Price Transparency 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

3,028 distinct procedures filed
68 distinct payers
278,775 rate rows
2026-05-13 last MRF observed
Data quality

270,227 of 278,775 rate rows are consumer-grade (96.9%)

8,548 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 4,321
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 3,590
percent-of-charges filed in the dollar field — excluded from medians 363
exceeds 10× this hospital's gross charge — excluded from medians 264
placeholder amount (≤ $0.02) — excluded from medians 10
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://wearesamaritan.org/wp-content/uploads/2026/03/CC_WSA_EPIC_MRF_2026_ALL_FINAL.xlsx
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-18
Content fingerprint d8bc0695cb52dcea… · 61,731,347 bytes · first seen 2026-05-13

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
$712
outlier · 164.4×
J2327
HCPCS 		Risankizumab-rzaa 600 Mg/10ml IV Soln 68 $9,289.98 $55,588.30 $47,981.48 nat. median
$2,241
outlier · 21.4×
J3590
HCPCS 		Idarucizumab 2.5 Gm/50ml IV Soln 68 $19,635.21 $33,609.81 $29,010.58 nat. median
$682
outlier · 42.5×
22514
CPT 		Hc Pr 22514 Perq Vertebral Augmentation Using Device Lumbar 15 $12,943.20 $14,561.10 $14,561.10 nat. median
$8,289
1.8× median
J3358
HCPCS 		Ustekinumab 130 Mg/26ml IV Soln 68 $1,657.01 $14,026.75 $12,107.30 nat. median
$214
outlier · 56.6×
Q5119
HCPCS 		Rituximab-pvvr 500 Mg/50ml IV Soln 68 $1,126.15 $12,966.31 $11,191.98 nat. median
$934
outlier · 12.0×
J3032
HCPCS 		Eptinezumab-jjmr 100 Mg/ml IV Soln 68 $1,760.43 $12,847.56 $11,089.48 nat. median
$72
outlier · 154.1×
PX-75010272
CDM 		Hc Endoscopy/Gastrointestinal Procedure Level 6 15 $9,328.00 $10,494.00 $10,494.00 nat. median
$3,663
outlier · 2.9×
72295
CPT 		Review By Radiologist Of Disc Of Lower Spine Image 15 $9,159.20 $10,304.10 $10,304.10 nat. median
$2,005
outlier · 5.1×
72285
CPT 		Review By Radiologist Of Disc Of Upper/middle Spine Image 15 $9,159.20 $10,304.10 $10,304.10 nat. median
$1,955
outlier · 5.3×
PX-36000026
CDM 		Rt Bronch Level 6 Cdm 15 $8,888.80 $9,999.90 $9,999.90 nat. median
$3,000
outlier · 3.3×
PX-75010319
CDM 		Hc Endoscopy/Gastrointestinal Procedure Level 5 15 $8,480.00 $9,540.00 $9,540.00 nat. median
$3,663
outlier · 2.6×
PX-36000025
CDM 		Rt Bronch Level 5 Cdm 15 $8,000.00 $9,000.00 $9,000.00 nat. median
$3,501
outlier · 2.6×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6ml Subq Sosy 68 $1,827.45 $10,392.05 $8,969.98 nat. median
$2,111
outlier · 4.2×
J9355
HCPCS 		Trastuzumab 150 Mg IV Solr 68 $1,223.97 $10,341.94 $8,926.73 nat. median
$989
outlier · 9.0×
PX-75010318
CDM 		Hc Endoscopy/Gastrointestinal Procedure Level 4 15 $7,747.20 $8,715.60 $8,715.60 nat. median
$3,663
outlier · 2.4×
C1764
HCPCS 		Lux-dx Ii+ Icm Model 312 68 $5,624.93 $9,628.25 $8,310.70 nat. median
$7,664
1.1× median
J0129
HCPCS 		Abatacept 250 Mg IV Solr 68 $1,078.18 $9,487.89 $8,189.55 nat. median
$1,082
outlier · 7.6×
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-36010371
CDM 		Hc Pain Room Services Level 6 15 $7,200.00 $8,100.00 $8,100.00 nat. median
$1,470
outlier · 5.5×
PX-72210004
CDM 		Hc Vaginal Delivery Level 4 Cdm 15 $7,040.00 $7,920.00 $7,920.00 nat. median
$7,480
1.1× median
PX-75010317
CDM 		Hc Endoscopy/Gastrointestinal Procedure Level 3 15 $6,886.40 $7,747.20 $7,747.20 nat. median
$1,832
outlier · 4.2×
J3101
HCPCS 		Tenecteplase 50 Mg IV Kit 39 $7,731.55 $47,661.75 $7,731.55 nat. median
$5,949
1.3× median
PX-72210003
CDM 		Hc Vaginal Delivery Level 3 Cdm 15 $6,640.00 $7,470.00 $7,470.00 nat. median
$7,055
1.1× median
J2323
HCPCS 		Natalizumab 300 Mg/15ml IV Conc 39 $0.20 $46,762.88 $7,453.80 nat. median
$201
outlier · 37.1×
Q4125
HCPCS 		Dermis Decell Aflex301 68 $4,947.61 $8,969.28 $7,309.99 nat. median
$471
outlier · 15.5×
PX-36010005
CDM 		Hc Pain Room Services Level 5 15 $6,400.00 $7,200.00 $7,200.00 nat. median
$1,470
outlier · 4.9×
PX-36000023
CDM 		Rt Bronch Level 3 Cdm 15 $6,400.00 $7,200.00 $7,200.00 nat. median
$4,458
1.6× median
PX-72210002
CDM 		Hc Vaginal Delivery Level 2 Cdm 15 $6,320.00 $7,110.00 $7,110.00 nat. median
$6,715
1.1× median
J3262
HCPCS 		Tocilizumab 200 Mg/10ml IV Soln 68 $1,250.38 $16,172.80 $7,027.40 nat. median
$1,425
outlier · 4.9×
J3357
HCPCS 		Hc Pr Rx Ustekinumab Sq Inj 1 Mg 39 $152.97 $167,137.20 $7,005.80 nat. median
$14,306
outlier · 0.5×
J3380
HCPCS 		Vedolizumab 300 Mg IV Solr 68 $0.20 $61,562.38 $6,756.90 nat. median
$288
outlier · 23.5×
PX-72210001
CDM 		Hc Vaginal Delivery Level 1 Cdm 15 $5,920.00 $6,660.00 $6,660.00 nat. median
$6,290
1.1× median
PX-75010316
CDM 		Hc Endoscopy/Gastrointestinal Procedure Level 2 15 $5,088.00 $5,724.00 $5,724.00 nat. median
$1,832
outlier · 3.1×
69706
CPT 		Dilation Of Canal Between Middle Ear And Throat 15 $4,614.40 $6,822.90 $5,628.00 nat. median
$5,945
0.9× median
C1886
HCPCS 		Mild Kit Mdk-0001 68 $3,778.02 $6,466.89 $5,581.95 nat. median
$2,848
2.0× median
PX-36000022
CDM 		Rt Bronch Level 2 Cdm 15 $4,800.00 $5,400.00 $5,400.00 nat. median
$2,303
outlier · 2.3×
PX-36010028
CDM 		Hc Operating Room Services Level 8 15 $4,763.20 $5,358.60 $5,358.60 nat. median
$5,359
1.0× median
J0875
HCPCS 		Dalbavancin Hcl 500 Mg IV Solr 68 $1,536.21 $6,158.14 $5,315.45 nat. median
$1,069
outlier · 5.0×
J2997
HCPCS 		Alteplase 2 Mg Injection Solr 68 $180.10 $53,353.43 $5,304.50 nat. median
$545
outlier · 9.7×
59510
CPT 		Hc Pr 59510 Total OB/Cesarean Delivery/Pp Car 15 $4,699.20 $5,286.60 $5,286.60 nat. median
$3,677
1.4× median
69705
CPT 		Dilation Of Canal Between Middle Ear And Throat 15 $4,328.00 $6,307.20 $5,237.70 nat. median
$5,977
0.9× median
36558
CPT 		Insert Tunneled Central Venous Tube For Iv=>5 Yrs 15 $1,655.20 $9,255.60 $5,044.65 nat. median
$3,479
1.5× median
Q4107
HCPCS 		Graftjacket 5x5 86mx5x05 15 $3,798.80 $5,255.78 $5,039.10 nat. median
$373
outlier · 13.5×
59610
CPT 		Hc Pr 59610 Total OB/Vbac/Pp Care 15 $4,431.20 $4,985.10 $4,985.10 nat. median
$3,356
1.5× median
PX-36010027
CDM 		Hc Operating Room Services Level 7 15 $4,410.40 $4,961.70 $4,961.70 nat. median
$4,962
1.0× median
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
$4,765
1.0× median
59400
CPT 		Hc Pr 59400 Total OB/Vaginal Delivery/Pp Care 15 $4,254.40 $4,786.20 $4,786.20 nat. median
$3,185
1.5× median
PX-36010004
CDM 		Hc Pain Room Services Level 4 15 $4,240.00 $4,770.00 $4,770.00 nat. median
$1,470
outlier · 3.2×
J1162
HCPCS 		Digoxin Immune Fab 40 Mg IV Solr 39 $4,639.51 $28,613.70 $4,639.51 nat. median
$7,316
0.6× median

Other procedures at this hospital

Browse this hospital's 3,028 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3357 HCPCS Hc Pr Rx Ustekinumab Sq Inj 1 Mg 82 39 $92,989.50 $271.00 100% off $152.97 $167,137.20 $7,005.80 2026-05-13
J2350 HCPCS Ocrelizumab 300 Mg/10ml IV Soln 74 68 $142,766.00 $142,766.00 $18,346.65 $135,627.70 $117,068.12 2026-05-13
J3380 HCPCS Vedolizumab 300 Mg IV Solr 107 68 $64,802.50 $64,802.50 $0.20 $61,562.38 $6,756.90 2026-05-13
J2327 HCPCS Risankizumab-rzaa 600 Mg/10ml IV Soln 74 68 $58,514.00 $58,514.00 $9,289.98 $55,588.30 $47,981.48 2026-05-13
J2997 HCPCS Alteplase 2 Mg Injection Solr 132 68 $1,688.25 $1,688.25 $180.10 $53,353.43 $5,304.50 2026-05-13
J3101 HCPCS Tenecteplase 50 Mg IV Kit 41 39 $52,957.50 $52,957.50 $7,731.55 $47,661.75 $7,731.55 2026-05-13
J2323 HCPCS Natalizumab 300 Mg/15ml IV Conc 57 39 $51,958.75 $51,958.75 $0.20 $46,762.88 $7,453.80 2026-05-13
J3590 HCPCS Idarucizumab 2.5 Gm/50ml IV Soln 74 68 $35,378.75 $35,378.75 $19,635.21 $33,609.81 $29,010.58 2026-05-13
J1162 HCPCS Digoxin Immune Fab 40 Mg IV Solr 41 39 $31,793.00 $31,793.00 $4,639.51 $28,613.70 $4,639.51 2026-05-13
C1776 HCPCS Insert Rev 36x6x12.5 Dwf361b 12,689 68 $3,661.12 $3,661.12 $4.66 $19,455.76 $2,764.82 2026-05-13
J3262 HCPCS Tocilizumab 200 Mg/10ml IV Soln 132 68 $8,570.00 $8,570.00 $1,250.38 $16,172.80 $7,027.40 2026-05-13
22514 CPT Hc Pr 22514 Perq Vertebral Augmentation Using Device Lumbar 16 15 $16,179.00 $16,179.00 $12,943.20 $14,561.10 $14,561.10 2026-05-13
J3358 HCPCS Ustekinumab 130 Mg/26ml IV Soln 74 68 $14,765.00 $14,765.00 $1,657.01 $14,026.75 $12,107.30 2026-05-13
Q5119 HCPCS Rituximab-pvvr 500 Mg/50ml IV Soln 74 68 $13,648.75 $13,648.75 $1,126.15 $12,966.31 $11,191.98 2026-05-13
J3032 HCPCS Eptinezumab-jjmr 100 Mg/ml IV Soln 74 68 $13,523.75 $13,523.75 $1,760.43 $12,847.56 $11,089.48 2026-05-13
PX-75010272 CDM Hc Endoscopy/Gastrointestinal Procedure Level 6 16 15 $11,660.00 $11,660.00 $9,328.00 $10,494.00 $10,494.00 2026-05-13
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6ml Subq Sosy 74 68 $10,939.00 $10,939.00 $1,827.45 $10,392.05 $8,969.98 2026-05-13
J9355 HCPCS Trastuzumab 150 Mg IV Solr 74 68 $10,886.25 $10,886.25 $1,223.97 $10,341.94 $8,926.73 2026-05-13
72295 CPT Review By Radiologist Of Disc Of Lower Spine Image 16 15 $11,449.00 $11,449.00 $9,159.20 $10,304.10 $10,304.10 2026-05-13
72285 CPT Review By Radiologist Of Disc Of Upper/middle Spine Image 16 15 $11,449.00 $11,449.00 $9,159.20 $10,304.10 $10,304.10 2026-05-13
PX-36000026 CDM Rt Bronch Level 6 Cdm 16 15 $11,111.00 $11,111.00 $8,888.80 $9,999.90 $9,999.90 2026-05-13
C1764 HCPCS Lux-dx Ii+ Icm Model 312 74 68 $10,135.00 $10,135.00 $5,624.93 $9,628.25 $8,310.70 2026-05-13
PX-75010319 CDM Hc Endoscopy/Gastrointestinal Procedure Level 5 16 15 $10,600.00 $10,600.00 $8,480.00 $9,540.00 $9,540.00 2026-05-13
J0129 HCPCS Abatacept 250 Mg IV Solr 74 68 $9,987.25 $9,987.25 $1,078.18 $9,487.89 $8,189.55 2026-05-13
36558 CPT Insert Tunneled Central Venous Tube For Iv=>5 Yrs 32 15 $6,176.50 $6,176.50 $1,655.20 $9,255.60 $5,044.65 2026-05-13
PX-36000025 CDM Rt Bronch Level 5 Cdm 16 15 $10,000.00 $10,000.00 $8,000.00 $9,000.00 $9,000.00 2026-05-13
Q4125 HCPCS Dermis Decell Aflex301 132 68 $8,914.62 $8,914.62 $4,947.61 $8,969.28 $7,309.99 2026-05-13
PX-75010318 CDM Hc Endoscopy/Gastrointestinal Procedure Level 4 16 15 $9,684.00 $9,684.00 $7,747.20 $8,715.60 $8,715.60 2026-05-13
J1950 HCPCS Hc Pr Rx Leuprolide Acetate Inj 3.75 Mg 93 55 $1,945.00 $1,945.00 $1,539.58 $8,500.60 $1,750.50 2026-05-13
PX-36000024 CDM Rt Bronch Level 4 Cdm 16 15 $9,000.00 $9,000.00 $7,200.00 $8,100.00 $8,100.00 2026-05-13
PX-36010371 CDM Hc Pain Room Services Level 6 16 15 $9,000.00 $9,000.00 $7,200.00 $8,100.00 $8,100.00 2026-05-13
59412 CPT Turning Of Fetus Through External Manipulation 132 68 $8,518.00 $8,518.00 $127.10 $8,092.10 $2,472.52 2026-05-13
PX-72210004 CDM Hc Vaginal Delivery Level 4 Cdm 16 15 $8,800.00 $8,800.00 $7,040.00 $7,920.00 $7,920.00 2026-05-13
PX-75010317 CDM Hc Endoscopy/Gastrointestinal Procedure Level 3 16 15 $8,608.00 $8,608.00 $6,886.40 $7,747.20 $7,747.20 2026-05-13
PX-72210003 CDM Hc Vaginal Delivery Level 3 Cdm 16 15 $8,300.00 $8,300.00 $6,640.00 $7,470.00 $7,470.00 2026-05-13
J0840 HCPCS Crotalidae Polyval Immune Fab IV Solr 41 39 $8,260.00 $8,260.00 $2,097.22 $7,434.00 $2,097.22 2026-05-13
PX-36010005 CDM Hc Pain Room Services Level 5 16 15 $8,000.00 $8,000.00 $6,400.00 $7,200.00 $7,200.00 2026-05-13
PX-36000023 CDM Rt Bronch Level 3 Cdm 16 15 $8,000.00 $8,000.00 $6,400.00 $7,200.00 $7,200.00 2026-05-13
PX-72210002 CDM Hc Vaginal Delivery Level 2 Cdm 16 15 $7,900.00 $7,900.00 $6,320.00 $7,110.00 $7,110.00 2026-05-13
27532 CPT Closed Treatment Of Broken Shin Bone With Traction 32 15 $4,561.50 $4,561.50 $1,204.80 $6,855.30 $3,724.50 2026-05-13
69706 CPT Dilation Of Canal Between Middle Ear And Throat 32 15 $6,674.50 $6,674.50 $4,614.40 $6,822.90 $5,628.00 2026-05-13
L8690 HCPCS Implant 4mm B1300 Baha 92129 32 15 $5,480.65 $5,480.65 $2,749.04 $6,772.50 $4,556.34 2026-05-13
41008 CPT Drain Abscess, Cyst, Or Blood Accumulation Under Jaw Bone 32 15 $4,067.50 $4,067.50 $508.00 $6,750.00 $3,285.75 2026-05-13
PX-72210001 CDM Hc Vaginal Delivery Level 1 Cdm 16 15 $7,400.00 $7,400.00 $5,920.00 $6,660.00 $6,660.00 2026-05-13
23605 CPT Closed Treatment Of Broken Top Of Upper Arm Bone 32 15 $4,039.50 $4,039.50 $598.40 $6,597.90 $3,269.00 2026-05-13
C1886 HCPCS Mild Kit Mdk-0001 74 68 $6,807.25 $6,807.25 $3,778.02 $6,466.89 $5,581.95 2026-05-13
69705 CPT Dilation Of Canal Between Middle Ear And Throat 32 15 $6,209.00 $6,209.00 $4,328.00 $6,307.20 $5,237.70 2026-05-13
54700 CPT Hc Pr Ed 54700 Drainage Of Scrotum Cdm 32 15 $3,640.00 $3,640.00 $308.80 $6,204.60 $2,931.30 2026-05-13
J0875 HCPCS Dalbavancin Hcl 500 Mg IV Solr 74 68 $6,482.25 $6,482.25 $1,536.21 $6,158.14 $5,315.45 2026-05-13
70546 CPT MRI Scan Of Blood Vessels Of Head Before And After Contrast 132 68 $6,342.00 $6,342.00 $85.47 $6,024.90 $1,833.06 2026-05-13
23931 CPT Drainage Of Fluid Filled Sac In Elbow Joint 32 15 $3,497.50 $3,497.50 $416.80 $5,826.60 $2,824.05 2026-05-13
49406 CPT Drain Fluid Of Abdominal Cavity By Tube W/imaging Guidance 32 15 $4,000.50 $4,000.50 $1,223.20 $5,824.80 $3,276.85 2026-05-13
13100 CPT Complicated Repair Wound Of Trunk, 1.1-2.5 Cm 32 15 $3,646.50 $3,646.50 $667.20 $5,813.10 $2,958.90 2026-05-13
PX-75010316 CDM Hc Endoscopy/Gastrointestinal Procedure Level 2 16 15 $6,360.00 $6,360.00 $5,088.00 $5,724.00 $5,724.00 2026-05-13
26775 CPT Closed Treatment Of Dislocated Finger Joint 32 15 $4,494.50 $4,494.50 $2,288.80 $5,515.20 $3,738.65 2026-05-13
PX-36000022 CDM Rt Bronch Level 2 Cdm 16 15 $6,000.00 $6,000.00 $4,800.00 $5,400.00 $5,400.00 2026-05-13
PX-36010028 CDM Hc Operating Room Services Level 8 16 15 $5,954.00 $5,954.00 $4,763.20 $5,358.60 $5,358.60 2026-05-13
C1897 HCPCS Infinion Cx Lead Kit 50cm Sc-2317-50 132 68 $5,635.00 $5,635.00 $1,254.30 $5,353.25 $2,637.22 2026-05-13
12037 CPT Intermediate Repair Wound Of Body, More Than 30.0 Cm 32 15 $3,708.50 $3,708.50 $1,180.00 $5,347.80 $3,040.55 2026-05-13
C1734 HCPCS Augment Bone Graft Kit 1.5cc Abg K20001510 74 68 $5,588.31 $5,588.31 $3,101.51 $5,308.89 $4,582.41 2026-05-13
20650 CPT Hc Pr 20650 Insert And Remove Bone Pin 32 15 $3,112.50 $3,112.50 $267.20 $5,301.90 $2,506.70 2026-05-13
59510 CPT Hc Pr 59510 Total OB/Cesarean Delivery/Pp Car 16 15 $5,874.00 $5,874.00 $4,699.20 $5,286.60 $5,286.60 2026-05-13
Q4107 HCPCS Graftjacket 5x5 86mx5x05 48 15 $5,599.00 $5,599.00 $3,798.80 $5,255.78 $5,039.10 2026-05-13
59610 CPT Hc Pr 59610 Total OB/Vbac/Pp Care 16 15 $5,539.00 $5,539.00 $4,431.20 $4,985.10 $4,985.10 2026-05-13
32556 CPT Drain Fluid From Chest Cavity With Insert Indwelling Tube 32 15 $3,264.00 $3,264.00 $800.00 $4,975.20 $2,661.20 2026-05-13
PX-36010027 CDM Hc Operating Room Services Level 7 16 15 $5,513.00 $5,513.00 $4,410.40 $4,961.70 $4,961.70 2026-05-13
27245 CPT Hc Pr 27245 Tx Inter/PR/Subtrchntric Fem Fx Imed Implt Screw Cdm 16 15 $5,489.00 $5,489.00 $4,391.20 $4,940.10 $4,940.10 2026-05-13
74185 CPT MRI Scan Of Blood Vessels Of Abdomen 48 15 $5,072.00 $5,072.00 $3,247.20 $4,928.40 $4,564.80 2026-05-13
27502 CPT Closed Treatment Of Broken Thigh Bone At Midportion 32 15 $3,383.00 $3,383.00 $1,044.80 $4,914.00 $2,771.70 2026-05-13
10121 CPT Remove Foreign Body From Tissue Under Skn Complex 32 15 $3,053.50 $3,053.50 $529.60 $4,900.50 $2,475.90 2026-05-13
62273 CPT Injection Of Blood Or Blood Clot Into Spinal Canal 48 15 $2,679.00 $2,679.00 $271.20 $4,832.10 $2,411.10 2026-05-13
23625 CPT Closed Treat Upper Arm Bone Broken At Shoulder Joint 32 15 $2,988.00 $2,988.00 $488.80 $4,828.50 $2,420.95 2026-05-13
36569 CPT Insert Tube For IV >5yrs 190 68 $3,950.00 $3,950.00 $1,694.42 $4,803.20 $2,747.70 2026-05-13
59400 CPT Hc Pr 59400 Total OB/Vaginal Delivery/Pp Care 16 15 $5,318.00 $5,318.00 $4,254.40 $4,786.20 $4,786.20 2026-05-13
PX-36010004 CDM Hc Pain Room Services Level 4 16 15 $5,300.00 $5,300.00 $4,240.00 $4,770.00 $4,770.00 2026-05-13
C1726 HCPCS Audion 6x20 Aet-100 132 68 $5,014.00 $5,014.00 $2,142.32 $4,763.30 $3,165.23 2026-05-13
77048 CPT MRI Scan Of 1 Breast 74 68 $5,004.00 $5,004.00 $2,777.22 $4,753.80 $4,103.28 2026-05-13
V2790 HCPCS Amniocord 3x5 Ac-5350 190 68 $4,049.88 $4,049.88 $1,372.93 $4,692.76 $3,062.65 2026-05-13
19081 CPT Biopsy Breast Using X-ray With Needle First Growth 74 68 $4,900.00 $4,900.00 $2,719.50 $4,655.00 $4,018.00 2026-05-13
PX-36010026 CDM Hc Operating Room Services Level 6 16 15 $5,072.00 $5,072.00 $4,057.60 $4,564.80 $4,564.80 2026-05-13
23675 CPT Closed Treat Dislocated Shoulder,broken Neck Upper Arm Bone 32 15 $4,552.00 $4,552.00 $3,268.80 $4,516.20 $3,845.90 2026-05-13
23655 CPT Closed Treatment Of Dislocated Shoulder 32 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 32 15 $4,125.50 $4,125.50 $2,586.40 $4,516.20 $3,462.05 2026-05-13
26742 CPT Closed Treatment Of Broken Finger Or Hand At Base Of Finger 32 15 $3,886.50 $3,886.50 $2,204.00 $4,516.20 $3,246.95 2026-05-13
25605 CPT Closed Treatment Of Broken Or Growth Plate Forearm Bone 32 15 $3,674.00 $3,674.00 $1,864.00 $4,516.20 $3,055.70 2026-05-13
27825 CPT Closed Treatment Of Broken Shin Bone At Wt Bearing Joint 32 15 $3,623.00 $3,623.00 $1,782.40 $4,516.20 $3,009.80 2026-05-13
24605 CPT Repair Of Dislocated Elbow Under Anesthesia 32 15 $3,564.00 $3,564.00 $1,688.00 $4,516.20 $2,956.70 2026-05-13
27818 CPT Closed Treatment Of 3 Broken Lower Leg Bones At Ankle 32 15 $3,491.50 $3,491.50 $1,572.00 $4,516.20 $2,891.45 2026-05-13
27810 CPT Closed Treatment Of 2 Broken Lower Leg Bones At Ankle 32 15 $3,477.00 $3,477.00 $1,548.80 $4,516.20 $2,878.40 2026-05-13
24675 CPT Hc Ed Treat Ulnar Fracture W/Manipulation Cdm 32 15 $3,449.50 $3,449.50 $1,504.80 $4,516.20 $2,853.65 2026-05-13
27510 CPT Closed Treatment Of Broken Thigh Bone At Knee Area 32 15 $3,126.00 $3,126.00 $987.20 $4,516.20 $2,562.50 2026-05-13
26675 CPT Closed Treatment Of Dislocated Hand Bone At Wrist Joint 32 15 $2,920.00 $2,920.00 $657.60 $4,516.20 $2,377.10 2026-05-13
27781 CPT Closed Treatment Of Broken Middle Or Upper End Of Leg Bone 32 15 $2,863.00 $2,863.00 $566.40 $4,516.20 $2,325.80 2026-05-13
27236 CPT Hc Pr 27236 Open Tx Thigh Fracture Without Manip 16 15 $4,991.00 $4,991.00 $3,992.80 $4,491.90 $4,491.90 2026-05-13
43632 CPT Hc Pr 43632 Removal Of Stomach Partial With Gastrojejunostomy 16 15 $4,893.00 $4,893.00 $3,914.40 $4,403.70 $4,403.70 2026-05-13
L8614 HCPCS Magnet Implant Bim400 93550 16 15 $4,874.50 $4,874.50 $3,899.60 $4,387.05 $4,387.05 2026-05-13
PX-45001310 CDM Trauma Response Without Cc Full Ctp 16 15 $4,848.00 $4,848.00 $3,878.40 $4,363.20 $4,363.20 2026-05-13
24620 CPT Closed Treatment Of Broken And Dislocated Forearm Bones 32 15 $3,659.00 $3,659.00 $1,976.00 $4,363.20 $3,050.70 2026-05-13
27252 CPT Closed Treatment Of Dislocated Hip Under Anesthesia 32 15 $3,104.50 $3,104.50 $1,088.80 $4,363.20 $2,551.65 2026-05-13
25505 CPT Closed Treat Broken Midpart Of Forearm Bone On Thumb Side 32 15 $2,857.00 $2,857.00 $692.80 $4,363.20 $2,328.90 2026-05-13
27842 CPT Closed Treatment Of Dislocated Ankle Under Anesthesia 32 15 $2,854.00 $2,854.00 $688.00 $4,363.20 $2,326.20 2026-05-13
38100 CPT Hc Pr 38100 Removal Of Spleen Total 16 15 $4,832.00 $4,832.00 $3,865.60 $4,348.80 $4,348.80 2026-05-13
20225 CPT Biopsy Of Bone Using Needle Or Trocar 132 68 $4,543.00 $4,543.00 $493.95 $4,315.85 $1,683.43 2026-05-13
27506 CPT Hc Pr 27506 Treatment Of Thigh Fx 16 15 $4,774.00 $4,774.00 $3,819.20 $4,296.60 $4,296.60 2026-05-13
70549 CPT Hc Pr 70549 MRA Neck Without &W/Contrast Material 32 15 $2,429.00 $2,429.00 $123.20 $4,233.60 $1,950.90 2026-05-13
73725 CPT MRI Scan Of Blood Vessels Of Leg 16 15 $4,652.00 $4,652.00 $3,721.60 $4,186.80 $4,186.80 2026-05-13
PX-36010025 CDM Hc Operating Room Services Level 5 16 15 $4,631.00 $4,631.00 $3,704.80 $4,167.90 $4,167.90 2026-05-13
70548 CPT MRI Scan Of Blood Vessels Of Neck With Contrast 16 15 $4,631.00 $4,631.00 $3,704.80 $4,167.90 $4,167.90 2026-05-13
27552 CPT Closed Treatment Of Dislocated Knee Under Anesthesia 32 15 $2,828.00 $2,828.00 $828.80 $4,158.00 $2,314.20 2026-05-13
10030 CPT Drain Fluid In Soft Tissue Using Imaging Guidance 132 68 $4,312.00 $4,312.00 $694.86 $4,096.40 $1,791.28 2026-05-13
27235 CPT Hc Pr 27235 Prq Skel Fixj Femoral Fx Prox End Neck 16 15 $4,490.00 $4,490.00 $3,592.00 $4,041.00 $4,041.00 2026-05-13
81162 CPT Gene Analysis (breast Cancer 1, 2) Full Sequence 74 68 $4,223.00 $4,223.00 $2,436.21 $4,011.85 $3,462.86 2026-05-13
47000 CPT Needle Biopsy Of Liver Through Skin 74 68 $4,223.00 $4,223.00 $2,343.77 $4,011.85 $3,462.86 2026-05-13
C1762 HCPCS Biocartilage Extracellular Matrix 0.75 Abs-1007-bc 248 68 $2,705.00 $2,705.00 $1,207.47 $3,963.88 $2,552.08 2026-05-13
32408 CPT Core Needle Biopsy Of Lung Or Center Cavity Of Chest 16 15 $4,384.00 $4,384.00 $3,507.20 $3,945.60 $3,945.60 2026-05-13
J1745 HCPCS Infliximab 100 Mg IV Solr 74 68 $4,147.25 $4,147.25 $329.66 $3,939.89 $3,400.75 2026-05-13
27511 CPT Hc Pr 27511 Optx Femoral Supracondylar Fracture Without Xtn Cdm 16 15 $4,359.00 $4,359.00 $3,487.20 $3,923.10 $3,923.10 2026-05-13
72149 CPT Hc Pr 72149 MRI Spinal Canal Lumbar W/Contrast Material 32 15 $2,245.00 $2,245.00 $122.40 $3,903.30 $1,803.65 2026-05-13
Q4148 HCPCS Clarafix Cfx-2000 16 15 $4,335.18 $4,335.18 $3,468.14 $3,901.66 $3,901.66 2026-05-13
26011 CPT Complicated Drainage Of Abscess In Finger 32 15 $2,574.50 $2,574.50 $669.60 $3,880.80 $2,101.45 2026-05-13
45915 CPT Removal Of Stool/foreign Body In Rectum Under General Anesthesia 32 15 $2,450.50 $2,450.50 $483.20 $3,867.30 $1,990.60 2026-05-13
C1771 HCPCS Sling Obtryx M0068505000 74 68 $4,066.05 $4,066.05 $2,256.66 $3,862.75 $3,334.16 2026-05-13
71271 CPT Low Dose CT Scan Of Chest For Lung Cancer Screening 16 15 $4,269.00 $4,269.00 $3,415.20 $3,842.10 $3,842.10 2026-05-13
44144 CPT Hc Pr 44144 Partial Removal Of Colon, With Resection 16 15 $4,269.00 $4,269.00 $3,415.20 $3,842.10 $3,842.10 2026-05-13
72198 CPT MRI Scan Of Blood Vessels Of Pelvis 32 15 $4,166.50 $4,166.50 $3,251.20 $3,842.10 $3,657.60 2026-05-13
PX-75010315 CDM Hc Endoscopy/Gastrointestinal Procedure Level 1 16 15 $4,240.00 $4,240.00 $3,392.00 $3,816.00 $3,816.00 2026-05-13
PX-36010024 CDM Hc Operating Room Services Level 4 16 15 $4,190.00 $4,190.00 $3,352.00 $3,771.00 $3,771.00 2026-05-13
73225 CPT MRI Scan Of Blood Vessels Of Arm 16 15 $4,185.00 $4,185.00 $3,348.00 $3,766.50 $3,766.50 2026-05-13
55100 CPT Drainage Of Abscess Of Scrotum 32 15 $2,454.00 $2,454.00 $593.60 $3,749.40 $2,000.30 2026-05-13
Q5103 HCPCS Infliximab-dyyb 100 Mg IV Solr 74 68 $3,937.00 $3,937.00 $140.69 $3,740.15 $3,228.34 2026-05-13
71551 CPT MRI Scan Of Chest With Contrast 16 15 $4,048.00 $4,048.00 $3,238.40 $3,643.20 $3,643.20 2026-05-13
59300 CPT Episiotomy Or Repair Of Vagina 32 15 $2,262.00 $2,262.00 $382.40 $3,641.40 $1,833.50 2026-05-13
49020 CPT Hc Pr 49020 Drain Abdominal Abscess, Open 16 15 $4,023.00 $4,023.00 $3,218.40 $3,620.70 $3,620.70 2026-05-13
44143 CPT Hc Pr 44143 Partial Removal Of Colon, Hartmann Procedure 16 15 $4,013.00 $4,013.00 $3,210.40 $3,611.70 $3,611.70 2026-05-13
71555 CPT MRI Scan Of Blood Vessels Of Chest 16 15 $4,011.00 $4,011.00 $3,208.80 $3,609.90 $3,609.90 2026-05-13
PX-36000021 CDM Rt Bronch Level 1 Cdm 16 15 $4,000.00 $4,000.00 $3,200.00 $3,600.00 $3,600.00 2026-05-13
38505 CPT Needle Biopsy Or Removal Of Surface Lymph Nodes 74 68 $3,747.00 $3,747.00 $2,079.59 $3,559.65 $3,072.54 2026-05-13
19082 CPT Biopsy Breast Using X-ray With Needle, Add Growth 74 68 $3,705.00 $3,705.00 $2,056.28 $3,519.75 $3,038.10 2026-05-13
44626 CPT Hc Pr 44626 Repair Bowel Opening, Hartmann Method 16 15 $3,877.00 $3,877.00 $3,101.60 $3,489.30 $3,489.30 2026-05-13
44151 CPT Hc Pr 44151 Removal Of Colon/Ileostomy, Without Proctectomy With Continent I 16 15 $3,870.00 $3,870.00 $3,096.00 $3,483.00 $3,483.00 2026-05-13
32100 CPT Incision And Exploration Of Chest Cavity 32 15 $3,079.00 $3,079.00 $1,835.20 $3,477.60 $2,577.90 2026-05-13
51102 CPT Aspiration Of Bladder With Insertion Of Bladder Tube To Skin 32 15 $2,215.50 $2,215.50 $464.80 $3,465.00 $1,801.45 2026-05-13
44146 CPT Hc Pr 44146 Partial Removal Of Colon With Coloproctostomy, With Colostomy 16 15 $3,832.00 $3,832.00 $3,065.60 $3,448.80 $3,448.80 2026-05-13
61312 CPT Hc Pr 61312 Craniectomy Hmtma Supratentorial Extra/Subdural Cdm 16 15 $3,817.00 $3,817.00 $3,053.60 $3,435.30 $3,435.30 2026-05-13
74182 CPT MRI Scan Of Abdomen With Contrast 16 15 $3,786.00 $3,786.00 $3,028.80 $3,407.40 $3,407.40 2026-05-13
25030001 HCPCS Poractant Alfa 80 Mg/ml Intratrachea Susp (wrapper) 16 15 $3,751.00 $3,751.00 $3,000.80 $3,375.90 $3,375.90 2026-05-13
PX-36010023 CDM Hc Operating Room Services Level 3 16 15 $3,749.00 $3,749.00 $2,999.20 $3,374.10 $3,374.10 2026-05-13
20206 CPT Needle Biopsy Of Muscle 74 68 $3,536.00 $3,536.00 $1,962.48 $3,359.20 $2,899.52 2026-05-13
PX-36010003 CDM Hc Pain Room Services Level 3 16 15 $3,700.00 $3,700.00 $2,960.00 $3,330.00 $3,330.00 2026-05-13
36565 CPT Insert 2 Central Venous Tubes In 2 Veins For Infusion 16 15 $3,693.00 $3,693.00 $2,954.40 $3,323.70 $3,323.70 2026-05-13
75573 CPT CT Scan Of Congenital Heart Disease With Contrast 16 15 $3,670.00 $3,670.00 $2,936.00 $3,303.00 $3,303.00 2026-05-13
70542 CPT MRI Scan Of Bone Of Eye Socket, Face, Neck W/contrast 16 15 $3,618.00 $3,618.00 $2,894.40 $3,256.20 $3,256.20 2026-05-13
15277 CPT Hc Pr 15277 Face/Neck/Hand/Feet/Genitalia Total > 100 Sq Cm 1st 100 Sq Cm 16 15 $3,549.00 $3,549.00 $2,839.20 $3,194.10 $3,194.10 2026-05-13
26765 CPT Hc Ed Open Tx Distal Phalangeal Fracture Each Cdm 32 15 $2,173.50 $2,173.50 $664.80 $3,164.40 $1,780.35 2026-05-13
72270 CPT Review By Radiologist Of Multiple Spinal Canals Image 16 15 $3,506.00 $3,506.00 $2,804.80 $3,155.40 $3,155.40 2026-05-13
70488 CPT CT Scan Of Face Before And After Contrast 16 15 $3,465.00 $3,465.00 $2,772.00 $3,118.50 $3,118.50 2026-05-13
44602 CPT Hc Pr 44602 Suture Small Intestine, Single Perforation 16 15 $3,405.00 $3,405.00 $2,724.00 $3,064.50 $3,064.50 2026-05-13
36573 CPT Insert Tube For IVwith Imaging Guidance, =>5 Yrs 74 68 $3,196.00 $3,196.00 $1,773.78 $3,036.20 $2,620.72 2026-05-13
19000 CPT Aspiration Of Cyst Of Breast, First Cyst 190 68 $3,142.00 $3,142.00 $138.20 $2,985.85 $1,948.04 2026-05-13
73219 CPT MRI Scan Of Arm With Contrast 16 15 $3,271.00 $3,271.00 $2,616.80 $2,943.90 $2,943.90 2026-05-13
70492 CPT CT Scan Of Soft Tissue Of Neck Before And After Contrast 16 15 $3,271.00 $3,271.00 $2,616.80 $2,943.90 $2,943.90 2026-05-13
43840 CPT Hc Pr 43840 Repair Of Stomach Lesion 16 15 $3,270.00 $3,270.00 $2,616.00 $2,943.00 $2,943.00 2026-05-13
44140 CPT Hc Pr 44140 Partial Removal Of Colon With Anastomosis 16 15 $3,231.00 $3,231.00 $2,584.80 $2,907.90 $2,907.90 2026-05-13
28297 CPT Hc Pr 28297 Corrj Hallux Valgus W/Sesmdc W/1metar Medial Cnf 16 15 $3,223.00 $3,223.00 $2,578.40 $2,900.70 $2,900.70 2026-05-13
44150 CPT Hc Pr 44150 Removal Of Colon, Without Proctectomy With Ileostomy Or Ileoproc 16 15 $3,221.00 $3,221.00 $2,576.80 $2,898.90 $2,898.90 2026-05-13
59515 CPT Hc Pr 59515 Cesarean Delivery W Pp Care 16 15 $3,186.00 $3,186.00 $2,548.80 $2,867.40 $2,867.40 2026-05-13
58260 CPT Hc Pr 58260 Vaginal Hysterectomy 16 15 $3,175.00 $3,175.00 $2,540.00 $2,857.50 $2,857.50 2026-05-13
44130 CPT Hc Pr 44130 Bowel To Bowel Fusion 16 15 $3,165.00 $3,165.00 $2,532.00 $2,848.50 $2,848.50 2026-05-13
50081 CPT Hc Pr 50081 Perq Nl/Pl Lithotrp Complex >2 Cm Mlt Locations Cdm 16 15 $3,158.00 $3,158.00 $2,526.40 $2,842.20 $2,842.20 2026-05-13
81408 CPT Molecular Pathology Procedure Level 9 74 68 $2,250.00 $2,250.00 $1,800.00 $2,800.00 $2,025.00 2026-05-13
P9037 HCPCS Platelets Pheresis Leukocytes Reduced Irradiated Ach Unit 74 68 $2,939.00 $2,939.00 $1,631.15 $2,792.05 $2,409.98 2026-05-13
28296 CPT Hc Pr 28296 Corrj Hallux Valgus W/Sesmdc W/Dist Metar Osteot 16 15 $3,082.00 $3,082.00 $2,465.60 $2,773.80 $2,773.80 2026-05-13
Q4186 HCPCS Epifix 4.0x4.5cm Es-4400 306 68 $2,585.13 $2,585.13 $201.49 $2,757.26 $1,686.48 2026-05-13
40654 CPT Repair Of Vertical Lip Wound Extending To Over Half Of Lip 32 15 $2,469.50 $2,469.50 $1,510.40 $2,745.90 $2,070.00 2026-05-13
75822 CPT X-ray Both Arms And Legs Veins Of Both Arms Or Legs 16 15 $3,028.00 $3,028.00 $2,422.40 $2,725.20 $2,725.20 2026-05-13
75820 CPT X-ray 1 Arm Or Leg Vein Of 1 Arm Or Leg 16 15 $3,028.00 $3,028.00 $2,422.40 $2,725.20 $2,725.20 2026-05-13
27132 CPT Hc Pr 27132 Conversion Prev Hip Surg To Tot Hip Arthroplas Cdm 16 15 $3,012.00 $3,012.00 $2,409.60 $2,710.80 $2,710.80 2026-05-13
45399 CPT Hc Pr 45399 Unlisted Procedure Colon 16 15 $2,994.00 $2,994.00 $2,395.20 $2,694.60 $2,694.60 2026-05-13
44160 CPT Hc Pr 44160 Removal Of Colon, Partial 16 15 $2,994.00 $2,994.00 $2,395.20 $2,694.60 $2,694.60 2026-05-13
19283 CPT Place Locating Device In Breast With X-ray Needle 74 68 $2,835.00 $2,835.00 $1,573.43 $2,693.25 $2,324.70 2026-05-13
19084 CPT Biopsy Breast Using Ultrasound, Each Add Growth 74 68 $2,827.00 $2,827.00 $1,568.99 $2,685.65 $2,318.14 2026-05-13
77046 CPT MRI Scan Of 1 Breast Without Contrast 16 15 $2,967.00 $2,967.00 $2,373.60 $2,670.30 $2,670.30 2026-05-13
75572 CPT CT Scan Of Heart Structure With Contrast 16 15 $2,951.00 $2,951.00 $2,360.80 $2,655.90 $2,655.90 2026-05-13
44120 CPT Hc Pr 44120 Removal Of Small Intestine, Single Resection 16 15 $2,947.00 $2,947.00 $2,357.60 $2,652.30 $2,652.30 2026-05-13
59410 CPT Hc Pr 59410 Vag Delivery W/Postpartum 16 15 $2,925.00 $2,925.00 $2,340.00 $2,632.50 $2,632.50 2026-05-13
24538 CPT Hc Pr 24538 Percutaneous Fixation Humeral 16 15 $2,916.00 $2,916.00 $2,332.80 $2,624.40 $2,624.40 2026-05-13
20999 CPT Hc Pr 20999 Musculoskeletal Surgery 16 15 $2,874.00 $2,874.00 $2,299.20 $2,586.60 $2,586.60 2026-05-13
23474 CPT Hc Pr 23474 Revis Reconst Shoulder Joint 16 15 $2,865.00 $2,865.00 $2,292.00 $2,578.50 $2,578.50 2026-05-13
44145 CPT Hc Pr 44145 Partial Removal Of Colon With Coloproctostomy 16 15 $2,856.00 $2,856.00 $2,284.80 $2,570.40 $2,570.40 2026-05-13
44346 CPT Hc Pr 44346 Revision Of Colostomy, With Hernia Repair 16 15 $2,853.00 $2,853.00 $2,282.40 $2,567.70 $2,567.70 2026-05-13
44125 CPT Hc Pr 44125 Removal Of Small Intestine, With Enterostomy 16 15 $2,848.00 $2,848.00 $2,278.40 $2,563.20 $2,563.20 2026-05-13
59514 CPT Hc Pr 59514 Cesarean Delivery Only 16 15 $2,811.00 $2,811.00 $2,248.80 $2,529.90 $2,529.90 2026-05-13
20692 CPT Hc Pr 20692 Application Multiplane External Fixation System Rhc 16 15 $2,751.00 $2,751.00 $2,200.80 $2,475.90 $2,475.90 2026-05-13
27827 CPT Hc Pr 27827 Open Tx Of Artucular Distal Tibia W/Fixation 16 15 $2,743.00 $2,743.00 $2,194.40 $2,468.70 $2,468.70 2026-05-13
Q4159 HCPCS Affinity 2.5x2.5 Af-1250 74 68 $2,597.50 $2,597.50 $1,441.61 $2,467.63 $2,129.95 2026-05-13
15734 CPT Hc Pr 15734 Muscle Flap Trunk 17 16 $2,735.00 $2,735.00 $1,550.67 $2,461.50 $2,461.50 2026-05-13
62272 CPT Remove Cerebrospinal Fluid With Lower Back Spinal Tap 16 15 $2,679.00 $2,679.00 $2,143.20 $2,411.10 $2,411.10 2026-05-13
44603 CPT Suture Of Small Intestine 16 15 $2,657.00 $2,657.00 $2,125.60 $2,391.30 $2,391.30 2026-05-13
44204 CPT Hc Pr 44204 Laparoscopy Partial Colectomy 16 15 $2,651.00 $2,651.00 $2,120.80 $2,385.90 $2,385.90 2026-05-13
59409 CPT Hc Pr Ed 59409 Vaginal Delivery Cdm 16 15 $2,644.00 $2,644.00 $2,115.20 $2,379.60 $2,379.60 2026-05-13
44005 CPT Hc Pr 44005 Freeing Of Bowel Adhesion 16 15 $2,634.00 $2,634.00 $2,107.20 $2,370.60 $2,370.60 2026-05-13
27446 CPT Hc Pr 27446 Revision Of Knee Joint 16 15 $2,618.00 $2,618.00 $2,094.40 $2,356.20 $2,356.20 2026-05-13
47600 CPT Hc Pr 47600 Cholecystectomy 16 15 $2,602.00 $2,602.00 $2,081.60 $2,341.80 $2,341.80 2026-05-13
23515 CPT Hc Pr 23515 Open Tx Clavicular Fracture Internal Fixation 16 15 $2,601.00 $2,601.00 $2,080.80 $2,340.90 $2,340.90 2026-05-13
23078 CPT Hc Pr 23078 Resect Shoulder Tum 5 Cm/> 16 15 $2,583.00 $2,583.00 $2,066.40 $2,324.70 $2,324.70 2026-05-13
43281 CPT Hc Pr 43281 Lap Paraesophag Hern Repair 52 49 $3,738.00 $3,738.00 $897.84 $2,305.93 $2,075.65 2026-05-13
75574 CPT CT Scan Of Heart, Coronary Arteries And Bypass Graft 16 15 $2,557.00 $2,557.00 $2,045.60 $2,301.30 $2,301.30 2026-05-13
44604 CPT Hc Pr 44604 Suture Large Intestine 16 15 $2,550.00 $2,550.00 $2,040.00 $2,295.00 $2,295.00 2026-05-13
49002 CPT Hc Pr 49002 Reopening Of Abdomen 16 15 $2,517.00 $2,517.00 $2,013.60 $2,265.30 $2,265.30 2026-05-13
44202 CPT Laparoscopy, Surgical; Enterectomy, Resection Of Small Intestine 16 15 $2,510.00 $2,510.00 $2,008.00 $2,259.00 $2,259.00 2026-05-13
44625 CPT Hc Pr 44625 Repair Bowel Opening, With Resection 16 15 $2,464.00 $2,464.00 $1,971.20 $2,217.60 $2,217.60 2026-05-13
32554 CPT Aspiration Of Fluid From Chest Cavity 48 15 $2,211.00 $2,211.00 $1,484.00 $2,198.70 $1,989.90 2026-05-13
29876 CPT Hc Pr 29876 Arthro Knee Synovectomy 2/>Compartments 16 15 $2,436.00 $2,436.00 $1,948.80 $2,192.40 $2,192.40 2026-05-13
PX-36010022 CDM Hc Operating Room Services Level 2 16 15 $2,426.00 $2,426.00 $1,940.80 $2,183.40 $2,183.40 2026-05-13
C1788 HCPCS Powerport Full Size 1808000 74 68 $2,295.25 $2,295.25 $1,273.86 $2,180.49 $1,882.11 2026-05-13
23455 CPT Hc Pr 23455 Repair Shoulder Capsule,Bankart 16 15 $2,421.00 $2,421.00 $1,936.80 $2,178.90 $2,178.90 2026-05-13
44640 CPT Hc Pr 44640 Repair Bowel-skin Fistula 16 15 $2,417.00 $2,417.00 $1,933.60 $2,175.30 $2,175.30 2026-05-13
27759 CPT Hc Pr 27759 Tx Tibl Shft Fx Imed Implt W/wo Screws&/Cercla 16 15 $2,412.00 $2,412.00 $1,929.60 $2,170.80 $2,170.80 2026-05-13
23472 CPT Hc Pr 23472 Arthroplasty Glenohumeral Joint Total Shoulder 52 49 $3,538.00 $3,538.00 $847.44 $2,157.96 $1,940.20 2026-05-13
44310 CPT Hc Pr 44310 Ileostomy/Jejunostomy 16 15 $2,397.00 $2,397.00 $1,917.60 $2,157.30 $2,157.30 2026-05-13
C2625 HCPCS Propel Contour Stent 50011 16 15 $2,395.00 $2,395.00 $1,916.00 $2,155.50 $2,155.50 2026-05-13
24363 CPT Hc Pr 24363 Replace Elbow Joint 52 49 $2,370.00 $2,370.00 $848.24 $2,153.85 $1,939.75 2026-05-13
C1768 HCPCS Hemashield 16x8x40 166168po 16 15 $2,393.01 $2,393.01 $1,914.41 $2,153.71 $2,153.71 2026-05-13
15738 CPT Hc Pr 15738 Muscle-skin Graft Leg 16 15 $2,380.00 $2,380.00 $1,904.00 $2,142.00 $2,142.00 2026-05-13
72127 CPT CT Scan Of Upper Spine Before And After Contrast 16 15 $2,373.00 $2,373.00 $1,898.40 $2,135.70 $2,135.70 2026-05-13
36563 CPT Hc Pr 36563 Insert Tunneled Cv Cath 16 15 $2,364.00 $2,364.00 $1,891.20 $2,127.60 $2,127.60 2026-05-13
47605 CPT Hc Pr 47605 Cholecystectomy With Cholangiography 16 15 $2,360.00 $2,360.00 $1,888.00 $2,124.00 $2,124.00 2026-05-13
27030 CPT Hc Pr 27030 Drainage Of Hip Joint 16 15 $2,357.00 $2,357.00 $1,885.60 $2,121.30 $2,121.30 2026-05-13
0042T CPT CT Of Brain Blood Flow, Vol, & Timing Of Flow With Contrast 16 15 $2,342.00 $2,342.00 $1,873.60 $2,107.80 $2,107.80 2026-05-13
58180 CPT Hc Pr 58180 Partial Hysterectomy 16 15 $2,336.00 $2,336.00 $1,868.80 $2,102.40 $2,102.40 2026-05-13
25605 HCPCS Hc Pr 25605 Cltx Dstl Rdl Fx/Epiphysl Sep W/Manj When Perf Rhc 16 15 $2,330.00 $2,330.00 $1,864.00 $2,097.00 $2,097.00 2026-05-13
90378 HCPCS Hc Pr Rx Respiratory Syncytial Virus Ig IM 50 Mg 36 35 $914.00 $914.00 $1,604.68 $2,090.71 $2,090.71 2026-05-13
19285 CPT Place Locating Device In Breast With Ultrasound 74 68 $2,200.00 $2,200.00 $1,221.00 $2,090.00 $1,804.00 2026-05-13
19281 CPT Place Locating Device In Breast With Imaging 74 68 $2,199.00 $2,199.00 $1,220.45 $2,089.05 $1,803.18 2026-05-13
60100 CPT Needle Biopsy Of Thyroid Through Skin 74 68 $2,195.00 $2,195.00 $1,218.23 $2,085.25 $1,799.90 2026-05-13
43774 CPT Hc Pr 43774 Laparoscopy Removal Gastric Adj All Parts 16 15 $2,306.00 $2,306.00 $1,844.80 $2,075.40 $2,075.40 2026-05-13
58660 CPT Hc Pr 58660 Laparoscopy Lysis 16 15 $2,298.00 $2,298.00 $1,838.40 $2,068.20 $2,068.20 2026-05-13
37617 CPT Hc Pr Ed 37617 Ligation Of Abdomen Artery Cdm 16 15 $2,289.00 $2,289.00 $1,831.20 $2,060.10 $2,060.10 2026-05-13
27880 CPT Hc Pr 27880 Amputation Leg Through Tibia & Fibula Cdm 16 15 $2,274.00 $2,274.00 $1,819.20 $2,046.60 $2,046.60 2026-05-13
58262 CPT Hc Pr 58262 Vaginal Hysterectomy Incl Tubes/Ovary(S) 16 15 $2,255.00 $2,255.00 $1,804.00 $2,029.50 $2,029.50 2026-05-13
44050 CPT Hc Pr 44050 Reduce Bowel Obstruction 16 15 $2,247.00 $2,247.00 $1,797.60 $2,022.30 $2,022.30 2026-05-13
58140 CPT Hc Pr 58140 Myomectomy Abdominal Method 16 15 $2,245.00 $2,245.00 $1,796.00 $2,020.50 $2,020.50 2026-05-13
58554 CPT Hc Pr 58554 Laparo-vaginal Hysterectomy With Tubes/Ovary(S) Complex 16 15 $2,242.00 $2,242.00 $1,793.60 $2,017.80 $2,017.80 2026-05-13
27752 CPT Closed Treatment Of Middle Part Of Broken Shin Bone 32 15 $2,152.50 $2,152.50 $1,651.20 $2,016.90 $1,857.60 2026-05-13
29828 CPT Hc Pr 29828 Arthroscopy Shoulder Surgical Biceps Tenodesis 16 15 $2,239.00 $2,239.00 $1,791.20 $2,015.10 $2,015.10 2026-05-13
88309 CPT Pathology Examination Of Tissue Using A Microscope 74 68 $2,117.00 $2,117.00 $1,174.94 $2,011.15 $1,735.94 2026-05-13
27130 CPT Hc Pr 27130 Total Hip Arthroplasty 52 49 $6,641.00 $6,641.00 $790.84 $2,009.99 $1,722.31 2026-05-13
27447 CPT Total Knee Arthroplasty 52 49 $6,000.00 $6,000.00 $789.84 $2,009.47 $1,720.49 2026-05-13
27648 CPT Injection For X-ray Imaging Of Ankle 74 68 $2,102.00 $2,102.00 $1,166.61 $1,996.90 $1,723.64 2026-05-13
44180 CPT Hc Pr 44180 Laparoscopy Enterolysis 16 15 $2,214.00 $2,214.00 $1,771.20 $1,992.60 $1,992.60 2026-05-13
58720 CPT Hc Pr 58720 Removal Of Ovary/Tube(S) 16 15 $2,202.00 $2,202.00 $1,761.60 $1,981.80 $1,981.80 2026-05-13
94660 CPT Therapy Procedure Using A Positive Pressure Ventilator 16 15 $2,198.00 $2,198.00 $1,758.40 $1,978.20 $1,978.20 2026-05-13
76080 CPT X-ray Abscess Or Sinus Cavity Study 16 15 $2,190.00 $2,190.00 $1,752.00 $1,971.00 $1,971.00 2026-05-13
35840 CPT Hc Pr 35840 Expl Post Op Hemrrg Thrombosis/Infctn Abdomen Cdm 16 15 $2,179.00 $2,179.00 $1,743.20 $1,961.10 $1,961.10 2026-05-13
P9035 HCPCS Platelets Pheresis Leukocytes Reduced Each Unit 16 15 $2,159.00 $2,159.00 $1,727.20 $1,943.10 $1,943.10 2026-05-13
43333 CPT Hc Pr 43333 Transab Esoph Hiat Hern Rpr 16 15 $2,146.00 $2,146.00 $1,716.80 $1,931.40 $1,931.40 2026-05-13
PX-71010010 CDM Hc Pacu Acuity Lvl 5 Initial 16 15 $2,143.00 $2,143.00 $1,714.40 $1,928.70 $1,928.70 2026-05-13
77054 CPT X-ray Breast Duct, Multiple Ducts 16 15 $2,135.00 $2,135.00 $1,708.00 $1,921.50 $1,921.50 2026-05-13
77053 CPT X-ray Breast Duct, Single Duct 16 15 $2,135.00 $2,135.00 $1,708.00 $1,921.50 $1,921.50 2026-05-13
58740 CPT Hc Pr 58740 Lysis Of Adhesions Salpinx/Ovary Cdm Cdm 16 15 $2,133.00 $2,133.00 $1,706.40 $1,919.70 $1,919.70 2026-05-13
27828 CPT Hc Pr 27828 Open Tx Of Artucular Distal Tibia Nx Fibula W/Fixation 52 49 $3,134.00 $3,134.00 $772.24 $1,915.96 $1,794.33 2026-05-13
28805 CPT Hc Pr 28805 Amputation Foot Transmetarsal 16 15 $2,110.00 $2,110.00 $1,688.00 $1,899.00 $1,899.00 2026-05-13
27244 CPT Tx Femoral Fracture W/Plate/Screw Type Implant 16 15 $2,108.00 $2,108.00 $1,686.40 $1,897.20 $1,897.20 2026-05-13
43332 CPT Hc Pr 43332 Paraesophageal Hiatal Hernia Repair Via Laparotomy 16 15 $2,104.00 $2,104.00 $1,683.20 $1,893.60 $1,893.60 2026-05-13
44960 CPT Hc Pr 44960 Appendectomy, Ruptured 16 15 $2,104.00 $2,104.00 $1,683.20 $1,893.60 $1,893.60 2026-05-13
PX-36010002 CDM Hc Pain Room Services Level 2 16 15 $2,100.00 $2,100.00 $1,680.00 $1,890.00 $1,890.00 2026-05-13
670 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 2026-05-13
44620 CPT Hc Pr 44620 Repair Bowel Opening 16 15 $2,092.00 $2,092.00 $1,673.60 $1,882.80 $1,882.80 2026-05-13
28585 CPT Hc Pr 28585 Repair Foot Dislocation 16 15 $2,090.00 $2,090.00 $1,672.00 $1,881.00 $1,881.00 2026-05-13
26770 HCPCS Hc Pr 26770 Cltx Iphal Jt Dislc W/Manj Without Anes Rhc 16 15 $2,086.00 $2,086.00 $1,668.80 $1,877.40 $1,877.40 2026-05-13
23335 CPT Hc Pr 233345 Prosthesis Removal Humeral And Glenoid Component Cdm 16 15 $2,085.00 $2,085.00 $1,668.00 $1,876.50 $1,876.50 2026-05-13
36558 HCPCS Hc Pr 36558 Insj Tunneled Cvc Without Subq Port/Pmp Age 5 Yr/> 16 15 $2,069.00 $2,069.00 $1,655.20 $1,862.10 $1,862.10 2026-05-13
44320 CPT Colostomy/Skin Level Cecostomy 16 15 $2,069.00 $2,069.00 $1,655.20 $1,862.10 $1,862.10 2026-05-13
76145 CPT Medical Physics Dose Evaluation For Radiation Exposure 16 15 $2,047.00 $2,047.00 $1,637.60 $1,842.30 $1,842.30 2026-05-13
27425 CPT Hc Pr 27425 Lateral Retinacular Release Open 16 15 $2,036.00 $2,036.00 $1,628.80 $1,832.40 $1,832.40 2026-05-13
27536 CPT Hc Pr 27536 Optx Tibial Fx Prox Bicondylar W/wo Int Fixj 16 15 $2,036.00 $2,036.00 $1,628.80 $1,832.40 $1,832.40 2026-05-13
28730 CPT Hc Pr 28730 Fusion Foot Bones,Midtarsal,Multi 16 15 $2,034.00 $2,034.00 $1,627.20 $1,830.60 $1,830.60 2026-05-13
57260 CPT Hc Pr 57260 Repair Of Vagina, Combined Anteroposterior Colporrhaphy 16 15 $2,032.00 $2,032.00 $1,625.60 $1,828.80 $1,828.80 2026-05-13
59612 CPT Hc Pr 59612 Vaginal Delivery After Cesarean Delivery 16 15 $2,027.00 $2,027.00 $1,621.60 $1,824.30 $1,824.30 2026-05-13
74330 CPT X-ray Tube Placement Into Bile And Pancreatic Duct 16 15 $1,989.00 $1,989.00 $1,591.20 $1,790.10 $1,790.10 2026-05-13
73719 CPT MRI Scan Of Leg With Contrast 16 15 $1,985.00 $1,985.00 $1,588.00 $1,786.50 $1,786.50 2026-05-13
PX-36010021 CDM Hc Operating Room Services Level 1 16 15 $1,985.00 $1,985.00 $1,588.00 $1,786.50 $1,786.50 2026-05-13
27818 HCPCS Hc Pr 27818 Cltx Trimalleolar Ankle Fx W/Manipulation Rhc 16 15 $1,965.00 $1,965.00 $1,572.00 $1,768.50 $1,768.50 2026-05-13
13120 CPT Complicated Repair Wound Of Scalp, Limbs, 1.1-2.5 Cm 16 15 $1,963.00 $1,963.00 $1,570.40 $1,766.70 $1,766.70 2026-05-13
10009 CPT Fine Needle Aspiration Biopsy Of Growth, First Growth 16 15 $1,961.00 $1,961.00 $1,568.80 $1,764.90 $1,764.90 2026-05-13
49900 CPT Hc Pr 49900 Sec Abdominal Wall Suture Evisceration/Dehsn Cdm 16 15 $1,953.00 $1,953.00 $1,562.40 $1,757.70 $1,757.70 2026-05-13
27810 HCPCS Hc Pr 27810 Closed Tx Bimalleolar Ankle Fracture W/Manj Rhc 16 15 $1,936.00 $1,936.00 $1,548.80 $1,742.40 $1,742.40 2026-05-13
47579 CPT Hc Pr 47579 Laparoscope Proc Biliary 16 15 $1,930.00 $1,930.00 $1,544.00 $1,737.00 $1,737.00 2026-05-13
14301 CPT Hc Pr 14301 Skin Tissue Rearrangement Any Area Defect 30.1 Sq Cm To 6 16 15 $1,928.00 $1,928.00 $1,542.40 $1,735.20 $1,735.20 2026-05-13
23077 CPT Hc Pr 23077 Rad Resection Tumor Soft Tissue Shoulder/Less Than 5cm 16 15 $1,927.00 $1,927.00 $1,541.60 $1,734.30 $1,734.30 2026-05-13
14001 CPT Hc Pr 14001 Adj Tiss Xfer Trunk 10.1-30 16 15 $1,918.00 $1,918.00 $1,534.40 $1,726.20 $1,726.20 2026-05-13
49255 CPT Hc Pr 49255 Omntc Epiploectomy Rescj Omentum Spx Rhc 16 15 $1,892.00 $1,892.00 $1,513.60 $1,702.80 $1,702.80 2026-05-13
59150 CPT Hc Pr 59150 Lap Ectopic Treatment 16 15 $1,888.00 $1,888.00 $1,510.40 $1,699.20 $1,699.20 2026-05-13
47564 CPT Hc Pr 47564 Laparoscopy Cholecystectomy/Explr 16 15 $1,882.00 $1,882.00 $1,505.60 $1,693.80 $1,693.80 2026-05-13
28003 CPT Hc Pr 28003 I&d Below Fascia Foot Multiple Areas Cdm 16 15 $1,882.00 $1,882.00 $1,505.60 $1,693.80 $1,693.80 2026-05-13
44615 CPT Hc Pr 44615 Intestinal Stricturoplasty 16 15 $1,855.00 $1,855.00 $1,484.00 $1,669.50 $1,669.50 2026-05-13
49000 CPT Hc Pr 49000 Exploration Of Abdomen 16 15 $1,850.00 $1,850.00 $1,480.00 $1,665.00 $1,665.00 2026-05-13
27125 CPT Hc Pr 27125 Partial Hip Replacement 16 15 $1,847.00 $1,847.00 $1,477.60 $1,662.30 $1,662.30 2026-05-13
49440 CPT Hc Pr 49440 Place Gastrostomy Tube Perc 16 15 $1,847.00 $1,847.00 $1,477.60 $1,662.30 $1,662.30 2026-05-13
49618 CPT Hc Pr 49618 Rpr Aa Hernia Recr > 10 Cm Ncrc8/Strangulated Cdm 16 15 $1,842.00 $1,842.00 $1,473.60 $1,657.80 $1,657.80 2026-05-13
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