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

Seattle Cancer Care Alliance

Seattle, WA · CCN 500138 · Rates published

4,355 distinct procedures filed
14 distinct payers
61,778 rate rows
2026-04-01 last MRF observed
Data quality

11,084 of 61,778 rate rows are consumer-grade (17.9%)

50,694 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 50,674
placeholder amount (≤ $0.02) — excluded from medians 20
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.fredhutch.org/content/dam/www/patient-care/insurance-billing/price-transparency/911935159_fred-hutchinson-cancer-center_standardcharges.json
Found on page https://www.fredhutch.org/en/patient-care/patient-services/insurance-and-billing/patient-pricing-information.html
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-21
Content fingerprint 6cd66ddc39b417be… · 17,650,200 bytes · first seen 2026-05-08

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 1 $10,586,750.00 $10,586,750.00 $10,586,750.00 nat. median
$4,505,000
outlier · 2.4×
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $8,660,376.67 $8,660,376.67 $8,660,376.67 nat. median
$3,685,267
outlier · 2.3×
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 1 $7,839,177.00 $7,839,177.00 $7,839,177.00 nat. median
$3,335,820
outlier · 2.4×
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $7,820,470.37 $7,820,470.37 $7,820,470.37 nat. median
$3,325,455
outlier · 2.4×
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 1 $7,643,393.99 $7,643,393.99 $7,643,393.99 nat. median
$3,248,446
outlier · 2.4×
J3387
HCPCS 		Inj Elivaldogene Autotemecel 1 $7,473,000.00 $7,473,000.00 $7,473,000.00 nat. median
$3,180,000
outlier · 2.4×
J3393
HCPCS 		Inj, Betibeglogene Autotemce 1 $6,908,926.89 $6,908,926.89 $6,908,926.89 nat. median
$2,968,000
outlier · 2.3×
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 1 $6,084,105.89 $6,084,105.89 $6,084,105.89 nat. median
$2,455,111
outlier · 2.5×
J3392
HCPCS 		Inj, Exagamglogene Autotem 1 $5,480,200.00 $5,480,200.00 $5,480,200.00 nat. median
$2,332,000
outlier · 2.4×
Q2057
HCPCS 		Afamitresgene Autoleucel 1 $1,810,957.00 $1,810,957.00 $1,810,957.00 nat. median
$813,967
outlier · 2.2×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 1 $1,380,976.49 $1,380,976.49 $1,380,976.49 nat. median
$599,737
outlier · 2.3×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 1 $1,331,348.56 $1,331,348.56 $1,331,348.56 nat. median
$621,313
outlier · 2.1×
Q2054
HCPCS 		Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 1 $1,321,172.91 $1,321,172.91 $1,321,172.91 nat. median
$579,571
outlier · 2.3×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 1 $1,311,492.07 $1,311,492.07 $1,311,492.07 nat. median
$574,037
outlier · 2.3×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $1,250,651.76 $1,250,651.76 $1,250,651.76 nat. median
$562,501
outlier · 2.2×
Q2053
HCPCS 		Brexucabtagene Car Pos T 1 $1,150,207.97 $1,150,207.97 $1,150,207.97 nat. median
$513,770
outlier · 2.2×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 1 $653,887.50 $653,887.50 $653,887.50 nat. median
$286,598
outlier · 2.3×
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 1 $473,922.20 $473,922.20 $473,922.20 nat. median
$207,733
outlier · 2.3×
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 12 — — $439,039.36 nat. median
$11,701
outlier · 37.5×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 12 — — $369,651.35 nat. median
$168,055
outlier · 2.2×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 12 — — $253,691.22 nat. median
$72,715
outlier · 3.5×
372
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Cc 12 — — $249,436.37 nat. median
$7,653
outlier · 32.6×
840
MS_DRG 		Lymphoma And Non-acute Leukemia With Mcc 12 — — $218,656.74 nat. median
$22,339
outlier · 9.8×
97
MS_DRG 		Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 12 — — $218,445.08 nat. median
$24,748
outlier · 8.8×
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $196,756.69 $196,756.69 $196,756.69 nat. median
$92,809
outlier · 2.1×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 1 $151,045.76 $151,045.76 $151,045.76 nat. median
$66,211
outlier · 2.3×
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 12 — — $144,394.94 nat. median
$7,418
outlier · 19.5×
A9543
HCPCS 		Y90 Ibritumomab, Rx 1 $133,537.69 $133,537.69 $133,537.69 nat. median
$65,477
outlier · 2.0×
808
MS_DRG 		Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 12 — — $130,032.28 nat. median
$15,758
outlier · 8.3×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 1 $127,849.66 $127,849.66 $127,849.66 nat. median
$63,499
outlier · 2.0×
A9699
HCPCS 		Radiopharm Rx Agent Noc 1 $109,733.56 $109,733.56 $109,733.56 nat. median
$7,098
outlier · 15.5×
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/Mcc 12 — — $102,359.53 nat. median
$38,932
outlier · 2.6×
J9226
HCPCS 		Supprelin La Implant 1 $101,485.55 $101,485.55 $101,485.55 nat. median
$57,036
1.8× median
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 12 — — $98,508.71 nat. median
$9,511
outlier · 10.4×
846
MS_DRG 		Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 12 — — $80,375.85 nat. median
$16,550
outlier · 4.9×
999
MS_DRG 		Ungroupable 12 — — $78,094.39 nat. median
$2,024
outlier · 38.6×
837
MS_DRG 		Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 12 — — $75,124.86 nat. median
$32,992
outlier · 2.3×
J9266
HCPCS 		Pegaspargase Injection 1 $66,796.54 $66,796.54 $66,796.54 nat. median
$31,084
outlier · 2.1×
175
MS_DRG 		Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 12 — — $65,836.12 nat. median
$10,317
outlier · 6.4×
423
MS_DRG 		Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 12 — — $57,319.67 nat. median
$29,159
2.0× median
J9600
HCPCS 		Porfimer Sodium Injection 1 $56,936.79 $56,936.79 $56,936.79 nat. median
$26,416
outlier · 2.2×
25
MS_DRG 		Craniotomy And Endovascular Intracranial Procedures With Mcc 12 — — $56,269.68 nat. median
$32,531
1.7× median
809
MS_DRG 		Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 12 — — $56,211.00 nat. median
$9,154
outlier · 6.1×
206
MS_DRG 		Other Respiratory System Diagnoses Without Mcc 12 — — $55,921.54 nat. median
$6,811
outlier · 8.2×
542
MS_DRG 		Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 12 — — $54,035.84 nat. median
$12,976
outlier · 4.2×
5661
OTHER 		Therapeutic Nuclear Medicine 13 — — $51,267.57 nat. median
$249
outlier · 205.8×
202
MS_DRG 		Bronchitis And Asthma With Cc/Mcc 12 — — $51,108.03 nat. median
$7,228
outlier · 7.1×
315
MS_DRG 		Other Circulatory System Diagnoses With Cc 12 — — $45,978.24 nat. median
$7,244
outlier · 6.3×
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 12 — — $44,833.17 nat. median
$14,442
outlier · 3.1×
153
MS_DRG 		Otitis Media And Uri Without Mcc 12 — — $42,515.29 nat. median
$5,379
outlier · 7.9×

Other procedures at this hospital

Browse this hospital's 4,355 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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 2 1 — — $10,586,750.00 $10,586,750.00 $10,586,750.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 2 1 — — $8,660,376.67 $8,660,376.67 $8,660,376.67 2026-04-01
J3389 HCPCS Topi Adm Prad Zami Per Treat 2 1 — — $7,839,177.00 $7,839,177.00 $7,839,177.00 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 2 1 — — $7,820,470.37 $7,820,470.37 $7,820,470.37 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 2 1 — — $7,643,393.99 $7,643,393.99 $7,643,393.99 2026-04-01
J3387 HCPCS Inj Elivaldogene Autotemecel 2 1 — — $7,473,000.00 $7,473,000.00 $7,473,000.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 2 1 — — $6,908,926.89 $6,908,926.89 $6,908,926.89 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 2 1 — — $6,084,105.89 $6,084,105.89 $6,084,105.89 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 2 1 — — $5,480,200.00 $5,480,200.00 $5,480,200.00 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 2 1 — — $1,810,957.00 $1,810,957.00 $1,810,957.00 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 4 1 $1,110,620.88 $999,558.79 $1,380,976.49 $1,380,976.49 $1,380,976.49 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 4 1 $913,882.08 $822,493.87 $1,331,348.56 $1,331,348.56 $1,331,348.56 2026-04-01
Q2054 HCPCS Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 4 1 $1,062,700.80 $956,430.72 $1,321,172.91 $1,321,172.91 $1,321,172.91 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 2 1 — — $1,311,492.07 $1,311,492.07 $1,311,492.07 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 4 1 $1,007,160.00 $906,444.00 $1,250,651.76 $1,250,651.76 $1,250,651.76 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 4 1 $924,000.00 $831,600.00 $1,150,207.97 $1,150,207.97 $1,150,207.97 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 2 1 — — $653,887.50 $653,887.50 $653,887.50 2026-04-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 2 1 — — $473,922.20 $473,922.20 $473,922.20 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 40 12 — — — — $439,039.36 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 40 12 — — — — $369,651.35 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 40 12 — — — — $253,691.22 2026-04-01
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 40 12 — — — — $249,436.37 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 40 12 — — — — $218,656.74 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 40 12 — — — — $218,445.08 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $196,756.69 $196,756.69 $196,756.69 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 2 1 — — $151,045.76 $151,045.76 $151,045.76 2026-04-01
178 MS_DRG Respiratory Infections And Inflammations With Cc 40 12 — — — — $144,394.94 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 2 1 — — $133,537.69 $133,537.69 $133,537.69 2026-04-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 40 12 — — — — $130,032.28 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 4 1 $132,717.30 $119,445.57 $127,849.66 $127,849.66 $127,849.66 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 2 1 — — $109,733.56 $109,733.56 $109,733.56 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 40 12 — — — — $102,359.53 2026-04-01
J9226 HCPCS Supprelin La Implant 2 1 — — $101,485.55 $101,485.55 $101,485.55 2026-04-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 40 12 — — — — $98,508.71 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 40 12 — — — — $80,375.85 2026-04-01
999 MS_DRG Ungroupable 40 12 — — — — $78,094.39 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 40 12 — — — — $75,124.86 2026-04-01
J9266 HCPCS Pegaspargase Injection 4 1 $54,632.27 $49,169.04 $66,796.54 $66,796.54 $66,796.54 2026-04-01
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 40 12 — — — — $65,836.12 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 40 12 — — — — $57,319.67 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 2 1 — — $56,936.79 $56,936.79 $56,936.79 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 40 12 — — — — $56,269.68 2026-04-01
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 40 12 — — — — $56,211.00 2026-04-01
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 40 12 — — — — $55,921.54 2026-04-01
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 40 12 — — — — $54,035.84 2026-04-01
5661 OTHER Therapeutic Nuclear Medicine 46 13 — — — — $51,267.57 2026-04-01
202 MS_DRG Bronchitis And Asthma With Cc/Mcc 40 12 — — — — $51,108.03 2026-04-01
315 MS_DRG Other Circulatory System Diagnoses With Cc 40 12 — — — — $45,978.24 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 40 12 — — — — $44,833.17 2026-04-01
153 MS_DRG Otitis Media And Uri Without Mcc 40 12 — — — — $42,515.29 2026-04-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 40 12 — — — — $42,472.08 2026-04-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 40 12 — — — — $41,809.65 2026-04-01
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 40 12 — — — — $39,386.81 2026-04-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 40 12 — — — — $37,531.17 2026-04-01
847 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc 40 12 — — — — $31,027.91 2026-04-01
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 40 12 — — — — $30,498.94 2026-04-01
5244 OTHER Level 4 Blood Product Exchange And Related Services 46 13 — — — — $30,389.87 2026-04-01
75 MS_DRG Viral Meningitis With Cc/Mcc 40 12 — — — — $29,987.40 2026-04-01
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 2 1 — — $29,501.22 $29,501.22 $29,501.22 2026-04-01
865 MS_DRG Viral Illness With Mcc 40 12 — — — — $28,916.84 2026-04-01
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 40 12 — — — — $28,899.65 2026-04-01
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 40 12 — — — — $28,641.53 2026-04-01
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 40 12 — — — — $27,210.03 2026-04-01
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 40 12 — — — — $25,642.72 2026-04-01
842 MS_DRG Lymphoma And Non-acute Leukemia Without Cc/Mcc 40 12 — — — — $25,126.26 2026-04-01
J9216 HCPCS Interferon Gamma 1-b Inj 2 1 — — $23,856.21 $23,856.21 $23,856.21 2026-04-01
919 MS_DRG Complications Of Treatment With Mcc 40 12 — — — — $20,689.72 2026-04-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 40 12 — — — — $18,970.35 2026-04-01
811 MS_DRG Red Blood Cell Disorders With Mcc 40 12 — — — — $18,822.16 2026-04-01
5184 OTHER Level 4 Vascular Procedures 46 13 — — — — $18,715.42 2026-04-01
375 MS_DRG Digestive Malignancy With Cc 40 12 — — — — $18,602.82 2026-04-01
5415 OTHER Level 5 Gynecologic Procedures 46 13 — — — — $18,268.11 2026-04-01
Q0224 HCPCS Pemivibart 500 Mg/4ml IV Soln 4 1 $2,412.17 $2,170.95 $17,011.65 $17,011.65 $17,011.65 2026-04-01
81416 HCPCS Hc Exome Seq Compare 4 1 $66,049.98 $59,444.98 $16,500.00 $16,500.00 $16,500.00 2026-04-01
602 MS_DRG Cellulitis With Mcc 40 12 — — — — $16,325.07 2026-04-01
5313 OTHER Level 3 Lower Gi Procedures 46 13 — — — — $16,184.84 2026-04-01
J0600 HCPCS Edetate Calcium Disodium Inj 2 1 — — $14,592.75 $14,592.75 $14,592.75 2026-04-01
5242 OTHER Level 2 Blood Product Exchange And Related Services 46 13 — — — — $14,242.01 2026-04-01
Q4310 HCPCS Procenta, Per 100 Mg 2 1 — — $13,959.71 $13,959.71 $13,959.71 2026-04-01
5114 OTHER Level 4 Musculoskeletal Procedures 46 13 — — — — $13,737.47 2026-04-01
5243 OTHER Level 3 Blood Product Exchange And Related Services 46 13 — — — — $13,395.42 2026-04-01
5375 OTHER Level 5 Urology And Related Services 46 13 — — — — $12,485.42 2026-04-01
J7504 HCPCS Lymphocyte Immune Globulin 2 1 — — $12,473.64 $12,473.64 $12,473.64 2026-04-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 40 12 — — — — $12,225.04 2026-04-01
J1162 HCPCS Digoxin Immune Fab (ovine) 2 1 — — $12,142.43 $12,142.43 $12,142.43 2026-04-01
J0225 HCPCS Inj, Vutrisiran, 1 Mg 2 1 — — $11,772.47 $11,772.47 $11,772.47 2026-04-01
864 MS_DRG Fever And Inflammatory Conditions 40 12 — — — — $11,723.79 2026-04-01
0315U OTHER Onc Cutan Sq Cll Ca Mrna 40 2 1 — — $11,687.50 $11,687.50 $11,687.50 2026-04-01
389 MS_DRG Gastrointestinal Obstruction With Cc 40 12 — — — — $11,674.55 2026-04-01
0211U OTHER Onc Pan-tum Dna&rna Gnrj Seq 2 1 — — $11,625.62 $11,625.62 $11,625.62 2026-04-01
J0841 HCPCS Inj Crotalidae IM F(ab')2 Eq 2 1 — — $11,574.13 $11,574.13 $11,574.13 2026-04-01
812 MS_DRG Red Blood Cell Disorders Without Mcc 40 12 — — — — $11,346.52 2026-04-01
A9571 HCPCS Indium In-111 Auto Platelet 2 1 — — $11,273.82 $11,273.82 $11,273.82 2026-04-01
J0480 HCPCS Basiliximab 2 1 — — $11,235.51 $11,235.51 $11,235.51 2026-04-01
J9225 HCPCS Vantas Implant 2 1 — — $11,067.40 $11,067.40 $11,067.40 2026-04-01
81552 HCPCS Onc Uveal Mlnma Mrna 15 Gene 2 1 — — $10,692.00 $10,692.00 $10,692.00 2026-04-01
5613 OTHER Level 3 Therapeutic Radiation Treatment Preparation 46 13 — — — — $10,499.70 2026-04-01
0582U OTHER Rare Ds Rpd Whlgen DNA Vrnts 2 1 — — $10,425.52 $10,425.52 $10,425.52 2026-04-01
0426U OTHER Genome Ultra-rapid Seq Alys 2 1 — — $10,425.52 $10,425.52 $10,425.52 2026-04-01
0094U OTHER Genome Rapid Sequence Alys 2 1 — — $10,425.52 $10,425.52 $10,425.52 2026-04-01
848 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis Without Cc/Mcc 40 12 — — — — $10,290.99 2026-04-01
J9200 HCPCS Floxuridine Injection 4 1 $11,456.80 $10,311.12 $9,999.06 $9,999.06 $9,999.06 2026-04-01
81529 HCPCS Onc Cutan Mlnma Mrna 31 Gene 2 1 — — $9,890.38 $9,890.38 $9,890.38 2026-04-01
J0801 HCPCS Inj. Acthar Gel To 40 Units 2 1 — — $9,805.45 $9,805.45 $9,805.45 2026-04-01
A9600 HCPCS Sr89 Strontium 2 1 — — $9,743.90 $9,743.90 $9,743.90 2026-04-01
A9542 HCPCS In111 Ibritumomab, Dx 2 1 — — $9,660.03 $9,660.03 $9,660.03 2026-04-01
5111 OTHER Level 1 Musculoskeletal Procedures 46 13 — — — — $9,620.93 2026-04-01
0267U OTHER Rare Do Id Opt Gen Mapg&seq 2 1 — — $9,266.58 $9,266.58 $9,266.58 2026-04-01
5154 OTHER Level 4 Airway Endoscopy 46 13 — — — — $9,258.92 2026-04-01
J2507 HCPCS Pegloticase Injection 2 1 — — $8,856.70 $8,856.70 $8,856.70 2026-04-01
J3316 HCPCS Inj., Triptorelin Xr 3.75 Mg 2 1 — — $8,847.73 $8,847.73 $8,847.73 2026-04-01
5524 OTHER Level 4 Imaging Without Contrast 46 13 — — — — $8,627.65 2026-04-01
948 MS_DRG Signs And Symptoms Without Mcc 40 12 — — — — $8,379.39 2026-04-01
J0802 HCPCS Inj. (ani), Up To 40 Units 2 1 — — $8,346.59 $8,346.59 $8,346.59 2026-04-01
5073 OTHER Level 3 Excision/ Biopsy/ Incision And Drainage 46 13 — — — — $8,320.94 2026-04-01
J1826 HCPCS Interferon Beta-1a Inj 2 1 — — $7,940.16 $7,940.16 $7,940.16 2026-04-01
J9015 HCPCS Aldesleukin Injection 2 1 — — $7,846.34 $7,846.34 $7,846.34 2026-04-01
5183 OTHER Level 3 Vascular Procedures 46 13 — — — — $7,780.18 2026-04-01
Q4246 HCPCS Coretext Or Protext, Per Cc 2 1 — — $7,567.00 $7,567.00 $7,567.00 2026-04-01
0265U OTHER Rar Do Whl Gn&mtcdrl DNA Als 2 1 — — $7,529.22 $7,529.22 $7,529.22 2026-04-01
0212U OTHER Rare Ds Gen DNA Alys Proband 2 1 — — $7,528.40 $7,528.40 $7,528.40 2026-04-01
0295U OTHER Onc Brst Dux Carc 7 Proteins 2 1 — — $7,473.12 $7,473.12 $7,473.12 2026-04-01
81554 HCPCS Pulm Ds Ipf Mrna 190 Gen Alg 2 1 — — $7,438.20 $7,438.20 $7,438.20 2026-04-01
A9604 HCPCS Sm 153 Lexidronam 2 1 — — $7,425.53 $7,425.53 $7,425.53 2026-04-01
0335U OTHER Rare Ds Whl Gen Seq Fetal 2 1 — — $7,183.83 $7,183.83 $7,183.83 2026-04-01
0214U OTHER Rare Ds Xom DNA Alys Proband 2 1 — — $7,183.83 $7,183.83 $7,183.83 2026-04-01
J3398 HCPCS Inj Luxturna 1 Billion Vec G 2 1 — — $7,112.98 $7,112.98 $7,112.98 2026-04-01
9521 OTHER Platelets Leukoreduced Irrad 46 13 — — — — $6,958.65 2026-04-01
0567U OTHER Rare Ds Whl Gen Seq Srs&lrs 2 1 — — $6,917.90 $6,917.90 $6,917.90 2026-04-01
0532U OTHER Rare Ds Whlgen&mitochdrl DNA 2 1 — — $6,917.90 $6,917.90 $6,917.90 2026-04-01
81425 HCPCS Hc Genome Seq Analysis 4 1 $48,855.78 $43,970.20 $6,917.90 $6,917.90 $6,917.90 2026-04-01
J7352 HCPCS Afamelanotide Implant, 1 Mg 2 1 — — $6,917.04 $6,917.04 $6,917.04 2026-04-01
5694 OTHER Level 4 Drug Administration 46 13 — — — — $6,899.16 2026-04-01
0242U OTHER Trgt Gen Seq Alys Pnl 55-74 2 1 — — $6,875.00 $6,875.00 $6,875.00 2026-04-01
J7294 HCPCS Seg Acet And Eth Estr Yearly 2 1 — — $6,825.95 $6,825.95 $6,825.95 2026-04-01
J2993 HCPCS Reteplase Injection 2 1 — — $6,825.76 $6,825.76 $6,825.76 2026-04-01
0108U OTHER Gi Barrett Esoph 9 Prtn Bmrk 2 1 — — $6,806.25 $6,806.25 $6,806.25 2026-04-01
J9286 HCPCS Inj Glofitamab Gxbm, 2.5 Mg 4 1 $25,879.38 $23,291.44 $6,682.44 $6,682.44 $6,682.44 2026-04-01
Q4114 HCPCS Integra Flowable Wound Matri 2 1 — — $6,651.72 $6,651.72 $6,651.72 2026-04-01
J9229 HCPCS Inotuzumab Ozogamicin 0.9 Mg IV Solr 4 1 $43,139.81 $38,825.83 $6,619.41 $6,619.41 $6,619.41 2026-04-01
81415 HCPCS Hc Exome Seq Analysis 4 1 $27,000.19 $24,300.17 $6,572.50 $6,572.50 $6,572.50 2026-04-01
0036U OTHER Xome Tum & Nml Spec Seq Alys 2 1 — — $6,572.50 $6,572.50 $6,572.50 2026-04-01
J2787 HCPCS Riboflavin 5?phos Opth<=3ml 2 1 — — $6,429.60 $6,429.60 $6,429.60 2026-04-01
5594 OTHER Level 4 Nuclear Medicine And Related Services 46 13 — — — — $6,290.97 2026-04-01
9511 OTHER Cryoprecipitate Each Unit 46 13 — — — — $6,252.44 2026-04-01
0473U OTHER Onc Sld Tum Bld/slv 648 Gene 2 1 — — $6,187.50 $6,187.50 $6,187.50 2026-04-01
Q4162 HCPCS Amnio Bio And Woundex Flow 2 1 — — $6,031.67 $6,031.67 $6,031.67 2026-04-01
J9268 HCPCS Pentostatin Injection 4 1 $9,293.92 $8,364.53 $5,962.19 $5,962.19 $5,962.19 2026-04-01
A9515 HCPCS Choline C-11 2 1 — — $5,913.61 $5,913.61 $5,913.61 2026-04-01
5072 OTHER Level 2 Excision/ Biopsy/ Incision And Drainage 46 13 — — — — $5,870.45 2026-04-01
5153 OTHER Level 3 Airway Endoscopy 46 13 — — — — $5,782.51 2026-04-01
0300U OTHER Onc Pan Tum Whl Gen Seq&opt 2 1 — — $5,751.80 $5,751.80 $5,751.80 2026-04-01
J0202 HCPCS Injection, Alemtuzumab 2 1 — — $5,750.69 $5,750.69 $5,750.69 2026-04-01
5626 OTHER Level 6 Radiation Therapy 46 13 — — — — $5,632.97 2026-04-01
0425U OTHER Genom Rpd Seq Alys Ea Cmprtr 2 1 — — $5,629.79 $5,629.79 $5,629.79 2026-04-01
90396 HCPCS Varicella-zoster Ig IM 2 1 — — $5,553.97 $5,553.97 $5,553.97 2026-04-01
A9582 HCPCS Iodine I-123 Iobenguane 2 1 — — $5,446.13 $5,446.13 $5,446.13 2026-04-01
0306U OTHER Onc Mrd Nxt-gnrj Alys 1st 2 1 — — $5,332.87 $5,332.87 $5,332.87 2026-04-01
0560U OTHER Onc Mrd Gsa Cfdna Baseline 2 1 — — $5,332.87 $5,332.87 $5,332.87 2026-04-01
81523 HCPCS Onc Brst Mrna 70 Cnt 31 Gene 2 1 — — $5,325.38 $5,325.38 $5,325.38 2026-04-01
0045U OTHER Onc Brst Dux Carc Is 12 Gene 2 1 — — $5,325.38 $5,325.38 $5,325.38 2026-04-01
81518 HCPCS Onc Brst Mrna 11 Genes 2 1 — — $5,325.38 $5,325.38 $5,325.38 2026-04-01
81522 HCPCS Onc Breast Mrna 12 Genes 2 1 — — $5,325.38 $5,325.38 $5,325.38 2026-04-01
0288U OTHER Onc Lung Mrna Quan Pcr 11&3 2 1 — — $5,325.38 $5,325.38 $5,325.38 2026-04-01
81519 HCPCS Oncology Breast Mrna 4 1 $14,958.50 $13,462.65 $5,325.38 $5,325.38 $5,325.38 2026-04-01
81541 HCPCS Onc Prostate Mrna 46 Genes 2 1 — — $5,325.38 $5,325.38 $5,325.38 2026-04-01
81542 HCPCS Onc Prostate Mrna 22 Cnt Gen 2 1 — — $5,325.38 $5,325.38 $5,325.38 2026-04-01
0047U OTHER Onc Prst8 Mrna 17 Gene Alg 2 1 — — $5,325.38 $5,325.38 $5,325.38 2026-04-01
81521 HCPCS Onc Breast Mrna 70 Genes 2 1 — — $5,325.38 $5,325.38 $5,325.38 2026-04-01
0497U OTHER Onc Prst8 Mrna Rt-pcr 6 Gene 2 1 — — $5,325.38 $5,325.38 $5,325.38 2026-04-01
0578U OTHER Onc Cutan Mln RNA Qpcr 10gen 2 1 — — $5,325.38 $5,325.38 $5,325.38 2026-04-01
0583U OTHER Rare Ds Rpd Whlgen Cmptr DNA 2 1 — — $5,212.76 $5,212.76 $5,212.76 2026-04-01
81540 HCPCS Oncology Tum Unknown Origin 2 1 — — $5,156.25 $5,156.25 $5,156.25 2026-04-01
90291 HCPCS Cmv Ig IV 2 1 — — $5,102.95 $5,102.95 $5,102.95 2026-04-01
9525 OTHER Platelets, Hla-m, L/r, Unit 46 13 — — — — $5,065.04 2026-04-01
0258U OTHER Ai Psor Mrna 50-100 Gen Alg 2 1 — — $5,053.12 $5,053.12 $5,053.12 2026-04-01
0019U OTHER Onc RNA Tiss Predict Alg 2 1 — — $5,053.12 $5,053.12 $5,053.12 2026-04-01
0485U OTHER Onc Sol Tum Cfdna&rna Ngs Gm 2 1 — — $5,018.04 $5,018.04 $5,018.04 2026-04-01
J3240 HCPCS Thyrotropin Injection 4 1 $5,490.24 $4,941.21 $4,995.25 $4,995.25 $4,995.25 2026-04-01
81546 HCPCS Onc Thyr Mrna 10,196 Gen Alg 2 1 — — $4,950.00 $4,950.00 $4,950.00 2026-04-01
0313U OTHER Onc Pncrs Dna&mrna Seq 74 2 1 — — $4,950.00 $4,950.00 $4,950.00 2026-04-01
0287U OTHER Onc Thyr Dna&mrna 112 Genes 2 1 — — $4,950.00 $4,950.00 $4,950.00 2026-04-01
0362U OTHER Onc Pap Thyr Ca RNA 82&10 2 1 — — $4,950.00 $4,950.00 $4,950.00 2026-04-01
0026U OTHER Onc Thyr Dna&mrna 112 Genes 2 1 — — $4,950.00 $4,950.00 $4,950.00 2026-04-01
0391U OTHER Onc Sld Tum Dna&rna 437 Gen 2 1 — — $4,950.00 $4,950.00 $4,950.00 2026-04-01
0340U OTHER Onc Pan Ca Alys Mrd Plasma 2 1 — — $4,936.25 $4,936.25 $4,936.25 2026-04-01
5593 OTHER Level 3 Nuclear Medicine And Related Services 46 13 — — — — $4,920.15 2026-04-01
0080U OTHER Onc Lng 5 Clin Rsk Factr Alg 2 1 — — $4,840.00 $4,840.00 $4,840.00 2026-04-01
0334U OTHER Onc Sld Orgn Tgsa DNA 84/+ 2 1 — — $4,812.50 $4,812.50 $4,812.50 2026-04-01
0244U OTHER Onc Solid Orgn DNA 257 Genes 2 1 — — $4,812.50 $4,812.50 $4,812.50 2026-04-01
0239U OTHER Trgt Gen Seq Alys Pnl 311+ 2 1 — — $4,812.50 $4,812.50 $4,812.50 2026-04-01
0037U OTHER Trgt Gen Seq DNA 324 Genes 2 1 — — $4,812.50 $4,812.50 $4,812.50 2026-04-01
0388U OTHER Onc Nonsm Cll Lng Ca 37 Gen 2 1 — — $4,812.50 $4,812.50 $4,812.50 2026-04-01
0016M OTHER Onc Bladder Mrna 209 Gen Alg 2 1 — — $4,798.24 $4,798.24 $4,798.24 2026-04-01
5624 OTHER Level 4 Radiation Therapy 46 13 — — — — $4,756.80 2026-04-01
5625 OTHER Level 5 Radiation Therapy 46 13 — — — — $4,730.67 2026-04-01
A9572 HCPCS Indium In-111 Pentetreotide 2 1 — — $4,702.21 $4,702.21 $4,702.21 2026-04-01
Q9991 HCPCS Buprenorph Xr 100 Mg Or Less 4 1 $4,324.68 $3,892.21 $4,696.55 $4,696.55 $4,696.55 2026-04-01
Q9992 HCPCS Buprenorphine Xr Over 100 Mg 4 1 $4,324.68 $3,892.21 $4,696.55 $4,696.55 $4,696.55 2026-04-01
Q4113 HCPCS Graftjacket Xpress 2 1 — — $4,694.13 $4,694.13 $4,694.13 2026-04-01
5443 OTHER Level 3 Nerve Injections 46 13 — — — — $4,686.55 2026-04-01
5674 OTHER Level 4 Pathology 46 13 — — — — $4,629.97 2026-04-01
5302 OTHER Level 2 Upper Gi Procedures 46 13 — — — — $4,629.45 2026-04-01
81440 HCPCS Mitochondrial Gene 2 1 — — $4,570.50 $4,570.50 $4,570.50 2026-04-01
Q9982 HCPCS Flutemetamol F18 Diagnostic 2 1 — — $4,568.42 $4,568.42 $4,568.42 2026-04-01
81464 HCPCS So Gsap Cll Fr Mcrstl Ins 2 1 — — $4,521.70 $4,521.70 $4,521.70 2026-04-01
0539U OTHER Onc Sol Tumor Cfctdna 152gen 2 1 — — $4,521.70 $4,521.70 $4,521.70 2026-04-01
0379U OTHER Tgsap Sl Or Neo Dna523&rna55 2 1 — — $4,521.70 $4,521.70 $4,521.70 2026-04-01
A9553 HCPCS Cr51 Chromate 2 1 — — $4,507.21 $4,507.21 $4,507.21 2026-04-01
81595 HCPCS Cardiology Hrt Trnspl Mrna 2 1 — — $4,455.00 $4,455.00 $4,455.00 2026-04-01
81558 HCPCS Trnspl Rej Kdn Mrna Qpcr 139 2 1 — — $4,455.00 $4,455.00 $4,455.00 2026-04-01
0576U OTHER Trnsplj Med Lar Quan Ddcfdna 2 1 — — $4,455.00 $4,455.00 $4,455.00 2026-04-01
0055U OTHER Card Hrt Trnspl 96 DNA Seq 2 1 — — $4,455.00 $4,455.00 $4,455.00 2026-04-01
0266U OTHER Unxpl Cnst Hrtbl Do Gn Xprsn 2 1 — — $4,400.00 $4,400.00 $4,400.00 2026-04-01
0262U OTHER Onc Sld Tum Rt-pcr 7 Gen 2 1 — — $4,400.00 $4,400.00 $4,400.00 2026-04-01
0153U OTHER Onc Breast Mrna 101 Genes 2 1 — — $4,344.20 $4,344.20 $4,344.20 2026-04-01
0253U OTHER Rprdtve Med RNA Gen Prfl 238 2 1 — — $4,344.20 $4,344.20 $4,344.20 2026-04-01
0088U OTHER Trnsplj Kdn Algrft Rej 1494 2 1 — — $4,344.20 $4,344.20 $4,344.20 2026-04-01
0087U OTHER Crd Hrt Trnspl Mrna 1283 Gen 2 1 — — $4,344.20 $4,344.20 $4,344.20 2026-04-01
J0840 HCPCS Crotalidae Poly Immune Fab 2 1 — — $4,292.32 $4,292.32 $4,292.32 2026-04-01
A9586 HCPCS Florbetapir F18 2 1 — — $4,290.25 $4,290.25 $4,290.25 2026-04-01
81525 HCPCS Oncology Colon Mrna 2 1 — — $4,284.50 $4,284.50 $4,284.50 2026-04-01
J0850 HCPCS Cytomegalovirus Imm IV /vial 2 1 — — $4,249.58 $4,249.58 $4,249.58 2026-04-01
5442 OTHER Level 2 Nerve Injections 46 13 — — — — $4,236.24 2026-04-01
0248U OTHER Onc Brn Sphrd Cll 12 Rx Pnl 2 1 — — $4,171.56 $4,171.56 $4,171.56 2026-04-01
0525U OTHER Onc Sphrd Cell Cul 11-rx Pnl 2 1 — — $4,171.56 $4,171.56 $4,171.56 2026-04-01
0435U OTHER Onc Chemo Rx Cytox Csc 14 Rx 2 1 — — $4,171.56 $4,171.56 $4,171.56 2026-04-01
0511U OTHER Onc Sol Tum 3dmicroenvir 36+ 2 1 — — $4,171.56 $4,171.56 $4,171.56 2026-04-01
0172U OTHER Onc Sld Tum Alys Brca1 Brca2 2 1 — — $4,166.25 $4,166.25 $4,166.25 2026-04-01
J1950 HCPCS Leuprolide Acetate (3 Month) 11.25 Mg IM Kit 4 1 $8,759.30 $7,883.37 $4,145.09 $4,145.09 $4,145.09 2026-04-01
0018U OTHER Onc Thyr 10 Microrna Seq Alg 2 1 — — $4,127.87 $4,127.87 $4,127.87 2026-04-01
5571 OTHER Level 1 Imaging With Contrast 46 13 — — — — $4,124.80 2026-04-01
81459 HCPCS So Neo Gsap Dna/dna&rna 4 1 $7,809.50 $7,028.55 $4,110.63 $4,110.63 $4,110.63 2026-04-01
0538U OTHER Onc Sol Tum Ngts Ffpe 600gen 2 1 — — $4,110.63 $4,110.63 $4,110.63 2026-04-01
0543U OTHER Onc Sol Tum Ngs DNA 517 Gens 2 1 — — $4,110.63 $4,110.63 $4,110.63 2026-04-01
5312 OTHER Level 2 Lower Gi Procedures 46 13 — — — — $4,089.85 2026-04-01
A9507 HCPCS In111 Capromab 2 1 — — $4,066.18 $4,066.18 $4,066.18 2026-04-01
0592U OTHER Onc Hl Neo DNA Tgs 417 Genes 2 1 — — $4,014.45 $4,014.45 $4,014.45 2026-04-01
0586U OTHER Onc Mrna Gen Xprsn 216 Genes 2 1 — — $4,014.45 $4,014.45 $4,014.45 2026-04-01
0297U OTHER Onc Pan Tum Whl Gen Seq DNA 2 1 — — $4,014.45 $4,014.45 $4,014.45 2026-04-01
0298U OTHER Onc Pan Tum Whl Trns Seq RNA 2 1 — — $4,014.45 $4,014.45 $4,014.45 2026-04-01
0585U OTHER Tgsap So Neo Cfdna 521 Genes 2 1 — — $4,014.45 $4,014.45 $4,014.45 2026-04-01
0530U OTHER Onc Pan-sol Tum Ctdna 77 Gen 2 1 — — $4,014.45 $4,014.45 $4,014.45 2026-04-01
81455 HCPCS Targeted Genomic Seq Analys 4 1 $11,053.59 $9,948.23 $4,014.45 $4,014.45 $4,014.45 2026-04-01
0409U OTHER Onc Sld Tum DNA 80 & RNA 36 2 1 — — $4,014.45 $4,014.45 $4,014.45 2026-04-01
81456 HCPCS Tgsap So/hl 51/< RNA Alys 4 1 $4,182.88 $3,764.59 $4,014.45 $4,014.45 $4,014.45 2026-04-01
0250U OTHER Onc Sld Org Neo DNA 505 Gene 2 1 — — $4,014.45 $4,014.45 $4,014.45 2026-04-01
0571U OTHER Onc Sol Tum Dna80&rna10g Ngs 2 1 — — $4,014.45 $4,014.45 $4,014.45 2026-04-01
0487U OTHER Onc Sol Tum Cfcdna Tgsap 84 2 1 — — $4,014.45 $4,014.45 $4,014.45 2026-04-01
0444U OTHER Onc Sld Orgn Neo Tgsap 361 2 1 — — $4,014.45 $4,014.45 $4,014.45 2026-04-01
0048U OTHER Onc Sld Org Neo DNA 468 Gene 2 1 — — $4,014.45 $4,014.45 $4,014.45 2026-04-01
0050U OTHER Trgt Gen Seq DNA 194 Genes 2 1 — — $4,010.32 $4,010.32 $4,010.32 2026-04-01
J0578 HCPCS Inj Brixadi, More Than 7 Day 2 1 — — $3,948.49 $3,948.49 $3,948.49 2026-04-01
81538 HCPCS Oncology Lung 2 1 — — $3,947.62 $3,947.62 $3,947.62 2026-04-01
A4642 HCPCS In111 Satumomab 2 1 — — $3,939.52 $3,939.52 $3,939.52 2026-04-01
5572 OTHER Level 2 Imaging With Contrast 46 13 — — — — $3,935.47 2026-04-01
0417U OTHER Rare Ds Alys 335 Nuc Genes 2 1 — — $3,908.48 $3,908.48 $3,908.48 2026-04-01
9536 OTHER Platelets Pheresis Path Redu 46 13 — — — — $3,865.00 2026-04-01
0118U OTHER Trnsplj Don-drv Cll-fr DNA 2 1 — — $3,785.72 $3,785.72 $3,785.72 2026-04-01
0540U OTHER Trnsplj Med Quan Dd-cfdna 2 1 — — $3,785.72 $3,785.72 $3,785.72 2026-04-01
0493U OTHER Trnspl Med Quan Dd-cfdna Ngs 2 1 — — $3,785.72 $3,785.72 $3,785.72 2026-04-01
9530 OTHER Plate Pheres Leukoredu Irrad 46 13 — — — — $3,759.07 2026-04-01
81426 HCPCS Hc Genome Seq Compare 4 1 $30,655.00 $27,589.50 $3,726.18 $3,726.18 $3,726.18 2026-04-01
0213U OTHER Rare Ds Gen DNA Alys Ea Comp 2 1 — — $3,726.18 $3,726.18 $3,726.18 2026-04-01
Q9983 HCPCS Florbetaben F18 Diagnostic 2 1 — — $3,723.97 $3,723.97 $3,723.97 2026-04-01
J9026 HCPCS Tarlatamab-dlle 10 Mg IV Solr 4 1 $33,365.00 $30,028.50 $3,681.49 $3,681.49 $3,681.49 2026-04-01
0320U OTHER Neph RNA Psttrnspl Perph Bld 2 1 — — $3,643.75 $3,643.75 $3,643.75 2026-04-01
0319U OTHER Neph RNA Pretrnspl Perph Bld 2 1 — — $3,643.75 $3,643.75 $3,643.75 2026-04-01
A2034 HCPCS Found Drs Solo, Per Sq Cm 2 1 — — $3,615.29 $3,615.29 $3,615.29 2026-04-01
5591 OTHER Level 1 Nuclear Medicine And Related Services 46 13 — — — — $3,612.27 2026-04-01
J7307 HCPCS Etonogestrel Implant System 2 1 — — $3,596.51 $3,596.51 $3,596.51 2026-04-01
J7298 HCPCS Mirena, 52 Mg 4 1 $3,741.06 $3,366.95 $3,588.29 $3,588.29 $3,588.29 2026-04-01
J7296 HCPCS Levonorgestrel 19.5 Mg Iu IUD 4 1 $3,741.06 $3,366.95 $3,588.29 $3,588.29 $3,588.29 2026-04-01
5301 OTHER Level 1 Upper Gi Procedures 46 13 — — — — $3,584.30 2026-04-01
0336U OTHER Rare Ds Whl Gen Seq Bld/slv 2 1 — — $3,540.14 $3,540.14 $3,540.14 2026-04-01
0215U OTHER Rare Ds Xom DNA Alys Ea Comp 2 1 — — $3,540.14 $3,540.14 $3,540.14 2026-04-01
0261U OTHER Onc Clrct Ca Img Alys W/ai 2 1 — — $3,455.72 $3,455.72 $3,455.72 2026-04-01
0120U OTHER Onc B Cll Lymphm Mrna 58 Gen 2 1 — — $3,451.54 $3,451.54 $3,451.54 2026-04-01
81520 HCPCS Onc Breast Mrna 58 Genes 2 1 — — $3,451.54 $3,451.54 $3,451.54 2026-04-01
0017M OTHER Onc Dlbcl Mrna 20 Genes Alg 2 1 — — $3,451.54 $3,451.54 $3,451.54 2026-04-01
0092U OTHER Onc Lng 3 Prtn Bmrk Plsm Alg 2 1 — — $3,421.00 $3,421.00 $3,421.00 2026-04-01
Q4174 HCPCS Palingen Or Promatrx 2 1 — — $3,387.53 $3,387.53 $3,387.53 2026-04-01
J0630 HCPCS Calcitonin Salmon Injection 4 1 $9,172.90 $8,255.61 $3,368.02 $3,368.02 $3,368.02 2026-04-01
5673 OTHER Level 3 Pathology 46 13 — — — — $3,367.80 2026-04-01
81419 HCPCS Epilepsy Gen Seq Alys Panel 2 1 — — $3,366.77 $3,366.77 $3,366.77 2026-04-01
0276U OTHER Hem Inh Thrombocytopenia 23 2 1 — — $3,366.77 $3,366.77 $3,366.77 2026-04-01
81441 HCPCS Ibmfs Seq Alys Pnl 30 Genes 2 1 — — $3,366.77 $3,366.77 $3,366.77 2026-04-01
81412 HCPCS Ashkenazi Jewish Assoc Dis 2 1 — — $3,366.77 $3,366.77 $3,366.77 2026-04-01
81443 HCPCS Hc Imd: Full Gene Panel 4 1 $7,454.25 $6,708.82 $3,366.77 $3,366.77 $3,366.77 2026-04-01
5592 OTHER Level 2 Nuclear Medicine And Related Services 46 13 — — — — $3,351.66 2026-04-01
A9589 HCPCS Insti Hexaminolevulinate Hcl 2 1 — — $3,348.21 $3,348.21 $3,348.21 2026-04-01
0338U OTHER Onc Sld Tum Crcg Tum Cl Slct 2 1 — — $3,348.12 $3,348.12 $3,348.12 2026-04-01
0337U OTHER Onc Plsm Cell Do&myeloma Id 2 1 — — $3,348.12 $3,348.12 $3,348.12 2026-04-01
0491U OTHER Onc Sol Tum Ctc Slct ER Prtn 2 1 — — $3,348.12 $3,348.12 $3,348.12 2026-04-01
0490U OTHER Onc Cutan/uveal Mlnma Cd146 2 1 — — $3,348.12 $3,348.12 $3,348.12 2026-04-01
0492U OTHER Onc Sol Tum Ctc Slctn Pd-l1 2 1 — — $3,348.12 $3,348.12 $3,348.12 2026-04-01
J7300 HCPCS Paragard Intrauterine Copper Iu IUD 4 1 $3,508.12 $3,157.31 $3,346.40 $3,346.40 $3,346.40 2026-04-01
A9584 HCPCS Iodine I-123 Ioflupane 2 1 — — $3,261.19 $3,261.19 $3,261.19 2026-04-01
81427 HCPCS Hc Genome Seq Reeval 4 1 $14,371.43 $12,934.29 $3,214.27 $3,214.27 $3,214.27 2026-04-01
J7299 HCPCS Intraut Copp Cont (miudella) 2 1 — — $3,211.98 $3,211.98 $3,211.98 2026-04-01
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