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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

AVERA HAND COUNTY MEMORIAL HOSPITAL AND CLINIC

Miller, SD · CCN 431337 · Rates published

761 distinct procedures filed
5 distinct payers
10,141 rate rows
2026-07-19 last MRF observed
Data quality

10,115 of 10,141 rate rows are consumer-grade (99.7%)

26 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
exceeds 10× this hospital's gross charge — excluded from medians 10
percent-of-charges filed in the dollar field — excluded from medians 8
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 6
placeholder amount (≤ $0.02) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.avera.org/app/files/public/468ebeb8-79b8-437d-979c-c6c2c81783e2/460224743_avera-hand-county-hospital_standardcharges.csv
Discovered viaDiscovered by HANK (automated)
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-23
Content fingerprint 27a6125580be3b3b… · 2,593,257 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J2350
HCPCS 		Ocrelizumab 300 Mg/10 Ml 5 $6.09 $84,350.22 $71,120.56 nat. median
$518
outlier · 137.3×
J3380
HCPCS 		Vedolizumab 300 Mg Vial 5 $72.63 $37,827.27 $33,049.09 nat. median
$168
outlier · 197.3×
J3101
HCPCS 		Tenecteplase 50 Mg/10 Ml Syrng 5 $0.41 $30,005.60 $25,299.46 nat. median
$3,824
outlier · 6.6×
J0717
HCPCS 		Certolizumab Pegol 400 Mg Kit 5 $3.42 $24,592.04 $20,734.97 nat. median
$1,573
outlier · 13.2×
J0896
HCPCS 		Luspatercept-aamt 25 Mg Vial 5 $1.20 $51,787.72 $17,381.40 nat. median
$4,628
outlier · 3.8×
J9312
HCPCS 		Rituximab 500 Mg/50 Ml Vial 5 $322.14 $20,224.74 $17,052.65 nat. median
$1,074
outlier · 15.9×
3512
APR_DRG 		Apr-DRG 3512 1 $15,838.40 $15,838.40 $15,838.40 nat. median
$5,510
outlier · 2.9×
193
MS_DRG 		Ms-DRG 193 1 $13,130.24 $13,130.24 $13,130.24 nat. median
$12,858
1.0× median
683
MS_DRG 		Ms-DRG 683 1 $13,130.24 $13,130.24 $13,130.24 nat. median
$9,102
1.4× median
1133
APR_DRG 		Apr-DRG 1133 1 $11,565.50 $11,565.50 $11,565.50 nat. median
$6,911
1.7× median
81352
CPT 		Tp53 Somatic Mutation, Prog 5 $8,361.60 $12,220.80 $10,419.84 nat. median
$428
outlier · 24.3×
74174
CPT 		CTA Abd&Pelv Wwo Dye 5 $6,107.40 $8,926.20 $7,836.46 nat. median
$988
outlier · 7.9×
J3358
HCPCS 		Ustekinumab 130 Mg/26ml Vial 5 $58.98 $8,686.09 $7,323.74 nat. median
$342
outlier · 21.4×
J0897
HCPCS 		Denosumab 60 Mg/ml Syringe 5 $9.69 $13,047.40 $7,167.92 nat. median
$1,973
outlier · 3.6×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml 5 $1,112.40 $8,478.75 $7,148.93 nat. median
$1,974
outlier · 3.6×
Q5122
HCPCS 		Pegfilgrastim 6 Mg/0.6 Ml Syr 5 $3,939.75 $8,095.86 $6,826.09 nat. median
$561
outlier · 12.2×
74178
CPT 		CT Abd & Pelv Wwo Contrast 5 $479.88 $7,170.60 $6,264.84 nat. median
$1,024
outlier · 6.1×
95811
CPT 		Polysomnogram W CPap 5 $4,768.40 $6,969.20 $6,088.88 nat. median
$1,894
outlier · 3.2×
74177
CPT 		CT Abd & Pelv W Contrast 5 $227.52 $6,632.90 $5,823.09 nat. median
$972
outlier · 6.0×
95810
CPT 		Polysomnogram 5 $4,553.25 $6,671.00 $5,814.15 nat. median
$1,827
outlier · 3.2×
J0129
HCPCS 		Abatacept 250 Mg Vial 5 $588.00 $6,162.29 $5,195.78 nat. median
$903
outlier · 5.8×
74176
CPT 		CT Abd & Pelvis Wo Contrast 5 $95.04 $5,932.75 $5,183.35 nat. median
$694
outlier · 7.5×
1401
APR_DRG 		Apr-DRG 1401 1 $5,100.78 $5,100.78 $5,100.78 nat. median
$4,616
1.1× median
J3262
HCPCS 		Tocilizumab 200 Mg/10 Ml Vial 5 $2.72 $11,496.13 $4,786.94 nat. median
$1,416
outlier · 3.4×
J9202
HCPCS 		Goserelin 3.6 Mg Implant 5 $77.09 $4,498.80 $3,930.53 nat. median
$1,836
outlier · 2.1×
78452
CPT 		Myocard Perf Spect Rest Stress 5 $2,980.25 $4,355.75 $3,805.55 nat. median
$1,815
outlier · 2.1×
J0630
HCPCS 		Calcitonin Salmon 400Unit/2ML 5 $0.18 $4,358.08 $3,674.55 nat. median
$1,892
1.9× median
J1439
HCPCS 		Ferric Carboxymalt 750mg/15ml 5 $11.91 $4,191.20 $3,661.79 nat. median
$14
outlier · 254.3×
74170
CPT 		CT Abdomen Wwo Dye 5 $58.22 $4,307.30 $3,631.73 nat. median
$710
outlier · 5.1×
300
MS_DRG 		Ms-DRG 300 1 $3,590.92 $3,590.92 $3,590.92 nat. median
$10,840
outlier · 0.3×
70470
CPT 		CT Head/Brain Wwo Contrast 5 $241.32 $4,029.90 $3,397.84 nat. median
$619
outlier · 5.5×
70498
CPT 		CT Angiography Neck W Cont 5 $278.39 $3,759.15 $3,284.31 nat. median
$736
outlier · 4.5×
70496
CPT 		CT Angiography Head W Cont 5 $246.84 $3,759.15 $3,284.31 nat. median
$746
outlier · 4.4×
71275
CPT 		CTA Chest Wwo Contrast 5 $2,455.70 $3,589.10 $3,166.24 nat. median
$753
outlier · 4.2×
99291
CPT 		Critical Care 1st 30-74 Min 5 $329.00 $4,574.25 $3,165.86 nat. median
$1,530
outlier · 2.1×
70491
CPT 		CT Soft Tissue Neck W Cont 5 $357.53 $3,552.05 $3,103.37 nat. median
$627
outlier · 5.0×
71260
CPT 		CT Thorax W Contrast 5 $80.31 $3,534.95 $3,088.43 nat. median
$648
outlier · 4.8×
71271
CPT 		Ldct For Lung Cancer Screen 5 $101.48 $3,467.50 $3,029.50 nat. median
$214
outlier · 14.2×
74175
CPT 		CTA Abdom Wwo Dye 5 $82.17 $3,385.80 $2,958.12 nat. median
$714
outlier · 4.1×
87154
CPT 		Culture Id By Amp Prb 6 Or 6+ 5 $2,373.15 $3,468.45 $2,957.31 nat. median
$289
outlier · 10.2×
73701
CPT 		CT Le W Dye Lt 5 $268.01 $3,429.50 $2,891.61 nat. median
$668
outlier · 4.3×
73706
CPT 		CTA Le Wwo Dye Lt 5 $71.13 $3,383.90 $2,853.16 nat. median
$740
outlier · 3.9×
75635
CPT 		CTA Abdominal Arteries 5 $592.68 $3,383.90 $2,853.16 nat. median
$719
outlier · 4.0×
750
CDM 		Colonoscopy 5 $1,912.30 $6,641.45 $2,848.29 nat. median
$3,784
0.8× median
74160
CPT 		CT Abdomen W Dye 5 $706.77 $3,322.15 $2,801.10 nat. median
$650
outlier · 4.3×
73201
CPT 		CT Ue W Dye Lt 5 $90.44 $3,199.60 $2,697.77 nat. median
$802
outlier · 3.4×
70490
CPT 		CT Soft Tissue Neck Wo Cont 5 $277.47 $3,078.95 $2,687.45 nat. median
$448
outlier · 6.0×
70450
CPT 		CT Head/Brain Wo Contrast 5 $2,031.90 $2,969.70 $2,643.12 nat. median
$450
outlier · 5.9×
71250
CPT 		CT Thorax Wo Contrast 5 $71.13 $2,969.70 $2,607.17 nat. median
$464
outlier · 5.6×
72128
CPT 		CT Thoracic Spine Wo Contrast 5 $107.93 $2,969.70 $2,594.58 nat. median
$458
outlier · 5.7×

Other procedures at this hospital

Browse this hospital's 761 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
             
94640 CPT Inhalation Treat Acute Initial 42 5 $353.00 $342.41 $208.65 $335.35 $292.99 2026-07-19
12001 CPT Repair Lac Simple <2.5 Cm 40 5 $281.00 $272.57 $86.23 $715.35 $266.95 2026-07-19
J3480 HCPCS D5/Ns Kcl 20 Meq 1000 Ml Bag 37 5 $313.00 $304.01 $9.57 $300.73 $260.13 2026-07-19
73502 CPT X-ray Hip Uni 2-3 Views Lt 36 5 $416.00 $403.52 $254.80 $860.42 $345.28 2026-07-19
750 CDM Colonoscopy 32 5 $3,513.00 $3,407.61 $1,912.30 $6,641.45 $2,848.29 2026-07-19
77067 CPT Mammo Screen Implant Bi 29 5 $579.00 $561.63 $376.35 $550.05 $480.57 2026-07-19
30903 CPT Control Anterior Hemorrhage Lt 28 5 $488.00 $473.36 $149.60 $571.90 $268.72 2026-07-19
12013 CPT Repair Lac Simple 2.6-5.0 Cm 25 5 $350.00 $339.50 $109.90 $715.35 $290.50 2026-07-19
12011 CPT Repair Lac Simple <2.5 Cm 25 5 $338.00 $327.86 $107.01 $715.35 $280.54 2026-07-19
12002 CPT Repair Lac Simple 2.6-7.5 Cm 25 5 $329.00 $319.13 $112.84 $715.35 $273.07 2026-07-19
96374 CPT IV Push Injection Initial 23 5 $402.00 $389.94 $209.30 $381.90 $305.90 2026-07-19
10120 CPT I&r Foreign Body Simple 22 5 $416.00 $403.52 $215.90 $665.00 $350.06 2026-07-19
73630 CPT X-ray Foot 3 Views Lt 21 5 $529.00 $513.13 $65.60 $502.55 $439.07 2026-07-19
73610 CPT X-ray Ankle 3 Views Lt 21 5 $518.00 $502.46 $99.63 $492.10 $429.94 2026-07-19
73030 CPT X-ray Shoulder Rt 21 5 $416.00 $403.52 $237.65 $395.20 $345.28 2026-07-19
73090 CPT X-ray Forearm 2 Views Rt 21 5 $392.00 $380.24 $254.80 $372.40 $325.36 2026-07-19
J3262 HCPCS Tocilizumab 200 Mg/10 Ml Vial 20 5 $5,976.00 $5,796.91 $2.72 $11,496.13 $4,786.94 2026-07-19
J9217 HCPCS Leuprolide Acetate 45 Mg Syr 20 5 $1,461.00 $1,417.46 $1.47 $4,067.26 $1,170.50 2026-07-19
25600 CPT Fx Distal Radius Lt 20 5 $1,084.00 $1,051.48 $704.60 $1,029.80 $899.72 2026-07-19
J0881 HCPCS Darbepoet Alfa 40mcg/0.4ml Syr 20 5 $972.00 $943.49 $453.99 $2,669.46 $876.87 2026-07-19
73130 CPT X-ray Hand Lt 20 5 $529.00 $513.13 $59.16 $502.55 $423.73 2026-07-19
73110 CPT X-ray Wrist 3 Views Lt 20 5 $518.00 $502.46 $58.22 $492.10 $414.92 2026-07-19
73620 CPT X-ray Foot 2 Views Lt 20 5 $392.00 $380.24 $212.82 $372.40 $325.36 2026-07-19
Q9967 HCPCS Iopamidol-370 100 Ml Vial 19 5 $1,580.00 $1,532.60 $253.80 $1,501.00 $1,125.75 2026-07-19
27786 CPT Fx Distal Fibula Lt 19 5 $1,084.00 $1,051.48 $704.60 $1,032.00 $899.72 2026-07-19
93971 CPT Extremity Study Rt 19 5 $1,024.00 $993.28 $665.60 $972.80 $849.92 2026-07-19
92523 CPT Speech Sound Lang Comprehen 19 5 $522.00 $506.34 $338.00 $495.90 $431.60 2026-07-19
73562 CPT X-ray Knee 3 Views Rt 19 5 $413.00 $400.61 $109.76 $413.00 $342.79 2026-07-19
73552 CPT X-ray Femur 2 Views Lt 19 5 $409.00 $396.73 $130.01 $388.55 $339.47 2026-07-19
73140 CPT X-ray Finger(s) Rt 19 5 $312.00 $302.64 $64.68 $296.40 $258.96 2026-07-19
73701 CPT CT Le W Dye Lt 18 5 $3,610.00 $3,501.70 $268.01 $3,429.50 $2,891.61 2026-07-19
73200 CPT CT Ue Wo Dye Rt 18 5 $2,807.00 $2,722.79 $70.19 $2,666.65 $2,329.81 2026-07-19
99285 CPT Emergency Room Visit Level 5 18 5 $2,426.00 $2,353.22 $267.73 $2,304.70 $1,743.08 2026-07-19
73564 CPT X-ray Knee 4 Lt 18 5 $591.00 $573.27 $88.66 $561.45 $473.39 2026-07-19
73080 CPT X-ray Elbow Lt 18 5 $529.00 $513.13 $38.91 $502.55 $423.73 2026-07-19
73070 CPT X-ray Elbow Lt 18 5 $392.00 $380.24 $41.69 $372.40 $325.36 2026-07-19
73600 CPT X-ray Ankle 2 Views Rt 18 5 $392.00 $380.24 $86.75 $372.40 $325.36 2026-07-19
73120 CPT X-ray Hand Lt 18 5 $392.00 $380.24 $198.99 $372.40 $325.36 2026-07-19
73590 CPT X-ray Lower Leg Rt 18 5 $369.00 $357.93 $73.88 $350.55 $306.27 2026-07-19
73660 CPT X-ray Toe(s) 2 Views Rt 18 5 $320.00 $310.40 $66.51 $304.00 $265.60 2026-07-19
J0897 HCPCS Denosumab 60 Mg/ml Syringe 17 5 $7,545.00 $7,318.82 $9.69 $13,047.40 $7,167.92 2026-07-19
99284 CPT Emergency Room Visit Level 4 17 5 $1,128.00 $1,094.16 $184.86 $1,071.60 $750.12 2026-07-19
Q5110 HCPCS Filgrastim-aafi 300 Mcg/0.5 Ml 17 5 $539.00 $522.95 $237.21 $927.00 $512.16 2026-07-19
J3489 HCPCS Zoledron Ac/Man/H2O 5mg/100ml 17 5 $414.00 $402.39 $17.25 $394.10 $269.65 2026-07-19
99291 CPT Critical Care 1st 30-74 Min 16 5 $4,815.00 $4,670.55 $329.00 $4,574.25 $3,165.86 2026-07-19
73706 CPT CTA Le Wwo Dye Lt 16 5 $3,562.00 $3,455.14 $71.13 $3,383.90 $2,853.16 2026-07-19
73700 CPT CT Le Wo Dye Lt 16 5 $3,149.00 $3,054.53 $76.65 $2,991.55 $2,522.35 2026-07-19
710 CDM Recovery Phase Ii 0-2 Hours 16 5 $1,472.00 $1,427.84 $899.60 $1,482.00 $1,192.43 2026-07-19
24650 CPT Fx Radial Head/Neck Wo Man Lt 16 5 $1,032.00 $1,001.04 $670.80 $980.40 $835.92 2026-07-19
93926 CPT Arterial Duplex Le Lt 16 5 $1,018.00 $987.46 $661.70 $967.10 $824.58 2026-07-19
76882 CPT Ultrasound Axilla Lt 16 5 $969.00 $939.93 $629.85 $920.55 $784.89 2026-07-19
99283 CPT Emergency Room Visit Level 3 16 5 $957.00 $928.29 $108.68 $909.15 $687.60 2026-07-19
64400 CPT Inj Trigeminal N Block Lt 16 5 $815.00 $790.55 $100.07 $774.25 $585.58 2026-07-19
12004 CPT Repair Lac Simple 7.6-12.5 Cm 16 5 $753.00 $730.41 $57.18 $715.35 $495.10 2026-07-19
11600 CPT Exc Mal Lesion <0.5 Trunk Limb 16 5 $724.00 $702.28 $52.88 $687.80 $476.03 2026-07-19
71101 CPT X-ray Ribs Uni W Chest Lt 16 5 $522.00 $506.34 $339.30 $3,427.98 $470.58 2026-07-19
94660 CPT CPap/BiPap First Day 16 5 $509.00 $493.73 $145.60 $754.30 $364.45 2026-07-19
73060 CPT X-ray Humerus Lt 16 5 $416.00 $403.52 $67.44 $395.20 $333.21 2026-07-19
85240 CPT Factor 8 16 5 $385.00 $373.45 $239.85 $380.95 $312.16 2026-07-19
73100 CPT X-ray Wrist 2 Views Lt 16 5 $384.00 $372.48 $66.51 $364.80 $307.59 2026-07-19
73000 CPT X-ray Collar Bone Lt 16 5 $384.00 $372.48 $187.04 $364.80 $307.59 2026-07-19
92950 CPT Heart/Lung Resuscitation Cpr 15 5 $815.00 $790.55 $275.08 $774.25 $541.98 2026-07-19
J0896 HCPCS Luspatercept-aamt 25 Mg Vial 14 5 $18,296.00 $17,747.32 $1.20 $51,787.72 $17,381.40 2026-07-19
J1745 HCPCS Infliximab 100 Mg Vial 14 5 $5,151.00 $4,996.69 $1.46 $4,893.67 $2,007.36 2026-07-19
11423 CPT Exc Ben Lesion 2.1-3.0 Neck 14 5 $1,688.00 $1,637.36 $322.18 $1,603.60 $1,109.86 2026-07-19
31500 CPT Insert Emergency Airway 14 5 $969.00 $939.93 $273.72 $920.55 $637.12 2026-07-19
23650 CPT Dislocation Shoulder Wo AnesRT 14 5 $654.00 $634.38 $425.10 $802.00 $621.30 2026-07-19
12034 CPT Repair Lac Interm 7.6-12.5 Cm 14 5 $857.00 $831.29 $413.34 $814.15 $570.46 2026-07-19
12042 CPT Repair Lac Interm 2.6-7.5 Cm 14 5 $857.00 $831.29 $396.46 $814.15 $563.47 2026-07-19
11760 CPT Repair Nailbed 14 5 $813.00 $788.61 $221.56 $772.35 $534.55 2026-07-19
28190 CPT Remove Foreign Body Foot Lt 14 5 $796.00 $772.12 $270.72 $756.20 $523.37 2026-07-19
11440 CPT Exc Ben Lesion <0.5 Face Ears 14 5 $724.00 $702.28 $221.35 $687.80 $476.03 2026-07-19
11400 CPT Exc Ben Lesion <0.5 Trunk Limb 14 5 $724.00 $702.28 $172.98 $687.80 $476.03 2026-07-19
11640 CPT Exc Mal Lesion <0.5 Face Ears 14 5 $724.00 $702.28 $257.09 $687.80 $476.03 2026-07-19
12006 CPT Repair Lac Simple 20.1-30.0 Cm 14 5 $717.00 $695.49 $221.02 $681.15 $471.43 2026-07-19
10061 CPT I&d Abscess Comp/Multiple 14 5 $602.00 $583.94 $373.43 $571.90 $443.12 2026-07-19
12052 CPT Repair Lac Interm 2.6-5.0 Cm 14 5 $481.00 $466.57 $312.65 $559.61 $418.55 2026-07-19
41800 CPT Drainage Gum Lesion 14 5 $573.00 $555.81 $324.75 $544.35 $404.29 2026-07-19
11750 CPT Exc Nail Matrix Part/Complete 14 5 $504.00 $488.88 $207.72 $478.80 $331.38 2026-07-19
99281 CPT Emergency Room Visit Level 1 14 5 $497.00 $482.09 $17.37 $472.15 $326.77 2026-07-19
36680 CPT Insert Needle Bone Cavity 14 5 $457.00 $443.29 $114.66 $434.15 $300.48 2026-07-19
99292 CPT Critical Care Ea Addl 30 Min 14 5 $429.00 $416.13 $164.83 $407.55 $282.07 2026-07-19
11102 CPT Tangential Biopsy 1st Lesion 14 5 $416.00 $403.52 $75.24 $395.20 $273.52 2026-07-19
11300 CPT Shave Lesion <0.5 Trunk Limbs 14 5 $416.00 $403.52 $67.60 $395.20 $273.52 2026-07-19
11104 CPT Punch Biopsy 1st Lesion 14 5 $416.00 $403.52 $92.98 $395.20 $273.52 2026-07-19
29700 CPT Remove/Revise Body Cast Lt 14 5 $402.00 $389.94 $65.19 $381.90 $264.31 2026-07-19
J0744 HCPCS Ciproflox/D5W 200 Mg/100ml Bag 14 5 $309.00 $299.95 $5.85 $296.33 $257.78 2026-07-19
96360 CPT Inf Therapy Hyd Initial 13 5 $648.00 $628.56 $421.20 $615.60 $542.96 2026-07-19
71046 CPT X-ray Chest 2v PA/Lateral 13 5 $487.00 $472.39 $316.55 $783.14 $415.41 2026-07-19
74177 CPT CT Abd & Pelv W Contrast 12 5 $6,982.00 $6,772.54 $227.52 $6,632.90 $5,823.09 2026-07-19
70491 CPT CT Soft Tissue Neck W Cont 12 5 $3,739.00 $3,626.83 $357.53 $3,552.05 $3,103.37 2026-07-19
71250 CPT CT Thorax Wo Contrast 12 5 $3,126.00 $3,032.22 $71.13 $2,969.70 $2,607.17 2026-07-19
77080 CPT Dexa Scan 12 5 $1,112.00 $1,078.64 $88.61 $1,056.40 $927.44 2026-07-19
76705 CPT Ultrasound Abdomen Limited 12 5 $1,081.00 $1,048.57 $702.65 $1,026.95 $897.23 2026-07-19
71045 CPT X-ray Chest 1 View 12 5 $607.00 $588.79 $394.55 $593.33 $517.77 2026-07-19
74019 CPT X-ray Abdomen 12 5 $561.00 $544.17 $364.65 $660.48 $478.53 2026-07-19
97162 CPT Pt Eval Mod Complexity 12 5 $347.00 $336.59 $225.55 $329.65 $288.01 2026-07-19
85379 CPT D-dimer Quant 12 5 $312.00 $302.64 $202.80 $296.40 $260.16 2026-07-19
95811 CPT Polysomnogram W CPap 11 5 $7,336.00 $7,115.92 $4,768.40 $6,969.20 $6,088.88 2026-07-19
74176 CPT CT Abd & Pelvis Wo Contrast 11 5 $6,245.00 $6,057.65 $95.04 $5,932.75 $5,183.35 2026-07-19
71260 CPT CT Thorax W Contrast 11 5 $3,721.00 $3,609.37 $80.31 $3,534.95 $3,088.43 2026-07-19
71271 CPT Ldct For Lung Cancer Screen 11 5 $3,650.00 $3,540.50 $101.48 $3,467.50 $3,029.50 2026-07-19
70486 CPT CT Maxillofacial Wo Contrast 11 5 $3,126.00 $3,032.22 $187.95 $2,969.70 $2,594.58 2026-07-19
93306 CPT Tte W Doppler Complete 11 5 $3,091.00 $2,998.27 $664.00 $2,936.45 $2,441.89 2026-07-19
C8929 HCPCS Echo M Mode 2d W Contrast 11 5 $2,731.00 $2,649.07 $1,775.15 $2,594.45 $2,266.73 2026-07-19
76870 CPT Ultrasound Scrotum 11 5 $1,081.00 $1,048.57 $702.65 $1,026.95 $897.23 2026-07-19
90684 CPT Pneumo Conjugate Vaccine 21 Va 11 5 $1,050.00 $1,018.79 $474.00 $1,050.30 $871.75 2026-07-19
76536 CPT Ultrasound Head And Neck 11 5 $855.00 $829.35 $555.75 $812.25 $709.65 2026-07-19
93246 CPT Ext ECG >7 Days Hook Up 11 5 $691.00 $670.27 $449.15 $656.45 $573.53 2026-07-19
A9500 HCPCS Radiophar Tc99M Sestamibi Dose 11 5 $662.00 $642.14 $430.30 $1,108.80 $549.46 2026-07-19
96365 CPT Inf Therapy Med Initial 11 5 $648.00 $628.56 $421.20 $615.60 $537.84 2026-07-19
93017 CPT Cardiovascular Stress Test 11 5 $570.00 $552.90 $353.76 $541.50 $473.10 2026-07-19
Q9956 HCPCS Perflutren Protein-a Microdota 11 5 $506.00 $490.89 $77.76 $480.77 $420.04 2026-07-19
72040 CPT X-ray Spine Cervical 2-3 Views 11 5 $446.00 $432.62 $289.90 $551.93 $380.44 2026-07-19
74018 CPT X-ray Abdomen 11 5 $413.00 $400.61 $268.45 $523.40 $352.29 2026-07-19
72170 CPT X-ray Pelvis 1-2 Views 11 5 $392.00 $380.24 $254.80 $372.40 $334.38 2026-07-19
97166 CPT Ot Eval Mod Complexity 11 5 $370.00 $358.90 $240.50 $351.50 $307.10 2026-07-19
92507 CPT Speech Therapy Trmt 11 5 $343.00 $332.71 $222.95 $325.85 $284.69 2026-07-19
97165 CPT Ot Eval Low Complexity 11 5 $335.00 $324.95 $217.75 $318.25 $278.05 2026-07-19
87147 CPT Penicillin Binding Protein 2a 11 5 $323.00 $313.31 $209.95 $306.85 $268.09 2026-07-19
J3380 HCPCS Vedolizumab 300 Mg Vial 10 5 $39,818.00 $38,623.63 $72.63 $37,827.27 $33,049.09 2026-07-19
74178 CPT CT Abd & Pelv Wwo Contrast 10 5 $7,548.00 $7,321.56 $479.88 $7,170.60 $6,264.84 2026-07-19
95810 CPT Polysomnogram 10 5 $7,005.00 $6,794.85 $4,553.25 $6,671.00 $5,814.15 2026-07-19
J9202 HCPCS Goserelin 3.6 Mg Implant 10 5 $4,735.00 $4,593.51 $77.09 $4,498.80 $3,930.53 2026-07-19
78452 CPT Myocard Perf Spect Rest Stress 10 5 $4,585.00 $4,447.45 $2,980.25 $4,355.75 $3,805.55 2026-07-19
J1439 HCPCS Ferric Carboxymalt 750mg/15ml 10 5 $4,411.00 $4,279.44 $11.91 $4,191.20 $3,661.79 2026-07-19
74170 CPT CT Abdomen Wwo Dye 10 5 $4,534.00 $4,397.98 $58.22 $4,307.30 $3,631.73 2026-07-19
70498 CPT CT Angiography Neck W Cont 10 5 $3,957.00 $3,838.29 $278.39 $3,759.15 $3,284.31 2026-07-19
70496 CPT CT Angiography Head W Cont 10 5 $3,957.00 $3,838.29 $246.84 $3,759.15 $3,284.31 2026-07-19
74175 CPT CTA Abdom Wwo Dye 10 5 $3,564.00 $3,457.08 $82.17 $3,385.80 $2,958.12 2026-07-19
70490 CPT CT Soft Tissue Neck Wo Cont 10 5 $3,241.00 $3,143.77 $277.47 $3,078.95 $2,687.45 2026-07-19
70450 CPT CT Head/Brain Wo Contrast 10 5 $3,126.00 $3,032.22 $2,031.90 $2,969.70 $2,643.12 2026-07-19
72128 CPT CT Thoracic Spine Wo Contrast 10 5 $3,126.00 $3,032.22 $107.93 $2,969.70 $2,594.58 2026-07-19
72131 CPT CT Lumbar Spine Wo Contrast 10 5 $3,126.00 $3,032.22 $234.87 $2,969.70 $2,594.58 2026-07-19
72125 CPT CT Cervical Spine Wo Contrast 10 5 $3,126.00 $3,032.22 $172.58 $2,969.70 $2,594.58 2026-07-19
Q5121 HCPCS Infliximab-axxq 100 Mg Vial 10 5 $2,161.00 $2,096.87 $1,405.12 $4,302.83 $1,948.79 2026-07-19
86255 CPT Pla2R Elisa 10 5 $1,310.00 $1,270.70 $851.50 $1,310.00 $1,087.30 2026-07-19
93356 CPT Myocardial Strain Image Speckl 10 5 $1,270.00 $1,231.90 $825.50 $1,206.50 $1,054.10 2026-07-19
83835 CPT Metanephrines Urine 10 5 $1,165.00 $1,130.05 $757.25 $1,106.75 $966.95 2026-07-19
Q0138 HCPCS Ferumoxy 510mg/17ml (non-esrd) 10 5 $1,145.00 $1,111.35 $7.28 $1,088.43 $950.95 2026-07-19
93970 CPT Venous Duplex 10 5 $1,167.00 $1,131.99 $717.95 $1,108.65 $945.27 2026-07-19
90677 CPT Pneumo Conjugate Vaccine 20 Va 10 5 $1,130.00 $1,096.10 $380.34 $1,076.10 $937.90 2026-07-19
76770 CPT Ultrasound Abdo Back Wall Comp 10 5 $1,081.00 $1,048.57 $702.65 $1,026.95 $897.23 2026-07-19
93308 CPT Echo Limited 10 5 $1,040.00 $1,008.80 $676.00 $988.00 $842.40 2026-07-19
76830 CPT Ultrasound Transvaginal 10 5 $969.00 $939.93 $629.85 $920.55 $804.27 2026-07-19
93226 CPT ECG Monit/Report Up To 48 Hour 10 5 $954.00 $925.38 $620.10 $908.00 $791.82 2026-07-19
P9016 HCPCS Red Blood Cells Lekoreduced 10 5 $870.00 $843.90 $565.50 $826.50 $722.10 2026-07-19
96413 CPT Chemotherapy Inf Initial 10 5 $823.00 $798.31 $534.95 $781.85 $666.63 2026-07-19
82610 CPT Cystatin C 10 5 $721.00 $699.37 $468.65 $684.95 $598.43 2026-07-19
94625 CPT Pulmonary Rehab Without Monitoring 10 5 $691.00 $670.27 $449.15 $656.45 $573.53 2026-07-19
72110 CPT X-ray Lumbosacral 4 Views 10 5 $679.00 $658.63 $67.44 $645.05 $563.57 2026-07-19
72050 CPT X-ray Spine Cervical 4-5 Views 10 5 $592.00 $574.24 $384.80 $746.06 $533.69 2026-07-19
81240 CPT Prothrombin Mutation 10 5 $639.00 $619.83 $188.41 $607.05 $517.59 2026-07-19
93922 CPT Ankle Arm Screen 10 5 $623.00 $604.31 $404.95 $591.85 $517.09 2026-07-19
94060 CPT Pft Pre & Post Screen Spirome 10 5 $612.00 $593.64 $397.80 $581.40 $507.96 2026-07-19
72072 CPT X-ray Spine Thoracic 3 Views 10 5 $578.00 $560.66 $375.70 $697.55 $486.38 2026-07-19
83993 CPT Calprotectin 10 5 $566.00 $549.02 $367.90 $537.70 $469.78 2026-07-19
80235 CPT Lacosamide 10 5 $539.00 $522.83 $350.35 $512.05 $447.37 2026-07-19
99282 CPT Emergency Room Visit Level 2 10 5 $513.00 $497.61 $333.45 $487.35 $425.79 2026-07-19
36430 CPT Blood Administration 10 5 $513.00 $497.61 $333.45 $487.35 $425.79 2026-07-19
87637 CPT Influ/RSV/CoV2 Pcr Ceph 10 5 $524.00 $508.28 $340.60 $497.80 $424.44 2026-07-19
87636 CPT Influ & CoV2 Pcr Ceph 10 5 $486.00 $471.42 $315.90 $461.70 $403.38 2026-07-19
G0404 HCPCS EKG Welcome To Medicare 10 5 $448.00 $434.56 $291.20 $426.00 $371.84 2026-07-19
72070 CPT X-ray Spine Thoracic 2 Views 10 5 $420.00 $407.40 $273.00 $1,015.91 $354.63 2026-07-19
71100 CPT X-ray Ribs 2 Views Lt 10 5 $392.00 $380.24 $254.80 $3,616.49 $353.39 2026-07-19
72100 CPT X-ray Lumbosacral 2-3 Views 10 5 $425.00 $412.25 $90.44 $403.75 $352.75 2026-07-19
72020 CPT X-ray Spine Single View 10 5 $424.00 $411.28 $244.37 $402.80 $351.92 2026-07-19
70250 CPT X-ray Skull < 4 Views 10 5 $413.00 $400.61 $94.25 $392.35 $342.79 2026-07-19
82985 CPT Fructosamine 10 5 $402.00 $389.94 $261.30 $381.90 $333.66 2026-07-19
87517 CPT Hep B Na Quan 10 5 $397.00 $385.09 $258.05 $377.15 $329.51 2026-07-19
86480 CPT Tbint Quantiferon 10 5 $393.00 $381.21 $255.45 $373.35 $326.19 2026-07-19
82652 CPT Vitamin D 125 Dihydroxy 10 5 $382.00 $370.54 $248.30 $362.90 $317.06 2026-07-19
83880 CPT B Type Natriuretic Peptide 10 5 $381.00 $369.57 $247.65 $361.95 $316.23 2026-07-19
80074 CPT Acute Hepatitis Panel 10 5 $377.00 $365.69 $245.05 $358.15 $312.91 2026-07-19
93225 CPT Holter Monitor Hook Up <48 Hrs 10 5 $376.00 $364.72 $244.40 $357.20 $304.56 2026-07-19
J2305 HCPCS Nitroglycer/D5W 50mg/250ml Bot 10 5 $363.00 $352.77 $3.20 $345.50 $301.85 2026-07-19
80177 CPT Levetiracetam 10 5 $338.00 $327.86 $219.70 $321.10 $280.54 2026-07-19
J0134 HCPCS Acetaminoph IV(Fresenius Kabi) 10 5 $319.00 $309.81 $21.48 $303.42 $265.09 2026-07-19
86304 CPT Ca 125 10 5 $318.00 $308.46 $206.70 $302.10 $263.94 2026-07-19
71275 CPT CTA Chest Wwo Contrast 9 5 $3,778.00 $3,664.66 $2,455.70 $3,589.10 $3,166.24 2026-07-19
70480 CPT CT Orbit Wo Contrast 9 5 $2,776.00 $2,692.72 $192.56 $2,637.20 $2,304.08 2026-07-19
J9155 HCPCS Degarelix 120 Mg Vial 9 5 $2,228.00 $2,161.29 $135.29 $2,116.72 $1,849.35 2026-07-19
C8924 HCPCS Tte 2d W Contrast Limited 9 5 $2,023.00 $1,962.31 $1,314.95 $1,921.85 $1,679.09 2026-07-19
88184 CPT Flow Cytometry First Mark 9 5 $367.00 $355.99 $238.55 $348.65 $304.61 2026-07-19
92526 CPT Dysphagia Treatment 9 5 $346.00 $335.62 $224.90 $328.70 $287.18 2026-07-19
J2350 HCPCS Ocrelizumab 300 Mg/10 Ml 8 5 $88,789.00 $86,126.02 $6.09 $84,350.22 $71,120.56 2026-07-19
J3101 HCPCS Tenecteplase 50 Mg/10 Ml Syrng 8 5 $31,584.00 $30,637.29 $0.41 $30,005.60 $25,299.46 2026-07-19
J0717 HCPCS Certolizumab Pegol 400 Mg Kit 8 5 $25,886.00 $25,109.77 $3.42 $24,592.04 $20,734.97 2026-07-19
J9312 HCPCS Rituximab 500 Mg/50 Ml Vial 8 5 $21,289.00 $20,650.52 $322.14 $20,224.74 $17,052.65 2026-07-19
81352 CPT Tp53 Somatic Mutation, Prog 8 5 $12,864.00 $12,478.08 $8,361.60 $12,220.80 $10,419.84 2026-07-19
74174 CPT CTA Abd&Pelv Wwo Dye 8 5 $9,396.00 $9,114.12 $6,107.40 $8,926.20 $7,836.46 2026-07-19
J3358 HCPCS Ustekinumab 130 Mg/26ml Vial 8 5 $9,143.00 $8,868.95 $58.98 $8,686.09 $7,323.74 2026-07-19
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6 Ml 8 5 $8,925.00 $8,657.25 $1,112.40 $8,478.75 $7,148.93 2026-07-19
Q5122 HCPCS Pegfilgrastim 6 Mg/0.6 Ml Syr 8 5 $8,521.00 $8,266.30 $3,939.75 $8,095.86 $6,826.09 2026-07-19
J0129 HCPCS Abatacept 250 Mg Vial 8 5 $6,486.00 $6,292.02 $588.00 $6,162.29 $5,195.78 2026-07-19
J0630 HCPCS Calcitonin Salmon 400Unit/2ML 8 5 $4,587.00 $4,449.83 $0.18 $4,358.08 $3,674.55 2026-07-19
70470 CPT CT Head/Brain Wwo Contrast 8 5 $4,242.00 $4,114.74 $241.32 $4,029.90 $3,397.84 2026-07-19
87154 CPT Culture Id By Amp Prb 6 Or 6+ 8 5 $3,651.00 $3,541.47 $2,373.15 $3,468.45 $2,957.31 2026-07-19
75635 CPT CTA Abdominal Arteries 8 5 $3,562.00 $3,455.14 $592.68 $3,383.90 $2,853.16 2026-07-19
74160 CPT CT Abdomen W Dye 8 5 $3,497.00 $3,392.09 $706.77 $3,322.15 $2,801.10 2026-07-19
73201 CPT CT Ue W Dye Lt 8 5 $3,368.00 $3,266.96 $90.44 $3,199.60 $2,697.77 2026-07-19
72192 CPT CT Pelvis Wo Dye 8 5 $3,126.00 $3,032.22 $597.02 $2,969.70 $2,503.93 2026-07-19
81479 CPT Bcr/abl Major & Minor Mut 8 5 $2,856.00 $2,770.32 $1,856.40 $2,713.20 $2,313.36 2026-07-19
J0248 HCPCS Remdesivir 100 Mg Vial 8 5 $2,842.00 $2,757.45 $70.71 $2,700.59 $2,277.03 2026-07-19
J0885 HCPCS Epoetin Alfa 40000 Unit/ML Vl 8 5 $2,600.00 $2,522.61 $0.06 $2,470.60 $2,083.11 2026-07-19
88377 CPT Morph Ana Ea Man Multpx Hema 8 5 $1,735.00 $1,682.95 $1,127.75 $1,648.25 $1,405.35 2026-07-19
76642 CPT Ultrasound Breast Limited Bi 8 5 $1,686.00 $1,635.42 $1,095.90 $1,601.70 $1,365.66 2026-07-19
93975 CPT Vascular Study 8 5 $1,622.00 $1,573.34 $1,054.30 $1,540.90 $1,313.82 2026-07-19
76700 CPT Ultrasound Abdomen Complete 8 5 $1,606.00 $1,557.82 $1,043.90 $1,525.70 $1,300.86 2026-07-19
93925 CPT Arterial Duplex Le Bi 8 5 $1,566.00 $1,519.02 $1,017.90 $1,487.70 $1,268.46 2026-07-19
93880 CPT Extracranial Bilat Study 8 5 $1,539.00 $1,492.83 $1,000.35 $1,462.05 $1,246.59 2026-07-19
G0390 HCPCS Trauma Team Level 5 8 5 $1,409.00 $1,366.73 $915.85 $1,338.55 $1,141.29 2026-07-19
689 CDM Trauma Team Evaluation Level 5 8 5 $1,409.00 $1,366.73 $915.85 $1,338.55 $1,141.29 2026-07-19
28470 CPT Fx Metatarsal 8 5 $1,392.00 $1,350.24 $904.80 $1,322.40 $1,127.52 2026-07-19
90651 CPT 9vHPV 3 Dose 8 5 $1,257.00 $1,220.16 $189.30 $1,195.01 $1,007.58 2026-07-19
87799 CPT Bk Virus Quant Pcr, Serum 8 5 $1,176.00 $1,140.72 $764.40 $1,117.20 $952.56 2026-07-19
J0174 HCPCS Lecanemab-irmb 200 Mg/2Ml Vial 8 5 $1,184.00 $1,148.62 $0.08 $1,124.93 $948.50 2026-07-19
27808 CPT Fx Bimalleolar Ankle Rt 8 5 $1,084.00 $1,051.48 $704.60 $1,029.80 $878.04 2026-07-19
26600 CPT Fx Metacarpal 8 5 $1,084.00 $1,051.48 $704.60 $1,029.80 $878.04 2026-07-19
24670 CPT Fx Ulna Proximal Wo Man Lt 8 5 $1,084.00 $1,051.48 $704.60 $1,029.80 $878.04 2026-07-19
23600 CPT Fx Prox Humeral Wo Man Rt 8 5 $1,084.00 $1,051.48 $704.60 $1,029.80 $878.04 2026-07-19
25530 CPT Fx Ulnar Shaft Wo Man Lt 8 5 $1,084.00 $1,051.48 $704.60 $1,029.80 $878.04 2026-07-19
0202U CPT Respir Path 22 Targets Biofire 8 5 $1,084.00 $1,051.48 $704.60 $1,029.80 $878.04 2026-07-19
71111 CPT X-ray Ribs Bilateral 4 Views 8 5 $1,064.00 $1,032.08 $63.74 $1,010.80 $852.26 2026-07-19
28510 CPT Fx Phalanges 8 5 $1,032.00 $1,001.04 $670.80 $980.40 $835.92 2026-07-19
26750 CPT Fx Distal Finger/Thumb Wo Man 8 5 $1,032.00 $1,001.04 $670.80 $980.40 $835.92 2026-07-19
26720 CPT Fx Finger/Thumb Wo Man 8 5 $1,032.00 $1,001.04 $670.80 $980.40 $835.92 2026-07-19
28490 CPT Fx Great Toe 8 5 $1,032.00 $1,001.04 $670.80 $980.40 $835.92 2026-07-19
90671 HCPCS Pneumo Conjugate Vaccine 15 Va 8 5 $1,013.00 $983.00 $16.40 $962.73 $811.73 2026-07-19
76856 CPT Ultrasound Pelvic Complete 8 5 $969.00 $939.93 $629.85 $920.55 $784.89 2026-07-19
J2997 HCPCS Alteplase 2 Mg Vial 8 5 $897.00 $870.45 $37.08 $852.50 $718.80 2026-07-19
76857 CPT Ultrasound Pelvic Limited 8 5 $885.00 $858.45 $575.25 $840.75 $716.85 2026-07-19
76604 CPT Ultrasound Chest 8 5 $854.00 $828.38 $555.10 $811.30 $691.74 2026-07-19
76775 CPT Ultrasound Aorta 8 5 $796.00 $772.12 $517.40 $756.20 $644.76 2026-07-19
93321 CPT Doppler Echo Exam Heart 8 5 $770.00 $746.90 $500.50 $731.50 $623.70 2026-07-19
93307 CPT Echo M Mode 2d Wo Color Spec 8 5 $770.00 $746.90 $500.50 $731.50 $623.70 2026-07-19
93325 CPT Echo Color Doppler 8 5 $770.00 $746.90 $500.50 $731.50 $623.70 2026-07-19
73523 CPT X-ray Hips 5 Views Bi 8 5 $665.00 $645.05 $432.25 $690.20 $599.50 2026-07-19
70100 CPT X-ray Mandible < 4 Views 8 5 $661.00 $641.17 $429.65 $4,852.95 $595.89 2026-07-19
81376 CPT Hla Celiac Dis Mayo 8 5 $702.00 $680.94 $456.30 $666.90 $568.62 2026-07-19
73522 CPT X-ray Hips 3-4 Views Bi 8 5 $567.00 $549.99 $368.55 $793.91 $511.15 2026-07-19
87522 CPT Hep C RNA Pcr Quant 8 5 $602.00 $583.94 $391.30 $571.90 $487.62 2026-07-19
Q9957 HCPCS Perflutren Lip Micro 2.2mg/2ml 8 5 $582.00 $565.41 $47.75 $553.76 $466.90 2026-07-19
94762 CPT Desaturation And Hr Study 8 5 $570.00 $552.90 $370.50 $541.50 $461.70 2026-07-19
86355 CPT B Cells Total Ss5 8 5 $554.00 $537.38 $360.10 $526.30 $448.74 2026-07-19
72220 CPT Sacrum Or Coccyx Min 2 View 8 5 $482.00 $467.54 $313.30 $457.90 $429.42 2026-07-19
80299 CPT Dexamethasone 8 5 $528.00 $512.16 $343.20 $501.60 $427.68 2026-07-19
70150 CPT X-ray Facial Bones 3 Views 8 5 $522.00 $506.34 $82.17 $495.90 $418.12 2026-07-19
81515 CPT Vpp 8 5 $497.00 $482.09 $323.05 $472.15 $402.57 2026-07-19
90680 CPT Rotavirus (rv5) 3 Dose 8 5 $498.00 $483.64 $51.26 $473.67 $399.38 2026-07-19
90750 CPT Zoster (hzv) IM 8 5 $492.00 $478.02 $237.23 $468.16 $394.73 2026-07-19
82668 CPT Erythropoietin 8 5 $479.00 $464.63 $311.35 $455.05 $387.99 2026-07-19
92610 CPT Swallow Eval Non Radiol 8 5 $478.00 $463.66 $310.70 $454.10 $387.18 2026-07-19
51700 CPT Irrigation Bladder Simple 8 5 $473.00 $458.81 $307.45 $449.35 $383.13 2026-07-19
85335 CPT Factor 8 Inhibitor 8 5 $468.00 $453.96 $304.20 $444.60 $379.08 2026-07-19
85247 CPT Von Willeb Multimer 8 5 $451.00 $437.47 $293.15 $428.45 $365.31 2026-07-19
82024 CPT Acth Adrenocorticotropic Hor 8 5 $448.00 $434.56 $291.20 $425.60 $362.88 2026-07-19
70360 CPT X-ray Neck Soft Tissue 8 5 $438.00 $424.86 $70.19 $416.10 $350.84 2026-07-19
70160 CPT X-ray Face Bones Redcd Servcs 8 5 $438.00 $424.86 $86.75 $416.10 $350.84 2026-07-19
85245 CPT Ristocetin CoFactor 8 5 $425.00 $412.25 $276.25 $403.75 $344.25 2026-07-19
88368 CPT Morphometric Ana Ea Hematologi 8 5 $419.00 $406.43 $272.35 $398.05 $339.39 2026-07-19
85246 CPT Factor Viii Rel Agn 8 5 $416.00 $403.52 $270.40 $395.20 $336.96 2026-07-19
83921 CPT Methylmalonic Acid 8 5 $407.00 $394.79 $264.55 $386.65 $329.67 2026-07-19
80197 CPT Tacrolimus 8 5 $401.00 $388.97 $260.65 $380.95 $324.81 2026-07-19
83704 CPT Lipoprotein By Nmr 8 5 $397.00 $385.09 $258.05 $377.15 $321.57 2026-07-19
94664 CPT Inhalation Treat Chronic Init 8 5 $393.00 $381.21 $255.45 $373.35 $318.33 2026-07-19
71110 CPT X-ray Ribs Bilateral 3 Views 8 5 $392.00 $380.24 $47.21 $372.40 $313.99 2026-07-19
86902 CPT Blood Typing Rbc Ag Unit 8 5 $387.00 $375.39 $251.55 $367.65 $313.47 2026-07-19
80203 CPT Zonisamide 8 5 $385.00 $373.45 $250.25 $365.75 $311.85 2026-07-19
96125 CPT Cognitive Performance Test St 8 5 $373.00 $361.81 $242.45 $354.35 $302.13 2026-07-19
76706 CPT Aaa Screening Medicare 8 5 $371.00 $359.87 $241.15 $352.45 $300.51 2026-07-19
J2020 HCPCS Linezolid 600 Mg/300 Ml Bag 8 5 $333.00 $323.04 $216.47 $968.84 $300.23 2026-07-19
73050 CPT X-ray Ac Joints 8 5 $373.00 $361.81 $196.25 $354.35 $298.77 2026-07-19
86870 CPT Rbc Antibody Identif Panel 8 5 $367.00 $355.99 $238.55 $348.65 $297.27 2026-07-19
86711 CPT Jcv Ab (with Index) Reflex 8 5 $355.00 $344.35 $230.75 $337.25 $287.55 2026-07-19
86812 CPT Hla B27 8 5 $346.00 $335.62 $224.90 $328.70 $280.26 2026-07-19
84305 CPT Somatomedin 8 5 $334.00 $323.98 $217.10 $317.30 $270.54 2026-07-19
90710 CPT Mmrv Subq 8 5 $337.00 $327.28 $98.13 $320.53 $270.25 2026-07-19
76010 CPT X-ray Nose To Rectum 8 5 $297.00 $288.09 $193.05 $499.97 $267.75 2026-07-19
84590 CPT Vitamin A 8 5 $328.00 $318.16 $213.20 $311.60 $265.68 2026-07-19
97163 CPT Pt Eval High Complexity 8 5 $327.00 $317.19 $212.55 $310.65 $264.87 2026-07-19
90633 CPT Hep A Vaccine Ped/Adol 2 Dose 8 5 $293.00 $284.89 $190.91 $319.14 $264.77 2026-07-19
72080 CPT X-ray Thoracolumbar Junc 2v 8 5 $329.00 $319.13 $79.40 $312.55 $263.53 2026-07-19
J2430 HCPCS Pamidronate 90 Mg/10 Ml Vial 8 5 $328.00 $318.23 $56.64 $311.67 $262.79 2026-07-19
J0136 HCPCS Acetamin IV (b Braun) 1,000 Mg 8 5 $324.00 $315.01 $16.88 $308.51 $260.12 2026-07-19
J0131 HCPCS Acetaminophen 1000mg/100ml Via 8 5 $323.00 $313.32 $145.73 $306.86 $258.73 2026-07-19
120 CDM Room Medical Unit Semi Private 6 5 $2,908.00 $2,820.76 $1,890.20 $2,762.60 $2,447.08 2026-07-19
129 CDM Room Swing Bed Skilled 6 5 $1,296.00 $1,257.12 $842.40 $1,231.20 $1,090.59 2026-07-19
110 CDM Room Custodial Care 6 5 $782.00 $758.54 $508.30 $742.90 $658.05 2026-07-19
115 CDM Room Hospice Respite Care 6 5 $745.00 $722.65 $484.25 $707.75 $626.92 2026-07-19
55100 CPT Drainage Scrotum Abscess 6 5 $530.00 $514.10 $339.58 $462.70 $369.56 2026-07-19
99223 CPT IP/Obs Initial High Comp 6 5 $583.00 $565.51 $270.04 $389.40 $334.66 2026-07-19
99205 CPT New Patient Level 5 High Comp 6 5 $271.00 $262.87 $282.08 $382.02 $320.46 2026-07-19
G0438 HCPCS Annual Wellness Visit Initial 6 5 $228.00 $221.16 $184.13 $358.02 $297.00 2026-07-19
3512 APR_DRG Apr-DRG 3512 2 1 — — $15,838.40 $15,838.40 $15,838.40 2026-07-19
193 MS_DRG Ms-DRG 193 2 1 — — $13,130.24 $13,130.24 $13,130.24 2026-07-19
683 MS_DRG Ms-DRG 683 2 1 — — $13,130.24 $13,130.24 $13,130.24 2026-07-19
1133 APR_DRG Apr-DRG 1133 2 1 — — $11,565.50 $11,565.50 $11,565.50 2026-07-19
1401 APR_DRG Apr-DRG 1401 2 1 — — $5,100.78 $5,100.78 $5,100.78 2026-07-19
300 MS_DRG Ms-DRG 300 2 1 — — $3,590.92 $3,590.92 $3,590.92 2026-07-19
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