Hospital

RUTLAND REGIONAL MEDICAL CENTER

Rutland, VT · CCN 470005 · Rates published

Your selected procedure

You selected 70551 (CPT)

MRI Brain w/o Contrast - 70551

This hospital’s price: $403 across 22 payers · range $50-$4,073

Source: https://www.rrmc.org/app/files/public/47f0fe40-cd79-42f2-bd09-793a36563ae6/030183483_RutlandRegionalMedicalCenter_standardcharges.csv · observed 2026-09-20

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.

5,262 distinct procedures filed

22 distinct payers

158,057 rate rows

2026-09-20 last MRF observed

Data quality

153,677 of 158,057 rate rows are consumer-grade (97.2%)

4,380 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	4,245
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	108
exceeds 10× this hospital's gross charge — excluded from medians	27

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://www.rrmc.org/app/files/public/47f0fe40-cd79-42f2-bd09-793a36563ae6/030183483_RutlandRegionalMedicalCenter_standardcharges.csv
Found on page	https://www.rrmc.org/patient-visitors/billing-insurance/pricing-estimates/
Discovered via	Discovered by HANK
Last fetch	success · 2026-09-20
Content fingerprint	8c25b8b9a5018db2… · 33,644,184 bytes · first seen 2026-09-20

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
C2622 HCPCS	Prosthesis Penile Tactra 11mmx16cm-25cm	16	$40,678.20	$40,678.20	$40,678.20	nat. median $8,606 outlier · 4.7×
C1813 HCPCS	Pump Preconnect Ms Lgx 700cx 18cm	16	$37,486.80	$37,486.80	$37,486.80	nat. median $10,938 outlier · 3.4×
C1897 HCPCS	Neurostimulator Interstim X Implant System	16	$35,101.35	$35,101.35	$35,101.35	nat. median $1,214 outlier · 28.9×
C1721 HCPCS	Icd Protecta-xt Dr	16	$34,650.00	$34,650.00	$34,650.00	nat. median $19,958 1.7× median
33264 CPT	Removal Pulse Generator With Replacement Pulse Generator Only Multiple Lead Syst…	22	$32,939.02	$32,939.02	$32,939.02	nat. median $32,779 1.0× median
33249 CPT	Insert Sc/dc Lead & Pulse Gen	22	$32,939.02	$32,939.02	$32,939.02	nat. median $32,069 1.0× median
Q4100 HCPCS	Matrix Wound Bilayer 4x5	16	$27,223.78	$27,223.78	$27,223.78	nat. median $2,305 outlier · 11.8×
C1602 HCPCS	Graft Bone Substitute W/antibiotic 10ml Cerament G	16	$24,095.88	$24,095.88	$24,095.88	nat. median $5,886 outlier · 4.1×
33263 CPT	Removal Pulse Generator With Replacement Pulse Generator Only Dual Lead System (…	22	$23,060.49	$23,060.49	$23,060.49	nat. median $23,924 1.0× median
33262 CPT	Removal Pulse Generator With Replacement Pulse Generator Only Single Lead System…	22	$23,060.49	$23,060.49	$23,060.49	nat. median $23,514 1.0× median
33240 CPT	Insertion Of Pacing Cardioverter-defibrillator Pulse Generator Only; With Exist Si…	22	$23,060.49	$23,060.49	$23,060.49	nat. median $23,398 1.0× median
33230 CPT	Insertion Of Pacing Cardioverter-defibrillator Pulse Generator Only; With Exist…	22	$23,060.49	$23,060.49	$23,060.49	nat. median $23,060 1.0× median
C1781 HCPCS	Mesh Hern Xenmatrix 5.9"x7.9"	16	$1,332.25	$22,751.28	$22,751.28	nat. median $1,566 outlier · 14.5×
0360 RC		16	$22,675.50	$22,675.50	$22,675.50	nat. median $1,707 outlier · 13.3×
33229 CPT	Removal Pulse Generator With Replacement Pulse Generator Only Multiple Lead Syst…	22	$19,593.09	$19,593.09	$19,593.09	nat. median $19,415 1.0× median
37184 CPT	Ir Primary Art Thromb Init Ves - 37184	22	$18,448.15	$18,448.15	$18,448.15	nat. median $15,255 1.2× median
36906 CPT	Ir Thrombectomy Dialysis Circuit W Stent Pl - 36906	22	$18,448.15	$18,448.15	$18,448.15	nat. median $18,501 1.0× median
37242 CPT	Ir Vascular Embolize/Occlude Artery - 37242	22	$18,448.15	$18,448.15	$18,448.15	nat. median $17,587 1.0× median
C1815 HCPCS	Reservoir Ams-800 4.0cm Iz	16	$18,325.44	$18,325.44	$18,325.44	nat. median $8,336 outlier · 2.2×
C9737 HCPCS	System Reflux Management 1.5t 13 Bead	16	$17,820.00	$17,820.00	$17,820.00	nat. median $17,820 1.0× median
37186 CPT	Secondary Arter Thromb; Add-on	16	$17,762.40	$17,762.40	$17,762.40	nat. median $2,572 outlier · 6.9×
C1714 HCPCS	Cath, Atherectomy	16	$16,718.40	$16,718.40	$16,718.40	nat. median $3,972 outlier · 4.2×
36909 CPT	Ir Dialysis Circuit Embolization Occlusion 36909	16	$16,598.70	$16,598.70	$16,598.70	nat. median $2,572 outlier · 6.5×
Q4107 HCPCS	Graft Matrix Mesh Bilayered 2x2	16	$16,587.34	$16,587.34	$16,587.34	nat. median $1,029 outlier · 16.1×
Q4116 HCPCS	Alloderm 8cm X 16cm Thick	16	$16,478.64	$16,478.64	$16,478.64	nat. median $1,706 outlier · 9.7×
L8691 HCPCS	Processor Sound 4 Chestnut Brown	16	$15,082.20	$15,082.20	$15,082.20	nat. median $4,705 outlier · 3.2×
C1764 HCPCS	Monitor Insertable Cardiac Confirm Rx	16	$11,664.00	$14,952.60	$14,904.00	nat. median $7,993 1.9× median
C2621 HCPCS	Pacer Pm3210 Anthem Rf	16	$14,576.76	$14,576.76	$14,576.76	nat. median $11,743 1.2× median
C1785 HCPCS	Pacer Edora 8 Hr-t	16	$6,566.15	$13,850.10	$13,850.10	nat. median $7,020 2.0× median
37261 CPT	Ir Iliac Stent Pl Com Ea Addl Rt 37261	16	$13,570.20	$13,570.20	$13,570.20	nat. median $6,105 outlier · 2.2×
Q4162 HCPCS	Graft Matrix Viaflow Placentaltissue 2.0cc	16	$13,478.40	$13,478.40	$13,478.40	nat. median $3,684 outlier · 3.7×
L8690 HCPCS	Implant Ponto Bhx 4mm W/12mm Abutment	16	$11,340.00	$13,374.72	$13,374.72	nat. median $5,832 outlier · 2.3×
A9566 HCPCS	Neutrospec Up To 25 Mci	16	$12,689.10	$12,689.10	$12,689.10	nat. median $3,472 outlier · 3.7×
C1898 HCPCS	Lead MRI Ingevity	16	$2,100.10	$12,389.76	$12,389.76	nat. median $1,225 outlier · 10.1×
37260 CPT	Ir Iliac Stent Pl Complex Lt 37260	22	$12,273.13	$12,273.13	$12,273.13	nat. median $12,440 1.0× median
37267 CPT	Ir Fem Pop Stent Pl Init Rt 37267	22	$12,273.13	$14,707.84	$12,273.13	nat. median $12,632 1.0× median
C1777 HCPCS	Lead 64cm Reliance 4-site Sg Active Fix Single Coil	16	$11,664.00	$11,664.00	$11,664.00	nat. median $6,830 1.7× median
36903 CPT	Ir Fistula Stent Placement 36903	22	$11,650.93	$11,650.93	$11,650.93	nat. median $12,181 1.0× median
37244 CPT	Ir Vascular Embolization Or Occlusion Hemorrhage - 37244	22	$11,650.93	$11,650.93	$11,650.93	nat. median $12,413 0.9× median
37243 CPT	US Vascular Embolization Organ Tumor Infarct-37243	22	$11,650.93	$11,650.93	$11,650.93	nat. median $12,495 0.9× median
37241 CPT	Ir Vascular Embolize/Occlude Venous - 37241	22	$11,650.93	$11,650.93	$11,650.93	nat. median $12,310 0.9× median
36905 CPT	Ir Thrombectomy Dialysis Circuit W Angioplasty- 36905	22	$11,650.93	$11,650.93	$11,650.93	nat. median $12,268 0.9× median
37187 CPT	Ir Transl Thromb Veins Initial - 37187	22	$11,650.93	$11,650.93	$11,650.93	nat. median $11,374 1.0× median
C1876 HCPCS	Lifestent Solo Vascular System 6x20	16	$3,265.49	$11,647.80	$11,647.80	nat. median $2,732 outlier · 4.3×
Q4160 HCPCS	Matrix Antimicrobial Wound Nushield 6x6"	16	$11,502.00	$11,502.00	$11,502.00	nat. median $320 outlier · 36.0×
37237 CPT	Ir Transcath Intravas Stent Ea Add 37237	16	$11,354.40	$11,354.40	$11,354.40	nat. median $3,792 outlier · 3.0×
0270 RC		16	$4.50	$11,317.75	$11,317.75	nat. median $122 outlier · 92.9×
Q4196 HCPCS	Matrix Antimicrobial Wound Pura Plyam Am 4.91x4.91"	16	$7,776.00	$11,016.00	$11,016.00	nat. median $275 outlier · 40.1×
Q4168 HCPCS	Matrix Amnioband Particulate 160mg	16	$10,800.00	$10,800.00	$10,800.00	nat. median $564 outlier · 19.2×
47556 CPT	Bilary Endosc W Dilation Stent	22	$10,696.15	$10,696.15	$10,696.15	nat. median $9,676 1.1× median

Other procedures at this hospital

Browse this hospital's 5,262 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

C2622	HCPCS	Prosthesis Penile Tactra 11mmx16cm-25cm	16	16	$45,198.00	$40,678.20	$40,678.20	$40,678.20	$40,678.20	2026-09-20
C1813	HCPCS	Pump Preconnect Ms Lgx 700cx 18cm	16	16	$41,652.00	$37,486.80	$37,486.80	$37,486.80	$37,486.80	2026-09-20
C1897	HCPCS	Neurostimulator Interstim X Implant System	16	16	$39,001.50	$35,101.35	$35,101.35	$35,101.35	$35,101.35	2026-09-20
C1721	HCPCS	Icd Protecta-xt Dr	16	16	$38,500.00	$34,650.00	$34,650.00	$34,650.00	$34,650.00	2026-09-20
33264	CPT	Removal Pulse Generator With Replacement Pulse Generator Only Multiple Lead Syst…	22	22	$21,519.00	$19,367.10	$32,939.02	$32,939.02	$32,939.02	2026-09-20
33249	CPT	Insert Sc/dc Lead & Pulse Gen	22	22	$31,041.00	$27,936.90	$32,939.02	$32,939.02	$32,939.02	2026-09-20
Q4100	HCPCS	Matrix Wound Bilayer 4x5	16	16	$30,248.64	$27,223.78	$27,223.78	$27,223.78	$27,223.78	2026-09-20
C1602	HCPCS	Graft Bone Substitute W/antibiotic 10ml Cerament G	16	16	$26,773.20	$24,095.88	$24,095.88	$24,095.88	$24,095.88	2026-09-20
33240	CPT	Insertion Of Pacing Cardioverter-defibrillator Pulse Generator Only; With Exist Si…	22	22	$28,860.00	$25,974.00	$23,060.49	$23,060.49	$23,060.49	2026-09-20
33262	CPT	Removal Pulse Generator With Replacement Pulse Generator Only Single Lead System…	22	22	$26,909.00	$24,218.10	$23,060.49	$23,060.49	$23,060.49	2026-09-20
33263	CPT	Removal Pulse Generator With Replacement Pulse Generator Only Dual Lead System (…	22	22	$24,793.00	$22,313.70	$23,060.49	$23,060.49	$23,060.49	2026-09-20
33230	CPT	Insertion Of Pacing Cardioverter-defibrillator Pulse Generator Only; With Exist …	22	22	$24,916.00	$22,424.40	$23,060.49	$23,060.49	$23,060.49	2026-09-20
C1781	HCPCS	Mesh Hern Xenmatrix 5.9"x7.9"	30	16	$25,279.20	$22,751.28	$1,332.25	$22,751.28	$22,751.28	2026-09-20
0360	RC	—	16	16	$25,195.00	$22,675.50	$22,675.50	$22,675.50	$22,675.50	2026-09-20
33229	CPT	Removal Pulse Generator With Replacement Pulse Generator Only Multiple Lead Syst…	22	22	$11,797.00	$10,617.30	$19,593.09	$19,593.09	$19,593.09	2026-09-20
37242	CPT	Ir Vascular Embolize/Occlude Artery - 37242	22	22	$21,563.00	$19,406.70	$18,448.15	$18,448.15	$18,448.15	2026-09-20
37184	CPT	Ir Primary Art Thromb Init Ves - 37184	22	22	$18,264.00	$16,437.60	$18,448.15	$18,448.15	$18,448.15	2026-09-20
36906	CPT	Ir Thrombectomy Dialysis Circuit W Stent Pl - 36906	22	22	$29,996.00	$26,996.40	$18,448.15	$18,448.15	$18,448.15	2026-09-20
C1815	HCPCS	Reservoir Ams-800 4.0cm Iz	16	16	$20,361.60	$18,325.44	$18,325.44	$18,325.44	$18,325.44	2026-09-20
C9737	HCPCS	System Reflux Management 1.5t 13 Bead	16	16	$19,800.00	$17,820.00	$17,820.00	$17,820.00	$17,820.00	2026-09-20
37186	CPT	Secondary Arter Thromb; Add-on	16	16	$19,736.00	$17,762.40	$17,762.40	$17,762.40	$17,762.40	2026-09-20
C1714	HCPCS	Cath, Atherectomy	16	16	$18,576.00	$16,718.40	$16,718.40	$16,718.40	$16,718.40	2026-09-20
36909	CPT	Ir Dialysis Circuit Embolization Occlusion 36909	16	16	$18,443.00	$16,598.70	$16,598.70	$16,598.70	$16,598.70	2026-09-20
Q4107	HCPCS	Graft Matrix Mesh Bilayered 2x2	16	16	$18,430.38	$16,587.34	$16,587.34	$16,587.34	$16,587.34	2026-09-20
Q4116	HCPCS	Alloderm 8cm X 16cm Thick	16	16	$18,309.60	$16,478.64	$16,478.64	$16,478.64	$16,478.64	2026-09-20
L8691	HCPCS	Processor Sound 4 Chestnut Brown	16	16	$16,758.00	$15,082.20	$15,082.20	$15,082.20	$15,082.20	2026-09-20
C1764	HCPCS	Monitor Insertable Cardiac Confirm Rx	26	16	$16,560.00	$14,904.00	$11,664.00	$14,952.60	$14,904.00	2026-09-20
C2621	HCPCS	Pacer Pm3210 Anthem Rf	16	16	$16,196.40	$14,576.76	$14,576.76	$14,576.76	$14,576.76	2026-09-20
C1785	HCPCS	Pacer Edora 8 Hr-t	26	16	$15,389.00	$13,850.10	$6,566.15	$13,850.10	$13,850.10	2026-09-20
37261	CPT	Ir Iliac Stent Pl Com Ea Addl Rt 37261	16	16	$15,078.00	$13,570.20	$13,570.20	$13,570.20	$13,570.20	2026-09-20
Q4162	HCPCS	Graft Matrix Viaflow Placentaltissue 2.0cc	16	16	$14,976.00	$13,478.40	$13,478.40	$13,478.40	$13,478.40	2026-09-20
L8690	HCPCS	Implant Ponto Bhx 4mm W/12mm Abutment	19	16	$14,860.80	$13,374.72	$11,340.00	$13,374.72	$13,374.72	2026-09-20
A9566	HCPCS	Neutrospec Up To 25 Mci	16	16	$14,099.00	$12,689.10	$12,689.10	$12,689.10	$12,689.10	2026-09-20
C1898	HCPCS	Lead MRI Ingevity	26	16	$13,766.40	$12,389.76	$2,100.10	$12,389.76	$12,389.76	2026-09-20
37260	CPT	Ir Iliac Stent Pl Complex Lt 37260	22	22	$23,135.00	$20,821.50	$12,273.13	$12,273.13	$12,273.13	2026-09-20
37267	CPT	Ir Fem Pop Stent Pl Init Rt 37267	22	22	$15,008.00	$13,507.20	$12,273.13	$14,707.84	$12,273.13	2026-09-20
C1777	HCPCS	Lead 64cm Reliance 4-site Sg Active Fix Single Coil	16	16	$12,960.00	$11,664.00	$11,664.00	$11,664.00	$11,664.00	2026-09-20
37244	CPT	Ir Vascular Embolization Or Occlusion Hemorrhage - 37244	22	22	$22,561.00	$20,304.90	$11,650.93	$11,650.93	$11,650.93	2026-09-20
37187	CPT	Ir Transl Thromb Veins Initial - 37187	22	22	$33,438.00	$30,094.20	$11,650.93	$11,650.93	$11,650.93	2026-09-20
37241	CPT	Ir Vascular Embolize/Occlude Venous - 37241	22	22	$20,738.00	$18,664.20	$11,650.93	$11,650.93	$11,650.93	2026-09-20
37243	CPT	US Vascular Embolization Organ Tumor Infarct-37243	22	22	$24,347.00	$21,912.30	$11,650.93	$11,650.93	$11,650.93	2026-09-20
36903	CPT	Ir Fistula Stent Placement 36903	22	22	$17,983.00	$16,184.70	$11,650.93	$11,650.93	$11,650.93	2026-09-20
36905	CPT	Ir Thrombectomy Dialysis Circuit W Angioplasty- 36905	22	22	$39,071.00	$35,163.90	$11,650.93	$11,650.93	$11,650.93	2026-09-20
C1876	HCPCS	Lifestent Solo Vascular System 6x20	23	16	$12,942.00	$11,647.80	$3,265.49	$11,647.80	$11,647.80	2026-09-20
Q4160	HCPCS	Matrix Antimicrobial Wound Nushield 6x6"	16	16	$12,780.00	$11,502.00	$11,502.00	$11,502.00	$11,502.00	2026-09-20
37237	CPT	Ir Transcath Intravas Stent Ea Add 37237	16	16	$12,616.00	$11,354.40	$11,354.40	$11,354.40	$11,354.40	2026-09-20
0270	RC	—	19	16	$12,575.27	$11,317.74	$4.50	$11,317.75	$11,317.75	2026-09-20
Q4196	HCPCS	Matrix Antimicrobial Wound Pura Plyam Am 4.91x4.91"	19	16	$12,240.00	$11,016.00	$7,776.00	$11,016.00	$11,016.00	2026-09-20
Q4168	HCPCS	Matrix Amnioband Particulate 160mg	16	16	$12,000.00	$10,800.00	$10,800.00	$10,800.00	$10,800.00	2026-09-20
47556	CPT	Bilary Endosc W Dilation Stent	22	22	$1,603.00	$1,442.70	$10,696.15	$10,696.15	$10,696.15	2026-09-20
C2617	HCPCS	Stent Esoph Wallflx 23mmx105mm	26	16	$11,250.00	$10,125.00	$495.02	$10,125.00	$10,125.00	2026-09-20
C1786	HCPCS	Pacer Accent Sr Rf	16	16	$11,132.00	$10,018.80	$10,018.80	$10,018.80	$10,018.80	2026-09-20
0481	RC	—	16	16	$10,609.00	$9,548.10	$9,548.10	$9,548.10	$9,548.10	2026-09-20
C1763	HCPCS	Connector Nerve Axoguard 3x15mm	16	16	$9,990.00	$8,991.00	$8,991.00	$8,991.00	$8,991.00	2026-09-20
V2790	HCPCS	Membrane Amniotic Barrier Actishield 4x4cm	16	16	$9,813.60	$8,832.24	$8,832.24	$8,832.24	$8,832.24	2026-09-20
C1771	HCPCS	System Urethral Align R Reto	19	16	$9,755.00	$8,779.50	$183.60	$8,779.50	$8,779.50	2026-09-20
C1783	HCPCS	Stent Istent Iol Lt	16	16	$9,750.00	$8,775.00	$8,775.00	$8,775.00	$8,775.00	2026-09-20
C9359	HCPCS	Putty Fiber Graft 6cc Lg Bioactive Bone Substitute	19	16	$9,733.50	$8,760.15	$650.35	$10,104.91	$8,760.15	2026-09-20
33227	CPT	Removal Pulse Generator With Replacement Pulse Generator Only Single Lead System…	22	22	$11,640.00	$10,476.00	$8,502.47	$8,502.47	$8,502.47	2026-09-20
A4649	HCPCS	Kit Aspira Peritoneal Drainage Essential	16	16	$9,360.00	$8,424.00	$8,424.00	$8,424.00	$8,424.00	2026-09-20
Q4124	HCPCS	Bandage Oasis Ultra Tri Layer Matrix 7x20cm	16	16	$9,128.00	$8,215.20	$8,215.20	$8,215.20	$8,215.20	2026-09-20
A9600	HCPCS	Strontium 89 Per Mci	16	16	$8,820.00	$7,938.00	$7,938.00	$7,938.00	$7,938.00	2026-09-20
77372	CPT	Radiation Delivery Stereotactic Cranial Linear-77372	22	22	$26,542.00	$23,887.80	$7,853.70	$7,853.70	$7,853.70	2026-09-20
CAPEAR	OTHER	Court Appearance	4	4	$8,000.00	$7,200.00	$7,840.00	$7,840.00	$7,840.00	2026-09-20
Q4186	HCPCS	Graft Epifix 2x4cm	16	16	$8,590.40	$7,731.36	$7,731.36	$7,731.36	$7,731.36	2026-09-20
A4264	HCPCS	System Essure Perm Birth Contr	16	16	$8,550.00	$7,695.00	$7,695.00	$7,695.00	$7,695.00	2026-09-20
C1762	HCPCS	Allograft Glenojet 10x29mm	30	16	$14,220.00	$12,798.00	$3,052.18	$12,798.00	$7,650.00	2026-09-20
0272	RC	—	16	16	$8,423.00	$7,580.70	$7,580.70	$7,580.70	$7,580.70	2026-09-20
C1789	HCPCS	Expander Contour Tissue 350 Cc	16	16	$8,407.50	$7,566.75	$7,566.75	$7,566.75	$7,566.75	2026-09-20
36907	CPT	Ir Pta Renal Dialysis Circ Angio 36907	16	16	$8,348.00	$7,513.20	$7,513.20	$7,513.20	$7,513.20	2026-09-20
A9562	HCPCS	Mag 3 Per Dose, Up To 15 Mci	16	16	$8,327.00	$7,494.30	$7,494.30	$7,494.30	$7,494.30	2026-09-20
C1882	HCPCS	Pacer Allure Crt-p MRI W/rf Telemetry	32	16	$8,153.84	$7,338.45	$1.14	$14,675.76	$7,338.45	2026-09-20
37247	CPT	Ir Translum Angio Artery Ea Add 37247	16	16	$8,089.00	$7,280.10	$7,280.10	$7,280.10	$7,280.10	2026-09-20
A9584	HCPCS	Datscan A9584	16	16	$7,951.00	$7,155.90	$277.60	$7,173.56	$7,155.90	2026-09-20
J9225	HCPCS	Histrelin (Vantas) 50mg Implant Amb Charge	16	16	$7,846.23	$7,061.61	$7,061.60	$7,061.60	$7,061.60	2026-09-20
50705	CPT	Ir Guided Ureteral Emboliz Occlude 50705	16	16	$7,808.00	$7,027.20	$7,027.20	$7,027.20	$7,027.20	2026-09-20
V5258	HCPCS	Hearing Aid Cic Binaural Premium	3	3	$7,800.00	$7,020.00	$7,020.00	$7,020.00	$7,020.00	2026-09-20
V5259	HCPCS	Hearing Aid Itc/hs Binaural Premium	3	3	$7,800.00	$7,020.00	$7,020.00	$7,020.00	$7,020.00	2026-09-20
V5261	HCPCS	Hearing Aid Bte Binaural Premium	3	3	$7,800.00	$7,020.00	$7,020.00	$7,020.00	$7,020.00	2026-09-20
V5260	HCPCS	Hearing Aid Ite Binaural Premium	3	3	$7,800.00	$7,020.00	$7,020.00	$7,020.00	$7,020.00	2026-09-20
C2628	HCPCS	Shunt Cartoid Outlying 9f 31cm Pruitt-inahara	16	16	$7,664.10	$6,897.69	$6,897.69	$6,897.69	$6,897.69	2026-09-20
C1880	HCPCS	Vena Cava Filter	16	16	$7,622.00	$6,859.80	$6,859.80	$6,859.80	$6,859.80	2026-09-20
Q4101	HCPCS	Graft Apligraf Commercial 44cm	16	16	$7,522.50	$6,770.25	$6,770.25	$6,770.25	$6,770.25	2026-09-20
A9560	HCPCS	Ultra Tag Kit/dose Upto 30 Mci	16	16	$7,517.00	$6,765.30	$6,765.30	$6,765.30	$6,765.30	2026-09-20
C1900	HCPCS	Lead Attainibility Bi-p L-vent	16	16	$7,500.00	$6,750.00	$6,750.00	$6,750.00	$6,750.00	2026-09-20
C1751	HCPCS	Catheter Infusion 134cmx50mm 2mm Clearway Rx	19	16	$7,375.00	$6,637.50	$1,316.25	$6,637.50	$6,637.50	2026-09-20
37249	CPT	Ir Translum Angio Vein Ea Add 37249	16	16	$7,315.00	$6,583.50	$6,583.50	$6,583.50	$6,583.50	2026-09-20
33214	CPT	Upgrade Of Implanted Pacemaker System, Conversion Of Single Chamber System To Du…	38	19	$2,315.00	$2,083.50	$435.06	$10,751.74	$6,518.06	2026-09-20
33206	CPT	Insertion Or Replacement Of Permanent Pacemaker With Transvenous Electrode(S); A…	38	19	$2,189.00	$1,970.10	$413.54	$10,751.74	$6,448.48	2026-09-20
33208	CPT	Insertion Or Replacement Of Permanent Pacemaker With Transvenous Electrode(S); A…	38	19	$2,614.00	$2,352.60	$467.99	$10,751.74	$6,416.82	2026-09-20
L8659	HCPCS	Implant Pip Proximal Interphalangeal Sz10	16	16	$7,050.62	$6,345.56	$6,345.56	$6,345.56	$6,345.56	2026-09-20
A9616	HCPCS	Pet/ct Supply Gozellix A9616	16	16	$7,028.00	$6,325.20	$6,325.20	$6,325.20	$6,325.20	2026-09-20
49605	CPT	Assist Rpr Lg Omphalocele W/wo Prosth	38	19	$16,572.50	$14,915.25	$4,443.01	$25,985.68	$6,186.86	2026-09-20
0722	RC	—	16	16	$6,800.00	$6,120.00	$6,120.00	$6,120.00	$6,120.00	2026-09-20
47999	CPT	Unlisted Procedure, Biliary Tract	4	4	$6,144.00	$5,529.60	$6,021.12	$6,021.12	$6,021.12	2026-09-20
75894	CPT	Ir Embolization Any Method - 75894	16	16	$6,688.00	$6,019.20	$6,019.20	$6,019.20	$6,019.20	2026-09-20
A9507	HCPCS	Prostascint Contrast Up To 10 Mci	16	16	$6,665.00	$5,998.50	$5,998.50	$5,998.50	$5,998.50	2026-09-20
50592	CPT	CT Renal Tumor Ablation Rf Bilat 50592- Add On	51	22	$11,390.00	$10,251.00	$2,637.37	$5,994.04	$5,994.04	2026-09-20
47382	CPT	US Liver Tumor Ablation Rf 47382	22	22	$10,618.00	$9,556.20	$5,994.04	$5,994.04	$5,994.04	2026-09-20
Q4128	HCPCS	Patch Allo Pilable Thin 4x8cm	16	16	$6,657.56	$5,991.80	$5,991.81	$5,991.81	$5,991.81	2026-09-20
C1768	HCPCS	Graft Vasc Thin Wall Gore-tex	16	16	$6,525.40	$5,872.86	$5,872.86	$5,872.86	$5,872.86	2026-09-20
37246	CPT	Ir Transluminal Angioplasty 37246	22	22	$16,685.00	$15,016.50	$5,857.56	$5,857.56	$5,857.56	2026-09-20
36904	CPT	Ir Thrombectomy Dialysis Circuit - 36904	22	22	$13,255.00	$11,929.50	$5,857.56	$5,857.56	$5,857.56	2026-09-20
0750	RC	—	16	16	$6,505.00	$5,854.50	$5,854.50	$5,854.50	$5,854.50	2026-09-20
36902	CPT	Ir Fistula Angioplasty - 36902	22	22	$18,905.00	$17,014.50	$3,245.49	$5,857.56	$5,802.21	2026-09-20
73225	CPT	MRA Upper Extremity Right - 73225	16	16	$6,353.00	$5,717.70	$5,717.70	$5,717.70	$5,717.70	2026-09-20
33228	CPT	Assist_REMOVAL Permanent Pacemaker Pulse Generator With Replacement Pulse Genera…	44	22	$6,494.00	$5,844.60	$322.85	$10,751.74	$5,674.24	2026-09-20
37200	CPT	Transcatheter Biopsy	22	22	$2,326.00	$2,093.40	$5,553.64	$5,553.64	$5,553.64	2026-09-20
37211	CPT	Ir Transcatheter Therapy, Arterial Infusion For Thrombolysis Initial Treatment D…	22	22	$3,845.00	$3,460.50	$5,553.64	$5,553.64	$5,553.64	2026-09-20
36557	CPT	Pci Tunneled<5 No Port No Pump	22	22	$3,829.00	$3,446.10	$5,553.64	$5,553.64	$5,553.64	2026-09-20
75736	CPT	Ir Angio Pelvic Selective - 75736	22	22	$5,801.00	$5,220.90	$5,553.64	$5,553.64	$5,553.64	2026-09-20
75726	CPT	Ir Angio Visceral Selective - 75726	22	22	$15,911.00	$14,319.90	$5,553.64	$5,553.64	$5,553.64	2026-09-20
75605	CPT	Ir Aortogram Thoracic With Serialography - 75605	22	22	$4,860.00	$4,374.00	$5,553.64	$5,553.64	$5,553.64	2026-09-20
36563	CPT	Pci Tunneled Pump	22	22	$1,795.00	$1,615.50	$5,553.64	$5,553.64	$5,553.64	2026-09-20
0759	RC	—	16	16	$5,914.00	$5,322.60	$5,322.60	$5,322.60	$5,322.60	2026-09-20
23406	CPT	Tenotomy Shoulder Multple Thru Incisions	38	19	$3,353.00	$3,017.70	$709.23	$7,339.24	$5,312.59	2026-09-20
C1729	HCPCS	Kit Aspira Pleural Drainage Essential	26	16	$9,360.00	$8,424.00	$583.48	$8,424.00	$5,310.00	2026-09-20
L8699	HCPCS	Metronidazole 500 Mg/100 Ml IV Sol 100ml	27	16	$1.53	$1.38	$1.38	$12,636.00	$5,298.02	2026-09-20
73725	CPT	MRA Lower Extremity Without Contrast Left - 73725	23	16	$5,724.00	$5,151.60	$5,151.60	$5,283.25	$5,151.60	2026-09-20
V5221	HCPCS	Hearing Aid, Contralateral Routing System, Binaural, Bte/bte, Premium	3	3	$5,700.00	$5,130.00	$5,130.00	$5,130.00	$5,130.00	2026-09-20
0200	RC	—	16	16	$5,664.00	$5,097.60	$5,097.60	$5,097.60	$5,097.60	2026-09-20
33285	CPT	Insertion Subq Cardiac Monitor W Prgrmg	52	20	$457.00	$411.30	$78.41	$8,502.47	$5,078.23	2026-09-20
A4642	HCPCS	Oncosint Per Dose, Up To 6 Mci	16	16	$5,479.00	$4,931.10	$4,931.10	$4,931.10	$4,931.10	2026-09-20
C9361	HCPCS	Graft Dural Matrix 1"x3" Lf Duragen Plus	16	16	$5,398.50	$4,858.65	$3,651.39	$4,858.65	$4,858.65	2026-09-20
21299	CPT	Unlisted Craniofacial And Maxillofacial Procedure 21299	4	4	$4,823.00	$4,340.70	$4,726.54	$4,726.54	$4,726.54	2026-09-20
L8606	HCPCS	Implant Macroplastique 2.5ml Uroplasty	16	16	$5,178.90	$4,661.01	$4,661.01	$4,661.01	$4,661.01	2026-09-20
J1162	HCPCS	Digoxin Immune Fab 40 Mg Inj	22	22	$5,850.83	$5,265.74	$4,593.57	$4,593.57	$4,593.57	2026-09-20
75970	CPT	Ir Biopsy Transcatheter - 75970	16	16	$4,977.00	$4,479.30	$4,479.30	$4,479.30	$4,479.30	2026-09-20
A9570	HCPCS	Indium In-111 Labeled Autologous White Blood Cells, Diagnostic, Per Study Dose	16	16	$4,944.00	$4,449.60	$4,449.60	$4,449.60	$4,449.60	2026-09-20
C1725	HCPCS	Balloon Pta Vascutrak	16	16	$4,849.50	$4,364.55	$4,364.55	$4,364.55	$4,364.55	2026-09-20
74185	CPT	MRA Abdomen Without Contrast - 74185	16	16	$4,705.00	$4,234.50	$4,234.50	$4,234.50	$4,234.50	2026-09-20
36253	CPT	Superselect Cath Place One Or More Second Order Or Higher Renal Art Braches, Rea…	38	19	$2,178.00	$1,960.20	$322.53	$5,553.64	$4,179.14	2026-09-20
J7298	HCPCS	Mirena Levonorgestrel Releasing IUD Amb Charge	16	16	$4,362.73	$3,926.46	$3,926.45	$4,362.73	$4,151.14	2026-09-20
69140	CPT	Remove Ear Canal Lesion(s)	38	19	$2,229.00	$2,006.10	$867.07	$6,077.56	$4,130.99	2026-09-20
C1884	HCPCS	System Occlusion Interlock-18 Embolization Coil 2-d 8mmx40cm	16	16	$4,580.61	$4,122.55	$4,122.55	$4,122.55	$4,122.55	2026-09-20
36482	CPT	Endovenous Ablation Therapy Of Incompentent Vein, Extremity, By Transcatheter De…	38	19	$1,066.00	$959.40	$160.33	$5,553.64	$4,084.49	2026-09-20
J7296	HCPCS	Levonorgestrel 19.5 Mg Device (Kyleena) Amb Charge	16	16	$4,362.73	$3,926.46	$3,926.45	$4,362.73	$4,026.80	2026-09-20
43659	CPT	Assist_Unlisted Laparoscopy Procedure,stomach	8	4	$4,065.50	$3,658.95	$1,593.48	$6,374.90	$3,984.19	2026-09-20
Q4114	HCPCS	Integra Flowable Wound Matrix, Injectable 1cc Integra Skin Graft Allograft	16	16	$4,265.00	$3,838.50	$3,838.50	$3,838.50	$3,838.50	2026-09-20
47361	CPT	Assist_ Suture Of Liver Wound To Control Bleeding	38	19	$10,009.00	$9,008.10	$2,737.65	$15,694.70	$3,815.34	2026-09-20
J7307	HCPCS	Nexplanon 68 Mg Implant Amb Charge	16	16	$4,081.34	$3,673.21	$3,673.20	$4,081.34	$3,767.08	2026-09-20
55707	CPT	Biopsy, Prostate, Transrectal, Ultrasound-guided (ie, Sextant, Ultrasound-locali…	35	22	$6,200.00	$5,580.00	$130.13	$3,747.56	$3,747.56	2026-09-20
33241	CPT	Removal Implantable Defib Pulse Generator Only	22	22	$10,580.00	$9,522.00	$3,738.90	$3,738.90	$3,738.90	2026-09-20
0124	RC	—	16	16	$4,105.00	$3,694.50	$3,694.50	$3,694.50	$3,694.50	2026-09-20
J7300	HCPCS	Copper-bearing IUD Charge	16	16	$4,059.00	$3,653.10	$3,653.10	$3,746.46	$3,653.10	2026-09-20
35092	CPT	Asst. Repair Aneurysm, Pseudoaneurysm, Or Excision And Graft Insertion	38	19	$9,512.00	$8,560.80	$2,273.74	$14,914.62	$3,644.40	2026-09-20
47533	CPT	Ir Biliary Drain Cath Placement Ext 47533	22	22	$10,342.00	$9,307.80	$3,625.64	$3,625.64	$3,625.64	2026-09-20
47555	CPT	Bilary Endos W Dilat No Stent	22	22	$2,876.00	$2,588.40	$3,625.64	$3,625.64	$3,625.64	2026-09-20
47531	CPT	Xr Fluoro T Tube Cholangiogram, Existing Catheter - 47531	22	22	$1,591.00	$1,431.90	$3,625.64	$3,625.64	$3,625.64	2026-09-20
47534	CPT	Ir Biliary Drain Cath Placement Int Ext 47534	22	22	$10,342.00	$9,307.80	$3,625.64	$3,625.64	$3,625.64	2026-09-20
47532	CPT	Ir Injection For Cholangiogram Inc Guide 47532	22	22	$7,191.00	$6,471.90	$3,625.64	$3,625.64	$3,625.64	2026-09-20
C1734	HCPCS	diltiaZEM 5 mg/mL IV Sol 10 Ml Vial	26	16	$3.74	$3.36	$3.37	$17,521.92	$3,597.77	2026-09-20
50694	CPT	Ir Stent Nephroureteral Bilateral Perc Placement;new Access Without Separate Nep…	29	22	$9,057.00	$8,151.30	$3,543.36	$8,171.32	$3,543.36	2026-09-20
50437	CPT	Ir Perc DilatUrin Tract W Guide New - 50437	22	22	$10,882.00	$9,793.80	$3,543.36	$3,543.36	$3,543.36	2026-09-20
50693	CPT	Ir Stent Nephroureteral Rt Perc Placement;via Pre Existing Nephrostomy Tract - 5…	22	22	$9,057.00	$8,151.30	$3,543.36	$3,543.36	$3,543.36	2026-09-20
50695	CPT	Ir Stent Nephroureteral Rt Perc Placement;new Access With Separate Nephrostomy C…	22	22	$9,057.00	$8,151.30	$3,543.36	$3,543.36	$3,543.36	2026-09-20
50433	CPT	Ir Nephrostomy Catheter Rt, New Access Perc Placement- 50433	22	22	$6,082.00	$5,473.80	$3,543.36	$3,543.36	$3,543.36	2026-09-20
50436	CPT	Ir Perc Dilat Exist Tract W Guide - 50436	22	22	$6,467.00	$5,820.30	$3,543.36	$3,543.36	$3,543.36	2026-09-20
MDADN	OTHER	Cu Med Director Of Athletic Training Education Program	4	4	$3,582.00	$3,223.80	$3,510.36	$3,510.36	$3,510.36	2026-09-20
MDATH	OTHER	Cu Med Director Of Athletic Training Admin	4	4	$3,582.00	$3,223.80	$3,510.36	$3,510.36	$3,510.36	2026-09-20
V5255	HCPCS	Hearing Aid Itc/hs Monaural Left Premium	3	3	$3,900.00	$3,510.00	$3,510.00	$3,510.00	$3,510.00	2026-09-20
V5257	HCPCS	Hearing Aid Bte Monaural Left Premium	3	3	$3,900.00	$3,510.00	$3,510.00	$3,510.00	$3,510.00	2026-09-20
V5254	HCPCS	Hearing Aid Cic Monaural Left Premium	3	3	$3,900.00	$3,510.00	$3,510.00	$3,510.00	$3,510.00	2026-09-20
V5256	HCPCS	Hearing Aid Ite Monaural Left Premium	3	3	$3,900.00	$3,510.00	$3,510.00	$3,510.00	$3,510.00	2026-09-20
48105	CPT	Resection Or Debridement Of Pancreas And Peripancreatic For Acute Necrotizing Pa…	19	19	$13,485.00	$12,136.50	$2,586.55	$13,215.30	$3,482.06	2026-09-20
C1878	HCPCS	Implant Prolaryn Gel Injectable	16	16	$3,812.50	$3,431.25	$3,431.25	$3,431.25	$3,431.25	2026-09-20
70544	CPT	MRA Head Without Contrast - 70544	22	22	$3,846.00	$3,461.40	$149.00	$3,769.08	$3,380.24	2026-09-20
37191	CPT	assist_INSERT Vc Filter,endovas	60	22	$1,358.00	$1,222.20	$199.80	$8,722.70	$3,353.01	2026-09-20
72198	CPT	MRA Pelvis With + Without Contrast - 72198	16	16	$3,715.00	$3,343.50	$3,343.50	$3,343.50	$3,343.50	2026-09-20
20956	CPT	Bone Graft With Microvascular Anastomosis; Iliac Crest	19	19	$7,486.00	$6,737.40	$2,460.59	$7,336.28	$3,335.06	2026-09-20
93451	CPT	Right Heart Catheterization Including Measurement(s) Of Oxygen Saturation And Ca…	24	22	$11,103.00	$9,992.70	$257.77	$3,304.44	$3,304.44	2026-09-20
93452	CPT	Lhc Including Intraprocedural Inj.for Lventriculography, Imagind Supervision And…	35	22	$15,063.00	$13,556.70	$261.68	$3,304.44	$3,304.44	2026-09-20
J7301	HCPCS	Skyla Levonorgestral-releasing Intrauterine System	16	16	$3,632.71	$3,269.44	$3,269.44	$3,352.99	$3,269.44	2026-09-20
58558	CPT	Hysteroscopy, Surgical; With Sampling (Biopsy) Of Endometrium And/Or Polypectomy…	41	22	$1,421.00	$1,278.90	$214.54	$7,878.00	$3,266.54	2026-09-20
43117	CPT	assist_PARTL Esophagectomy, Distl	38	19	$8,147.50	$7,332.75	$2,922.78	$12,775.28	$3,259.98	2026-09-20
36570	CPT	Ppi Picc W/port Child <5	22	22	$4,779.00	$4,301.10	$3,233.64	$3,233.64	$3,233.64	2026-09-20
75733	CPT	Ir Angiogram Adrenal Bilateral - 75733	22	22	$3,785.00	$3,406.50	$3,233.64	$3,233.64	$3,233.64	2026-09-20
37192	CPT	Ir Ivc Reposition	22	22	$12,166.00	$10,949.40	$3,233.64	$3,233.64	$3,233.64	2026-09-20
75741	CPT	Ir Angiogram Pulmonary Left - 75741	22	22	$4,354.00	$3,918.60	$3,233.64	$3,233.64	$3,233.64	2026-09-20
75831	CPT	Ir Venogram Renal Right - 75831	22	22	$4,644.00	$4,179.60	$3,233.64	$3,233.64	$3,233.64	2026-09-20
75743	CPT	Ir Angiogram Pulmonary Bilateral - 75743	22	22	$6,537.00	$5,883.30	$3,233.64	$3,233.64	$3,233.64	2026-09-20
36254	CPT	Superselective Catheter Placement Second Or Higher Order Bilateral Renal Artery …	22	22	$11,529.00	$10,376.10	$3,233.64	$3,233.64	$3,233.64	2026-09-20
36560	CPT	Pci Tunneled Port Child <5	22	22	$5,569.00	$5,012.10	$3,233.64	$3,233.64	$3,233.64	2026-09-20
37188	CPT	Transl Thromb Viens; Repeat	22	22	$25,484.00	$22,935.60	$3,233.64	$3,233.64	$3,233.64	2026-09-20
37193	CPT	Ir Ivc Retrieval	22	22	$11,171.00	$10,053.90	$3,233.64	$10,920.00	$3,233.64	2026-09-20
36581	CPT	Comp Rep Tun No Port No Pump	26	22	$3,584.00	$3,225.60	$3,143.16	$3,233.64	$3,233.64	2026-09-20
37214	CPT	Ir Transcatheter Therapy Art Or Ven For Thromb , Cont Tx On Sub Day, Cess, Cath …	22	22	$8,584.00	$7,725.60	$3,233.64	$3,233.64	$3,233.64	2026-09-20
75898	CPT	Angiography Through Existing Catheter For Follow-up Study For Transcatheter Ther…	22	22	$788.00	$709.20	$3,233.64	$3,233.64	$3,233.64	2026-09-20
0524T	OTHER	Ir Chem Ablat Extrem Vein Via Cath � 0524t	22	22	$9,820.00	$8,838.00	$3,233.64	$3,233.64	$3,233.64	2026-09-20
37212	CPT	Ir Transcatheter Therapy,venous Infusion For Thrombolysis Initial Treatment Day …	22	22	$3,845.00	$3,460.50	$3,233.64	$3,233.64	$3,233.64	2026-09-20
37213	CPT	Ir Transcatheter Therapy Arterial Or Venous For Thrombolysis , Continued Treatme…	22	22	$8,584.00	$7,725.60	$3,233.64	$3,233.64	$3,233.64	2026-09-20
75731	CPT	Ir Angiogram Adrenal Left - 75731	22	22	$4,714.00	$4,242.60	$3,233.64	$3,233.64	$3,233.64	2026-09-20
35206	CPT	Repair Blood Vessel, Direct; Upper Extremity	38	19	$3,976.00	$3,578.40	$719.52	$3,896.48	$3,233.64	2026-09-20
37197	CPT	Ir Transcatheter Retrieval Of Intravascular Foreign Body - 37197	22	22	$10,900.00	$9,810.00	$3,233.64	$3,233.64	$3,233.64	2026-09-20
36595	CPT	Cva Maint Fibrin Stripping	22	22	$1,741.00	$1,566.90	$3,233.64	$3,233.64	$3,233.64	2026-09-20
C1750	HCPCS	Cath Hickman Power Cvc Double 9.5fr	19	16	$3,522.75	$3,170.47	$1,228.50	$3,170.47	$3,170.47	2026-09-20
35103	CPT	Direct Repr Anyrsm/pseudoanyrsm/w/w/out Graft-ruptr Abdaor W/iliac Vess	19	19	$11,284.00	$10,155.60	$1,892.88	$11,058.32	$3,151.15	2026-09-20
29999	CPT	_assist Unlisted Arthroscopy Proce	8	4	$3,195.50	$2,875.95	$1,253.42	$5,010.74	$3,132.08	2026-09-20
J9358	HCPCS	Fam-trastuzumab Deruxtecan-nxki 100mg/5mL IV Sol	16	16	$3,393.74	$3,054.36	$31.30	$3,054.36	$3,054.36	2026-09-20
51595	CPT	Cystectomy Inc External Iliac_51595	19	19	$11,890.00	$10,701.00	$2,036.08	$11,652.20	$3,018.74	2026-09-20
A9521	HCPCS	Tagged Wh Blood Cell To 25 Mci	16	16	$3,351.00	$3,015.90	$3,015.90	$3,015.90	$3,015.90	2026-09-20
J7297	HCPCS	Levonorgestrel 52 Mg Device (Liletta) Amb Charge	16	16	$3,346.60	$3,011.94	$3,011.94	$3,011.94	$3,011.94	2026-09-20
33234	CPT	Removal Of Transvenous Pacemaker Electrode(s); Single Lead System, Atrial Or Ven…	38	19	$2,276.00	$2,048.40	$439.79	$3,738.90	$2,984.69	2026-09-20
27075	CPT	Radical Resection Of Tumor; Wing Of Ilium, 1 Pubic Or Ischial Ramus Or Symphysis…	19	19	$9,812.00	$8,830.80	$1,942.17	$9,615.76	$2,983.26	2026-09-20
C1769	HCPCS	Sodium Chloride 3% Inh Soln	33	16	$3,302.78	$2,972.50	$4.12	$3,184.20	$2,972.50	2026-09-20
19086	CPT	MRI Guided Breast Biopsy With Localization Device And Spec Imaging When Performe…	16	16	$3,285.00	$2,956.50	$2,956.50	$2,956.50	$2,956.50	2026-09-20
15931	CPT	Exc Sacral Pressure Ulcer	38	19	$3,066.00	$2,759.40	$661.05	$3,004.68	$2,940.38	2026-09-20
27043	CPT	Excise Tumor Pelvis/Hip >3Cm_27043	41	22	$2,061.00	$1,854.90	$441.73	$7,998.00	$2,940.38	2026-09-20
59409	CPT	59409 Vaginal Delivery Only (w Or Without Episiotomy)	38	19	$2,652.00	$2,386.80	$719.51	$3,266.54	$2,932.75	2026-09-20
44799	CPT	Assist_UNLISTED Procedure Intestine Removal Foreign Body From Colon	8	4	$2,976.00	$2,678.40	$1,166.20	$4,666.76	$2,916.48	2026-09-20
47120	CPT	Assist Hepatectomy, Resection Of The Liver, Partial Lobectomy	38	19	$6,308.00	$5,677.20	$2,134.93	$9,891.14	$2,911.18	2026-09-20
G2083	HCPCS	Visit Esketamine, > 56m	16	16	$3,181.00	$2,862.90	$2,862.90	$2,862.90	$2,862.90	2026-09-20
22510	CPT	Percutaneous Vertebroplasty (bone Biopsy Included When Performed), 1 Vertebral B…	38	19	$2,335.00	$2,101.50	$402.33	$3,333.41	$2,810.86	2026-09-20
36012	CPT	Renal Vein 2nd Order 36012	16	16	$3,117.00	$2,805.30	$2,805.30	$2,805.30	$2,805.30	2026-09-20
35082	CPT	assist_DIRECT Rep Aneurysm Ruptured	38	19	$7,849.00	$7,064.10	$1,900.01	$12,306.84	$2,798.10	2026-09-20
0190	RC	—	16	16	$3,092.00	$2,782.80	$2,782.80	$2,782.80	$2,782.80	2026-09-20
0120	RC	—	16	16	$3,092.00	$2,782.80	$2,782.80	$2,782.80	$2,782.80	2026-09-20
37765	CPT	Stab Phlebectomy Of Varicose Veins, 1 Extremity; 10-20 Stab Incisions	38	19	$2,284.00	$2,055.60	$242.03	$3,233.64	$2,735.98	2026-09-20
C1765	HCPCS	Barrier Adhesion 3x4" Inter- Ceed Absorbable Strl-lf	16	16	$3,034.51	$2,731.06	$2,586.80	$2,731.06	$2,731.06	2026-09-20
78815	CPT	PET CT Skull Base To Mid Thigh Pi - 78815	22	22	$10,071.00	$9,063.90	$299.70	$9,845.00	$2,723.55	2026-09-20
35907	CPT	Excision Of Infected Graft; Abdomen	19	19	$11,123.00	$10,010.70	$1,675.91	$10,900.54	$2,695.80	2026-09-20
36217	CPT	Intro Cath 3rd Thor/brachceph	16	16	$2,984.00	$2,685.60	$2,685.60	$2,685.60	$2,685.60	2026-09-20
77012	CPT	CT Guided Needle Placement - 77012	16	16	$2,973.00	$2,675.70	$1,788.16	$2,906.00	$2,675.70	2026-09-20
35540	CPT	Assist_Bypass Graft, With Vein; Aortobifemoral	19	19	$3,377.00	$3,039.30	$2,132.25	$4,031.19	$2,667.40	2026-09-20
93457	CPT	Catheter Placement In Coronary Including Intraprocedural Inj.for Coron. Angio, I…	38	19	$2,070.00	$1,863.00	$312.06	$3,304.44	$2,666.52	2026-09-20
27447	CPT	Arthroplasty, Knee, Condyle And Plateau; Medial And Lateral Compartments With Or…	66	22	$5,176.00	$4,658.40	$1,204.37	$6,762.98	$2,647.91	2026-09-20
35102	CPT	Direct Repair Of Aneurysm_35102	19	19	$10,328.00	$9,295.20	$1,646.77	$10,121.44	$2,635.50	2026-09-20
59618	CPT	Global Failed Vbac_59618	19	19	$9,738.00	$8,764.20	$2,465.62	$9,543.24	$2,626.21	2026-09-20
36252	CPT	Bilateral Renal (includes Abdominal Aortogram)	38	19	$2,017.00	$1,815.30	$316.43	$3,233.64	$2,619.93	2026-09-20
74363	CPT	Ir Biliary Duct Transhepatic Dilation - 74363	16	16	$2,899.00	$2,609.10	$2,609.10	$2,609.10	$2,609.10	2026-09-20
59510	CPT	assist_Global OB Care W/c-section	38	19	$3,357.00	$3,021.30	$730.10	$5,849.62	$2,602.45	2026-09-20
47780	CPT	Anastamosis Roux En Y Xtrahepatic Bilary Ducts	38	19	$8,053.50	$7,248.15	$2,252.60	$12,628.28	$2,592.02	2026-09-20
27047	CPT	Excision, Tumor, Soft Tissue Of Pelvis And Hip Area, Subcutaneous; Less Than 3 C…	38	19	$2,251.00	$2,025.90	$343.53	$2,940.38	$2,573.18	2026-09-20
21014	CPT	Excision Tumor, Soft Tissue Of Face And Scalp; Deep 2 Cm Or Greater	38	19	$2,171.00	$1,953.90	$497.32	$2,940.38	$2,533.98	2026-09-20
27134	CPT	Assist_ Rev Total Hip, Both Components	38	19	$7,762.50	$6,986.25	$1,774.51	$12,171.60	$2,529.95	2026-09-20
28825	CPT	Amputation, Toe; Interphalangeal Joint	44	22	$1,754.00	$1,578.60	$162.80	$8,958.00	$2,526.16	2026-09-20
44208	CPT	assist_LAP Colectomy W/colostomy	38	19	$6,339.00	$5,705.10	$1,806.62	$9,938.18	$2,518.75	2026-09-20
23076	CPT	Excision, Tumor, Soft Tissue Of Shoulder Area, Subfascial (Eg, Intramuscular); L…	38	19	$2,137.00	$1,923.30	$520.20	$2,940.38	$2,517.32	2026-09-20
A9539	HCPCS	Dtpa Per Dose, Up To 25 Mci	16	16	$2,786.00	$2,507.40	$2,507.40	$2,507.40	$2,507.40	2026-09-20
27228	CPT	_assist Repair Of Hip Fracture(s) - 27228	38	19	$5,499.50	$4,949.55	$1,753.94	$8,623.02	$2,475.11	2026-09-20
C1883	HCPCS	Lead Tendril MRI 56cm	16	16	$2,745.00	$2,470.50	$2,470.50	$2,470.50	$2,470.50	2026-09-20
L0148	HCPCS	Collar Unite Global Sz48	16	16	$2,745.00	$2,470.50	$2,470.50	$2,470.50	$2,470.50	2026-09-20
49329	CPT	Assist Unlisted Lapro Proc. Abd, Peritoneum And Omentum	8	4	$2,513.00	$2,261.70	$984.90	$3,940.58	$2,462.74	2026-09-20
77021	CPT	MRI Guidance Needle Placement - 77021	16	16	$2,709.00	$2,438.10	$2,438.10	$2,438.10	$2,438.10	2026-09-20
44146	CPT	Assist Colectomy, Partial, With Coloproctostomy & Colostomy	38	19	$6,717.50	$6,045.75	$1,922.72	$10,533.04	$2,430.19	2026-09-20
44155	CPT	assist_Removal Of Colon/Ileostomy	38	19	$5,766.00	$5,189.40	$1,256.36	$10,045.00	$2,422.05	2026-09-20
0490	RC	—	16	16	$2,681.00	$2,412.90	$2,412.90	$2,412.90	$2,412.90	2026-09-20
43848	CPT	Gastric Restrictive Procedure_43848	19	19	$9,810.00	$8,829.00	$1,770.25	$9,613.80	$2,409.64	2026-09-20
70486	CPT	CT Facial Bones Without IV Contrast - 70486	22	22	$2,666.00	$2,399.40	$21.85	$2,606.00	$2,405.34	2026-09-20
59610	CPT	Routine Obstetric Care Including Antepartum Care, Vaginal Delivery (With Or With…	19	19	$5,547.00	$4,992.30	$2,300.81	$5,436.06	$2,404.27	2026-09-20
55845	CPT	Assist_Prostatectomy,retrop Radic, With Pelv Lymphadenect	38	19	$5,562.50	$5,006.25	$1,274.94	$8,959.16	$2,402.16	2026-09-20
A9572	HCPCS	Octreoscan Up To 6 Millicuries A9572	16	16	$3,927.00	$3,534.30	$1,914.61	$3,534.30	$2,362.27	2026-09-20
44979	CPT	Unlisted Laparoscopy Procedure, Appendix	4	4	$2,410.00	$2,169.00	$2,361.80	$2,361.80	$2,361.80	2026-09-20
47760	CPT	Anastamosis Of Exhep Bile Duct	38	19	$7,292.50	$6,563.25	$2,050.99	$11,434.64	$2,360.99	2026-09-20
77013	CPT	CT Guided Tissue Ablation 77013	16	16	$2,620.00	$2,358.00	$2,358.00	$2,358.00	$2,358.00	2026-09-20
35585	CPT	Assist_fem-anterior Tibial Vein Bypass	38	19	$6,031.50	$5,428.35	$1,462.48	$9,457.00	$2,350.71	2026-09-20
11771	CPT	Excision Of Pilonidal Cyst Extensive	44	22	$1,791.00	$1,611.90	$424.80	$10,398.00	$2,347.78	2026-09-20
78431	CPT	PET CT Cardiac Rest And Stress 78431	22	22	$5,958.00	$5,362.20	$2,312.09	$3,931.20	$2,341.88	2026-09-20
22548	CPT	Arthrodesis, Anterior Transoral Or Extraoral Technique, Clivus-c1-c2 (atlas-axis…	19	19	$7,534.00	$6,780.60	$1,789.90	$7,383.32	$2,335.20	2026-09-20
35566	CPT	assist_BYPASS Graft, With Vein Femoral	38	19	$6,031.50	$5,428.35	$1,453.89	$9,457.00	$2,334.04	2026-09-20
36247	CPT	Initial Third Order Or More Selec Abd, Plevic, Of Lower Ext Art, Within A Family	36	19	$1,883.00	$1,694.70	$267.16	$2,845.92	$2,329.88	2026-09-20
43415	CPT	Assist Repair Esophagus Wound	38	19	$8,540.00	$7,686.00	$2,220.92	$13,390.72	$2,319.20	2026-09-20
45110	CPT	Proctectomy; Complete	19	19	$9,213.00	$8,291.70	$1,678.82	$9,028.74	$2,319.00	2026-09-20
44207	CPT	assist_L Colectomy/coloproctostomy	38	19	$5,952.50	$5,357.25	$1,659.08	$9,334.50	$2,315.16	2026-09-20
0649T	OTHER	Mr Quantitative Tissue Analysis 0649t	16	16	$2,563.00	$2,306.70	$2,306.70	$2,306.70	$2,306.70	2026-09-20
27487	CPT	Assist Bilateral Replace Knee Joint 27487	80	22	$2,033.00	$1,829.70	$1,494.50	$29,836.00	$2,300.19	2026-09-20
59400	CPT	Routine Obstetric Care Including Antepartum Care, Vaginal Delivery (With Or With…	19	19	$5,273.00	$4,745.70	$2,214.49	$5,167.54	$2,298.41	2026-09-20
A9541	HCPCS	Sulfurcolloid/dose Upto 20 Mci	16	16	$2,537.00	$2,283.30	$2,283.30	$2,480.00	$2,289.04	2026-09-20
47379	CPT	Assist_Unlisted Laparoscopic Procedure, Liver	8	4	$2,332.50	$2,099.25	$915.32	$3,656.38	$2,285.85	2026-09-20
23472	CPT	Arthroplasty, Glenohumeral Joint; Total Shoulder (Glenoid And Proximal Humeral R…	44	22	$4,247.00	$3,822.30	$1,357.03	$15,564.50	$2,283.17	2026-09-20
0370	RC	—	16	16	$2,530.00	$2,277.00	$2,277.00	$2,277.00	$2,277.00	2026-09-20
44238	CPT	Assist_Unlisted Laparoscopy Procedure, Intestine (except Rectum)	8	4	$2,299.50	$2,069.55	$382.20	$4,124.82	$2,253.51	2026-09-20
43499	CPT	Unlisted Procedure, Esophagus ( Endoscopic Repair Of Zenker�s) 43499	4	4	$2,295.00	$2,065.50	$2,249.10	$2,249.10	$2,249.10	2026-09-20
36011	CPT	Selective Cath/Venous/1st Order 36011	16	16	$2,474.00	$2,226.60	$2,226.60	$2,226.60	$2,226.60	2026-09-20
63081	CPT	Vertebral Corpectomy (Vertebral Body Resection), Partial Or Complete, Anterior A…	19	19	$7,829.00	$7,046.10	$1,614.08	$7,672.42	$2,223.63	2026-09-20
53060	CPT	Drainage Of Skene's Gland Abscess Or Cyst	42	22	$5,261.00	$4,734.90	$141.08	$2,222.38	$2,222.38	2026-09-20
35646	CPT	assist_BYPASS Graft; Aortobifemoral	38	19	$6,147.00	$5,532.30	$1,492.73	$9,638.30	$2,221.95	2026-09-20
35189	CPT	Assist_ Repair, Acquired Or Traumatic Arteriovenous Fistula; Thorax And Abdomen	38	19	$5,117.00	$4,605.30	$1,322.70	$8,023.26	$2,215.21	2026-09-20
27156	CPT	Osteotomy, Iliac, Acetabular Or Innominate Bone; With Femoral Osteotomy And With…	19	19	$7,868.00	$7,081.20	$1,595.72	$7,710.64	$2,212.03	2026-09-20
22633	CPT	Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Or In…	38	19	$4,422.50	$3,980.25	$1,663.00	$6,934.48	$2,198.38	2026-09-20
27132	CPT	assist_CONVERSION To Total Hip	38	19	$4,770.50	$4,293.45	$1,564.70	$7,480.34	$2,182.02	2026-09-20
77301	CPT	Imrt Treatment Plan	22	22	$10,485.00	$9,436.50	$281.15	$10,249.00	$2,178.86	2026-09-20
27130	CPT	Arthroplasty, Acetabular And Proximal Femoral Prosthetic Replacement (Total Hip …	86	22	$1,618.00	$1,456.20	$1,188.74	$12,493.00	$2,173.82	2026-09-20
44150	CPT	assist_REMOVAL Of Colon	38	19	$5,614.50	$5,053.05	$1,702.53	$8,804.32	$2,163.19	2026-09-20
27227	CPT	_assist Repair Hip Fracture(s) - 27227	38	19	$4,764.50	$4,288.05	$1,547.55	$7,470.54	$2,160.95	2026-09-20
75989	CPT	US Guide Perc Drain With Cath - 75989	16	16	$2,388.00	$2,149.20	$2,149.20	$2,149.20	$2,149.20	2026-09-20
32482	CPT	Assist_Removal Of Lung, Other Than Pneumonectomy; 2 Lobes (bilobectomy)	38	19	$5,221.50	$4,699.35	$1,424.79	$8,186.92	$2,142.53	2026-09-20
43632	CPT	Assist_Gastrectomy, Partial, Distal; With Gastrojejunostomy	38	19	$6,335.50	$5,701.95	$1,855.58	$9,934.26	$2,130.00	2026-09-20
32320	CPT	Assist_Decortication And Parietal Pleurectomy	38	19	$5,062.50	$4,556.25	$1,450.54	$7,938.00	$2,129.75	2026-09-20
34502	CPT	Reconstruction Of Vena Cava	19	19	$8,547.00	$7,692.30	$1,386.08	$8,376.06	$2,129.18	2026-09-20
27286	CPT	Arthrodesis, Hip Joint (Including Obtaining Graft); With Subtrochanteric Osteoto…	38	19	$4,719.50	$4,247.55	$1,538.97	$7,399.98	$2,127.70	2026-09-20
32220	CPT	Asssit_Decortication, Pulmonary (separate Procedure); Total	38	19	$4,550.50	$4,095.45	$1,449.68	$7,135.38	$2,124.82	2026-09-20
44899	CPT	Unlisted Procedure, Meckel's Diverticulum And The Mesentery	4	4	$2,166.00	$1,949.40	$2,122.68	$2,122.68	$2,122.68	2026-09-20
50434	CPT	Ir Nephrostomy Bil Cath Convert To Nephrouretrl Cath, Perc Cmplt Via Pre Exst Ne…	22	22	$2,118.00	$1,906.20	$2,104.57	$2,104.57	$2,104.57	2026-09-20
51102	CPT	Aspiration Bladder; With Insertion Suprapubic Cath	52	22	$6,246.00	$5,621.40	$132.25	$5,635.84	$2,104.57	2026-09-20
50382	CPT	Ir Replace Ureter Stent 50382	22	22	$6,220.00	$5,598.00	$2,104.57	$2,104.57	$2,104.57	2026-09-20
50432	CPT	Ir Nephrostomy Catheter Rt, Perc Placement- 50432	32	22	$4,865.00	$4,378.50	$420.92	$2,378.00	$2,104.57	2026-09-20
50384	CPT	Ir Removal Ureter Stent Percutaneous - 50384	22	22	$6,246.00	$5,621.40	$2,104.57	$2,104.57	$2,104.57	2026-09-20
50435	CPT	Ir Nephrostomy Lt Cath Exchange Perctunaneous - 50435	22	22	$2,118.00	$1,906.20	$2,104.57	$2,104.57	$2,104.57	2026-09-20
50387	CPT	Ir Replace Nephroureteral Cath - 50387	22	22	$6,304.00	$5,673.60	$2,104.57	$2,104.57	$2,104.57	2026-09-20

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