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 →

Export CSV
Hospital

NORTH COUNTRY HOSPITAL AND HEALTH CENTER

Newport, VT · CCN 471304 · Rates published

Your selected procedure

You selected 29806 (HCPCS)

This facility hasn’t published a payer-negotiated rate for this exact code. See its full rate list below.

4,556 distinct procedures filed
6 distinct payers
213,470 rate rows
2026-01-01 last MRF observed
Data quality

124,754 of 213,470 rate rows are consumer-grade (58.4%)

88,716 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
professional (physician) fee — not the facility price 67,438
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 10,023
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 7,863
per-diem day rate — not a per-procedure price 3,117
template filing: same amount across many unrelated codes — excluded 134
placeholder amount (≤ $0.02) — excluded from medians 74
percent-of-charges filed in the dollar field — excluded from medians 66
exceeds 10× this hospital's gross charge — excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://northcountryhospital.org/wp-content/uploads/030185556_north-country-hospital-and-health-center-inc_standardcharges.csv
Found on page https://northcountryhospital.com/financial-services/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-31
Content fingerprint 6a94e04ff8fe0e1c… · 50,284,902 bytes · first seen 2026-08-01

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J2350
HCPCS 		Ocrelizumab 300 Mg/10 Ml Sol 6 $7,097.18 $26,614.44 $24,248.71 nat. median
$714
outlier · 34.0×
C1767
HCPCS 		Interstim Nervestimulator 6 $4,764.04 $17,865.14 $16,277.13 nat. median
$23,834
0.7× median
J9271
HCPCS 		Pembrolizumab 25 mg/mL Sol 6 $4,112.68 $15,422.56 $14,051.67 nat. median
$323
outlier · 43.5×
J2327
HCPCS 		Risankizumab Rzaa 60 mg/mL Sol 6 $3,625.09 $13,594.10 $12,385.73 nat. median
$2,512
outlier · 4.9×
J3380
HCPCS 		Vedolizumab 300 Mg Pow 6 $3,119.97 $11,699.88 $10,659.89 nat. median
$204
outlier · 52.3×
9399351
CDM 		Rt Polysomnography W/cpap Charge 6 $2,725.50 $10,220.63 $9,312.13 nat. median
$9,312
1.0× median
J3101
HCPCS 		Tenecteplase 50 Mg Pow 6 $2,586.23 $9,698.37 $8,836.30 nat. median
$4,042
outlier · 2.2×
47532
HCPCS 		47532 Xr Chole Perc-new Acc: Pro Fee 6 $2,436.18 $9,181.35 $8,323.62 nat. median
$3,790
outlier · 2.2×
47490
HCPCS 		47490 US Cholecystostomy, Perc 6 $2,436.18 $9,181.35 $8,323.62 nat. median
$3,890
outlier · 2.1×
19101
HCPCS 		19101 Biopsy Of Breast; Open, Incisional ProFee 6 $2,416.50 $9,107.10 $8,256.38 nat. median
$3,653
outlier · 2.3×
47531
HCPCS 		47531 Xr Chole Perc-exist Acc: Prof 6 $2,344.38 $8,835.30 $8,009.97 nat. median
$3,308
outlier · 2.4×
78831
HCPCS 		78831 Nm Spect Multi Area Or Multi Day 6 $2,246.04 $8,464.73 $7,673.97 nat. median
$1,665
outlier · 4.6×
8078488
CDM 		Rt Polysomnography Charge 6 $2,204.40 $8,266.50 $7,531.70 nat. median
$7,532
1.0× median
36556
HCPCS 		36556 Central Venous Catheter Place>2yr Hosp P 6 $2,190.00 $8,253.45 $7,482.50 nat. median
$2,477
outlier · 3.0×
78816
HCPCS 		78816 Nm PET Scan: Whole Body Profee- Initial 6 $2,114.88 $8,547.98 $7,482.31 nat. median
$2,784
outlier · 2.7×
J9332
HCPCS 		Efgartigimod Alfa 400 Mg/20 Ml Sol 6 $2,142.00 $8,032.50 $7,318.50 nat. median
$112
outlier · 65.1×
70498
HCPCS 		70498 CT Angio Neck Profee 6 $2,030.88 $7,653.83 $6,938.84 nat. median
$735
outlier · 9.4×
59412
HCPCS 		59412 External Cephalic Version, With Or Without Tocolysis 6 $2,007.48 $7,565.63 $6,858.89 nat. median
$2,979
outlier · 2.3×
33210
HCPCS 		33210 Pacemaker Or Implantable Defibrillator ProFee 6 $1,986.00 $7,447.50 $6,785.50 nat. median
$8,300
0.8× median
78815
HCPCS 		78815 Nm PET Scan: Eyes To Thigh Profee-initia 6 $1,963.14 $7,414.20 $6,717.76 nat. median
$2,810
outlier · 2.4×
J2993
HCPCS 		Reteplase 10 Units IV Kit 6 $1,964.36 $7,366.36 $6,711.57 nat. median
$3,474
1.9× median
70496
HCPCS 		70496 CT Angio Brain/Head Profee 6 $1,961.04 $7,390.58 $6,700.22 nat. median
$741
outlier · 9.0×
73720
HCPCS 		73720 MRI Foot With + Without Contrast Left Profee 6 $1,914.00 $7,213.28 $6,539.50 nat. median
$1,123
outlier · 5.8×
9849103
CDM 		Sure Scan Pacing Lead 6 $1,857.34 $6,965.02 $6,345.91 nat. median
$6,346
1.0× median
95811
HCPCS 		95811 Psg With Cpap - Tech Portion 6 $1,577.40 $10,220.63 $6,178.92 nat. median
$1,887
outlier · 3.3×
10978845
CDM 		Linq Ii System 6 $1,798.20 $6,743.25 $6,143.85 nat. median
$6,144
1.0× median
2120844
CDM 		Room/bed ICU 6 $5,894.56 $6,656.40 $6,138.68 nat. median
$2,773
outlier · 2.2×
73220
HCPCS 		73220 MRI Ue Non Joint With + Without Contrast Profee 6 $1,773.36 $6,683.40 $6,058.98 nat. median
$1,122
outlier · 5.4×
74178
HCPCS 		74178 CT Abdomen And Pelvis With + Without Contrast Profee 6 $1,737.12 $6,546.83 $5,935.16 nat. median
$1,023
outlier · 5.8×
9846544
CDM 		Fracture Kyphon First Express 10/2 6 $1,710.00 $6,412.50 $5,842.50 nat. median
$5,842
1.0× median
73723
HCPCS 		73723 MRI Ankle With + Without Contrast Left Profee 6 $1,608.90 $6,684.30 $5,827.13 nat. median
$1,191
outlier · 4.9×
J0517
HCPCS 		Benralizumab 30 mg/mL 6 $1,704.79 $6,392.97 $5,824.71 nat. median
$969
outlier · 6.0×
75635
HCPCS 		75635 CT Angio Abdomen Aorta + Iliofemoral Profee 6 $1,701.42 $6,412.28 $5,813.19 nat. median
$725
outlier · 8.0×
95783
HCPCS 		Psg W/cpap Younger Than 6 Yrs Old- Physician 6 $1,654.26 $6,234.53 $5,652.06 nat. median
$1,677
outlier · 3.4×
95810
HCPCS 		95810 Polysomnography -tech Portion 6 $1,355.94 $8,266.50 $5,586.01 nat. median
$1,814
outlier · 3.1×
74175
HCPCS 		74175 CT Angio Abdomen Profee 6 $1,634.70 $6,160.73 $5,585.23 nat. median
$714
outlier · 7.8×
72158
HCPCS 		72158 MRI Spine Lumbar With + Without Contrast Profee 6 $1,627.68 $6,134.40 $5,561.24 nat. median
$1,083
outlier · 5.1×
73223
HCPCS 		73223 MRI Finger(s) With + Without Contrast Left 6 $1,601.52 $6,472.35 $5,538.59 nat. median
$1,166
outlier · 4.8×
70553
HCPCS 		70553 MRI Brain With + Without Contrast Profee 6 $1,599.54 $6,658.88 $5,531.74 nat. median
$1,122
outlier · 4.9×
00597019705
NDC 		idaruCIZUmab 2.5 G/50 Ml 6 $1,594.08 $5,977.80 $5,446.44 nat. median
$2,948
1.8× median
597019705
NDC 		idaruCIZUmab 2.5 G/50 Ml 6 $1,594.08 $5,977.80 $5,429.83 nat. median
$3,634
1.5× median
9821367
CDM 		00597-0197-05 - idaruCIZUmab 2.5 G/50 Ml [ncty] 6 $1,594.08 $5,977.80 $5,429.83 nat. median
$5,430
1.0× median
58805
HCPCS 		58805 US Asp Ovarian Cyst(s) Abd 6 $1,588.86 $5,987.93 $5,428.61 nat. median
$3,277
1.7× median
9846713
CDM 		Body Djd Ii Variax Elbow 6 $1,560.77 $5,852.89 $5,332.63 nat. median
$5,333
1.0× median
71275
HCPCS 		71275 CT Angio Chest Profee 6 $1,552.86 $5,852.25 $5,305.61 nat. median
$753
outlier · 7.0×
72156
HCPCS 		72156 MRI Spine Cervical With + Without Contrast Profee 6 $1,547.16 $5,830.88 $5,286.13 nat. median
$1,096
outlier · 4.8×
9839144
CDM 		Del10205 Birthing Greater ?20 Hr Charge 6 $1,538.88 $5,770.80 $5,257.84 nat. median
$5,258
1.0× median
1378486-8
CDM 		Level 2 6 $1,527.30 $5,727.38 $5,218.28 nat. median
$5,218
1.0× median
9839152
CDM 		Del10205 Birthing Greater ?20 Hr Charge 6 $1,531.20 $5,742.00 $5,215.65 nat. median
$5,216
1.0× median
72197
HCPCS 		72197 MRI Pelvis With + Without Contrast Profee 6 $1,522.92 $5,739.53 $5,203.31 nat. median
$1,058
outlier · 4.9×

Other procedures at this hospital

Browse this hospital's 4,556 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
             
J2350 HCPCS Ocrelizumab 300 Mg/10 Ml Sol 21 6 $29,571.60 $23,657.28 20% off $7,097.18 $26,614.44 $24,248.71 2026-01-01
C1767 HCPCS Interstim Nervestimulator 21 6 $19,850.16 $15,880.13 $4,764.04 $17,865.14 $16,277.13 2026-01-01
J9271 HCPCS Pembrolizumab 25 mg/mL Sol 21 6 $17,136.18 $13,708.94 20% off $4,112.68 $15,422.56 $14,051.67 2026-01-01
J2327 HCPCS Risankizumab Rzaa 60 mg/mL Sol 21 6 $15,104.55 $12,083.64 20% off $3,625.09 $13,594.10 $12,385.73 2026-01-01
J3380 HCPCS Vedolizumab 300 Mg Pow 21 6 $12,999.87 $10,399.90 $3,119.97 $11,699.88 $10,659.89 2026-01-01
9399351 CDM Rt Polysomnography W/cpap Charge 11 6 $11,356.25 $9,085.00 20% off $2,725.50 $10,220.63 $9,312.13 2026-01-01
J3101 HCPCS Tenecteplase 50 Mg Pow 21 6 $10,775.97 $8,620.78 $2,586.23 $9,698.37 $8,836.30 2026-01-01
47532 HCPCS 47532 Xr Chole Perc-new Acc: Pro Fee 21 6 $10,201.50 $8,161.20 20% off $2,436.18 $9,181.35 $8,323.62 2026-01-01
47490 HCPCS 47490 US Cholecystostomy, Perc 21 6 $10,201.50 $8,161.20 20% off $2,436.18 $9,181.35 $8,323.62 2026-01-01
19101 HCPCS 19101 Biopsy Of Breast; Open, Incisional ProFee 21 6 $10,119.00 $8,095.20 20% off $2,416.50 $9,107.10 $8,256.38 2026-01-01
47531 HCPCS 47531 Xr Chole Perc-exist Acc: Prof 21 6 $9,817.00 $7,853.60 $2,344.38 $8,835.30 $8,009.97 2026-01-01
78831 HCPCS 78831 Nm Spect Multi Area Or Multi Day 21 6 $9,405.25 $7,524.20 20% off $2,246.04 $8,464.73 $7,673.97 2026-01-01
8078488 CDM Rt Polysomnography Charge 11 6 $9,185.00 $7,348.00 20% off $2,204.40 $8,266.50 $7,531.70 2026-01-01
36556 HCPCS 36556 Central Venous Catheter Place>2yr Hosp P 21 6 $9,170.50 $7,336.40 20% off $2,190.00 $8,253.45 $7,482.50 2026-01-01
78816 HCPCS 78816 Nm PET Scan: Whole Body Profee- Initial 42 6 $9,153.25 $7,322.60 $2,114.88 $8,547.98 $7,482.31 2026-01-01
J9332 HCPCS Efgartigimod Alfa 400 Mg/20 Ml Sol 21 6 $8,925.00 $7,140.00 20% off $2,142.00 $8,032.50 $7,318.50 2026-01-01
70498 HCPCS 70498 CT Angio Neck Profee 21 6 $8,504.25 $6,803.40 20% off $2,030.88 $7,653.83 $6,938.84 2026-01-01
59412 HCPCS 59412 External Cephalic Version, With Or Without Tocolysis 21 6 $8,406.25 $6,725.00 20% off $2,007.48 $7,565.63 $6,858.89 2026-01-01
33210 HCPCS 33210 Pacemaker Or Implantable Defibrillator ProFee 11 6 $8,275.00 $6,620.00 20% off $1,986.00 $7,447.50 $6,785.50 2026-01-01
78815 HCPCS 78815 Nm PET Scan: Eyes To Thigh Profee-initia 42 6 $8,220.75 $6,576.60 $1,963.14 $7,414.20 $6,717.76 2026-01-01
J2993 HCPCS Reteplase 10 Units IV Kit 21 6 $8,184.84 $6,547.87 20% off $1,964.36 $7,366.36 $6,711.57 2026-01-01
70496 HCPCS 70496 CT Angio Brain/Head Profee 21 6 $8,211.75 $6,569.40 20% off $1,961.04 $7,390.58 $6,700.22 2026-01-01
73720 HCPCS 73720 MRI Foot With + Without Contrast Left Profee 42 6 $8,014.75 $6,411.80 20% off $1,914.00 $7,213.28 $6,539.50 2026-01-01
9849103 CDM Sure Scan Pacing Lead 21 6 $7,738.91 $6,191.13 $1,857.34 $6,965.02 $6,345.91 2026-01-01
95811 HCPCS 95811 Psg With Cpap - Tech Portion 84 6 $11,299.75 $9,039.80 20% off $1,577.40 $10,220.63 $6,178.92 2026-01-01
10978845 CDM Linq Ii System 21 6 $7,492.50 $5,994.00 20% off $1,798.20 $6,743.25 $6,143.85 2026-01-01
2120844 CDM Room/bed ICU 15 6 $7,396.00 $5,916.80 20% off $5,894.56 $6,656.40 $6,138.68 2026-01-01
73220 HCPCS 73220 MRI Ue Non Joint With + Without Contrast Profee 42 6 $7,426.00 $5,940.80 20% off $1,773.36 $6,683.40 $6,058.98 2026-01-01
74178 HCPCS 74178 CT Abdomen And Pelvis With + Without Contrast Profee 21 6 $7,274.25 $5,819.40 20% off $1,737.12 $6,546.83 $5,935.16 2026-01-01
9846544 CDM Fracture Kyphon First Express 10/2 21 6 $7,125.00 $5,700.00 20% off $1,710.00 $6,412.50 $5,842.50 2026-01-01
73723 HCPCS 73723 MRI Ankle With + Without Contrast Left Profee 126 6 $7,106.25 $5,685.00 20% off $1,608.90 $6,684.30 $5,827.13 2026-01-01
J0517 HCPCS Benralizumab 30 mg/mL 21 6 $7,103.30 $5,682.64 20% off $1,704.79 $6,392.97 $5,824.71 2026-01-01
75635 HCPCS 75635 CT Angio Abdomen Aorta + Iliofemoral Profee 21 6 $7,124.75 $5,699.80 20% off $1,701.42 $6,412.28 $5,813.19 2026-01-01
95783 HCPCS Psg W/cpap Younger Than 6 Yrs Old- Physician 21 6 $6,927.25 $5,541.80 20% off $1,654.26 $6,234.53 $5,652.06 2026-01-01
95810 HCPCS 95810 Polysomnography -tech Portion 84 6 $9,139.25 $7,311.40 20% off $1,355.94 $8,266.50 $5,586.01 2026-01-01
74175 HCPCS 74175 CT Angio Abdomen Profee 21 6 $6,845.25 $5,476.20 20% off $1,634.70 $6,160.73 $5,585.23 2026-01-01
72158 HCPCS 72158 MRI Spine Lumbar With + Without Contrast Profee 21 6 $6,816.00 $5,452.80 20% off $1,627.68 $6,134.40 $5,561.24 2026-01-01
73223 HCPCS 73223 MRI Finger(s) With + Without Contrast Left 63 6 $6,706.25 $5,365.00 20% off $1,601.52 $6,472.35 $5,538.59 2026-01-01
70553 HCPCS 70553 MRI Brain With + Without Contrast Profee 31 6 $6,698.00 $5,358.40 20% off $1,599.54 $6,658.88 $5,531.74 2026-01-01
00597019705 NDC idaruCIZUmab 2.5 G/50 Ml 11 6 $6,642.00 $5,313.60 $1,594.08 $5,977.80 $5,446.44 2026-01-01
597019705 NDC idaruCIZUmab 2.5 G/50 Ml 10 6 $6,642.00 $5,313.60 $1,594.08 $5,977.80 $5,429.83 2025-11-14
9821367 CDM 00597-0197-05 - idaruCIZUmab 2.5 G/50 Ml [ncty] 10 6 $6,642.00 $5,313.60 $1,594.08 $5,977.80 $5,429.83 2025-11-14
58805 HCPCS 58805 US Asp Ovarian Cyst(s) Abd 21 6 $6,653.25 $5,322.60 $1,588.86 $5,987.93 $5,428.61 2026-01-01
9846713 CDM Body Djd Ii Variax Elbow 21 6 $6,503.21 $5,202.57 $1,560.77 $5,852.89 $5,332.63 2026-01-01
71275 HCPCS 71275 CT Angio Chest Profee 21 6 $6,502.50 $5,202.00 20% off $1,552.86 $5,852.25 $5,305.61 2026-01-01
72156 HCPCS 72156 MRI Spine Cervical With + Without Contrast Profee 21 6 $6,478.75 $5,183.00 20% off $1,547.16 $5,830.88 $5,286.13 2026-01-01
9839144 CDM Del10205 Birthing Greater ?20 Hr Charge 11 6 $6,412.00 $5,129.60 $1,538.88 $5,770.80 $5,257.84 2026-01-01
1378486-8 CDM Level 2 11 6 $6,363.75 $5,091.00 20% off $1,527.30 $5,727.38 $5,218.28 2026-01-01
9839152 CDM Del10205 Birthing Greater ?20 Hr Charge 10 6 $6,380.00 $5,104.00 20% off $1,531.20 $5,742.00 $5,215.65 2025-11-14
72197 HCPCS 72197 MRI Pelvis With + Without Contrast Profee 21 6 $6,377.25 $5,101.80 20% off $1,522.92 $5,739.53 $5,203.31 2026-01-01
1378486 CDM Level 2 10 6 $6,332.00 $5,065.60 $1,519.68 $5,698.80 $5,176.41 2025-11-14
95782 HCPCS 95782 Psg Younger 6 Yrs Old- Physician 21 6 $6,291.00 $5,032.80 20% off $1,502.34 $5,661.90 $5,133.00 2026-01-01
J2353 HCPCS Octreotide 20 Mg IM Inj 42 6 $5,870.19 $4,696.15 20% off $1,408.85 $8,513.40 $5,063.04 2026-01-01
94002 HCPCS Rt Ventilator Services Initial Charge 21 6 $6,156.75 $4,925.40 20% off $1,470.24 $5,541.08 $5,023.32 2026-01-01
78227 HCPCS 78227 Nm Hepatobilary With Ef: Prof 21 6 $6,155.25 $4,924.20 20% off $1,469.94 $5,539.73 $5,022.30 2026-01-01
1378485-6 CDM Level 1 11 6 $6,038.75 $4,831.00 20% off $1,449.30 $5,434.88 $4,951.78 2026-01-01
J1162 HCPCS Digoxin Immune Fab 40 Mg Inj 21 6 $6,002.36 $4,801.89 $1,440.57 $5,402.12 $4,921.94 2026-01-01
93975 HCPCS 93975 US Duplex Scan Art/ven:comp Pr 21 6 $6,025.25 $4,820.20 20% off $1,438.86 $5,422.73 $4,916.11 2026-01-01
1378485 CDM Level 1 10 6 $6,008.75 $4,807.00 20% off $1,442.10 $5,407.88 $4,912.16 2025-11-14
70549 HCPCS 70549 MRA Neck With + Without Contrast Profee 21 6 $5,975.75 $4,780.60 $1,427.04 $5,378.18 $4,875.72 2026-01-01
73718 HCPCS 73718 MRI Foot Without Contrast Left Profee 84 6 $5,784.75 $4,627.80 $1,372.26 $5,232.38 $4,726.39 2026-01-01
54150 HCPCS 54150 Excision Procedures On The Penis 21 6 $5,746.00 $4,596.80 $1,372.20 $5,171.40 $4,688.35 2026-01-01
J0565 HCPCS Bezlotoxumab 1000 Mg/ 40 Ml Sol 21 6 $5,700.00 $4,560.00 20% off $1,368.00 $5,130.00 $4,674.00 2026-01-01
74177 HCPCS 74177 CT Abd & Pelvis W/contrast ProFee 42 6 $5,723.25 $4,578.60 $1,366.74 $5,153.85 $4,671.03 2026-01-01
73222 HCPCS 73222 MRI Shoulder With Contrast Left 147 6 $5,665.75 $4,532.60 $1,240.86 $5,431.95 $4,640.61 2026-01-01
73722 HCPCS 73722 MRI Hip With Contrast Right 126 6 $5,675.25 $4,540.20 20% off $1,303.14 $5,482.35 $4,630.54 2026-01-01
73719 HCPCS 73719 MRI Foot With Contrast Left Profee 84 6 $5,553.75 $4,443.00 20% off $1,326.24 $5,205.60 $4,621.47 2026-01-01
78582 HCPCS 78582 Nm Lung Perf/vent(v/q): Prof 21 6 $5,544.25 $4,435.40 20% off $1,324.02 $4,989.83 $4,523.74 2026-01-01
73219 HCPCS 73219 MRI Ue Non Joint With Contrast Lt Profee 42 6 $5,543.75 $4,435.00 20% off $1,323.90 $4,989.38 $4,523.33 2026-01-01
9839143 CDM Del10200 Birthing 10-20 Hours L2 Charge 11 6 $5,445.50 $4,356.40 20% off $1,306.92 $4,900.95 $4,465.31 2026-01-01
9839151 CDM Del10200 Birthing 10-20 Hours L2 Charge 10 6 $5,418.50 $4,334.80 $1,300.44 $4,876.65 $4,429.62 2025-11-14
73218 HCPCS 73218 MRI Ue Non Joint Without Contrast Profee 21 6 $5,411.00 $4,328.80 $1,292.16 $4,869.90 $4,414.88 2026-01-01
4232581 CDM Room/bed: Intermediate 15 6 $5,273.00 $4,218.40 20% off $4,202.85 $4,745.70 $4,376.59 2026-01-01
94003 HCPCS Rt Ventilator Services Subsequent Charge 21 6 $5,207.75 $4,166.20 20% off $1,243.62 $4,686.98 $4,249.04 2026-01-01
78306 HCPCS 78306 Nm Bone Scan, Whole Body 21 6 $5,201.75 $4,161.40 20% off $1,242.18 $4,681.58 $4,244.12 2026-01-01
74174 HCPCS 74174 CT Angio Abdomen And Pelvis Profee 21 6 $5,187.75 $4,150.20 20% off $1,238.88 $4,668.98 $4,232.84 2026-01-01
70481 HCPCS 70481 CT Orbit Sella Etc. Or Iac With Cont Profee 21 6 $5,173.50 $4,138.80 $1,235.46 $4,656.15 $4,221.16 2026-01-01
72191 HCPCS 72191 CT Angio Pelvis Profee 21 6 $5,141.00 $4,112.80 $1,227.72 $4,626.90 $4,194.71 2026-01-01
9849085 CDM Stent Colonic Wallflex 21 6 $5,095.70 $4,076.56 20% off $1,222.97 $4,586.13 $4,178.47 2026-01-01
78814 HCPCS 78814 Nm PET Scan:limited Profee-initial 21 6 $5,102.00 $4,081.60 20% off $1,218.36 $4,591.80 $4,162.73 2026-01-01
74183 HCPCS 74183 MRI Abdomen With + Without Contrast Profee 21 6 $5,018.25 $4,014.60 20% off $1,198.38 $4,516.43 $4,094.47 2026-01-01
73206 HCPCS 73206 CT Angio Upper Extremity Right 63 6 $4,929.50 $3,943.60 20% off $1,177.20 $8,872.88 $4,071.15 2026-01-01
70551 HCPCS 70551 MRI Brain Without Contrast Profee 31 6 $4,926.75 $3,941.40 20% off $1,176.54 $4,770.23 $4,068.87 2026-01-01
72148 HCPCS 72148 MRI Spine Lumbar Without Contrast Profee 21 6 $4,939.50 $3,951.60 20% off $1,179.60 $4,445.55 $4,030.30 2026-01-01
73706 HCPCS 73706 CT Angio Lower Extremity Right 63 6 $4,852.25 $3,881.80 $1,158.72 $8,733.38 $4,007.24 2026-01-01
72146 HCPCS 72146 MRI Spine Thoracic Without Contrast Profee 21 6 $4,884.75 $3,907.80 $1,166.52 $4,396.28 $3,985.61 2026-01-01
81229 HCPCS Chromosomal Microarray, Congenital Mayo 21 6 $4,883.00 $3,906.40 20% off $1,166.10 $4,394.70 $3,984.18 2026-01-01
70543 HCPCS 70543 MRI Neck With +without Contrast Profee 21 6 $4,881.00 $3,904.80 $1,165.62 $4,392.90 $3,982.54 2026-01-01
93306 HCPCS 93306 Echocardiography 2-d W/dopp ProFee 21 6 $4,825.50 $3,860.40 20% off $1,152.36 $4,342.95 $3,937.23 2026-01-01
C8929 HCPCS C8929 Ue Echo Complete With Contrast 21 6 $4,825.50 $3,860.40 20% off $1,152.36 $4,342.95 $3,937.23 2026-01-01
72141 HCPCS 72141 MRI Spine Cervical Without Contrast Profee 21 6 $4,818.75 $3,855.00 20% off $1,150.74 $4,336.88 $3,931.70 2026-01-01
99291 HCPCS 99291 Critical Care E&m-unstabl ProFee 21 6 $4,814.00 $3,851.20 20% off $1,149.60 $4,332.60 $3,927.80 2026-01-01
12410929 CDM Micromatrix Flex 5cc 21 6 $4,616.07 $3,692.86 $1,107.86 $4,154.46 $3,785.18 2026-01-01
70480 HCPCS 70480 CT Orbit Sella Etc. Or Iac Without Cont Profee 21 6 $4,524.25 $3,619.40 20% off $1,080.42 $4,071.83 $3,691.44 2026-01-01
95805 HCPCS 95805 Multiple Sleep Latency Study- Physician 21 6 $4,511.25 $3,609.00 20% off $1,077.30 $4,060.13 $3,680.78 2026-01-01
10121 HCPCS 10121 Incision & Removal Foreign Body Subq Tiss Compl TechFee 21 6 $4,509.00 $3,607.20 20% off $1,076.76 $4,058.10 $3,678.93 2026-01-01
20206 HCPCS 20206 CT Bx Soft Tissue Biopsy 21 6 $4,509.00 $3,607.20 20% off $1,076.76 $4,058.10 $3,678.93 2026-01-01
36569 HCPCS 36569 Insertion Of Peripherally Inserted Central Venous Catheter 21 6 $4,506.25 $3,605.00 20% off $1,076.10 $4,055.63 $3,676.68 2026-01-01
71552 HCPCS 71552 MRI Chest With + Without Contrast Profee 21 6 $4,463.75 $3,571.00 20% off $1,065.96 $4,017.38 $3,642.03 2026-01-01
27842 HCPCS 27842 Cltx Ankle Dislc Req Anes W/wo Prq Skel Fixj TechFee 21 6 $4,462.25 $3,569.80 $1,065.60 $4,016.03 $3,640.80 2026-01-01
23655 HCPCS 23655 Clsd Tx Shoulder Dislc W/manipulation Req Anes TechFee 21 6 $4,462.25 $3,569.80 $1,065.60 $4,016.03 $3,640.80 2026-01-01
27810 HCPCS 27810 Closed Tx Bimalleolar Ankle Fracture W/manj TechFee 21 6 $4,462.25 $3,569.80 $1,065.60 $4,016.03 $3,640.80 2026-01-01
70546 HCPCS 70546 MRA Brain/Head With + Without Contrast Profee 21 6 $4,432.25 $3,545.80 $1,058.46 $3,989.03 $3,616.41 2026-01-01
41115 HCPCS Frenectomy 21 6 $4,335.25 $3,468.20 20% off $1,035.30 $3,901.73 $3,537.28 2026-01-01
10047288 CDM Pain Clinic Level 2 Procedure 11 6 $4,286.25 $3,429.00 20% off $1,028.70 $3,857.63 $3,514.73 2026-01-01
1378487 CDM Level 3 21 6 $4,295.00 $3,436.00 20% off $1,025.70 $3,865.50 $3,504.48 2026-01-01
10047300 CDM Pain Clinic Level 2 Procedure 10 6 $4,265.00 $3,412.00 20% off $1,023.60 $3,838.50 $3,486.64 2025-11-14
9821371-395 CDM 44206-0439-40 - Immune Globulin **Privigen** 10% IV Sol 400 Ml 11 6 $4,224.00 $3,379.20 20% off $1,013.76 $3,801.60 $3,463.68 2026-01-01
72149 HCPCS 72149 MRI Spine Lumbar With Contrast Profee 21 6 $4,232.75 $3,386.20 20% off $1,010.82 $3,809.48 $3,453.64 2026-01-01
72157 HCPCS 72157 MRI Spine Thoracic With + Without Contrast Profee 21 6 $4,184.00 $3,347.20 20% off $999.18 $3,765.60 $3,413.87 2026-01-01
J2182 HCPCS Mepolizumab 100 Mg Pow 21 6 $4,111.02 $3,288.82 $986.64 $3,699.92 $3,371.04 2026-01-01
12153309 CDM Micromatrix, 1000 Mg 10 6 $4,077.00 $3,261.60 20% off $978.48 $3,669.30 $3,332.95 2025-11-14
93880 HCPCS 93880 US Carotid Bilat: Prof 21 6 $4,040.75 $3,232.60 20% off $964.98 $3,636.68 $3,297.02 2026-01-01
70544 HCPCS 70544 MRA Brain/Head Without Contrast Profee 21 6 $3,993.50 $3,194.80 $953.70 $3,594.15 $3,258.48 2026-01-01
19083 HCPCS 19083 US Bx Breast Vac Core Prof 21 6 $3,992.00 $3,193.60 20% off $953.34 $3,592.80 $3,257.25 2026-01-01
77001 HCPCS 77001 Xr Fluoro Cvad Pro Fee 21 6 $3,893.25 $3,114.60 20% off $929.76 $3,503.93 $3,176.68 2026-01-01
78459 HCPCS 78459 Nm PET Cardiac Metabolic Prof 21 6 $3,873.00 $3,098.40 20% off $924.90 $3,485.70 $3,160.08 2026-01-01
78491 HCPCS 78491 Nm PET Cardiac Perf Single: Prof 21 6 $3,873.00 $3,098.40 20% off $924.90 $3,485.70 $3,160.08 2026-01-01
78492 HCPCS 78492 Nm PET Cardiac Perf Multi:prof 21 6 $3,873.00 $3,098.40 20% off $924.90 $3,485.70 $3,160.08 2026-01-01
78608 HCPCS 78608 Nm PET Brain Metabolic Prof 21 6 $3,873.00 $3,098.40 20% off $924.90 $3,485.70 $3,160.08 2026-01-01
78609 HCPCS 78609 Nm PET Brain: Perfusion Prof 21 6 $3,873.00 $3,098.40 20% off $924.90 $3,485.70 $3,160.08 2026-01-01
J3111 HCPCS Romosozumab-aqqg (Evenity) 105 Mg/1.17 Ml Sol 53 6 $3,894.10 $3,115.28 $901.28 $3,549.04 $3,158.65 2026-01-01
8163851 CDM Room/bed: Private With Telemetry 8 6 $3,766.00 $3,012.80 $3,016.57 $3,389.40 $3,135.20 2026-01-01
10085430 CDM Room/bed: Semi-private Telemetry 15 6 $3,765.00 $3,012.00 20% off $3,000.55 $3,388.50 $3,124.95 2026-01-01
70552 HCPCS 70552 MRI Brain With Contrast Profee 31 6 $3,757.00 $3,005.60 20% off $897.18 $3,800.93 $3,102.75 2026-01-01
J2997 HCPCS Alteplase 100 Mg IV Inj 63 6 $6,407.48 $5,125.98 20% off $143.03 $11,502.69 $3,067.38 2026-01-01
73221 HCPCS 73221 MRI Elbow Without Contrast Left Profee 63 6 $3,757.00 $3,005.60 20% off $897.18 $3,381.30 $3,065.37 2026-01-01
73721 HCPCS 73721 MRI Ankle Without Contrast Left Profee 126 6 $3,731.75 $2,985.40 20% off $442.56 $6,748.65 $3,041.07 2026-01-01
9884496 CDM Del10145 Birthing < 10 Hours L1 Charge 11 6 $3,696.50 $2,957.20 20% off $887.16 $3,326.85 $3,031.13 2026-01-01
74170 HCPCS 74170 CT Abdomen With + Without Contrast Profee 21 6 $3,702.50 $2,962.00 20% off $884.16 $3,332.25 $3,020.88 2026-01-01
72195 HCPCS 72195 MRI Pelvis Without Contrast Profee 21 6 $3,695.25 $2,956.20 20% off $882.42 $3,325.73 $3,014.94 2026-01-01
9884500 CDM Del10145 Birthing < 10 Hours L1 Charge 10 6 $3,678.00 $2,942.40 20% off $882.72 $3,310.20 $3,006.77 2025-11-14
72196 HCPCS 72196 MRI Pelvis With Contrast Profee 21 6 $3,646.50 $2,917.20 20% off $870.78 $3,281.85 $2,975.17 2026-01-01
74176 HCPCS 74176 CT Abdomen And Pelvis Without Contrast 32 6 $3,616.25 $2,893.00 20% off $863.64 $3,254.85 $2,958.05 2026-01-01
74420 HCPCS 74420 Xr Urography Retrograde Prof 21 6 $3,622.25 $2,897.80 $865.02 $3,260.03 $2,955.49 2026-01-01
9680488 CDM Room/bed: Semi Private Peds 8 6 $3,509.00 $2,807.20 20% off $2,810.71 $3,158.10 $2,921.24 2026-01-01
8081565 CDM Room/bed: Private 8 6 $3,509.00 $2,807.20 20% off $2,810.71 $3,158.10 $2,921.24 2026-01-01
8163849 CDM Room/bed: OB 8 6 $3,509.00 $2,807.20 20% off $2,810.71 $3,158.10 $2,921.24 2026-01-01
8078890 CDM Room/bed: Semi-private 15 6 $3,509.00 $2,807.20 20% off $2,797.09 $3,158.10 $2,912.47 2026-01-01
2120840 CDM Room/bed: Inpatient 15 6 $3,509.00 $2,807.20 20% off $2,797.09 $3,158.10 $2,912.47 2026-01-01
70490 HCPCS 70490 CT Neck Soft Tissue Without Contrast Profee 21 6 $3,568.00 $2,854.40 20% off $852.06 $3,211.20 $2,911.21 2026-01-01
73040 HCPCS 73040 Xr Arthrogram Shoulder Bilat 63 6 $3,507.50 $2,806.00 20% off $837.60 $6,313.05 $2,896.70 2026-01-01
70547 HCPCS 70547 MRA Neck Without Contrast Profee 21 6 $3,545.50 $2,836.40 20% off $846.66 $3,190.95 $2,892.76 2026-01-01
12709997 CDM Mesh, Phasix St 7x10 Cm 21 6 $3,568.95 $2,855.16 20% off $831.60 $3,212.06 $2,875.95 2026-01-01
70542 HCPCS 70542 MRI Face Neck Orbit With Contrast Profee 21 6 $3,519.25 $2,815.40 20% off $840.42 $3,167.33 $2,871.44 2026-01-01
72130 HCPCS 72130 CT Spine Thoracic With + Without Contrast Profee 21 6 $3,476.75 $2,781.40 20% off $830.28 $3,129.08 $2,836.79 2026-01-01
9849051 CDM Mesh Phasix St 3x4 Biologic 10 6 $3,465.00 $2,772.00 20% off $831.60 $3,118.50 $2,832.64 2025-11-14
93017 HCPCS 93017 Cardiac Stress Test Opnch 21 6 $3,466.25 $2,773.00 20% off $827.76 $3,119.63 $2,828.18 2026-01-01
73700 HCPCS 73700 CT Lower Extremity Without Contrast Bilat Profee 63 6 $3,411.00 $2,728.80 $814.56 $6,140.03 $2,817.02 2026-01-01
73200 HCPCS 73200 CT Upper Ext Bilat Without Cont 63 6 $3,403.75 $2,723.00 20% off $812.82 $6,126.53 $2,811.00 2026-01-01
71270 HCPCS 71270 CT Chest With + Without Contrast Profee 21 6 $3,443.25 $2,754.60 20% off $822.24 $3,098.93 $2,809.32 2026-01-01
78014 HCPCS 78014 Nm Thyroid Uptake &scan Prof 21 6 $3,439.75 $2,751.80 $821.46 $3,095.78 $2,806.66 2026-01-01
72128 HCPCS 72128 CT Spine Thoracic Without Contrast Profee 21 6 $3,427.25 $2,741.80 $818.46 $3,084.53 $2,796.41 2026-01-01
93976 HCPCS 93976 US Duplex Scan Art/ven:lim Pro 21 6 $3,425.50 $2,740.40 20% off $818.04 $3,082.95 $2,794.97 2026-01-01
74185 HCPCS 74185 MRA Abdomen With + Without Contrast Profee 21 6 $3,400.25 $2,720.20 20% off $811.98 $3,060.23 $2,774.27 2026-01-01
78226 HCPCS 78226 Nm Hepatobiliary Without Ef: Prof 21 6 $3,396.75 $2,717.40 20% off $811.14 $3,057.08 $2,771.40 2026-01-01
70470 HCPCS 70470 CT Brain/Head With + Without Contrast Profee 21 6 $3,380.00 $2,704.00 20% off $807.18 $3,042.00 $2,757.87 2026-01-01
77075 HCPCS 77075 Xr Osseous Survey Compl Prof 21 6 $3,378.25 $2,702.60 20% off $806.76 $3,040.43 $2,756.43 2026-01-01
70482 HCPCS 70482 CT Orbit Sella Etc. Or Iac With + Without Cont Profee 21 6 $3,371.50 $2,697.20 20% off $805.14 $3,034.35 $2,750.90 2026-01-01
76936 HCPCS 76936 US Guidance Comp Repair: Prof 21 6 $3,342.75 $2,674.20 20% off $798.24 $3,008.48 $2,727.32 2026-01-01
93930 HCPCS US Dupp Upp Ext Art Bilat Profee 21 6 $3,342.25 $2,673.80 $798.12 $3,008.03 $2,726.91 2026-01-01
71550 HCPCS 71550 MRI Chest Without Contrast Profee 21 6 $3,339.25 $2,671.40 20% off $797.46 $3,005.33 $2,724.66 2026-01-01
73701 HCPCS 73701 CT Knee With Contrast Left 63 6 $3,290.75 $2,632.60 20% off $785.88 $5,922.90 $2,717.84 2026-01-01
46320 HCPCS 46320 Excision Of Thrombosed Hemorrhoid, External ProFee 21 6 $3,323.25 $2,658.60 20% off $793.62 $2,990.93 $2,711.54 2026-01-01
74182 HCPCS 74182 MRI Abdomen With Contrast Profee 21 6 $3,318.75 $2,655.00 20% off $792.54 $2,986.88 $2,707.85 2026-01-01
73725 HCPCS 73725 MRA Lower Extremity With + Without Cnt Left Profee 168 6 $3,285.50 $2,628.40 20% off $507.00 $3,267.23 $2,694.11 2026-01-01
9839142 CDM Nrs10115 Nursery Level 3 Charge 15 6 $3,243.00 $2,594.40 20% off $2,585.03 $2,918.70 $2,691.69 2026-01-01
4232588 CDM Room/bed: Nursery Level 3 15 6 $3,243.00 $2,594.40 20% off $2,584.83 $2,918.70 $2,691.69 2026-01-01
74181 HCPCS 74181 MRI Abdomen Without Contrast Profee 42 6 $3,272.00 $2,617.60 20% off $781.38 $2,944.80 $2,669.72 2026-01-01
72133 HCPCS 72133 CT Spine Lumbar With + Without Contrast Profee 21 6 $3,249.00 $2,599.20 20% off $775.86 $2,924.10 $2,650.86 2026-01-01
72127 HCPCS 72127 CT Spine Cervical With + Without Contrast Profee 21 6 $3,249.00 $2,599.20 20% off $775.86 $2,924.10 $2,650.86 2026-01-01
Q4137 HCPCS Amnio Excel Amniotic Allograft Membrane 10cm X10cm 42 6 $7,461.75 $5,969.40 20% off $625.32 $11,086.20 $2,650.64 2026-01-01
74250 HCPCS 74250 Xr Sbft Single Contrast Pro Fee 21 6 $3,223.50 $2,578.80 $769.80 $2,901.15 $2,630.15 2026-01-01
71551 HCPCS 71551 MRI Chest With Contrast Profee 21 6 $3,199.50 $2,559.60 20% off $764.04 $2,879.55 $2,610.47 2026-01-01
81420 HCPCS MaterniT21 Plus Mayo 21 6 $3,195.50 $2,556.40 20% off $763.08 $2,875.95 $2,607.19 2026-01-01
J3358 HCPCS Ustekinumab 130 Mg/26 Ml Sol 21 6 $3,177.72 $2,542.18 $762.65 $2,859.95 $2,605.73 2026-01-01
1378486-7 CDM Level 2 11 6 $3,174.25 $2,539.40 20% off $761.82 $2,856.83 $2,602.89 2026-01-01
78452 HCPCS 78452 Nm Myocard Multi W.wm.ef: Prof 21 6 $3,159.75 $2,527.80 $754.56 $2,843.78 $2,578.08 2026-01-01
72142 HCPCS 72142 MRI Spine Cervical With Contrast Profee 21 6 $3,127.50 $2,502.00 20% off $746.88 $2,814.75 $2,551.84 2026-01-01
32408 HCPCS 32408 CT Bx Lung Percw/guidance:needle 21 6 $3,118.75 $2,495.00 20% off $744.78 $2,806.88 $2,544.67 2026-01-01
78598 HCPCS 78598 Nm Lung V/q W/diff Quant:prof 21 6 $3,117.25 $2,493.80 $744.42 $2,805.53 $2,543.44 2026-01-01
9846693 CDM Tube Dynamization/distraction 21 6 $3,092.63 $2,474.10 20% off $742.23 $2,783.37 $2,535.96 2026-01-01
70548 HCPCS 70548 MRA Neck With Contrast Profee 21 6 $3,104.25 $2,483.40 20% off $741.30 $2,793.83 $2,532.78 2026-01-01
70336 HCPCS 70336 MRI Tmj Profee 21 6 $3,095.75 $2,476.60 20% off $739.26 $2,786.18 $2,525.81 2026-01-01
93925 HCPCS US Extrem Low Arterial-bil Pro 21 6 $3,092.50 $2,474.00 20% off $738.48 $2,783.25 $2,523.14 2026-01-01
71260 HCPCS 71260 CT Chest With Contrast Profee 21 6 $3,081.00 $2,464.80 $735.78 $2,772.90 $2,513.92 2026-01-01
73225 HCPCS 73225 MRA Upper Extremity With + Without Cnt Left Profee 42 6 $3,032.50 $2,426.00 20% off $724.20 $2,729.25 $2,474.35 2026-01-01
9849105 CDM Programmer For Neurostimulator 21 6 $3,012.75 $2,410.20 20% off $723.06 $2,711.48 $2,470.46 2026-01-01
1378485-5 CDM Level 1 11 6 $3,012.75 $2,410.20 20% off $723.06 $2,711.48 $2,470.46 2026-01-01
74160 HCPCS 74160 CT Abdomen With Contrast Profee 21 6 $3,019.25 $2,415.40 20% off $721.02 $2,717.33 $2,463.49 2026-01-01
C1771 HCPCS Sling Tvt Vag Gynecare Device 21 6 $3,001.44 $2,401.15 20% off $720.35 $2,701.30 $2,461.18 2026-01-01
74280 HCPCS 74280 Xr Barium Enema Ac* Pro Fee 21 6 $3,013.25 $2,410.60 20% off $719.58 $2,711.93 $2,458.57 2026-01-01
58822 HCPCS 58822 US Drain Ovarian Abscess Abd 21 6 $3,012.25 $2,409.80 $719.34 $2,711.03 $2,457.75 2026-01-01
13216286 CDM Tyrx Antibiotic Pouch 11 6 $2,992.50 $2,394.00 20% off $718.20 $2,693.25 $2,453.85 2026-01-01
72193 HCPCS 72193 CT Pelvis With Contrast Profee 21 6 $3,001.75 $2,401.40 20% off $716.82 $2,701.58 $2,449.14 2026-01-01
70491 HCPCS 70491 CT Neck Soft Tissue With Contrast Profee 21 6 $2,993.00 $2,394.40 20% off $714.72 $2,693.70 $2,441.96 2026-01-01
23650 HCPCS 23650 Clsd Tx Shoulder Dislc W/manipulation Without Anes ProFee 21 6 $2,970.50 $2,376.40 $709.38 $2,673.45 $2,423.72 2026-01-01
70492 HCPCS 70492 CT Neck Soft Tissue With + Without Contrast Profee 21 6 $2,965.50 $2,372.40 $708.18 $2,668.95 $2,419.62 2026-01-01
73115 HCPCS 73115 Xr Arthrogram Wrist Bilat 63 6 $2,921.75 $2,337.40 $697.74 $5,258.93 $2,413.02 2026-01-01
71555 HCPCS 71555 MRA Chest With + Without Contrast Profee 21 6 $2,952.25 $2,361.80 $705.00 $2,657.03 $2,408.75 2026-01-01
J1602 HCPCS Golimumab 50 Mg/4 Ml 21 6 $2,924.40 $2,339.52 20% off $701.86 $2,631.96 $2,398.01 2026-01-01
70540 HCPCS 70540 MRI Face Neck Orbit Without Contrast Profee 21 6 $2,895.75 $2,316.60 20% off $691.50 $2,606.18 $2,362.63 2026-01-01
9921042 CDM Ncty Pacu 21 6 $2,890.75 $2,312.60 20% off $690.30 $2,601.68 $2,358.53 2026-01-01
70545 HCPCS 70545 MRA Brain/Head With Contrast Profee 21 6 $2,883.00 $2,306.40 $688.50 $2,594.70 $2,352.38 2026-01-01
93978 HCPCS US Duplex Aorta/ivc Comp Prof 21 6 $2,872.00 $2,297.60 20% off $685.86 $2,584.80 $2,343.36 2026-01-01
74300 HCPCS 74300 Xr Cholangiogram Operative 21 6 $2,862.75 $2,290.20 20% off $683.64 $2,576.48 $2,335.77 2026-01-01
74251 HCPCS 74251 Xr Sbft Enteroclysis Double Cont Prof 21 6 $2,857.25 $2,285.80 $682.32 $2,571.53 $2,331.26 2026-01-01
94621 HCPCS Pulmonary Stress Testing 21 6 $2,842.00 $2,273.60 20% off $678.66 $2,557.80 $2,318.76 2026-01-01
76812 HCPCS 76812 US OB Fetal Anat, Ea Add: Prof 21 6 $2,807.25 $2,245.80 $670.38 $2,526.53 $2,290.47 2026-01-01
72147 HCPCS 72147 MRI Spine Thoracic With Contrast Profee 21 6 $2,765.25 $2,212.20 20% off $660.36 $2,488.73 $2,256.23 2026-01-01
70486 HCPCS 70486 CT Maxillofacial Without Contrast Profee 42 6 $2,621.50 $2,097.20 20% off $626.04 $3,353.18 $2,255.26 2026-01-01
78315 HCPCS 78315 Nm Bone Scan, 3 Phase: Prof 21 6 $2,718.50 $2,174.80 $649.20 $2,446.65 $2,218.10 2026-01-01
72131 HCPCS 72131 CT Spine Lumbar Without Contrast Profee 21 6 $2,671.75 $2,137.40 $638.04 $2,404.58 $2,179.97 2026-01-01
J3032 HCPCS Eptinezumab-jjmr 100 mg/mL Sol 21 6 $2,651.60 $2,121.28 $636.38 $2,386.44 $2,174.31 2026-01-01
78195 HCPCS 78195 Nm Lymphography:prof 21 6 $2,663.00 $2,130.40 $635.94 $2,396.70 $2,172.80 2026-01-01
74283 HCPCS 74283 Xr Barium Enema Therapeutic Pf 21 6 $2,638.00 $2,110.40 $630.00 $2,374.20 $2,152.50 2026-01-01
72125 HCPCS 72125 CT Spine Cervical Without Contrast Profee 21 6 $2,628.75 $2,103.00 20% off $627.78 $2,365.88 $2,144.92 2026-01-01
9839140 CDM Nrs10105 Nursery Level 2 Charge 15 6 $2,575.00 $2,060.00 20% off $2,052.56 $2,317.50 $2,137.25 2026-01-01
4232587 CDM Room/bed: Nursery Level 2 15 6 $2,575.00 $2,060.00 20% off $2,052.16 $2,317.50 $2,137.25 2026-01-01
49082 HCPCS 49082 Abdominal Paracentesis (diagnostic Or Therapeutic) Withou 21 6 $2,615.25 $2,092.20 20% off $624.54 $2,353.73 $2,133.85 2026-01-01
J0897 HCPCS Denosumab 120 Mg/1.7 Ml 63 6 $2,600.93 $2,080.74 20% off $609.98 $4,207.17 $2,132.76 2026-01-01
78013 HCPCS 78013 Nm Thyroid Scan(i123)prof 42 6 $2,616.00 $2,092.80 $591.24 $2,493.00 $2,129.89 2026-01-01
P9035 HCPCS E3057 Aph Plt Acda Lr Irr 2 21 6 $2,581.50 $2,065.20 20% off $616.50 $2,323.35 $2,106.38 2026-01-01
78103 HCPCS 78103 Nm Bone Marrow Multiple: Prof 21 6 $2,577.75 $2,062.20 20% off $615.60 $2,319.98 $2,103.30 2026-01-01
50430 HCPCS 50430 Xr Urography Antegrade Prof 21 6 $2,576.75 $2,061.40 $615.36 $2,319.08 $2,102.48 2026-01-01
8163847 CDM Room/bed Newborn 8 6 $2,515.00 $2,012.00 20% off $2,014.52 $2,263.50 $2,093.74 2026-01-01
9839141 CDM Nrs10110 Nursery Level 1 Charge 15 6 $2,515.00 $2,012.00 20% off $2,004.50 $2,263.50 $2,087.45 2026-01-01
2120838 CDM Room/bed: Nursery Level 1 15 6 $2,515.00 $2,012.00 20% off $2,004.10 $2,263.50 $2,087.45 2026-01-01
73525 HCPCS 73525 Xr Arthrogram Hip Bilat 63 6 $2,518.25 $2,014.60 20% off $601.38 $4,532.18 $2,079.77 2026-01-01
72194 HCPCS 72194 CT Pelvis With + Without Contrast Profee 21 6 $2,544.25 $2,035.40 $607.56 $2,289.83 $2,075.83 2026-01-01
74150 HCPCS 74150 CT Abdomen Without Contrast Profee 21 6 $2,531.50 $2,025.20 20% off $604.56 $2,278.35 $2,065.58 2026-01-01
72192 HCPCS 72192 CT Pelvis Without Contrast Profee 21 6 $2,528.25 $2,022.60 20% off $603.78 $2,275.43 $2,062.92 2026-01-01
77076 HCPCS 77076 Xr Osseous Survey Child Prof 21 6 $2,515.00 $2,012.00 20% off $600.60 $2,263.50 $2,052.05 2026-01-01
Q5111 HCPCS Pegfilgrastim Cbqv 6 Mg/0.6 Ml 21 6 $2,502.11 $2,001.69 $600.51 $2,251.90 $2,051.73 2026-01-01
76885 HCPCS 76885 US Infant Hips With Manip: Prof 21 6 $2,499.25 $1,999.40 $596.82 $2,249.33 $2,039.14 2026-01-01
78300 HCPCS 78300 Nm Bone Scan, Limited: Prof 21 6 $2,495.50 $1,996.40 $595.92 $2,245.95 $2,036.06 2026-01-01
13258327 CDM Nail Troch 170mm D10x170mm 130deg 11 6 $2,460.00 $1,968.00 20% off $590.40 $2,214.00 $2,017.20 2026-01-01
13258321 CDM Nail Troch 170mm D9x170mm 130deg 11 6 $2,460.00 $1,968.00 20% off $590.40 $2,214.00 $2,017.20 2026-01-01
13258324 CDM Nail Troch 170mm D10x170mm 125deg (8125-0170s) 11 6 $2,460.00 $1,968.00 20% off $590.40 $2,214.00 $2,017.20 2026-01-01
71250 HCPCS 71250 CT Chest Without Contrast Profee 21 6 $2,466.50 $1,973.20 20% off $589.02 $2,219.85 $2,012.49 2026-01-01
L3900 HCPCS L3900 Wrist - Tenodesis Orthosis 21 6 $2,455.75 $1,964.60 20% off $586.44 $2,210.18 $2,003.67 2026-01-01
70460 HCPCS 70460 CT Brain/Head With Contrast Profee 21 6 $2,451.50 $1,961.20 20% off $585.42 $2,206.35 $2,000.19 2026-01-01
81479 HCPCS .gamma-globin Full Gene Sequencing Mayo 21 6 $2,399.50 $1,919.60 20% off $573.00 $2,159.55 $1,957.75 2026-01-01
76811 HCPCS 76811 US OB Fetal Detail >14 Wk:prof 21 6 $2,373.25 $1,898.60 20% off $566.76 $2,135.93 $1,936.43 2026-01-01
J0875 HCPCS Dalbavancin 500 Mg Pow 21 6 $2,360.07 $1,888.06 $566.42 $2,124.06 $1,935.26 2026-01-01
76700 HCPCS 76700 US Abdomen Complete: Prof 21 6 $2,370.25 $1,896.20 20% off $566.04 $2,133.23 $1,933.97 2026-01-01
C8924 HCPCS C8924 Ue Echo Limited With Contrast 21 6 $2,370.25 $1,896.20 20% off $566.04 $2,133.23 $1,933.97 2026-01-01
77021 HCPCS 77021 MRI Guided Needle Placement Profee 21 6 $2,361.75 $1,889.40 $564.00 $2,125.58 $1,927.00 2026-01-01
74410 HCPCS 74410 Xr Ivp Without Tomos Pro Fee 21 6 $2,357.50 $1,886.00 20% off $562.98 $2,121.75 $1,923.52 2026-01-01
J9355 HCPCS Trastuzumab 150 Mg Pow 21 6 $2,337.63 $1,870.10 20% off $561.03 $2,103.87 $1,916.86 2026-01-01
75822 HCPCS 75822 Xr Venogram Ext Bilat Prof 21 6 $2,339.25 $1,871.40 $558.60 $2,105.33 $1,908.55 2026-01-01
12014 HCPCS 12014 Simple Repair F/e/e/n/l/m 5.1cm-7.5 Cm ProFee 42 6 $2,313.25 $1,850.60 20% off $552.42 $2,094.75 $1,896.89 2026-01-01
49406 HCPCS 49406 CT Drain Appendix Abscess,perc 21 6 $2,322.25 $1,857.80 20% off $554.58 $2,090.03 $1,894.82 2026-01-01
49405 HCPCS 49405 CT Drain Liver Abscess,perc 21 6 $2,317.75 $1,854.20 20% off $553.50 $2,085.98 $1,891.13 2026-01-01
71271 HCPCS 71271 CT Low Dose Lung Screening 21 6 $2,306.50 $1,845.20 20% off $550.80 $2,075.85 $1,881.90 2026-01-01
72198 HCPCS 72198 MRA Pelvis With + Without Contrast Profee 63 6 $2,986.25 $2,389.00 20% off $501.78 $2,701.13 $1,881.68 2026-01-01
73201 HCPCS 73201 CT Upper Ext Bilat W Cont 63 6 $2,262.25 $1,809.80 20% off $540.24 $4,071.83 $1,868.33 2026-01-01
78264 HCPCS 78264 Nm Gastric Emptying Study:prof 21 6 $2,289.25 $1,831.40 $546.66 $2,060.33 $1,867.76 2026-01-01
74455 HCPCS 74455 Xr Void Cystourethrogram Prof 21 6 $2,287.75 $1,830.20 20% off $546.30 $2,058.98 $1,866.53 2026-01-01
75809 HCPCS 75809 Xr Shuntogram Prof 21 6 $2,284.50 $1,827.60 20% off $545.58 $2,056.05 $1,864.07 2026-01-01
92960 HCPCS 92960 Phy Cardioversion External ProFee 21 6 $2,283.00 $1,826.40 $545.22 $2,054.70 $1,862.84 2026-01-01
70450 HCPCS 70450 CT Brain/Head Without Contrast Profee 21 6 $2,279.75 $1,823.80 20% off $544.44 $2,051.78 $1,860.17 2026-01-01
77085 HCPCS 77085 Bm Bmd Dxa Hip, Spine, Fx Assess 21 6 $2,260.75 $1,808.60 20% off $539.88 $2,034.68 $1,844.59 2026-01-01
76770 HCPCS 76770 US Retroperitoneal Cmpl:prof 21 6 $2,243.25 $1,794.60 20% off $535.68 $2,018.93 $1,830.24 2026-01-01
12069671 CDM Micromatrix, 500 Mg 10 6 $2,227.50 $1,782.00 20% off $534.60 $2,004.75 $1,820.98 2025-11-14
78451 HCPCS 78451 Nm Myocard Single W/wm/ef:prof 21 6 $2,228.75 $1,783.00 20% off $532.26 $2,005.88 $1,818.56 2026-01-01
70488 HCPCS 70488 CT Maxillofacial With + Without Contrast Profee 42 6 $3,551.00 $2,840.80 $503.22 $3,211.88 $1,812.83 2026-01-01
9820988-156 CDM 00003-2187-10 - Abatacept 250 Mg IV Inj [ncty] 11 6 $2,204.19 $1,763.35 20% off $529.01 $1,983.77 $1,807.44 2026-01-01
J0129 HCPCS Abatacept 250 Mg IV Inj 21 6 $2,204.19 $1,763.35 20% off $529.01 $1,983.77 $1,807.44 2026-01-01
78278 HCPCS 78278 Nm Gi Bleed:prof 21 6 $2,210.00 $1,768.00 20% off $527.76 $1,989.00 $1,803.18 2026-01-01
78472 HCPCS 78472 Nm Muga: Prof 21 6 $2,202.50 $1,762.00 20% off $525.96 $1,982.25 $1,797.03 2026-01-01
76800 HCPCS 76800 US Spinal Canal: Prof 21 6 $2,171.25 $1,737.00 20% off $518.52 $1,954.13 $1,771.61 2026-01-01
78803 HCPCS 78803 Nm Spect: Prof 21 6 $2,169.50 $1,735.60 20% off $518.10 $1,952.55 $1,770.18 2026-01-01
72126 HCPCS 72126 CT Spine Cervical With Contrast Profee 21 6 $2,166.50 $1,733.20 20% off $517.38 $1,949.85 $1,767.72 2026-01-01
72129 HCPCS 72129 CT Spine Thoracic With Contrast Profee 21 6 $2,166.50 $1,733.20 20% off $517.38 $1,949.85 $1,767.72 2026-01-01
72132 HCPCS 72132 CT Spine Lumbar With Contrast Profee 21 6 $2,166.50 $1,733.20 20% off $517.38 $1,949.85 $1,767.72 2026-01-01
74740 HCPCS 74740 Xr Hysterosalpingography: Prof 21 6 $2,158.25 $1,726.60 20% off $515.40 $1,942.43 $1,760.95 2026-01-01
9847473 CDM Cath Kit Edge 90 Procedure 21 6 $2,140.50 $1,712.40 $513.72 $1,926.45 $1,755.21 2026-01-01
74270 HCPCS 74270 Xr Be Single Contrast Pro Fee 21 6 $2,150.00 $1,720.00 20% off $513.42 $1,935.00 $1,754.19 2026-01-01
76100 HCPCS 76100 Xr Volume Rad Pro Fee 21 6 $2,144.25 $1,715.40 $512.04 $1,929.83 $1,749.47 2026-01-01
76801 HCPCS 76801 US Ob, 1st Trimester, Prof 21 6 $2,134.75 $1,707.80 20% off $509.82 $1,921.28 $1,741.89 2026-01-01
93882 HCPCS US Carotid Unilat/ltd Prof 21 6 $2,133.50 $1,706.80 20% off $509.52 $1,920.15 $1,740.86 2026-01-01
9821370-393 CDM 44206-0438-20 - Immune Globulin **Privigen** 10% IV Sol 200 Ml 11 6 $2,112.00 $1,689.60 20% off $506.88 $1,900.80 $1,731.84 2026-01-01
94060 HCPCS 94060 Pft Phys Review & Interp ProFee 21 6 $2,113.25 $1,690.60 20% off $504.66 $1,901.93 $1,724.26 2026-01-01
76870 HCPCS 76870 Pocus US Scrotum Contents Prof 21 6 $2,102.75 $1,682.20 20% off $502.14 $1,892.48 $1,715.65 2026-01-01
93931 HCPCS 93931 US Dup Upp Ext Art Rt 42 6 $2,088.00 $1,670.40 $498.60 $1,879.20 $1,703.55 2026-01-01
J2802 HCPCS 55513-0223-01 - romiPLOStim 125 Mcg Pow [ncty] 22 6 $1,966.47 $1,573.18 $471.95 $3,539.24 $1,696.08 2026-01-01
J2796 HCPCS romiPLOStim 125 Mcg Pow 42 6 $2,949.48 $2,359.59 $471.95 $3,539.24 $1,696.08 2026-01-01
93979 HCPCS US Duplex Aorta/ivs Lim Prof 21 6 $2,068.50 $1,654.80 20% off $493.98 $1,861.65 $1,687.77 2026-01-01
76536 HCPCS 76536 Pocus US Soft Tissue Hd/neck Prof 21 6 $2,068.25 $1,654.60 20% off $493.92 $1,861.43 $1,687.56 2026-01-01
9847662 CDM Kit Tightrope Knotless 21 6 $2,056.95 $1,645.56 $493.67 $1,851.26 $1,686.70 2026-01-01
10626258 CDM Kit Jada System Vacuum-induced Hemorrhage 21 6 $2,092.50 $1,674.00 20% off $466.20 $1,883.25 $1,676.09 2026-01-01
9847472 CDM Cath Kit Edge 180 Procedure 21 6 $2,038.50 $1,630.80 20% off $489.24 $1,834.65 $1,671.57 2026-01-01
9847638 CDM Cath Kit Edge 45 Procedure 21 6 $2,038.50 $1,630.80 20% off $489.24 $1,834.65 $1,671.57 2026-01-01
20606 HCPCS 20606 US Arthrocent Asp/inj W/guide Medum Jt 21 6 $2,033.75 $1,627.00 20% off $485.70 $1,830.38 $1,659.48 2026-01-01
64450 HCPCS 64450 Injection, Anesthetic Agent; Other Peripheral Nerve Or Bra 21 6 $2,033.75 $1,627.00 20% off $485.70 $1,830.38 $1,659.48 2026-01-01
73702 HCPCS 73702 CT Knee Bilat W&wo Cont 63 6 $1,989.00 $1,591.20 20% off $474.96 $3,579.98 $1,642.57 2026-01-01
99292 HCPCS 99292 Critical Care E&m-unstabl ProFee 21 6 $1,999.50 $1,599.60 20% off $477.48 $1,799.55 $1,631.39 2026-01-01
19285 HCPCS 19285 US Breast Needle Loc Unilateral 21 6 $1,993.50 $1,594.80 20% off $476.04 $1,794.15 $1,626.47 2026-01-01
10080 HCPCS 10080 Incision And Drainage Of Pilonidal Cyst; Simple 21 6 $1,993.50 $1,594.80 20% off $476.04 $1,794.15 $1,626.47 2026-01-01
See an error in this hospital's data? Submit a correction