985.00 $1,611.55 $2,040.00 $1,872.10 2026-02-01
21011 CPT Excision Tumor Soft Tiss Face/Scalp Subq <2cm 58 19 $2,079.00 $2,079.00 $1,294.25 $2,608.00 $1,863.84 2026-02-01
26075 CPT Hc Arthrotomy, With Exploration, Drainage, Or Removal Of Loose Or Foreign Body 58 19 $2,048.50 $2,048.50 $1,532.23 $2,262.00 $1,861.88 2026-02-01
26725 CPT Cltx Phlngl Fx Prox/Middle Px/F/T W/Manj Ea 29 19 $1,945.00 $1,945.00 $1,624.08 $1,945.00 $1,847.75 2026-02-01
12052 CPT Pro Repair Intermediate F/E/E/N/L&/Muc 2.6-5.0 Cm 58 19 $2,036.50 $2,036.50 $1,380.26 $2,420.00 $1,836.85 2026-02-01
87901 CPT Ref HIV 1 Genotypic Drug Resist 29 19 $1,924.00 $1,924.00 $1,606.54 $1,924.00 $1,827.80 2026-02-01
49422 CPT Pro Removal Tunneled Intraperitoneal Catheter 58 19 $2,082.50 $2,082.50 $759.02 $3,256.00 $1,813.88 2026-02-01
36589 CPT Rmvl Tun Cvc Without Subq Port/Pmp 29 19 $1,903.00 $1,903.00 $1,589.01 $1,903.00 $1,807.85 2026-02-01
11044 CPT Pro Debridement Bone Muscle &/Fascia 20 Sq Cm/< 29 19 $1,898.00 $1,898.00 $1,584.83 $1,898.00 $1,803.10 2026-02-01
93975 CPT Dup-scan Artl Flo Abdl/Pel/Scrot&/Rpr Orgn Com 29 19 $1,888.00 $1,888.00 $1,576.48 $1,888.00 $1,793.60 2026-02-01
J1442 HCPCS Filgrastim 480 Mcg/0.8 Ml Injection Syringe 29 19 $1,886.71 $1,886.71 $1,575.40 $1,886.71 $1,792.37 2026-02-01
28192 CPT Removal Foreign Body Foot Deep 29 19 $1,877.00 $1,877.00 $1,567.30 $1,877.00 $1,783.15 2026-02-01
93925 CPT Dup-scan Lxtr Art/Artl Bpgs Compl Bi Study 29 19 $1,874.00 $1,874.00 $1,564.79 $1,874.00 $1,780.30 2026-02-01
12035 CPT Pro Repair Intermediate S/a/T/E 12.6-20.0cm 58 19 $1,934.50 $1,934.50 $1,414.49 $2,175.00 $1,755.07 2026-02-01
93930 CPT Dup-scan Uxtr Art/Artl Bpgs Compl Bi Study 29 19 $1,830.00 $1,830.00 $1,528.05 $1,830.00 $1,738.50 2026-02-01
43239 CPT Egd Transoral Biopsy Single/Multiple 58 19 $1,926.50 $1,926.50 $1,074.65 $2,566.00 $1,714.81 2026-02-01
49083 CPT Abdom Paracentesis Dx/Ther W/Imaging Guidance 58 19 $1,881.50 $1,881.50 $1,356.88 $2,138.00 $1,705.12 2026-02-01
62272 CPT Pro Spinal Puncture Ther Drain Cerebrospinal Fluid 29 19 $1,790.00 $1,790.00 $1,494.65 $1,790.00 $1,700.50 2026-02-01
86363 CPT Hc Ref Mog Facs, S (Mayo) 29 19 $1,773.00 $1,773.00 $1,480.46 $1,773.00 $1,684.35 2026-02-01
PX-2704000545 CDM Hc Frh Supp Dressing Grafixpl 1.5 X 2 29 19 $1,746.00 $1,746.00 $1,457.91 $1,746.00 $1,658.70 2026-02-01
PX-2704000558 CDM Frh Supp Tube Minnesota 18fr 29 19 $1,746.00 $1,746.00 $1,457.91 $1,746.00 $1,658.70 2026-02-01
43245 CPT Egd Dilation Gastric/Duodenal Stricture 58 19 $1,841.50 $1,841.50 $1,119.74 $2,342.00 $1,648.28 2026-02-01
46600 CPT Anoscopy Dx W/Collj Spec Br/Wa Spx When Prfrmd 58 19 $1,870.00 $1,870.00 $740.65 $2,853.00 $1,634.63 2026-02-01
93880 CPT Duplex Scan Extracranial Art Compl Bi Study 29 19 $1,718.00 $1,718.00 $1,434.53 $1,718.00 $1,632.10 2026-02-01
20520 CPT Pro Removal Foreign Body Muscle/Tendon Sheath Simple 29 19 $1,715.00 $1,715.00 $1,432.03 $1,715.00 $1,629.25 2026-02-01
27786 CPT Pro Cltx Dstl Fibular Fx Lat Malls Without Manj 29 19 $1,714.00 $1,714.00 $1,431.19 $1,714.00 $1,628.30 2026-02-01
36590 CPT Rmvl Tun Ctr Vad W/Subq Port/Pmp Ctr/Prph Insj 29 19 $1,713.00 $1,713.00 $1,430.36 $1,713.00 $1,627.35 2026-02-01
28043 CPT Excision Of Foot Lesion 58 19 $1,790.00 $1,790.00 $1,252.50 $2,080.00 $1,618.40 2026-02-01
93970 CPT Dup-scan Xtr Veins Complete Bilateral Study 29 19 $1,691.00 $1,691.00 $1,411.99 $1,691.00 $1,606.45 2026-02-01
J1670 HCPCS Tetanus Immune Globulin (pf) 250 Unit/ml Intramuscular Syringe 29 19 $1,688.50 $1,688.50 $1,409.90 $1,688.50 $1,604.08 2026-02-01
12042 CPT Repair Intermediate N/H/F/Xtrnl Gent 2.6-7.5 Cm 29 19 $1,641.00 $1,641.00 $1,370.24 $1,641.00 $1,558.95 2026-02-01
72129 CPT CT Thoracic Spine W/Contrast Material 29 19 $1,634.00 $1,634.00 $1,364.39 $1,634.00 $1,552.30 2026-02-01
81372 CPT Ref Hla I Class Molecular 29 19 $1,615.00 $1,615.00 $1,348.53 $1,615.00 $1,534.25 2026-02-01
PX-2704000472 CDM Hc Frh Supp Prevena Plus 35cm Kit. 29 19 $1,608.00 $1,608.00 $1,342.68 $1,608.00 $1,527.60 2026-02-01
93978 CPT Dup-scan Aorta Ivc Iliac Vascl/Bpgs Complete 29 19 $1,600.00 $1,600.00 $1,336.00 $1,600.00 $1,520.00 2026-02-01
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