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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

POTOMAC VALLEY HOSPITAL

Keyser, WV · CCN 511315 · Rates published

4,320 distinct procedures filed
28 distinct payers
245,544 rate rows
2026-05-22 last MRF observed
Data quality

18,654 of 245,544 rate rows are consumer-grade (7.6%)

226,890 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 225,294
per-diem day rate — not a per-procedure price 920
exceeds 10× this hospital's gross charge — excluded from medians 418
template filing: same amount across many unrelated codes — excluded 250
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 6
placeholder amount (≤ $0.02) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://wvumedicine.org/wp-content/uploads/2026/04/550420956_Potomac-Valley-Hospital-of-WV-Inc._standardcharges.csv
Found on page https://wvumedicine.org/billing-and-insurance/costs-and-charges/
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-22
Content fingerprint 7a7abdec40c218ad… · 19,209,260 bytes · first seen 2026-05-13

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
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 27 $101,970.00 $101,970.00 $101,970.00 nat. median
$68,423
1.5× median
J9226
HCPCS 		Supprelin La Implant 27 $73,550.30 $73,550.30 $73,550.30 nat. median
$55,159
1.3× median
J0480
HCPCS 		Basiliximab 27 $7,385.85 $7,385.85 $7,385.85 nat. median
$6,695
1.1× median
J2787
HCPCS 		Riboflavin 5'phos Opth<=3ml 27 $4,108.50 $4,108.50 $4,108.50 nat. median
$4,061
1.0× median
J3240
HCPCS 		Thyrotropin Injection 27 $3,334.93 $3,334.93 $3,334.93 nat. median
$2,980
1.1× median
J1950
HCPCS 		Leuprolide Acetate /3.75 Mg 27 $2,581.59 $2,581.59 $2,581.59 nat. median
$3,902
0.7× median
110348902
OTHER 		Hchg Inject, Intravitreal Vancomycin, Per Dose 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
110474902
OTHER 		Hchg Belotero Balance With Lidocaine Per 1ml Syringe 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
500330902
OTHER 		Hchg Hospice Daily 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
110299902
OTHER 		Hchg Gi Cocktail - Maalox Max 10ml & Lidocane Viscous 2% 5ml- Per 15ml 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
110470902
OTHER 		Hchg Juv Derm Volbella Xc Per 1ml Syringe 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
100021902
OTHER 		Hchg Step Down Room 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
94003
CPT 		Vent Mgmt Inpat Subq Day 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$828
outlier · 3.0×
110337902
OTHER 		Hchg Bupivacaine Hcl Pf (marcaine) 0.25% Inj Per 1ml 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
110468902
OTHER 		Hchg Juv Derm Ultra Plus Xc Per 1ml Syringe 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
110469902
OTHER 		Hchg Juv Derm Volbella Xc Per (1) 0.55ml Syringe 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
94668
CPT 		Chest Wall Manipulation 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$136
outlier · 18.2×
110471902
OTHER 		Hchg Juv Derm Vollure Per 1ml Syringe 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
110333902
OTHER 		Hchg Sufentanil 50mcg/ml Inj (sufenta) - Per 1ml 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
110356902
OTHER 		Hchg Hydralazine Per 25 Mg Tab 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
100022902
OTHER 		Hchg Telemetry Room 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
100007902
OTHER 		Hchg Intensive Care Room 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
100117902
OTHER 		Hchg Transitional Care Bed 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
110467902
OTHER 		Hchg Juv Derm Ultra Plus Xc Per (1) 0.55ml Syringe 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
J3490
HCPCS 		Drugs Unclassified Injection 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$47
outlier · 52.2×
110472902
OTHER 		Hchg Restylane Per 1ml Syringe 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
110274902
OTHER 		Hchg 0.9% Ns 250 Ml 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
94667
CPT 		Chest Wall Manipulation 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$153
outlier · 16.2×
100120902
OTHER 		Hchg Hospice Room 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
110283902
OTHER 		Hchg Sodium Chloride Syringe 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
110323902
OTHER 		Hchg Methotrexate Ophth 400mcg/0.1ml Per Dose 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
89220
CPT 		Sputum Specimen Collection 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$160
outlier · 15.4×
82075
CPT 		Assay Of Breath Ethanol 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$35
outlier · 70.4×
94645
CPT 		Cbt Each Addl Hour 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$140
outlier · 17.6×
110407902
OTHER 		Hchg Clindamycin Intravitreal Inj Per 1mg/0.1ml 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
110051902
OTHER 		Hchg Pharmacy Flat Rate 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
94664
CPT 		Evaluate Pt Use Of Inhaler 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$194
outlier · 12.7×
94644
CPT 		Cbt 1st Hour 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$183
outlier · 13.5×
94002
CPT 		Vent Mgmt Inpat Init Day 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$917
outlier · 2.7×
100029902
OTHER 		Hchg Respite Room 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
100003902
OTHER 		Hchg Cardiac Care Room 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
100008902
OTHER 		Hchg Isolation Room 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
110334902
OTHER 		Hchg Ganciclovir Ophth 2mg/0.1ml Per Dose 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
100020902
OTHER 		Hchg Routine Room 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
G0239
HCPCS 		Oth Resp Proc, Group 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$79
outlier · 31.3×
110473902
OTHER 		Hchg Belotero Balance Per 1ml Syringe 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
94660
CPT 		Pos Airway Pressure Cpap 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$363
outlier · 6.8×
94640
CPT 		Airway Inhalation Treatment 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$195
outlier · 12.7×
110480902
OTHER 		Hchg Sodium Tetradecyl Sulfate (sotradecol) Per 1ml 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median
919605902
OTHER 		Hchg Phenol Ez Swabs Each 12 $2,470.06 $2,470.06 $2,470.06 nat. median
$2,470
1.0× median

Other procedures at this hospital

Browse this hospital's 4,320 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
             
J9029 HCPCS Instill Adstiladrin, Tx Dose 58 27 $138,420.00 $69,210.00 50% off $101,970.00 $101,970.00 $101,970.00 2026-05-22
J9226 HCPCS Supprelin La Implant 58 27 $150,543.00 $75,271.50 50% off $73,550.30 $73,550.30 $73,550.30 2026-05-22
J0480 HCPCS Basiliximab 58 27 $13,463.00 $6,731.50 50% off $7,385.85 $7,385.85 $7,385.85 2026-05-22
J2787 HCPCS Riboflavin 5'phos Opth<=3ml 58 27 $13,680.00 $6,840.00 50% off $4,108.50 $4,108.50 $4,108.50 2026-05-22
J3240 HCPCS Thyrotropin Injection 58 27 $6,067.00 $3,033.50 50% off $3,334.93 $3,334.93 $3,334.93 2026-05-22
J1950 HCPCS Leuprolide Acetate /3.75 Mg 58 27 $5,215.00 $2,607.50 50% off $2,581.59 $2,581.59 $2,581.59 2026-05-22
J7298 HCPCS Mirena, 52 Mg 58 27 $3,644.00 $1,822.00 50% off $2,290.45 $2,290.45 $2,290.45 2026-05-22
J7296 HCPCS Kyleena, 19.5 Mg 58 27 $3,644.00 $1,822.00 50% off $2,290.45 $2,290.45 $2,290.45 2026-05-22
J9357 HCPCS Valrubicin Injection 58 27 $4,088.00 $2,044.00 50% off $2,250.35 $2,250.35 $2,250.35 2026-05-22
J7300 HCPCS Intra Copp Contra (paragard) 58 27 $3,127.00 $1,563.50 50% off $2,148.30 $2,148.30 $2,148.30 2026-05-22
J7301 HCPCS Skyla, 13.5 Mg 58 27 $3,035.00 $1,517.50 50% off $1,907.17 $1,907.17 $1,907.17 2026-05-22
J7297 HCPCS Liletta, 52 Mg 58 27 $2,796.00 $1,398.00 50% off $1,756.97 $1,756.97 $1,756.97 2026-05-22
J7307 HCPCS Etonogestrel Implant System 58 27 $1,657.00 $828.50 50% off $1,657.00 $1,657.00 $1,657.00 2026-05-22
Q4194 HCPCS Novachor 1 Sq Cm 58 27 $1,592.00 $796.00 50% off $1,592.00 $1,592.00 $1,592.00 2026-05-22
90380 CPT Rsv Monoc Antb Seasn .5ml IM 58 27 $1,578.00 $789.00 50% off $1,578.00 $1,578.00 $1,578.00 2026-05-22
J0178 HCPCS Aflibercept Injection 58 27 $1,694.00 $847.00 50% off $1,422.76 $1,422.76 $1,422.76 2026-05-22
J7327 HCPCS Monovisc Inj Per Dose 58 27 $1,802.00 $901.00 50% off $1,178.71 $1,178.71 $1,178.71 2026-05-22
J1212 HCPCS Dimethyl Sulfoxide 50% 50 Ml 58 27 $2,011.00 $1,005.50 50% off $1,123.35 $1,123.35 $1,123.35 2026-05-22
A2001 HCPCS Innovamatrix Ac, Per Sq Cm 58 27 $1,048.40 $524.20 50% off $1,048.40 $1,048.40 $1,048.40 2026-05-22
J9202 HCPCS Goserelin Acetate Implant 58 27 $3,372.00 $1,686.00 50% off $1,004.87 $1,004.87 $1,004.87 2026-05-22
90381 CPT Rsv Monoc Antb Seasn 1 Ml IM 58 27 $1,578.00 $789.00 50% off $980.10 $980.10 $980.10 2026-05-22
A9595 HCPCS Piflu F-18, Dia 1 Millicurie 58 27 $1,154.00 $577.00 50% off $957.58 $957.58 $957.58 2026-05-22
Q4282 HCPCS Cygnus Dual Per Sq Cm 60 27 $922.00 $461.00 50% off $922.00 $1,374.00 $922.00 2026-05-22
J7314 HCPCS Inj., Yutiq, 0.01 Mg 58 27 $1,545.00 $772.50 50% off $872.85 $872.85 $872.85 2026-05-22
J7326 HCPCS Gel-one 58 27 $1,485.00 $742.50 50% off $820.53 $820.53 $820.53 2026-05-22
J7313 HCPCS Inj., Iluvien, 0.01 Mg 58 27 $1,454.00 $727.00 50% off $810.07 $810.07 $810.07 2026-05-22
G0378 HCPCS Hospital Observation Per Hr 56 27 $59.00 $29.50 50% off $708.61 $708.61 $708.61 2026-05-22
J3315 HCPCS Triptorelin Pamoate 58 27 $2,316.00 $1,158.00 50% off $682.42 $682.42 $682.42 2026-05-22
A9500 HCPCS Tc99m Sestamibi 58 27 $661.00 $330.50 50% off $661.00 $661.00 $661.00 2026-05-22
A9552 HCPCS F18 Fdg 58 27 $854.00 $427.00 50% off $647.79 $647.79 $647.79 2026-05-22
J7308 HCPCS Aminolevulinic Acid Hcl Top 58 27 $1,180.00 $590.00 50% off $647.33 $647.33 $647.33 2026-05-22
Q4159 HCPCS Affinity1 Square Cm 58 27 $949.00 $474.50 50% off $593.44 $593.44 $593.44 2026-05-22
90678 CPT Rsv Vacc Pref Bivalent IM 58 27 $812.00 $406.00 50% off $584.10 $584.10 $584.10 2026-05-22
90651 CPT 9vhpv Vaccine 2/3 Dose IM 58 27 $871.00 $435.50 50% off $569.07 $569.07 $569.07 2026-05-22
90378 CPT Rsv Mab IM 50mg 58 27 $5,462.00 $2,731.00 50% off $560.47 $560.47 $560.47 2026-05-22
90679 CPT Rsv Vacc Pref Recomb Adjt IM 58 27 $684.00 $342.00 50% off $554.40 $554.40 $554.40 2026-05-22
J3241 HCPCS Inj. Teprotumumab-trbw 10 Mg 58 27 $1,082.00 $541.00 50% off $541.20 $541.20 $541.20 2026-05-22
90675 CPT Rabies Vaccine IM 58 27 $1,218.00 $609.00 50% off $535.82 $535.82 $535.82 2026-05-22
Q4210 HCPCS Axolotl Graf Dualgraf Sq Cm 58 27 $515.00 $257.50 50% off $515.00 $515.00 $515.00 2026-05-22
90738 CPT Inactivated Je Vacc IM 58 27 $1,063.00 $531.50 50% off $504.42 $504.42 $504.42 2026-05-22
A9513 HCPCS Lutetium Lu 177 Dotatat Ther 58 27 $556.00 $278.00 50% off $479.23 $479.23 $479.23 2026-05-22
90677 CPT Pcv20 Vaccine IM 58 27 $727.00 $363.50 50% off $476.29 $476.29 $476.29 2026-05-22
Q4199 HCPCS Cygnus Matrix, Per Sq Cm 62 27 $443.00 $221.50 50% off $207.00 $443.00 $443.00 2026-05-22
90671 CPT Pcv15 Vaccine IM 58 27 $545.00 $272.50 50% off $418.37 $418.37 $418.37 2026-05-22
90620 CPT Menb-4c Vaccine IM 58 27 $458.00 $229.00 50% off $411.10 $411.10 $411.10 2026-05-22
90621 CPT Menb-fhbp Vacc 2/3 Dose IM 58 27 $509.00 $254.50 50% off $376.46 $376.46 $376.46 2026-05-22
90716 CPT Var Vaccine Live Subq 58 27 $548.00 $274.00 50% off $344.92 $344.92 $344.92 2026-05-22
J7351 HCPCS Inj Bimatoprost Itc Imp1mcg 58 27 $608.00 $304.00 50% off $340.25 $340.25 $340.25 2026-05-22
J7312 HCPCS Dexamethasone Intra Implant 58 27 $589.00 $294.50 50% off $339.26 $339.26 $339.26 2026-05-22
90619 CPT Menacwy-tt Vaccine IM 58 27 $441.00 $220.50 50% off $330.38 $330.38 $330.38 2026-05-22
J1610 HCPCS Glucagon Hydrochloride/1 Mg 58 27 $410.00 $205.00 50% off $310.81 $310.81 $310.81 2026-05-22
90734 CPT Menacwyd/menacwycrm Vacc IM 58 27 $313.00 $156.50 50% off $299.95 $299.95 $299.95 2026-05-22
J9217 HCPCS Leuprolide Acetate Suspnsion 58 27 $513.00 $256.50 50% off $299.15 $299.15 $299.15 2026-05-22
J0475 HCPCS Baclofen 10 Mg Injection 58 27 $709.00 $354.50 50% off $293.37 $293.37 $293.37 2026-05-22
A9541 HCPCS Tc99m Sulfur Colloid 58 27 $290.00 $145.00 50% off $290.00 $290.00 $290.00 2026-05-22
J0517 HCPCS Inj., Benralizumab, 1 Mg 58 27 $585.00 $292.50 50% off $279.68 $279.68 $279.68 2026-05-22
J1426 HCPCS Injection, Casimersen, 10 Mg 58 27 $362.00 $181.00 50% off $274.28 $274.28 $274.28 2026-05-22
A9606 HCPCS Radium Ra223 Dichloride Ther 58 27 $317.00 $158.50 50% off $265.91 $265.91 $265.91 2026-05-22
90739 CPT Hepb Vacc 2/4 Dose Adult IM 58 27 $380.00 $190.00 50% off $264.46 $264.46 $264.46 2026-05-22
90717 CPT Yellow Fever Vaccine Subq 58 27 $617.00 $308.50 50% off $263.36 $263.36 $263.36 2026-05-22
J2781 HCPCS Inj, Pegcetacoplan, 1mg 58 27 $452.00 $226.00 50% off $249.91 $249.91 $249.91 2026-05-22
91304 CPT Sarscov2 Vac 5mcg/0.5ml IM 58 27 $315.00 $157.50 50% off $244.53 $244.53 $244.53 2026-05-22
91322 CPT Sarscov2 Vac 50 Mcg/0.5ml IM 58 27 $372.00 $186.00 50% off $240.77 $240.77 $240.77 2026-05-22
91321 CPT Sarscov2 Vac 25 Mcg/.25ml IM 58 27 $339.00 $169.50 50% off $240.77 $240.77 $240.77 2026-05-22
90371 CPT Hep B Ig IM 58 27 $464.00 $232.00 50% off $227.52 $227.52 $227.52 2026-05-22
90732 CPT Ppsv23 Vacc 2 Yrs+ Subq/im 58 27 $316.00 $158.00 50% off $220.23 $220.23 $220.23 2026-05-22
90710 CPT Mmrv Vaccine Sc 58 27 $808.00 $404.00 50% off $218.94 $218.94 $218.94 2026-05-22
90698 CPT Dtap-ipv/hib Vaccine IM 58 27 $318.00 $159.00 50% off $217.26 $217.26 $217.26 2026-05-22
91320 CPT Sarscv2 Vac 30mcg Trs-suc IM 58 27 $301.00 $150.50 50% off $216.32 $216.32 $216.32 2026-05-22
J7324 HCPCS Orthovisc Inj Per Dose 58 27 $360.00 $180.00 50% off $215.56 $215.56 $215.56 2026-05-22
90636 CPT Hep A/hep B Vacc Adult IM 58 27 $286.00 $143.00 50% off $213.39 $213.39 $213.39 2026-05-22
J7323 HCPCS Euflexxa Inj Per Dose 58 27 $1,003.00 $501.50 50% off $210.05 $210.05 $210.05 2026-05-22
Q4197 HCPCS Puraply Xt 1 Sq Cm 58 27 $222.00 $111.00 50% off $202.92 $202.92 $202.92 2026-05-22
Q4122 HCPCS Dermacell, Awm, Porous Sq Cm 74 27 $265.00 $132.50 50% off $140.00 $199.70 $199.70 2026-05-22
90680 CPT Rv5 Vacc 3 Dose Live Oral 58 27 $253.00 $126.50 50% off $189.75 $189.75 $189.75 2026-05-22
90723 CPT Dtap-hep B-ipv Vaccine IM 58 27 $189.00 $94.50 50% off $187.79 $187.79 $187.79 2026-05-22
A9516 HCPCS Iodine I-123 Sod Iodide Mic 58 27 $185.00 $92.50 50% off $185.00 $185.00 $185.00 2026-05-22
90681 CPT Rv1 Vacc 2 Dose Live Oral 58 27 $309.00 $154.50 50% off $182.97 $182.97 $182.97 2026-05-22
90707 CPT Mmr Vaccine Sc 58 27 $233.00 $116.50 50% off $182.39 $182.39 $182.39 2026-05-22
96360 CPT Hydration IV Infusion Init 60 27 $475.00 $237.50 50% off $69.00 $336.96 $180.98 2026-05-22
90691 CPT Typhoid Vaccine IM 58 27 $425.00 $212.50 50% off $180.23 $180.23 $180.23 2026-05-22
J2778 HCPCS Ranibizumab Injection 58 27 $180.00 $90.00 50% off $180.00 $180.00 $180.00 2026-05-22
90696 CPT Dtap-ipv Vaccine 4-6 Yrs IM 60 27 $172.00 $86.00 50% off $138.00 $172.00 $172.00 2026-05-22
Q4201 HCPCS Matrion 1 Sq Cm 60 27 $302.00 $151.00 50% off $163.00 $171.96 $171.96 2026-05-22
Q4196 HCPCS Puraply Am 1 Sq Cm 58 27 $292.00 $146.00 50% off $171.22 $171.22 $171.22 2026-05-22
A9537 HCPCS Tc99m Mebrofenin 58 27 $167.00 $83.50 50% off $167.00 $167.00 $167.00 2026-05-22
A9560 HCPCS Tc99m Labeled Rbc 58 27 $709.00 $354.50 50% off $166.40 $166.40 $166.40 2026-05-22
Q4160 HCPCS Nushield 1 Square Cm 58 27 $266.00 $133.00 50% off $161.68 $161.68 $161.68 2026-05-22
J2997 HCPCS Alteplase Recombinant 58 27 $243.00 $121.50 50% off $146.80 $146.80 $146.80 2026-05-22
91319 CPT Sarscv2 Vac 10mcg Trs-suc IM 58 27 $135.00 $67.50 50% off $135.00 $135.00 $135.00 2026-05-22
J2790 HCPCS Rho D Immune Globulin Inj 58 27 $204.00 $102.00 50% off $133.91 $133.91 $133.91 2026-05-22
J2779 HCPCS Inj, Susvimo 0.1 Mg 58 27 $172.00 $86.00 50% off $133.29 $133.29 $133.29 2026-05-22
J1566 HCPCS Immune Globulin, Powder 58 27 $232.00 $116.00 50% off $129.53 $129.53 $129.53 2026-05-22
90743 CPT Hepb Vacc 2 Dose Adolesc IM 58 27 $139.00 $69.50 50% off $124.00 $124.00 $124.00 2026-05-22
90662 CPT Iiv No Prsv Increased Ag IM 58 27 $238.00 $119.00 50% off $121.11 $121.11 $121.11 2026-05-22
J7321 HCPCS Hyalgan Supartz Visco-3 Dose 58 27 $712.00 $356.00 50% off $120.62 $120.62 $120.62 2026-05-22
90746 CPT Hepb Vaccine 3 Dose Adult IM 58 27 $139.00 $69.50 50% off $116.13 $116.13 $116.13 2026-05-22
90632 CPT Hepa Vaccine Adult IM 58 27 $195.00 $97.50 50% off $115.93 $115.93 $115.93 2026-05-22
J0775 HCPCS Collagenase, Clost Hist Inj 58 27 $247.00 $123.50 50% off $109.35 $109.35 $109.35 2026-05-22
J9280 HCPCS Mitomycin Injection 58 27 $242.00 $121.00 50% off $104.53 $104.53 $104.53 2026-05-22
90281 CPT Human Ig IM 58 27 $286.00 $143.00 50% off $92.80 $92.80 $92.80 2026-05-22
P9047 HCPCS Albumin (human), 25%, 50ml 58 27 $105.00 $52.50 50% off $87.58 $87.58 $87.58 2026-05-22
J0490 HCPCS Belimumab Injection 58 27 $162.00 $81.00 50% off $85.80 $85.80 $85.80 2026-05-22
90713 CPT Poliovirus Ipv Sc/im 58 27 $123.00 $61.50 50% off $84.18 $84.18 $84.18 2026-05-22
J1460 HCPCS Gamma Globulin 1 Cc Inj 58 27 $143.00 $71.50 50% off $83.70 $83.70 $83.70 2026-05-22
J1561 HCPCS Gamunex-c/gammaked 58 27 $178.00 $89.00 50% off $82.15 $82.15 $82.15 2026-05-22
J3299 HCPCS Inj Xipere 1 Mg 58 27 $124.00 $62.00 50% off $80.16 $80.16 $80.16 2026-05-22
J1459 HCPCS Inj Ivig Privigen 500 Mg 58 27 $110.00 $55.00 50% off $79.68 $79.68 $79.68 2026-05-22
J1455 HCPCS Foscarnet Sodium Injection 58 27 $79.00 $39.50 50% off $79.00 $79.00 $79.00 2026-05-22
J1569 HCPCS Gammagard Liquid Injection 58 27 $169.00 $84.50 50% off $72.85 $72.85 $72.85 2026-05-22
J1110 HCPCS Inj Dihydroergotamine Mesylt 58 27 $130.00 $65.00 50% off $69.86 $69.86 $69.86 2026-05-22
90633 CPT Hepa Vacc Ped/adol 2 Dose IM 58 27 $98.00 $49.00 50% off $68.72 $68.72 $68.72 2026-05-22
J2406 HCPCS Injection, Oritavancin 10 Mg 58 27 $123.00 $61.50 50% off $67.52 $67.52 $67.52 2026-05-22
J0565 HCPCS Inj, Bezlotoxumab, 10 Mg 58 27 $137.00 $68.50 50% off $65.77 $65.77 $65.77 2026-05-22
J2357 HCPCS Omalizumab Injection 58 27 $148.00 $74.00 50% off $65.11 $65.11 $65.11 2026-05-22
90715 CPT Tdap Vaccine 7 Yrs/> IM 58 27 $106.00 $53.00 50% off $63.21 $63.21 $63.21 2026-05-22
A9503 HCPCS Tc99m Medronate 58 27 $104.00 $52.00 50% off $61.59 $61.59 $61.59 2026-05-22
J2777 HCPCS Inj, Faricimab-svoa, 0.1mg 58 27 $72.00 $36.00 50% off $59.55 $59.55 $59.55 2026-05-22
90647 CPT Hib Prp-omp Vacc 3 Dose IM 58 27 $83.00 $41.50 50% off $58.58 $58.58 $58.58 2026-05-22
90700 CPT Dtap Vaccine < 7 Yrs IM 58 27 $64.00 $32.00 50% off $56.96 $56.96 $56.96 2026-05-22
Q2038 HCPCS Fluzone Vacc, 3 Yrs & >, IM 58 27 $54.00 $27.00 50% off $54.00 $54.00 $54.00 2026-05-22
J9334 HCPCS Inj Efgart-alfa 2mg Hya-qvfc 58 27 $98.00 $49.00 50% off $53.20 $53.20 $53.20 2026-05-22
A9540 HCPCS Tc99m Maa 58 27 $1,723.00 $861.50 50% off $52.95 $52.95 $52.95 2026-05-22
90744 CPT Hepb Vacc 3 Dose Ped/adol IM 58 27 $64.00 $32.00 50% off $50.77 $50.77 $50.77 2026-05-22
J2182 HCPCS Injection, Mepolizumab, 1mg 58 27 $116.00 $58.00 50% off $50.34 $50.34 $50.34 2026-05-22
Q4101 HCPCS Apligraf 58 27 $62.00 $31.00 50% off $50.16 $50.16 $50.16 2026-05-22
90714 CPT Td Vacc No Presv 7 Yrs+ IM 58 27 $117.00 $58.50 50% off $50.06 $50.06 $50.06 2026-05-22
96361 CPT Hydrate IV Infusion Add-on 60 27 $380.00 $190.00 50% off $27.00 $74.68 $49.84 2026-05-22
A9539 HCPCS Tc99m Pentetate 58 27 $429.00 $214.50 50% off $49.17 $49.17 $49.17 2026-05-22
J2407 HCPCS Injection, Oritavancin 58 27 $80.00 $40.00 50% off $45.54 $45.54 $45.54 2026-05-22
J0834 HCPCS Inj., Cosyntropin, 0.25 Mg 58 27 $90.00 $45.00 50% off $44.73 $44.73 $44.73 2026-05-22
J9208 HCPCS Ifosfamide Injection 58 27 $83.00 $41.50 50% off $44.14 $44.14 $44.14 2026-05-22
Q5107 HCPCS Inj Mvasi 10 Mg 58 27 $181.00 $90.50 50% off $42.27 $42.27 $42.27 2026-05-22
J0897 HCPCS Denosumab Injection 58 27 $91.00 $45.50 50% off $41.58 $41.58 $41.58 2026-05-22
J2799 HCPCS Inj, Uzedy, 1 Mg 58 27 $68.00 $34.00 50% off $40.76 $40.76 $40.76 2026-05-22
J0561 HCPCS Penicillin G Benzathine Inj 58 27 $85.00 $42.50 50% off $35.85 $35.85 $35.85 2026-05-22
A9567 HCPCS Technetium Tc-99m Aerosol 58 27 $1,131.00 $565.50 50% off $34.04 $34.04 $34.04 2026-05-22
J1120 HCPCS Acetazolamid Sodium Injectio 58 27 $31.00 $15.50 50% off $31.00 $31.00 $31.00 2026-05-22
J2356 HCPCS Inj Tezepelumab-ekko, 1mg 58 27 $67.00 $33.50 50% off $30.67 $30.67 $30.67 2026-05-22
J0558 HCPCS Peng Benzathine/procaine Inj 58 27 $56.00 $28.00 50% off $29.01 $29.01 $29.01 2026-05-22
J3304 HCPCS Inj Triamcinolone Ace Xr 1mg 58 27 $65.00 $32.50 50% off $28.94 $28.94 $28.94 2026-05-22
J0491 HCPCS Inj Anifrolumab-fnia 1mg 58 27 $55.00 $27.50 50% off $28.35 $28.35 $28.35 2026-05-22
90660 CPT Laiv3 Vaccine Intranasal 58 27 $73.00 $36.50 50% off $27.56 $27.56 $27.56 2026-05-22
J0875 HCPCS Injection, Dalbavancin 58 27 $27.00 $13.50 50% off $25.23 $25.23 $25.23 2026-05-22
90648 CPT Hib Prp-t Vaccine 4 Dose IM 58 27 $34.00 $17.00 50% off $25.21 $25.21 $25.21 2026-05-22
J2426 HCPCS Inj, Invega Sustenna, 1 Mg 58 27 $43.00 $21.50 50% off $23.63 $23.63 $23.63 2026-05-22
90870 CPT Electroconvulsive Therapy 56 26 $1,646.00 $823.00 50% off $1,048.58 $1,048.58 $1,048.58 2026-05-22
Q3014 HCPCS Telehealth Facility Fee 56 26 $114.00 $57.00 50% off $25.00 $25.00 $25.00 2026-05-22
99292 CPT Critical Care Addl 30 Min 56 26 $871.00 $435.50 50% off $25.00 $25.00 $25.00 2026-05-22
99282 CPT Emergency Dept Visit Sf Mdm 56 26 $378.00 $189.00 50% off $25.00 $25.00 $25.00 2026-05-22
96376 CPT Tx/pro/dx Inj Same Drug Adon 56 26 $117.00 $58.50 50% off $25.00 $25.00 $25.00 2026-05-22
96367 CPT Tx/proph/dg Addl Seq IV Inf 56 26 $456.00 $228.00 50% off $25.00 $25.00 $25.00 2026-05-22
99281 CPT Emr Dpt Vst Mayx Req Phy/qhp 56 26 $340.00 $170.00 50% off $25.00 $25.00 $25.00 2026-05-22
96366 CPT Ther/proph/diag IV Inf Addon 56 26 $464.00 $232.00 50% off $25.00 $25.00 $25.00 2026-05-22
69209 CPT Remove Impacted Ear Wax Uni 56 26 $200.00 $100.00 50% off $25.00 $25.00 $25.00 2026-05-22
64418 CPT Njx Aa&/strd Sprscap Nrv 56 26 $1,357.00 $678.50 50% off $25.00 $25.00 $25.00 2026-05-22
59025 CPT Fetal Non-stress Test 56 26 $1,177.00 $588.50 50% off $25.00 $25.00 $25.00 2026-05-22
62272 CPT Ther Spi Pnxr DRG Csf 56 26 $2,387.00 $1,193.50 50% off $25.00 $25.00 $25.00 2026-05-22
46050 CPT Incision Of Anal Abscess 56 26 $2,806.00 $1,403.00 50% off $25.00 $25.00 $25.00 2026-05-22
42182 CPT Repair Palate 56 26 $12,084.00 $6,042.00 50% off $25.00 $25.00 $25.00 2026-05-22
43754 CPT Dx Gastr Intub W/asp Spec 56 26 $823.00 $411.50 50% off $25.00 $25.00 $25.00 2026-05-22
36680 CPT Insert Needle Bone Cavity 56 26 $1,044.00 $522.00 50% off $25.00 $25.00 $25.00 2026-05-22
37195 CPT Thrombolytic Therapy Stroke 56 26 $667.00 $333.50 50% off $25.00 $25.00 $25.00 2026-05-22
43762 CPT Rplc Gtube No Revj Trc 56 26 $917.00 $458.50 50% off $25.00 $25.00 $25.00 2026-05-22
31500 CPT Insert Emergency Airway 56 26 $620.00 $310.00 50% off $25.00 $25.00 $25.00 2026-05-22
32551 CPT Insertion Of Chest Tube 56 26 $4,092.00 $2,046.00 50% off $25.00 $25.00 $25.00 2026-05-22
29130 CPT Application Of Finger Splint 56 26 $256.00 $128.00 50% off $25.00 $25.00 $25.00 2026-05-22
30903 CPT Control Of Nosebleed 56 26 $319.00 $159.50 50% off $25.00 $25.00 $25.00 2026-05-22
33016 CPT Pericardiocentesis W/imaging 56 26 $5,417.00 $2,708.50 50% off $25.00 $25.00 $25.00 2026-05-22
27552 CPT Treat Knee Dislocation 56 26 $3,112.00 $1,556.00 50% off $25.00 $25.00 $25.00 2026-05-22
26770 CPT Treat Finger Dislocation 56 26 $570.00 $285.00 50% off $25.00 $25.00 $25.00 2026-05-22
24640 CPT Treat Elbow Dislocation 56 26 $477.00 $238.50 50% off $25.00 $25.00 $25.00 2026-05-22
23655 CPT Cltx Sho Dslc W/mnpj W/anes 56 26 $3,945.00 $1,972.50 50% off $25.00 $25.00 $25.00 2026-05-22
15004 CPT Wound Prep F/n/hf/g 56 26 $1,205.00 $602.50 50% off $25.00 $25.00 $25.00 2026-05-22
20611 CPT Drain/inj Joint/bursa W/us 56 26 $883.00 $441.50 50% off $25.00 $25.00 $25.00 2026-05-22
21480 CPT Cltx Tmprmand Dislc 1st/sbsq 56 26 $570.00 $285.00 50% off $25.00 $25.00 $25.00 2026-05-22
23931 CPT I&d Upr A/e Bursa 56 26 $3,173.00 $1,586.50 50% off $25.00 $25.00 $25.00 2026-05-22
27222 CPT Treat Hip Socket Fracture 56 26 $523.00 $261.50 50% off $25.00 $25.00 $25.00 2026-05-22
27842 CPT Treat Ankle Dislocation 56 26 $4,935.00 $2,467.50 50% off $25.00 $25.00 $25.00 2026-05-22
30905 CPT Control Of Nosebleed 56 26 $389.00 $194.50 50% off $25.00 $25.00 $25.00 2026-05-22
30906 CPT Repeat Control Of Nosebleed 56 26 $454.00 $227.00 50% off $25.00 $25.00 $25.00 2026-05-22
31575 CPT Diagnostic Laryngoscopy 56 26 $573.00 $286.50 50% off $25.00 $25.00 $25.00 2026-05-22
31605 CPT Emer Tracheostomy Cthyr Mem 56 26 $504.00 $252.00 50% off $25.00 $25.00 $25.00 2026-05-22
35206 CPT Repair Blood Vessel Dir Uxtr 56 26 $4,776.00 $2,388.00 50% off $25.00 $25.00 $25.00 2026-05-22
36000 CPT Place Needle In Vein 56 26 $214.00 $107.00 50% off $25.00 $25.00 $25.00 2026-05-22
41825 CPT Excision Of Gum Lesion 56 26 $6,643.00 $3,321.50 50% off $25.00 $25.00 $25.00 2026-05-22
42700 CPT Drainage Of Tonsil Abscess 56 26 $572.00 $286.00 50% off $25.00 $25.00 $25.00 2026-05-22
27840 CPT Treat Ankle Dislocation 56 26 $570.00 $285.00 50% off $25.00 $25.00 $25.00 2026-05-22
54220 CPT Irrg Crpra Cavrnosa Priapism 56 26 $591.00 $295.50 50% off $25.00 $25.00 $25.00 2026-05-22
57415 CPT Remove Vaginal Foreign Body 56 26 $6,559.00 $3,279.50 50% off $25.00 $25.00 $25.00 2026-05-22
59899 CPT Unlisted Px Mat Care&dlvr 56 26 $392.00 $196.00 50% off $25.00 $25.00 $25.00 2026-05-22
64405 CPT Njx Aa&/strd Gr Ocpl Nrv 56 26 $770.00 $385.00 50% off $25.00 $25.00 $25.00 2026-05-22
64447 CPT Njx Aa&/strd Femoral Nrv Img 56 26 $1,357.00 $678.50 50% off $25.00 $25.00 $25.00 2026-05-22
110337902 OTHER Hchg Bupivacaine Hcl Pf (marcaine) 0.25% Inj Per 1ml 24 12 $2.00 $1.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110299902 OTHER Hchg Gi Cocktail - Maalox Max 10ml & Lidocane Viscous 2% 5ml- Per 15ml 24 12 $4.00 $2.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
94645 CPT Cbt Each Addl Hour 24 12 $109.00 $54.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
919606902 OTHER Hchg Silvadene 1% Cream, Per 1 Gm 24 12 $2.00 $1.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110051902 OTHER Hchg Pharmacy Flat Rate 24 12 $37.00 $18.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110467902 OTHER Hchg Juv Derm Ultra Plus Xc Per (1) 0.55ml Syringe 24 12 $861.00 $430.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110334902 OTHER Hchg Ganciclovir Ophth 2mg/0.1ml Per Dose 24 12 $1.00 $0.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
J3490 HCPCS Drugs Unclassified Injection 24 12 $7.00 $3.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
94664 CPT Evaluate Pt Use Of Inhaler 24 12 $227.00 $113.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110356902 OTHER Hchg Hydralazine Per 25 Mg Tab 24 12 $1.00 $0.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110480902 OTHER Hchg Sodium Tetradecyl Sulfate (sotradecol) Per 1ml 24 12 $78.00 $39.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110473902 OTHER Hchg Belotero Balance Per 1ml Syringe 24 12 $855.00 $427.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
919605902 OTHER Hchg Phenol Ez Swabs Each 24 12 $13.00 $6.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
919607902 OTHER Hchg Silver Nitrate Swabs - Each 24 12 $3.00 $1.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110323902 OTHER Hchg Methotrexate Ophth 400mcg/0.1ml Per Dose 24 12 $1.00 $0.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
94667 CPT Chest Wall Manipulation 24 12 $177.00 $88.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110407902 OTHER Hchg Clindamycin Intravitreal Inj Per 1mg/0.1ml 24 12 $20.00 $10.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
94668 CPT Chest Wall Manipulation 24 12 $176.00 $88.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110333902 OTHER Hchg Sufentanil 50mcg/ml Inj (sufenta) - Per 1ml 24 12 $35.00 $17.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110472902 OTHER Hchg Restylane Per 1ml Syringe 24 12 $899.00 $449.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
89220 CPT Sputum Specimen Collection 24 12 $101.00 $50.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
94003 CPT Vent Mgmt Inpat Subq Day 24 12 $1,529.00 $764.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
100008902 OTHER Hchg Isolation Room 26 12 $1,825.00 $912.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
100029902 OTHER Hchg Respite Room 26 12 $479.00 $239.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
100022902 OTHER Hchg Telemetry Room 26 12 $1,921.00 $960.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110471902 OTHER Hchg Juv Derm Vollure Per 1ml Syringe 24 12 $1,128.00 $564.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
919608902 OTHER Hchg Triple Antibiotic Ointment (neosporin) Unit Dose Packets 24 12 $1.00 $0.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
94660 CPT Pos Airway Pressure Cpap 24 12 $591.00 $295.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110469902 OTHER Hchg Juv Derm Volbella Xc Per (1) 0.55ml Syringe 24 12 $615.00 $307.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
100020902 OTHER Hchg Routine Room 26 12 $1,410.00 $705.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
100120902 OTHER Hchg Hospice Room 26 12 $551.00 $275.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110468902 OTHER Hchg Juv Derm Ultra Plus Xc Per 1ml Syringe 24 12 $1,047.00 $523.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110470902 OTHER Hchg Juv Derm Volbella Xc Per 1ml Syringe 24 12 $1,128.00 $564.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110283902 OTHER Hchg Sodium Chloride Syringe 24 12 $2.00 $1.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
100003902 OTHER Hchg Cardiac Care Room 26 12 $2,681.00 $1,340.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
500330902 OTHER Hchg Hospice Daily 26 12 $771.00 $385.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
94640 CPT Airway Inhalation Treatment 24 12 $16.00 $8.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
G0239 HCPCS Oth Resp Proc, Group 24 12 $117.00 $58.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
94002 CPT Vent Mgmt Inpat Init Day 24 12 $1,544.00 $772.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110474902 OTHER Hchg Belotero Balance With Lidocaine Per 1ml Syringe 24 12 $987.00 $493.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
82075 CPT Assay Of Breath Ethanol 24 12 $78.00 $39.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110274902 OTHER Hchg 0.9% Ns 250 Ml 24 12 $12.00 $6.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
94644 CPT Cbt 1st Hour 24 12 $537.00 $268.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
110348902 OTHER Hchg Inject, Intravitreal Vancomycin, Per Dose 24 12 $1.00 $0.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
100117902 OTHER Hchg Transitional Care Bed 26 12 $768.00 $384.00 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
100007902 OTHER Hchg Intensive Care Room 26 12 $2,615.00 $1,307.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
100021902 OTHER Hchg Step Down Room 26 12 $1,511.00 $755.50 50% off $2,470.06 $2,470.06 $2,470.06 2026-05-22
P9612 HCPCS Catheterize For Urine Spec 2 1 $19.00 $9.50 50% off $25.00 $25.00 $25.00 2026-05-22
99291 CPT Critical Care First Hour 2 1 $575.00 $287.50 50% off $25.00 $25.00 $25.00 2026-05-22
99285 CPT Emergency Dept Visit Hi Mdm 2 1 $371.00 $185.50 50% off $25.00 $25.00 $25.00 2026-05-22
99283 CPT Emergency Dept Visit Low Mdm 2 1 $212.00 $106.00 50% off $25.00 $25.00 $25.00 2026-05-22
99284 CPT Emergency Dept Visit Mod Mdm 2 1 $278.00 $139.00 50% off $25.00 $25.00 $25.00 2026-05-22
99211 CPT Off/op Est May X Req Phy/qhp 2 1 $18.00 $9.00 50% off $25.00 $25.00 $25.00 2026-05-22
99152 CPT Mod Sed Same Phys/qhp 5/>yrs 2 1 $27.00 $13.50 50% off $25.00 $25.00 $25.00 2026-05-22
99212 CPT Office O/p Est Sf 10 Min 2 1 $71.00 $35.50 50% off $25.00 $25.00 $25.00 2026-05-22
97597 CPT Dbrdmt Opn Wnd 1st 20 Cm/< 2 1 $78.00 $39.00 50% off $25.00 $25.00 $25.00 2026-05-22
69200 CPT Clear Outer Ear Canal 2 1 $104.00 $52.00 50% off $25.00 $25.00 $25.00 2026-05-22
65222 CPT Remove Foreign Body From Eye 2 1 $93.00 $46.50 50% off $25.00 $25.00 $25.00 2026-05-22
64505 CPT N Block Spenopalatine Gangl 2 1 $224.00 $112.00 50% off $25.00 $25.00 $25.00 2026-05-22
65205 CPT Remove Foreign Body From Eye 2 1 $62.00 $31.00 50% off $25.00 $25.00 $25.00 2026-05-22
76529 CPT Echo Exam Of Eye 2 1 $70.00 $35.00 50% off $25.00 $25.00 $25.00 2026-05-22
62270 CPT Dx Lmbr Spi Pnxr 2 1 $141.00 $70.50 50% off $25.00 $25.00 $25.00 2026-05-22
56405 CPT I & D Of Vulva/perineum 2 1 $273.00 $136.50 50% off $25.00 $25.00 $25.00 2026-05-22
46083 CPT Incise External Hemorrhoid 2 1 $231.00 $115.50 50% off $25.00 $25.00 $25.00 2026-05-22
46200 CPT Removal Of Anal Fissure 2 1 $753.00 $376.50 50% off $25.00 $25.00 $25.00 2026-05-22
56605 CPT Biopsy Of Vulva/perineum 2 1 $132.00 $66.00 50% off $25.00 $25.00 $25.00 2026-05-22
62320 CPT Njx Interlaminar Crv/thrc 2 1 $220.00 $110.00 50% off $25.00 $25.00 $25.00 2026-05-22
43752 CPT Nasal/orogastric W/tube Plmt 2 1 $80.00 $40.00 50% off $25.00 $25.00 $25.00 2026-05-22
36556 CPT Insert Non-tunnel Cv Cath 2 1 $340.00 $170.00 50% off $25.00 $25.00 $25.00 2026-05-22
31624 CPT Dx Bronchoscope/lavage 2 1 $289.00 $144.50 50% off $25.00 $25.00 $25.00 2026-05-22
30901 CPT Control Of Nosebleed 2 1 $127.00 $63.50 50% off $25.00 $25.00 $25.00 2026-05-22
45399 CPT Unlisted Procedure Colon 2 1 $182.00 $91.00 50% off $25.00 $25.00 $25.00 2026-05-22
27560 CPT Treat Kneecap Dislocation 2 1 $871.00 $435.50 50% off $25.00 $25.00 $25.00 2026-05-22
26010 CPT Drainage Of Finger Abscess 2 1 $304.00 $152.00 50% off $25.00 $25.00 $25.00 2026-05-22
27818 CPT Treatment Of Ankle Fracture 2 1 $980.00 $490.00 50% off $25.00 $25.00 $25.00 2026-05-22
13122 CPT Cmplx Rpr S/a/l Addl 5 Cm/> 2 1 $158.00 $79.00 50% off $25.00 $25.00 $25.00 2026-05-22
12046 CPT Intmd Rpr N-hf/genit20.1-30 2 1 $714.00 $357.00 50% off $25.00 $25.00 $25.00 2026-05-22
12004 CPT Rpr S/n/ax/gen/trk7.6-12.5cm 2 1 $172.00 $86.00 50% off $25.00 $25.00 $25.00 2026-05-22
12015 CPT Rpr F/e/e/n/l/m 7.6-12.5 Cm 2 1 $216.00 $108.00 50% off $25.00 $25.00 $25.00 2026-05-22
11750 CPT Removal Of Nail Bed 2 1 $209.00 $104.50 50% off $25.00 $25.00 $25.00 2026-05-22
11401 CPT Exc Tr-ext B9+marg 0.6-1 Cm 2 1 $225.00 $112.50 50% off $25.00 $25.00 $25.00 2026-05-22
11760 CPT Repair Of Nail Bed 2 1 $236.00 $118.00 50% off $25.00 $25.00 $25.00 2026-05-22
12020 CPT Tx Supfc Wnd Dehsn Smpl Clsr 2 1 $400.00 $200.00 50% off $25.00 $25.00 $25.00 2026-05-22
12014 CPT Rpr F/e/e/n/l/m 5.1-7.5 Cm 2 1 $174.00 $87.00 50% off $25.00 $25.00 $25.00 2026-05-22
12041 CPT Intmd Rpr N-hf/genit 2.5cm/< 2 1 $289.00 $144.50 50% off $25.00 $25.00 $25.00 2026-05-22
12042 CPT Intmd Rpr N-hf/genit2.6-7.5 2 1 $375.00 $187.50 50% off $25.00 $25.00 $25.00 2026-05-22
12053 CPT Intmd Rpr Face/mm 5.1-7.5 Cm 2 1 $420.00 $210.00 50% off $25.00 $25.00 $25.00 2026-05-22
13120 CPT Cmplx Rpr S/a/l 1.1-2.5 Cm 2 1 $443.00 $221.50 50% off $25.00 $25.00 $25.00 2026-05-22
23650 CPT Cltx Sho Dslc W/mnpj Wo Anes 2 1 $802.00 $401.00 50% off $25.00 $25.00 $25.00 2026-05-22
24341 CPT Rpr Tdn/musc Upr A/e Each 2 1 $1,640.00 $820.00 50% off $25.00 $25.00 $25.00 2026-05-22
26410 CPT Repair Hand Tendon 2 1 $1,205.00 $602.50 50% off $25.00 $25.00 $25.00 2026-05-22
26418 CPT Repair Finger Tendon 2 1 $1,306.00 $653.00 50% off $25.00 $25.00 $25.00 2026-05-22
27265 CPT Treat Hip Dislocation 2 1 $926.00 $463.00 50% off $25.00 $25.00 $25.00 2026-05-22
29105 CPT Apply Long Arm Splint 2 1 $90.00 $45.00 50% off $25.00 $25.00 $25.00 2026-05-22
29505 CPT Application Long Leg Splint 2 1 $121.00 $60.50 50% off $25.00 $25.00 $25.00 2026-05-22
30300 CPT Remove Nasal Foreign Body 2 1 $257.00 $128.50 50% off $25.00 $25.00 $25.00 2026-05-22
36569 CPT Insj Picc 5 Yr+ Without Imaging 2 1 $210.00 $105.00 50% off $25.00 $25.00 $25.00 2026-05-22
36573 CPT Insj Picc Rs&i 5 Yr+ 2 1 $168.00 $84.00 50% off $25.00 $25.00 $25.00 2026-05-22
40804 CPT Removal Foreign Body Mouth 2 1 $251.00 $125.50 50% off $25.00 $25.00 $25.00 2026-05-22
43246 CPT Egd Place Gastrostomy Tube 2 1 $438.00 $219.00 50% off $25.00 $25.00 $25.00 2026-05-22
46040 CPT Incision Of Rectal Abscess 2 1 $969.00 $484.50 50% off $25.00 $25.00 $25.00 2026-05-22
54600 CPT Reduce Testis Torsion 2 1 $946.00 $473.00 50% off $25.00 $25.00 $25.00 2026-05-22
58999 CPT Unlisted Px Fml Genital Sys 2 1 $1,430.00 $715.00 50% off $25.00 $25.00 $25.00 2026-05-22
59612 CPT Vbac Delivery Only 2 1 $1,989.00 $994.50 50% off $25.00 $25.00 $25.00 2026-05-22
64400 CPT Njx Aa&/strd Trigeminal Nrv 2 1 $111.00 $55.50 50% off $25.00 $25.00 $25.00 2026-05-22
64466 CPT Thrc Fascial Pln Blk Uni Njx 2 1 $143.00 $71.50 50% off $25.00 $25.00 $25.00 2026-05-22
65220 CPT Remove Foreign Body From Eye 2 1 $90.00 $45.00 50% off $25.00 $25.00 $25.00 2026-05-22
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