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

WHIDBEYHEALTH MEDICAL CENTER

Coupeville, WA · CCN 501339 · Rates published

Your selected procedure

You selected 93306 (CPT)

Echocardiography transthoracic real-time with image documentation (2D) includes M-mode recording when performed complete with spectral Doppler echocardiography and with color flow Doppler echocardiography

This hospital’s price: $774 across 20 payers · range $104-$3,420

Source: https://whidbeyhealth.org/wp-content/uploads/CMS/910843135_whidbeyhealth-medical-center_standardcharges.csv · observed 2026-10-02

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.

10,942 distinct procedures filed
21 distinct payers
513,573 rate rows
2026-10-02 last MRF observed
Data quality

509,469 of 513,573 rate rows are consumer-grade (99.2%)

4,104 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 1,361
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 1,186
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 626
placeholder amount (≤ $0.02) — excluded from medians 553
percent-of-charges filed in the dollar field — excluded from medians 284
exceeds 10× this hospital's gross charge — excluded from medians 82
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 12
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://whidbeyhealth.org/wp-content/uploads/CMS/910843135_whidbeyhealth-medical-center_standardcharges.csv
Found on page https://whidbeyhealth.org/patients-visitors/financial-services/price-transparency/
Discovered viaCMS hospital list
Last fetch success · 2026-10-02
Content fingerprint 74a659458c80b912… · 14,708,770 bytes · first seen 2026-10-02

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
J9309
HCPCS 		Polatuzumab Vedotin 140 Mg Vl 9 $6,314.09 $112,176.95 $27,242.75 nat. median
$4,472
outlier · 6.1×
J9228
HCPCS 		Ipilimumab 200mg/40ml Inj 9 $15,002.06 $69,323.40 $22,822.00 nat. median
$8,966
outlier · 2.5×
J9144
HCPCS 		Dartmumb-hyl 1800mg/15m Pr10mg 9 $20,269.85 $68,772.69 $22,803.58 nat. median
$211
outlier · 107.8×
J9272
HCPCS 		Dostrlmab-gxly 500 Mg/10ml Vl 9 $19,876.08 $67,436.70 $22,360.59 nat. median
$786
outlier · 28.4×
J9022
HCPCS 		Atezolizumab 1200mg/20ml Vial 9 $13,407.64 $65,154.29 $20,990.61 nat. median
$6,720
outlier · 3.1×
J2327
HCPCS 		Risankizumab-rzaa 600mg/10mL V 9 $16,843.68 $57,148.20 $18,949.14 nat. median
$1,767
outlier · 10.7×
4050920382
CDM 		Tmj Unilateral Implant Oversz 19 $5,956.60 $59,416.80 $18,441.59 nat. median
$18,442
1.0× median
J3380
HCPCS 		Vedolizumab 300mg Injection 9 $15,535.66 $52,710.27 $17,477.61 nat. median
$155
outlier · 113.1×
J2323
HCPCS 		Natalizumab 300mg Inj 9 $14,532.28 $49,305.95 $16,348.82 nat. median
$180
outlier · 91.0×
J9299
HCPCS 		Nivolumab 100mg/10ml Inj Pr1mg 9 $4,162.62 $44,261.36 $13,476.48 nat. median
$2,849
outlier · 4.7×
J9306
HCPCS 		Pertuzumab 420mg/14ml Inj 9 $11,136.16 $37,783.40 $12,528.18 nat. median
$75
outlier · 166.9×
J9354
HCPCS 		Ado-trastuzumab 100mg 9 $6,549.20 $35,727.60 $11,367.01 nat. median
$4,219
outlier · 2.7×
J0896
HCPCS 		Luspatercpt 25mg Vl Pr0.25mg 9 $3,495.03 $35,593.86 $11,015.36 nat. median
$4,569
outlier · 2.4×
J9271
HCPCS 		Pembrolizumab 100mg/4ml Inj 9 $9,389.49 $31,857.21 $10,563.18 nat. median
$275
outlier · 38.5×
4050917837
CDM 		Stem Fem Slvls Offset 15x190mm 19 $3,253.60 $32,454.85 $10,073.17 nat. median
$10,073
1.0× median
4050921681
CDM 		Plate Orth 3d Ti Lefrt Sml- Rt 19 $1,716.70 $31,546.65 $9,297.96 nat. median
$9,298
1.0× median
4050921680
CDM 		Plate Orth 3d Ti Lefrt Sml- Lt 19 $1,716.70 $31,546.65 $9,297.96 nat. median
$9,298
1.0× median
4050006404
CDM 		Kit Trauma Lg Ex Fix03301011s 19 $2,913.20 $29,059.55 $9,019.33 nat. median
$9,019
1.0× median
J1930
HCPCS 		Lanreotide Acetate 120mg/0.5ml 9 $7,328.64 $24,865.03 $8,244.72 nat. median
$5,088
1.6× median
4050922084
CDM 		Rt Zyg Max 9 $7,280.00 $24,700.00 $8,190.00 nat. median
$8,190
1.0× median
J9173
HCPCS 		Durvalumab 500mg/10ml Vial 9 $7,093.69 $24,067.87 $7,980.40 nat. median
$1,119
outlier · 7.1×
C1813
HCPCS 		Cylinder Set With Pump Scrotal 19 $1,016.70 $27,607.00 $7,893.22 nat. median
$10,455
0.8× median
4050000738
CDM 		Solution Systems 8 St Lg 19 $2,486.60 $24,803.55 $7,698.47 nat. median
$7,698
1.0× median
J9177
HCPCS 		Enfortumb Vdotn-ejfv 20mg Vl 9 $4,607.46 $23,438.91 $7,457.27 nat. median
$2,933
outlier · 2.5×
J9061
HCPCS 		Amivantamab-vmjw 350mg/7 mLvl 9 $6,267.84 $21,265.90 $7,051.33 nat. median
$68
outlier · 104.1×
J3101
HCPCS 		Tenecteplase 50mg Inj 9 $6,085.19 $20,646.17 $6,845.84 nat. median
$3,787
1.8× median
4050912238
CDM 		Stem Femoral Taperloc 20x160 19 $2,210.30 $22,047.60 $6,843.06 nat. median
$6,843
1.0× median
4050913530
CDM 		Fitmore Hip Stem B Size4 19 $2,209.90 $22,043.80 $6,841.86 nat. median
$6,842
1.0× median
4050921114
CDM 		Plate,orthogn Titan Lefort Lg 19 $2,208.10 $22,025.75 $6,836.27 nat. median
$6,836
1.0× median
4050913246
CDM 		Wsl Revis Stem 135a 15x265mm 19 $2,206.70 $22,011.50 $6,831.89 nat. median
$6,832
1.0× median
4050002060
CDM 		Penile Implant 72401450 19 $2,147.50 $21,421.55 $6,648.70 nat. median
$6,649
1.0× median
4050920181
CDM 		Journey Cr Oxi Verilast W/np 19 $1,998.60 $19,935.75 $6,187.62 nat. median
$6,188
1.0× median
4050900712
CDM 		Global Cap CTA Duofix 44x18 19 $1,980.80 $19,758.10 $6,132.49 nat. median
$6,132
1.0× median
4050900713
CDM 		Global Cap CTA Duofix 48x18 19 $1,980.80 $19,758.10 $6,132.49 nat. median
$6,132
1.0× median
4050900718
CDM 		Global Cap CTA Duofix 56x21 19 $1,980.80 $19,758.10 $6,132.49 nat. median
$6,132
1.0× median
4050900709
CDM 		Global Cap CTA Duofix 40x15 19 $1,980.80 $19,758.10 $6,132.49 nat. median
$6,132
1.0× median
4050900710
CDM 		Global Cap CTA Duofix 40x18 19 $1,980.80 $19,758.10 $6,132.49 nat. median
$6,132
1.0× median
4050900716
CDM 		Global Cap CTA Duofix 52x21 19 $1,980.80 $19,758.10 $6,132.49 nat. median
$6,132
1.0× median
4050900711
CDM 		Global Cap CTA Duofix 44x15 19 $1,980.80 $19,758.10 $6,132.49 nat. median
$6,132
1.0× median
4050900714
CDM 		Global Cap CTA Duofix 48x21 19 $1,980.80 $19,758.10 $6,132.49 nat. median
$6,132
1.0× median
4050900715
CDM 		Global Cap CTA Duofix 52x18 19 $1,980.80 $19,758.10 $6,132.49 nat. median
$6,132
1.0× median
4050900717
CDM 		Global Cap CTA Duofix 56x18 19 $1,980.80 $19,758.10 $6,132.49 nat. median
$6,132
1.0× median
4050914770
CDM 		Psn Fem Cr Cmt Ccr Nrw Sz7 L 19 $1,949.60 $19,447.45 $6,035.99 nat. median
$6,036
1.0× median
4050002595
CDM 		Sigma Tc3 Fem Left S24 19 $1,902.50 $18,977.20 $5,890.10 nat. median
$5,890
1.0× median
4050911452
CDM 		Tc3 Femoral Cemented Size 3lt 19 $1,895.10 $18,904.05 $5,867.30 nat. median
$5,867
1.0× median
J1437
HCPCS 		Monoferric 1000 Mg/10 Ml Vial 9 $5,203.24 $17,653.85 $5,853.65 nat. median
$45
outlier · 129.6×
4050914230
CDM 		Cone Prox Body Por Plsm Uncemt 19 $1,887.80 $18,830.90 $5,844.65 nat. median
$5,845
1.0× median
4050920376
CDM 		Jii Med Dish Art Ins Lt Sz5-6 19 $1,882.20 $18,774.85 $5,827.27 nat. median
$5,827
1.0× median
4050914353
CDM 		Nexgen Lps Femoral Size G-rt 19 $1,881.50 $18,768.20 $5,825.16 nat. median
$5,825
1.0× median
J9358
HCPCS 		Fam-tras Derux-nxki 100mg Vial 9 $5,165.55 $17,525.98 $5,811.25 nat. median
$95
outlier · 61.0×

Other procedures at this hospital

Browse this hospital's 10,942 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J9309 HCPCS Polatuzumab Vedotin 140 Mg Vl 22 9 $70,315.67 $70,315.67 $6,314.09 $112,176.95 $27,242.75 2026-10-02
J9228 HCPCS Ipilimumab 200mg/40ml Inj 22 9 $63,275.40 $63,275.40 $15,002.06 $69,323.40 $22,822.00 2026-10-02
J9144 HCPCS Dartmumb-hyl 1800mg/15m Pr10mg 11 9 $72,392.31 $72,392.31 $20,269.85 $68,772.69 $22,803.58 2026-10-02
J9272 HCPCS Dostrlmab-gxly 500 Mg/10ml Vl 11 9 $70,986.00 $70,986.00 $19,876.08 $67,436.70 $22,360.59 2026-10-02
J9022 HCPCS Atezolizumab 1200mg/20ml Vial 22 9 $58,233.94 $58,233.94 $13,407.64 $65,154.29 $20,990.61 2026-10-02
J2327 HCPCS Risankizumab-rzaa 600mg/10mL V 11 9 $60,156.00 $60,156.00 $16,843.68 $57,148.20 $18,949.14 2026-10-02
4050920382 CDM Tmj Unilateral Implant Oversz 34 19 $59,566.00 $59,566.00 $5,956.60 $59,416.80 $18,441.59 2026-10-02
J3380 HCPCS Vedolizumab 300mg Injection 11 9 $55,484.49 $55,484.49 $15,535.66 $52,710.27 $17,477.61 2026-10-02
J2323 HCPCS Natalizumab 300mg Inj 11 9 $51,901.00 $51,901.00 $14,532.28 $49,305.95 $16,348.82 2026-10-02
J9299 HCPCS Nivolumab 100mg/10ml Inj Pr1mg 22 9 $30,728.71 $30,728.71 $4,162.62 $44,261.36 $13,476.48 2026-10-02
J9306 HCPCS Pertuzumab 420mg/14ml Inj 11 9 $39,772.00 $39,772.00 $11,136.16 $37,783.40 $12,528.18 2026-10-02
J9354 HCPCS Ado-trastuzumab 100mg 22 9 $30,499.00 $30,499.00 $6,549.20 $35,727.60 $11,367.01 2026-10-02
J0896 HCPCS Luspatercpt 25mg Vl Pr0.25mg 22 9 $24,974.73 $24,974.73 $3,495.03 $35,593.86 $11,015.36 2026-10-02
J9271 HCPCS Pembrolizumab 100mg/4ml Inj 11 9 $33,533.90 $33,533.90 $9,389.49 $31,857.21 $10,563.18 2026-10-02
4050917837 CDM Stem Fem Slvls Offset 15x190mm 34 19 $32,536.00 $32,536.00 $3,253.60 $32,454.85 $10,073.17 2026-10-02
4050921680 CDM Plate Orth 3d Ti Lefrt Sml- Lt 34 19 $17,167.00 $17,167.00 $1,716.70 $31,546.65 $9,297.96 2026-10-02
4050921681 CDM Plate Orth 3d Ti Lefrt Sml- Rt 34 19 $17,167.00 $17,167.00 $1,716.70 $31,546.65 $9,297.96 2026-10-02
4050006404 CDM Kit Trauma Lg Ex Fix03301011s 34 19 $29,132.00 $29,132.00 $2,913.20 $29,059.55 $9,019.33 2026-10-02
J1930 HCPCS Lanreotide Acetate 120mg/0.5ml 11 9 $26,173.72 $26,173.72 $7,328.64 $24,865.03 $8,244.72 2026-10-02
4050922084 CDM Rt Zyg Max 11 9 $26,000.00 $26,000.00 $7,280.00 $24,700.00 $8,190.00 2026-10-02
J9173 HCPCS Durvalumab 500mg/10ml Vial 11 9 $25,334.60 $25,334.60 $7,093.69 $24,067.87 $7,980.40 2026-10-02
C1813 HCPCS Cylinder Set With Pump Scrotal 68 19 $19,175.50 $19,175.50 $1,016.70 $27,607.00 $7,893.22 2026-10-02
4050000738 CDM Solution Systems 8 St Lg 34 19 $24,866.00 $24,866.00 $2,486.60 $24,803.55 $7,698.47 2026-10-02
J9177 HCPCS Enfortumb Vdotn-ejfv 20mg Vl 22 9 $20,563.89 $20,563.89 $4,607.46 $23,438.91 $7,457.27 2026-10-02
J9061 HCPCS Amivantamab-vmjw 350mg/7 mLvl 11 9 $22,385.16 $22,385.16 $6,267.84 $21,265.90 $7,051.33 2026-10-02
J3101 HCPCS Tenecteplase 50mg Inj 11 9 $21,732.81 $21,732.81 $6,085.19 $20,646.17 $6,845.84 2026-10-02
4050912238 CDM Stem Femoral Taperloc 20x160 34 19 $22,103.00 $22,103.00 $2,210.30 $22,047.60 $6,843.06 2026-10-02
4050913530 CDM Fitmore Hip Stem B Size4 34 19 $22,099.00 $22,099.00 $2,209.90 $22,043.80 $6,841.86 2026-10-02
4050921114 CDM Plate,orthogn Titan Lefort Lg 34 19 $22,081.00 $22,081.00 $2,208.10 $22,025.75 $6,836.27 2026-10-02
4050913246 CDM Wsl Revis Stem 135a 15x265mm 34 19 $22,067.00 $22,067.00 $2,206.70 $22,011.50 $6,831.89 2026-10-02
4050002060 CDM Penile Implant 72401450 34 19 $21,475.00 $21,475.00 $2,147.50 $21,421.55 $6,648.70 2026-10-02
4050920181 CDM Journey Cr Oxi Verilast W/np 34 19 $19,986.00 $19,986.00 $1,998.60 $19,935.75 $6,187.62 2026-10-02
4050900711 CDM Global Cap CTA Duofix 44x15 34 19 $19,808.00 $19,808.00 $1,980.80 $19,758.10 $6,132.49 2026-10-02
4050900710 CDM Global Cap CTA Duofix 40x18 34 19 $19,808.00 $19,808.00 $1,980.80 $19,758.10 $6,132.49 2026-10-02
4050900712 CDM Global Cap CTA Duofix 44x18 34 19 $19,808.00 $19,808.00 $1,980.80 $19,758.10 $6,132.49 2026-10-02
4050900713 CDM Global Cap CTA Duofix 48x18 34 19 $19,808.00 $19,808.00 $1,980.80 $19,758.10 $6,132.49 2026-10-02
4050900714 CDM Global Cap CTA Duofix 48x21 34 19 $19,808.00 $19,808.00 $1,980.80 $19,758.10 $6,132.49 2026-10-02
4050900717 CDM Global Cap CTA Duofix 56x18 34 19 $19,808.00 $19,808.00 $1,980.80 $19,758.10 $6,132.49 2026-10-02
4050900709 CDM Global Cap CTA Duofix 40x15 34 19 $19,808.00 $19,808.00 $1,980.80 $19,758.10 $6,132.49 2026-10-02
4050900716 CDM Global Cap CTA Duofix 52x21 34 19 $19,808.00 $19,808.00 $1,980.80 $19,758.10 $6,132.49 2026-10-02
4050900715 CDM Global Cap CTA Duofix 52x18 34 19 $19,808.00 $19,808.00 $1,980.80 $19,758.10 $6,132.49 2026-10-02
4050900718 CDM Global Cap CTA Duofix 56x21 34 19 $19,808.00 $19,808.00 $1,980.80 $19,758.10 $6,132.49 2026-10-02
4050914770 CDM Psn Fem Cr Cmt Ccr Nrw Sz7 L 34 19 $19,496.00 $19,496.00 $1,949.60 $19,447.45 $6,035.99 2026-10-02
4050002595 CDM Sigma Tc3 Fem Left S24 34 19 $19,025.00 $19,025.00 $1,902.50 $18,977.20 $5,890.10 2026-10-02
4050911452 CDM Tc3 Femoral Cemented Size 3lt 34 19 $18,951.00 $18,951.00 $1,895.10 $18,904.05 $5,867.30 2026-10-02
J1437 HCPCS Monoferric 1000 Mg/10 Ml Vial 11 9 $18,583.00 $18,583.00 $5,203.24 $17,653.85 $5,853.65 2026-10-02
4050914230 CDM Cone Prox Body Por Plsm Uncemt 34 19 $18,878.00 $18,878.00 $1,887.80 $18,830.90 $5,844.65 2026-10-02
4050920376 CDM Jii Med Dish Art Ins Lt Sz5-6 34 19 $18,822.00 $18,822.00 $1,882.20 $18,774.85 $5,827.27 2026-10-02
4050914353 CDM Nexgen Lps Femoral Size G-rt 34 19 $18,815.00 $18,815.00 $1,881.50 $18,768.20 $5,825.16 2026-10-02
J9358 HCPCS Fam-tras Derux-nxki 100mg Vial 11 9 $18,448.40 $18,448.40 $5,165.55 $17,525.98 $5,811.25 2026-10-02
4050002177 CDM Pump Ms 700cx 18x12 72404232 34 19 $18,759.00 $18,759.00 $1,875.90 $18,712.15 $5,807.80 2026-10-02
4050920698 CDM Kit Mand Recon Surg Planning 34 19 $18,709.00 $18,709.00 $1,870.90 $18,661.80 $5,792.24 2026-10-02
4050921116 CDM Guide, Orthog Titanium 34 19 $13,373.00 $13,373.00 $1,337.30 $19,359.10 $5,741.49 2026-10-02
4050912956 CDM Shell Accetab 4h 58mm 34 19 $12,541.00 $12,541.00 $1,254.10 $19,414.20 $5,722.08 2026-10-02
4050002003 CDM Pump Ms 700lgx 72404251 34 19 $18,214.00 $18,214.00 $1,821.40 $18,168.75 $5,639.10 2026-10-02
4050001749 CDM Pump 700 15cm 72404231 34 19 $18,214.00 $18,214.00 $1,821.40 $18,168.75 $5,639.10 2026-10-02
4050900702 CDM Global Cap Head Ha 52x18 34 19 $18,117.00 $18,117.00 $1,811.70 $18,071.85 $5,609.05 2026-10-02
4050900698 CDM Global Cap Head Ha 48x18 34 19 $18,117.00 $18,117.00 $1,811.70 $18,071.85 $5,609.05 2026-10-02
4050900708 CDM Global Cap Head Ha 56x21 34 19 $18,095.00 $18,095.00 $1,809.50 $18,050.00 $5,602.25 2026-10-02
4050900704 CDM Global Cap Head Ha 52x21 34 19 $18,095.00 $18,095.00 $1,809.50 $18,050.00 $5,602.25 2026-10-02
4050919021 CDM Jii Bcs Oxi W/np Tib Cnst Inst 34 19 $17,926.00 $17,926.00 $1,792.60 $17,880.90 $5,549.85 2026-10-02
4050918682 CDM Jii Xr Cr Oxi W/xr Isrt Xr Tib 34 19 $17,926.00 $17,926.00 $1,792.60 $17,880.90 $5,549.85 2026-10-02
4050918767 CDM Hip-porousfem With Cocrhd & R3 34 19 $17,926.00 $17,926.00 $1,792.60 $17,880.90 $5,549.85 2026-10-02
4050900699 CDM Global Cap Head Pc 48x21 34 19 $17,758.00 $17,758.00 $1,775.80 $17,713.70 $5,497.89 2026-10-02
4050900703 CDM Global Cap Head Pc 52x21 34 19 $17,758.00 $17,758.00 $1,775.80 $17,713.70 $5,497.89 2026-10-02
4050900695 CDM Global Cap Head Pc 44x18 34 19 $17,758.00 $17,758.00 $1,775.80 $17,713.70 $5,497.89 2026-10-02
4050900701 CDM Global Cap Head Pc 52x18 34 19 $17,758.00 $17,758.00 $1,775.80 $17,713.70 $5,497.89 2026-10-02
4050900689 CDM Global Cap Head Pc 40x15 34 19 $17,758.00 $17,758.00 $1,775.80 $17,713.70 $5,497.89 2026-10-02
4050900693 CDM Global Cap Head Pc 44x15 34 19 $17,758.00 $17,758.00 $1,775.80 $17,713.70 $5,497.89 2026-10-02
4050900697 CDM Global Cap Head Pc 48x18 34 19 $17,758.00 $17,758.00 $1,775.80 $17,713.70 $5,497.89 2026-10-02
4050900705 CDM Global Cap Head Pc 56x18 34 19 $17,758.00 $17,758.00 $1,775.80 $17,713.70 $5,497.89 2026-10-02
4050900691 CDM Global Cap Head Pc 40x18 34 19 $17,758.00 $17,758.00 $1,775.80 $17,713.70 $5,497.89 2026-10-02
4050900707 CDM Global Cap Head Pc 56x21 34 19 $17,758.00 $17,758.00 $1,775.80 $17,713.70 $5,497.89 2026-10-02
4050914277 CDM Stem Humeral Frac 10mm Pps 34 19 $17,594.00 $17,594.00 $1,759.40 $17,550.30 $5,447.15 2026-10-02
4050911929 CDM Femoral Cr Rt 72.5mm Vangrd 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911938 CDM Femoral Cr Left 70mm Vanguard 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911937 CDM Femoral Cr Left 67.5mm Vangrd 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911245 CDM Fem.comp. Vanguard Lt Cr 65mm 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911939 CDM Femoral Cr Left 57.5mm Vangrd 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911940 CDM Femoral Cr Left 55mm Vanguard 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911932 CDM Femoral Cr Rt 67.5mm Vangrd 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911798 CDM Femoral Cr 60mm Vanguard 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911924 CDM Fem Comp Cr 75mm Left 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911138 CDM Vanguard Fem Comp Cr 65 Rt 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911933 CDM Femoral Cr Rt 62.5mm Vangrd 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911931 CDM Femoral Cr Rt 75mm Vanguard 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911930 CDM Femoral Cr Rt 70mm Vanguard 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911935 CDM Femoral Cr Left 72.5mm Vangrd 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050911936 CDM Femoral Cr Left 60mm Vanguard 34 19 $17,464.00 $17,464.00 $1,746.40 $17,420.15 $5,406.82 2026-10-02
4050918894 CDM Syn Por Plus Ha Fem Sz 13 Ho 34 19 $17,454.00 $17,454.00 $1,745.40 $17,410.65 $5,403.81 2026-10-02
4050001833 CDM Stem Fem Lg Stature 155402165 34 19 $17,399.00 $17,399.00 $1,739.90 $17,355.55 $5,386.74 2026-10-02
4050001880 CDM Head Global C.a.p.pc 52 X 18 34 19 $17,299.00 $17,299.00 $1,729.90 $17,255.80 $5,355.78 2026-10-02
4050912988 CDM Dressing Wound Matrix Bmw4051 34 19 $17,296.00 $17,296.00 $1,729.60 $17,252.95 $5,354.87 2026-10-02
4050912513 CDM Bmp Infuse Bone Graft 5.6m 34 19 $17,293.00 $17,293.00 $1,729.30 $17,250.10 $5,353.97 2026-10-02
4050916578 CDM Stem Humeral Mini 13x83mm 34 19 $17,264.00 $17,264.00 $1,726.40 $17,220.65 $5,344.91 2026-10-02
4050914789 CDM Mini Humeral Stem 11x83mm 34 19 $17,264.00 $17,264.00 $1,726.40 $17,220.65 $5,344.91 2026-10-02
4050916724 CDM Humeral Stem Mini 15x83mm 34 19 $17,264.00 $17,264.00 $1,726.40 $17,220.65 $5,344.91 2026-10-02
4050900706 CDM Global Cap Head Ha 56x18 34 19 $17,252.00 $17,252.00 $1,725.20 $17,209.25 $5,341.28 2026-10-02
4050900696 CDM Global Cap Head Ha 44x18 34 19 $17,252.00 $17,252.00 $1,725.20 $17,209.25 $5,341.28 2026-10-02
4050900694 CDM Global Cap Head Ha 44x15 34 19 $17,252.00 $17,252.00 $1,725.20 $17,209.25 $5,341.28 2026-10-02
4050900692 CDM Global Cap Head Ha 40x18 34 19 $17,252.00 $17,252.00 $1,725.20 $17,209.25 $5,341.28 2026-10-02
4050900700 CDM Global Cap Head Ha 48x21 34 19 $17,252.00 $17,252.00 $1,725.20 $17,209.25 $5,341.28 2026-10-02
4050900690 CDM Global Cap Head Ha 40x15 34 19 $17,252.00 $17,252.00 $1,725.20 $17,209.25 $5,341.28 2026-10-02
4050913206 CDM Humeral Head 10x83mm 34 19 $16,958.00 $16,958.00 $1,695.80 $16,915.70 $5,250.21 2026-10-02
4050917125 CDM Syn Por Plus Ha Stem Sz 12 34 19 $16,909.00 $16,909.00 $1,690.90 $16,866.30 $5,234.96 2026-10-02
4050918021 CDM Syn Por Plus Ha Fem Sz 15 Ho 34 19 $16,909.00 $16,909.00 $1,690.90 $16,866.30 $5,234.96 2026-10-02
4050916164 CDM Syn Por Plus Ha Stem Sz 15 34 19 $16,909.00 $16,909.00 $1,690.90 $16,866.30 $5,234.96 2026-10-02
4050920373 CDM Syn Por Plus Ha Stem Sz 10 34 19 $16,909.00 $16,909.00 $1,690.90 $16,866.30 $5,234.96 2026-10-02
4050916875 CDM Syn Por Plus Ha Stem Sz 14 34 19 $16,909.00 $16,909.00 $1,690.90 $16,866.30 $5,234.96 2026-10-02
4050916679 CDM Syn Por Plus Ha Stem Sz 14 34 19 $16,909.00 $16,909.00 $1,690.90 $16,866.30 $5,234.96 2026-10-02
4050006565 CDM Pulse Generator + Lead 5820 34 19 $16,899.00 $16,899.00 $1,689.90 $16,856.80 $5,231.94 2026-10-02
4050006567 CDM Zephyr Xl Dr Pacemaker-5826 34 19 $16,899.00 $16,899.00 $1,689.90 $16,856.80 $5,231.94 2026-10-02
4050006566 CDM Pulse Generator Accent Dr Rf 34 19 $16,858.00 $16,858.00 $1,685.80 $16,815.95 $5,219.25 2026-10-02
4050001986 CDM Mesh Surgisis Gld Csah8h20x20 34 19 $16,852.00 $16,852.00 $1,685.20 $16,810.25 $5,217.44 2026-10-02
4050002631 CDM Stem Global Fx 1128-08-000 34 19 $16,807.00 $16,807.00 $1,680.70 $16,764.65 $5,203.40 2026-10-02
4050001896 CDM Stem Humeral 1128-12-000 34 19 $16,807.00 $16,807.00 $1,680.70 $16,764.65 $5,203.40 2026-10-02
4050002619 CDM Stem 1521-21-000 34 19 $16,787.00 $16,787.00 $1,678.70 $16,744.70 $5,197.20 2026-10-02
4050002605 CDM Sleeve Fem 1294-53-216 34 19 $16,663.00 $16,663.00 $1,666.30 $16,621.20 $5,158.84 2026-10-02
4050911872 CDM Stem Femoral 11x142mm Type 1 34 19 $16,448.00 $16,448.00 $1,644.80 $16,406.50 $5,092.24 2026-10-02
4050912168 CDM Stem Femoral Taperloc 8 X 136 34 19 $16,448.00 $16,448.00 $1,644.80 $16,406.50 $5,092.24 2026-10-02
4050911921 CDM Stem Fem Taperloc 9x137mm 34 19 $16,448.00 $16,448.00 $1,644.80 $16,406.50 $5,092.24 2026-10-02
4050912696 CDM Stem Fem Taperloc 15x150mm 34 19 $16,416.00 $16,416.00 $1,641.60 $16,375.15 $5,082.43 2026-10-02
4050913043 CDM Taperloc Fem Pcstem 18x156mm 34 19 $16,416.00 $16,416.00 $1,641.60 $16,375.15 $5,082.43 2026-10-02
4050913706 CDM Fem Por Coated Stem 17x154mm 34 19 $16,416.00 $16,416.00 $1,641.60 $16,375.15 $5,082.43 2026-10-02
4050902141 CDM Biomet Troch Plate Short159mm 34 19 $16,373.00 $16,373.00 $1,637.30 $16,332.40 $5,069.14 2026-10-02
4050915330 CDM Tprlc 133 T1 Pps Ho 13x146mm 34 19 $16,344.00 $16,344.00 $1,634.40 $16,302.95 $5,060.07 2026-10-02
4050911998 CDM Stem Fem 7x134mm Taperloc Std 34 19 $16,344.00 $16,344.00 $1,634.40 $16,302.95 $5,060.07 2026-10-02
4050912057 CDM Stem Fem Std Typ1 14x148mm Tl 34 19 $16,344.00 $16,344.00 $1,634.40 $16,302.95 $5,060.07 2026-10-02
4050912923 CDM Fem Stem 14x148mm High Offset 34 19 $16,344.00 $16,344.00 $1,634.40 $16,302.95 $5,060.07 2026-10-02
4050913219 CDM Taperloc Fem Stem 17x154mm 34 19 $16,344.00 $16,344.00 $1,634.40 $16,302.95 $5,060.07 2026-10-02
4050915616 CDM Stem Fem Prim6x132mm Taperloc 34 19 $16,344.00 $16,344.00 $1,634.40 $16,302.95 $5,060.07 2026-10-02
4050911790 CDM Stem Taperloc 10 X 140mm Typ1 34 19 $16,344.00 $16,344.00 $1,634.40 $16,302.95 $5,060.07 2026-10-02
4050916023 CDM Stem Fem Taperloc 16x152mm 34 19 $16,344.00 $16,344.00 $1,634.40 $16,302.95 $5,060.07 2026-10-02
4050911985 CDM Stem Fem Taperloc12x144mm Hig 34 19 $16,344.00 $16,344.00 $1,634.40 $16,302.95 $5,060.07 2026-10-02
4050922283 CDM Plate Buttress Plate 2h 1.5mm 11 9 $15,982.00 $15,982.00 $4,474.96 $15,182.90 $5,034.33 2026-10-02
4050911147 CDM Head Copeland Resurf Sz6 34 19 $16,079.00 $16,079.00 $1,607.90 $16,038.85 $4,978.07 2026-10-02
4050911220 CDM Head Copeland Ha Sz4 Resurf 34 19 $16,079.00 $16,079.00 $1,607.90 $16,038.85 $4,978.07 2026-10-02
4050910898 CDM Cr Fem Rt 52 7 Cem 150400207 34 19 $15,997.00 $15,997.00 $1,599.70 $15,957.15 $4,952.69 2026-10-02
4050918976 CDM Nail Fibulock 3.0x130mm Left 34 19 $15,974.00 $15,974.00 $1,597.40 $15,934.35 $4,945.60 2026-10-02
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 $22,620.00 $22,620.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
713 MS_DRG Transurethral Prostatectomy With Cc/mcc 1 1 $88,153.50 $88,153.50 $4,939.00 $4,939.00 $4,939.00 2026-07-15
412 MS_DRG Cholecystectomy With C.d.e. With Cc 1 1 $34,183.00 $34,183.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 1 1 $63,336.52 $63,336.52 $4,939.00 $4,939.00 $4,939.00 2026-07-15
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 1 1 $61,113.00 $61,113.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
671 MS_DRG Urethral Procedures With Cc/mcc 1 1 $53,264.00 $53,264.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
14 MS_DRG Allogeneic Bone Marrow Transplant 1 1 $78,904.90 $78,904.90 $4,939.00 $4,939.00 $4,939.00 2026-07-15
740 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Cc 1 1 $48,295.50 $48,295.50 $4,939.00 $4,939.00 $4,939.00 2026-07-15
901 MS_DRG Wound Debridements For Injuries With Mcc 1 1 $51,316.00 $51,316.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 1 1 $86,926.00 $86,926.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
663 MS_DRG Minor Bladder Procedures With Cc 1 1 $25,144.00 $25,144.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 1 1 $143,742.00 $143,742.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 $21,945.00 $21,945.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 1 1 $45,466.00 $45,466.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
421 MS_DRG Hepatobiliary Diagnostic Procedures With Cc 1 1 $21,558.00 $21,558.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 1 1 $40,286.00 $40,286.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
770 MS_DRG Abortion With D&c, Aspiration Curettage Or Hysterotomy 1 1 $58,190.50 $58,190.50 $4,939.00 $4,939.00 $4,939.00 2026-07-15
769 MS_DRG Postpartum And Post Abortion Diagnoses With O.r. Procedures 1 1 $55,263.50 $55,263.50 $4,939.00 $4,939.00 $4,939.00 2026-07-15
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 1 1 $26,675.00 $26,675.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 1 1 $26,718.00 $26,718.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 1 1 $44,918.00 $44,918.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 $60,607.00 $60,607.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 1 1 $241,141.00 $241,141.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 1 1 $123,086.00 $123,086.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 1 $73,021.00 $73,021.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
906 MS_DRG Hand Procedures For Injuries 1 1 $21,479.00 $21,479.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 $37,976.00 $37,976.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 1 1 $46,485.50 $46,485.50 $4,939.00 $4,939.00 $4,939.00 2026-07-15
627 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures Without Cc/mcc 1 1 $25,798.00 $25,798.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 1 1 $29,171.00 $29,171.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
798 MS_DRG Vaginal Delivery With Sterilization And/or D&c Without Cc/mcc 1 1 $54,999.00 $54,999.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 1 1 $19,934.00 $19,934.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 1 1 $113,240.00 $113,240.00 $4,939.00 $4,939.00 $4,939.00 2026-07-15
4050001973 CDM Mesh Permcol P101520 34 19 $15,841.00 $15,841.00 $1,584.10 $15,801.35 $4,904.36 2026-10-02
11752 CPT ER Fee Removal Of Nail Tip 5 5 $5,371.00 $4,296.80 $3,665.71 $5,102.45 $4,887.61 2026-07-31
19085LT OTHER MRI Bx Breast Lt 5 5 $5,369.00 $4,295.20 20% off $1,426.00 $5,100.55 $4,885.79 2026-07-31
4050911266 CDM Head Humrl Copeland Resurfsz4 34 19 $15,628.00 $15,628.00 $1,562.80 $15,588.55 $4,838.37 2026-10-02
4050911050 CDM Head Copeland Ha Sz6 Resurf 34 19 $15,628.00 $15,628.00 $1,562.80 $15,588.55 $4,838.37 2026-10-02
4050912292 CDM Humeral Head Copeland Sz 3 34 19 $15,627.00 $15,627.00 $1,562.70 $15,587.60 $4,838.07 2026-10-02
4050919130 CDM Nail Fibulock 3.8x130mm Rt 34 19 $15,559.00 $15,559.00 $1,555.90 $15,520.15 $4,817.07 2026-10-02
4050919471 CDM Nail Fibulock 3.0x130mm Rt 34 19 $15,559.00 $15,559.00 $1,555.90 $15,520.15 $4,817.07 2026-10-02
4170001888 CDM Sactuzumb Gvtcn-hziy 180mg Vl 11 9 $15,120.18 $15,120.18 $4,233.65 $14,364.17 $4,762.86 2026-10-02
J0894 HCPCS Decitabine 50mg Injection 5 5 $5,215.00 $4,172.00 20% off $3,559.24 $4,954.25 $4,745.65 2026-07-31
4050002655 CDM Tray Tib Sz 3 Mbt 1294-35-130 34 19 $15,316.00 $15,316.00 $1,531.60 $15,277.90 $4,741.86 2026-10-02
4050002632 CDM Stem Global Fx 1128-10-000 34 19 $15,280.00 $15,280.00 $1,528.00 $15,241.80 $4,730.69 2026-10-02
4050911455 CDM Tray Tibial Rp Revision Sz 3 34 19 $15,257.00 $15,257.00 $1,525.70 $15,219.00 $4,723.59 2026-10-02
Q5117 HCPCS Trastuzumab-anns 150mg Vial 22 9 $10,576.50 $10,576.50 $1,567.72 $14,776.30 $4,701.20 2026-10-02
4050916593 CDM Stem Shoulder 11mm X 122mm 34 19 $15,178.00 $15,178.00 $1,517.80 $15,140.15 $4,699.12 2026-10-02
4050916695 CDM Stem Should 9mm X 125mm 34 19 $15,178.00 $15,178.00 $1,517.80 $15,140.15 $4,699.12 2026-10-02
73222RT OTHER MRI Arthrogram Shoulder Rt 5 5 $5,103.00 $4,082.40 20% off $421.50 $4,847.85 $4,643.73 2026-07-31
73222LT OTHER MRI Arthrogram Shoulder Lt 5 5 $5,103.00 $4,082.40 20% off $421.50 $4,847.85 $4,643.73 2026-07-31
4050921886 CDM Plate Orth 3d Ti Man Sm Lt 34 19 $14,959.00 $14,959.00 $1,495.90 $14,921.65 $4,631.32 2026-10-02
788 MS_DRG Cesarean Section Without Sterilization Without Cc/mcc 1 1 $40,791.00 $40,791.00 $4,618.00 $4,618.00 $4,618.00 2026-07-15
4050912803 CDM Stem Shoulder 10mm X 122mm 34 19 $14,909.00 $14,909.00 $1,490.90 $14,871.30 $4,615.76 2026-10-02
4050917225 CDM Per Cem Fem/cem Tib/ve Sur Std 34 19 $14,898.00 $14,898.00 $1,489.80 $14,860.85 $4,612.43 2026-10-02
4050912822 CDM G7 Acet Shel Multi Hole 56mm 34 19 $14,876.00 $14,876.00 $1,487.60 $14,839.00 $4,605.64 2026-10-02
4050912542 CDM Vangrd Femoral Cr Right 65mm 34 19 $14,703.00 $14,703.00 $1,470.30 $14,666.10 $4,552.02 2026-10-02
4050900633 CDM Vanguard Cr Ret.femrl Lt62.5 34 19 $14,655.00 $14,655.00 $1,465.50 $14,618.60 $4,537.23 2026-10-02
4050922072 CDM Nail Fem Retro 10mm X 32cm 11 9 $14,400.00 $14,400.00 $4,032.00 $13,680.00 $4,536.00 2026-10-02
4050922071 CDM Nail Femoral 11.5mm X 30cm 11 9 $14,400.00 $14,400.00 $4,032.00 $13,680.00 $4,536.00 2026-10-02
4050921969 CDM Nail Fem Retro 10mmx38cm 11 9 $14,400.00 $14,400.00 $4,032.00 $13,680.00 $4,536.00 2026-10-02
4050901823 CDM Tri-lock Fem Stem Sz 9 Std 34 19 $14,570.00 $14,570.00 $1,457.00 $14,534.05 $4,510.95 2026-10-02
4050908175 CDM Tri-lock Fem Stem Sz 5 Hi 34 19 $14,570.00 $14,570.00 $1,457.00 $14,534.05 $4,510.95 2026-10-02
4050902615 CDM Tri-lock Fem Stem Sz 10 Std 34 19 $14,570.00 $14,570.00 $1,457.00 $14,534.05 $4,510.95 2026-10-02
4050910122 CDM Tri-lock Fem Stem Sz 11 Std 34 19 $14,570.00 $14,570.00 $1,457.00 $14,534.05 $4,510.95 2026-10-02
4050902614 CDM Tri-lock Fem Stem Sz 8 Std 34 19 $14,570.00 $14,570.00 $1,457.00 $14,534.05 $4,510.95 2026-10-02
4050902617 CDM Tri-lock Fem Stem Sz 6 Hi 34 19 $14,570.00 $14,570.00 $1,457.00 $14,534.05 $4,510.95 2026-10-02
4050902613 CDM Tri-lock Fem Stem Sz 7 Std 34 19 $14,570.00 $14,570.00 $1,457.00 $14,534.05 $4,510.95 2026-10-02
4050902618 CDM Tri-lock Fem Stem Sz 7 Hi 34 19 $14,570.00 $14,570.00 $1,457.00 $14,534.05 $4,510.95 2026-10-02
4050902616 CDM Tri-lock Fem Stem Sz 2 Hi 34 19 $14,570.00 $14,570.00 $1,457.00 $14,534.05 $4,510.95 2026-10-02
4050902612 CDM Tri-lock Fem Stem Sz 6 Std 34 19 $14,570.00 $14,570.00 $1,457.00 $14,534.05 $4,510.95 2026-10-02
4050902608 CDM Tri-lock Fem Stem Sz 2 Std 34 19 $14,570.00 $14,570.00 $1,457.00 $14,534.05 $4,510.95 2026-10-02
4050908182 CDM Tri-lock Fem Stem Sz 3 Hi 34 19 $14,570.00 $14,570.00 $1,457.00 $14,534.05 $4,510.95 2026-10-02
4050902611 CDM Tri-lock Fem Stem Sz 5 Std 34 19 $14,570.00 $14,570.00 $1,457.00 $14,534.05 $4,510.95 2026-10-02
4050902610 CDM Tri-lock Fem Stem Sz 4 Std 34 19 $14,569.00 $14,569.00 $1,456.90 $14,532.15 $4,510.49 2026-10-02
4050902609 CDM Tri-lock Fem Stem Sz 3 Std 34 19 $14,569.00 $14,569.00 $1,456.90 $14,532.15 $4,510.49 2026-10-02
4050900126 CDM Stem Sz4 Hi Offset 1012-14040 34 19 $14,552.00 $14,552.00 $1,455.20 $14,516.00 $4,505.36 2026-10-02
4050900121 CDM Stem Sz1 Sd Offset 1012-04010 34 19 $14,551.00 $14,551.00 $1,455.10 $14,515.05 $4,505.06 2026-10-02
4050921132 CDM Speedbrg Imp Sys With Bc Swvlk 34 19 $14,532.00 $14,532.00 $1,453.20 $14,496.05 $4,499.17 2026-10-02
4050913623 CDM Psn Fem Ps Cmt Ccr Std Sz1or 34 19 $14,528.00 $14,528.00 $1,452.80 $14,491.30 $4,497.81 2026-10-02
4050918614 CDM Lgn Gii Oxi Por Tib Std Insert 34 19 $14,526.00 $14,526.00 $1,452.60 $14,489.40 $4,497.20 2026-10-02
4050914902 CDM Psn Fem Ps Cmt Ccr Nrw Sz7 L 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050916289 CDM Psn Fem Cr Smt Ccr Nrw Sz 8 L 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050914973 CDM Psn Fem Ps Cmt Ccr Std Sz 5 L 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050914030 CDM Psn Fem Ps Cmt Ccr Std Sz10l 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050914886 CDM Psn Fem Ps Cmt Ccr Std Sz7 L 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050914994 CDM Psn Fem Cr Cmt Ccr Nrw Sz6 R 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050914222 CDM Psn Fem Cr Cmt Ccr Nrw Sz4r 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050913759 CDM Psn Fem Ps Cmt Ccr Nrw Sz7r 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050915489 CDM Pas Fem Cr Cmt Ccr Std Sz8 L 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050914175 CDM Psn Fem Ps Cmt Ccr Std Sz11l 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050915255 CDM Psn Fem Cr Cmt Ccr Std Sz6 R 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050914550 CDM Psn Fem Ps Cmt Ccr Std Sz7 R 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050915736 CDM Psn Fem Cr Cmt Ccr Nrw Sz8 R 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050914755 CDM Psn Fem Cr Cmt Ccr Std Sz 12 R 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050915800 CDM Psn Fem Cr Cmt Ccr Nrw Sz5 R 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050914534 CDM Psn Fem Ps Cmt Ccr Std Sz8 R 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050914662 CDM Psn Fem Cr Cmt Ccr Std Sz6 L 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050914629 CDM Psn Fem Ps Cmt Ccr Std Sz9 R 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050914603 CDM Psn Fem Ps Cmt Ccr Nrw Sz8 L 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
4050914609 CDM Psn Fem Cr Cmt Ccr Nrw Sz6 L 34 19 $14,464.00 $14,464.00 $1,446.40 $14,427.65 $4,478.02 2026-10-02
J1950 HCPCS Leuprolide 11.25 Mg Syringe 22 9 $10,148.00 $10,148.00 $1,422.68 $14,454.25 $4,473.21 2026-10-02
4050912832 CDM Cruc Ret Intlk Fmrl Lt 55mm 34 19 $14,443.00 $14,443.00 $1,444.30 $14,406.75 $4,471.53 2026-10-02
4050913401 CDM Cruc Ret Ilok Fmrl Lt 57.5mm 34 19 $14,443.00 $14,443.00 $1,444.30 $14,406.75 $4,471.53 2026-10-02
4050912160 CDM Femoral Cr Vanguard Rt 60mm 34 19 $14,443.00 $14,443.00 $1,444.30 $14,406.75 $4,471.53 2026-10-02
4050912463 CDM Vangrd Cr Femoral Right 70mm 34 19 $14,443.00 $14,443.00 $1,444.30 $14,406.75 $4,471.53 2026-10-02
4050912500 CDM Vangrd Cr Femoral 70mm Left 34 19 $14,443.00 $14,443.00 $1,444.30 $14,406.75 $4,471.53 2026-10-02
4050912541 CDM Vangrd Femoral Cr Left 65mm 34 19 $14,443.00 $14,443.00 $1,444.30 $14,406.75 $4,471.53 2026-10-02
4050921872 CDM Nail Fem Retro 10mmx30cm 34 19 $14,400.00 $14,400.00 $1,440.00 $14,364.00 $4,458.24 2026-10-02
4050914315 CDM Tm Humeral Stem 48 Deg 11x130m 34 19 $14,374.00 $14,374.00 $1,437.40 $14,338.35 $4,450.24 2026-10-02
4050913359 CDM Acet Shell 54mm Cementless 34 19 $12,541.00 $12,541.00 $1,254.10 $14,635.70 $4,421.52 2026-10-02
4050918011 CDM Stem Fem Std Offset Sz 7 34 19 $14,147.00 $14,147.00 $1,414.70 $14,111.30 $4,379.86 2026-10-02
4050916415 CDM Intertan 10s 10mmx44cm 125d Rt 34 19 $14,139.00 $14,139.00 $1,413.90 $14,103.70 $4,377.44 2026-10-02
4050916426 CDM Intertan 13x38cm 125 Lt 34 19 $14,139.00 $14,139.00 $1,413.90 $14,103.70 $4,377.44 2026-10-02
4050915922 CDM Intertan 13x42cm 125 Rt 34 19 $14,139.00 $14,139.00 $1,413.90 $14,103.70 $4,377.44 2026-10-02
4050915512 CDM Intertan 10s 10mmx38cm 125d Ri 34 19 $14,139.00 $14,139.00 $1,413.90 $14,103.70 $4,377.44 2026-10-02
4050921907 CDM Bioinductive Implant Med 34 19 $14,136.00 $14,136.00 $1,413.60 $14,100.85 $4,376.53 2026-10-02
4050921721 CDM Bioinductive Implant Lg 34 19 $14,136.00 $14,136.00 $1,413.60 $14,100.85 $4,376.53 2026-10-02
4050918179 CDM Journey Cr Cocr W/np Tib 34 19 $14,073.00 $14,073.00 $1,407.30 $14,038.15 $4,357.06 2026-10-02
4050918012 CDM Femoral Head Taper 36mm -3 11 9 $13,792.00 $13,792.00 $3,861.76 $13,102.40 $4,344.48 2026-10-02
4050917858 CDM Hip Tandem Bipolar Porfem 34 19 $13,955.00 $13,955.00 $1,395.50 $13,920.35 $4,320.50 2026-10-02
4050901437 CDM Global Advant Hum Stem 14mm 34 19 $13,923.00 $13,923.00 $1,392.30 $13,888.05 $4,310.54 2026-10-02
4050917296 CDM Trigen 11.5mmx38cm 125 Nail L 34 19 $13,914.00 $13,914.00 $1,391.40 $13,879.50 $4,307.82 2026-10-02
4050917084 CDM Intertan 10s 10mmx40cm 125d Rt 34 19 $13,914.00 $13,914.00 $1,391.40 $13,879.50 $4,307.82 2026-10-02
4050915548 CDM Intertn 1.5 11.5x45cm 125d Rt 34 19 $13,914.00 $13,914.00 $1,391.40 $13,879.50 $4,307.82 2026-10-02
4050915578 CDM Intertan 10s 10mmx34cm 125d Rt 34 19 $13,914.00 $13,914.00 $1,391.40 $13,879.50 $4,307.82 2026-10-02
4050921720 CDM Tendon Anchor 34 19 $9,894.00 $9,894.00 $989.40 $14,593.90 $4,301.36 2026-10-02
4050921719 CDM Bone Anchor 34 19 $9,894.00 $9,894.00 $989.40 $14,593.90 $4,301.36 2026-10-02
4050018585 CDM Speedbrg Imp Sys With Swvlck 11 9 $13,593.00 $13,593.00 $3,806.04 $12,913.35 $4,281.80 2026-10-02
4050901779 CDM Calcar Fem Stem Sz 3 X 45mm 34 19 $13,808.00 $13,808.00 $1,380.80 $13,773.10 $4,274.90 2026-10-02
4050910805 CDM Sleeve Universal Fem 31mm 34 19 $13,778.00 $13,778.00 $1,377.80 $13,743.65 $4,265.68 2026-10-02
4050915250 CDM Psn Fem Cr Cmt Ccr Nrw Sz 7 R 34 19 $14,464.00 $14,464.00 $1,446.40 $13,740.80 $4,252.42 2026-10-02
4050914017 CDM Psn Fem Cr Cmt Ccr Std Sz7 L 34 19 $14,464.00 $14,464.00 $1,446.40 $13,740.80 $4,252.42 2026-10-02
4050914270 CDM Psn Fem Cr Cmt Ccr Std Sz5 R 34 19 $14,464.00 $14,464.00 $1,446.40 $13,740.80 $4,252.42 2026-10-02
4050917355 CDM Psn Fem Cr Cmt Ccr Std Sz8 R 34 19 $14,464.00 $14,464.00 $1,446.40 $13,740.80 $4,252.42 2026-10-02
77058 CPT MRI Breast Rt 5 5 $4,666.00 $3,732.80 $3,184.55 $4,432.70 $4,246.06 2026-07-31
4050001958 CDM Mbt Rev Tib Tray Sz 2.5 34 19 $13,676.00 $13,676.00 $1,367.60 $13,642.00 $4,234.12 2026-10-02
4050913429 CDM Equinox Pl Fx Hum St Cem 10.5 34 19 $13,667.00 $13,667.00 $1,366.70 $13,632.50 $4,231.25 2026-10-02
77295 CPT 3-dimensional Radiotherapy Plan, Including Dose-volume Histograms 63 20 $14,254.00 $14,254.00 $389.50 $14,218.65 $4,212.86 2026-10-02
4050912836 CDM Brng Tib E1 Vangrd12mx63/67mm 34 19 $13,600.00 $13,600.00 $1,360.00 $13,566.00 $4,210.56 2026-10-02
19085RT OTHER MRI Bx Breast Rt 5 5 $4,618.00 $3,694.40 20% off $1,426.00 $4,387.10 $4,202.38 2026-07-31
J2356 HCPCS Tzpelumab-ekko 210mg/1.91ml Sy 11 9 $13,330.50 $13,330.50 $3,732.54 $12,663.98 $4,199.11 2026-10-02
Q5107 HCPCS Bevacizumab-awwb 400 Mg/16 Ml 11 9 $13,309.00 $13,309.00 $3,726.52 $12,643.55 $4,192.34 2026-10-02
4050921869 CDM Plate 3.5 18hole L Tibia 34 19 $13,508.00 $13,508.00 $1,350.80 $13,473.85 $4,182.01 2026-10-02
4050915540 CDM Psn Fem Cr Cmt Ccr Std Sz7 R 34 19 $14,464.00 $14,464.00 $1,446.40 $13,740.80 $4,181.76 2026-10-02
4050912138 CDM Nail Hip Fx Rt 130deg11x380mm 34 19 $13,422.00 $13,422.00 $1,342.20 $13,388.35 $4,155.43 2026-10-02
4050913143 CDM Affixus Hip Fx Nail 11x340mm 34 19 $13,422.00 $13,422.00 $1,342.20 $13,388.35 $4,155.43 2026-10-02
4050921281 CDM Plate Lat Prox Tib 8hl 113mm 34 19 $13,415.00 $13,415.00 $1,341.50 $13,381.70 $4,153.32 2026-10-02
4050912063 CDM Femur Ps 70 Right Vanguard 34 19 $13,401.00 $13,401.00 $1,340.10 $13,367.45 $4,148.94 2026-10-02
4050912041 CDM Femur Ps 80 Rt Vanguard 34 19 $13,401.00 $13,401.00 $1,340.10 $13,367.45 $4,148.94 2026-10-02
4050912028 CDM Femur Ps 75 Right Vanguard 34 19 $13,401.00 $13,401.00 $1,340.10 $13,367.45 $4,148.94 2026-10-02
4050911993 CDM Femur Ps 65 Left Vanguard 34 19 $13,401.00 $13,401.00 $1,340.10 $13,367.45 $4,148.94 2026-10-02
4050912064 CDM Femur Ps 60 Right Vanguard 34 19 $13,401.00 $13,401.00 $1,340.10 $13,367.45 $4,148.94 2026-10-02
4050911945 CDM Femur Ps 75 Left Vanguard 34 19 $13,401.00 $13,401.00 $1,340.10 $13,367.45 $4,148.94 2026-10-02
4050912044 CDM Femur Ps 72.5 Rt Vanguard 34 19 $13,401.00 $13,401.00 $1,340.10 $13,367.45 $4,148.94 2026-10-02
4050911989 CDM Femur Ps 70 Left Vanguard 34 19 $13,401.00 $13,401.00 $1,340.10 $13,367.45 $4,148.94 2026-10-02
4050911990 CDM Femur Ps 72.5 Left Vanguard 34 19 $13,401.00 $13,401.00 $1,340.10 $13,367.45 $4,148.94 2026-10-02
4050912065 CDM Femur Ps 62.5 Right Vanguard 34 19 $13,401.00 $13,401.00 $1,340.10 $13,367.45 $4,148.94 2026-10-02
4050911991 CDM Femur Ps 57.5 Left Vanguard 34 19 $13,401.00 $13,401.00 $1,340.10 $13,367.45 $4,148.94 2026-10-02
4050911992 CDM Femur Ps 62.5 Left Vanguard 34 19 $13,401.00 $13,401.00 $1,340.10 $13,367.45 $4,148.94 2026-10-02
4050911942 CDM Femur Ps 80 Left Vanguard 34 19 $13,401.00 $13,401.00 $1,340.10 $13,367.45 $4,148.94 2026-10-02
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