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

LAVACA MEDICAL CENTER

Hallettsville, TX · CCN 451376 · Rates published

3,365 distinct procedures filed
8 distinct payers
11,000 rate rows
2026-04-01 last MRF observed
Data quality

4,003 of 11,000 rate rows are consumer-grade (36.4%)

6,997 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 6,997
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.lavacamedcen.com/docs/746240037_LavacaMedicalCenter_standardcharges.csv
Found on page https://www.lavacamedcen.com/getpage.php?name=Price_Transparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint ed7c96329e4c536e… · 3,315,851 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
949
MS_DRG 		Aftercare With Cc/Mcc 1 $26,847.00 $26,847.00 $26,847.00 nat. median
$12,475
outlier · 2.2×
81416
HCPCS 		Exome Sequence Analysis 2 $12,000.00 $17,400.00 $14,700.00 nat. median
$12,000
1.2× median
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 1 $14,202.00 $14,202.00 $14,202.00 nat. median
$9,125
1.6× median
699
MS_DRG 		Other Kidney And Urinary Tract Diagnoses With Cc 1 $14,202.00 $14,202.00 $14,202.00 nat. median
$10,935
1.3× median
603
MS_DRG 		Cellulitis Without Mcc 1 $14,202.00 $14,202.00 $14,202.00 nat. median
$9,571
1.5× median
0315U
HCPCS 		Onc Cutan Sq Cll Ca Mrna 40 1 $12,325.00 $12,325.00 $12,325.00 nat. median
$8,670
1.4× median
0211U
HCPCS 		Onc Pan-tum Dna&rna Gnrj Seq 1 $12,259.75 $12,259.75 $12,259.75 nat. median
$8,455
1.4× median
81552
HCPCS 		Onc Uveal Mlnma Mrna 15 Gene 1 $11,275.20 $11,275.20 $11,275.20 nat. median
$8,165
1.4× median
0426U
HCPCS 		Genome Ultra-rapid Seq Alys 1 $10,994.19 $10,994.19 $10,994.19 nat. median
$7,798
1.4× median
0094U
HCPCS 		Genome Rapid Sequence Alys 1 $10,994.19 $10,994.19 $10,994.19 nat. median
$7,810
1.4× median
0582U
HCPCS 		Rare Ds Rpd Whlgen DNA Vrnts 1 $10,994.19 $10,994.19 $10,994.19 nat. median
$5,335
outlier · 2.1×
81529
HCPCS 		Onc Cutan Mlnma Mrna 31 Gene 1 $10,429.85 $10,429.85 $10,429.85 nat. median
$7,553
1.4× median
195
MS_DRG 		Simple Pneumonia And Pleurisy Without Cc/Mcc 1 $10,157.40 $10,157.40 $10,157.40 nat. median
$7,338
1.4× median
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 1 $10,157.40 $10,157.40 $10,157.40 nat. median
$13,648
0.7× median
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 1 $10,157.40 $10,157.40 $10,157.40 nat. median
$16,234
0.6× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 1 $10,157.40 $10,157.40 $10,157.40 nat. median
$19,634
0.5× median
0267U
HCPCS 		Rare Do Id Opt Gen Mapg&seq 1 $9,772.03 $9,772.03 $9,772.03 nat. median
$6,942
1.4× median
0265U
HCPCS 		Rar Do Whl Gn&mtcdrl DNA Als 1 $7,939.91 $7,939.91 $7,939.91 nat. median
$5,585
1.4× median
0212U
HCPCS 		Rare Ds Gen DNA Alys Proband 1 $7,939.04 $7,939.04 $7,939.04 nat. median
$5,585
1.4× median
0295U
HCPCS 		Onc Brst Dux Carc 7 Proteins 1 $7,880.75 $7,880.75 $7,880.75 nat. median
$5,474
1.4× median
81554
HCPCS 		Pulm Ds Ipf Mrna 190 Gen Alg 1 $7,843.92 $7,843.92 $7,843.92 nat. median
$5,717
1.4× median
0214U
HCPCS 		Rare Ds Xom DNA Alys Proband 1 $7,575.67 $7,575.67 $7,575.67 nat. median
$5,329
1.4× median
0335U
HCPCS 		Rare Ds Whl Gen Seq Fetal 1 $7,575.67 $7,575.67 $7,575.67 nat. median
$5,329
1.4× median
0532U
HCPCS 		Rare Ds Whlgen&mitochdrl DNA 1 $7,295.24 $7,295.24 $7,295.24 nat. median
$5,132
1.4× median
0567U
HCPCS 		Rare Ds Whl Gen Seq Srs&lrs 1 $7,295.24 $7,295.24 $7,295.24 nat. median
$5,132
1.4× median
0242U
HCPCS 		Trgt Gen Seq Alys Pnl 55-74 1 $7,250.00 $7,250.00 $7,250.00 nat. median
$5,100
1.4× median
0326U
HCPCS 		Trgt Gen Seq Alys Pnl 83+ 1 $7,250.00 $7,250.00 $7,250.00 nat. median
$5,100
1.4× median
0108U
HCPCS 		Gi Barrett Esoph 9 Prtn Bmrk 1 $7,177.50 $7,177.50 $7,177.50 nat. median
$5,049
1.4× median
0473U
HCPCS 		Onc Sld Tum Bld/slv 648 Gene 1 $6,525.00 $6,525.00 $6,525.00 nat. median
$4,590
1.4× median
81425
HCPCS 		Genome Sequence Analysis 2 $5,031.20 $7,295.24 $6,163.22 nat. median
$5,132
1.2× median
0300U
HCPCS 		Onc Pan Tum Whl Gen Seq&opt 1 $6,065.54 $6,065.54 $6,065.54 nat. median
$4,267
1.4× median
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 1 $6,033.67 $6,033.67 $6,033.67 nat. median
$10,873
0.6× median
0425U
HCPCS 		Genom Rpd Seq Alys Ea Cmprtr 1 $5,936.87 $5,936.87 $5,936.87 nat. median
$4,217
1.4× median
0036U
HCPCS 		Xome Tum & Nml Spec Seq Alys 2 $4,780.00 $6,931.00 $5,855.50 nat. median
$4,923
1.2× median
81415
HCPCS 		Exome Sequence Analysis 2 $4,780.00 $6,931.00 $5,855.50 nat. median
$4,923
1.2× median
0560U
HCPCS 		Onc Mrd Gsa Cfdna Baseline 1 $5,623.75 $5,623.75 $5,623.75 nat. median
$3,956
1.4× median
0306U
HCPCS 		Onc Mrd Nxt-gnrj Alys 1st 1 $5,623.75 $5,623.75 $5,623.75 nat. median
$3,956
1.4× median
0497U
HCPCS 		Onc Prst8 Mrna Rt-pcr 6 Gene 1 $5,615.85 $5,615.85 $5,615.85 nat. median
$3,950
1.4× median
81523
HCPCS 		Onc Brst Mrna 70 Cnt 31 Gene 1 $5,615.85 $5,615.85 $5,615.85 nat. median
$4,105
1.4× median
0578U
HCPCS 		Onc Cutan Mln RNA Qpcr 10gen 1 $5,615.85 $5,615.85 $5,615.85 nat. median
$3,950
1.4× median
81542
HCPCS 		Onc Prostate Mrna 22 Cnt Gen 1 $5,615.85 $5,615.85 $5,615.85 nat. median
$4,067
1.4× median
81522
HCPCS 		Onc Breast Mrna 12 Genes 1 $5,615.85 $5,615.85 $5,615.85 nat. median
$4,067
1.4× median
0288U
HCPCS 		Onc Lung Mrna Quan Pcr 11&3 1 $5,615.85 $5,615.85 $5,615.85 nat. median
$3,950
1.4× median
0583U
HCPCS 		Rare Ds Rpd Whlgen Cmptr DNA 1 $5,497.09 $5,497.09 $5,497.09 nat. median
$2,880
1.9× median
0019U
HCPCS 		Onc RNA Tiss Predict Alg 1 $5,328.75 $5,328.75 $5,328.75 nat. median
$3,785
1.4× median
0258U
HCPCS 		Ai Psor Mrna 50-100 Gen Alg 1 $5,328.75 $5,328.75 $5,328.75 nat. median
$3,785
1.4× median
0485U
HCPCS 		Onc Sol Tum Cfdna&rna Ngs Gm 1 $5,291.75 $5,291.75 $5,291.75 nat. median
$3,722
1.4× median
81546
HCPCS 		Onc Thyr Mrna 10,196 Gen Alg 1 $5,220.00 $5,220.00 $5,220.00 nat. median
$3,780
1.4× median
0391U
HCPCS 		Onc Sld Tum Dna&rna 437 Gen 1 $5,220.00 $5,220.00 $5,220.00 nat. median
$3,690
1.4× median
0313U
HCPCS 		Onc Pncrs Dna&mrna Seq 74 1 $5,220.00 $5,220.00 $5,220.00 nat. median
$3,672
1.4× median

Other procedures at this hospital

Browse this hospital's 3,365 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
949 MS_DRG Aftercare With Cc/Mcc 1 1 — — $26,847.00 $26,847.00 $26,847.00 2026-04-01
81416 HCPCS Exome Sequence Analysis 2 2 — — $12,000.00 $17,400.00 $14,700.00 2026-04-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 1 1 — — $14,202.00 $14,202.00 $14,202.00 2026-04-01
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 1 1 — — $14,202.00 $14,202.00 $14,202.00 2026-04-01
603 MS_DRG Cellulitis Without Mcc 1 1 — — $14,202.00 $14,202.00 $14,202.00 2026-04-01
0315U HCPCS Onc Cutan Sq Cll Ca Mrna 40 1 1 — — $12,325.00 $12,325.00 $12,325.00 2026-04-01
0211U HCPCS Onc Pan-tum Dna&rna Gnrj Seq 1 1 — — $12,259.75 $12,259.75 $12,259.75 2026-04-01
81552 HCPCS Onc Uveal Mlnma Mrna 15 Gene 1 1 — — $11,275.20 $11,275.20 $11,275.20 2026-04-01
0426U HCPCS Genome Ultra-rapid Seq Alys 1 1 — — $10,994.19 $10,994.19 $10,994.19 2026-04-01
0582U HCPCS Rare Ds Rpd Whlgen DNA Vrnts 1 1 — — $10,994.19 $10,994.19 $10,994.19 2026-04-01
0094U HCPCS Genome Rapid Sequence Alys 1 1 — — $10,994.19 $10,994.19 $10,994.19 2026-04-01
81529 HCPCS Onc Cutan Mlnma Mrna 31 Gene 1 1 — — $10,429.85 $10,429.85 $10,429.85 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 1 1 — — $10,157.40 $10,157.40 $10,157.40 2026-04-01
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/Mcc 1 1 — — $10,157.40 $10,157.40 $10,157.40 2026-04-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 1 1 — — $10,157.40 $10,157.40 $10,157.40 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 1 1 — — $10,157.40 $10,157.40 $10,157.40 2026-04-01
0267U HCPCS Rare Do Id Opt Gen Mapg&seq 1 1 — — $9,772.03 $9,772.03 $9,772.03 2026-04-01
0265U HCPCS Rar Do Whl Gn&mtcdrl DNA Als 1 1 — — $7,939.91 $7,939.91 $7,939.91 2026-04-01
0212U HCPCS Rare Ds Gen DNA Alys Proband 1 1 — — $7,939.04 $7,939.04 $7,939.04 2026-04-01
0295U HCPCS Onc Brst Dux Carc 7 Proteins 1 1 — — $7,880.75 $7,880.75 $7,880.75 2026-04-01
81554 HCPCS Pulm Ds Ipf Mrna 190 Gen Alg 1 1 — — $7,843.92 $7,843.92 $7,843.92 2026-04-01
0214U HCPCS Rare Ds Xom DNA Alys Proband 1 1 — — $7,575.67 $7,575.67 $7,575.67 2026-04-01
0335U HCPCS Rare Ds Whl Gen Seq Fetal 1 1 — — $7,575.67 $7,575.67 $7,575.67 2026-04-01
0532U HCPCS Rare Ds Whlgen&mitochdrl DNA 1 1 — — $7,295.24 $7,295.24 $7,295.24 2026-04-01
0567U HCPCS Rare Ds Whl Gen Seq Srs&lrs 1 1 — — $7,295.24 $7,295.24 $7,295.24 2026-04-01
0326U HCPCS Trgt Gen Seq Alys Pnl 83+ 1 1 — — $7,250.00 $7,250.00 $7,250.00 2026-04-01
0242U HCPCS Trgt Gen Seq Alys Pnl 55-74 1 1 — — $7,250.00 $7,250.00 $7,250.00 2026-04-01
0108U HCPCS Gi Barrett Esoph 9 Prtn Bmrk 1 1 — — $7,177.50 $7,177.50 $7,177.50 2026-04-01
0473U HCPCS Onc Sld Tum Bld/slv 648 Gene 1 1 — — $6,525.00 $6,525.00 $6,525.00 2026-04-01
81425 HCPCS Genome Sequence Analysis 2 2 — — $5,031.20 $7,295.24 $6,163.22 2026-04-01
0300U HCPCS Onc Pan Tum Whl Gen Seq&opt 1 1 — — $6,065.54 $6,065.54 $6,065.54 2026-04-01
178 MS_DRG Respiratory Infections And Inflammations With Cc 1 1 — — $6,033.67 $6,033.67 $6,033.67 2026-04-01
0425U HCPCS Genom Rpd Seq Alys Ea Cmprtr 1 1 — — $5,936.87 $5,936.87 $5,936.87 2026-04-01
81415 HCPCS Exome Sequence Analysis 2 2 — — $4,780.00 $6,931.00 $5,855.50 2026-04-01
0036U HCPCS Xome Tum & Nml Spec Seq Alys 2 2 — — $4,780.00 $6,931.00 $5,855.50 2026-04-01
0560U HCPCS Onc Mrd Gsa Cfdna Baseline 1 1 — — $5,623.75 $5,623.75 $5,623.75 2026-04-01
0306U HCPCS Onc Mrd Nxt-gnrj Alys 1st 1 1 — — $5,623.75 $5,623.75 $5,623.75 2026-04-01
0497U HCPCS Onc Prst8 Mrna Rt-pcr 6 Gene 1 1 — — $5,615.85 $5,615.85 $5,615.85 2026-04-01
0288U HCPCS Onc Lung Mrna Quan Pcr 11&3 1 1 — — $5,615.85 $5,615.85 $5,615.85 2026-04-01
0578U HCPCS Onc Cutan Mln RNA Qpcr 10gen 1 1 — — $5,615.85 $5,615.85 $5,615.85 2026-04-01
81542 HCPCS Onc Prostate Mrna 22 Cnt Gen 1 1 — — $5,615.85 $5,615.85 $5,615.85 2026-04-01
81523 HCPCS Onc Brst Mrna 70 Cnt 31 Gene 1 1 — — $5,615.85 $5,615.85 $5,615.85 2026-04-01
81522 HCPCS Onc Breast Mrna 12 Genes 1 1 — — $5,615.85 $5,615.85 $5,615.85 2026-04-01
0583U HCPCS Rare Ds Rpd Whlgen Cmptr DNA 1 1 — — $5,497.09 $5,497.09 $5,497.09 2026-04-01
0019U HCPCS Onc RNA Tiss Predict Alg 1 1 — — $5,328.75 $5,328.75 $5,328.75 2026-04-01
0258U HCPCS Ai Psor Mrna 50-100 Gen Alg 1 1 — — $5,328.75 $5,328.75 $5,328.75 2026-04-01
0485U HCPCS Onc Sol Tum Cfdna&rna Ngs Gm 1 1 — — $5,291.75 $5,291.75 $5,291.75 2026-04-01
0391U HCPCS Onc Sld Tum Dna&rna 437 Gen 1 1 — — $5,220.00 $5,220.00 $5,220.00 2026-04-01
0313U HCPCS Onc Pncrs Dna&mrna Seq 74 1 1 — — $5,220.00 $5,220.00 $5,220.00 2026-04-01
0362U HCPCS Onc Pap Thyr Ca RNA 82&10 1 1 — — $5,220.00 $5,220.00 $5,220.00 2026-04-01
0287U HCPCS Onc Thyr Dna&mrna 112 Genes 1 1 — — $5,220.00 $5,220.00 $5,220.00 2026-04-01
81546 HCPCS Onc Thyr Mrna 10,196 Gen Alg 1 1 — — $5,220.00 $5,220.00 $5,220.00 2026-04-01
0340U HCPCS Onc Pan Ca Alys Mrd Plasma 1 1 — — $5,205.50 $5,205.50 $5,205.50 2026-04-01
0080U HCPCS Onc Lng 5 Clin Rsk Factr Alg 1 1 — — $5,104.00 $5,104.00 $5,104.00 2026-04-01
0239U HCPCS Trgt Gen Seq Alys Pnl 311+ 1 1 — — $5,075.00 $5,075.00 $5,075.00 2026-04-01
0334U HCPCS Onc Sld Orgn Tgsa DNA 84/+ 1 1 — — $5,075.00 $5,075.00 $5,075.00 2026-04-01
0388U HCPCS Onc Nonsm Cll Lng Ca 37 Gen 1 1 — — $5,075.00 $5,075.00 $5,075.00 2026-04-01
0244U HCPCS Onc Solid Orgn DNA 257 Genes 1 1 — — $5,075.00 $5,075.00 $5,075.00 2026-04-01
0016M HCPCS Onc Bladder Mrna 209 Gen Alg 1 1 — — $5,059.96 $5,059.96 $5,059.96 2026-04-01
0329U HCPCS Onc Neo Xome&trns Seq Alys 1 1 — — $4,985.07 $4,985.07 $4,985.07 2026-04-01
5183 OTHER Level 3 Vascular Procedures 1 1 — — $4,921.54 $4,921.54 $4,921.54 2026-04-01
0539U HCPCS Onc Sol Tumor Cfctdna 152gen 1 1 — — $4,768.34 $4,768.34 $4,768.34 2026-04-01
81464 HCPCS So Gsap Cll Fr Mcrstl Ins 1 1 — — $4,768.34 $4,768.34 $4,768.34 2026-04-01
0379U HCPCS Tgsap Sl Or Neo Dna523&rna55 1 1 — — $4,768.34 $4,768.34 $4,768.34 2026-04-01
81518 HCPCS Onc Brst Mrna 11 Genes 2 2 — — $3,873.00 $5,615.85 $4,744.43 2026-04-01
81541 HCPCS Onc Prostate Mrna 46 Genes 2 2 — — $3,873.00 $5,615.85 $4,744.43 2026-04-01
81521 HCPCS Onc Breast Mrna 70 Genes 2 2 — — $3,873.00 $5,615.85 $4,744.43 2026-04-01
0045U HCPCS Onc Brst Dux Carc Is 12 Gene 2 2 — — $3,873.00 $5,615.85 $4,744.43 2026-04-01
0047U HCPCS Onc Prst8 Mrna 17 Gene Alg 2 2 — — $3,873.00 $5,615.85 $4,744.43 2026-04-01
0055U HCPCS Card Hrt Trnspl 96 DNA Seq 1 1 — — $4,698.00 $4,698.00 $4,698.00 2026-04-01
0576U HCPCS Trnsplj Med Lar Quan Ddcfdna 1 1 — — $4,698.00 $4,698.00 $4,698.00 2026-04-01
81558 HCPCS Trnspl Rej Kdn Mrna Qpcr 139 1 1 — — $4,698.00 $4,698.00 $4,698.00 2026-04-01
0266U HCPCS Unxpl Cnst Hrtbl Do Gn Xprsn 1 1 — — $4,640.00 $4,640.00 $4,640.00 2026-04-01
0262U HCPCS Onc Sld Tum Rt-pcr 7 Gen 1 1 — — $4,640.00 $4,640.00 $4,640.00 2026-04-01
0253U HCPCS Rprdtve Med RNA Gen Prfl 238 1 1 — — $4,581.16 $4,581.16 $4,581.16 2026-04-01
0088U HCPCS Trnsplj Kdn Algrft Rej 1494 1 1 — — $4,581.16 $4,581.16 $4,581.16 2026-04-01
0087U HCPCS Crd Hrt Trnspl Mrna 1283 Gen 1 1 — — $4,581.16 $4,581.16 $4,581.16 2026-04-01
0153U HCPCS Onc Breast Mrna 101 Genes 1 1 — — $4,581.16 $4,581.16 $4,581.16 2026-04-01
81519 HCPCS Oncology Breast Mrna 2 2 — — $3,415.84 $5,615.85 $4,515.85 2026-04-01
0026U HCPCS Onc Thyr Dna&mrna 112 Genes 2 2 — — $3,600.00 $5,220.00 $4,410.00 2026-04-01
0435U HCPCS Onc Chemo Rx Cytox Csc 14 Rx 1 1 — — $4,399.10 $4,399.10 $4,399.10 2026-04-01
0525U HCPCS Onc Sphrd Cell Cul 11-rx Pnl 1 1 — — $4,399.10 $4,399.10 $4,399.10 2026-04-01
0511U HCPCS Onc Sol Tum 3dmicroenvir 36+ 1 1 — — $4,399.10 $4,399.10 $4,399.10 2026-04-01
0248U HCPCS Onc Brn Sphrd Cll 12 Rx Pnl 1 1 — — $4,399.10 $4,399.10 $4,399.10 2026-04-01
0172U HCPCS Onc Sld Tum Alys Brca1 Brca2 1 1 — — $4,393.50 $4,393.50 $4,393.50 2026-04-01
0018U HCPCS Onc Thyr 10 Microrna Seq Alg 1 1 — — $4,353.03 $4,353.03 $4,353.03 2026-04-01
0543U HCPCS Onc Sol Tum Ngs DNA 517 Gens 1 1 — — $4,334.85 $4,334.85 $4,334.85 2026-04-01
0538U HCPCS Onc Sol Tum Ngts Ffpe 600gen 1 1 — — $4,334.85 $4,334.85 $4,334.85 2026-04-01
81459 HCPCS So Neo Gsap Dna/dna&rna 1 1 — — $4,334.85 $4,334.85 $4,334.85 2026-04-01
0037U HCPCS Trgt Gen Seq DNA 324 Genes 2 2 — — $3,500.00 $5,075.00 $4,287.50 2026-04-01
5361 OTHER Level 1 Laparoscopy And Related Services 1 1 — — $4,242.00 $4,242.00 $4,242.00 2026-04-01
0250U HCPCS Onc Sld Org Neo DNA 505 Gene 1 1 — — $4,233.42 $4,233.42 $4,233.42 2026-04-01
0048U HCPCS Onc Sld Org Neo DNA 468 Gene 1 1 — — $4,233.42 $4,233.42 $4,233.42 2026-04-01
0586U HCPCS Onc Mrna Gen Xprsn 216 Genes 1 1 — — $4,233.42 $4,233.42 $4,233.42 2026-04-01
0409U HCPCS Onc Sld Tum DNA 80 & RNA 36 1 1 — — $4,233.42 $4,233.42 $4,233.42 2026-04-01
0530U HCPCS Onc Pan-sol Tum Ctdna 77 Gen 1 1 — — $4,233.42 $4,233.42 $4,233.42 2026-04-01
0298U HCPCS Onc Pan Tum Whl Trns Seq RNA 1 1 — — $4,233.42 $4,233.42 $4,233.42 2026-04-01
0585U HCPCS Tgsap So Neo Cfdna 521 Genes 1 1 — — $4,233.42 $4,233.42 $4,233.42 2026-04-01
81456 HCPCS Tgsap So/hl 51/< RNA Alys 1 1 — — $4,233.42 $4,233.42 $4,233.42 2026-04-01
0592U HCPCS Onc Hl Neo DNA Tgs 417 Genes 1 1 — — $4,233.42 $4,233.42 $4,233.42 2026-04-01
0444U HCPCS Onc Sld Orgn Neo Tgsap 361 1 1 — — $4,233.42 $4,233.42 $4,233.42 2026-04-01
0487U HCPCS Onc Sol Tum Cfcdna Tgsap 84 1 1 — — $4,233.42 $4,233.42 $4,233.42 2026-04-01
0571U HCPCS Onc Sol Tum Dna80&rna10g Ngs 1 1 — — $4,233.42 $4,233.42 $4,233.42 2026-04-01
0297U HCPCS Onc Pan Tum Whl Gen Seq DNA 1 1 — — $4,233.42 $4,233.42 $4,233.42 2026-04-01
0050U HCPCS Trgt Gen Seq DNA 194 Genes 1 1 — — $4,229.07 $4,229.07 $4,229.07 2026-04-01
81540 HCPCS Oncology Tum Unknown Origin 2 2 — — $2,920.30 $5,437.50 $4,178.90 2026-04-01
0417U HCPCS Rare Ds Alys 335 Nuc Genes 1 1 — — $4,121.67 $4,121.67 $4,121.67 2026-04-01
81440 HCPCS Mitochondrial Gene 2 2 — — $3,324.00 $4,819.80 $4,071.90 2026-04-01
0118U HCPCS Trnsplj Don-drv Cll-fr DNA 1 1 — — $3,992.21 $3,992.21 $3,992.21 2026-04-01
0540U HCPCS Trnsplj Med Quan Dd-cfdna 1 1 — — $3,992.21 $3,992.21 $3,992.21 2026-04-01
0493U HCPCS Trnspl Med Quan Dd-cfdna Ngs 1 1 — — $3,992.21 $3,992.21 $3,992.21 2026-04-01
0213U HCPCS Rare Ds Gen DNA Alys Ea Comp 1 1 — — $3,929.43 $3,929.43 $3,929.43 2026-04-01
0320U HCPCS Neph RNA Psttrnspl Perph Bld 1 1 — — $3,842.50 $3,842.50 $3,842.50 2026-04-01
0319U HCPCS Neph RNA Pretrnspl Perph Bld 1 1 — — $3,842.50 $3,842.50 $3,842.50 2026-04-01
81525 HCPCS Oncology Colon Mrna 2 2 — — $3,125.73 $4,518.20 $3,821.97 2026-04-01
81595 HCPCS Cardiology Hrt Trnspl Mrna 2 2 — — $2,840.75 $4,698.00 $3,769.38 2026-04-01
5691 OTHER Level 1 Drug Administration 2 2 — — $3,114.74 $4,366.59 $3,740.66 2026-04-01
0336U HCPCS Rare Ds Whl Gen Seq Bld/slv 1 1 — — $3,733.24 $3,733.24 $3,733.24 2026-04-01
0215U HCPCS Rare Ds Xom DNA Alys Ea Comp 1 1 — — $3,733.24 $3,733.24 $3,733.24 2026-04-01
0261U HCPCS Onc Clrct Ca Img Alys W/ai 1 1 — — $3,644.21 $3,644.21 $3,644.21 2026-04-01
0120U HCPCS Onc B Cll Lymphm Mrna 58 Gen 1 1 — — $3,639.80 $3,639.80 $3,639.80 2026-04-01
0017M HCPCS Onc Dlbcl Mrna 20 Genes Alg 1 1 — — $3,639.80 $3,639.80 $3,639.80 2026-04-01
0092U HCPCS Onc Lng 3 Prtn Bmrk Plsm Alg 1 1 — — $3,607.60 $3,607.60 $3,607.60 2026-04-01
81455 HCPCS Targeted Genomic Seq Analys 2 2 — — $2,919.60 $4,233.42 $3,576.51 2026-04-01
0276U HCPCS Hem Inh Thrombocytopenia 23 1 1 — — $3,550.41 $3,550.41 $3,550.41 2026-04-01
81419 HCPCS Epilepsy Gen Seq Alys Panel 1 1 — — $3,550.41 $3,550.41 $3,550.41 2026-04-01
81441 HCPCS Ibmfs Seq Alys Pnl 30 Genes 1 1 — — $3,550.41 $3,550.41 $3,550.41 2026-04-01
0338U HCPCS Onc Sld Tum Crcg Tum Cl Slct 1 1 — — $3,530.75 $3,530.75 $3,530.75 2026-04-01
0337U HCPCS Onc Plsm Cell Do&myeloma Id 1 1 — — $3,530.75 $3,530.75 $3,530.75 2026-04-01
0492U HCPCS Onc Sol Tum Ctc Slctn Pd-l1 1 1 — — $3,530.75 $3,530.75 $3,530.75 2026-04-01
0490U HCPCS Onc Cutan/uveal Mlnma Cd146 1 1 — — $3,530.75 $3,530.75 $3,530.75 2026-04-01
0491U HCPCS Onc Sol Tum Ctc Slct ER Prtn 1 1 — — $3,530.75 $3,530.75 $3,530.75 2026-04-01
81520 HCPCS Onc Breast Mrna 58 Genes 2 2 — — $3,099.02 $3,639.80 $3,369.41 2026-04-01
81426 HCPCS Genome Sequence Analysis 2 2 — — $2,709.95 $3,929.43 $3,319.69 2026-04-01
0218U HCPCS Neuro Musc Dys Dmd Seq Alys 1 1 — — $3,304.55 $3,304.55 $3,304.55 2026-04-01
81545 HCPCS Oncology Thyroid 1 1 — — $3,222.40 $3,222.40 $3,222.40 2026-04-01
0249U HCPCS Onc Brst Alys 32 Phsprtn Alg 1 1 — — $3,217.74 $3,217.74 $3,217.74 2026-04-01
0206U HCPCS Neuro Alzheimer Cell Aggregj 1 1 — — $3,212.33 $3,212.33 $3,212.33 2026-04-01
0303U HCPCS Hem Rbc Ads Whl Bld Hypoxic 1 1 — — $3,192.35 $3,192.35 $3,192.35 2026-04-01
0217U HCPCS Neuro Inh Ataxia DNA 51 Gene 1 1 — — $3,187.61 $3,187.61 $3,187.61 2026-04-01
81538 HCPCS Oncology Lung 2 2 — — $2,126.78 $4,162.95 $3,144.86 2026-04-01
5491 OTHER Level 1 Intraocular Procedures 2 2 — — $2,841.81 $3,402.00 $3,121.90 2026-04-01
0480U HCPCS Nfct Ds Csf Metag Ngs Alys 1 1 — — $3,082.99 $3,082.99 $3,082.99 2026-04-01
0323U HCPCS Iadna Cns Pthgn Next Gen Seq 1 1 — — $3,082.99 $3,082.99 $3,082.99 2026-04-01
0152U HCPCS Nfct Bct Fng Prst DNA >1000 1 1 — — $3,082.99 $3,082.99 $3,082.99 2026-04-01
0304U HCPCS Hem Rbc Ads Whl Bld Normoxic 1 1 — — $3,009.91 $3,009.91 $3,009.91 2026-04-01
81443 HCPCS Genetic Tstg Severe Inh Cond 2 2 — — $2,448.56 $3,550.41 $2,999.48 2026-04-01
0317U HCPCS Onc Lung Ca 4-prb Fish Assay 1 1 — — $2,943.50 $2,943.50 $2,943.50 2026-04-01
0364U HCPCS Onc Hl Neo Gen Seq Alys Alg 1 1 — — $2,910.51 $2,910.51 $2,910.51 2026-04-01
81427 HCPCS Genome Re-evaluation 2 2 — — $2,337.65 $3,389.59 $2,863.62 2026-04-01
28297 HCPCS Correction Hallux Valgus 2 2 — — $2,678.00 $3,000.00 $2,839.00 2026-04-01
28299 HCPCS Correction Hallux Valgus 2 2 — — $2,678.00 $3,000.00 $2,839.00 2026-04-01
28296 HCPCS Correction Hallux Valgus 2 2 — — $2,678.00 $3,000.00 $2,839.00 2026-04-01
28292 HCPCS Correction Hallux Valgus 2 2 — — $2,678.00 $3,000.00 $2,839.00 2026-04-01
20900 HCPCS Removal Of Bone For Graft 2 2 — — $2,678.00 $3,000.00 $2,839.00 2026-04-01
15734 HCPCS Muscle-skin Graft Trunk 2 2 — — $2,678.00 $3,000.00 $2,839.00 2026-04-01
49591 HCPCS Rpr Aa Hrn 1st < 3 Cm Rdc 2 2 — — $2,678.00 $3,000.00 $2,839.00 2026-04-01
27685 HCPCS Revision Of Lower Leg Tendon 2 2 — — $2,678.00 $3,000.00 $2,839.00 2026-04-01
0090U HCPCS Onc Cutan Mlnma Mrna 23 Gene 1 1 — — $2,827.50 $2,827.50 $2,827.50 2026-04-01
0170U HCPCS Neuro Asd RNA Next Gen Seq 1 1 — — $2,827.50 $2,827.50 $2,827.50 2026-04-01
0314U HCPCS Onc Cutan Mlnma Mrna 35 Gene 1 1 — — $2,827.50 $2,827.50 $2,827.50 2026-04-01
0296U HCPCS Onc Orl&/orop Ca 20 Mlc Feat 1 1 — — $2,827.50 $2,827.50 $2,827.50 2026-04-01
0022U HCPCS Trgt Gen Seq Dna&rna 23 Gene 1 1 — — $2,827.50 $2,827.50 $2,827.50 2026-04-01
0422U HCPCS Onc Pan Solid Tum Alys DNA 1 1 — — $2,817.65 $2,817.65 $2,817.65 2026-04-01
0179U HCPCS Onc Nonsm Cll Lng Ca Alys 23 1 1 — — $2,817.65 $2,817.65 $2,817.65 2026-04-01
0114U HCPCS Gi Barretts Esoph Vim&ccna1 1 1 — — $2,810.11 $2,810.11 $2,810.11 2026-04-01
0506U HCPCS Gi Barretts Esophgl Cell 89 1 1 — — $2,810.11 $2,810.11 $2,810.11 2026-04-01
0465U HCPCS Onc Urthl Carc DNA Qmsp 2gen 1 1 — — $2,810.11 $2,810.11 $2,810.11 2026-04-01
5593 OTHER Level 3 Nuclear Medicine And Related Services 1 1 — — $2,768.04 $2,768.04 $2,768.04 2026-04-01
0341U HCPCS Ftl Aneup DNA Seq Cmpr Alys 1 1 — — $2,755.29 $2,755.29 $2,755.29 2026-04-01
0067U HCPCS Onc Brst Imhchem Prfl 4 Bmrk 1 1 — — $2,750.65 $2,750.65 $2,750.65 2026-04-01
81195 HCPCS Cytog Genom-wid Alys Hem Mal 1 1 — — $2,701.67 $2,701.67 $2,701.67 2026-04-01
0331U HCPCS Onc Hl Neo Opt Gen Mapping 1 1 — — $2,701.67 $2,701.67 $2,701.67 2026-04-01
0299U HCPCS Onc Pan Tum Whl Gen Opt Mapg 1 1 — — $2,701.67 $2,701.67 $2,701.67 2026-04-01
21501 HCPCS Drain Neck/chest Lesion 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28825 HCPCS Partial Amputation Of Toe 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28315 HCPCS Removal Of Sesamoid Bone 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28313 HCPCS Repair Deformity Of Toe 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28011 HCPCS Incision Of Toe Tendons 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
11772 HCPCS Remove Pilonidal Cyst Compl 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28111 HCPCS Part Removal Of Metatarsal 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28104 HCPCS Removal Of Foot Lesion 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28288 HCPCS Partial Removal Of Foot Bone 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
64721 HCPCS Carpal Tunnel Surgery 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28090 HCPCS Removal Of Foot Lesion 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28110 HCPCS Part Removal Of Metatarsal 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28160 HCPCS Partial Removal Of Toe 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28010 HCPCS Incision Of Toe Tendon 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
27327 HCPCS Exc Thigh/knee Les Sc < 3 Cm 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
64624 HCPCS Dstrj Nulyt Agt Gnclr Nrv 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28308 HCPCS Incision Of Metatarsal 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28270 HCPCS Release Of Foot Contracture 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28232 HCPCS Incision Of Toe Tendon 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
25071 HCPCS Exc Forearm Les Sc 3 Cm/> 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28805 HCPCS Amputation Thru Metatarsal 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28080 HCPCS Removal Of Foot Lesion 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
21552 HCPCS Exc Neck Les Sc 3 Cm/> 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
20680 HCPCS Removal Of Support Implant 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28820 HCPCS Amputation Of Toe 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28810 HCPCS Amputation Toe & Metatarsal 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28285 HCPCS Repair Of Hammertoe 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
28755 HCPCS Fusion Of Big Toe Joint 2 2 — — $2,415.00 $2,975.00 $2,695.00 2026-04-01
0356U HCPCS Onc Orop 17 DNA Ddpcr Alg 1 1 — — $2,610.00 $2,610.00 $2,610.00 2026-04-01
0405U HCPCS Onc Pncrtc 59 Mthltn Blk Mrk 1 1 — — $2,567.20 $2,567.20 $2,567.20 2026-04-01
0318U HCPCS Ped Whl Gen Mthyltn Alys 50+ 1 1 — — $2,567.20 $2,567.20 $2,567.20 2026-04-01
81162 HCPCS Brca1&2 Seq & Full Dup/del 2 2 — — $2,485.86 $2,646.08 $2,565.97 2026-04-01
0292U HCPCS Psyc Strs Do Mrna 72 Genes 1 1 — — $2,544.75 $2,544.75 $2,544.75 2026-04-01
0291U HCPCS Psyc Mood Do Mrna 144 Genes 1 1 — — $2,544.75 $2,544.75 $2,544.75 2026-04-01
0398U HCPCS Gi Baret Esph DNA Mthyln Aly 1 1 — — $2,544.75 $2,544.75 $2,544.75 2026-04-01
0103U HCPCS Hered Ova Ca Pnl 24 Genes 1 1 — — $2,528.73 $2,528.73 $2,528.73 2026-04-01
0101U HCPCS Hered Colon Ca Do 15 Genes 1 1 — — $2,528.73 $2,528.73 $2,528.73 2026-04-01
0156U HCPCS Copy Number Sequence Alys 1 1 — — $2,523.00 $2,523.00 $2,523.00 2026-04-01
0014U HCPCS Hem Hmtlmf Neo Gene Reargmt 1 1 — — $2,515.60 $2,515.60 $2,515.60 2026-04-01
0013U HCPCS Onc Sld Org Neo Gene Reargmt 1 1 — — $2,515.60 $2,515.60 $2,515.60 2026-04-01
0012U HCPCS Germln Do Gene Reargmt Detcj 1 1 — — $2,515.60 $2,515.60 $2,515.60 2026-04-01
81551 HCPCS Onc Prostate 3 Genes 2 2 — — $2,030.00 $2,943.50 $2,486.75 2026-04-01
81408 HCPCS Mopath Procedure Level 9 2 2 — — $2,000.00 $2,900.00 $2,450.00 2026-04-01
28485 HCPCS Treat Metatarsal Fracture 2 2 — — $1,045.00 $3,771.00 $2,408.00 2026-04-01
28730 HCPCS Fusion Of Foot Bones 2 2 — — $1,045.00 $3,771.00 $2,408.00 2026-04-01
49592 HCPCS Rpr Aa Hrn 1st < 3 Ncr/strn 2 2 — — $1,045.00 $3,771.00 $2,408.00 2026-04-01
28740 HCPCS Fusion Of Foot Bones 2 2 — — $1,045.00 $3,771.00 $2,408.00 2026-04-01
47562 HCPCS Laparoscopic Cholecystectomy 2 2 — — $1,045.00 $3,771.00 $2,408.00 2026-04-01
28750 HCPCS Fusion Of Big Toe Joint 2 2 — — $1,045.00 $3,771.00 $2,408.00 2026-04-01
49594 HCPCS Rpr Aa Hrn 1st 3-10 Ncr/strn 2 2 — — $1,045.00 $3,771.00 $2,408.00 2026-04-01
49616 HCPCS Rpr Aa Hrn Rcr 3-10 Ncr/strn 2 2 — — $1,045.00 $3,771.00 $2,408.00 2026-04-01
47563 HCPCS Laparo Cholecystectomy/graph 2 2 — — $1,045.00 $3,771.00 $2,408.00 2026-04-01
28291 HCPCS Corrj Halux Rigdus W/implt 2 2 — — $1,045.00 $3,771.00 $2,408.00 2026-04-01
0486U HCPCS Onc Pan Sol Tum Ngs Cfctdna 1 1 — — $2,384.16 $2,384.16 $2,384.16 2026-04-01
0216U HCPCS Neuro Inh Ataxia DNA 12 Com 1 1 — — $2,228.68 $2,228.68 $2,228.68 2026-04-01
0467U HCPCS Onc Bldr DNA Ngs 60gen&aneup 1 1 — — $2,202.64 $2,202.64 $2,202.64 2026-04-01
0171U HCPCS Trgt Gen Seq Alys Pnl DNA 23 1 1 — — $2,202.64 $2,202.64 $2,202.64 2026-04-01
0436U HCPCS Onc Lng Plsm Alys 388 Prtn 1 1 — — $2,181.15 $2,181.15 $2,181.15 2026-04-01
5524 OTHER Level 4 Imaging Without Contrast 1 1 — — $2,177.89 $2,177.89 $2,177.89 2026-04-01
0537U HCPCS Onc Clrct Ca Cfdna >2500 Dmr 1 1 — — $2,167.75 $2,167.75 $2,167.75 2026-04-01
81412 HCPCS Ashkenazi Jewish Assoc Dis 2 2 — — $602.10 $3,550.41 $2,076.26 2026-04-01
444 MS_DRG Disorders Of The Biliary Tract With Mcc 1 1 — — $2,025.00 $2,025.00 $2,025.00 2026-04-01
81430 HCPCS Hearing Loss Sequence Analys 2 2 — — $1,625.00 $2,356.25 $1,990.62 2026-04-01
0523U HCPCS Onc Soltum DNA Ngs Snv 22gen 1 1 — — $1,960.53 $1,960.53 $1,960.53 2026-04-01
0498U HCPCS Onc Clrct Ngs Mut Detc 43gen 1 1 — — $1,950.70 $1,950.70 $1,950.70 2026-04-01
81463 HCPCS So Gsap Cl Fr Cpy Nmbr&mcrst 1 1 — — $1,950.70 $1,950.70 $1,950.70 2026-04-01
0345U HCPCS Psyc Genom Alys Pnl 15 Gen 1 1 — — $1,937.33 $1,937.33 $1,937.33 2026-04-01
0419U HCPCS Nrpsyc Gen Seq Vrnt Aly 13 1 1 — — $1,937.33 $1,937.33 $1,937.33 2026-04-01
0392U HCPCS Rx Metab Genrx Ia 16 Genes 1 1 — — $1,937.33 $1,937.33 $1,937.33 2026-04-01
0347U HCPCS Rx Metab/pcx DNA 16 Gen Alys 1 1 — — $1,937.33 $1,937.33 $1,937.33 2026-04-01
0411U HCPCS Psyc Genom Alys Pnl 15 Gen 1 1 — — $1,937.33 $1,937.33 $1,937.33 2026-04-01
0175U HCPCS Psyc Gen Alys Panel 15 Genes 1 1 — — $1,937.33 $1,937.33 $1,937.33 2026-04-01
0350U HCPCS Rx Metab/pcx DNA 27 Gen Alys 1 1 — — $1,937.33 $1,937.33 $1,937.33 2026-04-01
0420U HCPCS Onc Urthl Mrna Xprsn 6 Snp 1 1 — — $1,926.06 $1,926.06 $1,926.06 2026-04-01
0015M HCPCS Adrnl Cortcl Tum Bchm Asy 25 1 1 — — $1,892.79 $1,892.79 $1,892.79 2026-04-01
0174U HCPCS Onc Solid Tumor 30 Prtn Trgt 1 1 — — $1,892.79 $1,892.79 $1,892.79 2026-04-01
0129U HCPCS Hered Brst Ca Rltd Do Panel 1 1 — — $1,890.73 $1,890.73 $1,890.73 2026-04-01
0102U HCPCS Hered Brst Ca Rltd Do 17 Gen 1 1 — — $1,890.73 $1,890.73 $1,890.73 2026-04-01
0475U HCPCS Hered Prst8 Ca Gsap 23 Genes 1 1 — — $1,890.73 $1,890.73 $1,890.73 2026-04-01
0474U HCPCS Hered Pan Ca Gsap 88gene Ngs 1 1 — — $1,890.73 $1,890.73 $1,890.73 2026-04-01
81442 HCPCS Noonan Spectrum Disorders 2 2 — — $602.10 $3,108.22 $1,855.16 2026-04-01
0245U HCPCS Onc Thyr Mut Alys 10 Gen&37 1 1 — — $1,835.80 $1,835.80 $1,835.80 2026-04-01
0413U HCPCS Onc Hl Neo Opt Gen Mapg DNA 1 1 — — $1,832.12 $1,832.12 $1,832.12 2026-04-01
0264U HCPCS Rare Ds Id Opt Genome Mapg 1 1 — — $1,832.12 $1,832.12 $1,832.12 2026-04-01
0260U HCPCS Rare Ds Id Opt Genome Mapg 1 1 — — $1,832.12 $1,832.12 $1,832.12 2026-04-01
81354 HCPCS Cytog Alys Chrml Abnor Ogm 1 1 — — $1,832.12 $1,832.12 $1,832.12 2026-04-01
0454U HCPCS U Rare Ds Id Opt Genome Mapg 1 1 — — $1,832.12 $1,832.12 $1,832.12 2026-04-01
81509 HCPCS Ftl Cgen Abnor 3 Proteins 2 2 — — $1,487.37 $2,156.69 $1,822.03 2026-04-01
81349 HCPCS Cytog Alys Chrml Abnr Lw-ps 1 1 — — $1,737.01 $1,737.01 $1,737.01 2026-04-01
0469U HCPCS Rare Ds Whl Gen Seq Ftl Samp 1 1 — — $1,737.01 $1,737.01 $1,737.01 2026-04-01
81462 HCPCS So Gsap Cll Fr Dna/dna&rna 1 1 — — $1,733.95 $1,733.95 $1,733.95 2026-04-01
0565U HCPCS Onc Hcc Ngs Detc 6626epigalt 1 1 — — $1,682.00 $1,682.00 $1,682.00 2026-04-01
0410U HCPCS Onc Pncrtc DNA Whl Gn Seq 5- 1 1 — — $1,682.00 $1,682.00 $1,682.00 2026-04-01
81277 HCPCS Cytogenomic Neo Microra Alys 1 1 — — $1,682.00 $1,682.00 $1,682.00 2026-04-01
0507U HCPCS Onc Ovr DNA Whole Gen W/5hmc 1 1 — — $1,682.00 $1,682.00 $1,682.00 2026-04-01
0332U HCPCS Onc Pan Tum Gen Prflg 8 DNA 1 1 — — $1,655.99 $1,655.99 $1,655.99 2026-04-01
81411 HCPCS Aortic Dysfunction/dilation 2 2 — — $1,350.19 $1,957.78 $1,653.99 2026-04-01
44360 HCPCS Small Bowel Endoscopy 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
67840 HCPCS Remove Eyelid Lesion 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
27618 HCPCS Exc Leg/ankle Tum < 3 Cm 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
45378 HCPCS Diagnostic Colonoscopy 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
28043 HCPCS Exc Foot/toe Tum Sc < 1.5 Cm 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
45380 HCPCS Colonoscopy And Biopsy 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
26055 HCPCS Incise Finger Tendon Sheath 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
43235 HCPCS Egd Diagnostic Brush Wash 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
36590 HCPCS Removal Tunneled Cv Cath 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
11424 HCPCS Exc H-f-nk-sp B9+marg 3.1-4 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
21555 HCPCS Exc Neck Les Sc < 3 Cm 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
43239 HCPCS Egd Biopsy Single/multiple 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
46220 HCPCS Excise Anal Ext Tag/papilla 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
25075 HCPCS Exc Forearm Les Sc < 3 Cm 2 2 — — $1,234.00 $1,950.00 $1,592.00 2026-04-01
81460 HCPCS Whole Mitochondrial Genome 2 2 — — $1,287.00 $1,866.15 $1,576.58 2026-04-01
81458 HCPCS So Gsap DNA Cpy Nmbr&mcrstl 1 1 — — $1,517.21 $1,517.21 $1,517.21 2026-04-01
81229 HCPCS Cytogen M Array Copy No&snp 2 2 — — $1,160.00 $1,682.00 $1,421.00 2026-04-01
81432 HCPCS Hrdtry Brst Ca-rlatd Dsordrs 2 2 — — $931.48 $1,890.73 $1,411.11 2026-04-01
0105U HCPCS Neph Ckd Mult Eclia Tum Nec 1 1 — — $1,377.50 $1,377.50 $1,377.50 2026-04-01
0407U HCPCS Neph Dbtc Ckd Mult Eclia Alg 1 1 — — $1,377.50 $1,377.50 $1,377.50 2026-04-01
0387U HCPCS Onc Mlnma Ambra1&amlo 1 1 — — $1,375.32 $1,375.32 $1,375.32 2026-04-01
81435 HCPCS Hereditary Colon Ca Dsordrs 2 2 — — $795.93 $1,890.73 $1,343.33 2026-04-01
0461U HCPCS Onc Rxgenom Alys Rtpcr 24gen 1 1 — — $1,329.77 $1,329.77 $1,329.77 2026-04-01
81418 HCPCS Rx Metab Gen Seq Alys Pnl 6 1 1 — — $1,329.77 $1,329.77 $1,329.77 2026-04-01
0460U HCPCS Onc Whl Bld/bucc Rtpcr 24gen 1 1 — — $1,329.77 $1,329.77 $1,329.77 2026-04-01
5312 OTHER Level 2 Lower Gi Procedures 5 4 — — $742.92 $3,289.50 $1,312.33 2026-04-01
0367U HCPCS Onc Bldr 10 Flwg Trurl Rescj 1 1 — — $1,308.16 $1,308.16 $1,308.16 2026-04-01
0375U HCPCS Onc Ovrn Bchm Asy 7 Prtn Alg 1 1 — — $1,300.65 $1,300.65 $1,300.65 2026-04-01
0366U HCPCS Onc Bldr 10 Prb Recr Bldr Ca 1 1 — — $1,300.65 $1,300.65 $1,300.65 2026-04-01
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