Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

MID VALLEY HOSPITAL & CLINIC

Omak, WA · CCN 501328 · Rates published

20,161 distinct procedures filed
11 distinct payers
551,214 rate rows
2026-03-30 last MRF observed
Data quality

373,023 of 551,214 rate rows are consumer-grade (67.7%)

178,191 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
professional (physician) fee — not the facility price 103,326
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 73,181
placeholder amount (≤ $0.02) — excluded from medians 1,682
exceeds 10× this hospital's gross charge — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mid-valley.goredde.com/Estimator/Files/91-0750229_Mid-Valley_Hospital_standardcharges.csv
Found on page https://mid-valley.goredde.com/Estimator/Location.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint ee3a63934118e743… · 140,302,930 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
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 11 $2,188,750.00 $2,232,525.00 $2,210,637.50 nat. median
$2,469,189
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 11 $508,800.00 $508,800.00 $508,800.00 nat. median
$754,974
0.7× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 11 $474,300.00 $474,300.00 $474,300.00 nat. median
$675,122
0.7× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 11 $466,400.10 $466,400.10 $466,400.10 nat. median
$625,184
0.7× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 11 $456,171.54 $456,171.54 $456,171.54 nat. median
$674,188
0.7× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 11 $410,970.00 $448,752.40 $429,861.20 nat. median
$620,080
0.7× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 11 $410,970.00 $432,480.00 $421,725.00 nat. median
$634,511
0.7× median
Q0480
HCPCS 		Dme Pos 11 $60,121.57 $99,999.91 $80,060.74 nat. median
$111,989
0.7× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 11 $63,005.77 $70,418.21 $68,871.20 nat. median
$62,507
1.1× median
E0766
HCPCS 		Dme Pos 11 $11,955.86 $113,457.59 $62,706.72 nat. median
$16,785
outlier · 3.7×
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 11 $61,200.00 $61,200.00 $61,200.00 nat. median
$69,774
0.9× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 11 $50,311.63 $63,657.39 $56,984.51 nat. median
$66,682
0.9× median
90288
CPT 		Botulism Ig IV 11 $48,705.00 $48,705.00 $48,705.00 nat. median
$55,037
0.9× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 11 $38,268.11 $57,294.42 $47,781.26 nat. median
$76,377
0.6× median
J9226
HCPCS 		Supprelin La Implant 11 $41,645.55 $49,164.61 $45,405.08 nat. median
$60,368
0.8× median
L7181
HCPCS 		Dme Pos 11 $30,680.38 $57,069.24 $41,035.38 nat. median
$50,598
0.8× median
L7180
HCPCS 		Dme Pos 11 $28,576.68 $53,156.12 $38,221.67 nat. median
$49,027
0.8× median
L8688
HCPCS 		Implt Nrostm Pls Gen Dua Non 11 $5,323.27 $59,297.63 $32,310.45 nat. median
$12,140
outlier · 2.7×
L2006
HCPCS 		Dme Pos 11 $29,507.32 $30,964.47 $30,235.90 nat. median
$39,823
0.8× median
L8687
HCPCS 		Implt Nrostm Pls Gen Dua Rec 11 $8,342.54 $49,312.82 $28,827.68 nat. median
$14,605
2.0× median
J9266
HCPCS 		Pegaspargase Injection 11 $21,544.13 $28,359.61 $24,951.87 nat. median
$34,109
0.7× median
L5856
HCPCS 		Dme Pos 11 $18,381.43 $34,191.69 $24,585.38 nat. median
$30,273
0.8× median
L6880
HCPCS 		Dme Pos 11 $18,294.63 $34,030.25 $24,469.29 nat. median
$30,168
0.8× median
L8614
HCPCS 		Dme Pos 11 $14,652.60 $27,255.62 $20,954.11 nat. median
$23,402
0.9× median
L5858
HCPCS 		Dme Pos 11 $14,230.80 $26,471.02 $19,033.86 nat. median
$23,442
0.8× median
Q0483
HCPCS 		Dme Pos 11 $12,516.01 $21,027.58 $16,771.79 nat. median
$23,616
0.7× median
L6975
HCPCS 		Dme Pos 11 $12,464.44 $23,185.37 $16,671.34 nat. median
$23,177
0.7× median
C2616
HCPCS 		Brachytx, Non-str,yttrium-90 11 $15,821.91 $15,821.91 $15,821.91 nat. median
$28,125
0.6× median
L5859
HCPCS 		Dme Pos 11 $11,773.23 $21,899.65 $15,746.84 nat. median
$18,334
0.9× median
L6965
HCPCS 		Dme Pos 11 $11,457.55 $21,312.44 $15,324.61 nat. median
$22,149
0.7× median
C1816
HCPCS 		Receiver/transmitter, Neuro 11 $15,310.20 $15,310.20 $15,310.20 nat. median
$13,332
1.1× median
L6970
HCPCS 		Dme Pos 11 $11,375.96 $21,160.66 $15,215.48 nat. median
$22,513
0.7× median
L5973
HCPCS 		Dme Pos 11 $13,460.66 $16,758.02 $15,109.34 nat. median
$21,820
0.7× median
L8685
HCPCS 		Implt Nrostm Pls Gen Sng Rec 11 $6,410.29 $23,569.69 $14,989.99 nat. median
$12,132
1.2× median
Q0489
HCPCS 		Dme Pos 11 $10,850.70 $18,229.76 $14,540.23 nat. median
$20,518
0.7× median
L6960
HCPCS 		Dme Pos 11 $10,145.87 $18,872.56 $13,570.23 nat. median
$16,650
0.8× median
E0194
HCPCS 		Dme Pos 11 $3,016.87 $23,644.90 $13,330.89 nat. median
$4,451
outlier · 3.0×
Q0481
HCPCS 		Dme Pos 11 $9,699.90 $16,296.36 $12,998.13 nat. median
$15,051
0.9× median
J9600
HCPCS 		Porfimer Sodium Injection 11 $3,230.48 $22,751.10 $12,990.79 nat. median
$31,644
outlier · 0.4×
L8686
HCPCS 		Implt Nrostm Pls Gen Sng Non 11 $4,090.35 $21,132.49 $12,611.42 nat. median
$7,058
1.8× median
J7310
HCPCS 		Ganciclovir Long Act Implant 11 $5,795.56 $19,200.00 $12,497.78 nat. median
$19,181
0.7× median
L6955
HCPCS 		Dme Pos 11 $9,315.72 $17,328.36 $12,459.88 nat. median
$16,060
0.8× median
L5969
HCPCS 		Ak/ft Power Asst Incl Motors 11 $12,290.79 $12,290.79 $12,290.79 nat. median
$15,234
0.8× median
620T
CPT 		Evasc Ven Artlz Tibl/prnl Vn 11 $10,065.70 $14,360.46 $12,213.08 —
C1882
HCPCS 		Aicd, Other Than Sing/dual 11 $12,087.27 $12,087.27 $12,087.27 nat. median
$27,112
outlier · 0.4×
A9604
HCPCS 		Sm 153 Lexidronam 11 $5,258.25 $18,562.49 $11,910.37 nat. median
$11,413
1.0× median
L6945
HCPCS 		Dme Pos 11 $8,735.70 $16,249.47 $11,684.11 nat. median
$14,026
0.8× median
D7949
HCPCS 		Reconstruct Midface W/graft 11 $7,423.72 $15,734.40 $11,579.06 nat. median
$4,294
outlier · 2.7×
J1412
HCPCS 		Inj Roctavian Ml 2x10^13vc G 11 $11,554.69 $11,554.69 $11,554.69 nat. median
$13,558
0.9× median
L6950
HCPCS 		Dme Pos 11 $8,234.86 $15,317.84 $11,014.23 nat. median
$12,941
0.9× median

Other procedures at this hospital

Browse this hospital's 20,161 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
             
L6310 HCPCS Dme Pos 22 11 — — $2,737.18 $5,596.18 $3,956.07 2026-03-30
D7630 HCPCS Open Red Simpl Mandible Fx 22 11 — — $2,535.23 $5,377.60 $3,956.41 2026-03-30
47361 CPT Repair Liver Wound 22 11 — — $1,702.15 $5,339.55 $3,960.85 2026-03-30
S2118 HCPCS Total Hip Resurfacing 22 11 — — $1,960.50 $5,969.79 $3,965.14 2026-03-30
33463 CPT Valvuloplasty Tricuspid 22 11 — — $1,700.45 $5,333.59 $3,965.36 2026-03-30
33412 CPT Replacement Of Aortic Valve 22 11 — — $1,733.47 $5,438.38 $3,976.24 2026-03-30
E0786 HCPCS Dme Pos 22 11 — — $830.45 $7,127.36 $3,978.91 2026-03-30
47765 CPT Fuse Liver Ducts & Bowel 22 11 — — $1,670.84 $5,241.90 $3,983.47 2026-03-30
C1722 HCPCS Aicd, Single Chamber 22 11 — — $3,988.80 $3,988.80 $3,988.80 2026-03-30
237T CPT Trluml Perip Athrc Brchiocph 22 11 — — $525.54 $7,473.77 $3,999.66 2026-03-30
33545 CPT Repair Of Heart Damage 22 11 — — $1,691.71 $5,306.80 $4,008.55 2026-03-30
E1220 HCPCS Whlchr Special Size/constrc 22 11 — — $4,026.02 $4,026.02 $4,026.02 2026-03-30
47125 CPT Partial Removal Of Liver 22 11 — — $1,735.18 $5,443.15 $4,029.28 2026-03-30
61592 CPT Orbitocranial Approach/skull 22 11 — — $1,811.29 $5,679.52 $4,032.22 2026-03-30
A9600 HCPCS Sr89 Strontium 22 11 — — $561.45 $4,275.00 $4,050.00 2026-03-30
33782 CPT Nikaidoh Proc 22 11 — — $1,777.88 $4,555.49 $4,064.36 2026-03-30
D8080 HCPCS Compre Dental Tx Adolescent 22 11 — — $2,621.75 $5,513.60 $4,067.68 2026-03-30
48153 CPT Pancreatectomy 22 11 — — $1,754.54 $5,504.47 $4,069.77 2026-03-30
Q0482 HCPCS Dme Pos 22 11 — — $3,038.20 $5,104.33 $4,071.26 2026-03-30
E0783 HCPCS Dme Pos 22 11 — — $851.39 $7,306.82 $4,079.11 2026-03-30
48150 CPT Partial Removal Of Pancreas 22 11 — — $1,761.75 $5,525.31 $4,084.12 2026-03-30
A9542 HCPCS In111 Ibritumomab, Dx 22 11 — — $3,140.14 $5,264.90 $4,095.00 2026-03-30
33863 CPT Ascending Aortic Graft 22 11 — — $1,733.09 $5,436.60 $4,095.72 2026-03-30
L5781 HCPCS Dme Pos 22 11 — — $3,063.72 $5,698.88 $4,097.76 2026-03-30
61585 CPT Orbitocranial Approach/skull 22 11 — — $1,880.19 $5,898.63 $4,112.69 2026-03-30
L5105 HCPCS Dme Pos 22 11 — — $3,075.71 $5,721.20 $4,113.80 2026-03-30
D7860 HCPCS Tmj Cutting Into Joint 22 11 — — $1,873.87 $6,355.20 $4,114.53 2026-03-30
S4016 HCPCS Frozen Ivf Case Rate 22 11 — — $3,998.40 $4,243.30 $4,120.85 2026-03-30
D8090 HCPCS Compre Dental Tx Adult 22 11 — — $2,737.27 $5,513.60 $4,125.44 2026-03-30
D7490 HCPCS Maxilla Or Mandible Resectio 22 11 — — $4,050.99 $4,202.33 $4,126.66 2026-03-30
K0840 HCPCS Dme Pos 22 11 — — $949.62 $7,306.60 $4,128.11 2026-03-30
61608 CPT Resect/excise Cranial Lesion 22 11 — — $1,870.51 $5,867.07 $4,143.95 2026-03-30
61613 CPT Remove Aneurysm Sinus 22 11 — — $1,872.98 $5,874.81 $4,146.86 2026-03-30
D7874 HCPCS Tmj Arthroscopy Disc Reposit 22 11 — — $1,963.40 $6,335.20 $4,149.30 2026-03-30
20805 CPT Replant Forearm Complete 22 11 — — $1,865.19 $5,850.40 $4,150.84 2026-03-30
L2005 HCPCS Dme Pos 22 11 — — $3,251.98 $5,595.70 $4,161.24 2026-03-30
26553 CPT Single Transfer Toe-hand 22 11 — — $1,891.01 $5,931.97 $4,176.12 2026-03-30
L6881 HCPCS Dme Pos 22 11 — — $3,130.40 $5,822.92 $4,186.94 2026-03-30
L5840 HCPCS Dme Pos 22 11 — — $3,057.20 $5,855.93 $4,187.94 2026-03-30
673T CPT Abltj B9 Thyr Ndul Perq Lasr 22 11 — — $3,594.91 $4,783.09 $4,189.00 2026-03-30
33864 CPT Ascending Aortic Graft 22 11 — — $1,771.24 $5,556.27 $4,192.83 2026-03-30
61526 CPT Removal Of Brain Lesion 22 11 — — $1,903.91 $4,652.15 $4,198.32 2026-03-30
61616 CPT Resect/excise Lesion Skull 22 11 — — $1,909.61 $5,990.32 $4,199.58 2026-03-30
L5200 HCPCS Dme Pos 22 11 — — $2,979.70 $5,910.00 $4,200.18 2026-03-30
26551 CPT Great Toe-hand Transfer 22 11 — — $1,903.53 $5,971.86 $4,204.33 2026-03-30
J9216 HCPCS Interferon Gamma 1-b Inj 22 11 — — $425.13 $7,993.21 $4,209.17 2026-03-30
33413 CPT Replacement Of Aortic Valve 22 11 — — $1,777.69 $5,576.52 $4,211.65 2026-03-30
L5980 HCPCS Dme Pos 22 11 — — $3,162.05 $5,881.80 $4,229.28 2026-03-30
33440 CPT Rplcmt A-valve Tlcj Autol Pv 22 11 — — $1,874.30 $4,904.98 $4,229.45 2026-03-30
43117 CPT Partial Removal Of Esophagus 22 11 — — $1,813.76 $5,690.24 $4,233.23 2026-03-30
32851 CPT Lung Transplant Single 22 11 — — $1,811.48 $5,682.50 $4,235.23 2026-03-30
47785 CPT Fuse Bile Ducts And Bowel 22 11 — — $1,825.72 $5,727.15 $4,237.74 2026-03-30
43286 CPT Esphg Tot W/laps Moblj 22 11 — — $1,782.44 $5,591.40 $4,250.05 2026-03-30
L5150 HCPCS Dme Pos 22 11 — — $3,167.50 $5,915.67 $4,250.45 2026-03-30
E1007 HCPCS Dme Pos 22 11 — — $731.21 $7,801.58 $4,266.40 2026-03-30
E1008 HCPCS Dme Pos 22 11 — — $745.00 $7,802.28 $4,273.64 2026-03-30
236T CPT Trluml Perip Athrc Abd Aorta 22 11 — — $1,083.48 $7,467.77 $4,275.62 2026-03-30
36836 CPT Prq Av Fstl Crtj Uxtr 1 Acs 14 9 — — $338.54 $13,444.13 $4,285.75 2026-03-30
L7259 HCPCS Dme Pos 22 11 — — $3,047.27 $6,037.68 $4,291.72 2026-03-30
J0801 HCPCS Inj. Acthar Gel To 40 Units 22 11 — — $4,090.09 $4,504.85 $4,297.47 2026-03-30
L8044 HCPCS Dme Pos 22 11 — — $3,215.07 $5,980.43 $4,300.20 2026-03-30
33622 CPT Redo Compl Cardiac Anomaly 22 11 — — $1,889.68 $5,358.99 $4,319.47 2026-03-30
L5782 HCPCS Dme Pos 22 11 — — $3,229.85 $6,007.90 $4,319.96 2026-03-30
L6885 HCPCS Dme Pos 22 11 — — $2,873.00 $6,161.66 $4,320.64 2026-03-30
L6360 HCPCS Dme Pos 22 11 — — $2,873.00 $6,161.66 $4,320.64 2026-03-30
47130 CPT Partial Removal Of Liver 22 11 — — $1,863.11 $5,844.45 $4,328.01 2026-03-30
S3865 HCPCS Comp Genet Test Hyp Cardiomy 22 11 — — $4,332.95 $4,332.95 $4,332.95 2026-03-30
26556 CPT Toe Joint Transfer 22 11 — — $1,967.31 $6,171.32 $4,341.04 2026-03-30
D6116 HCPCS Imp/abut Fixed Dent Part Max 22 11 — — $1,031.00 $7,652.80 $4,341.90 2026-03-30
33411 CPT Replacement Of Aortic Valve 22 11 — — $1,851.15 $5,806.34 $4,362.41 2026-03-30
D6117 HCPCS Imp/abut Fixed Dent Part Man 22 11 — — $1,031.00 $7,709.60 $4,370.30 2026-03-30
46744 CPT Repair Of Cloacal Anomaly 22 11 — — $2,001.66 $5,642.65 $4,389.57 2026-03-30
33783 CPT Nikaidoh Proc W/ostia Implt 22 11 — — $1,920.62 $4,923.99 $4,390.06 2026-03-30
25448 CPT Arthroplasty, Intercarpal Or Carpometacarpal Joints; Suspension, Including Trans… 4 1 — — $4,395.87 $4,395.87 $4,395.87 2026-03-30
48160 CPT Pancreas Removal/transplant 22 11 — — $3,915.49 $4,981.39 $4,401.69 2026-03-30
D7730 HCPCS Open Reduct Compd Mandble Fx 22 11 — — $3,139.44 $5,666.40 $4,402.92 2026-03-30
61700 CPT Brain Aneurysm Repr Simple 22 11 — — $1,913.78 $6,003.42 $4,403.26 2026-03-30
L5321 HCPCS Dme Pos 22 11 — — $2,964.57 $6,279.27 $4,412.29 2026-03-30
A9571 HCPCS Indium In-111 Auto Platelet 22 11 — — $3,647.78 $5,292.45 $4,443.84 2026-03-30
A9570 HCPCS Indium In-111 Auto Wbc 22 11 — — $3,647.78 $5,292.45 $4,443.84 2026-03-30
D6050 HCPCS Odontics Transosteal Implnt 22 11 — — $2,777.12 $6,143.20 $4,460.16 2026-03-30
J0480 HCPCS Basiliximab 22 11 — — $4,029.23 $4,923.89 $4,476.56 2026-03-30
47122 CPT Extensive Removal Of Liver 22 11 — — $1,929.92 $6,053.43 $4,479.49 2026-03-30
L5312 HCPCS Dme Pos 22 11 — — $3,043.56 $6,380.86 $4,491.43 2026-03-30
D7850 HCPCS Tmj Meniscectomy 22 11 — — $2,831.72 $6,188.00 $4,509.86 2026-03-30
L5701 HCPCS Dme Pos 22 11 — — $3,066.88 $6,437.78 $4,530.54 2026-03-30
43112 CPT Esphg Tot W/thrcm 22 11 — — $1,932.38 $6,062.36 $4,540.31 2026-03-30
L6026 HCPCS Dme Pos 22 11 — — $3,406.23 $6,335.99 $4,555.86 2026-03-30
32445 CPT Removal Of Lung Extrapleural 22 11 — — $1,954.97 $6,132.62 $4,561.53 2026-03-30
L6205 HCPCS Dme Pos 22 11 — — $3,284.65 $6,438.90 $4,585.64 2026-03-30
32852 CPT Lung Transplant With Bypass 22 11 — — $1,957.44 $6,139.76 $4,618.48 2026-03-30
61520 CPT Removal Of Brain Lesion 22 11 — — $2,113.46 $5,241.15 $4,663.98 2026-03-30
J1162 HCPCS Digoxin Immune Fab (ovine) 22 11 — — $4,101.15 $5,255.19 $4,678.17 2026-03-30
47140 CPT Partial Removal Donor Liver 22 11 — — $2,019.50 $6,335.06 $4,680.35 2026-03-30
D7875 HCPCS Tmj Arthroscopy Synovectomy 22 11 — — $2,133.44 $7,232.00 $4,682.72 2026-03-30
61692 CPT Intracranial Vessel Surgery 22 11 — — $2,054.24 $6,443.42 $4,693.43 2026-03-30
E0636 HCPCS Dme Pos 22 11 — — $915.10 $8,486.47 $4,700.78 2026-03-30
43118 CPT Partial Removal Of Esophagus 22 11 — — $2,004.70 $6,288.61 $4,705.19 2026-03-30
33877 CPT Thoracoabdominal Graft 22 11 — — $1,978.32 $6,205.26 $4,705.65 2026-03-30
L5595 HCPCS Dme Pos 22 11 — — $3,520.99 $6,549.47 $4,709.36 2026-03-30
D5932 HCPCS Postsurgical Obturator 22 11 — — $3,110.29 $6,333.60 $4,721.94 2026-03-30
K0855 HCPCS Dme Pos 22 11 — — $1,224.13 $8,221.62 $4,722.88 2026-03-30
43287 CPT Esphg Dstl 2/3 W/laps Moblj 22 11 — — $1,977.37 $6,202.28 $4,738.38 2026-03-30
D7840 HCPCS Removal Of Tmj Condyle 22 11 — — $3,110.29 $6,451.20 $4,780.74 2026-03-30
L6300 HCPCS Dme Pos 22 11 — — $3,360.47 $6,741.71 $4,781.63 2026-03-30
E0483 HCPCS Dme Pos 22 11 — — $1,105.58 $8,555.36 $4,830.47 2026-03-30
335U CPT Rare Ds Whl Gen Seq Feta 22 11 — — $4,440.91 $5,224.60 $4,832.76 2026-03-30
214U CPT Rare Ds Xom DNA Alys Proband 22 11 — — $4,440.91 $5,224.60 $4,832.76 2026-03-30
26554 CPT Double Transfer Toe-hand 22 11 — — $2,197.73 $6,894.73 $4,860.73 2026-03-30
D7854 HCPCS Tmj Excisn Of Joint Membrane 22 11 — — $3,383.49 $6,344.80 $4,864.15 2026-03-30
81425 CPT Genome Sequence Analysis 17 8 — — $2,113.10 $5,031.20 $4,884.29 2026-03-30
J9219 HCPCS Leuprolide Acetate Implant 22 11 — — $4,096.85 $5,684.00 $4,890.43 2026-03-30
L6550 HCPCS Dme Pos 22 11 — — $3,439.51 $6,899.01 $4,893.35 2026-03-30
E0466 HCPCS Dme Pos 22 11 — — $843.74 $9,035.04 $4,939.39 2026-03-30
E0465 HCPCS Dme Pos 22 11 — — $843.74 $9,035.04 $4,939.39 2026-03-30
43124 CPT Removal Of Esophagus 22 11 — — $2,110.99 $6,621.44 $4,943.87 2026-03-30
46746 CPT Repair Of Cloacal Anomaly 22 11 — — $2,202.85 $6,215.63 $4,954.72 2026-03-30
A9582 HCPCS Iodine I-123 Iobenguane 22 11 — — $3,182.03 $6,730.76 $4,956.40 2026-03-30
S4011 HCPCS Ivf Package 22 11 — — $4,986.54 $4,986.54 $4,986.54 2026-03-30
43288 CPT Esphg Thrsc Moblj 22 11 — — $2,088.59 $6,549.40 $4,992.51 2026-03-30
211U CPT Onc Pan-tum Dna&rna Gnrj Seq 22 11 — — $1,543.50 $8,455.00 $4,999.25 2026-03-30
K0854 HCPCS Dme Pos 22 11 — — $1,295.86 $8,703.36 $4,999.61 2026-03-30
V5263 HCPCS Hearing Aid, Disp, Binaural 22 11 — — $5,000.00 $5,000.00 $5,000.00 2026-03-30
C1721 HCPCS Aicd, Dual Chamber 22 11 — — $5,000.00 $5,000.00 $5,000.00 2026-03-30
43659 CPT Unlisted Laparoscopy Procedure Stomach ProFee 22 11 $6,896.00 $4,827.20 30% off $3,206.64 $6,896.00 $5,007.87 2026-03-30
L5230 HCPCS Dme Pos 22 11 — — $3,431.32 $7,136.28 $5,030.02 2026-03-30
61702 CPT Inner Skull Vessel Surgery 22 11 — — $2,263.40 $7,098.95 $5,031.18 2026-03-30
D7852 HCPCS Tmj Repair Of Joint Disc 22 11 — — $3,278.49 $6,832.80 $5,055.65 2026-03-30
L5961 HCPCS Dme Pos 22 11 — — $3,784.05 $7,038.78 $5,061.21 2026-03-30
212U CPT Rare Ds Gen DNA Alys Proband 22 11 — — $4,653.92 $5,475.20 $5,064.56 2026-03-30
265U CPT Rar Do Whl Gn&mtcdrl DNA Als 22 11 — — $4,654.43 $5,475.80 $5,065.11 2026-03-30
L5160 HCPCS Dme Pos 22 11 — — $3,445.23 $7,217.30 $5,080.87 2026-03-30
J0225 HCPCS Inj, Vutrisiran, 1 Mg 22 11 — — $4,727.70 $5,442.12 $5,084.91 2026-03-30
J9225 HCPCS Vantas Implant 22 11 — — $4,971.34 $5,203.36 $5,087.35 2026-03-30
K0878 HCPCS Pwc Gp4 Std Sing Pow Opt Cap 22 11 — — $5,133.40 $5,133.40 $5,133.40 2026-03-30
K0877 HCPCS Pwc Gp4 Std Sing Pow Opt S/b 22 11 — — $5,133.40 $5,133.40 $5,133.40 2026-03-30
20808 CPT Replantation Hand Complete 22 11 — — $2,246.70 $7,047.75 $5,171.52 2026-03-30
A0430 HCPCS Fixed Wing Air Transport 22 11 — — $3,570.00 $6,773.05 $5,171.52 2026-03-30
J0716 HCPCS Centruroides Immune F(ab) 22 11 — — $4,996.29 $5,351.02 $5,173.65 2026-03-30
33305 CPT Repair Of Heart Wound 22 11 — — $2,251.06 $7,061.44 $5,192.20 2026-03-30
L8690 HCPCS Dme Pos 22 11 — — $3,642.61 $6,775.69 $5,209.15 2026-03-30
K0860 HCPCS Dme Pos 22 11 — — $1,351.74 $9,078.66 $5,215.20 2026-03-30
K0863 HCPCS Dme Pos 22 11 — — $1,351.74 $9,078.66 $5,215.20 2026-03-30
C1772 HCPCS Infusion Pump, Programmable 22 11 — — $5,219.30 $5,219.30 $5,219.30 2026-03-30
46748 CPT Repair Of Cloacal Anomaly 22 11 — — $2,385.25 $6,734.58 $5,232.30 2026-03-30
55970 CPT Sex Transformation M To F 22 11 — — $5,173.26 $5,380.49 $5,276.88 2026-03-30
L7008 HCPCS Dme Pos 22 11 — — $4,713.08 $5,867.61 $5,290.35 2026-03-30
61576 CPT Skull Base/brainstem Surgery 22 11 — — $2,382.60 $7,473.46 $5,299.59 2026-03-30
33916 CPT Surgery Of Great Vessel 22 11 — — $2,279.00 $7,214.46 $5,309.20 2026-03-30
L6350 HCPCS Dme Pos 22 11 — — $3,533.03 $7,577.21 $5,313.24 2026-03-30
61697 CPT Brain Aneurysm Repr Complx 22 11 — — $2,378.23 $7,459.77 $5,325.36 2026-03-30
S4021 HCPCS Ivf Canc P Aspir Case Rate 22 11 — — $5,343.26 $5,343.26 $5,343.26 2026-03-30
L8609 HCPCS Dme Pos 22 11 — — $4,988.92 $5,713.91 $5,351.41 2026-03-30
61682 CPT Intracranial Vessel Surgery 22 11 — — $2,334.39 $7,322.23 $5,379.20 2026-03-30
94U CPT Genome Rapid Sequence Alys 22 11 — — $3,184.52 $7,582.20 $5,383.36 2026-03-30
S4025 HCPCS Donor Serv Ivf Case Rate 22 11 — — $5,389.56 $5,389.56 $5,389.56 2026-03-30
A9515 HCPCS Choline C-11 22 11 — — $5,100.00 $5,700.00 $5,400.00 2026-03-30
33935 CPT Transplantation Heart/lung 22 11 — — $2,718.17 $6,835.25 $5,456.37 2026-03-30
L6570 HCPCS Dme Pos 22 11 — — $3,947.89 $7,690.41 $5,483.14 2026-03-30
L5702 HCPCS Dme Pos 22 11 — — $3,918.83 $7,708.67 $5,486.55 2026-03-30
E0764 HCPCS Dme Pos 22 11 — — $1,150.84 $9,877.14 $5,513.99 2026-03-30
D5913 HCPCS Nasal Prosthesis 22 11 — — $3,539.46 $7,556.80 $5,548.13 2026-03-30
55980 CPT Sex Transformation F To M 22 11 — — $5,461.37 $5,679.99 $5,570.68 2026-03-30
47141 CPT Partial Removal Donor Liver 22 11 — — $2,412.02 $7,565.15 $5,588.96 2026-03-30
43113 CPT Removal Of Esophagus 22 11 — — $2,403.85 $7,540.74 $5,636.56 2026-03-30
C1817 HCPCS Septal Defect Imp Sys 22 11 — — $5,678.91 $5,678.91 $5,678.91 2026-03-30
61698 CPT Brain Aneurysm Repr Complx 22 11 — — $2,600.11 $8,154.60 $5,743.93 2026-03-30
D7944 HCPCS Bone Cutting Segmented 22 11 — — $3,399.99 $8,096.00 $5,747.99 2026-03-30
61686 CPT Intracranial Vessel Surgery 22 11 — — $2,525.33 $7,920.61 $5,752.97 2026-03-30
43108 CPT Removal Of Esophagus 22 11 — — $2,455.29 $7,702.09 $5,763.99 2026-03-30
L5600 HCPCS Dme Pos 22 11 — — $4,010.66 $8,255.18 $5,829.02 2026-03-30
D7680 HCPCS Reduct Simple Facial Bone Fx 22 11 — — $3,652.92 $8,010.40 $5,831.66 2026-03-30
43123 CPT Partial Removal Of Esophagus 22 11 — — $2,491.35 $7,814.03 $5,841.64 2026-03-30
K0869 HCPCS Pwc Gp 4 Std Cap Chair 22 11 — — $5,844.80 $5,844.80 $5,844.80 2026-03-30
D5914 HCPCS Auricular Prosthesis 22 11 — — $3,539.46 $8,177.60 $5,858.53 2026-03-30
K0868 HCPCS Pwc Gp 4 Std Seat/back 22 11 — — $5,899.20 $5,899.20 $5,899.20 2026-03-30
32853 CPT Lung Transplant Double 22 11 — — $2,525.90 $7,924.18 $5,899.38 2026-03-30
S2411 HCPCS Fetoscop Laser Ther Ttts 22 11 — — $5,900.59 $5,900.59 $5,900.59 2026-03-30
C1899 HCPCS Lead, Pmkr/aicd Combination 22 11 — — $5,962.88 $5,962.88 $5,962.88 2026-03-30
L8683 HCPCS Dme Pos 22 11 — — $4,174.10 $7,764.34 $5,969.22 2026-03-30
D6040 HCPCS Odontics Eposteal Implant 22 11 — — $3,603.99 $8,336.00 $5,969.99 2026-03-30
E0467 HCPCS Dme Pos 22 11 — — $999.52 $11,109.23 $6,054.38 2026-03-30
81552 CPT Onc Uveal Mlnma Mrna 15 Gene 22 11 — — $3,265.92 $7,776.00 $6,065.28 2026-03-30
S4023 HCPCS Incompl Donor Egg Case Rate 22 11 — — $6,092.48 $6,092.48 $6,092.48 2026-03-30
36837 CPT Prq Av Fstl Crt Uxtr Sep Acs 14 9 — — $437.34 $19,135.56 $6,100.27 2026-03-30
47142 CPT Partial Removal Donor Liver 22 11 — — $2,647.18 $8,304.64 $6,154.03 2026-03-30
J0600 HCPCS Edetate Calcium Disodium Inj 22 11 — — $5,708.59 $6,624.52 $6,166.56 2026-03-30
K0884 HCPCS Pwc Gp4 Std Mult Pow Opt S/b 22 11 — — $6,185.44 $6,185.44 $6,185.44 2026-03-30
K0864 HCPCS Dme Pos 22 11 — — $1,608.57 $10,803.60 $6,206.09 2026-03-30
D7865 HCPCS Tmj Reshaping Components 22 11 — — $3,693.13 $8,743.20 $6,218.16 2026-03-30
33945 CPT Transplantation Of Heart 22 11 — — $2,687.99 $8,431.46 $6,219.61 2026-03-30
A0431 HCPCS Rotary Wing Air Transport 22 11 — — $4,585.79 $7,874.64 $6,230.22 2026-03-30
267U CPT Rare Do Id Opt Gen Mapg&seq 22 11 — — $5,728.43 $6,739.33 $6,233.88 2026-03-30
32854 CPT Lung Transplant With Bypass 22 11 — — $2,675.08 $8,390.97 $6,254.26 2026-03-30
L5331 HCPCS Dme Pos 22 11 — — $4,194.98 $8,909.55 $6,257.67 2026-03-30
238T CPT Trluml Perip Athrc Iliac Art 22 11 — — $789.58 $11,823.50 $6,306.54 2026-03-30
D5915 HCPCS Orbital Prosthesis 22 11 — — $4,784.11 $7,896.80 $6,340.45 2026-03-30
L7170 HCPCS Dme Pos 22 11 — — $4,762.63 $8,859.06 $6,370.07 2026-03-30
D7945 HCPCS Bone Cutting Body Mandible 22 11 — — $4,162.21 $8,652.80 $6,407.51 2026-03-30
49605 CPT Repair Umbilical Lesion 22 11 — — $2,762.20 $8,663.07 $6,433.49 2026-03-30
43116 CPT Partial Removal Of Esophagus 22 11 — — $2,743.98 $8,608.29 $6,439.24 2026-03-30
81416 CPT Exome Sequence Analysis 22 11 — — $958.56 $12,000.00 $6,479.28 2026-03-30
K0014 HCPCS Other Power Whlchr Base 22 11 — — $6,502.60 $6,502.60 $6,502.60 2026-03-30
S2404 HCPCS Fetal Surg Myelomeningo 22 11 — — $6,518.90 $6,518.90 $6,518.90 2026-03-30
L5341 HCPCS Dme Pos 22 11 — — $4,558.62 $9,299.11 $6,576.34 2026-03-30
L5250 HCPCS Dme Pos 22 11 — — $4,680.02 $9,286.42 $6,599.27 2026-03-30
81529 CPT Onc Cutan Mlnma Mrna 31 Gene 22 11 — — $3,021.06 $10,214.06 $6,617.56 2026-03-30
S2068 HCPCS Breast Diep Or Siea Flap 22 11 — — $3,473.76 $9,800.00 $6,636.88 2026-03-30
A9572 HCPCS Indium In-111 Pentetreotide 22 11 — — $5,789.52 $8,519.60 $6,640.92 2026-03-30
D7943 HCPCS Cutting Ramus Open W/graft 22 11 — — $3,815.49 $9,478.40 $6,646.94 2026-03-30
L7185 HCPCS Dme Pos 22 11 — — $5,002.55 $9,305.34 $6,690.96 2026-03-30
D6115 HCPCS Implnt/abut Fixed Dent Mand 22 11 — — $1,344.79 $12,192.00 $6,768.40 2026-03-30
L8682 HCPCS Dme Pos 22 11 — — $4,742.07 $8,820.84 $6,781.45 2026-03-30
L5280 HCPCS Dme Pos 22 11 — — $4,592.63 $9,849.73 $6,906.76 2026-03-30
D6114 HCPCS Implnt/abut Fixed Dent Max 22 11 — — $1,344.79 $12,484.80 $6,914.80 2026-03-30
K0879 HCPCS Pwc Gp4 Hd Sing Pow Opt S/b 22 11 — — $6,932.50 $6,932.50 $6,932.50 2026-03-30
L5270 HCPCS Dme Pos 22 11 — — $4,639.02 $9,949.22 $6,976.52 2026-03-30
47135 CPT Transplantation Of Liver 22 11 — — $3,048.05 $9,561.53 $7,036.70 2026-03-30
D7941 HCPCS Bone Cutting Ramus Closed 22 11 — — $4,152.98 $10,074.40 $7,113.69 2026-03-30
L8679 HCPCS Dme Pos 22 11 — — $6,637.06 $7,601.56 $7,119.31 2026-03-30
K0886 HCPCS Pwc Gp4 Hd Mult Pow S/b 22 11 — — $7,153.10 $7,153.10 $7,153.10 2026-03-30
D7780 HCPCS Reduct Compnd Facial Bone Fx 22 11 — — $4,782.12 $9,816.00 $7,299.06 2026-03-30
39503 CPT Repair Of Diaphragm Hernia 22 11 — — $3,210.33 $8,255.03 $7,334.98 2026-03-30
D7947 HCPCS Reconstruct Maxilla Segment 22 11 — — $4,473.16 $10,245.60 $7,359.38 2026-03-30
L5987 HCPCS Dme Pos 22 11 — — $5,508.29 $10,246.09 $7,367.40 2026-03-30
L8627 HCPCS Dme Pos 22 11 — — $5,306.23 $9,870.24 $7,588.23 2026-03-30
D7946 HCPCS Reconstruction Maxilla Total 22 11 — — $4,872.80 $10,613.60 $7,743.20 2026-03-30
L7186 HCPCS Dme Pos 22 11 — — $6,899.37 $8,589.45 $7,744.41 2026-03-30
K0885 HCPCS Pwc Gp4 Std Mult Pow Opt Cap 22 11 — — $7,745.10 $7,745.10 $7,745.10 2026-03-30
K0890 HCPCS Pwc Gp5 Ped Sing Pow Opt S/b 22 11 — — $7,874.59 $7,874.59 $7,874.59 2026-03-30
C1813 HCPCS Prosthesis, Penile, Inflatab 22 11 — — $7,961.62 $7,961.62 $7,961.62 2026-03-30
L7191 HCPCS Dme Pos 22 11 — — $7,209.42 $8,975.47 $8,092.44 2026-03-30
L6920 HCPCS Dme Pos 22 11 — — $6,019.63 $11,289.65 $8,105.35 2026-03-30
L7190 HCPCS Dme Pos 22 11 — — $6,214.71 $11,560.12 $8,312.25 2026-03-30
D7858 HCPCS Tmj Reconstruction 22 11 — — $5,182.60 $11,857.60 $8,520.10 2026-03-30
L6930 HCPCS Dme Pos 22 11 — — $6,056.96 $12,249.09 $8,675.62 2026-03-30
L5857 HCPCS Dme Pos 22 11 — — $6,522.45 $12,132.55 $8,723.85 2026-03-30
L6925 HCPCS Dme Pos 22 11 — — $6,637.64 $12,346.83 $8,877.93 2026-03-30
L5991 HCPCS Dme Pos 22 11 — — $8,556.01 $9,323.85 $8,939.93 2026-03-30
L8619 HCPCS Dme Pos 22 11 — — $6,290.26 $11,700.66 $8,995.46 2026-03-30
D7948 HCPCS Reconstruct Midface No Graft 22 11 — — $5,385.88 $13,148.00 $9,266.94 2026-03-30
L6935 HCPCS Dme Pos 22 11 — — $6,959.54 $12,945.61 $9,308.48 2026-03-30
K0891 HCPCS Pwc Gp5 Ped Mult Pow Opt S/b 22 11 — — $5,688.67 $13,531.66 $9,610.17 2026-03-30
S4015 HCPCS Complete Ivf Nos Case Rate 22 11 — — $6,802.34 $12,500.00 $9,651.17 2026-03-30
C1767 HCPCS Generator, Neuro Non-recharg 22 11 — — $9,908.33 $9,908.33 $9,908.33 2026-03-30
K0606 HCPCS Dme Pos 22 11 — — $2,247.55 $17,588.70 $9,918.12 2026-03-30
L6940 HCPCS Dme Pos 22 11 — — $7,884.26 $14,665.69 $10,545.30 2026-03-30
Q0479 HCPCS Dme Pos 22 11 — — $7,992.45 $13,427.75 $10,710.10 2026-03-30
505T CPT Ev Fempop Artl Revsc 22 11 — — $6,937.85 $14,510.96 $10,724.41 2026-03-30
K0880 HCPCS Pwc Gp4 Vhd Sing Pow Opt S/b 22 11 — — $10,848.70 $10,848.70 $10,848.70 2026-03-30
L6950 HCPCS Dme Pos 22 11 — — $8,234.86 $15,317.84 $11,014.23 2026-03-30
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 22 11 — — $11,554.69 $11,554.69 $11,554.69 2026-03-30
D7949 HCPCS Reconstruct Midface W/graft 22 11 — — $7,423.72 $15,734.40 $11,579.06 2026-03-30
L6945 HCPCS Dme Pos 22 11 — — $8,735.70 $16,249.47 $11,684.11 2026-03-30
A9604 HCPCS Sm 153 Lexidronam 22 11 — — $5,258.25 $18,562.49 $11,910.37 2026-03-30
C1882 HCPCS Aicd, Other Than Sing/dual 22 11 — — $12,087.27 $12,087.27 $12,087.27 2026-03-30
620T CPT Evasc Ven Artlz Tibl/prnl Vn 22 11 — — $10,065.70 $14,360.46 $12,213.08 2026-03-30
L5969 HCPCS Ak/ft Power Asst Incl Motors 22 11 — — $12,290.79 $12,290.79 $12,290.79 2026-03-30
L6955 HCPCS Dme Pos 22 11 — — $9,315.72 $17,328.36 $12,459.88 2026-03-30
J7310 HCPCS Ganciclovir Long Act Implant 22 11 — — $5,795.56 $19,200.00 $12,497.78 2026-03-30
L8686 HCPCS Implt Nrostm Pls Gen Sng Non 22 11 — — $4,090.35 $21,132.49 $12,611.42 2026-03-30
J9600 HCPCS Porfimer Sodium Injection 22 11 — — $3,230.48 $22,751.10 $12,990.79 2026-03-30
Q0481 HCPCS Dme Pos 22 11 — — $9,699.90 $16,296.36 $12,998.13 2026-03-30
E0194 HCPCS Dme Pos 22 11 — — $3,016.87 $23,644.90 $13,330.89 2026-03-30
L6960 HCPCS Dme Pos 22 11 — — $10,145.87 $18,872.56 $13,570.23 2026-03-30
Q0489 HCPCS Dme Pos 22 11 — — $10,850.70 $18,229.76 $14,540.23 2026-03-30
L8685 HCPCS Implt Nrostm Pls Gen Sng Rec 22 11 — — $6,410.29 $23,569.69 $14,989.99 2026-03-30
L5973 HCPCS Dme Pos 22 11 — — $13,460.66 $16,758.02 $15,109.34 2026-03-30
L6970 HCPCS Dme Pos 22 11 — — $11,375.96 $21,160.66 $15,215.48 2026-03-30
C1816 HCPCS Receiver/transmitter, Neuro 22 11 — — $15,310.20 $15,310.20 $15,310.20 2026-03-30
L6965 HCPCS Dme Pos 22 11 — — $11,457.55 $21,312.44 $15,324.61 2026-03-30
L5859 HCPCS Dme Pos 22 11 — — $11,773.23 $21,899.65 $15,746.84 2026-03-30
C2616 HCPCS Brachytx, Non-str,yttrium-90 22 11 — — $15,821.91 $15,821.91 $15,821.91 2026-03-30
L6975 HCPCS Dme Pos 22 11 — — $12,464.44 $23,185.37 $16,671.34 2026-03-30
Q0483 HCPCS Dme Pos 22 11 — — $12,516.01 $21,027.58 $16,771.79 2026-03-30
L5858 HCPCS Dme Pos 22 11 — — $14,230.80 $26,471.02 $19,033.86 2026-03-30
L8614 HCPCS Dme Pos 22 11 — — $14,652.60 $27,255.62 $20,954.11 2026-03-30
L6880 HCPCS Dme Pos 22 11 — — $18,294.63 $34,030.25 $24,469.29 2026-03-30
L5856 HCPCS Dme Pos 22 11 — — $18,381.43 $34,191.69 $24,585.38 2026-03-30
J9266 HCPCS Pegaspargase Injection 22 11 — — $21,544.13 $28,359.61 $24,951.87 2026-03-30
L8687 HCPCS Implt Nrostm Pls Gen Dua Rec 22 11 — — $8,342.54 $49,312.82 $28,827.68 2026-03-30
L2006 HCPCS Dme Pos 22 11 — — $29,507.32 $30,964.47 $30,235.90 2026-03-30
L8688 HCPCS Implt Nrostm Pls Gen Dua Non 22 11 — — $5,323.27 $59,297.63 $32,310.45 2026-03-30
L7180 HCPCS Dme Pos 22 11 — — $28,576.68 $53,156.12 $38,221.67 2026-03-30
L7181 HCPCS Dme Pos 22 11 — — $30,680.38 $57,069.24 $41,035.38 2026-03-30
J9226 HCPCS Supprelin La Implant 22 11 — — $41,645.55 $49,164.61 $45,405.08 2026-03-30
J7330 HCPCS Cultured Chondrocytes Implnt 22 11 — — $38,268.11 $57,294.42 $47,781.26 2026-03-30
90288 CPT Botulism Ig IV 22 11 — — $48,705.00 $48,705.00 $48,705.00 2026-03-30
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 22 11 — — $50,311.63 $63,657.39 $56,984.51 2026-03-30
J9029 HCPCS Instill Adstiladrin, Tx Dose 22 11 — — $61,200.00 $61,200.00 $61,200.00 2026-03-30
E0766 HCPCS Dme Pos 22 11 — — $11,955.86 $113,457.59 $62,706.72 2026-03-30
A9543 HCPCS Y90 Ibritumomab, Rx 22 11 — — $63,005.77 $70,418.21 $68,871.20 2026-03-30
Q0480 HCPCS Dme Pos 22 11 — — $60,121.57 $99,999.91 $80,060.74 2026-03-30
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 22 11 — — $410,970.00 $432,480.00 $421,725.00 2026-03-30
Q2053 HCPCS Brexucabtagene Car Pos T 22 11 — — $410,970.00 $448,752.40 $429,861.20 2026-03-30
Q2054 HCPCS Lisocabtagene Mara Car Pos T 22 11 — — $456,171.54 $456,171.54 $456,171.54 2026-03-30
Q2055 HCPCS Idecabtagene Vicleucel Car 22 11 — — $466,400.10 $466,400.10 $466,400.10 2026-03-30
Q2056 HCPCS Ciltacabtagene Car-pos T 22 11 — — $474,300.00 $474,300.00 $474,300.00 2026-03-30
Q2042 HCPCS Tisagenlecleucel Car-pos T 22 11 — — $508,800.00 $508,800.00 $508,800.00 2026-03-30
J3399 HCPCS Inj Onase Abepar-xioi Treat 22 11 — — $2,188,750.00 $2,232,525.00 $2,210,637.50 2026-03-30
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