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

GARFIELD COUNTY PUBLIC HOSPITAL DISTRICT #1

Pomeroy, WA · CCN 501301 · Rates published

Your selected procedure

You selected 93306 (HCPCS)

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This hospital’s price: $1,809 across 11 payers · range $150-$2,010

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbGCMHPOMEROYWA&type=CDMWithoutLabel&fileType=CSV · observed 2026-01-15

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

1,416 distinct procedures filed
11 distinct payers
17,595 rate rows
2026-01-15 last MRF observed
Data quality

17,551 of 17,595 rate rows are consumer-grade (99.7%)

44 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
percent-of-charges filed in the dollar field — excluded from medians 44
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbGCMHPOMEROYWA&type=CDMWithoutLabel&fileType=CSV
Found on page https://www.garfieldcountyhospital.com/pricing-transparency.html
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-23
Content fingerprint 68c73ee4f5dca42f… · 6,340,983 bytes · first seen 2026-07-17

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
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 11 $8,443.08 $10,553.85 $9,498.47 nat. median
$3,787
outlier · 2.5×
J0517
HCPCS 		Injection, Benralizumab, 1 Mg 11 $5,686.45 $7,108.06 $6,397.25 nat. median
$919
outlier · 7.0×
J0840
HCPCS 		Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 11 $4,678.29 $5,847.86 $5,263.07 nat. median
$3,452
1.5× median
J3262
HCPCS 		Injection, Tocilizumab, 1 Mg 11 $3,038.40 $3,798.00 $3,418.20 nat. median
$1,413
outlier · 2.4×
99291
HCPCS 		Critical Care, First 30-74 Minutes 11 $431.80 $3,000.00 $2,700.00 nat. median
$1,530
1.8× median
36556
HCPCS 		Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 11 $1,096.50 $3,000.00 $2,700.00 nat. median
$2,483
1.1× median
99292
HCPCS 		Critical Care, Each Additional 30 Minutes 11 $194.65 $2,987.00 $2,688.30 nat. median
$517
outlier · 5.2×
19083
HCPCS 		Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 11 $2,384.00 $2,980.00 $2,682.00 nat. median
$2,147
1.2× median
307017012
CDM 		Nd- Hemodialysis Acute Ip 11 $2,320.00 $2,900.00 $2,610.00 nat. median
$2,610
1.0× median
439000000
CDM 		Nd-hemodialysis Acute Ip 11 $2,320.00 $2,900.00 $2,610.00 nat. median
$1,161
outlier · 2.2×
99285
HCPCS 		Emergency Department Visit With High Level Of Medical Decision Making 11 $264.35 $2,500.00 $2,250.00 nat. median
$1,187
1.9× median
13100
HCPCS 		Complicated Repair Of Wound Of Trunk, 1.1-2.5 Cm 11 $325.55 $2,372.00 $2,134.80 nat. median
$778
outlier · 2.7×
32555
HCPCS 		Aspiration Of Fluid From Chest Cavity Using Imaging Guidance 11 $1,774.40 $2,218.00 $1,996.20 nat. median
$1,096
1.8× median
49083
HCPCS 		Drainage Of Fluid From Abdominal Cavity Using Imaging Guidance 11 $1,760.00 $2,200.00 $1,980.00 nat. median
$1,222
1.6× median
J0897
HCPCS 		Injection, Denosumab, 1 Mg 11 $1,734.32 $2,167.90 $1,951.11 nat. median
$1,982
1.0× median
J1745
HCPCS 		Injection, Infliximab, Excludes Biosimilar, 10 Mg 11 $1,683.20 $2,104.00 $1,893.60 nat. median
$405
outlier · 4.7×
93306
HCPCS 		Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 11 $149.60 $2,010.00 $1,809.00 nat. median
$993
1.8× median
307010104
CDM 		Room & Board - Private (one Bed) - General Classification 11 $1,600.00 $2,000.00 $1,800.00 nat. median
$1,800
1.0× median
J7325
HCPCS 		Hyaluronan Or Derivative, Synvisc Or Synvisc-one, For Intra-articular Injection,… 11 $1,520.96 $1,901.20 $1,711.08 nat. median
$145
outlier · 11.8×
28090
HCPCS 		Removal Of Growth Of Tendon Covering Or Joint Capsule Of Foot 11 $1,440.00 $1,800.00 $1,620.00 nat. median
$2,008
0.8× median
307010103
CDM 		Room & Board - Private (one Bed) - General Classification 11 $1,360.00 $1,700.00 $1,530.00 nat. median
$1,530
1.0× median
99284
HCPCS 		Emergency Department Visit With Moderate Level Of Medical Decision Making 11 $193.80 $1,700.00 $1,530.00 nat. median
$754
outlier · 2.0×
49082
HCPCS 		Drainage Of Fluid From Abdominal Cavity 11 $134.30 $1,699.00 $1,529.10 nat. median
$1,057
1.4× median
92960
HCPCS 		External Shock To Heart To Regulate Heart Beat 11 $1,332.00 $1,665.00 $1,498.50 nat. median
$987
1.5× median
J3489
HCPCS 		Injection, Zoledronic Acid, 1 Mg 11 $1,320.59 $1,650.74 $1,485.67 nat. median
$131
outlier · 11.3×
27552
HCPCS 		Closed Treatment Of Dislocated Knee Under Anesthesia 11 $1,122.85 $1,549.00 $1,394.10 nat. median
$2,033
0.7× median
24605
HCPCS 		Repair Of Dislocated Elbow Under Anesthesia 11 $824.50 $1,533.00 $1,379.70 nat. median
$1,894
0.7× median
93880
HCPCS 		Ultrasound Of Both Sides Of Head And Neck Blood Flow 11 $149.60 $1,519.00 $1,367.10 nat. median
$531
outlier · 2.6×
93976
HCPCS 		Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 11 $149.60 $1,402.00 $1,261.80 nat. median
$345
outlier · 3.7×
62322
HCPCS 		Injection Of Substance Into Lower Spine Canal 11 $277.10 $1,393.00 $1,253.70 nat. median
$1,149
1.1× median
19084
HCPCS 		Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, Each Additio… 11 $1,070.40 $1,338.00 $1,204.20 nat. median
$1,408
0.9× median
87633
HCPCS 		Detection Test By Nucleic Acid For Multiple Types Of Respiratory Virus, Multiple… 11 $1,061.60 $1,327.00 $1,194.30 nat. median
$531
outlier · 2.2×
27266
HCPCS 		Closed Treatment Of Dislocated Hip Prosthesis Under Anesthesia 5 $1,024.25 $1,144.75 $1,144.75 nat. median
$2,037
0.6× median
19285
HCPCS 		Placement Of Locating Device In Breast Using Ultrasound Guidance, First Growth 11 $998.40 $1,248.00 $1,123.20 nat. median
$1,058
1.1× median
417040780
CDM 		Remdesivir 100 Mg Vial 100 Mcg, 1 Each 11 $954.37 $1,192.96 $1,073.66 nat. median
$1,074
1.0× median
93930
HCPCS 		Ultrasound Of Arm Arteries Or Artery Grafts 11 $149.60 $1,145.00 $1,030.50 nat. median
$482
outlier · 2.1×
25605
HCPCS 		Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 5 $899.30 $1,005.10 $1,005.10 nat. median
$1,667
0.6× median
93307
HCPCS 		Ultrasound Of Heart 11 $890.40 $1,113.00 $1,001.70 nat. median
$519
1.9× median
92950
HCPCS 		Manual Attempt To Restore Blood Circulation And Breathing 11 $829.60 $1,134.00 $985.15 nat. median
$581
1.7× median
93975
HCPCS 		Complete Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 11 $149.60 $1,073.00 $965.70 nat. median
$564
1.7× median
13131
HCPCS 		Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 11 $395.25 $1,044.00 $939.60 nat. median
$607
1.5× median
13151
HCPCS 		Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 1.1-2.5 Cm 11 $454.75 $1,036.00 $932.40 nat. median
$839
1.1× median
J0585
HCPCS 		Injection, Onabotulinumtoxina, 1 Unit 11 $812.00 $1,015.00 $913.50 nat. median
$198
outlier · 4.6×
93970
HCPCS 		Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers 11 $55.25 $1,512.00 $909.90 nat. median
$565
1.6× median
99283
HCPCS 		Emergency Department Visit With Low Level Of Medical Decision Making 11 $106.25 $1,000.00 $900.00 nat. median
$460
2.0× median
32554
HCPCS 		Aspiration Of Fluid From Chest Cavity 11 $162.35 $980.00 $882.00 nat. median
$861
1.0× median
88262
HCPCS 		Chromosome Analysis For Genetic Defects, Count 15-20 Cells 11 $761.60 $952.00 $856.80 nat. median
$226
outlier · 3.8×
27810
HCPCS 		Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation 5 $746.30 $834.10 $834.10 nat. median
$1,641
0.5× median
93925
HCPCS 		Ultrasound Of Leg Arteries Or Artery Grafts 11 $67.15 $1,257.00 $828.10 nat. median
$524
1.6× median
93308
HCPCS 		Ultrasound Of Heart, Follow-up 11 $149.60 $897.00 $807.30 nat. median
$444
1.8× median

Other procedures at this hospital

Browse this hospital's 1,416 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3101 HCPCS Injection, Tenecteplase, 1 Mg 11 11 $10,553.85 $8,970.77 $8,443.08 $10,553.85 $9,498.47 2026-01-15
J0517 HCPCS Injection, Benralizumab, 1 Mg 11 11 $7,108.06 $6,041.85 $5,686.45 $7,108.06 $6,397.25 2026-01-15
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 11 11 $5,847.86 $4,970.68 $4,678.29 $5,847.86 $5,263.07 2026-01-15
J3262 HCPCS Injection, Tocilizumab, 1 Mg 11 11 $3,798.00 $3,228.30 $3,038.40 $3,798.00 $3,418.20 2026-01-15
99291 HCPCS Critical Care, First 30-74 Minutes 16 11 $3,000.00 $2,550.00 $431.80 $3,000.00 $2,700.00 2026-01-15
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 16 11 $3,000.00 $2,550.00 $1,096.50 $3,000.00 $2,700.00 2026-01-15
99292 HCPCS Critical Care, Each Additional 30 Minutes 16 11 $2,987.00 $2,538.95 $194.65 $2,987.00 $2,688.30 2026-01-15
19083 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 11 11 $2,980.00 $2,533.00 $2,384.00 $2,980.00 $2,682.00 2026-01-15
439000000 CDM Nd-hemodialysis Acute Ip 11 11 $2,900.00 $2,465.00 $2,320.00 $2,900.00 $2,610.00 2026-01-15
307017012 CDM Nd- Hemodialysis Acute Ip 11 11 $2,900.00 $2,465.00 $2,320.00 $2,900.00 $2,610.00 2026-01-15
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 16 11 $2,500.00 $2,125.00 $264.35 $2,500.00 $2,250.00 2026-01-15
13100 HCPCS Complicated Repair Of Wound Of Trunk, 1.1-2.5 Cm 16 11 $2,372.00 $2,016.20 $325.55 $2,372.00 $2,134.80 2026-01-15
32555 HCPCS Aspiration Of Fluid From Chest Cavity Using Imaging Guidance 11 11 $2,218.00 $1,885.30 $1,774.40 $2,218.00 $1,996.20 2026-01-15
49083 HCPCS Drainage Of Fluid From Abdominal Cavity Using Imaging Guidance 11 11 $2,200.00 $1,870.00 $1,760.00 $2,200.00 $1,980.00 2026-01-15
J0897 HCPCS Injection, Denosumab, 1 Mg 11 11 $2,167.90 $1,842.72 $1,734.32 $2,167.90 $1,951.11 2026-01-15
J1745 HCPCS Injection, Infliximab, Excludes Biosimilar, 10 Mg 11 11 $2,104.00 $1,788.40 $1,683.20 $2,104.00 $1,893.60 2026-01-15
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 16 11 $2,010.00 $1,708.50 $149.60 $2,010.00 $1,809.00 2026-01-15
307010104 CDM Room & Board - Private (one Bed) - General Classification 11 11 $2,000.00 $1,700.00 $1,600.00 $2,000.00 $1,800.00 2026-01-15
J7325 HCPCS Hyaluronan Or Derivative, Synvisc Or Synvisc-one, For Intra-articular Injection,… 11 11 $1,901.20 $1,616.02 $1,520.96 $1,901.20 $1,711.08 2026-01-15
28090 HCPCS Removal Of Growth Of Tendon Covering Or Joint Capsule Of Foot 11 11 $1,800.00 $1,530.00 $1,440.00 $1,800.00 $1,620.00 2026-01-15
99284 HCPCS Emergency Department Visit With Moderate Level Of Medical Decision Making 16 11 $1,700.00 $1,445.00 $193.80 $1,700.00 $1,530.00 2026-01-15
307010103 CDM Room & Board - Private (one Bed) - General Classification 11 11 $1,700.00 $1,445.00 $1,360.00 $1,700.00 $1,530.00 2026-01-15
49082 HCPCS Drainage Of Fluid From Abdominal Cavity 16 11 $1,699.00 $1,444.15 $134.30 $1,699.00 $1,529.10 2026-01-15
92960 HCPCS External Shock To Heart To Regulate Heart Beat 11 11 $1,665.00 $1,415.25 $1,332.00 $1,665.00 $1,498.50 2026-01-15
J3489 HCPCS Injection, Zoledronic Acid, 1 Mg 11 11 $1,650.74 $1,403.13 $1,320.59 $1,650.74 $1,485.67 2026-01-15
27552 HCPCS Closed Treatment Of Dislocated Knee Under Anesthesia 16 11 $1,549.00 $1,316.65 $1,122.85 $1,549.00 $1,394.10 2026-01-15
24605 HCPCS Repair Of Dislocated Elbow Under Anesthesia 16 11 $1,533.00 $1,303.05 $824.50 $1,533.00 $1,379.70 2026-01-15
93880 HCPCS Ultrasound Of Both Sides Of Head And Neck Blood Flow 16 11 $1,519.00 $1,291.15 $149.60 $1,519.00 $1,367.10 2026-01-15
93976 HCPCS Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 16 11 $1,402.00 $1,191.70 $149.60 $1,402.00 $1,261.80 2026-01-15
62322 HCPCS Injection Of Substance Into Lower Spine Canal 16 11 $1,393.00 $1,184.05 $277.10 $1,393.00 $1,253.70 2026-01-15
19084 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, Each Additio… 11 11 $1,338.00 $1,137.30 $1,070.40 $1,338.00 $1,204.20 2026-01-15
87633 HCPCS Detection Test By Nucleic Acid For Multiple Types Of Respiratory Virus, Multiple… 11 11 $1,327.00 $1,127.95 $1,061.60 $1,327.00 $1,194.30 2026-01-15
27266 HCPCS Closed Treatment Of Dislocated Hip Prosthesis Under Anesthesia 5 5 $1,205.00 $1,024.25 $1,024.25 $1,144.75 $1,144.75 2026-01-15
19285 HCPCS Placement Of Locating Device In Breast Using Ultrasound Guidance, First Growth 22 11 $1,248.00 $1,060.80 $998.40 $1,248.00 $1,123.20 2026-01-15
417040780 CDM Remdesivir 100 Mg Vial 100 Mcg, 1 Each 11 11 $1,192.96 $1,014.02 $954.37 $1,192.96 $1,073.66 2026-01-15
93930 HCPCS Ultrasound Of Arm Arteries Or Artery Grafts 16 11 $1,145.00 $973.25 $149.60 $1,145.00 $1,030.50 2026-01-15
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 5 5 $1,058.00 $899.30 $899.30 $1,005.10 $1,005.10 2026-01-15
93307 HCPCS Ultrasound Of Heart 11 11 $1,113.00 $946.05 $890.40 $1,113.00 $1,001.70 2026-01-15
92950 HCPCS Manual Attempt To Restore Blood Circulation And Breathing 22 11 $1,085.50 $922.67 $829.60 $1,134.00 $985.15 2026-01-15
93975 HCPCS Complete Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 16 11 $1,073.00 $912.05 $149.60 $1,073.00 $965.70 2026-01-15
13131 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 16 11 $1,044.00 $887.40 $395.25 $1,044.00 $939.60 2026-01-15
13151 HCPCS Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 1.1-2.5 Cm 16 11 $1,036.00 $880.60 $454.75 $1,036.00 $932.40 2026-01-15
J0585 HCPCS Injection, Onabotulinumtoxina, 1 Unit 11 11 $1,015.00 $862.75 $812.00 $1,015.00 $913.50 2026-01-15
93970 HCPCS Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers 37 11 $1,011.00 $859.35 $55.25 $1,512.00 $909.90 2026-01-15
99283 HCPCS Emergency Department Visit With Low Level Of Medical Decision Making 16 11 $1,000.00 $850.00 $106.25 $1,000.00 $900.00 2026-01-15
32554 HCPCS Aspiration Of Fluid From Chest Cavity 16 11 $980.00 $833.00 $162.35 $980.00 $882.00 2026-01-15
88262 HCPCS Chromosome Analysis For Genetic Defects, Count 15-20 Cells 11 11 $952.00 $809.20 $761.60 $952.00 $856.80 2026-01-15
27810 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation 5 5 $878.00 $746.30 $746.30 $834.10 $834.10 2026-01-15
93925 HCPCS Ultrasound Of Leg Arteries Or Artery Grafts 32 11 $910.00 $773.50 $67.15 $1,257.00 $828.10 2026-01-15
93308 HCPCS Ultrasound Of Heart, Follow-up 16 11 $897.00 $762.45 $149.60 $897.00 $807.30 2026-01-15
76700 HCPCS Complete Ultrasound Scan Of Abdomen 16 11 $895.00 $760.75 $149.60 $895.00 $805.50 2026-01-15
93971 HCPCS Ultrasound Study Of One Arm Or Leg Veins With Compression And Maneuvers 38 11 $877.00 $745.45 $149.60 $877.00 $789.30 2026-01-15
23650 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation 16 11 $876.00 $744.60 $504.90 $876.00 $788.40 2026-01-15
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 5 5 $828.00 $703.80 $703.80 $786.60 $786.60 2026-01-15
76770 HCPCS Complete Ultrasound Scan Behind Abdominal Cavity 16 11 $862.00 $732.70 $149.60 $862.00 $775.80 2026-01-15
13121 HCPCS Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 2.6-7.5 Cm 16 11 $835.00 $709.75 $423.30 $835.00 $751.50 2026-01-15
88309 HCPCS Pathology Examination Of Tissue Using A Microscope, High Complexity 11 11 $819.00 $696.15 $655.20 $819.00 $737.10 2026-01-15
76536 HCPCS Ultrasound Scan Of Head And Neck Soft Tissue 16 11 $818.00 $695.30 $149.60 $818.00 $736.20 2026-01-15
99236 HCPCS Hospital Inpatient Or Observation Care With Admission And Discharge On The Same … 5 5 $769.00 $653.65 $653.65 $730.55 $730.55 2026-01-15
12057 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More … 5 5 $751.00 $638.35 $638.35 $713.45 $713.45 2026-01-15
12016 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 12.… 16 11 $785.00 $667.25 $204.00 $785.00 $706.50 2026-01-15
76705 HCPCS Limited Ultrasound Scan Of Abdomen 16 11 $766.00 $651.10 $149.60 $766.00 $689.40 2026-01-15
20103 HCPCS Exploration Of Wound Of Arm Or Leg 5 5 $725.00 $616.25 $616.25 $688.75 $688.75 2026-01-15
87497 HCPCS Detection Test By Nucleic Acid For Cytomegalovirus, Quantification 11 11 $759.00 $645.15 $607.20 $759.00 $683.10 2026-01-15
24600 HCPCS Repair Of Dislocated Elbow 5 5 $689.00 $585.65 $585.65 $654.55 $654.55 2026-01-15
76775 HCPCS Limited Ultrasound Scan Behind Abdominal Cavity 16 11 $724.00 $615.40 $149.60 $724.00 $651.60 2026-01-15
26742 HCPCS Closed Treatment Of Broken Finger Or Hand At Base Of Finger With Manipulation 5 5 $684.00 $581.40 $581.40 $649.80 $649.80 2026-01-15
76830 HCPCS Ultrasound Scan Of Uterus, Ovaries, Tubes, Cervix And Pelvic Area Through Vagina 16 11 $712.00 $605.20 $149.60 $712.00 $640.80 2026-01-15
51725 HCPCS Simple Measurement Of Pressure Of Urine Flow In Bladder 16 11 $705.00 $599.25 $228.65 $705.00 $634.50 2026-01-15
28192 HCPCS Removal Of Foreign Body Of Foot Tissue, Deep 5 5 $667.00 $566.95 $566.95 $633.65 $633.65 2026-01-15
11606 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 11 11 $700.00 $595.00 $560.00 $700.00 $630.00 2026-01-15
11042 HCPCS Removal Of Skin And Tissue, 20.0 Sq Cm Or Less 22 11 $750.50 $637.92 $204.80 $1,245.00 $626.00 2026-01-15
12015 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6… 16 11 $689.00 $585.65 $149.60 $689.00 $620.10 2026-01-15
76811 HCPCS Ultrasound Scan Of Pregnant Uterus With Detailed Fetal Anatomic Examination, Sin… 16 11 $688.00 $584.80 $149.60 $688.00 $619.20 2026-01-15
13152 HCPCS Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 2.6-7.5 Cm 5 5 $649.00 $551.65 $551.65 $616.55 $616.55 2026-01-15
12056 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 20.1-… 5 5 $645.00 $548.25 $548.25 $612.75 $612.75 2026-01-15
11603 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 11 11 $670.00 $569.50 $536.00 $670.00 $603.00 2026-01-15
11604 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 11 11 $670.00 $569.50 $536.00 $670.00 $603.00 2026-01-15
26010 HCPCS Simple Drainage Of Abscess Of Finger 16 11 $667.00 $566.95 $325.55 $667.00 $600.30 2026-01-15
12034 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 7.6-12.5… 16 11 $659.00 $560.15 $324.70 $659.00 $593.10 2026-01-15
12014 HCPCS Simple Repair Of Surface Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1… 16 11 $656.00 $557.60 $119.00 $656.00 $590.40 2026-01-15
26700 HCPCS Closed Treatment Of Dislocated Hand Joint At Base Of Finger With Manipulation 16 11 $652.00 $554.20 $521.60 $652.00 $589.33 2026-01-15
26160 HCPCS Removal Of Growth Of Tendon Finger Or Hand 5 5 $616.00 $523.60 $523.60 $585.20 $585.20 2026-01-15
99282 HCPCS Emergency Department Visit With Straightforward Medical Decision Making 16 11 $650.00 $552.50 $70.55 $650.00 $585.00 2026-01-15
27301 HCPCS Drainage Of Deep Abscess Or Blood Accumulation Of Thigh Or Knee 5 5 $615.00 $522.75 $522.75 $584.25 $584.25 2026-01-15
88368 HCPCS Microscopic Genetic Analysis Of Tissue, Manual, Initial Procedure 11 11 $643.00 $546.55 $514.40 $643.00 $578.70 2026-01-15
88184 HCPCS Flow Cytometry Technique For DNA Or Cell Analysis, First Marker 11 11 $643.00 $546.55 $514.40 $643.00 $578.70 2026-01-15
88307 HCPCS Pathology Examination Of Tissue Using A Microscope, Moderately High Complexity 11 11 $643.00 $546.55 $514.40 $643.00 $578.70 2026-01-15
12037 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, More Tha… 5 5 $604.00 $513.40 $513.40 $573.80 $573.80 2026-01-15
99235 HCPCS Hospital Inpatient Or Observation Care With Admission And Discharge On The Same … 5 5 $603.00 $512.55 $512.55 $572.85 $572.85 2026-01-15
12051 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.5 C… 21 11 $647.00 $549.95 $270.30 $647.00 $569.05 2026-01-15
11601 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm 11 11 $630.00 $535.50 $504.00 $630.00 $567.00 2026-01-15
93926 HCPCS Ultrasound Of One Leg Arteries Or Artery Grafts 27 11 $628.00 $533.80 $149.60 $628.00 $565.20 2026-01-15
13133 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 5 5 $594.00 $504.90 $504.90 $564.30 $564.30 2026-01-15
76870 HCPCS Ultrasound Scan Of Scrotum 16 11 $626.00 $532.10 $149.60 $626.00 $563.40 2026-01-15
51705 HCPCS Simple Change Of Bladder Tube 16 11 $625.00 $531.25 $226.95 $625.00 $562.50 2026-01-15
93923 HCPCS Complete Ultrasound Study Of Arm And Leg Arteries 16 11 $622.00 $528.70 $149.60 $622.00 $559.80 2026-01-15
72052 HCPCS X-ray Of Upper Spine, 6 Or More Views 16 11 $620.00 $527.00 $22.10 $620.00 $558.00 2026-01-15
13132 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 5 5 $586.00 $498.10 $498.10 $556.70 $556.70 2026-01-15
46230 HCPCS Removal Of Multiple External Noncancer Growths Of Anus 11 11 $616.00 $523.60 $492.80 $616.00 $554.40 2026-01-15
93990 HCPCS Ultrasound Of Hemodialysis Access 11 11 $612.00 $520.20 $489.60 $612.00 $550.80 2026-01-15
76881 HCPCS Complete Ultrasound Scan Of Joint 11 11 $612.00 $520.20 $489.60 $612.00 $550.80 2026-01-15
16030 HCPCS Dressing Change Or Removal Of Burn Tissue, More Than 10% Of Total Body Surface 16 11 $612.00 $520.20 $211.65 $612.00 $550.80 2026-01-15
12042 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 2.6-7.5 Cm 16 11 $612.00 $520.20 $315.35 $612.00 $550.80 2026-01-15
76776 HCPCS Ultrasound Scan Of Transplanted Kidney 16 11 $610.00 $518.50 $149.60 $610.00 $549.00 2026-01-15
74022 HCPCS X-ray Series Of Abdomen With Single X-ray Of Chest 16 11 $608.00 $516.80 $22.10 $608.00 $547.20 2026-01-15
27560 HCPCS Closed Treatment Of Dislocated Kneecap 5 5 $576.00 $489.60 $489.60 $547.20 $547.20 2026-01-15
81270 HCPCS Gene Analysis (Janus Kinase 2) Variant 11 11 $599.00 $509.15 $479.20 $599.00 $539.10 2026-01-15
12055 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 12.6-… 5 5 $567.00 $481.95 $481.95 $538.65 $538.65 2026-01-15
31500 HCPCS Emergent Insertion Of Breathing Tube Into Windpipe Using An Endoscope 11 11 $598.00 $508.30 $478.40 $598.00 $538.20 2026-01-15
76805 HCPCS Ultrasound Scan Of Pregnant Uterus (14 Weeks Or More), Single Or First Fetus 16 11 $598.00 $508.30 $149.60 $598.00 $538.20 2026-01-15
76942 HCPCS Ultrasonic Guidance For Needle Placement 38 11 $597.00 $507.45 $149.60 $597.00 $537.30 2026-01-15
11600 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 0.5 Cm Or Less 11 11 $593.00 $504.05 $474.40 $593.00 $533.70 2026-01-15
12020 HCPCS Simple Closure Of Surface Wound Reopening 11 11 $591.00 $502.35 $472.80 $591.00 $531.90 2026-01-15
96365 HCPCS Infusion Into A Vein For Therapy, Prevention, Or Diagnosis, 1 Hour Or Less 14 11 $587.00 $498.95 $469.60 $587.00 $528.30 2026-01-15
80050 HCPCS General Health Panel 11 11 $580.00 $493.00 $464.00 $580.00 $522.00 2026-01-15
76882 HCPCS Limited Ultrasound Scan Of Joint Or Other Extremity Structure Except Blood Vesse… 38 11 $572.00 $486.20 $149.60 $594.00 $520.52 2026-01-15
11602 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 1.1-2.0 Cm 11 11 $578.00 $491.30 $462.40 $578.00 $520.20 2026-01-15
93931 HCPCS Ultrasound Of One Arm Arteries Or Artery Grafts 38 11 $574.00 $487.90 $149.60 $574.00 $516.60 2026-01-15
72080 HCPCS X-ray Of Middle And Lower Spine, 2 Views 16 11 $560.00 $476.00 $22.10 $560.00 $504.00 2026-01-15
87506 HCPCS Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S… 11 11 $559.00 $475.15 $447.20 $559.00 $503.10 2026-01-15
93882 HCPCS Ultrasound Of One Side Of Head And Neck Blood Flow 27 11 $557.00 $473.45 $149.60 $557.00 $501.30 2026-01-15
87799 HCPCS Detection Test By Nucleic Acid For Organism, Quantification 11 11 $553.00 $470.05 $442.40 $553.00 $497.70 2026-01-15
72050 HCPCS X-ray Of Upper Spine, 4-5 Views 16 11 $552.00 $469.20 $22.10 $552.00 $496.80 2026-01-15
72110 HCPCS X-ray Of Lower And Sacral Spine, Minimum Of 4 Views 16 11 $549.00 $466.65 $22.10 $549.00 $494.10 2026-01-15
12041 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 2.5 Cm Or Less 27 11 $520.00 $442.00 $237.15 $624.00 $494.00 2026-01-15
12036 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 20.1-30.… 5 5 $515.00 $437.75 $437.75 $489.25 $489.25 2026-01-15
12031 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.5 Cm O… 16 11 $541.00 $459.85 $240.55 $541.00 $486.90 2026-01-15
72072 HCPCS X-ray Of Middle Spine, 3 Views 16 11 $535.00 $454.75 $22.10 $535.00 $481.50 2026-01-15
46999 HCPCS Other Procedure On Anus 11 11 $534.00 $453.90 $427.20 $534.00 $480.60 2026-01-15
88230 HCPCS Tissue Culture To Identify White Blood Cell Disorders 11 11 $533.00 $453.05 $426.40 $533.00 $479.70 2026-01-15
12046 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 20.1-30.0 Cm 5 5 $499.00 $424.15 $424.15 $474.05 $474.05 2026-01-15
76801 HCPCS Ultrasound Scan Of Pregnant Uterus (less Than 14 Weeks), Single Or First Fetus 16 11 $514.00 $436.90 $149.60 $514.00 $462.60 2026-01-15
417040467 CDM Pneumovax 23 Syringe 11 11 $512.50 $435.63 $410.00 $512.50 $461.25 2026-01-15
76856 HCPCS Complete Ultrasound Scan Of Pelvis 27 11 $481.00 $408.85 $149.60 $840.00 $456.95 2026-01-15
405127255 CDM Cs-ortho Glass Splint 6''x15' 11 11 $498.00 $423.30 $398.40 $498.00 $448.20 2026-01-15
13101 HCPCS Complicated Repair Of Wound Of Trunk, 2.6-7.5 Cm 5 5 $470.00 $399.50 $399.50 $446.50 $446.50 2026-01-15
11402 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 1.1-2.0 Cm 22 11 $515.00 $437.75 $272.80 $689.00 $446.10 2026-01-15
76818 HCPCS Ultrasound And Monitoring Of Heart Of Fetus 16 11 $495.00 $420.75 $149.60 $495.00 $445.50 2026-01-15
417040149 CDM Glucagon 1 Mg Emergency Kit 11 11 $491.10 $417.44 $392.88 $491.10 $441.99 2026-01-15
87902 HCPCS Analysis Test By Nucleic Acid For Hepatitis C Virus 11 11 $483.00 $410.55 $386.40 $483.00 $434.70 2026-01-15
76857 HCPCS Limited Ultrasound Scan Of Pelvis 16 11 $481.00 $408.85 $149.60 $481.00 $432.90 2026-01-15
99234 HCPCS Hospital Inpatient Or Observation Care With Admission And Discharge On The Same … 5 5 $455.00 $386.75 $386.75 $432.25 $432.25 2026-01-15
71101 HCPCS X-ray Of Ribs On Side Of Body, Minimum Of 3 Views 27 11 $480.00 $408.00 $22.10 $480.00 $432.00 2026-01-15
28002 HCPCS Drainage Of Fluid Filled Sac Below Connective Tissue In Foot Joint 11 11 $480.00 $408.00 $384.00 $480.00 $432.00 2026-01-15
72100 HCPCS X-ray Of Lower And Sacral Spine, 2-3 Views 16 11 $478.00 $406.30 $22.10 $478.00 $430.20 2026-01-15
96360 HCPCS Infusion Into A Vein For Hydration, 31-60 Minutes 13 11 $476.00 $404.60 $380.80 $476.00 $428.40 2026-01-15
43753 HCPCS Insertion Of Stomach Tube And Aspiration Of Stomach Contents 16 11 $474.00 $402.90 $76.50 $474.00 $426.60 2026-01-15
12035 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.… 5 5 $444.00 $377.40 $377.40 $421.80 $421.80 2026-01-15
C1751 HCPCS Catheter, Infusion, Inserted Peripherally, Centrally Or Midline (other Than Hemo… 22 11 $479.70 $407.75 $292.32 $594.00 $420.30 2026-01-15
87522 HCPCS Detection Test By Nucleic Acid For Hepatitis C Virus, Quantification 11 11 $465.00 $395.25 $372.00 $465.00 $418.50 2026-01-15
76817 HCPCS Vaginal Ultrasound Of Pregnant Uterus 16 11 $465.00 $395.25 $149.60 $465.00 $418.50 2026-01-15
72020 HCPCS X-ray Of Spine, 1 View 16 11 $463.00 $393.55 $22.10 $463.00 $416.70 2026-01-15
13120 HCPCS Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 1.1-2.5 Cm 5 5 $438.00 $372.30 $372.30 $416.10 $416.10 2026-01-15
36590 HCPCS Removal Of Central Venous Tube With Port Or Pump 5 5 $433.00 $368.05 $368.05 $411.35 $411.35 2026-01-15
11403 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 2.1-3.0 Cm 22 11 $453.00 $385.05 $314.40 $513.00 $401.70 2026-01-15
11404 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 11 11 $444.00 $377.40 $355.20 $444.00 $399.60 2026-01-15
71111 HCPCS X-ray Of Ribs On Both Sides Of Body, Minimum Of 4 Views 16 11 $439.00 $373.15 $22.10 $439.00 $395.10 2026-01-15
93922 HCPCS Ultrasound Study Of Arm And Leg Arteries 27 11 $415.00 $352.75 $149.60 $557.00 $394.25 2026-01-15
405127254 CDM Cs-ortho Glass Splint 5''x15' 11 11 $438.00 $372.30 $350.40 $438.00 $394.20 2026-01-15
76641 HCPCS Complete Ultrasound Scan Of 1 Breast 38 11 $437.00 $371.45 $149.60 $437.00 $393.30 2026-01-15
12054 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6-1… 5 5 $414.00 $351.90 $351.90 $393.30 $393.30 2026-01-15
76604 HCPCS Ultrasound Scan Of Chest 16 11 $436.00 $370.60 $149.60 $436.00 $392.40 2026-01-15
99205 HCPCS New Patient Office Or Other Outpatient Visit With A High Level Of Medical Decisi… 11 11 $436.00 $370.60 $348.80 $436.00 $392.40 2026-01-15
73565 HCPCS X-ray Of Both Knees While Standing 16 11 $435.00 $369.75 $22.10 $435.00 $391.50 2026-01-15
72040 HCPCS X-ray Of Upper Spine, 2-3 Views 16 11 $435.00 $369.75 $22.10 $435.00 $391.50 2026-01-15
76816 HCPCS Follow-up Ultrasound Scan Of Pregnant Uterus 16 11 $434.00 $368.90 $149.60 $434.00 $390.60 2026-01-15
20520 HCPCS Removal Of Foreign Body In Muscle Or Tendon 16 11 $432.00 $367.20 $260.95 $432.00 $388.80 2026-01-15
73010 HCPCS X-ray Of Shoulder Blade 27 11 $430.00 $365.50 $22.10 $430.00 $387.00 2026-01-15
76819 HCPCS Ultrasound Scan Of Fetus 16 11 $424.00 $360.40 $149.60 $424.00 $381.60 2026-01-15
99223 HCPCS Initial Hospital Inpatient Or Observation Care With High Level Of Medical Decisi… 5 5 $400.00 $340.00 $340.00 $380.00 $380.00 2026-01-15
12045 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 12.6-20.0 Cm 5 5 $399.00 $339.15 $339.15 $379.05 $379.05 2026-01-15
76815 HCPCS Limited Ultrasound Of Pregnant Uterus 16 11 $415.00 $352.75 $149.60 $415.00 $373.50 2026-01-15
12053 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7… 5 5 $393.00 $334.05 $334.05 $373.35 $373.35 2026-01-15
81596 HCPCS Biochemical Assays For Evaluation Of Chronic Hepatitis C Virus Infection 11 11 $414.00 $351.90 $331.20 $414.00 $372.60 2026-01-15
99222 HCPCS Initial Hospital Inpatient Or Observation Care With Moderate Level Of Medical De… 5 5 $391.00 $332.35 $332.35 $371.45 $371.45 2026-01-15
72220 HCPCS X-ray Of Sacrum And Tailbone, Minimum Of 2 Views 16 11 $412.00 $350.20 $22.10 $412.00 $370.80 2026-01-15
72202 HCPCS X-ray Of Joint Between Lower Spine And Hip Bone, 3 Or More Views 16 11 $410.00 $348.50 $22.10 $410.00 $369.00 2026-01-15
99221 HCPCS Initial Hospital Care With Straightforward Or Low Level Of Medical Decision Maki… 5 5 $384.00 $326.40 $326.40 $364.80 $364.80 2026-01-15
76642 HCPCS Limited Ultrasound Scan Of 1 Breast 38 11 $404.00 $343.40 $149.60 $404.00 $363.60 2026-01-15
73000 HCPCS X-ray Of Collar Bone 27 11 $400.00 $340.00 $22.10 $400.00 $360.00 2026-01-15
71110 HCPCS X-ray Of Ribs On Both Sides Of Body, 3 Views 11 11 $400.00 $340.00 $320.00 $400.00 $360.00 2026-01-15
36680 HCPCS Insertion Of Needle For Infusion Into Bone 16 11 $400.00 $340.00 $102.00 $400.00 $360.00 2026-01-15
12052 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.6-5… 5 5 $378.00 $321.30 $321.30 $359.10 $359.10 2026-01-15
90677 HCPCS Pneumococcal Conjugate Vaccine, 20 Valent (pcv20), For Intramuscular Use 11 11 $397.00 $337.45 $317.60 $397.00 $357.30 2026-01-15
72190 HCPCS X-ray Of Pelvis, Minimum Of 3 Views 16 11 $393.00 $334.05 $22.10 $393.00 $353.70 2026-01-15
71046 HCPCS X-ray Of Chest, 2 Views 16 11 $390.00 $331.50 $22.10 $390.00 $351.00 2026-01-15
11400 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.5 Cm Or Less 22 11 $407.00 $345.95 $203.20 $560.00 $351.00 2026-01-15
46083 HCPCS Incision Of External Hemorrhoid With Blood Clot 11 11 $389.00 $330.65 $311.20 $389.00 $350.10 2026-01-15
10061 HCPCS Complicated Or Multiple Drainage Of Skin Abscess 27 11 $364.00 $309.40 $284.75 $500.00 $345.80 2026-01-15
16025 HCPCS Dressing Change Or Removal Of Burn Tissue, 5-10% Of Total Body Surface 16 11 $383.00 $325.55 $175.95 $383.00 $344.70 2026-01-15
99244 HCPCS Office Or Other Outpatient Consultation With Moderate Level Of Medical Decision … 5 5 $362.00 $307.70 $307.70 $343.90 $343.90 2026-01-15
70150 HCPCS X-ray Of Face Bones, Minimum Of 3 Views 16 11 $381.00 $323.85 $22.10 $381.00 $342.90 2026-01-15
12032 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 2.6-7.5 … 5 5 $360.00 $306.00 $306.00 $342.00 $342.00 2026-01-15
405127253 CDM Cs-ortho Glass Splint 4''x15' 11 11 $379.00 $322.15 $303.20 $379.00 $341.10 2026-01-15
90792 HCPCS Psychiatric Diagnostic Evaluation With Medical Services 11 11 $379.00 $322.15 $303.20 $379.00 $341.10 2026-01-15
73070 HCPCS X-ray Of Elbow, 2 Views 27 11 $376.00 $319.60 $22.10 $376.00 $338.40 2026-01-15
70260 HCPCS X-ray Of Skull, Minimum Of 4 Views 16 11 $376.00 $319.60 $22.10 $376.00 $338.40 2026-01-15
417040759 CDM Trelegy Ellipta 100-62.5-25 11 11 $373.61 $317.57 $298.89 $373.61 $336.25 2026-01-15
10160 HCPCS Aspiration Of Abscess, Blood, Or Cyst 22 11 $396.00 $336.60 $153.60 $600.00 $336.00 2026-01-15
70120 HCPCS X-ray Of Bone Behind The Ear, 1-2 Views Per Side 16 11 $372.00 $316.20 $22.10 $372.00 $334.80 2026-01-15
99239 HCPCS Hospital Inpatient Or Observation Discharge Day Management, More Than 30 Minutes 5 5 $352.00 $299.20 $299.20 $334.40 $334.40 2026-01-15
70360 HCPCS X-ray Of Soft Tissue Of Neck 16 11 $371.00 $315.35 $22.10 $371.00 $333.90 2026-01-15
86340 HCPCS Intrinsic Factor (stomach Protein) Antibody Measurement 11 11 $370.00 $314.50 $296.00 $370.00 $333.00 2026-01-15
40810 HCPCS Removal Of Growth Of Tissue Of Mouth 5 5 $350.00 $297.50 $297.50 $332.50 $332.50 2026-01-15
30300 HCPCS Removal Of Foreign Body In Nose 16 11 $369.00 $313.65 $222.70 $369.00 $332.10 2026-01-15
97602 HCPCS Removal Of Tissue From Wound Gradually 11 11 $366.00 $311.10 $292.80 $366.00 $329.40 2026-01-15
99233 HCPCS Subsequent Hospital Inpatient Or Observation Care With High Level Of Medical Dec… 5 5 $346.00 $294.10 $294.10 $328.70 $328.70 2026-01-15
93225 HCPCS Electrocardiogram (ecg) 2-day Continuous 11 11 $365.00 $310.25 $292.00 $365.00 $328.50 2026-01-15
73552 HCPCS X-ray Of Thigh Bone, Minimum 2 Views 27 11 $364.00 $309.40 $22.10 $364.00 $327.60 2026-01-15
87632 HCPCS Detection Test By Nucleic Acid For Multiple Types Of Respiratory Virus, Multiple… 11 11 $363.00 $308.55 $290.40 $363.00 $326.70 2026-01-15
73564 HCPCS X-ray Of Knee, 4 Or More Views 27 11 $361.00 $306.85 $22.10 $361.00 $324.90 2026-01-15
71100 HCPCS X-ray Of Ribs On Side Of Body, 2 Views 27 11 $360.00 $306.00 $22.10 $360.00 $324.00 2026-01-15
P9016 HCPCS Red Blood Cells, Leukocytes Reduced, Each Unit 11 11 $359.00 $305.15 $287.20 $359.00 $323.10 2026-01-15
99350 HCPCS Residence Visit For Established Patient With High Level Of Medical Decision Maki… 11 11 $358.00 $304.30 $286.40 $358.00 $322.20 2026-01-15
17281 HCPCS Destruction Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, … 11 11 $357.00 $303.45 $285.60 $357.00 $321.30 2026-01-15
99215 HCPCS Established Patient Office Or Other Outpatient Visit With High Level Of Medical … 11 11 $356.00 $302.60 $284.80 $356.00 $320.40 2026-01-15
73060 HCPCS X-ray Of Upper Arm, Minimum Of 2 Views 27 11 $356.00 $302.60 $22.10 $356.00 $320.40 2026-01-15
11422 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 1.1-2… 11 11 $355.00 $301.75 $284.00 $355.00 $319.50 2026-01-15
29505 HCPCS Application Of Long Leg Splint From Thigh To Ankle Or Toe 5 5 $333.00 $283.05 $283.05 $316.35 $316.35 2026-01-15
72170 HCPCS X-ray Of Pelvis, 1-2 Views 16 11 $351.00 $298.35 $22.10 $351.00 $315.90 2026-01-15
11401 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 0.6-1.0 Cm 22 11 $356.00 $302.60 $247.20 $403.00 $315.70 2026-01-15
74019 HCPCS X-ray Of Abdomen, 2 Views 16 11 $350.00 $297.50 $22.10 $350.00 $315.00 2026-01-15
72074 HCPCS X-ray Of Middle Spine, Minimum Of 4 Views 16 11 $350.00 $297.50 $22.10 $350.00 $315.00 2026-01-15
11765 HCPCS Removal Of Skin Of Fingernail Or Toenail 27 11 $328.00 $278.80 $149.60 $409.00 $311.60 2026-01-15
97163 HCPCS Evaluation For Physical Therapy, Typically 45 Minutes 11 11 $346.00 $294.10 $276.80 $346.00 $311.40 2026-01-15
73521 HCPCS X-ray Of Both Hips, 2 Views 16 11 $344.00 $292.40 $22.10 $344.00 $309.60 2026-01-15
70200 HCPCS X-ray Of Eye Socket, Minimum Of 4 Views 16 11 $339.00 $288.15 $22.10 $339.00 $305.10 2026-01-15
74018 HCPCS X-ray Of Abdomen, 1 View 16 11 $338.00 $287.30 $22.10 $338.00 $304.20 2026-01-15
87798 HCPCS Detection Test By Nucleic Acid For Organism, Amplified Probe Technique 11 11 $338.00 $287.30 $270.40 $338.00 $304.20 2026-01-15
70110 HCPCS X-ray Of Lower Jaw, Minimum Of 4 Views 16 11 $338.00 $287.30 $22.10 $338.00 $304.20 2026-01-15
91304 HCPCS Severe Acute Respiratory Syndrome Coronavirus 2 (covid-19) Vaccine, Recombinant … 11 11 $337.50 $286.88 $270.00 $337.50 $303.75 2026-01-15
90791 HCPCS Psychiatric Diagnostic Evaluation 11 11 $337.00 $286.45 $269.60 $337.00 $303.30 2026-01-15
86364 HCPCS Measurement Of Tissue Transglutaminase 11 11 $336.00 $285.60 $268.80 $336.00 $302.40 2026-01-15
88360 HCPCS Microscopic Genetic Analysis Of Tumor, Manual 11 11 $335.00 $284.75 $268.00 $335.00 $301.50 2026-01-15
G0402 HCPCS Initial Preventive Physical Examination; Face-to-face Visit, Services Limited To… 11 11 $335.00 $284.75 $268.00 $335.00 $301.50 2026-01-15
71045 HCPCS X-ray Of Chest, 1 View 16 11 $332.00 $282.20 $22.10 $332.00 $298.80 2026-01-15
51798 HCPCS Ultrasound Measurement Of Bladder Capacity After Voiding 11 11 $332.00 $282.20 $265.60 $332.00 $298.80 2026-01-15
74021 HCPCS X-ray Of Abdomen, Minimum Of 3 Views 16 11 $331.00 $281.35 $22.10 $331.00 $297.90 2026-01-15
99204 HCPCS New Patient Office Or Other Outpatient Visit With Moderate Level Of Medical Deci… 11 11 $331.00 $281.35 $264.80 $331.00 $297.90 2026-01-15
82131 HCPCS Amino Acid Analysis, Quantitative, Each Specimen 11 11 $330.00 $280.50 $264.00 $330.00 $297.00 2026-01-15
76802 HCPCS Ultrasound Scan Of Pregnant Uterus (less Than 14 Weeks), Each Additional Fetus 16 11 $330.00 $280.50 $149.60 $330.00 $297.00 2026-01-15
73560 HCPCS X-ray Of Knee, 1-2 Views 27 11 $329.00 $279.65 $22.10 $329.00 $296.10 2026-01-15
51702 HCPCS Simple Insertion Of Temporary Bladder Tube 16 11 $327.00 $277.95 $44.20 $327.00 $294.30 2026-01-15
J0878 HCPCS Injection, Daptomycin, 1 Mg 11 11 $326.50 $277.53 $261.20 $326.50 $293.85 2026-01-15
30901 HCPCS Simple Control Of Nose Bleed 27 11 $309.00 $262.65 $102.00 $410.00 $293.55 2026-01-15
G0438 HCPCS Annual Wellness Visit; Includes A Personalized Prevention Plan Of Service (pps),… 11 11 $325.00 $276.25 $260.00 $325.00 $292.50 2026-01-15
72120 HCPCS X-ray Lower And Sacral Spine, 2-3 Views Bending Views 16 11 $325.00 $276.25 $22.10 $325.00 $292.50 2026-01-15
99281 HCPCS Emergency Department Visit For Problem That May Not Require Health Care Professi… 16 11 $325.00 $276.25 $37.40 $325.00 $292.50 2026-01-15
73620 HCPCS X-ray Of Foot, 2 Views 27 11 $324.00 $275.40 $22.10 $324.00 $291.60 2026-01-15
87641 HCPCS Detection Test By Nucleic Acid For Staphylococcus Aureus, Methicillin Resistant … 11 11 $320.00 $272.00 $256.00 $320.00 $288.00 2026-01-15
80074 HCPCS Acute Hepatitis Panel 11 11 $318.00 $270.30 $254.40 $318.00 $286.20 2026-01-15
11750 HCPCS Permanent Removal Fingernail Or Toenail 11 11 $317.00 $269.45 $253.60 $317.00 $285.30 2026-01-15
11421 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 0.6-1… 11 11 $316.00 $268.60 $252.80 $316.00 $284.40 2026-01-15
90837 HCPCS Psychotherapy, 1 Hour 11 11 $311.00 $264.35 $248.80 $311.00 $279.90 2026-01-15
97162 HCPCS Evaluation For Physical Therapy, Typically 30 Minutes 11 11 $311.00 $264.35 $248.80 $311.00 $279.90 2026-01-15
83993 HCPCS Stool Calprotectin (protein) Level 11 11 $310.00 $263.50 $248.00 $310.00 $279.00 2026-01-15
96374 HCPCS Injection Of Drug Or Substance Into Vein 12 11 $310.00 $263.50 $248.00 $310.00 $279.00 2026-01-15
70250 HCPCS X-ray Of Skull, 1-3 Views 16 11 $308.00 $261.80 $22.10 $308.00 $277.20 2026-01-15
87536 HCPCS Detection Test By Nucleic Acid For HIV-1 Virus, Quantification 11 11 $308.00 $261.80 $246.40 $308.00 $277.20 2026-01-15
81206 HCPCS Translocation Analysis (bcr/abl1) Major Breakpoint 11 11 $308.00 $261.80 $246.40 $308.00 $277.20 2026-01-15
405127252 CDM Cs-ortho Glass Splint 3''x15' 11 11 $306.00 $260.10 $244.80 $306.00 $275.40 2026-01-15
86885 HCPCS Red Blood Cell Antibody Detection Test, Indirect 11 11 $305.00 $259.25 $244.00 $305.00 $274.50 2026-01-15
88342 HCPCS Special Stained Specimen Slides To Examine Tissue, Initial Procedure 11 11 $305.00 $259.25 $244.00 $305.00 $274.50 2026-01-15
88365 HCPCS Genetic Sequencing Localization, Initial Procedure 11 11 $305.00 $259.25 $244.00 $305.00 $274.50 2026-01-15
11106 HCPCS Incision Biopsy, First Skin Growth 11 11 $304.00 $258.40 $243.20 $304.00 $273.60 2026-01-15
81240 HCPCS Gene Analysis (prothrombin, Coagulation Factor Ii) A Variant 11 11 $304.00 $258.40 $243.20 $304.00 $273.60 2026-01-15
42809 HCPCS Removal Of Foreign Body In Throat 11 11 $304.00 $258.40 $243.20 $304.00 $273.60 2026-01-15
73120 HCPCS X-ray Of Hand, 2 Views 27 11 $303.00 $257.55 $22.10 $303.00 $272.70 2026-01-15
93005 HCPCS Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing 11 11 $303.00 $257.55 $242.40 $303.00 $272.70 2026-01-15
417040843 CDM Advair Hfa 115-21 Mcg Inhaler 11 11 $302.50 $257.13 $242.00 $302.50 $272.25 2026-01-15
J0666 HCPCS Injection, Bupivacaine Liposome, 1 Mg 11 11 $302.50 $257.13 $242.00 $302.50 $272.25 2026-01-15
Q5105 HCPCS Injection, Epoetin Alfa-epbx, Biosimilar, (retacrit) (for Esrd On Dialysis), 100… 11 11 $302.50 $257.13 $242.00 $302.50 $272.25 2026-01-15
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 11 11 $302.50 $257.13 $242.00 $302.50 $272.25 2026-01-15
J1335 HCPCS Injection, Ertapenem Sodium, 500 Mg 11 11 $302.50 $257.13 $242.00 $302.50 $272.25 2026-01-15
417040466 CDM Prevnar 13 Syringe 11 11 $302.50 $257.13 $242.00 $302.50 $272.25 2026-01-15
90651 HCPCS Human Papillomavirus Vaccine Types 6, 11, 16, 18, 31, 33, 45, 52, 58, Nonavalent 11 11 $301.46 $256.24 $241.17 $301.46 $271.31 2026-01-15
85306 HCPCS Protein S (clotting Inhibitor) Measurement 11 11 $301.00 $255.85 $240.80 $301.00 $270.90 2026-01-15
28190 HCPCS Removal Of Foreign Body Of Foot Tissue, Accessed Beneath The Skin 5 5 $285.00 $242.25 $242.25 $270.75 $270.75 2026-01-15
96522 HCPCS Refilling And Maintenance Of Implantable Pump Or Reservoir For Drug Delivery 12 11 $296.00 $251.60 $236.80 $296.00 $269.36 2026-01-15
73562 HCPCS X-ray Of Knee, 3 Views 27 11 $299.00 $254.15 $22.10 $299.00 $269.10 2026-01-15
90670 HCPCS Pneumococcal Vaccine, 13-valent 22 11 $301.52 $256.29 $214.43 $335.00 $268.02 2026-01-15
73110 HCPCS X-ray Of Wrist, Minimum Of 3 Views 27 11 $282.00 $239.70 $22.10 $322.00 $267.90 2026-01-15
73100 HCPCS X-ray Of Wrist, 2 Views 27 11 $282.00 $239.70 $22.10 $322.00 $267.90 2026-01-15
417040901 CDM Symbicort 160-4.5 Mcg Inhaler 11 11 $297.34 $252.74 $237.87 $297.34 $267.61 2026-01-15
83520 HCPCS Measurement Of Substance Using Immunoassay Technique 22 11 $298.50 $253.72 $220.00 $322.00 $267.48 2026-01-15
81256 HCPCS Gene Analysis (hemochromatosis) Common Variants 11 11 $297.00 $252.45 $237.60 $297.00 $267.30 2026-01-15
80307 HCPCS Testing For Presence Of Drug, By Chemistry Analyzers 11 11 $296.00 $251.60 $236.80 $296.00 $266.40 2026-01-15
J0282 HCPCS Injection, Amiodarone Hydrochloride, 30 Mg 11 11 $294.85 $250.62 $235.88 $294.85 $265.37 2026-01-15
73030 HCPCS X-ray Of Shoulder, Minimum Of 2 Views 27 11 $293.00 $249.05 $22.10 $293.00 $263.70 2026-01-15
70330 HCPCS X-ray Of Jaw Joints On Both Sides Of Mouth 16 11 $292.00 $248.20 $22.10 $292.00 $262.80 2026-01-15
11983 HCPCS Removal With Reinsertion Of Drug Delivery Implant Into Tissue 16 11 $276.00 $234.60 $220.80 $508.25 $262.20 2026-01-15
73080 HCPCS X-ray Of Elbow, Minimum Of 3 Views 27 11 $291.00 $247.35 $22.10 $291.00 $261.90 2026-01-15
73610 HCPCS X-ray Of Ankle, Minimum Of 3 Views 27 11 $290.00 $246.50 $22.10 $290.00 $261.00 2026-01-15
12007 HCPCS Simple Repair Of Surface Wound To Scalp, Neck, Underarms, Trunk, Arms, Or Legs, … 5 5 $274.00 $232.90 $232.90 $260.30 $260.30 2026-01-15
73130 HCPCS X-ray Of Hand, Minimum Of 3 Views 27 11 $288.00 $244.80 $22.10 $288.00 $259.20 2026-01-15
83970 HCPCS Parathormone (parathyroid Hormone) Level 11 11 $288.00 $244.80 $230.40 $288.00 $259.20 2026-01-15
65220 HCPCS Removal Of Foreign Body In Cornea 16 11 $288.00 $244.80 $76.50 $288.00 $259.20 2026-01-15
86156 HCPCS Measurement Of Cold Agglutinin (protein) To Screen For Infection Or Disease 11 11 $288.00 $244.80 $230.40 $288.00 $259.20 2026-01-15
84376 HCPCS Carbohydrate Analysis, Single Qualitative 11 11 $288.00 $244.80 $230.40 $288.00 $259.20 2026-01-15
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