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

SAMARITAN HOSPITAL

Moses Lake, WA · CCN 500033 · Rates published

3,145 distinct procedures filed
68 distinct payers
557,550 rate rows
2026-05-13 last MRF observed
Data quality

540,026 of 557,550 rate rows are consumer-grade (96.9%)

17,524 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
per-diem day rate — not a per-procedure price 8,642
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 7,180
percent-of-charges filed in the dollar field — excluded from medians 726
exceeds 10× this hospital's gross charge — excluded from medians 528
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 428
placeholder amount (≤ $0.02) — excluded from medians 20
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://wearesamaritan.org/wp-content/uploads/2026/06/916001698_grant-county-public-hospital-district-1-dba-samaritan_standardcharges.zip
Found on page https://wearesamaritan.org/billing-insurance/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-02
Content fingerprint dda9a7e4bbae4e89… · 10,760,614 bytes · first seen 2026-07-06

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/10ml IV Soln 68 $18,346.65 $135,627.70 $117,068.12 nat. median
$133
outlier · 880.5×
J2327
HCPCS 		Risankizumab-rzaa 600 Mg/10ml IV Soln 68 $9,289.98 $55,588.30 $47,981.48 nat. median
$48
outlier · 1000.1×
J3590
HCPCS 		Idarucizumab 2.5 Gm/50ml IV Soln 68 $19,635.21 $33,609.81 $29,010.58 nat. median
$1,549
outlier · 18.7×
22514
CPT 		Hc Pr 22514 Perq Vertebral Augmentation Using Device Lumbar 15 $12,943.20 $14,561.10 $14,561.10 nat. median
$7,967
1.8× median
J3358
HCPCS 		Ustekinumab 130 Mg/26ml IV Soln 68 $1,657.01 $14,026.75 $12,107.30 nat. median
$38
outlier · 319.3×
Q5119
HCPCS 		Rituximab-pvvr 500 Mg/50ml IV Soln 68 $1,126.15 $12,966.31 $11,191.98 nat. median
$318
outlier · 35.2×
J3032
HCPCS 		Eptinezumab-jjmr 100 Mg/ml IV Soln 68 $1,760.43 $12,847.56 $11,089.48 nat. median
$35
outlier · 316.7×
PX-75010272
CDM 		Hc Endoscopy/Gastrointestinal Procedure Level 6 15 $9,328.00 $10,494.00 $10,494.00 —
72285
CPT 		Review By Radiologist Of Disc Of Upper/middle Spine Image 15 $9,159.20 $10,304.10 $10,304.10 nat. median
$1,958
outlier · 5.3×
72295
CPT 		Review By Radiologist Of Disc Of Lower Spine Image 15 $9,159.20 $10,304.10 $10,304.10 nat. median
$1,977
outlier · 5.2×
PX-36000026
CDM 		Rt Bronch Level 6 Cdm 15 $8,888.80 $9,999.90 $9,999.90 nat. median
$8,012
1.2× median
PX-75010319
CDM 		Hc Endoscopy/Gastrointestinal Procedure Level 5 15 $8,480.00 $9,540.00 $9,540.00 —
PX-36000025
CDM 		Rt Bronch Level 5 Cdm 15 $8,000.00 $9,000.00 $9,000.00 nat. median
$4,451
outlier · 2.0×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6ml Subq Sosy 68 $1,827.45 $10,392.05 $8,969.98 nat. median
$665
outlier · 13.5×
J9355
HCPCS 		Trastuzumab 150 Mg IV Solr 68 $1,223.97 $10,341.94 $8,926.73 nat. median
$191
outlier · 46.8×
PX-75010318
CDM 		Hc Endoscopy/Gastrointestinal Procedure Level 4 15 $7,747.20 $8,715.60 $8,715.60 —
C1764
HCPCS 		Lux-dx Ii+ Icm Model 312 68 $5,624.93 $9,628.25 $8,310.70 nat. median
$7,993
1.0× median
J0129
HCPCS 		Abatacept 250 Mg IV Solr 68 $1,078.18 $9,487.89 $8,189.55 nat. median
$122
outlier · 67.1×
PX-36010371
CDM 		Hc Pain Room Services Level 6 15 $7,200.00 $8,100.00 $8,100.00 —
PX-36000024
CDM 		Rt Bronch Level 4 Cdm 15 $7,200.00 $8,100.00 $8,100.00 nat. median
$3,116
outlier · 2.6×
PX-72210004
CDM 		Hc Vaginal Delivery Level 4 Cdm 15 $7,040.00 $7,920.00 $7,920.00 —
PX-75010317
CDM 		Hc Endoscopy/Gastrointestinal Procedure Level 3 15 $6,886.40 $7,747.20 $7,747.20 —
J3101
HCPCS 		Tenecteplase 50 Mg IV Kit 39 $7,731.55 $47,661.75 $7,731.55 nat. median
$498
outlier · 15.5×
PX-72210003
CDM 		Hc Vaginal Delivery Level 3 Cdm 15 $6,640.00 $7,470.00 $7,470.00 —
J2323
HCPCS 		Natalizumab 300 Mg/15ml IV Conc 39 $0.20 $46,762.88 $7,453.80 nat. median
$50
outlier · 147.8×
Q4125
HCPCS 		Dermis Decell Aflex301 68 $4,947.61 $8,969.28 $7,309.99 nat. median
$1,744
outlier · 4.2×
PX-36010005
CDM 		Hc Pain Room Services Level 5 15 $6,400.00 $7,200.00 $7,200.00 —
PX-36000023
CDM 		Rt Bronch Level 3 Cdm 15 $6,400.00 $7,200.00 $7,200.00 —
PX-72210002
CDM 		Hc Vaginal Delivery Level 2 Cdm 15 $6,320.00 $7,110.00 $7,110.00 —
J3262
HCPCS 		Tocilizumab 200 Mg/10ml IV Soln 68 $1,250.38 $16,172.80 $7,027.40 nat. median
$1,287
outlier · 5.5×
J3357
HCPCS 		Hc Pr Rx Ustekinumab Sq Inj 1 Mg 39 $152.97 $167,137.20 $7,005.80 nat. median
$20,264
outlier · 0.3×
J3380
HCPCS 		Vedolizumab 300 Mg IV Solr 68 $0.20 $61,562.38 $6,756.90 nat. median
$59
outlier · 114.9×
PX-72210001
CDM 		Hc Vaginal Delivery Level 1 Cdm 15 $5,920.00 $6,660.00 $6,660.00 —
PX-75010316
CDM 		Hc Endoscopy/Gastrointestinal Procedure Level 2 15 $5,088.00 $5,724.00 $5,724.00 —
69706
CPT 		Dilation Of Canal Between Middle Ear And Throat 15 $4,614.40 $6,822.90 $5,628.00 nat. median
$6,054
0.9× median
C1886
HCPCS 		Mild Kit Mdk-0001 68 $3,778.02 $6,466.89 $5,581.95 nat. median
$3,358
1.7× median
PX-36000022
CDM 		Rt Bronch Level 2 Cdm 15 $4,800.00 $5,400.00 $5,400.00 nat. median
$132
outlier · 41.0×
PX-36010028
CDM 		Hc Operating Room Services Level 8 15 $4,763.20 $5,358.60 $5,358.60 —
J0875
HCPCS 		Dalbavancin Hcl 500 Mg IV Solr 68 $1,536.21 $6,158.14 $5,315.45 nat. median
$49
outlier · 107.5×
J2997
HCPCS 		Alteplase 2 Mg Injection Solr 68 $180.10 $53,353.43 $5,304.50 nat. median
$428
outlier · 12.4×
59510
CPT 		Hc Pr 59510 Total OB/Cesarean Delivery/Pp Car 15 $4,699.20 $5,286.60 $5,286.60 nat. median
$3,349
1.6× median
69705
CPT 		Dilation Of Canal Between Middle Ear And Throat 15 $4,328.00 $6,307.20 $5,237.70 nat. median
$6,305
0.8× median
36558
CPT 		Insert Tunneled Central Venous Tube For Iv=>5 Yrs 15 $1,655.20 $9,255.60 $5,044.65 nat. median
$3,467
1.5× median
Q4107
HCPCS 		Graftjacket 5x5 86mx5x05 15 $3,798.80 $5,255.78 $5,039.10 nat. median
$1,029
outlier · 4.9×
59610
CPT 		Hc Pr 59610 Total OB/Vbac/Pp Care 15 $4,431.20 $4,985.10 $4,985.10 nat. median
$3,150
1.6× median
PX-36010027
CDM 		Hc Operating Room Services Level 7 15 $4,410.40 $4,961.70 $4,961.70 —
27245
CPT 		Hc Pr 27245 Tx Inter/PR/Subtrchntric Fem Fx Imed Implt Screw Cdm 15 $4,391.20 $4,940.10 $4,940.10 nat. median
$5,566
0.9× median
59400
CPT 		Hc Pr 59400 Total OB/Vaginal Delivery/Pp Care 15 $4,254.40 $4,786.20 $4,786.20 nat. median
$2,933
1.6× median
PX-36010004
CDM 		Hc Pain Room Services Level 4 15 $4,240.00 $4,770.00 $4,770.00 —
J1162
HCPCS 		Digoxin Immune Fab 40 Mg IV Solr 39 $4,639.51 $28,613.70 $4,639.51 nat. median
$6,265
0.7× median

Other procedures at this hospital

Browse this hospital's 3,145 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
             
0042T CPT CT Of Brain Blood Flow, Vol, & Timing Of Flow With Contrast 32 15 $2,342.00 $2,342.00 $1,873.60 $2,107.80 $2,107.80 2026-05-13
00670 CPT Hc Pr 00670 Anesth Spine Cord Surgery 16 15 $2,096.00 $2,096.00 $1,676.80 $1,886.40 $1,886.40 2026-01-04
10009 CPT Fine Needle Aspiration Biopsy Of Growth, First Growth 32 15 $1,961.00 $1,961.00 $1,568.80 $1,764.90 $1,764.90 2026-05-13
10030 CPT Drain Fluid In Soft Tissue Using Imaging Guidance 264 68 $4,312.00 $4,312.00 $694.86 $4,096.40 $1,791.28 2026-05-13
10121 CPT Remove Foreign Body From Tissue Under Skn Complex 64 15 $3,053.50 $3,053.50 $529.60 $4,900.50 $2,475.90 2026-05-13
12037 CPT Intermediate Repair Wound Of Body, More Than 30.0 Cm 64 15 $3,708.50 $3,708.50 $1,180.00 $5,347.80 $3,040.55 2026-05-13
13100 CPT Complicated Repair Wound Of Trunk, 1.1-2.5 Cm 64 15 $3,646.50 $3,646.50 $667.20 $5,813.10 $2,958.90 2026-05-13
13120 CPT Complicated Repair Wound Of Scalp, Limbs, 1.1-2.5 Cm 32 15 $1,963.00 $1,963.00 $1,570.40 $1,766.70 $1,766.70 2026-05-13
14001 CPT Hc Pr 14001 Adj Tiss Xfer Trunk 10.1-30 32 15 $1,918.00 $1,918.00 $1,534.40 $1,726.20 $1,726.20 2026-05-13
14301 CPT Hc Pr 14301 Skin Tissue Rearrangement Any Area Defect 30.1 Sq Cm To 6 32 15 $1,928.00 $1,928.00 $1,542.40 $1,735.20 $1,735.20 2026-05-13
15277 CPT Hc Pr 15277 Face/Neck/Hand/Feet/Genitalia Total > 100 Sq Cm 1st 100 Sq Cm 32 15 $3,549.00 $3,549.00 $2,839.20 $3,194.10 $3,194.10 2026-05-13
15734 CPT Hc Pr 15734 Muscle Flap Trunk 34 16 $2,735.00 $2,735.00 $1,550.67 $2,461.50 $2,461.50 2026-05-13
15738 CPT Hc Pr 15738 Muscle-skin Graft Leg 32 15 $2,380.00 $2,380.00 $1,904.00 $2,142.00 $2,142.00 2026-05-13
19000 CPT Aspiration Of Cyst Of Breast, First Cyst 380 68 $3,142.00 $3,142.00 $138.20 $2,985.85 $1,948.04 2026-05-13
19081 CPT Biopsy Breast Using X-ray With Needle First Growth 148 68 $4,900.00 $4,900.00 $2,719.50 $4,655.00 $4,018.00 2026-05-13
19082 CPT Biopsy Breast Using X-ray With Needle, Add Growth 148 68 $3,705.00 $3,705.00 $2,056.28 $3,519.75 $3,038.10 2026-05-13
19084 CPT Biopsy Breast Using Ultrasound, Each Add Growth 148 68 $2,827.00 $2,827.00 $1,568.99 $2,685.65 $2,318.14 2026-05-13
19281 CPT Place Locating Device In Breast With Imaging 148 68 $2,199.00 $2,199.00 $1,220.45 $2,089.05 $1,803.18 2026-05-13
19283 CPT Place Locating Device In Breast With X-ray Needle 148 68 $2,835.00 $2,835.00 $1,573.43 $2,693.25 $2,324.70 2026-05-13
19285 CPT Place Locating Device In Breast With Ultrasound 148 68 $2,200.00 $2,200.00 $1,221.00 $2,090.00 $1,804.00 2026-05-13
20206 CPT Needle Biopsy Of Muscle 148 68 $3,536.00 $3,536.00 $1,962.48 $3,359.20 $2,899.52 2026-05-13
20225 CPT Biopsy Of Bone Using Needle Or Trocar 264 68 $4,543.00 $4,543.00 $493.95 $4,315.85 $1,683.43 2026-05-13
20650 CPT Hc Pr 20650 Insert And Remove Bone Pin 64 15 $3,112.50 $3,112.50 $267.20 $5,301.90 $2,506.70 2026-05-13
20692 CPT Hc Pr 20692 Application Multiplane External Fixation System Rhc 32 15 $2,751.00 $2,751.00 $2,200.80 $2,475.90 $2,475.90 2026-05-13
20999 CPT Hc Pr 20999 Musculoskeletal Surgery 32 15 $2,874.00 $2,874.00 $2,299.20 $2,586.60 $2,586.60 2026-05-13
22514 CPT Hc Pr 22514 Perq Vertebral Augmentation Using Device Lumbar 32 15 $16,179.00 $16,179.00 $12,943.20 $14,561.10 $14,561.10 2026-05-13
23077 CPT Hc Pr 23077 Rad Resection Tumor Soft Tissue Shoulder/Less Than 5cm 32 15 $1,927.00 $1,927.00 $1,541.60 $1,734.30 $1,734.30 2026-05-13
23078 CPT Hc Pr 23078 Resect Shoulder Tum 5 Cm/> 32 15 $2,583.00 $2,583.00 $2,066.40 $2,324.70 $2,324.70 2026-05-13
23335 CPT Hc Pr 233345 Prosthesis Removal Humeral And Glenoid Component Cdm 32 15 $2,085.00 $2,085.00 $1,668.00 $1,876.50 $1,876.50 2026-05-13
23455 CPT Hc Pr 23455 Repair Shoulder Capsule,Bankart 32 15 $2,421.00 $2,421.00 $1,936.80 $2,178.90 $2,178.90 2026-05-13
23472 CPT Hc Pr 23472 Arthroplasty Glenohumeral Joint Total Shoulder 104 49 $3,538.00 $3,538.00 $847.44 $2,157.96 $1,940.20 2026-05-13
23474 CPT Hc Pr 23474 Revis Reconst Shoulder Joint 32 15 $2,865.00 $2,865.00 $2,292.00 $2,578.50 $2,578.50 2026-05-13
23515 CPT Hc Pr 23515 Open Tx Clavicular Fracture Internal Fixation 32 15 $2,601.00 $2,601.00 $2,080.80 $2,340.90 $2,340.90 2026-05-13
23605 CPT Closed Treatment Of Broken Top Of Upper Arm Bone 64 15 $4,039.50 $4,039.50 $598.40 $6,597.90 $3,269.00 2026-05-13
23625 CPT Closed Treat Upper Arm Bone Broken At Shoulder Joint 64 15 $2,988.00 $2,988.00 $488.80 $4,828.50 $2,420.95 2026-05-13
23655 CPT Closed Treatment Of Dislocated Shoulder 64 15 $4,138.00 $4,138.00 $2,606.40 $4,516.20 $3,473.30 2026-05-13
23665 CPT Closed Treatment Dislocated Shoulder/broken Upper Arm Bone 64 15 $4,125.50 $4,125.50 $2,586.40 $4,516.20 $3,462.05 2026-05-13
23675 CPT Closed Treat Dislocated Shoulder,broken Neck Upper Arm Bone 64 15 $4,552.00 $4,552.00 $3,268.80 $4,516.20 $3,845.90 2026-05-13
23931 CPT Drainage Of Fluid Filled Sac In Elbow Joint 64 15 $3,497.50 $3,497.50 $416.80 $5,826.60 $2,824.05 2026-05-13
24363 CPT Hc Pr 24363 Replace Elbow Joint 104 49 $2,370.00 $2,370.00 $848.24 $2,153.85 $1,939.75 2026-05-13
24538 CPT Hc Pr 24538 Percutaneous Fixation Humeral 32 15 $2,916.00 $2,916.00 $2,332.80 $2,624.40 $2,624.40 2026-05-13
24605 CPT Repair Of Dislocated Elbow Under Anesthesia 64 15 $3,564.00 $3,564.00 $1,688.00 $4,516.20 $2,956.70 2026-05-13
24620 CPT Closed Treatment Of Broken And Dislocated Forearm Bones 64 15 $3,659.00 $3,659.00 $1,976.00 $4,363.20 $3,050.70 2026-05-13
24675 CPT Hc Ed Treat Ulnar Fracture W/Manipulation Cdm 64 15 $3,449.50 $3,449.50 $1,504.80 $4,516.20 $2,853.65 2026-05-13
25030001 OTHER Poractant Alfa 80 Mg/ml Intratrachea Susp (wrapper) 32 15 $3,751.00 $3,751.00 $3,000.80 $3,375.90 $3,375.90 2026-05-13
25505 CPT Closed Treat Broken Midpart Of Forearm Bone On Thumb Side 64 15 $2,857.00 $2,857.00 $692.80 $4,363.20 $2,328.90 2026-05-13
25605 CPT Closed Treatment Of Broken Or Growth Plate Forearm Bone 64 15 $3,674.00 $3,674.00 $1,864.00 $4,516.20 $3,055.70 2026-05-13
25605 HCPCS Hc Pr 25605 Cltx Dstl Rdl Fx/Epiphysl Sep W/Manj When Perf Rhc 32 15 $2,330.00 $2,330.00 $1,864.00 $2,097.00 $2,097.00 2026-05-13
26011 CPT Complicated Drainage Of Abscess In Finger 64 15 $2,574.50 $2,574.50 $669.60 $3,880.80 $2,101.45 2026-05-13
26675 CPT Closed Treatment Of Dislocated Hand Bone At Wrist Joint 64 15 $2,920.00 $2,920.00 $657.60 $4,516.20 $2,377.10 2026-05-13
26742 CPT Closed Treatment Of Broken Finger Or Hand At Base Of Finger 64 15 $3,886.50 $3,886.50 $2,204.00 $4,516.20 $3,246.95 2026-05-13
26765 CPT Hc Ed Open Tx Distal Phalangeal Fracture Each Cdm 64 15 $2,173.50 $2,173.50 $664.80 $3,164.40 $1,780.35 2026-05-13
26770 HCPCS Hc Pr 26770 Cltx Iphal Jt Dislc W/Manj Without Anes Rhc 32 15 $2,086.00 $2,086.00 $1,668.80 $1,877.40 $1,877.40 2026-05-13
26775 CPT Closed Treatment Of Dislocated Finger Joint 64 15 $4,494.50 $4,494.50 $2,288.80 $5,515.20 $3,738.65 2026-05-13
27030 CPT Hc Pr 27030 Drainage Of Hip Joint 32 15 $2,357.00 $2,357.00 $1,885.60 $2,121.30 $2,121.30 2026-05-13
27130 CPT Hc Pr 27130 Total Hip Arthroplasty 104 49 $6,641.00 $6,641.00 $790.84 $2,009.99 $1,722.31 2026-05-13
27132 CPT Hc Pr 27132 Conversion Prev Hip Surg To Tot Hip Arthroplas Cdm 32 15 $3,012.00 $3,012.00 $2,409.60 $2,710.80 $2,710.80 2026-05-13
27235 CPT Hc Pr 27235 Prq Skel Fixj Femoral Fx Prox End Neck 32 15 $4,490.00 $4,490.00 $3,592.00 $4,041.00 $4,041.00 2026-05-13
27236 CPT Hc Pr 27236 Open Tx Thigh Fracture Without Manip 32 15 $4,991.00 $4,991.00 $3,992.80 $4,491.90 $4,491.90 2026-05-13
27244 CPT Tx Femoral Fracture W/Plate/Screw Type Implant 32 15 $2,108.00 $2,108.00 $1,686.40 $1,897.20 $1,897.20 2026-05-13
27245 CPT Hc Pr 27245 Tx Inter/PR/Subtrchntric Fem Fx Imed Implt Screw Cdm 32 15 $5,489.00 $5,489.00 $4,391.20 $4,940.10 $4,940.10 2026-05-13
27252 CPT Closed Treatment Of Dislocated Hip Under Anesthesia 64 15 $3,104.50 $3,104.50 $1,088.80 $4,363.20 $2,551.65 2026-05-13
27425 CPT Hc Pr 27425 Lateral Retinacular Release Open 32 15 $2,036.00 $2,036.00 $1,628.80 $1,832.40 $1,832.40 2026-05-13
27446 CPT Hc Pr 27446 Revision Of Knee Joint 32 15 $2,618.00 $2,618.00 $2,094.40 $2,356.20 $2,356.20 2026-05-13
27447 CPT Total Knee Arthroplasty 104 49 $6,000.00 $6,000.00 $789.84 $2,009.47 $1,720.49 2026-05-13
27502 CPT Closed Treatment Of Broken Thigh Bone At Midportion 64 15 $3,383.00 $3,383.00 $1,044.80 $4,914.00 $2,771.70 2026-05-13
27506 CPT Hc Pr 27506 Treatment Of Thigh Fx 32 15 $4,774.00 $4,774.00 $3,819.20 $4,296.60 $4,296.60 2026-05-13
27510 CPT Closed Treatment Of Broken Thigh Bone At Knee Area 64 15 $3,126.00 $3,126.00 $987.20 $4,516.20 $2,562.50 2026-05-13
27511 CPT Hc Pr 27511 Optx Femoral Supracondylar Fracture Without Xtn Cdm 32 15 $4,359.00 $4,359.00 $3,487.20 $3,923.10 $3,923.10 2026-05-13
27532 CPT Closed Treatment Of Broken Shin Bone With Traction 64 15 $4,561.50 $4,561.50 $1,204.80 $6,855.30 $3,724.50 2026-05-13
27536 CPT Hc Pr 27536 Optx Tibial Fx Prox Bicondylar W/wo Int Fixj 32 15 $2,036.00 $2,036.00 $1,628.80 $1,832.40 $1,832.40 2026-05-13
27552 CPT Closed Treatment Of Dislocated Knee Under Anesthesia 64 15 $2,828.00 $2,828.00 $828.80 $4,158.00 $2,314.20 2026-05-13
27648 CPT Injection For X-ray Imaging Of Ankle 148 68 $2,102.00 $2,102.00 $1,166.61 $1,996.90 $1,723.64 2026-05-13
27752 CPT Closed Treatment Of Middle Part Of Broken Shin Bone 64 15 $2,152.50 $2,152.50 $1,651.20 $2,016.90 $1,857.60 2026-05-13
27759 CPT Hc Pr 27759 Tx Tibl Shft Fx Imed Implt W/wo Screws&/Cercla 32 15 $2,412.00 $2,412.00 $1,929.60 $2,170.80 $2,170.80 2026-05-13
27781 CPT Closed Treatment Of Broken Middle Or Upper End Of Leg Bone 64 15 $2,863.00 $2,863.00 $566.40 $4,516.20 $2,325.80 2026-05-13
27810 CPT Closed Treatment Of 2 Broken Lower Leg Bones At Ankle 64 15 $3,477.00 $3,477.00 $1,548.80 $4,516.20 $2,878.40 2026-05-13
27810 HCPCS Hc Pr 27810 Closed Tx Bimalleolar Ankle Fracture W/Manj Rhc 32 15 $1,936.00 $1,936.00 $1,548.80 $1,742.40 $1,742.40 2026-05-13
27818 CPT Closed Treatment Of 3 Broken Lower Leg Bones At Ankle 64 15 $3,491.50 $3,491.50 $1,572.00 $4,516.20 $2,891.45 2026-05-13
27818 HCPCS Hc Pr 27818 Cltx Trimalleolar Ankle Fx W/Manipulation Rhc 32 15 $1,965.00 $1,965.00 $1,572.00 $1,768.50 $1,768.50 2026-05-13
27825 CPT Closed Treatment Of Broken Shin Bone At Wt Bearing Joint 64 15 $3,623.00 $3,623.00 $1,782.40 $4,516.20 $3,009.80 2026-05-13
27827 CPT Hc Pr 27827 Open Tx Of Artucular Distal Tibia W/Fixation 32 15 $2,743.00 $2,743.00 $2,194.40 $2,468.70 $2,468.70 2026-05-13
27828 CPT Hc Pr 27828 Open Tx Of Artucular Distal Tibia Nx Fibula W/Fixation 104 49 $3,134.00 $3,134.00 $772.24 $1,915.96 $1,794.33 2026-05-13
27842 CPT Closed Treatment Of Dislocated Ankle Under Anesthesia 64 15 $2,854.00 $2,854.00 $688.00 $4,363.20 $2,326.20 2026-05-13
27880 CPT Hc Pr 27880 Amputation Leg Through Tibia & Fibula Cdm 32 15 $2,274.00 $2,274.00 $1,819.20 $2,046.60 $2,046.60 2026-05-13
28003 CPT Hc Pr 28003 I&d Below Fascia Foot Multiple Areas Cdm 32 15 $1,882.00 $1,882.00 $1,505.60 $1,693.80 $1,693.80 2026-05-13
28296 CPT Hc Pr 28296 Corrj Hallux Valgus W/Sesmdc W/Dist Metar Osteot 32 15 $3,082.00 $3,082.00 $2,465.60 $2,773.80 $2,773.80 2026-05-13
28297 CPT Hc Pr 28297 Corrj Hallux Valgus W/Sesmdc W/1metar Medial Cnf 32 15 $3,223.00 $3,223.00 $2,578.40 $2,900.70 $2,900.70 2026-05-13
28585 CPT Hc Pr 28585 Repair Foot Dislocation 32 15 $2,090.00 $2,090.00 $1,672.00 $1,881.00 $1,881.00 2026-05-13
28730 CPT Hc Pr 28730 Fusion Foot Bones,Midtarsal,Multi 32 15 $2,034.00 $2,034.00 $1,627.20 $1,830.60 $1,830.60 2026-05-13
28805 CPT Hc Pr 28805 Amputation Foot Transmetarsal 32 15 $2,110.00 $2,110.00 $1,688.00 $1,899.00 $1,899.00 2026-05-13
29828 CPT Hc Pr 29828 Arthroscopy Shoulder Surgical Biceps Tenodesis 32 15 $2,239.00 $2,239.00 $1,791.20 $2,015.10 $2,015.10 2026-05-13
29876 CPT Hc Pr 29876 Arthro Knee Synovectomy 2/>Compartments 32 15 $2,436.00 $2,436.00 $1,948.80 $2,192.40 $2,192.40 2026-05-13
32100 CPT Incision And Exploration Of Chest Cavity 64 15 $3,079.00 $3,079.00 $1,835.20 $3,477.60 $2,577.90 2026-05-13
32408 CPT Core Needle Biopsy Of Lung Or Center Cavity Of Chest 32 15 $4,384.00 $4,384.00 $3,507.20 $3,945.60 $3,945.60 2026-05-13
32554 CPT Aspiration Of Fluid From Chest Cavity 96 15 $2,211.00 $2,211.00 $1,484.00 $2,198.70 $1,989.90 2026-05-13
32556 CPT Drain Fluid From Chest Cavity With Insert Indwelling Tube 64 15 $3,264.00 $3,264.00 $800.00 $4,975.20 $2,661.20 2026-05-13
35840 CPT Hc Pr 35840 Expl Post Op Hemrrg Thrombosis/Infctn Abdomen Cdm 32 15 $2,179.00 $2,179.00 $1,743.20 $1,961.10 $1,961.10 2026-05-13
36558 CPT Insert Tunneled Central Venous Tube For Iv=>5 Yrs 64 15 $6,176.50 $6,176.50 $1,655.20 $9,255.60 $5,044.65 2026-05-13
36558 HCPCS Hc Pr 36558 Insj Tunneled Cvc Without Subq Port/Pmp Age 5 Yr/> 32 15 $2,069.00 $2,069.00 $1,655.20 $1,862.10 $1,862.10 2026-05-13
36563 CPT Hc Pr 36563 Insert Tunneled Cv Cath 32 15 $2,364.00 $2,364.00 $1,891.20 $2,127.60 $2,127.60 2026-05-13
36565 CPT Insert 2 Central Venous Tubes In 2 Veins For Infusion 32 15 $3,693.00 $3,693.00 $2,954.40 $3,323.70 $3,323.70 2026-05-13
36569 CPT Insert Tube For IV >5yrs 380 68 $3,950.00 $3,950.00 $1,694.42 $4,803.20 $2,747.70 2026-05-13
36573 CPT Insert Tube For IVwith Imaging Guidance, =>5 Yrs 148 68 $3,196.00 $3,196.00 $1,773.78 $3,036.20 $2,620.72 2026-05-13
37617 CPT Hc Pr Ed 37617 Ligation Of Abdomen Artery Cdm 32 15 $2,289.00 $2,289.00 $1,831.20 $2,060.10 $2,060.10 2026-05-13
38100 CPT Hc Pr 38100 Removal Of Spleen Total 32 15 $4,832.00 $4,832.00 $3,865.60 $4,348.80 $4,348.80 2026-05-13
38505 CPT Needle Biopsy Or Removal Of Surface Lymph Nodes 148 68 $3,747.00 $3,747.00 $2,079.59 $3,559.65 $3,072.54 2026-05-13
40654 CPT Repair Of Vertical Lip Wound Extending To Over Half Of Lip 64 15 $2,469.50 $2,469.50 $1,510.40 $2,745.90 $2,070.00 2026-05-13
41008 CPT Drain Abscess, Cyst, Or Blood Accumulation Under Jaw Bone 64 15 $4,067.50 $4,067.50 $508.00 $6,750.00 $3,285.75 2026-05-13
43281 CPT Hc Pr 43281 Lap Paraesophag Hern Repair 104 49 $3,738.00 $3,738.00 $897.84 $2,305.93 $2,075.65 2026-05-13
43332 CPT Hc Pr 43332 Paraesophageal Hiatal Hernia Repair Via Laparotomy 32 15 $2,104.00 $2,104.00 $1,683.20 $1,893.60 $1,893.60 2026-05-13
43333 CPT Hc Pr 43333 Transab Esoph Hiat Hern Rpr 32 15 $2,146.00 $2,146.00 $1,716.80 $1,931.40 $1,931.40 2026-05-13
43632 CPT Hc Pr 43632 Removal Of Stomach Partial With Gastrojejunostomy 32 15 $4,893.00 $4,893.00 $3,914.40 $4,403.70 $4,403.70 2026-05-13
43774 CPT Hc Pr 43774 Laparoscopy Removal Gastric Adj All Parts 32 15 $2,306.00 $2,306.00 $1,844.80 $2,075.40 $2,075.40 2026-05-13
43840 CPT Hc Pr 43840 Repair Of Stomach Lesion 32 15 $3,270.00 $3,270.00 $2,616.00 $2,943.00 $2,943.00 2026-05-13
44005 CPT Hc Pr 44005 Freeing Of Bowel Adhesion 32 15 $2,634.00 $2,634.00 $2,107.20 $2,370.60 $2,370.60 2026-05-13
44050 CPT Hc Pr 44050 Reduce Bowel Obstruction 32 15 $2,247.00 $2,247.00 $1,797.60 $2,022.30 $2,022.30 2026-05-13
44120 CPT Hc Pr 44120 Removal Of Small Intestine, Single Resection 32 15 $2,947.00 $2,947.00 $2,357.60 $2,652.30 $2,652.30 2026-05-13
44125 CPT Hc Pr 44125 Removal Of Small Intestine, With Enterostomy 32 15 $2,848.00 $2,848.00 $2,278.40 $2,563.20 $2,563.20 2026-05-13
44130 CPT Hc Pr 44130 Bowel To Bowel Fusion 32 15 $3,165.00 $3,165.00 $2,532.00 $2,848.50 $2,848.50 2026-05-13
44140 CPT Hc Pr 44140 Partial Removal Of Colon With Anastomosis 32 15 $3,231.00 $3,231.00 $2,584.80 $2,907.90 $2,907.90 2026-05-13
44143 CPT Hc Pr 44143 Partial Removal Of Colon, Hartmann Procedure 32 15 $4,013.00 $4,013.00 $3,210.40 $3,611.70 $3,611.70 2026-05-13
44144 CPT Hc Pr 44144 Partial Removal Of Colon, With Resection 32 15 $4,269.00 $4,269.00 $3,415.20 $3,842.10 $3,842.10 2026-05-13
44145 CPT Hc Pr 44145 Partial Removal Of Colon With Coloproctostomy 32 15 $2,856.00 $2,856.00 $2,284.80 $2,570.40 $2,570.40 2026-05-13
44146 CPT Hc Pr 44146 Partial Removal Of Colon With Coloproctostomy, With Colostomy 32 15 $3,832.00 $3,832.00 $3,065.60 $3,448.80 $3,448.80 2026-05-13
44150 CPT Hc Pr 44150 Removal Of Colon, Without Proctectomy With Ileostomy Or Ileoproc 32 15 $3,221.00 $3,221.00 $2,576.80 $2,898.90 $2,898.90 2026-05-13
44151 CPT Hc Pr 44151 Removal Of Colon/Ileostomy, Without Proctectomy With Continent I 32 15 $3,870.00 $3,870.00 $3,096.00 $3,483.00 $3,483.00 2026-05-13
44160 CPT Hc Pr 44160 Removal Of Colon, Partial 32 15 $2,994.00 $2,994.00 $2,395.20 $2,694.60 $2,694.60 2026-05-13
44180 CPT Hc Pr 44180 Laparoscopy Enterolysis 32 15 $2,214.00 $2,214.00 $1,771.20 $1,992.60 $1,992.60 2026-05-13
44202 CPT Laparoscopy, Surgical; Enterectomy, Resection Of Small Intestine 32 15 $2,510.00 $2,510.00 $2,008.00 $2,259.00 $2,259.00 2026-05-13
44204 CPT Hc Pr 44204 Laparoscopy Partial Colectomy 32 15 $2,651.00 $2,651.00 $2,120.80 $2,385.90 $2,385.90 2026-05-13
44310 CPT Hc Pr 44310 Ileostomy/Jejunostomy 32 15 $2,397.00 $2,397.00 $1,917.60 $2,157.30 $2,157.30 2026-05-13
44320 CPT Colostomy/Skin Level Cecostomy 32 15 $2,069.00 $2,069.00 $1,655.20 $1,862.10 $1,862.10 2026-05-13
44346 CPT Hc Pr 44346 Revision Of Colostomy, With Hernia Repair 32 15 $2,853.00 $2,853.00 $2,282.40 $2,567.70 $2,567.70 2026-05-13
44602 CPT Hc Pr 44602 Suture Small Intestine, Single Perforation 32 15 $3,405.00 $3,405.00 $2,724.00 $3,064.50 $3,064.50 2026-05-13
44603 CPT Suture Of Small Intestine 32 15 $2,657.00 $2,657.00 $2,125.60 $2,391.30 $2,391.30 2026-05-13
44604 CPT Hc Pr 44604 Suture Large Intestine 32 15 $2,550.00 $2,550.00 $2,040.00 $2,295.00 $2,295.00 2026-05-13
44615 CPT Hc Pr 44615 Intestinal Stricturoplasty 32 15 $1,855.00 $1,855.00 $1,484.00 $1,669.50 $1,669.50 2026-05-13
44620 CPT Hc Pr 44620 Repair Bowel Opening 32 15 $2,092.00 $2,092.00 $1,673.60 $1,882.80 $1,882.80 2026-05-13
44625 CPT Hc Pr 44625 Repair Bowel Opening, With Resection 32 15 $2,464.00 $2,464.00 $1,971.20 $2,217.60 $2,217.60 2026-05-13
44626 CPT Hc Pr 44626 Repair Bowel Opening, Hartmann Method 32 15 $3,877.00 $3,877.00 $3,101.60 $3,489.30 $3,489.30 2026-05-13
44640 CPT Hc Pr 44640 Repair Bowel-skin Fistula 32 15 $2,417.00 $2,417.00 $1,933.60 $2,175.30 $2,175.30 2026-05-13
44960 CPT Hc Pr 44960 Appendectomy, Ruptured 32 15 $2,104.00 $2,104.00 $1,683.20 $1,893.60 $1,893.60 2026-05-13
45399 CPT Hc Pr 45399 Unlisted Procedure Colon 32 15 $2,994.00 $2,994.00 $2,395.20 $2,694.60 $2,694.60 2026-05-13
45915 CPT Removal Of Stool/foreign Body In Rectum Under General Anesthesia 64 15 $2,450.50 $2,450.50 $483.20 $3,867.30 $1,990.60 2026-05-13
47000 CPT Needle Biopsy Of Liver Through Skin 148 68 $4,223.00 $4,223.00 $2,343.77 $4,011.85 $3,462.86 2026-05-13
47564 CPT Hc Pr 47564 Laparoscopy Cholecystectomy/Explr 32 15 $1,882.00 $1,882.00 $1,505.60 $1,693.80 $1,693.80 2026-05-13
47579 CPT Hc Pr 47579 Laparoscope Proc Biliary 32 15 $1,930.00 $1,930.00 $1,544.00 $1,737.00 $1,737.00 2026-05-13
47600 CPT Hc Pr 47600 Cholecystectomy 32 15 $2,602.00 $2,602.00 $2,081.60 $2,341.80 $2,341.80 2026-05-13
47605 CPT Hc Pr 47605 Cholecystectomy With Cholangiography 32 15 $2,360.00 $2,360.00 $1,888.00 $2,124.00 $2,124.00 2026-05-13
49000 CPT Hc Pr 49000 Exploration Of Abdomen 32 15 $1,850.00 $1,850.00 $1,480.00 $1,665.00 $1,665.00 2026-05-13
49002 CPT Hc Pr 49002 Reopening Of Abdomen 32 15 $2,517.00 $2,517.00 $2,013.60 $2,265.30 $2,265.30 2026-05-13
49020 CPT Hc Pr 49020 Drain Abdominal Abscess, Open 32 15 $4,023.00 $4,023.00 $3,218.40 $3,620.70 $3,620.70 2026-05-13
49255 CPT Hc Pr 49255 Omntc Epiploectomy Rescj Omentum Spx Rhc 32 15 $1,892.00 $1,892.00 $1,513.60 $1,702.80 $1,702.80 2026-05-13
49406 CPT Drain Fluid Of Abdominal Cavity By Tube W/imaging Guidance 64 15 $4,000.50 $4,000.50 $1,223.20 $5,824.80 $3,276.85 2026-05-13
49440 CPT Hc Pr 49440 Place Gastrostomy Tube Perc 32 15 $1,847.00 $1,847.00 $1,477.60 $1,662.30 $1,662.30 2026-05-13
49900 CPT Hc Pr 49900 Sec Abdominal Wall Suture Evisceration/Dehsn Cdm 32 15 $1,953.00 $1,953.00 $1,562.40 $1,757.70 $1,757.70 2026-05-13
50081 CPT Hc Pr 50081 Perq Nl/Pl Lithotrp Complex >2 Cm Mlt Locations Cdm 32 15 $3,158.00 $3,158.00 $2,526.40 $2,842.20 $2,842.20 2026-05-13
51102 CPT Aspiration Of Bladder With Insertion Of Bladder Tube To Skin 64 15 $2,215.50 $2,215.50 $464.80 $3,465.00 $1,801.45 2026-05-13
54700 CPT Hc Pr Ed 54700 Drainage Of Scrotum Cdm 64 15 $3,640.00 $3,640.00 $308.80 $6,204.60 $2,931.30 2026-05-13
55100 CPT Drainage Of Abscess Of Scrotum 64 15 $2,454.00 $2,454.00 $593.60 $3,749.40 $2,000.30 2026-05-13
57260 CPT Hc Pr 57260 Repair Of Vagina, Combined Anteroposterior Colporrhaphy 32 15 $2,032.00 $2,032.00 $1,625.60 $1,828.80 $1,828.80 2026-05-13
58140 CPT Hc Pr 58140 Myomectomy Abdominal Method 32 15 $2,245.00 $2,245.00 $1,796.00 $2,020.50 $2,020.50 2026-05-13
58180 CPT Hc Pr 58180 Partial Hysterectomy 32 15 $2,336.00 $2,336.00 $1,868.80 $2,102.40 $2,102.40 2026-05-13
58260 CPT Hc Pr 58260 Vaginal Hysterectomy 32 15 $3,175.00 $3,175.00 $2,540.00 $2,857.50 $2,857.50 2026-05-13
58262 CPT Hc Pr 58262 Vaginal Hysterectomy Incl Tubes/Ovary(S) 32 15 $2,255.00 $2,255.00 $1,804.00 $2,029.50 $2,029.50 2026-05-13
58554 CPT Hc Pr 58554 Laparo-vaginal Hysterectomy With Tubes/Ovary(S) Complex 32 15 $2,242.00 $2,242.00 $1,793.60 $2,017.80 $2,017.80 2026-05-13
58660 CPT Hc Pr 58660 Laparoscopy Lysis 32 15 $2,298.00 $2,298.00 $1,838.40 $2,068.20 $2,068.20 2026-05-13
58720 CPT Hc Pr 58720 Removal Of Ovary/Tube(S) 32 15 $2,202.00 $2,202.00 $1,761.60 $1,981.80 $1,981.80 2026-05-13
58740 CPT Hc Pr 58740 Lysis Of Adhesions Salpinx/Ovary Cdm Cdm 32 15 $2,133.00 $2,133.00 $1,706.40 $1,919.70 $1,919.70 2026-05-13
59150 CPT Hc Pr 59150 Lap Ectopic Treatment 32 15 $1,888.00 $1,888.00 $1,510.40 $1,699.20 $1,699.20 2026-05-13
59300 CPT Episiotomy Or Repair Of Vagina 64 15 $2,262.00 $2,262.00 $382.40 $3,641.40 $1,833.50 2026-05-13
59400 CPT Hc Pr 59400 Total OB/Vaginal Delivery/Pp Care 32 15 $5,318.00 $5,318.00 $4,254.40 $4,786.20 $4,786.20 2026-05-13
59409 CPT Hc Pr Ed 59409 Vaginal Delivery Cdm 32 15 $2,644.00 $2,644.00 $2,115.20 $2,379.60 $2,379.60 2026-05-13
59410 CPT Hc Pr 59410 Vag Delivery W/Postpartum 32 15 $2,925.00 $2,925.00 $2,340.00 $2,632.50 $2,632.50 2026-05-13
59412 CPT Turning Of Fetus Through External Manipulation 264 68 $8,518.00 $8,518.00 $127.10 $8,092.10 $2,472.52 2026-05-13
59510 CPT Hc Pr 59510 Total OB/Cesarean Delivery/Pp Car 32 15 $5,874.00 $5,874.00 $4,699.20 $5,286.60 $5,286.60 2026-05-13
59514 CPT Hc Pr 59514 Cesarean Delivery Only 32 15 $2,811.00 $2,811.00 $2,248.80 $2,529.90 $2,529.90 2026-05-13
59515 CPT Hc Pr 59515 Cesarean Delivery W Pp Care 32 15 $3,186.00 $3,186.00 $2,548.80 $2,867.40 $2,867.40 2026-05-13
59610 CPT Hc Pr 59610 Total OB/Vbac/Pp Care 32 15 $5,539.00 $5,539.00 $4,431.20 $4,985.10 $4,985.10 2026-05-13
59612 CPT Hc Pr 59612 Vaginal Delivery After Cesarean Delivery 32 15 $2,027.00 $2,027.00 $1,621.60 $1,824.30 $1,824.30 2026-05-13
60100 CPT Needle Biopsy Of Thyroid Through Skin 148 68 $2,195.00 $2,195.00 $1,218.23 $2,085.25 $1,799.90 2026-05-13
61312 CPT Hc Pr 61312 Craniectomy Hmtma Supratentorial Extra/Subdural Cdm 32 15 $3,817.00 $3,817.00 $3,053.60 $3,435.30 $3,435.30 2026-05-13
62272 CPT Remove Cerebrospinal Fluid With Lower Back Spinal Tap 32 15 $2,679.00 $2,679.00 $2,143.20 $2,411.10 $2,411.10 2026-05-13
62273 CPT Injection Of Blood Or Blood Clot Into Spinal Canal 96 15 $2,679.00 $2,679.00 $271.20 $4,832.10 $2,411.10 2026-05-13
670 OTHER Hc Pr 00670 Anesth Spine Cord Surgery 16 15 $2,096.00 $2,096.00 $1,676.80 $1,886.40 $1,886.40 2026-05-13
69705 CPT Dilation Of Canal Between Middle Ear And Throat 64 15 $6,209.00 $6,209.00 $4,328.00 $6,307.20 $5,237.70 2026-05-13
69706 CPT Dilation Of Canal Between Middle Ear And Throat 64 15 $6,674.50 $6,674.50 $4,614.40 $6,822.90 $5,628.00 2026-05-13
70488 CPT CT Scan Of Face Before And After Contrast 32 15 $3,465.00 $3,465.00 $2,772.00 $3,118.50 $3,118.50 2026-05-13
70492 CPT CT Scan Of Soft Tissue Of Neck Before And After Contrast 32 15 $3,271.00 $3,271.00 $2,616.80 $2,943.90 $2,943.90 2026-05-13
70542 CPT MRI Scan Of Bone Of Eye Socket, Face, Neck W/contrast 32 15 $3,618.00 $3,618.00 $2,894.40 $3,256.20 $3,256.20 2026-05-13
70546 CPT MRI Scan Of Blood Vessels Of Head Before And After Contrast 264 68 $6,342.00 $6,342.00 $85.47 $6,024.90 $1,833.06 2026-05-13
70548 CPT MRI Scan Of Blood Vessels Of Neck With Contrast 32 15 $4,631.00 $4,631.00 $3,704.80 $4,167.90 $4,167.90 2026-05-13
70549 CPT Hc Pr 70549 MRA Neck Without &W/Contrast Material 64 15 $2,429.00 $2,429.00 $123.20 $4,233.60 $1,950.90 2026-05-13
71271 CPT Low Dose CT Scan Of Chest For Lung Cancer Screening 32 15 $4,269.00 $4,269.00 $3,415.20 $3,842.10 $3,842.10 2026-05-13
71551 CPT MRI Scan Of Chest With Contrast 32 15 $4,048.00 $4,048.00 $3,238.40 $3,643.20 $3,643.20 2026-05-13
71555 CPT MRI Scan Of Blood Vessels Of Chest 32 15 $4,011.00 $4,011.00 $3,208.80 $3,609.90 $3,609.90 2026-05-13
72127 CPT CT Scan Of Upper Spine Before And After Contrast 32 15 $2,373.00 $2,373.00 $1,898.40 $2,135.70 $2,135.70 2026-05-13
72149 CPT Hc Pr 72149 MRI Spinal Canal Lumbar W/Contrast Material 64 15 $2,245.00 $2,245.00 $122.40 $3,903.30 $1,803.65 2026-05-13
72198 CPT MRI Scan Of Blood Vessels Of Pelvis 64 15 $4,166.50 $4,166.50 $3,251.20 $3,842.10 $3,657.60 2026-05-13
72270 CPT Review By Radiologist Of Multiple Spinal Canals Image 32 15 $3,506.00 $3,506.00 $2,804.80 $3,155.40 $3,155.40 2026-05-13
72285 CPT Review By Radiologist Of Disc Of Upper/middle Spine Image 32 15 $11,449.00 $11,449.00 $9,159.20 $10,304.10 $10,304.10 2026-05-13
72295 CPT Review By Radiologist Of Disc Of Lower Spine Image 32 15 $11,449.00 $11,449.00 $9,159.20 $10,304.10 $10,304.10 2026-05-13
73219 CPT MRI Scan Of Arm With Contrast 32 15 $3,271.00 $3,271.00 $2,616.80 $2,943.90 $2,943.90 2026-05-13
73225 CPT MRI Scan Of Blood Vessels Of Arm 32 15 $4,185.00 $4,185.00 $3,348.00 $3,766.50 $3,766.50 2026-05-13
73719 CPT MRI Scan Of Leg With Contrast 32 15 $1,985.00 $1,985.00 $1,588.00 $1,786.50 $1,786.50 2026-05-13
73725 CPT MRI Scan Of Blood Vessels Of Leg 32 15 $4,652.00 $4,652.00 $3,721.60 $4,186.80 $4,186.80 2026-05-13
74182 CPT MRI Scan Of Abdomen With Contrast 32 15 $3,786.00 $3,786.00 $3,028.80 $3,407.40 $3,407.40 2026-05-13
74185 CPT MRI Scan Of Blood Vessels Of Abdomen 96 15 $5,072.00 $5,072.00 $3,247.20 $4,928.40 $4,564.80 2026-05-13
74330 CPT X-ray Tube Placement Into Bile And Pancreatic Duct 32 15 $1,989.00 $1,989.00 $1,591.20 $1,790.10 $1,790.10 2026-05-13
75572 CPT CT Scan Of Heart Structure With Contrast 32 15 $2,951.00 $2,951.00 $2,360.80 $2,655.90 $2,655.90 2026-05-13
75573 CPT CT Scan Of Congenital Heart Disease With Contrast 32 15 $3,670.00 $3,670.00 $2,936.00 $3,303.00 $3,303.00 2026-05-13
75574 CPT CT Scan Of Heart, Coronary Arteries And Bypass Graft 32 15 $2,557.00 $2,557.00 $2,045.60 $2,301.30 $2,301.30 2026-05-13
75820 CPT X-ray 1 Arm Or Leg Vein Of 1 Arm Or Leg 32 15 $3,028.00 $3,028.00 $2,422.40 $2,725.20 $2,725.20 2026-05-13
75822 CPT X-ray Both Arms And Legs Veins Of Both Arms Or Legs 32 15 $3,028.00 $3,028.00 $2,422.40 $2,725.20 $2,725.20 2026-05-13
76080 CPT X-ray Abscess Or Sinus Cavity Study 32 15 $2,190.00 $2,190.00 $1,752.00 $1,971.00 $1,971.00 2026-05-13
76145 CPT Medical Physics Dose Evaluation For Radiation Exposure 32 15 $2,047.00 $2,047.00 $1,637.60 $1,842.30 $1,842.30 2026-05-13
77046 CPT MRI Scan Of 1 Breast Without Contrast 32 15 $2,967.00 $2,967.00 $2,373.60 $2,670.30 $2,670.30 2026-05-13
77048 CPT MRI Scan Of 1 Breast 148 68 $5,004.00 $5,004.00 $2,777.22 $4,753.80 $4,103.28 2026-05-13
77053 CPT X-ray Breast Duct, Single Duct 32 15 $2,135.00 $2,135.00 $1,708.00 $1,921.50 $1,921.50 2026-05-13
77054 CPT X-ray Breast Duct, Multiple Ducts 32 15 $2,135.00 $2,135.00 $1,708.00 $1,921.50 $1,921.50 2026-05-13
78803 CPT Nuclear Medicine Spect 1 Area/single Acquisition 154 68 $2,775.00 $2,775.00 $84.55 $2,636.25 $1,720.50 2026-05-13
81162 CPT Gene Analysis (breast Cancer 1, 2) Full Sequence 148 68 $4,223.00 $4,223.00 $2,436.21 $4,011.85 $3,462.86 2026-05-13
81408 CPT Molecular Pathology Procedure Level 9 148 68 $2,250.00 $2,250.00 $1,800.00 $2,800.00 $2,025.00 2026-05-13
88309 CPT Pathology Examination Of Tissue Using A Microscope 148 68 $2,117.00 $2,117.00 $1,174.94 $2,011.15 $1,735.94 2026-05-13
90378 HCPCS Hc Pr Rx Respiratory Syncytial Virus Ig IM 50 Mg 72 35 $914.00 $914.00 $1,604.68 $2,090.71 $2,090.71 2026-05-13
94660 CPT Therapy Procedure Using A Positive Pressure Ventilator 32 15 $2,198.00 $2,198.00 $1,758.40 $1,978.20 $1,978.20 2026-05-13
C1726 HCPCS Audion 6x20 Aet-100 264 68 $5,014.00 $5,014.00 $2,142.32 $4,763.30 $3,165.23 2026-05-13
C1734 HCPCS Augment Bone Graft Kit 1.5cc Abg K20001510 148 68 $5,588.31 $5,588.31 $3,101.51 $5,308.89 $4,582.41 2026-05-13
C1762 HCPCS Biocartilage Extracellular Matrix 0.75 Abs-1007-bc 496 68 $2,705.00 $2,705.00 $1,207.47 $3,963.88 $2,552.08 2026-05-13
C1764 HCPCS Lux-dx Ii+ Icm Model 312 148 68 $10,135.00 $10,135.00 $5,624.93 $9,628.25 $8,310.70 2026-05-13
C1768 HCPCS Hemashield 16x8x40 166168po 32 15 $2,393.01 $2,393.01 $1,914.41 $2,153.71 $2,153.71 2026-05-13
C1771 HCPCS Sling Obtryx M0068505000 148 68 $4,066.05 $4,066.05 $2,256.66 $3,862.75 $3,334.16 2026-05-13
C1776 HCPCS Insert Rev 36x6x12.5 Dwf361b 25,378 68 $3,661.12 $3,661.12 $4.66 $19,455.76 $2,764.82 2026-05-13
C1788 HCPCS Powerport Full Size 1808000 148 68 $2,295.25 $2,295.25 $1,273.86 $2,180.49 $1,882.11 2026-05-13
C1886 HCPCS Mild Kit Mdk-0001 148 68 $6,807.25 $6,807.25 $3,778.02 $6,466.89 $5,581.95 2026-05-13
C1897 HCPCS Infinion Cx Lead Kit 50cm Sc-2317-50 264 68 $5,635.00 $5,635.00 $1,254.30 $5,353.25 $2,637.22 2026-05-13
C2625 HCPCS Propel Contour Stent 50011 32 15 $2,395.00 $2,395.00 $1,916.00 $2,155.50 $2,155.50 2026-05-13
J0129 HCPCS Abatacept 250 Mg IV Solr 148 68 $9,987.25 $9,987.25 $1,078.18 $9,487.89 $8,189.55 2026-05-13
J0840 HCPCS Crotalidae Polyval Immune Fab IV Solr 82 39 $8,260.00 $8,260.00 $2,097.22 $7,434.00 $2,097.22 2026-05-13
J0875 HCPCS Dalbavancin Hcl 500 Mg IV Solr 148 68 $6,482.25 $6,482.25 $1,536.21 $6,158.14 $5,315.45 2026-05-13
J1162 HCPCS Digoxin Immune Fab 40 Mg IV Solr 82 39 $31,793.00 $31,793.00 $4,639.51 $28,613.70 $4,639.51 2026-05-13
J1745 HCPCS Infliximab 100 Mg IV Solr 148 68 $4,147.25 $4,147.25 $329.66 $3,939.89 $3,400.75 2026-05-13
J1950 HCPCS Hc Pr Rx Leuprolide Acetate Inj 3.75 Mg 186 55 $1,945.00 $1,945.00 $1,539.58 $8,500.60 $1,750.50 2026-05-13
J2323 HCPCS Natalizumab 300 Mg/15ml IV Conc 114 39 $51,958.75 $51,958.75 $0.20 $46,762.88 $7,453.80 2026-05-13
J2327 HCPCS Risankizumab-rzaa 600 Mg/10ml IV Soln 148 68 $58,514.00 $58,514.00 $9,289.98 $55,588.30 $47,981.48 2026-05-13
J2350 HCPCS Ocrelizumab 300 Mg/10ml IV Soln 148 68 $142,766.00 $142,766.00 $18,346.65 $135,627.70 $117,068.12 2026-05-13
J2997 HCPCS Alteplase 2 Mg Injection Solr 264 68 $1,688.25 $1,688.25 $180.10 $53,353.43 $5,304.50 2026-05-13
J3032 HCPCS Eptinezumab-jjmr 100 Mg/ml IV Soln 148 68 $13,523.75 $13,523.75 $1,760.43 $12,847.56 $11,089.48 2026-05-13
J3101 HCPCS Tenecteplase 50 Mg IV Kit 82 39 $52,957.50 $52,957.50 $7,731.55 $47,661.75 $7,731.55 2026-05-13
J3262 HCPCS Tocilizumab 200 Mg/10ml IV Soln 264 68 $8,570.00 $8,570.00 $1,250.38 $16,172.80 $7,027.40 2026-05-13
J3357 HCPCS Hc Pr Rx Ustekinumab Sq Inj 1 Mg 164 39 $92,989.50 $271.00 100% off $152.97 $167,137.20 $7,005.80 2026-05-13
J3358 HCPCS Ustekinumab 130 Mg/26ml IV Soln 148 68 $14,765.00 $14,765.00 $1,657.01 $14,026.75 $12,107.30 2026-05-13
J3380 HCPCS Vedolizumab 300 Mg IV Solr 214 68 $64,802.50 $64,802.50 $0.20 $61,562.38 $6,756.90 2026-05-13
J3590 HCPCS Idarucizumab 2.5 Gm/50ml IV Soln 148 68 $35,378.75 $35,378.75 $19,635.21 $33,609.81 $29,010.58 2026-05-13
J9355 HCPCS Trastuzumab 150 Mg IV Solr 148 68 $10,886.25 $10,886.25 $1,223.97 $10,341.94 $8,926.73 2026-05-13
L8614 HCPCS Magnet Implant Bim400 93550 32 15 $4,874.50 $4,874.50 $3,899.60 $4,387.05 $4,387.05 2026-05-13
L8690 HCPCS Implant 4mm B1300 Baha 92129 64 15 $5,480.65 $5,480.65 $2,749.04 $6,772.50 $4,556.34 2026-05-13
P9035 HCPCS Platelets Pheresis Leukocytes Reduced Each Unit 32 15 $2,159.00 $2,159.00 $1,727.20 $1,943.10 $1,943.10 2026-05-13
P9037 HCPCS Platelets Pheresis Leukocytes Reduced Irradiated Ach Unit 148 68 $2,939.00 $2,939.00 $1,631.15 $2,792.05 $2,409.98 2026-05-13
PX-36000021 CDM Rt Bronch Level 1 Cdm 32 15 $4,000.00 $4,000.00 $3,200.00 $3,600.00 $3,600.00 2026-05-13
PX-36000022 CDM Rt Bronch Level 2 Cdm 32 15 $6,000.00 $6,000.00 $4,800.00 $5,400.00 $5,400.00 2026-05-13
PX-36000023 CDM Rt Bronch Level 3 Cdm 32 15 $8,000.00 $8,000.00 $6,400.00 $7,200.00 $7,200.00 2026-05-13
PX-36000024 CDM Rt Bronch Level 4 Cdm 32 15 $9,000.00 $9,000.00 $7,200.00 $8,100.00 $8,100.00 2026-05-13
PX-36000025 CDM Rt Bronch Level 5 Cdm 32 15 $10,000.00 $10,000.00 $8,000.00 $9,000.00 $9,000.00 2026-05-13
PX-36000026 CDM Rt Bronch Level 6 Cdm 32 15 $11,111.00 $11,111.00 $8,888.80 $9,999.90 $9,999.90 2026-05-13
PX-36010002 CDM Hc Pain Room Services Level 2 32 15 $2,100.00 $2,100.00 $1,680.00 $1,890.00 $1,890.00 2026-05-13
PX-36010003 CDM Hc Pain Room Services Level 3 32 15 $3,700.00 $3,700.00 $2,960.00 $3,330.00 $3,330.00 2026-05-13
PX-36010004 CDM Hc Pain Room Services Level 4 32 15 $5,300.00 $5,300.00 $4,240.00 $4,770.00 $4,770.00 2026-05-13
PX-36010005 CDM Hc Pain Room Services Level 5 32 15 $8,000.00 $8,000.00 $6,400.00 $7,200.00 $7,200.00 2026-05-13
PX-36010021 CDM Hc Operating Room Services Level 1 32 15 $1,985.00 $1,985.00 $1,588.00 $1,786.50 $1,786.50 2026-05-13
PX-36010022 CDM Hc Operating Room Services Level 2 32 15 $2,426.00 $2,426.00 $1,940.80 $2,183.40 $2,183.40 2026-05-13
PX-36010023 CDM Hc Operating Room Services Level 3 32 15 $3,749.00 $3,749.00 $2,999.20 $3,374.10 $3,374.10 2026-05-13
PX-36010024 CDM Hc Operating Room Services Level 4 32 15 $4,190.00 $4,190.00 $3,352.00 $3,771.00 $3,771.00 2026-05-13
PX-36010025 CDM Hc Operating Room Services Level 5 32 15 $4,631.00 $4,631.00 $3,704.80 $4,167.90 $4,167.90 2026-05-13
PX-36010026 CDM Hc Operating Room Services Level 6 32 15 $5,072.00 $5,072.00 $4,057.60 $4,564.80 $4,564.80 2026-05-13
PX-36010027 CDM Hc Operating Room Services Level 7 32 15 $5,513.00 $5,513.00 $4,410.40 $4,961.70 $4,961.70 2026-05-13
PX-36010028 CDM Hc Operating Room Services Level 8 32 15 $5,954.00 $5,954.00 $4,763.20 $5,358.60 $5,358.60 2026-05-13
PX-36010371 CDM Hc Pain Room Services Level 6 32 15 $9,000.00 $9,000.00 $7,200.00 $8,100.00 $8,100.00 2026-05-13
PX-45001310 CDM Trauma Response Without Cc Full Ctp 32 15 $4,848.00 $4,848.00 $3,878.40 $4,363.20 $4,363.20 2026-05-13
PX-71010010 CDM Hc Pacu Acuity Lvl 5 Initial 32 15 $2,143.00 $2,143.00 $1,714.40 $1,928.70 $1,928.70 2026-05-13
PX-72210001 CDM Hc Vaginal Delivery Level 1 Cdm 32 15 $7,400.00 $7,400.00 $5,920.00 $6,660.00 $6,660.00 2026-05-13
PX-72210002 CDM Hc Vaginal Delivery Level 2 Cdm 32 15 $7,900.00 $7,900.00 $6,320.00 $7,110.00 $7,110.00 2026-05-13
PX-72210003 CDM Hc Vaginal Delivery Level 3 Cdm 32 15 $8,300.00 $8,300.00 $6,640.00 $7,470.00 $7,470.00 2026-05-13
PX-72210004 CDM Hc Vaginal Delivery Level 4 Cdm 32 15 $8,800.00 $8,800.00 $7,040.00 $7,920.00 $7,920.00 2026-05-13
PX-75010272 CDM Hc Endoscopy/Gastrointestinal Procedure Level 6 32 15 $11,660.00 $11,660.00 $9,328.00 $10,494.00 $10,494.00 2026-05-13
PX-75010315 CDM Hc Endoscopy/Gastrointestinal Procedure Level 1 32 15 $4,240.00 $4,240.00 $3,392.00 $3,816.00 $3,816.00 2026-05-13
PX-75010316 CDM Hc Endoscopy/Gastrointestinal Procedure Level 2 32 15 $6,360.00 $6,360.00 $5,088.00 $5,724.00 $5,724.00 2026-05-13
PX-75010317 CDM Hc Endoscopy/Gastrointestinal Procedure Level 3 32 15 $8,608.00 $8,608.00 $6,886.40 $7,747.20 $7,747.20 2026-05-13
PX-75010318 CDM Hc Endoscopy/Gastrointestinal Procedure Level 4 32 15 $9,684.00 $9,684.00 $7,747.20 $8,715.60 $8,715.60 2026-05-13
PX-75010319 CDM Hc Endoscopy/Gastrointestinal Procedure Level 5 32 15 $10,600.00 $10,600.00 $8,480.00 $9,540.00 $9,540.00 2026-05-13
Q4107 HCPCS Graftjacket 5x5 86mx5x05 96 15 $5,599.00 $5,599.00 $3,798.80 $5,255.78 $5,039.10 2026-05-13
Q4125 HCPCS Dermis Decell Aflex301 264 68 $8,914.62 $8,914.62 $4,947.61 $8,969.28 $7,309.99 2026-05-13
Q4148 HCPCS Clarafix Cfx-2000 32 15 $4,335.18 $4,335.18 $3,468.14 $3,901.66 $3,901.66 2026-05-13
Q4159 HCPCS Affinity 2.5x2.5 Af-1250 148 68 $2,597.50 $2,597.50 $1,441.61 $2,467.63 $2,129.95 2026-05-13
Q4186 HCPCS Epifix 4.0x4.5cm Es-4400 612 68 $2,585.13 $2,585.13 $201.49 $2,757.26 $1,686.48 2026-05-13
Q5103 HCPCS Infliximab-dyyb 100 Mg IV Solr 148 68 $3,937.00 $3,937.00 $140.69 $3,740.15 $3,228.34 2026-05-13
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6ml Subq Sosy 148 68 $10,939.00 $10,939.00 $1,827.45 $10,392.05 $8,969.98 2026-05-13
Q5119 HCPCS Rituximab-pvvr 500 Mg/50ml IV Soln 148 68 $13,648.75 $13,648.75 $1,126.15 $12,966.31 $11,191.98 2026-05-13
V2790 HCPCS Amniocord 3x5 Ac-5350 380 68 $4,049.88 $4,049.88 $1,372.93 $4,692.76 $3,062.65 2026-05-13
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