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

FERRY COUNTY MEMORIAL HOSPITAL

Republic, WA · CCN 501322 · Rates published

20,646 distinct procedures filed
31 distinct payers
339,591 rate rows
2026-09-14 last MRF observed
Data quality

67,961 of 339,591 rate rows are consumer-grade (20.0%)

271,630 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 252,441
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 8,437
professional (physician) fee — not the facility price 8,343
per-diem day rate — not a per-procedure price 2,301
percent-of-charges filed in the dollar field — excluded from medians 75
placeholder amount (≤ $0.02) — excluded from medians 18
exceeds 10× this hospital's gross charge — excluded from medians 15
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mrfs.hyvehealthcare.com/FerryCounty/910879683_ferry-county-public-hospital-district-no-1_standardcharges.csv
Found on page https://www.fcphd.org/#Transparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-28
Content fingerprint 3a2ab567ce15b538… · 64,877,978 bytes · first seen 2026-09-28

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
4172834
OTHER 		Tenecteplase 50mg Inj 8 $17,200.00 $40,105.80 $27,499.80 nat. median
$27,500
1.0× median
4173231
OTHER 		Vedolizumab-entyvio 8 $16,678.40 $18,763.20 $18,763.20 nat. median
$18,763
1.0× median
J3380
HCPCS 		Vedolizumab-entyvio 13 $9,631.77 $20,431.04 $18,242.00 nat. median
$168
outlier · 108.9×
4172667
OTHER 		Pegfilgrastim 6mg/0.6ml Inj 8 $12,785.20 $14,383.35 $14,383.35 nat. median
$14,383
1.0× median
J2506
HCPCS 		Pegfilgrastim 6mg/0.6ml Inj 13 $7,383.45 $15,661.87 $13,983.81 nat. median
$1,651
outlier · 8.5×
J3470
HCPCS 		Hyaluronidase 150un Inj 13 $5,985.44 $12,696.39 $11,336.06 nat. median
$100
outlier · 113.1×
Q5111
HCPCS 		Pegfilgrastim-cbqv 6 Mg/0.6 Ml 13 $5,918.22 $12,553.80 $11,208.75 nat. median
$1,974
outlier · 5.7×
J1950
HCPCS 		Leuprolide Inj 13 $5,544.00 $11,760.00 $10,500.00 nat. median
$3,921
outlier · 2.7×
J3101
HCPCS 		Tenecteplase 50 Mg Vial 13 $251.39 $27,489.98 $6,746.40 nat. median
$3,824
1.8× median
43254
CPT 		Egd Endo Mucosal Resection 13 $2,789.53 $5,917.20 $5,283.21 nat. median
$2,371
outlier · 2.2×
G0390
HCPCS 		Trauma Resp Tm W/critcare 15 $3,301.76 $5,719.12 $5,070.56 nat. median
$3,212
1.6× median
4230004
OTHER 		Trauma Resp Tm W/critcare 8 $4,327.02 $4,867.89 $4,867.89 nat. median
$4,868
1.0× median
74178
CPT 		CT Abd/pelvis W/wo Contrast 23 $2,327.04 $6,887.97 $4,835.41 nat. median
$1,024
outlier · 4.7×
54670
CPT 		Suture/repair Testi Injr 23 $655.76 $7,688.10 $4,673.09 nat. median
$3,536
1.3× median
74174
CPT 		CTA Abd/pel W&without Contrast 23 $2,227.19 $7,275.97 $4,627.93 nat. median
$988
outlier · 4.7×
74177
CPT 		CT Abd/pelvis With Contrast 23 $2,236.84 $5,247.70 $4,598.50 nat. median
$972
outlier · 4.7×
72158
CPT 		MRI L-spine W/wo Contrast 23 $2,171.35 $6,673.60 $4,511.91 nat. median
$1,090
outlier · 4.1×
25260
CPT 		Repr Tendn/musl Flx F/arm/wrst 23 $1,054.48 $5,182.24 $4,494.80 nat. median
$3,452
1.3× median
81408
CPT 		Molecular Path Proced Level 9 13 $2,359.89 $5,005.84 $4,469.50 nat. median
$943
outlier · 4.7×
74183
CPT 		MRI Abd W/wo Contrast 23 $2,120.16 $5,224.42 $4,405.54 nat. median
$1,099
outlier · 4.0×
72157
CPT 		MRI T-spine W/wo Contrast 23 $2,117.01 $5,194.35 $4,398.98 nat. median
$1,103
outlier · 4.0×
73720
CPT 		MRI Lo Ext W/wo Jnt W/wo 23 $2,347.42 $4,979.38 $4,374.82 nat. median
$1,125
outlier · 3.9×
72156
CPT 		MRI C-spine W/wo Contrast 23 $2,048.08 $5,011.02 $4,255.76 nat. median
$1,103
outlier · 3.9×
J1451
HCPCS 		Fomepizole 1.5gm/1.5ml 13 $2,221.29 $4,711.84 $4,207.00 nat. median
$1,035
outlier · 4.1×
46040
CPT 		I&d Ischiorect/perirect Abs 23 $703.36 $6,132.34 $4,205.64 nat. median
$1,699
outlier · 2.5×
43247
CPT 		Egd With Fb Removal 23 $2,194.05 $4,688.01 $4,156.38 nat. median
$1,411
outlier · 2.9×
70549
CPT 		MRA Neck W/wo Contrast 23 $1,958.85 $4,827.69 $4,070.35 nat. median
$1,054
outlier · 3.9×
64999
CPT 		Nervous Sys Oth Surg/proc 23 $2,065.60 $4,381.58 $4,044.53 nat. median
$716
outlier · 5.6×
72197
CPT 		MRI Pelvis W/wo Contrast 23 $1,926.75 $4,914.02 $4,003.64 nat. median
$1,063
outlier · 3.8×
73223
CPT 		MRI Up Ext W/jnt W/wo 23 $2,142.60 $4,544.92 $3,942.02 nat. median
$1,158
outlier · 3.4×
70553
CPT 		MRI Brain W/wo Contrast 23 $1,477.93 $6,698.82 $3,867.36 nat. median
$1,132
outlier · 3.4×
4237613
OTHER 		Pf Critical Care Initl 30-74 M 8 $3,429.54 $3,858.23 $3,858.23 nat. median
$3,858
1.0× median
73723
CPT 		MRI Lo Ext W/jnt W/wo 23 $2,051.03 $4,350.68 $3,773.54 nat. median
$1,191
outlier · 3.2×
24101
CPT 		Pf Arthrotomy Elbw W/exp 15 $2,441.60 $4,229.20 $3,749.60 nat. median
$3,504
1.1× median
73220
CPT 		MRI Up Ext Without Jnt W/wo 23 $1,931.69 $4,158.39 $3,686.82 nat. median
$1,128
outlier · 3.3×
59409
CPT 		Pf Vaginal Delivery Only 23 $1,210.67 $6,298.57 $3,658.55 nat. median
$3,155
1.2× median
24000
CPT 		Pf Arthro Elbw Exp/drain/ro Fb 15 $2,369.36 $4,104.07 $3,638.66 nat. median
$3,513
1.0× median
15940
CPT 		Exc Ischial Press Ulcr W/sutre 23 $1,665.83 $4,055.04 $3,590.40 nat. median
$3,050
1.2× median
74176
CPT 		CT Abd/pelvis Wo Contrast 23 $1,778.28 $4,075.94 $3,571.70 nat. median
$694
outlier · 5.2×
72142
CPT 		MRI C Spine Wc 23 $1,703.14 $4,761.73 $3,539.00 nat. median
$972
outlier · 3.6×
70552
CPT 		MRI-brain With Contrast 23 $1,695.54 $4,294.19 $3,523.20 nat. median
$960
outlier · 3.7×
70546
CPT 		MRA Head W/wo Contrast 23 $1,695.54 $4,990.65 $3,523.20 nat. median
$1,068
outlier · 3.3×
4230320
OTHER 		Crit Care Each Add'l 30min 8 $3,083.86 $3,469.34 $3,469.34 nat. median
$3,469
1.0× median
75635
CPT 		CTA Abd Aor/bi Iliofem Lo 23 $1,668.33 $4,099.22 $3,466.67 nat. median
$719
outlier · 4.8×
11047
CPT 		Debride Bone Ea Add 20 Sq Cm 23 $1,161.80 $3,883.20 $3,438.25 nat. median
$941
outlier · 3.7×
26350
CPT 		Pf Repair Flex Tendon Wo Graft 15 $2,206.40 $3,821.80 $3,388.40 nat. median
$3,392
1.0× median
45385
CPT 		Colonoscopy Remove Tpl W/snare 23 $449.68 $5,657.54 $3,350.70 nat. median
$1,672
outlier · 2.0×
72149
CPT 		MRI L Spine W/contrast 23 $1,634.43 $3,800.46 $3,330.30 nat. median
$976
outlier · 3.4×
70496
CPT 		CTA Head (cow) 23 $1,597.93 $3,913.95 $3,320.38 nat. median
$746
outlier · 4.5×
71275
CPT 		CTA Chest 23 $1,597.92 $4,533.78 $3,320.37 nat. median
$753
outlier · 4.4×

Other procedures at this hospital

Browse this hospital's 20,646 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
28825 CPT Amput Interphalangeal Jnt 44 23 $2,540.00 $2,159.00 $1,207.60 $2,561.59 $2,159.00 2026-09-14
26952 CPT Amput W/local Adv Flaps 44 23 $3,804.00 $3,233.40 $577.36 $4,642.73 $3,233.40 2026-09-14
26951 CPT Amputat Fing/thumb Drct Close 29 23 $2,203.00 $1,872.55 $1,233.68 $4,642.73 $2,136.91 2026-09-14
15271 CPT App Epifix Ar/100sqcm 1 25sqcm 44 23 $1,791.24 $1,522.55 $142.80 $3,894.72 $1,567.33 2026-09-14
26070 CPT Arthrotomy W/expl/drain/ro Fb 44 23 $2,281.00 $1,938.85 $1,053.82 $2,235.38 $1,938.85 2026-09-14
81490 CPT Autoimmune Rheumatoid Art Maaa 29 23 $1,472.00 $1,251.20 $680.06 $1,442.56 $1,265.92 2026-09-14
28292 CPT Bunion Procedure 29 23 $2,770.00 $2,354.50 $2,354.50 $9,154.28 $2,659.20 2026-09-14
81223 CPT Cftr Gene Analysis Full Gene 29 23 $2,242.00 $1,905.70 $1,035.80 $2,197.16 $1,928.12 2026-09-14
27810 CPT Closed Bimal Ankle Fx W/man 44 23 $2,903.00 $2,467.55 $1,272.32 $2,924.34 $2,467.55 2026-09-14
25675 CPT Closed Dist Radioulnar W/man 44 23 $2,126.84 $1,807.81 $691.60 $2,381.35 $1,807.81 2026-09-14
25605 CPT Closed Distal Radial Fx W/man 44 23 $2,434.00 $2,068.90 $780.08 $3,006.46 $2,068.90 2026-09-14
24605 CPT Closed Elbow Disloc W/ane 44 23 $2,120.00 $1,802.00 $448.56 $3,047.84 $1,802.00 2026-09-14
23625 CPT Closed Humer Tuber Fx W/man 44 23 $2,508.84 $2,132.51 $582.96 $3,671.45 $2,132.51 2026-09-14
26607 CPT Closed Mc Fx W/man Ext Fixat 44 23 $2,531.00 $2,151.35 $640.64 $3,636.15 $2,151.35 2026-09-14
28475 CPT Closed Metatarsal Fx W/man 44 23 $1,398.00 $1,188.30 $681.52 $1,695.90 $1,188.30 2026-09-14
27266 CPT Closed Post Hip Disloc W/ane 44 23 $1,630.00 $1,385.50 $308.56 $3,494.76 $1,393.65 2026-09-14
27781 CPT Closed Prox Fib/shaft W/man 44 23 $2,089.00 $1,775.65 $661.92 $2,047.53 $1,775.65 2026-09-14
24655 CPT Closed Rad Hd/neck Fx Wo Man 44 23 $1,696.68 $1,442.18 $314.72 $1,820.69 $1,442.17 2026-09-14
25505 CPT Closed Rad Shaft Fx W/man 44 23 $1,554.00 $1,320.90 $611.55 $2,235.85 $1,320.90 2026-09-14
25565 CPT Closed Radial Ulnar Fx W/man 44 23 $2,089.32 $1,775.92 $343.84 $2,822.70 $1,775.92 2026-09-14
23665 CPT Closed Shldr Dis W/fx W/man 44 23 $2,132.00 $1,812.20 $556.08 $2,409.26 $1,812.20 2026-09-14
23655 CPT Closed Shldr Dis W/man W/ane 44 23 $1,835.00 $1,559.75 $948.08 $4,004.54 $1,642.21 2026-09-14
23650 CPT Closed Shldr Disl W/man Wo Ane 44 23 $1,389.00 $1,180.65 $374.08 $1,513.78 $1,180.65 2026-09-14
27752 CPT Closed Tibia Fx W/man W/wo Trc 44 23 $2,150.00 $1,827.50 $965.26 $2,900.30 $1,992.17 2026-09-14
27818 CPT Closed Trimal Ankle Fx W/man 44 23 $2,483.08 $2,110.62 $179.76 $3,533.71 $2,110.61 2026-09-14
24600 CPT Closed Tx Elbow Disloc Wo Ane 44 23 $1,504.00 $1,278.40 $585.24 $1,655.79 $1,278.40 2026-09-14
27502 CPT Closed Tx Femoral Fx W/manip 44 23 $2,477.00 $2,105.45 $695.52 $3,454.80 $2,105.45 2026-09-14
23605 CPT Closed Tx Humeral Fx W/man 44 23 $2,694.00 $2,289.90 $236.88 $5,062.48 $2,303.37 2026-09-14
27762 CPT Closed Tx Inside/shin Bone Ank 59 23 $2,323.00 $1,974.55 $1,227.52 $2,757.99 $2,160.39 2026-09-14
26605 CPT Closed Tx Mc Fx W/man Ea Bone 102 23 $1,364.83 $1,160.11 $612.64 $1,506.09 $1,201.05 2026-09-14
28635 CPT Closed Tx Mtpj Dislc W/anes 44 23 $2,514.87 $2,137.64 $498.96 $4,157.42 $2,200.51 2026-09-14
27562 CPT Closed Tx Patella Dislc W/anes 44 23 $2,094.00 $1,779.90 $905.52 $3,601.97 $1,779.90 2026-09-14
45384 CPT Colon Rm Tpl Hot Bx Forcep 44 23 $3,812.00 $3,240.20 $388.08 $4,865.93 $3,240.20 2026-09-14
44389 CPT Colon Stoma W/bx Single Mult 29 23 $3,873.00 $3,292.05 $859.43 $3,756.81 $2,168.88 2026-09-14
45380 CPT Colon W/bx Single/multi 44 23 $3,832.86 $3,257.93 $354.48 $3,777.18 $3,257.93 2026-09-14
45379 CPT Colon W/removal Fb 44 23 $2,964.00 $2,519.40 $390.88 $4,388.08 $2,519.40 2026-09-14
45381 CPT Colon W/submucosal Inj 44 23 $3,116.00 $2,648.60 $1,008.00 $5,672.86 $2,661.47 2026-09-14
G0121 HCPCS Colonoscopy Mdcr Scrn Nhr 44 23 $1,417.72 $1,205.06 $654.98 $2,672.35 $1,248.10 2026-09-14
45385 CPT Colonoscopy Remove Tpl W/snare 44 23 $3,942.00 $3,350.70 $449.68 $5,657.54 $3,350.70 2026-09-14
4350407 OTHER Colonoscopy Screen High Risk 8 8 $3,593.97 — $2,875.18 $3,234.57 $3,234.57 2026-07-06
G0105 HCPCS Colonoscopy Screen High Risk 44 23 $2,491.36 $2,117.66 $392.56 $3,800.46 $2,155.86 2026-09-14
45382 CPT Colonoscopy W/control Bleed 44 23 $3,427.00 $2,912.95 $422.80 $4,388.08 $2,912.95 2026-09-14
13102 CPT Complex Repair Wnd Add<5cm 29 23 $1,183.00 $1,005.55 $662.48 $2,655.21 $1,147.51 2026-09-14
13151 CPT Complex Repair Wound 1.1-2.5cm 44 23 $1,515.17 $1,287.89 $672.00 $1,811.96 $1,287.89 2026-09-14
13131 CPT Complex Repair Wound 1.1-2.5cm 44 23 $1,420.00 $1,207.00 $646.24 $1,758.35 $1,207.00 2026-09-14
4230320 OTHER Crit Care Each Add'l 30min 8 8 $3,854.82 — $3,083.86 $3,469.34 $3,469.34 2026-07-06
4230319 OTHER Crit Care Each Add'l 30min 8 8 $1,865.61 — $1,492.49 $1,679.05 $1,679.05 2026-07-06
99292 CPT Crit Care Each Add'l 30min 73 23 $1,509.69 $1,283.24 $255.94 $1,972.98 $1,195.67 2026-09-14
74170 CPT CT Abd W/wo Contrast 29 23 $3,332.00 $2,832.20 $1,365.59 $3,232.04 $2,832.20 2026-09-14
74160 CPT CT Abd With Contrast 29 23 $2,843.00 $2,416.55 $1,185.01 $2,757.71 $2,416.55 2026-09-14
74150 CPT CT Abd Without Contrast 29 23 $1,954.00 $1,660.90 $944.36 $2,003.18 $1,737.45 2026-09-14
74178 CPT CT Abd/pelvis W/wo Contrast 29 23 $7,101.00 $6,035.85 $2,327.04 $6,887.97 $4,835.41 2026-09-14
74177 CPT CT Abd/pelvis With Contrast 29 23 $5,410.00 $4,598.50 $2,236.84 $5,247.70 $4,598.50 2026-09-14
74176 CPT CT Abd/pelvis Wo Contrast 29 23 $4,202.00 $3,571.70 $1,778.28 $4,075.94 $3,571.70 2026-09-14
72127 CPT CT Cervical W/wo Contrast 29 23 $4,603.00 $3,912.55 $1,248.88 $4,464.91 $2,649.15 2026-09-14
72126 CPT CT Cervical With Contrast 29 23 $3,541.00 $3,009.85 $1,408.88 $3,434.77 $2,927.55 2026-09-14
72125 CPT CT Cervical Without Contrast 29 23 $2,946.00 $2,504.10 $1,099.05 $2,857.62 $2,283.75 2026-09-14
71260 CPT CT Chest W/contrast Diag 29 23 $3,093.00 $2,629.05 $1,227.16 $3,000.21 $2,549.96 2026-09-14
71270 CPT CT Chest W/wo Contrast Diag 29 23 $3,866.00 $3,286.10 $1,575.45 $3,750.02 $3,273.67 2026-09-14
71250 CPT CT Chest Wo Contrast Diag 29 23 $2,379.00 $2,022.15 $941.69 $2,307.63 $1,956.76 2026-09-14
70482 CPT CT Ear W/wo Contrast 29 23 $3,658.00 $3,109.30 $1,271.95 $3,548.26 $2,643.02 2026-09-14
70481 CPT CT Ear With Contrast 44 23 $2,814.00 $2,391.90 $1,145.39 $2,838.22 $2,405.97 2026-09-14
70480 CPT CT Ear Without Contrast 29 23 $2,165.00 $1,840.25 $923.62 $2,100.05 $1,840.25 2026-09-14
70470 CPT CT Head W/wo Contrast 29 23 $3,546.00 $3,014.10 $1,260.86 $3,439.62 $2,619.97 2026-09-14
70460 CPT CT Head With Contrast 29 23 $2,718.00 $2,310.30 $1,025.58 $2,636.46 $2,131.09 2026-09-14
70450 CPT CT Head Without Contrast 29 23 $2,175.00 $1,848.75 $1,004.85 $2,131.50 $1,870.50 2026-09-14
73702 CPT CT Low Extr W/wo Contrast 29 23 $3,501.00 $2,975.85 $1,427.02 $3,395.97 $2,965.23 2026-09-14
73701 CPT CT Lower Extremity With C 29 23 $2,694.00 $2,289.90 $1,211.65 $2,613.18 $2,316.84 2026-09-14
73700 CPT CT Lower Extremity Withou 29 23 $2,241.00 $1,904.85 $894.90 $2,173.77 $1,859.54 2026-09-14
72132 CPT CT Lumbar With Contrast 29 23 $2,967.00 $2,521.95 $1,494.02 $3,169.15 $2,748.75 2026-09-14
72133 CPT CT Lumbar With/wo Contrast 29 23 $3,857.00 $3,278.45 $1,271.03 $3,741.29 $2,641.10 2026-09-14
72131 CPT CT Lumbar Without Contrast 29 23 $2,468.00 $2,097.80 $1,042.42 $2,393.96 $2,097.80 2026-09-14
70486 CPT CT Maxillofacial Without Contrast 29 23 $2,349.00 $1,996.65 $937.20 $2,278.53 $1,947.44 2026-09-14
70488 CPT CT Maxillofacial W/wo Contrast 29 23 $3,670.00 $3,119.50 $1,171.89 $3,559.90 $2,435.11 2026-09-14
70487 CPT CT Maxillofacial With Contrast 29 23 $2,824.00 $2,400.40 $1,165.16 $2,739.28 $2,400.40 2026-09-14
72194 CPT CT Pelvis W/wo Contrast 29 23 $3,014.00 $2,561.90 $1,051.73 $2,923.58 $2,185.43 2026-09-14
72193 CPT CT Pelvis With Contrast 29 23 $2,963.00 $2,518.55 $1,292.61 $2,874.11 $2,518.55 2026-09-14
72192 CPT CT Pelvis Without Contrast 29 23 $2,279.00 $1,937.15 $1,000.93 $2,210.63 $1,949.86 2026-09-14
70492 CPT CT St Neck W/wo Contrast 29 23 $3,844.00 $3,267.40 $1,204.84 $3,728.68 $2,503.58 2026-09-14
70491 CPT CT St Neck With Contrast 29 23 $3,199.00 $2,719.15 $1,132.76 $3,103.03 $2,353.80 2026-09-14
70490 CPT CT St Neck Without Contrast 29 23 $2,461.00 $2,091.85 $913.22 $2,387.17 $1,897.60 2026-09-14
72128 CPT CT Thoracic Without Contrast 29 23 $2,571.00 $2,185.35 $1,020.86 $2,493.87 $2,121.28 2026-09-14
72129 CPT CT Thoracic With Contrast 29 23 $3,090.00 $2,626.50 $1,324.03 $2,997.30 $2,626.50 2026-09-14
72130 CPT CT Thoracic With/wo Contrast 29 23 $4,016.00 $3,413.60 $1,455.07 $3,895.52 $3,023.53 2026-09-14
73202 CPT CT Up Ext W/wo Contrast 29 23 $3,909.00 $3,322.65 $1,255.27 $3,791.73 $2,608.36 2026-09-14
73200 CPT CT Upper Extremity Without 29 23 $2,502.00 $2,126.70 $882.65 $2,426.94 $1,834.08 2026-09-14
73201 CPT CT Upper Extremity W/contrast 29 23 $3,007.00 $2,555.95 $1,255.14 $2,916.79 $2,555.95 2026-09-14
75635 CPT CTA Abd Aor/bi Iliofem Lo 29 23 $4,226.00 $3,592.10 $1,668.33 $4,099.22 $3,466.67 2026-09-14
74174 CPT CTA Abd/pel W&without Contrast 29 23 $7,501.00 $6,375.85 $2,227.19 $7,275.97 $4,627.93 2026-09-14
74175 CPT CTA Abdomen 29 23 $4,307.00 $3,660.95 $1,546.18 $4,177.79 $3,212.84 2026-09-14
70498 CPT CTA Cartoid 29 23 $4,176.00 $3,549.60 $1,565.00 $4,050.72 $3,251.96 2026-09-14
71275 CPT CTA Chest 29 23 $4,674.00 $3,972.90 $1,597.92 $4,533.78 $3,320.37 2026-09-14
70496 CPT CTA Head (cow) 29 23 $4,035.00 $3,429.75 $1,597.93 $3,913.95 $3,320.38 2026-09-14
73706 CPT CTA Lower Extremity 29 23 $3,818.00 $3,245.30 $1,522.08 $3,703.46 $3,162.77 2026-09-14
72191 CPT CTA Pelvis 29 23 $3,665.00 $3,115.25 $1,403.79 $3,555.05 $2,916.97 2026-09-14
73206 CPT CTA Upper Extremity 29 23 $2,053.00 $1,745.05 $1,149.68 $2,974.28 $1,970.88 2026-09-14
87150 CPT Cult Nuc Acd Amp Prb Cult/isol 29 23 $2,584.00 $2,196.40 $68.14 $2,506.48 $1,447.04 2026-09-14
11044 CPT Debrid Bn Mscl/fascia<20 Sq Cm 73 23 $1,940.00 $1,649.00 $346.91 $4,752.96 $1,668.40 2026-09-14
11047 CPT Debride Bone Ea Add 20 Sq Cm 29 23 $4,045.00 $3,438.25 $1,161.80 $3,883.20 $3,438.25 2026-09-14
11043 CPT Debride Mscle Fascia <20 Sq Cm 88 23 $1,409.00 $1,197.65 $249.76 $3,431.04 $1,280.24 2026-09-14
11010 CPT Debride W/remv Fb Opn Fx/dislc 44 23 $2,018.00 $1,715.30 $673.12 $2,555.17 $1,715.30 2026-09-14
4173270 OTHER Denosumab 120mg 16 8 $3,327.50 — $44.00 $5,940.00 $2,664.75 2026-07-06
55100 CPT Drainage Of Scrotum Abscess 44 23 $2,122.44 $1,804.07 $244.16 $3,504.61 $1,857.13 2026-09-14
93975 CPT Duplex Complete 58 23 $1,606.50 $1,365.53 $638.48 $1,794.38 $1,326.72 2026-09-14
93970 CPT Duplex Extremity Vein Complete 29 23 $1,592.00 $1,353.20 $792.88 $1,681.87 $1,458.77 2026-09-14
93925 CPT Duplex Lower Ext Art Complete 29 23 $1,866.00 $1,586.10 $631.54 $1,810.02 $1,312.29 2026-09-14
93306 CPT Echo Heart Complete 44 23 $2,078.00 $1,766.30 $194.32 $2,278.04 $1,766.30 2026-09-14
4230317 OTHER Ed Facility Level 4 8 8 $1,727.42 — $1,381.94 $1,554.68 $1,554.68 2026-07-06
4230318 OTHER Ed Facility Level 5 8 8 $2,778.69 — $2,222.95 $2,500.82 $2,500.82 2026-07-06
99285 CPT Ed Facility Level 5 58 23 $2,261.72 $1,922.46 $416.08 $2,938.13 $1,563.64 2026-09-14
43254 CPT Egd Endo Mucosal Resection 14 13 $6,037.96 $5,132.27 $2,789.53 $5,917.20 $5,283.21 2026-09-14
43246 CPT Egd Place Gastrostomy Tube 44 23 $2,679.00 $2,277.15 $385.84 $4,866.20 $2,285.61 2026-09-14
43247 CPT Egd With Fb Removal 29 23 $4,833.00 $4,108.05 $2,194.05 $4,688.01 $4,156.38 2026-09-14
43239 CPT Egd W/biopsy Single/mult 44 23 $3,675.00 $3,123.75 $244.16 $4,146.45 $3,123.75 2026-09-14
43255 CPT Egd W/control Of Bleed 44 23 $1,618.28 $1,375.54 $747.60 $3,073.93 $1,415.99 2026-09-14
43250 CPT Egd W/ro Tpl 44 23 $3,284.00 $2,791.40 $1,159.76 $6,231.85 $2,807.82 2026-09-14
43235 CPT Egd-diag Flex W/spec Collect 44 23 $3,430.00 $2,915.50 $216.16 $3,607.40 $2,915.50 2026-09-14
43200 CPT Esophago Flextransoral 44 23 $3,197.00 $2,717.45 $140.56 $3,220.32 $2,717.45 2026-09-14
21930 CPT Exc Back Les Sc <3cm 14 13 $2,124.84 $1,806.11 $981.67 $2,082.34 $1,859.23 2026-09-14
11426 CPT Exc Benign LES+MARG>4cm 44 23 $1,568.00 $1,332.80 $708.54 $2,053.44 $1,480.94 2026-09-14
15940 CPT Exc Ischial Press Ulcr W/sutre 29 23 $4,224.00 $3,590.40 $1,665.83 $4,055.04 $3,590.40 2026-09-14
40810 CPT Exc Les Muc/sub Vst Mth Wo Rpr 87 23 $4,676.36 $3,974.91 $205.52 $5,744.34 $2,647.64 2026-09-14
11642 CPT Exc Mal Les+marg1.1-2cm 44 23 $1,422.00 $1,208.70 $594.13 $4,826.59 $1,270.04 2026-09-14
11643 CPT Exc Mal Les+marg2.1-3cm 44 23 $1,775.00 $1,508.75 $750.28 $4,039.58 $1,594.51 2026-09-14
11644 CPT Exc Mal Les+marg3.1-4cm 44 23 $2,152.00 $1,829.20 $854.33 $3,129.79 $1,893.76 2026-09-14
26111 CPT Exc Tumor HAND/FING<1.5cm 44 23 $2,342.00 $1,990.70 $981.67 $4,087.68 $2,095.07 2026-09-14
28090 CPT Excise Les Tndn Sheath/cap Ft 44 23 $2,132.00 $1,812.20 $868.00 $2,089.36 $1,812.20 2026-09-14
19120 CPT Excision Cyst 1+ Lesion 35 23 $1,764.00 $1,499.40 $987.84 $8,410.78 $1,693.44 2026-09-14
25111 CPT Excision Ganglion Wrist Prim 44 23 $1,873.00 $1,592.05 $1,036.15 $7,066.53 $1,601.41 2026-09-14
11770 CPT Excision Pilonidal Cyst Simple 44 23 $1,795.00 $1,525.75 $660.58 $7,513.92 $1,579.60 2026-09-14
45399 CPT Excisional Laparo Proc Rectum 29 23 $2,017.00 $1,714.45 $931.85 $1,976.66 $1,734.62 2026-09-14
20103 CPT Exp Penetrate Wnd Extremity 44 23 $2,610.96 $2,219.32 $954.24 $2,910.97 $2,219.31 2026-09-14
J1439 HCPCS Ferric Carboxymaltose 42 13 $2,964.72 $2,520.01 $1,363.87 $2,940.00 $2,603.44 2026-09-14
10005 CPT Fine Needle Bx W/us 1st Les 102 23 $1,806.00 $1,535.10 $97.48 $2,228.75 $1,244.60 2026-09-14
J1451 HCPCS Fomepizole 1.5gm/1.5ml 14 13 $4,808.00 $4,086.80 $2,221.29 $4,711.84 $4,207.00 2026-09-14
46255 CPT Hemorrhoidectomy, I & E 44 23 $1,523.00 $1,294.55 $579.04 $3,642.46 $1,378.32 2026-09-14
4173315 OTHER Hyaluronate Sod Inj (Monovisc) 8 8 $3,074.50 — $2,459.60 $2,767.05 $2,767.05 2026-07-06
J7327 HCPCS Hyaluronate Sod Inj (monovisc) 14 13 $3,074.50 $2,613.33 $1,420.41 $3,013.01 $2,690.19 2026-09-14
J3470 HCPCS Hyaluronidase 150un Inj 14 13 $12,955.50 $11,012.18 $5,985.44 $12,696.39 $11,336.06 2026-09-14
23930 CPT I&d Arm/elbow Deep Abscess 44 23 $1,398.00 $1,188.30 $314.72 $1,936.48 $1,188.30 2026-09-14
27301 CPT I&d Deep Abs/burs Thgh/knee 102 23 $2,193.00 $1,864.05 $1,013.16 $3,533.58 $1,994.99 2026-09-14
46040 CPT I&d Ischiorect/perirect Abs 44 23 $4,947.82 $4,205.65 $703.36 $6,132.34 $4,205.64 2026-09-14
27603 CPT I&d Leg/ankle Deep Abs/hema 44 23 $2,006.00 $1,705.10 $1,123.36 $3,533.58 $1,705.10 2026-09-14
87633 CPT Iadna Resp Prb Rev Trnscr12-25 29 23 $1,573.00 $1,337.05 $726.72 $1,541.54 $1,352.78 2026-09-14
88377 CPT Incyte Morphometric Analysis 29 23 $1,635.00 $1,389.75 $755.37 $1,602.30 $1,406.10 2026-09-14
4050806 CDM Infovac Wound Care 15 15 $3,133.00 $2,663.05 $1,754.48 $3,039.01 $2,694.38 2025-07-01
64420 CPT Inj Ane 1 Intercostal Nerve 74 23 $1,751.00 $1,488.35 $90.16 $2,785.92 $1,488.35 2026-09-14
36556 CPT Insert Non-tunn Cent Cath>5y 87 23 $2,284.00 $1,941.40 $399.63 $3,416.81 $1,937.65 2026-09-14
36555 CPT Insert Of Cent Veno Acc Device 44 23 $3,060.00 $2,601.00 $119.28 $4,154.57 $2,601.00 2026-09-14
36558 CPT Insrt Tunnl Cent Cath Wo Prt<5 59 23 $2,132.00 $1,812.20 $738.08 $2,687.87 $1,642.75 2026-09-14
12045 CPT Inter Repair Wnd 12.6-20cm 44 23 $1,378.00 $1,171.30 $427.84 $1,404.34 $1,171.30 2026-09-14
12046 CPT Inter Repair Wnd 20.1-30cm 44 23 $1,561.00 $1,326.85 $492.24 $1,589.96 $1,326.85 2026-09-14
12054 CPT Inter Repair Wnd 7.6-12.5cm 44 23 $1,365.33 $1,160.53 $456.96 $1,451.12 $1,160.53 2026-09-14
12035 CPT Inter Repair Wnd12.6-20cm 44 23 $1,360.00 $1,156.00 $662.04 $1,404.34 $1,203.30 2026-09-14
71271 CPT Ldct Lung Cancer Screen 29 23 $2,353.00 $2,000.05 $298.17 $2,282.41 $1,317.68 2026-09-14
J1950 HCPCS Leuprolide Inj 14 13 $12,000.00 $10,200.00 $5,544.00 $11,760.00 $10,500.00 2026-09-14
19020 CPT Mastotomy Exp/drain Absc Deep 44 23 $2,313.00 $1,966.05 $1,152.28 $2,444.23 $1,966.05 2026-09-14
81408 CPT Molecular Path Proced Level 9 14 13 $5,108.00 $4,341.80 $2,359.89 $5,005.84 $4,469.50 2026-09-14
74185 CPT MRA Abd 29 23 $3,352.00 $2,849.20 $1,376.21 $3,251.44 $2,849.20 2026-09-14
71555 CPT MRA Chest 29 23 $3,354.00 $2,850.90 $1,651.69 $3,503.59 $3,038.83 2026-09-14
70544 CPT MRA Head Without Contrast 29 23 $3,567.00 $3,031.95 $1,695.54 $3,596.60 $3,119.50 2026-09-14
70546 CPT MRA Head W/wo Contrast 29 23 $5,145.00 $4,373.25 $1,695.54 $4,990.65 $3,523.20 2026-09-14
73725 CPT MRA Low Ext 29 23 $3,585.00 $3,047.25 $1,577.32 $3,477.45 $3,072.70 2026-09-14
70547 CPT MRA Neck Without Contrast 29 23 $3,191.00 $2,712.35 $1,477.93 $3,135.02 $2,744.26 2026-09-14
70549 CPT MRA Neck W/wo Contrast 29 23 $4,977.00 $4,230.45 $1,958.85 $4,827.69 $4,070.35 2026-09-14
72198 CPT MRA Pelvis 29 23 $3,354.00 $2,850.90 $1,484.79 $3,253.38 $2,884.44 2026-09-14
74181 CPT MRI Abd Without Contrast 29 23 $3,334.00 $2,833.90 $1,437.25 $3,233.98 $2,833.90 2026-09-14
74183 CPT MRI Abd W/wo Contrast 29 23 $5,386.00 $4,578.10 $2,120.16 $5,224.42 $4,405.54 2026-09-14
70551 CPT MRI Brain Without Contrast 29 23 $3,971.00 $3,375.35 $1,304.68 $3,851.87 $2,711.04 2026-09-14
70553 CPT MRI Brain W/wo Contrast 29 23 $6,906.00 $5,870.10 $1,477.93 $6,698.82 $3,867.36 2026-09-14
72142 CPT MRI C Spine Wc 29 23 $4,909.00 $4,172.65 $1,703.14 $4,761.73 $3,539.00 2026-09-14
72141 CPT MRI C-spine Without Contrast 29 23 $4,018.00 $3,415.30 $1,414.11 $3,897.46 $2,938.42 2026-09-14
72156 CPT MRI C-spine W/wo Contrast 29 23 $5,166.00 $4,391.10 $2,048.08 $5,011.02 $4,255.76 2026-09-14
71550 CPT MRI Chest Without Contrast 29 23 $3,359.00 $2,855.15 $1,695.54 $3,596.60 $3,119.50 2026-09-14
71552 CPT MRI Chest W/wo Contrast 29 23 $5,038.00 $4,282.30 $1,477.93 $4,886.86 $3,071.04 2026-09-14
72149 CPT MRI L Spine W/contrast 29 23 $3,918.00 $3,330.30 $1,634.43 $3,800.46 $3,330.30 2026-09-14
72148 CPT MRI L-spine Without Contrast 29 23 $4,248.00 $3,610.80 $1,427.61 $4,120.56 $2,966.46 2026-09-14
72158 CPT MRI L-spine W/wo Contrast 29 23 $6,880.00 $5,848.00 $2,171.35 $6,673.60 $4,511.91 2026-09-14
73718 CPT MRI Lo Ex Without Jnt Without 29 23 $3,612.00 $3,070.20 $1,337.27 $3,503.64 $2,778.75 2026-09-14
73721 CPT MRI Lo Ext W/jnt Without 29 23 $3,368.00 $2,862.80 $1,556.01 $3,300.64 $2,896.48 2026-09-14
73723 CPT MRI Lo Ext W/jnt W/wo 29 23 $4,362.00 $3,707.70 $2,051.03 $4,350.68 $3,773.54 2026-09-14
73720 CPT MRI Lo Ext W/wo Jnt W/wo 29 23 $5,087.00 $4,323.95 $2,347.42 $4,979.38 $4,374.82 2026-09-14
70540 CPT MRI Orb/face/neck Without Con 29 23 $2,526.00 $2,147.10 $1,368.31 $2,902.47 $2,424.96 2026-09-14
70543 CPT MRI Orb/face/neck W/wo 29 23 $4,466.00 $3,796.10 $1,304.68 $4,332.02 $2,711.04 2026-09-14
72195 CPT MRI Pelvis Without Contrast 29 23 $3,413.00 $2,901.05 $1,392.04 $3,310.61 $2,892.56 2026-09-14
72197 CPT MRI Pelvis W/wo Contrast 29 23 $5,066.00 $4,306.10 $1,926.75 $4,914.02 $4,003.64 2026-09-14
72146 CPT MRI T-spine Without Contrast 29 23 $3,790.00 $3,221.50 $1,430.85 $3,676.30 $2,973.19 2026-09-14
72157 CPT MRI T-spine W/wo Contrast 29 23 $5,355.00 $4,551.75 $2,117.01 $5,194.35 $4,398.98 2026-09-14
70336 CPT MRI Temporo Joint 29 23 $3,000.00 $2,550.00 $1,314.72 $2,910.00 $2,561.14 2026-09-14
73221 CPT MRI Up Ext W/jnt Without Cont 29 23 $3,761.00 $3,196.85 $1,323.05 $3,648.17 $2,749.20 2026-09-14
73223 CPT MRI Up Ext W/jnt W/wo 29 23 $4,568.00 $3,882.80 $2,142.60 $4,544.92 $3,942.02 2026-09-14
73220 CPT MRI Up Ext Without Jnt W/wo 29 23 $4,287.00 $3,643.95 $1,931.69 $4,158.39 $3,686.82 2026-09-14
73218 CPT MRI Up Ext Wo Jnt Wo Cont 29 23 $3,397.00 $2,887.45 $1,327.56 $3,295.09 $2,758.57 2026-09-14
70552 CPT MRI-brain With Contrast 29 23 $4,427.00 $3,762.95 $1,695.54 $4,294.19 $3,523.20 2026-09-14
64421 CPT Mult Nerve Blck Inj Rib Nerve 88 23 $1,845.90 $1,569.01 $38.08 $4,757.74 $1,469.56 2026-09-14
64999 CPT Nervous Sys Oth Surg/proc 44 23 $4,471.00 $3,800.35 $2,065.60 $4,381.58 $4,044.53 2026-09-14
81503 CPT Onco Biochemi Assay 5 Prt 29 23 $2,584.00 $2,196.40 $1,193.80 $2,532.32 $2,222.24 2026-09-14
49083 CPT Paracentesis Abdominal W/image 74 23 $1,876.80 $1,595.28 $123.76 $2,544.96 $1,595.28 2026-09-14
49082 CPT Paracentesis-abd Without Guid 102 23 $1,638.52 $1,392.74 $139.44 $2,241.67 $1,304.63 2026-09-14
4172667 OTHER Pegfilgrastim 6mg/0.6ml Inj 8 8 $15,981.50 — $12,785.20 $14,383.35 $14,383.35 2026-07-06
J2506 HCPCS Pegfilgrastim 6mg/0.6ml Inj 14 13 $15,981.50 $13,584.28 $7,383.45 $15,661.87 $13,983.81 2026-09-14
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6 Ml 14 13 $12,810.00 $10,888.50 $5,918.22 $12,553.80 $11,208.75 2026-09-14
24000 CPT Pf Arthro Elbw Exp/drain/ro Fb 15 15 $4,231.00 $3,596.35 $2,369.36 $4,104.07 $3,638.66 2026-09-14
25040 CPT Pf Arthro W Exp/drain/ro Fb 15 15 $3,442.00 $2,925.70 $1,927.52 $3,338.74 $2,960.12 2026-09-14
26075 CPT Pf Arthro W/exp/drain/ro Fb 15 15 $2,117.00 $1,799.45 $1,185.52 $2,053.49 $1,820.62 2026-09-14
24101 CPT Pf Arthrotomy Elbw W/exp 15 15 $4,360.00 $3,706.00 $2,441.60 $4,229.20 $3,749.60 2026-09-14
26080 CPT Pf Arthrotomy-interphalangea 15 15 $1,959.00 $1,665.15 $1,097.04 $1,900.23 $1,684.74 2026-09-14
31635 CPT Pf Bronchoscopy W/fb Remove 15 15 $3,166.00 $2,691.10 $1,772.96 $3,071.02 $2,722.76 2026-09-14
25624 CPT Pf Close Carp Scaphod Fx W/man 15 15 $2,147.00 $1,824.95 $1,202.32 $2,082.59 $1,846.42 2026-09-14
24500 CPT Pf Close Humer Shaft Fx Wo Man 15 15 $1,484.00 $1,261.40 $831.04 $1,439.48 $1,276.24 2026-09-14
23545 CPT Pf Closed Ac Disloc Wo Man 44 23 $1,367.00 $1,161.95 $420.00 $1,535.42 $1,161.95 2026-09-14
27842 CPT Pf Closed Ankle Disloc W/ane 15 15 $1,918.00 $1,630.30 $1,074.08 $1,860.46 $1,649.48 2026-09-14
27760 CPT Pf Closed Ankle Fx Wo Man 15 15 $1,484.00 $1,261.40 $831.04 $1,439.48 $1,276.24 2026-09-14
27808 CPT Pf Closed Bimal Ank Fx Wo Man 15 15 $1,668.00 $1,417.80 $934.08 $1,617.96 $1,434.48 2026-09-14
25635 CPT Pf Closed Carpal Fx W/man 15 15 $2,036.00 $1,730.60 $1,140.16 $1,974.92 $1,750.96 2026-09-14
23505 CPT Pf Closed Clavicular Fx W/man 15 15 $1,652.00 $1,404.20 $925.12 $1,602.44 $1,420.72 2026-09-14
26432 CPT Pf Closed Dis Tendn W/wo Pin 15 15 $2,210.00 $1,878.50 $1,237.60 $2,143.70 $1,900.60 2026-09-14
27788 CPT Pf Closed Distal Fib Fx W/man 102 23 $1,316.00 $1,118.60 $485.26 $2,744.00 $1,209.03 2026-09-14
27786 CPT Pf Closed Distal Fib Fx Wo Man 15 15 $1,416.00 $1,203.60 $792.96 $1,373.52 $1,217.76 2026-09-14
23620 CPT Pf Closed Grt Humer Fx Wo Man 15 15 $1,332.00 $1,132.20 $745.92 $1,292.04 $1,145.52 2026-09-14
25560 CPT Pf Closed Rad Ulnar Fx Wo Man 15 15 $1,360.00 $1,156.00 $761.60 $1,319.20 $1,169.60 2026-09-14
24675 CPT Pf Closed Ulnar Fx Prox W/man 15 15 $1,940.00 $1,649.00 $1,086.40 $1,881.80 $1,668.40 2026-09-14
4350192 OTHER Pf Colnscpy Mdcr Scrn Nhr 8 8 $2,527.28 — $2,021.82 $2,274.55 $2,274.55 2026-07-06
45378 CPT Pf Colon Diag Flex/spec Coll 44 23 $3,591.00 $3,052.35 $326.48 $3,564.62 $3,052.35 2026-09-14
45390 CPT Pf Colonoscopy W/resection 44 23 $2,670.00 $2,269.50 $535.36 $3,377.93 $2,269.50 2026-09-14
4237614 OTHER Pf Critical Care Add'l 30 M 8 8 $1,509.02 — $1,207.22 $1,358.12 $1,358.12 2026-07-06
4237613 OTHER Pf Critical Care Initl 30-74 M 8 8 $4,286.92 — $3,429.54 $3,858.23 $3,858.23 2026-07-06
99291 CPT Pf Critical Care Initl 30-74 M 59 23 $4,202.00 $3,571.70 $554.40 $4,532.81 $2,353.12 2026-09-14
26025 CPT Pf Drain Palmar Bursa Sin 15 15 $2,434.00 $2,068.90 $1,363.04 $2,360.98 $2,093.24 2026-09-14
11444 CPT Pf Ex Benign Les+marg3.1-4cm 15 15 $1,342.00 $1,140.70 $751.52 $1,301.74 $1,154.12 2026-09-14
11450 CPT Pf Ex Hidradenitis Axi W/rpr 15 15 $1,976.00 $1,679.60 $1,106.56 $1,916.72 $1,699.36 2026-09-14
11446 CPT Pf Exc Benign Les+marg >4cm 15 15 $1,813.00 $1,541.05 $1,015.28 $1,758.61 $1,559.18 2026-09-14
11451 CPT Pf Exc Hidradeni Axi Cmp Rpr 15 15 $2,476.00 $2,104.60 $1,386.56 $2,401.72 $2,129.36 2026-09-14
11623 CPT Pf Exc Mal Les+marg2.1-3cm 15 15 $1,420.00 $1,207.00 $795.20 $1,377.40 $1,221.20 2026-09-14
11624 CPT Pf Exc Mal Les+marg3.1-4cm 15 15 $1,734.00 $1,473.90 $971.04 $1,681.98 $1,491.24 2026-09-14
11646 CPT Pf Exc Mal LES+MARG>4cm 15 15 $2,792.00 $2,373.20 $1,563.52 $2,708.24 $2,401.12 2026-09-14
11626 CPT Pf Exc Mal LES+MARG>4cm 15 15 $2,118.00 $1,800.30 $1,186.08 $2,054.46 $1,821.48 2026-09-14
11606 CPT Pf Exc Mal LES+MARG>4cm 15 15 $1,745.00 $1,483.25 $977.20 $1,692.65 $1,500.70 2026-09-14
11772 CPT Pf Excis Pilonidal Cyst Compl 15 15 $3,266.00 $2,776.10 $1,828.96 $3,168.02 $2,808.76 2026-09-14
11771 CPT Pf Excis Pilonidal Cyst Exten 15 15 $2,830.00 $2,405.50 $1,584.80 $2,745.10 $2,433.80 2026-09-14
26116 CPT Pf Excis Tmr HAND/FING<1.5cm 15 15 $2,535.00 $2,154.75 $1,419.60 $2,458.95 $2,180.10 2026-09-14
24105 CPT Pf Excision Olecranon Bursa 15 15 $2,293.00 $1,949.05 $1,284.08 $2,224.21 $1,971.98 2026-09-14
24076 CPT Pf Excision Tmr ARM/ELBW<5cm 15 15 $2,667.00 $2,266.95 $1,493.52 $2,586.99 $2,293.62 2026-09-14
21555 CPT Pf Excision Tmr SUBCUT<3cm 15 15 $2,718.00 $2,310.30 $1,522.08 $2,636.46 $2,337.48 2026-09-14
25028 CPT Pf I&d Fore/wrist Deep Abscess 15 15 $1,828.00 $1,553.80 $1,023.68 $1,773.16 $1,572.08 2026-09-14
46060 CPT Pf Incision Of Rec Absces 15 15 $3,749.00 $3,186.65 $2,099.44 $3,636.53 $3,224.14 2026-09-14
12055 CPT Pf Inter Repair Wnd12.6-20cm 15 15 $1,945.00 $1,653.25 $1,089.20 $1,886.65 $1,672.70 2026-09-14
12056 CPT Pf Inter Repair Wnd20.1-30cm 15 15 $2,538.00 $2,157.30 $1,421.28 $2,461.86 $2,182.68 2026-09-14
12036 CPT Pf Inter Repair Wnd20.1-30cm 15 15 $1,583.00 $1,345.55 $886.48 $1,535.51 $1,361.38 2026-09-14
12057 CPT Pf Inter Repair WND>30cm 15 15 $2,970.00 $2,524.50 $1,663.20 $2,880.90 $2,554.20 2026-09-14
12047 CPT Pf Inter Repair WND>30cm 15 15 $1,880.00 $1,598.00 $1,052.80 $1,823.60 $1,616.80 2026-09-14
12037 CPT Pf Inter Repair WND>30cm 15 15 $1,776.00 $1,509.60 $994.56 $1,722.72 $1,527.36 2026-09-14
31237 CPT Pf Nasal/sinus Endoscopy W/b 15 15 $1,828.00 $1,553.80 $1,023.68 $1,773.16 $1,572.08 2026-09-14
26765 CPT Pf Open Distal Phalange Fx 29 23 $1,841.00 $1,564.85 $632.94 $1,785.77 $1,315.20 2026-09-14
11762 CPT Pf Reconstruct Nailbed W/graft 15 15 $1,695.00 $1,440.75 $949.20 $1,644.15 $1,457.70 2026-09-14
69205 CPT Pf Remove Fb Ext Auditry Canal 44 23 $3,047.04 $2,589.98 $173.04 $3,130.19 $2,589.98 2026-09-14
26433 CPT Pf Repair Exten Tendn Wo Graft 15 15 $2,561.00 $2,176.85 $1,434.16 $2,484.17 $2,202.46 2026-09-14
26350 CPT Pf Repair Flex Tendon Wo Graft 15 15 $3,940.00 $3,349.00 $2,206.40 $3,821.80 $3,388.40 2026-09-14
26591 CPT Pf Repair Intrinsic Muscle Hd 15 15 $2,702.00 $2,296.70 $1,513.12 $2,620.94 $2,323.72 2026-09-14
26410 CPT Pf Repr Ext Tendn Hd Wo F Graf 15 15 $2,147.00 $1,824.95 $1,202.32 $2,082.59 $1,846.42 2026-09-14
36589 CPT Pf Rmvl Tun Cvc Without Port/pmp 14 13 $1,714.00 $1,456.90 $791.86 $1,679.72 $1,499.75 2026-09-14
24201 CPT Pf Ro Fb Arm/elbow Subq Deep 15 15 $1,986.00 $1,688.10 $1,112.16 $1,926.42 $1,707.96 2026-09-14
11463 CPT Pf Ro Swgl Les, Ing, Comp 15 15 $2,232.00 $1,897.20 $1,249.92 $2,165.04 $1,919.52 2026-09-14
11462 CPT Pf Ro Swgl Les, Ing, Simp 15 15 $1,833.00 $1,558.05 $1,026.48 $1,778.01 $1,576.38 2026-09-14
11471 CPT Pf Ro Swgl Les, P/u, Comp 15 15 $2,429.00 $2,064.65 $1,360.24 $2,356.13 $2,088.94 2026-09-14
11470 CPT Pf Ro Swgl Les, P/u, Simp 15 15 $2,132.00 $1,812.20 $1,193.92 $2,068.04 $1,833.52 2026-09-14
13160 CPT Pf Sec Close/dehis Wnd Complx 15 15 $3,160.00 $2,686.00 $1,769.60 $3,065.20 $2,717.60 2026-09-14
12016 CPT Pf Simp Repair Sf Wnd12.6-20cm 15 15 $1,327.00 $1,127.95 $743.12 $1,287.19 $1,141.22 2026-09-14
11011 CPT Pf Skn Sc Tiss Mscl Fasci/mscl 15 15 $2,385.00 $2,027.25 $1,335.60 $2,313.45 $2,051.10 2026-09-14
31603 CPT Pf Tracheostomy 15 15 $2,827.00 $2,402.95 $1,583.12 $2,742.19 $2,431.22 2026-09-14
59409 CPT Pf Vaginal Delivery Only 88 23 $4,855.00 $4,126.75 $1,210.67 $6,298.57 $3,658.55 2026-09-14
36569 CPT Picc Mid/line Insertion 74 23 $1,383.00 $1,175.55 $571.20 $2,264.97 $1,297.17 2026-09-14
45300 CPT Proctosigmoidoscopy 44 23 $2,049.00 $1,741.65 $259.28 $2,589.39 $1,741.65 2026-09-14
90675 CPT Rabies Pcec Vaccine For Inj 14 13 $1,401.50 $1,191.28 $647.49 $1,373.47 $1,226.31 2026-09-14
75989 CPT Radiological Guidance 29 23 $1,484.00 $1,261.40 $831.04 $1,964.06 $1,424.64 2026-09-14
36590 CPT Rem Central Line W Pump 44 23 $3,776.00 $3,209.60 $2,114.56 $4,901.09 $3,209.60 2026-09-14
26418 CPT Repair Ex Tendon Fing Wo Graft 44 23 $2,037.00 $1,731.45 $708.40 $2,020.51 $1,731.45 2026-09-14
11760 CPT Repair Of Nail Bed 44 23 $2,130.93 $1,811.29 $185.36 $2,627.73 $1,811.29 2026-09-14
25260 CPT Repr Tendn/musl Flx F/arm/wrst 44 23 $5,288.00 $4,494.80 $1,054.48 $5,182.24 $4,494.80 2026-09-14
11406 CPT Ro Skin Lesion, Over 4cm 44 23 $1,533.64 $1,303.59 $708.54 $2,053.44 $1,341.93 2026-09-14
35207 CPT Rpr Blood Ves; Hand, Finger 44 23 $3,311.00 $2,814.35 $454.16 $4,735.47 $2,814.35 2026-09-14
45335 CPT Sigmoid. With Dir Submucosal Inj 74 23 $2,007.00 $1,705.95 $395.36 $2,153.84 $1,223.80 2026-09-14
45331 CPT Sigmoidoscopy And Biopsy 74 23 $3,030.00 $2,575.50 $117.04 $4,681.10 $2,259.35 2026-09-14
12018 CPT Simple Repair Sf Wound >30cm 44 23 $1,223.00 $1,039.55 $565.02 $1,916.72 $1,161.85 2026-09-14
11012 CPT Skin Sc Tissue Mf/muscle/bone 44 23 $3,685.52 $3,132.69 $1,702.71 $4,330.08 $3,132.69 2026-09-14
54670 CPT Suture/repair Testi Injr 88 23 $6,237.47 $5,301.84 $655.76 $7,688.10 $4,673.09 2026-09-14
J3101 HCPCS Tenecteplase 50 Mg Vial 28 13 $14,297.57 $12,152.93 $251.39 $27,489.98 $6,746.40 2026-09-14
4172834 OTHER Tenecteplase 50mg Inj 16 8 $33,031.00 — $17,200.00 $40,105.80 $27,499.80 2026-07-06
32551 CPT Thoracostomy 44 23 $2,151.00 $1,828.35 $903.28 $2,169.67 $1,828.35 2026-09-14
J3246 HCPCS Tirofiban 12.5mg/250ml Inj 14 13 $1,937.50 $1,646.88 $895.12 $1,898.75 $1,695.31 2026-09-14
J3290 HCPCS Tranexamic Acid 1000mg/10ml 28 13 $2,755.50 $2,342.17 $16.63 $5,365.50 $1,282.36 2026-09-14
36430 CPT Transfus Bld/bld Compon 52 23 $1,584.00 $1,346.40 $731.80 $2,030.40 $1,446.90 2026-09-14
G0390 HCPCS Trauma Resp Tm W/critcare 15 15 $5,896.00 $5,011.60 $3,301.76 $5,719.12 $5,070.56 2026-09-14
4230004 OTHER Trauma Resp Tm W/critcare 8 8 $5,408.77 — $4,327.02 $4,867.89 $4,867.89 2026-07-06
59812 CPT Tx Incomplete Ab Any Tri 74 23 $3,880.56 $3,298.48 $473.76 $5,698.75 $3,298.47 2026-09-14
43251 CPT Upper Gastro Endo W/ro By 44 23 $2,613.00 $2,221.05 $831.37 $2,721.82 $2,221.05 2026-09-14
43243 CPT Upper Gi Endoscpy W Inj. 44 23 $3,802.00 $3,231.70 $1,263.92 $4,141.95 $3,231.70 2026-09-14
J2598 HCPCS Vasopressin 20 Unit/ml Vial 28 13 $2,745.00 $2,333.25 $6.93 $5,365.50 $1,272.08 2026-09-14
4173231 OTHER Vedolizumab-entyvio 8 8 $20,848.00 — $16,678.40 $18,763.20 $18,763.20 2026-07-06
J3380 HCPCS Vedolizumab-entyvio 14 13 $20,848.00 $17,720.80 $9,631.77 $20,431.04 $18,242.00 2026-09-14
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