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

INTERMOUNTAIN HEALTH SPANISH FORK HOSPITAL

Spanish Fork, UT · CCN 460062 · Rates published

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You selected 93350 (CPT)

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This hospital’s price: $89 across 10 payers · range $67-$111

Source: https://intermountainhealthcare.org/-/media/files/intermountain-health/locations/hospital-prices/942854057_spanish-fork-hospital_standardcharges.ashx · observed 2026-07-15

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

12,037 distinct procedures filed
30 distinct payers
329,737 rate rows
2026-07-15 last MRF observed
Data quality

325,529 of 329,737 rate rows are consumer-grade (98.7%)

4,208 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
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 4,085
placeholder amount (≤ $0.02) — excluded from medians 114
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 7
template filing: same amount across many unrelated codes — excluded 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://intermountainhealthcare.org/-/media/files/intermountain-health/locations/hospital-prices/942854057_spanish-fork-hospital_standardcharges.ashx
Found on page https://hospitalpricingfiles.org/details/Price%20transparency%20-%20Spanish%20Fork%20Hospital
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-26
Content fingerprint 1c4757533957fe67… · 7,544,398 bytes · first seen 2026-05-14

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
J3391
HCPCS 		Inj Atidarsagene Autotemcel 10 $4,505,000.00 $4,955,500.00 $4,685,200.00 nat. median
$4,505,000
1.0× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 10 $3,335,820.00 $3,812,842.26 $3,469,252.80 nat. median
$3,335,820
1.0× median
J3394
HCPCS 		Inj Lovotibeglogene Autotem 12 $3,193,000.00 $3,717,616.74 $3,348,000.00 nat. median
$3,286,000
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 10 $3,180,000.00 $3,634,740.00 $3,307,200.00 nat. median
$3,180,000
1.0× median
J3393
HCPCS 		Inj Betibeglogene Autotemce 12 $2,939,968.89 $3,360,384.44 $3,024,000.00 nat. median
$2,994,107
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 12 $2,403,458.75 $2,959,205.55 $2,588,981.23 nat. median
$2,467,386
1.0× median
J3392
HCPCS 		Inj Exagamglogene Autotem 11 $2,332,000.00 $2,665,476.00 $2,425,280.00 nat. median
$2,401,965
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 10 $770,620.00 $880,818.66 $801,444.80 nat. median
$813,967
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 12 $551,318.34 $671,683.46 $614,776.73 nat. median
$646,415
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 12 $565,623.84 $647,545.28 $592,875.01 nat. median
$739,258
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 12 $516,485.97 $642,596.02 $588,343.59 nat. median
$640,950
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 12 $528,312.43 $637,887.42 $584,032.53 nat. median
$622,450
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 12 $489,517.15 $608,295.73 $556,939.18 nat. median
$608,239
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 12 $488,051.51 $559,441.58 $512,209.64 nat. median
$591,721
0.9× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 10 $278,250.00 $318,039.75 $289,380.00 nat. median
$319,951
0.9× median
J3403
HCPCS 		Revakinagene Per Implant 10 $265,000.00 $302,895.00 $275,600.00 nat. median
$265,000
1.0× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 10 $201,669.02 $230,507.69 $209,735.78 nat. median
$209,753
1.0× median
Q0480
HCPCS 		Driver Pneumatic Vad Rep 12 $99,999.93 $303,449.79 $117,565.87 nat. median
$111,503
1.1× median
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 11 $67,452.66 $78,640.35 $71,553.78 nat. median
$70,178
1.0× median
J9029
HCPCS 		Instill Adstiladrin Tx Dose 12 $63,402.04 $74,113.13 $67,263.57 nat. median
$68,423
1.0× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $65,518.20 $65,518.20 $65,518.20 nat. median
$75,000
0.9× median
L8614
HCPCS 		Cochlear Device 2 $56,406.93 $67,303.72 $64,098.78 nat. median
$22,351
outlier · 2.9×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 12 $53,981.46 $64,357.43 $54,404.11 nat. median
$65,720
0.8× median
L7181
HCPCS 		Electronic Elbo Simultaneous 12 $48,901.12 $141,240.29 $52,198.52 nat. median
$50,516
1.0× median
L7180
HCPCS 		Electronic Elbow Sequential 12 $42,853.91 $123,774.25 $45,743.55 nat. median
$46,980
1.0× median
J9226
HCPCS 		Supprelin La Implant 12 $43,185.34 $53,051.20 $43,324.60 nat. median
$55,159
0.8× median
L2006
HCPCS 		Kaf Sng/dbl Swg/stn Mcpr Cus 12 $39,482.40 $114,036.33 $42,144.70 nat. median
$39,921
1.1× median
L8701
HCPCS 		Ewh S/d Uprt Micro Sensor 11 $34,284.44 $39,970.86 $36,368.94 nat. median
$35,670
1.0× median
L5856
HCPCS 		Elec Knee-shin Swing/stance 12 $29,277.32 $84,561.19 $31,251.49 nat. median
$30,017
1.0× median
L6880
HCPCS 		Elec Hand Ind Art Digits 12 $29,217.93 $84,389.66 $31,188.10 nat. median
$30,019
1.0× median
L6700
HCPCS 		Ue Add Ext Power Myoel 10 $29,510.19 $33,730.15 $30,690.60 nat. median
$30,378
1.0× median
J9266
HCPCS 		Pegaspargase Injection 12 $23,577.00 $32,488.70 $28,424.06 nat. median
$33,233
0.9× median
L8679
HCPCS 		Imp Neurosti Pls Gn Any Type 2 $24,968.10 $29,791.48 $28,372.84 nat. median
$11,015
outlier · 2.6×
J9600
HCPCS 		Porfimer Sodium Injection 12 $24,228.42 $27,693.08 $25,188.84 nat. median
$30,131
0.8× median
Q0483
HCPCS 		Monitor Elec Vad Rep 12 $22,928.60 $66,224.29 $24,474.67 nat. median
$23,335
1.0× median
L5858
HCPCS 		Stance Phase Only 12 $22,682.29 $65,512.88 $24,211.76 nat. median
$23,237
1.0× median
L6975
HCPCS 		Interscap-thor Myoelectronic 12 $22,653.52 $65,429.79 $24,181.04 nat. median
$22,826
1.1× median
L5973
HCPCS 		Ank-foot Sys Dors-plant Flex 12 $21,285.87 $61,479.61 $22,721.18 nat. median
$21,726
1.0× median
L6970
HCPCS 		Interscapular-thor Switch CT 12 $21,143.84 $61,069.41 $22,569.58 nat. median
$20,980
1.1× median
L6965
HCPCS 		Shldr Disartic Myoelectronic 12 $20,885.99 $60,324.64 $22,294.33 nat. median
$19,981
1.1× median
L8609
HCPCS 		Artificial Cornea 2 $19,286.94 $23,012.83 $21,916.98 nat. median
$8,066
outlier · 2.7×
K1014
HCPCS 		Ak 4 Bar Link Hydl Swg/stanc 2 $18,839.23 $22,478.63 $21,408.22 nat. median
$8,507
outlier · 2.5×
Q0489
HCPCS 		Pwr Pck Base Combo Vad Rep 12 $19,877.86 $57,412.89 $21,218.22 nat. median
$20,275
1.0× median
L6960
HCPCS 		Shldr Disartic Switch Contro 12 $19,277.39 $55,678.58 $20,577.27 nat. median
$16,650
1.2× median
L6955
HCPCS 		Above Elbow Myoelectronic CT 12 $19,113.49 $55,205.17 $20,402.32 nat. median
$15,745
1.3× median
L8682
HCPCS 		Implt Neurostim Radiofq Rec 2 $17,839.32 $21,285.56 $20,271.96 nat. median
$7,454
outlier · 2.7×
Q0481
HCPCS 		Microprcsr Cu Elec Vad Rep 12 $17,769.70 $51,323.93 $18,967.90 nat. median
$15,219
1.2× median
L5859
HCPCS 		Knee-shin Pro Flex/ext Cont 12 $17,707.86 $51,145.31 $18,901.90 nat. median
$18,321
1.0× median
L6945
HCPCS 		Elbow Disart Myoelectronic C 12 $16,334.84 $47,179.65 $17,436.29 nat. median
$13,912
1.3× median
L6950
HCPCS 		Above Elbow Switch Control 12 $15,959.35 $46,095.12 $17,035.49 nat. median
$12,858
1.3× median

Other procedures at this hospital

Browse this hospital's 12,037 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
             
J3391 HCPCS Inj Atidarsagene Autotemcel 15 10 — — $4,505,000.00 $4,955,500.00 $4,685,200.00 2026-07-15
J3389 HCPCS Topi Adm Prad Zami Per Treat 16 10 — — $3,335,820.00 $3,812,842.26 $3,469,252.80 2026-07-15
J3394 HCPCS Inj Lovotibeglogene Autotem 24 12 — — $3,193,000.00 $3,717,616.74 $3,348,000.00 2026-07-15
J3387 HCPCS Inj Elivaldogene Autotemecel 16 10 — — $3,180,000.00 $3,634,740.00 $3,307,200.00 2026-07-15
J3393 HCPCS Inj Betibeglogene Autotemce 24 12 — — $2,939,968.89 $3,360,384.44 $3,024,000.00 2026-07-15
J3399 HCPCS Inj Onase Abepar-xioi Treat 24 12 — — $2,403,458.75 $2,959,205.55 $2,588,981.23 2026-07-15
J3392 HCPCS Inj Exagamglogene Autotem 17 11 — — $2,332,000.00 $2,665,476.00 $2,425,280.00 2026-07-15
Q2057 HCPCS Afamitresgene Autoleucel 16 10 — — $770,620.00 $880,818.66 $801,444.80 2026-07-15
Q2056 HCPCS Ciltacabtagene Car-pos T 24 12 — — $551,318.34 $671,683.46 $614,776.73 2026-07-15
Q2042 HCPCS Tisagenlecleucel Car-pos T 24 12 — — $565,623.84 $647,545.28 $592,875.01 2026-07-15
Q2054 HCPCS Lisocabtagene Mara Car Pos T 24 12 — — $516,485.97 $642,596.02 $588,343.59 2026-07-15
Q2055 HCPCS Idecabtagene Vicleucel Car 24 12 — — $528,312.43 $637,887.42 $584,032.53 2026-07-15
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 24 12 — — $489,517.15 $608,295.73 $556,939.18 2026-07-15
Q2053 HCPCS Brexucabtagene Car Pos T 24 12 — — $488,051.51 $559,441.58 $512,209.64 2026-07-15
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 16 10 — — $278,250.00 $318,039.75 $289,380.00 2026-07-15
J3403 HCPCS Revakinagene Per Implant 16 10 — — $265,000.00 $302,895.00 $275,600.00 2026-07-15
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 16 10 — — $201,669.02 $230,507.69 $209,735.78 2026-07-15
Q0480 HCPCS Driver Pneumatic Vad Rep 24 12 — — $99,999.93 $303,449.79 $117,565.87 2026-07-15
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 17 11 — — $67,452.66 $78,640.35 $71,553.78 2026-07-15
J9029 HCPCS Instill Adstiladrin Tx Dose 24 12 — — $63,402.04 $74,113.13 $67,263.57 2026-07-15
J7330 HCPCS Cultured Chondrocytes Implnt 7 2 — — $65,518.20 $65,518.20 $65,518.20 2026-07-15
L8614 HCPCS Cochlear Device 7 2 — — $56,406.93 $67,303.72 $64,098.78 2026-07-15
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 40 12 — — $53,981.46 $64,357.43 $54,404.11 2026-07-15
L7181 HCPCS Electronic Elbo Simultaneous 24 12 — — $48,901.12 $141,240.29 $52,198.52 2026-07-15
L7180 HCPCS Electronic Elbow Sequential 24 12 — — $42,853.91 $123,774.25 $45,743.55 2026-07-15
J9226 HCPCS Supprelin La Implant 40 12 — — $43,185.34 $53,051.20 $43,324.60 2026-07-15
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 24 12 — — $39,482.40 $114,036.33 $42,144.70 2026-07-15
L8701 HCPCS Ewh S/d Uprt Micro Sensor 17 11 — — $34,284.44 $39,970.86 $36,368.94 2026-07-15
L5856 HCPCS Elec Knee-shin Swing/stance 24 12 — — $29,277.32 $84,561.19 $31,251.49 2026-07-15
L6880 HCPCS Elec Hand Ind Art Digits 24 12 — — $29,217.93 $84,389.66 $31,188.10 2026-07-15
L6700 HCPCS Ue Add Ext Power Myoel 16 10 — — $29,510.19 $33,730.15 $30,690.60 2026-07-15
J9266 HCPCS Pegaspargase Injection 40 12 — — $23,577.00 $32,488.70 $28,424.06 2026-07-15
L8679 HCPCS Imp Neurosti Pls Gn Any Type 7 2 — — $24,968.10 $29,791.48 $28,372.84 2026-07-15
J9600 HCPCS Porfimer Sodium Injection 24 12 — — $24,228.42 $27,693.08 $25,188.84 2026-07-15
Q0483 HCPCS Monitor Elec Vad Rep 24 12 — — $22,928.60 $66,224.29 $24,474.67 2026-07-15
L5858 HCPCS Stance Phase Only 24 12 — — $22,682.29 $65,512.88 $24,211.76 2026-07-15
L6975 HCPCS Interscap-thor Myoelectronic 24 12 — — $22,653.52 $65,429.79 $24,181.04 2026-07-15
L5973 HCPCS Ank-foot Sys Dors-plant Flex 24 12 — — $21,285.87 $61,479.61 $22,721.18 2026-07-15
L6970 HCPCS Interscapular-thor Switch CT 24 12 — — $21,143.84 $61,069.41 $22,569.58 2026-07-15
L6965 HCPCS Shldr Disartic Myoelectronic 24 12 — — $20,885.99 $60,324.64 $22,294.33 2026-07-15
L8609 HCPCS Artificial Cornea 7 2 — — $19,286.94 $23,012.83 $21,916.98 2026-07-15
K1014 HCPCS Ak 4 Bar Link Hydl Swg/stanc 7 2 — — $18,839.23 $22,478.63 $21,408.22 2026-07-15
Q0489 HCPCS Pwr Pck Base Combo Vad Rep 24 12 — — $19,877.86 $57,412.89 $21,218.22 2026-07-15
L6960 HCPCS Shldr Disartic Switch Contro 24 12 — — $19,277.39 $55,678.58 $20,577.27 2026-07-15
L6955 HCPCS Above Elbow Myoelectronic CT 24 12 — — $19,113.49 $55,205.17 $20,402.32 2026-07-15
L8682 HCPCS Implt Neurostim Radiofq Rec 7 2 — — $17,839.32 $21,285.56 $20,271.96 2026-07-15
Q0481 HCPCS Microprcsr Cu Elec Vad Rep 24 12 — — $17,769.70 $51,323.93 $18,967.90 2026-07-15
L5859 HCPCS Knee-shin Pro Flex/ext Cont 24 12 — — $17,707.86 $51,145.31 $18,901.90 2026-07-15
L6945 HCPCS Elbow Disart Myoelectronic C 24 12 — — $16,334.84 $47,179.65 $17,436.29 2026-07-15
L6950 HCPCS Above Elbow Switch Control 24 12 — — $15,959.35 $46,095.12 $17,035.49 2026-07-15
L8690 HCPCS Aud Osseo Dev Int/ext Comp 7 2 — — $14,082.21 $16,802.64 $16,002.51 2026-07-15
Q0479 HCPCS Power Module Combo Vad Rep 24 12 — — $14,650.25 $42,314.07 $15,638.12 2026-07-15
L7191 HCPCS Elbow Child Myoelectronic CT 24 12 — — $14,225.90 $41,088.43 $15,185.16 2026-07-15
L6940 HCPCS Elbow Disarticulation Switch 24 12 — — $14,040.80 $40,553.81 $14,987.58 2026-07-15
L7186 HCPCS Electron Elbow Child Switch 24 12 — — $13,884.71 $40,102.99 $14,820.95 2026-07-15
S2411 HCPCS Fetoscop Laser Ther Ttts 1 1 — — $12,954.18 $12,954.18 $12,954.18 2026-07-15
S2402 HCPCS Fetal Surg Cong Cyst Malf 1 1 — — $12,954.18 $12,954.18 $12,954.18 2026-07-15
S2400 HCPCS Fetal Surg Congen Hernia 1 1 — — $12,954.18 $12,954.18 $12,954.18 2026-07-15
S2405 HCPCS Fetal Surg Sacrococ Teratoma 1 1 — — $12,954.18 $12,954.18 $12,954.18 2026-07-15
S2118 HCPCS Total Hip Resurfacing 1 1 — — $12,954.18 $12,954.18 $12,954.18 2026-07-15
S2404 HCPCS Fetal Surg Myelomeningo 1 1 — — $12,954.18 $12,954.18 $12,954.18 2026-07-15
S2325 HCPCS Hip Core Decompression 1 1 — — $12,954.18 $12,954.18 $12,954.18 2026-07-15
S2403 HCPCS Fetal Surg Pulmon Sequest 1 1 — — $12,954.18 $12,954.18 $12,954.18 2026-07-15
S2235 HCPCS Implant Auditory Brain Imp 1 1 — — $12,954.18 $12,954.18 $12,954.18 2026-07-15
S2401 HCPCS Fetal Surg Urin Trac Obstr 1 1 — — $12,954.18 $12,954.18 $12,954.18 2026-07-15
L5991 HCPCS Low Pros Ext Osseo Connector 24 12 — — $11,524.55 $33,286.16 $12,301.65 2026-07-15
81416 CPT Exome Sequence Analysis 16 10 — — $12,000.00 $12,000.00 $12,000.00 2026-07-15
L6935 HCPCS Below Elbow Myoelectronic CT 24 12 — — $10,983.70 $31,724.03 $11,724.33 2026-07-15
L6925 HCPCS Wrist Disart Myoelectronic C 24 12 — — $10,501.57 $30,331.53 $11,209.69 2026-07-15
L5857 HCPCS Elec Knee-shin Swing Only 24 12 — — $10,375.38 $29,967.05 $11,074.99 2026-07-15
L6930 HCPCS Below Elbow Switch Control 24 12 — — $10,230.50 $29,548.56 $10,920.35 2026-07-15
L8619 HCPCS Coch Imp Ext Proc/contr Rplc 24 12 — — $10,003.53 $28,893.02 $10,678.07 2026-07-15
L6920 HCPCS Wrist Disarticul Switch Ctrl 24 12 — — $9,736.85 $28,122.78 $10,393.41 2026-07-15
L7190 HCPCS Elbow Adolescent Myoelectron 24 12 — — $9,692.58 $27,994.93 $10,346.15 2026-07-15
K0606 HCPCS Aed Garment W Elec Analysis 7 2 — — $8,517.15 $10,162.51 $9,678.58 2026-07-15
L5987 HCPCS Shank Ft W Vert Load Pylon 24 12 — — $8,779.60 $25,357.98 $9,371.60 2026-07-15
L8627 HCPCS Cid Ext Speech Process Repl 24 12 — — $8,474.28 $24,476.13 $9,045.70 2026-07-15
37231 CPT Tib/per Revasc Stent & Ather 32 10 — — $1,051.76 $16,771.50 $8,911.63 2026-07-15
J9216 HCPCS Interferon Gamma 1-b Inj 7 2 — — $8,793.47 $8,793.47 $8,793.47 2026-07-15
L5280 HCPCS Hemipelvect Canad Sing Axis 24 12 — — $8,105.34 $23,410.53 $8,651.89 2026-07-15
37227 CPT Fem/popl Revasc Stnt & Ather 32 10 — — $1,025.63 $15,980.03 $8,502.83 2026-07-15
0211U CPT Onc Pan-tum Dna&rna Gnrj Seq 16 10 — — $8,455.00 $8,455.00 $8,455.00 2026-07-15
L5250 HCPCS Hip Canad Sing Axi Cons Fric 24 12 — — $7,822.45 $22,593.46 $8,349.92 2026-07-15
L5615 HCPCS Ak 4 Bar Link Hydl Swg/stanc 17 11 — — $7,782.70 $9,073.53 $8,255.88 2026-07-15
L7185 HCPCS Electron Elbow Adolescent Sw 24 12 — — $7,660.93 $22,126.93 $8,177.51 2026-07-15
L7170 HCPCS Electronic Elbow Hosmer Swit 24 12 — — $7,384.16 $21,327.53 $7,882.07 2026-07-15
81552 CPT Onc Uveal Mlnma Mrna 15 Gene 16 10 — — $7,776.00 $7,776.00 $7,776.00 2026-07-15
L5341 HCPCS Hemipelvectomy Canadian Sach 24 12 — — $7,280.84 $21,029.15 $7,771.79 2026-07-15
L5827 HCPCS Endo Knee Shin Single Axis 16 10 — — $7,457.49 $8,523.91 $7,755.79 2026-07-15
Q0224 HCPCS Inj Pemivibart 4500 Mg 23 11 — — $7,701.45 $7,701.45 $7,701.45 2026-07-15
L5270 HCPCS Tilt Table Locking Hip Sing 24 12 — — $7,135.50 $20,609.36 $7,616.65 2026-07-15
0094U CPT Genome Rapid Sequence Alys 16 10 — — $7,582.20 $7,582.20 $7,582.20 2026-07-15
L7008 HCPCS Pediatric Electric Hand 24 12 — — $6,950.26 $20,074.31 $7,418.92 2026-07-15
L8631 HCPCS Mcp Joint Repl 2 Pc Or More 7 2 — — $6,413.44 $7,652.40 $7,288.00 2026-07-15
81529 CPT Onc Cutan Mlnma Mrna 31 Gene 16 10 — — $7,193.00 $7,193.00 $7,193.00 2026-07-15
L5331 HCPCS Hip Disart Canadian Sach Ft 24 12 — — $6,724.11 $19,421.14 $7,177.52 2026-07-15
L8683 HCPCS Radiofq Trsmtr For Implt Neu 24 12 — — $6,486.97 $18,736.22 $6,924.39 2026-07-15
37230 CPT Tib/per Revasc W/stent 32 10 — — $989.93 $12,703.59 $6,846.76 2026-07-15
37229 CPT Tib/per Revasc W/ather 32 10 — — $992.75 $12,686.64 $6,839.69 2026-07-15
L6570 HCPCS Scap Thorac Prosth Tiss Shap 24 12 — — $6,314.52 $18,238.10 $6,740.31 2026-07-15
0267U CPT Rare Do Id Opt Gen Mapg&seq 16 10 — — $6,739.33 $6,739.33 $6,739.33 2026-07-15
L5702 HCPCS Replace Socket Hip 24 12 — — $6,265.41 $18,096.27 $6,687.89 2026-07-15
37225 CPT Fem/popl Revas W/ather 32 10 — — $854.57 $12,478.34 $6,666.45 2026-07-15
L5961 HCPCS Endo Poly Hip Pneu/hyd/rot 24 12 — — $6,154.17 $17,774.98 $6,569.14 2026-07-15
L5230 HCPCS Fem Focal Defic Constant Fri 24 12 — — $6,087.90 $17,583.59 $6,498.40 2026-07-15
L8659 HCPCS Interphalangeal Joint Repl 7 2 — — $5,712.26 $6,815.76 $6,491.20 2026-07-15
L6550 HCPCS Shldr Disar Prosth Tiss Shap 24 12 — — $6,068.83 $17,528.49 $6,478.06 2026-07-15
L5980 HCPCS Flex Foot System 24 12 — — $5,933.53 $17,137.70 $6,333.62 2026-07-15
37226 CPT Fem/popl Revasc W/stent 32 10 — — $741.72 $11,610.98 $6,176.35 2026-07-15
L6026 HCPCS Part Hand Myo Exclu Term Dev 24 12 — — $5,716.86 $16,511.90 $6,102.35 2026-07-15
K0864 HCPCS Pwc Gp3 Xhd Mult Pow Opt S/b 7 2 — — $5,231.54 $6,242.18 $5,944.93 2026-07-15
Q0482 HCPCS Microprcsr Cu Combo Vad Rep 24 12 — — $5,565.80 $16,075.59 $5,941.11 2026-07-15
L6350 HCPCS Thoracic Intern Lock Elbow 24 12 — — $5,489.98 $15,856.63 $5,860.17 2026-07-15
J0600 HCPCS Edetate Calcium Disodium Inj 16 10 — — $5,708.59 $5,708.59 $5,708.59 2026-07-15
L5600 HCPCS Hip Disart Sach Laminat Mold 24 12 — — $5,336.83 $15,414.29 $5,696.69 2026-07-15
81554 CPT Pulm Ds Ipf Mrna 190 Gen Alg 16 10 — — $5,520.00 $5,520.00 $5,520.00 2026-07-15
L5782 HCPCS Hd Low Limb Pros Vacuum Pump 24 12 — — $5,148.04 $14,868.99 $5,495.17 2026-07-15
L5160 HCPCS Mold Socket Bent Knee Shin S 24 12 — — $5,141.23 $14,849.33 $5,487.90 2026-07-15
0265U CPT Rar Do Whl Gn&mtcdrl DNA Als 16 10 — — $5,475.80 $5,475.80 $5,475.80 2026-07-15
0212U CPT Rare Ds Gen DNA Alys Proband 16 10 — — $5,475.20 $5,475.20 $5,475.20 2026-07-15
Q0495 HCPCS Charger Elec/combo Vad Rep 24 12 — — $5,108.11 $14,753.68 $5,452.55 2026-07-15
L2005 HCPCS Kafo Sng/dbl Mechanical Act 24 12 — — $5,001.34 $14,445.28 $5,338.58 2026-07-15
L6881 HCPCS Term Dev Auto Grasp Feature 24 12 — — $4,989.46 $14,410.97 $5,325.90 2026-07-15
L6450 HCPCS Elb Disart Prosth Tiss Shap 24 12 — — $4,933.93 $14,250.59 $5,266.62 2026-07-15
J9225 HCPCS Vantas Implant 7 2 — — $5,263.77 $5,263.77 $5,263.77 2026-07-15
0214U CPT Rare Ds Xom DNA Alys Proband 16 10 — — $5,224.60 $5,224.60 $5,224.60 2026-07-15
0335U CPT Rare Ds Whl Gen Seq Feta 16 10 — — $5,224.60 $5,224.60 $5,224.60 2026-07-15
L5781 HCPCS Lower Limb Pros Vacuum Pump 24 12 — — $4,883.25 $14,104.21 $5,212.53 2026-07-15
L6500 HCPCS Above Elbow Prosth Tiss Shap 24 12 — — $4,851.92 $14,013.72 $5,179.09 2026-07-15
L5595 HCPCS Hip Disartic Sach Thermopls 24 12 — — $4,832.77 $13,958.40 $5,158.65 2026-07-15
L6300 HCPCS Shlder Disart Int Lock Elbow 24 12 — — $4,778.05 $13,800.36 $5,100.24 2026-07-15
L8044 HCPCS Hemi-facial Prosthesis 24 12 — — $4,734.26 $13,673.88 $5,053.49 2026-07-15
81425 CPT Genome Sequence Analysis 16 10 — — $5,031.20 $5,031.20 $5,031.20 2026-07-15
0242U CPT Trgt Gen Seq Alys Pnl 55-74 16 10 — — $5,000.00 $5,000.00 $5,000.00 2026-07-15
L5840 HCPCS Multi-axial Knee/shin System 24 12 — — $4,684.02 $13,528.77 $4,999.86 2026-07-15
K0860 HCPCS Pwc Gp3 Vhd Sing Pow Opt S/b 7 2 — — $4,396.25 $5,245.53 $4,995.74 2026-07-15
K0863 HCPCS Pwc Gp3 Vhd Mult Pow Opt S/b 7 2 — — $4,396.25 $5,245.53 $4,995.74 2026-07-15
L5150 HCPCS Mold Sckt Ext Knee Shin Sach 24 12 — — $4,668.49 $13,483.92 $4,983.28 2026-07-15
0108U CPT Gi Barrett Esoph 9 Prtn Bmrk 16 10 — — $4,950.00 $4,950.00 $4,950.00 2026-07-15
0261U CPT Onc Clrct Ca Img Alys W/ai 16 10 — — $4,950.00 $4,950.00 $4,950.00 2026-07-15
L7259 HCPCS Electronic Wrist Rotator Any 24 12 — — $4,628.37 $13,368.03 $4,940.47 2026-07-15
36837 CPT Prq Av Fstl Crt Uxtr Sep Acs 32 10 — — $444.91 $9,405.97 $4,925.44 2026-07-15
L6624 HCPCS Flex/ext/rotation Wrist Unit 24 12 — — $4,596.36 $13,275.57 $4,906.30 2026-07-15
L5105 HCPCS Plast Socket Jts/thgh Lacer 24 12 — — $4,574.04 $13,211.15 $4,882.47 2026-07-15
L5701 HCPCS Replace Socket Above Knee 24 12 — — $4,545.81 $13,129.59 $4,852.34 2026-07-15
L5814 HCPCS Endo Knee-shin Hydral Swg Ph 24 12 — — $4,532.61 $13,091.47 $4,838.24 2026-07-15
K0854 HCPCS Pwc Gp 3 Xhd Seat/back 7 2 — — $4,214.51 $5,028.68 $4,789.22 2026-07-15
L6205 HCPCS Elbow Molded With Expand Inter 24 12 — — $4,482.45 $12,946.57 $4,784.70 2026-07-15
0036U CPT Xome Tum & Nml Spec Seq Alys 16 10 — — $4,780.00 $4,780.00 $4,780.00 2026-07-15
81415 CPT Exome Sequence Analysis 16 10 — — $4,780.00 $4,780.00 $4,780.00 2026-07-15
L8035 HCPCS Custom Breast Prosthesis 24 12 — — $4,471.26 $12,914.25 $4,772.76 2026-07-15
Q0484 HCPCS Monitor Elec Or Comb Vad Rep 24 12 — — $4,452.60 $12,860.36 $4,752.83 2026-07-15
L5968 HCPCS Multiaxial Ankle W Dorsiflex 24 12 — — $4,435.02 $12,809.59 $4,734.07 2026-07-15
L5312 HCPCS Knee Disart Sach Ft Endo 24 12 — — $4,377.37 $12,643.09 $4,672.54 2026-07-15
J7504 HCPCS Lymphocyte Immune Globulin 40 12 — — $3,002.82 $6,066.96 $4,642.33 2026-07-15
L7009 HCPCS Adult Electric Hook 24 12 — — $4,324.66 $12,490.85 $4,616.27 2026-07-15
J1162 HCPCS Digoxin Immune Fab (ovine) 16 10 — — $4,597.02 $4,597.02 $4,597.02 2026-07-15
L3904 HCPCS Whfo Electric Custom Fitted 24 12 — — $4,304.52 $12,432.68 $4,594.77 2026-07-15
L8043 HCPCS Upper Facial Prosthesis 24 12 — — $4,276.13 $12,350.69 $4,564.47 2026-07-15
K0855 HCPCS Pwc Gp 3 Xhd Cap Chair 7 2 — — $3,981.23 $4,750.33 $4,524.12 2026-07-15
L7007 HCPCS Adult Electric Hand 24 12 — — $4,130.11 $11,928.92 $4,408.61 2026-07-15
37243 CPT Vasc Embolize/occlude Organ 32 10 — — $538.76 $8,221.41 $4,380.09 2026-07-15
L5930 HCPCS High Activity Knee Frame 24 12 — — $4,095.11 $11,827.84 $4,371.24 2026-07-15
L5060 HCPCS Symes Met Fr Leath Socket Ar 24 12 — — $4,050.18 $11,698.06 $4,323.28 2026-07-15
J9200 HCPCS Floxuridine Injection 40 12 — — $2,890.16 $4,863.37 $4,254.92 2026-07-15
J0480 HCPCS Basiliximab 16 10 — — $4,238.68 $4,238.68 $4,238.68 2026-07-15
L6648 HCPCS Ext Pwrd Shlder Lock/unlock 24 12 — — $3,970.01 $11,466.49 $4,237.70 2026-07-15
L5200 HCPCS Kne Sing Axis Fric Shin Sach 24 12 — — $3,964.97 $11,451.96 $4,232.32 2026-07-15
L5321 HCPCS Ak Open End Sach 24 12 — — $3,944.84 $11,393.82 $4,210.84 2026-07-15
L1005 HCPCS Tension Based Scoliosis Orth 24 12 — — $3,898.62 $11,260.34 $4,161.50 2026-07-15
L5981 HCPCS Flex-walk Sys Low Ext Prosth 24 12 — — $3,877.43 $11,199.10 $4,138.89 2026-07-15
L6715 HCPCS Term Device Multi Art Digit 24 12 — — $3,860.85 $11,151.21 $4,121.19 2026-07-15
L6646 HCPCS Multipo Locking Shoulder Jnt 24 12 — — $3,849.31 $11,117.89 $4,108.88 2026-07-15
L6885 HCPCS Replc Sockt Shldr Dis/interc 24 12 — — $3,822.98 $11,041.87 $4,080.76 2026-07-15
L6360 HCPCS Thoracic Passive Restor Comp 24 12 — — $3,822.98 $11,041.87 $4,080.76 2026-07-15
L8042 HCPCS Orbital Prosthesis 24 12 — — $3,817.97 $11,027.40 $4,075.42 2026-07-15
L5828 HCPCS Endo Knee-shin Fluid Swg/sta 24 12 — — $3,811.44 $11,008.53 $4,068.45 2026-07-15
L5826 HCPCS Miniature Knee Joint 24 12 — — $3,811.38 $11,008.35 $4,068.39 2026-07-15
Q4303 HCPCS Complete Aa Per Sq Cm 8 2 — — $144.02 $4,048.58 $4,048.58 2026-07-15
L6882 HCPCS Microprocessor Control Uplmb 24 12 — — $3,784.81 $10,931.60 $4,040.03 2026-07-15
L6400 HCPCS Below Elbow Prosth Tiss Shap 24 12 — — $3,713.38 $10,725.32 $3,963.78 2026-07-15
L5613 HCPCS Ak 4 Bar Ling W/hydraul Swig 24 12 — — $3,687.53 $10,650.61 $3,936.18 2026-07-15
L5590 HCPCS Prep Ak Ischial Laminated 24 12 — — $3,684.89 $10,643.02 $3,933.36 2026-07-15
0340U CPT Onc Pan Ca Alys Mrd Plasma 16 10 — — $3,920.00 $3,920.00 $3,920.00 2026-07-15
L6200 HCPCS Elbow Mold Outsid Lock Hinge 24 12 — — $3,659.84 $10,570.65 $3,906.62 2026-07-15
20983 CPT Ablate Bone Tumor(s) Perq 32 10 — — $496.61 $7,301.42 $3,899.02 2026-07-15
L6310 HCPCS Shoulder Passive Restor Comp 24 12 — — $3,642.26 $10,519.89 $3,887.86 2026-07-15
81523 CPT Onc Brst Mrna 70 Cnt 31 Gene 16 10 — — $3,873.00 $3,873.00 $3,873.00 2026-07-15
81518 CPT Onc Brst Mrna 11 Genes 16 10 — — $3,873.00 $3,873.00 $3,873.00 2026-07-15
0288U CPT Onc Lung Mrna Quan Pcr 11&3 16 10 — — $3,873.00 $3,873.00 $3,873.00 2026-07-15
81521 CPT Onc Breast Mrna 70 Genes 16 10 — — $3,873.00 $3,873.00 $3,873.00 2026-07-15
81541 CPT Onc Prostate Mrna 46 Genes 16 10 — — $3,873.00 $3,873.00 $3,873.00 2026-07-15
81519 CPT Oncology Breast Mrna 16 10 — — $3,873.00 $3,873.00 $3,873.00 2026-07-15
0047U CPT Onc Prst8 Mrna 17 Gene Alg 16 10 — — $3,873.00 $3,873.00 $3,873.00 2026-07-15
0045U CPT Onc Brst Dux Carc Is 12 Gene 16 10 — — $3,873.00 $3,873.00 $3,873.00 2026-07-15
81542 CPT Onc Prostate Mrna 22 Cnt Gen 16 10 — — $3,873.00 $3,873.00 $3,873.00 2026-07-15
81522 CPT Onc Breast Mrna 12 Genes 16 10 — — $3,873.00 $3,873.00 $3,873.00 2026-07-15
J0800 HCPCS Corticotropin Injection 16 10 — — $3,870.32 $3,870.32 $3,870.32 2026-07-15
L5220 HCPCS No Knee Joint With Artic Ali 24 12 — — $3,617.25 $10,447.64 $3,861.16 2026-07-15
L0830 HCPCS Halo Cerv Into Milwaukee Typ 24 12 — — $3,532.74 $10,203.56 $3,770.96 2026-07-15
J2507 HCPCS Pegloticase Injection 40 12 — — $3,194.98 $4,307.75 $3,768.81 2026-07-15
J3316 HCPCS Inj. Triptorelin Xr 3.75 Mg 24 12 — — $3,512.09 $4,303.38 $3,764.99 2026-07-15
81540 CPT Oncology Tum Unknown Origin 16 10 — — $3,750.00 $3,750.00 $3,750.00 2026-07-15
Q4280 HCPCS Xcell Amnio Matrix Per Sq Cm 8 2 — — $144.02 $3,720.00 $3,720.00 2026-07-15
L5585 HCPCS Prep Ak Ischial Open End 24 12 — — $3,473.78 $10,033.24 $3,708.02 2026-07-15
L6693 HCPCS Lockingelbow Forearm Cntrbal 24 12 — — $3,464.86 $10,007.48 $3,698.50 2026-07-15
L5580 HCPCS Prep Ak Ischial Thermo Mold 24 12 — — $3,464.71 $10,007.09 $3,698.33 2026-07-15
0258U CPT Ai Psor Mrna 50-100 Gen Alg 16 10 — — $3,675.00 $3,675.00 $3,675.00 2026-07-15
0019U CPT Onc RNA Tiss Predict Alg 16 10 — — $3,675.00 $3,675.00 $3,675.00 2026-07-15
L5728 HCPCS Knee-shin Fluid Swg & Stance 24 12 — — $3,437.85 $9,929.49 $3,669.66 2026-07-15
L5700 HCPCS Replace Socket Below Knee 24 12 — — $3,405.83 $9,837.03 $3,635.49 2026-07-15
L6590 HCPCS Shdr Fair Lead Cable Direct 24 12 — — $3,402.51 $9,827.41 $3,631.94 2026-07-15
L8041 HCPCS Midfacial Prosthesis 24 12 — — $3,397.99 $9,814.36 $3,627.12 2026-07-15
L6055 HCPCS Wrst Mold Sock W/exp Interfa 24 12 — — $3,396.97 $9,811.39 $3,626.03 2026-07-15
L6130 HCPCS Elbow Stump Activated Lock H 24 12 — — $3,395.13 $9,806.11 $3,624.06 2026-07-15
L6588 HCPCS Shdr Fair Lead Cable Molded 24 12 — — $3,392.51 $9,798.53 $3,621.27 2026-07-15
K0853 HCPCS Pwc Gp 3 Vhd Cap Chair 7 2 — — $3,181.31 $3,795.89 $3,615.13 2026-07-15
37242 CPT Vasc Embolize/occlude Artery 32 10 — — $456.69 $6,768.37 $3,612.53 2026-07-15
L7040 HCPCS Prehensile Actuator 24 12 — — $3,383.69 $9,773.06 $3,611.86 2026-07-15
0313U CPT Onc Pncrs Dna&mrna Seq 74 16 10 — — $3,600.00 $3,600.00 $3,600.00 2026-07-15
0287U CPT Onc Thyr Dna&mrna 112 Genes 16 10 — — $3,600.00 $3,600.00 $3,600.00 2026-07-15
0026U CPT Onc Thyr Dna&mrna 112 Genes 16 10 — — $3,600.00 $3,600.00 $3,600.00 2026-07-15
81546 CPT Onc Thyr Mrna 10196 Gen Alg 16 10 — — $3,600.00 $3,600.00 $3,600.00 2026-07-15
J9015 HCPCS Aldesleukin Injection 24 12 — — $3,338.87 $5,995.58 $3,589.28 2026-07-15
L5979 HCPCS Multi-axial Ankle/ft Prosth 24 12 — — $3,315.12 $9,575.00 $3,538.65 2026-07-15
0080U CPT Onc Lng 5 Clin Rsk Factr Alg 16 10 — — $3,520.00 $3,520.00 $3,520.00 2026-07-15
K0852 HCPCS Pwc Gp 3 Vhd Seat/back 7 2 — — $3,096.88 $3,695.14 $3,519.18 2026-07-15
K0840 HCPCS Pwc Gp2 Xhd Sing Pow Opt S/b 7 2 — — $3,095.99 $3,694.08 $3,518.17 2026-07-15
0037U CPT Trgt Gen Seq DNA 324 Genes 16 10 — — $3,500.00 $3,500.00 $3,500.00 2026-07-15
0244U CPT Onc Solid Orgn DNA 257 Genes 16 10 — — $3,500.00 $3,500.00 $3,500.00 2026-07-15
0239U CPT Trgt Gen Seq Alys Pnl 311+ 16 10 — — $3,500.00 $3,500.00 $3,500.00 2026-07-15
K0858 HCPCS Pwc Gp3 Hd Sing Pow Opt S/b 7 2 — — $3,077.25 $3,671.71 $3,496.87 2026-07-15
K0862 HCPCS Pwc Gp3 Hd Mult Pow Opt S/b 7 2 — — $3,077.25 $3,671.71 $3,496.87 2026-07-15
Q4204 HCPCS Xwrap 1 Sq Cm 8 2 — — $144.02 $3,496.80 $3,496.80 2026-07-15
0016M CPT Onc Bladder Mrna 219 Gen Alg 16 10 — — $3,489.63 $3,489.63 $3,489.63 2026-07-15
L6250 HCPCS Elbow Inter Loc Elbow Forarm 24 12 — — $3,258.55 $9,411.62 $3,478.27 2026-07-15
36836 CPT Prq Av Fstl Crtj Uxtr 1 Acs 32 10 — — $341.14 $6,610.78 $3,475.96 2026-07-15
37244 CPT Vasc Embolize/occlude Bleed 32 10 — — $636.17 $6,284.17 $3,460.17 2026-07-15
L5610 HCPCS Above Knee Hydracadence 24 12 — — $3,218.05 $9,294.64 $3,435.04 2026-07-15
L5841 HCPCS Addition Endoskletl Knee-shi 17 11 — — $3,175.53 $3,702.21 $3,368.59 2026-07-15
L6120 HCPCS Elbow Mold Doub Splt Soc Ste 24 12 — — $3,146.87 $9,089.05 $3,359.07 2026-07-15
L5210 HCPCS No Knee/ankle Joints With Ft B 24 12 — — $3,139.28 $9,067.12 $3,350.97 2026-07-15
37228 CPT Tib/per Revasc W/tla 32 10 — — $774.08 $5,923.94 $3,349.01 2026-07-15
K0859 HCPCS Pwc Gp3 Hd Sing Pow Opt Cap 7 2 — — $2,934.75 $3,501.69 $3,334.94 2026-07-15
81440 CPT Mitochondrial Gene 16 10 — — $3,324.00 $3,324.00 $3,324.00 2026-07-15
L5570 HCPCS Prep Ak Ischial Direct Form 24 12 — — $3,084.54 $8,909.05 $3,292.53 2026-07-15
L7406 HCPCS Add Upp Ext Mec Limb Vol Lam 16 10 — — $3,150.07 $3,600.53 $3,276.07 2026-07-15
L5783 HCPCS Add Low Ext Mec Limb Vol Lam 17 11 — — $3,088.30 $3,600.53 $3,276.07 2026-07-15
L8046 HCPCS Partial Facial Prosthesis 24 12 — — $3,054.36 $8,821.84 $3,260.31 2026-07-15
L6638 HCPCS Elec Lock On Manual Pw Elbow 24 12 — — $3,052.03 $8,815.13 $3,257.82 2026-07-15
L0810 HCPCS Halo Cervical Into Jckt Vest 24 12 — — $3,035.91 $8,768.58 $3,240.62 2026-07-15
0055U CPT Card Hrt Trnspl 96 DNA Seq 16 10 — — $3,240.00 $3,240.00 $3,240.00 2026-07-15
81595 CPT Cardiology Hrt Trnspl Mrna 16 10 — — $3,240.00 $3,240.00 $3,240.00 2026-07-15
47135 CPT Transplantation Of Liver 48 10 — — $834.28 $4,223.54 $3,232.84 2026-07-15
0266U CPT Unxpl Cnst Hrtbl Do Gn Xprsn 16 10 — — $3,200.00 $3,200.00 $3,200.00 2026-07-15
0262U CPT Onc Sld Tum Rt-pcr 7 Gen 16 10 — — $3,200.00 $3,200.00 $3,200.00 2026-07-15
L5050 HCPCS Ank Symes Mold Sckt Sach Ft 24 12 — — $2,988.14 $8,630.60 $3,189.63 2026-07-15
J3398 HCPCS Inj Luxturna 1 Billion Vec G 24 12 — — $3,026.80 $3,459.63 $3,175.68 2026-07-15
L8045 HCPCS Auricular Prosthesis 24 12 — — $2,964.34 $8,561.85 $3,164.23 2026-07-15
0253U CPT Rprdtve Med RNA Gen Prfl 238 16 10 — — $3,159.42 $3,159.42 $3,159.42 2026-07-15
0088U CPT Trnsplj Kdn Algrft Rej 1494 16 10 — — $3,159.42 $3,159.42 $3,159.42 2026-07-15
0087U CPT Crd Hrt Trnspl Mrna 1283 Gen 16 10 — — $3,159.42 $3,159.42 $3,159.42 2026-07-15
0153U CPT Onc Breast Mrna 101 Genes 16 10 — — $3,159.42 $3,159.42 $3,159.42 2026-07-15
81525 CPT Oncology Colon Mrna 16 10 — — $3,116.00 $3,116.00 $3,116.00 2026-07-15
61697 CPT Brain Aneurysm Repr Complx 16 10 — — $3,109.44 $3,109.44 $3,109.44 2026-07-15
K0828 HCPCS Pwc Gp 2 Xtra Hd Seat/back 7 2 — — $2,728.06 $3,255.07 $3,100.07 2026-07-15
K0609 HCPCS Repl Electrode For Aed 7 2 — — $2,726.26 $3,252.92 $3,098.02 2026-07-15
37235 CPT Tib/per Revasc Stnt & Ather 32 10 — — $533.46 $5,648.01 $3,090.74 2026-07-15
J7352 HCPCS Afamelanotide Implant 1 Mg 24 12 — — $2,873.33 $3,364.33 $3,080.29 2026-07-15
L6721 HCPCS Hook/hand Hvy Dty Vol Open 24 12 — — $2,870.46 $8,290.67 $3,064.02 2026-07-15
K0850 HCPCS Pwc Gp 3 Hd Seat/back 7 2 — — $2,680.25 $3,198.03 $3,045.74 2026-07-15
L5560 HCPCS Prep Ak Ischial Plast Molded 24 12 — — $2,850.32 $8,232.54 $3,042.52 2026-07-15
J2993 HCPCS Reteplase Injection 24 12 — — $2,777.14 $3,319.93 $3,039.64 2026-07-15
0248U CPT Onc Sphrd Cell Cul 12 Rx Pnl 16 10 — — $3,033.86 $3,033.86 $3,033.86 2026-07-15
0172U CPT Onc Sld Tum Alys Brca1 Brca2 16 10 — — $3,030.00 $3,030.00 $3,030.00 2026-07-15
L8040 HCPCS Nasal Prosthesis 24 12 — — $2,819.01 $8,142.11 $3,009.10 2026-07-15
L5020 HCPCS Tibial Tubercle Hgt With Toe F 24 12 — — $2,812.59 $8,123.57 $3,002.24 2026-07-15
0018U CPT Onc Thyr 10 Microrna Seq Alg 16 10 — — $3,002.09 $3,002.09 $3,002.09 2026-07-15
L6621 HCPCS Flex/ext Wrist W/wo Friction 24 12 — — $2,791.55 $8,062.79 $2,979.78 2026-07-15
L5100 HCPCS Molded Socket Shin Sach Foot 24 12 — — $2,789.55 $8,057.00 $2,977.65 2026-07-15
69535 CPT Remove Part Of Temporal Bone 32 10 — — $2,054.12 $3,900.23 $2,977.18 2026-07-15
J9286 HCPCS Inj Glofitamab Gxbm 2.5 Mg 24 12 — — $2,770.91 $3,250.22 $2,975.82 2026-07-15
Q4246 HCPCS Coretext Or Protext Per Cc 23 11 — — $2,968.00 $9,006.40 $2,968.00 2026-07-15
37183 CPT Revision Tips 32 10 — — $360.13 $5,572.58 $2,966.36 2026-07-15
L5301 HCPCS Bk Mold Socket Sach Ft Endo 24 12 — — $2,778.50 $8,025.10 $2,965.86 2026-07-15
K0829 HCPCS Pwc Gp 2 Xtra Hd Cap Chair 7 2 — — $2,605.81 $3,109.21 $2,961.15 2026-07-15
K0851 HCPCS Pwc Gp 3 Hd Cap Chair 7 2 — — $2,577.10 $3,074.95 $2,928.52 2026-07-15
81456 CPT So/hl 51/>gsap RNA Alys 16 10 — — $2,919.60 $2,919.60 $2,919.60 2026-07-15
0334U CPT Onc Sld Orgn Tgsa DNA 84/+ 16 10 — — $2,919.60 $2,919.60 $2,919.60 2026-07-15
0298U CPT Onc Pan Tum Whl Trns Seq RNA 16 10 — — $2,919.60 $2,919.60 $2,919.60 2026-07-15
0250U CPT Onc Sld Org Neo DNA 505 Gene 16 10 — — $2,919.60 $2,919.60 $2,919.60 2026-07-15
0048U CPT Onc Sld Org Neo DNA 468 Gene 16 10 — — $2,919.60 $2,919.60 $2,919.60 2026-07-15
0204U CPT Onc Thyr Mrna Xprsn Alys 593 16 10 — — $2,919.60 $2,919.60 $2,919.60 2026-07-15
81455 CPT So/hl 51/>gsap Dna/dna&rna 16 10 — — $2,919.60 $2,919.60 $2,919.60 2026-07-15
33935 CPT Transplantation Heart/lung 48 10 — — $752.97 $3,953.11 $2,917.77 2026-07-15
0050U CPT Trgt Gen Seq DNA 194 Genes 16 10 — — $2,916.60 $2,916.60 $2,916.60 2026-07-15
19364 CPT Brst Rcnstj Free Flap 32 10 — — $1,872.37 $3,955.71 $2,914.04 2026-07-15
Q4299 HCPCS Amnicore Pro+ Per Sq Cm 8 2 — — $144.02 $2,914.00 $2,914.00 2026-07-15
L5703 HCPCS Symes Ankle Without (sach) Foot 24 12 — — $2,715.61 $7,843.46 $2,898.73 2026-07-15
33945 CPT Transplantation Of Heart 50 10 — — $744.12 $3,906.65 $2,883.48 2026-07-15
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