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

JACKSON GENERAL HOSPITAL

Ripley, WV · CCN 511320 · Rates published

4,909 distinct procedures filed
32 distinct payers
231,959 rate rows
2026-05-13 last MRF observed
Data quality

18,108 of 231,959 rate rows are consumer-grade (7.8%)

213,851 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 212,710
per-diem day rate — not a per-procedure price 709
exceeds 10× this hospital's gross charge — excluded from medians 419
placeholder amount (≤ $0.02) — excluded from medians 13
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://wvumedicine.org/wp-content/uploads/2026/04/550462730_Community-Health-Association_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 508a8322ecebc098… · 42,617,083 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 30 $101,970.00 $101,970.00 $101,970.00 nat. median
$68,400
1.5× median
J9226
HCPCS 		Supprelin La Implant 30 $73,550.30 $73,550.30 $73,550.30 nat. median
$55,159
1.3× median
J0480
HCPCS 		Basiliximab 30 $7,385.85 $7,385.85 $7,385.85 nat. median
$6,695
1.1× median
J2787
HCPCS 		Riboflavin 5'phos Opth<=3ml 30 $4,108.50 $4,108.50 $4,108.50 nat. median
$4,061
1.0× median
J3240
HCPCS 		Thyrotropin Injection 30 $3,334.93 $3,334.93 $3,334.93 nat. median
$2,976
1.1× median
Q4113
HCPCS 		Graftjacket Xpress 30 $3,295.88 $3,295.88 $3,295.88 nat. median
$1,850
1.8× median
J1950
HCPCS 		Leuprolide Acetate /3.75 Mg 30 $2,581.59 $2,581.59 $2,581.59 nat. median
$3,921
0.7× median
J7298
HCPCS 		Mirena, 52 Mg 30 $2,290.45 $2,290.45 $2,290.45 nat. median
$1,679
1.4× median
50419-0423-01
OTHER 		Mirena 30 $2,290.45 $2,290.45 $2,290.45 nat. median
$2,290
1.0× median
J7296
HCPCS 		Kyleena, 19.5 Mg 30 $2,290.45 $2,290.45 $2,290.45 nat. median
$1,659
1.4× median
50419-0424-01
OTHER 		Kyleena 30 $2,290.45 $2,290.45 $2,290.45 nat. median
$1,757
1.3× median
78206-0145-01
OTHER 		Nexplanon 30 $2,289.44 $2,289.44 $2,289.44 nat. median
$2,208
1.0× median
J9357
HCPCS 		Valrubicin Injection 30 $2,250.35 $2,250.35 $2,250.35 nat. median
$1,799
1.3× median
919606928
OTHER 		Hchg Silvadene 1% Cream, Per 1 Gm 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
100020928
OTHER 		Hchg Routine Room 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
110323928
OTHER 		Hchg Methotrexate Ophth 400mcg/0.1ml Per Dose 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
110333928
OTHER 		Hchg Sufentanil 50mcg/ml Inj (sufenta) - Per 1ml 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
00264-7750-00
OTHER 		Lactated Ringer's 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,000
1.1× median
110337928
OTHER 		Hchg Bupivacaine Hcl Pf (marcaine) 0.25% Inj Per 1ml 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
00264-7800-00
OTHER 		Sodium Chloride 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,000
1.1× median
94667
CPT 		Initial Therapy Service To Facilitate Lung Function 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$153
outlier · 14.6×
00270-1316-35
OTHER 		Isovue-370 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,208
1.0× median
00338-0017-04
OTHER 		Dextrose 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,000
1.1× median
00264-7510-20
OTHER 		Dextrose 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,882
0.8× median
00407-1412-33
OTHER 		Omnipaque 240 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$1,297
1.7× median
100022928
OTHER 		Hchg Telemetry Room 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
A9270
HCPCS 		Non-covered Item Or Service 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$13
outlier · 166.2×
00338-0017-48
OTHER 		Dextrose 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$6
outlier · 353.7×
110473928
OTHER 		Hchg Belotero Balance Per 1ml Syringe 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
00264-7510-10
OTHER 		Dextrose 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,000
1.1× median
94640
CPT 		Inhalation Treatment For Airway Obstruction Or Sputum Production 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$195
outlier · 11.4×
110472928
OTHER 		Hchg Restylane Per 1ml Syringe 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
G0239
HCPCS 		Oth Resp Proc, Group 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$79
outlier · 28.2×
500330928
OTHER 		Hchg Hospice Daily 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
110467928
OTHER 		Hchg Juv Derm Ultra Plus Xc Per (1) 0.55ml Syringe 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
J3490
HCPCS 		Drugs Unclassified Injection 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$47
outlier · 47.1×
00990-7983-09
OTHER 		Sodium Chloride 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,242
1.0× median
919607928
OTHER 		Hchg Silver Nitrate Swabs - Each 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
100021928
OTHER 		Hchg Step Down Room 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
00270-1315-35
OTHER 		Isovue-300 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,242
1.0× median
110274928
OTHER 		Hchg 0.9% Ns 250 Ml 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
94644
CPT 		Cbt 1st Hour 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$183
outlier · 12.2×
Q9967
HCPCS 		Low Osmolar Contrast Material; 300-399 Mg/ml Iodine Concentration; Per Ml 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$65
outlier · 34.4×
94664
CPT 		Evaluate Pt Use Of Inhaler 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$194
outlier · 11.5×
00338-0049-04
OTHER 		Sodium Chloride 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,000
1.1× median
110471928
OTHER 		Hchg Juv Derm Vollure Per 1ml Syringe 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
919608928
OTHER 		Hchg Triple Antibiotic Ointment (neosporin) Unit Dose Packets 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
00270-0445-40
OTHER 		Gastrografin 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
110334928
OTHER 		Hchg Ganciclovir Ophth 2mg/0.1ml Per Dose 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median
110480928
OTHER 		Hchg Sodium Tetradecyl Sulfate (sotradecol) Per 1ml 11 $2,224.96 $2,224.96 $2,224.96 nat. median
$2,225
1.0× median

Other procedures at this hospital

Browse this hospital's 4,909 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
             
J3111 HCPCS Inj. Romosozumab-aqqg 1 Mg 32 30 $38.00 $19.00 50% off $17.70 $17.70 $17.70 2026-05-13
J2274 HCPCS Inj Morphine Pf Epid Ithc 32 30 $55.00 $27.50 50% off $18.55 $18.55 $18.55 2026-05-13
J7402 HCPCS Mometasone Sinus Sinuva 32 30 $33.00 $16.50 50% off $18.73 $18.73 $18.73 2026-05-13
J3396 HCPCS Verteporfin Injection 32 30 $26.00 $13.00 50% off $19.02 $19.02 $19.02 2026-05-13
J2798 HCPCS Inj., Perseris, 0.5 Mg 32 30 $34.00 $17.00 50% off $19.17 $19.17 $19.17 2026-05-13
J1306 HCPCS Injection, Inclisiran, 1 Mg 32 30 $36.00 $18.00 50% off $20.01 $20.01 $20.01 2026-05-13
J2794 HCPCS Inj Risperdal Consta, 0.5 Mg 32 30 $36.00 $18.00 50% off $20.05 $20.05 $20.05 2026-05-13
J2427 HCPCS Inj, Invega Hafyera/trinza 32 30 $38.00 $19.00 50% off $20.15 $20.15 $20.15 2026-05-13
71288-0201-85 OTHER Regadenoson 32 30 $20.58 $10.29 50% off $20.58 $20.58 $20.58 2026-05-13
19515-0904-41 OTHER FluLaval 2025-2026 Formula 1 1 $42.00 $21.00 50% off $21.07 $21.07 $21.07 2026-05-13
19515-0814-41 OTHER FluLaval Quadrivalent 2023-2024 Formula 32 30 $42.00 $21.00 50% off $21.07 $21.07 $21.07 2026-05-13
70461-0025-04 OTHER Fluad 2025-2026 Formula 1 1 $174.00 $87.00 50% off $21.07 $21.07 $21.07 2026-05-13
58160-0912-41 OTHER Fluarix 2025-2026 Formula 32 30 $42.00 $21.00 50% off $21.07 $21.07 $21.07 2026-05-13
19515-0904-52 OTHER FluLaval 2025-2026 Formula 32 30 $42.00 $21.00 50% off $21.07 $21.07 $21.07 2026-05-13
19515-0810-41 OTHER FluLaval 2024-2025 Formula 32 30 $42.00 $21.00 50% off $21.07 $21.07 $21.07 2026-05-13
90656 CPT Iiv3 Vacc No Prsv 0.5 Ml IM 32 30 $39.00 $19.50 50% off $21.07 $21.07 $21.07 2026-05-13
42023-0221-01 OTHER Ertapenem 32 30 $30.17 $15.09 50% off $21.40 $21.40 $21.40 2026-05-13
43598-0901-11 OTHER Ertapenem 32 30 $67.52 $33.76 50% off $21.40 $21.40 $21.40 2026-05-13
J1335 HCPCS Ertapenem Injection 32 30 $30.00 $15.00 50% off $21.40 $21.40 $21.40 2026-05-13
16714-0889-01 OTHER Ertapenem 32 30 $87.07 $43.54 50% off $21.40 $21.40 $21.40 2026-05-13
J0587 HCPCS Inj, Rimabotulinumtoxinb 32 30 $39.00 $19.50 50% off $21.50 $21.50 $21.50 2026-05-13
90657 CPT Iiv3 Vaccine Splt 0.25 Ml IM 32 30 $27.00 $13.50 50% off $21.62 $21.62 $21.62 2026-05-13
63323-0842-21 OTHER Dicyclomine HCl 32 30 $22.05 $11.03 50% off $22.05 $22.05 $22.05 2026-05-13
60505-6116-00 OTHER Regadenoson 32 30 $68.91 $34.46 50% off $23.56 $23.56 $23.56 2026-05-13
00641-6253-01 OTHER Regadenoson 32 30 $41.34 $20.67 50% off $23.56 $23.56 $23.56 2026-05-13
J2426 HCPCS Inj, Invega Sustenna, 1 Mg 32 30 $43.00 $21.50 50% off $23.63 $23.63 $23.63 2026-05-13
49281-0544-58 OTHER Pentacel-acthib Component 33 30 $36.00 $18.00 50% off $25.21 $217.26 $25.21 2026-05-13
49281-0547-58 OTHER ActHIB 32 30 $36.00 $18.00 50% off $25.21 $25.21 $25.21 2026-05-13
49281-0546-58 OTHER Haemophilus Influenzae Type B Vaccine; Prp-t Conjugate 32 30 $36.00 $18.00 50% off $25.21 $25.21 $25.21 2026-05-13
90648 CPT Hib Prp-t Vaccine 4 Dose IM 32 30 $34.00 $17.00 50% off $25.21 $25.21 $25.21 2026-05-13
J0875 HCPCS Injection, Dalbavancin 32 30 $27.00 $13.50 50% off $25.23 $25.23 $25.23 2026-05-13
00074-5015-01 OTHER Skyrizi 600mg/10ml 32 30 $29,296.56 $14,648.28 50% off $25.34 $25.34 $25.34 2026-05-13
90660 CPT Laiv3 Vaccine Intranasal 32 30 $73.00 $36.50 50% off $27.56 $27.56 $27.56 2026-05-13
00310-3040-00 OTHER Saphnelo 32 30 $15,688.11 $7,844.06 50% off $28.35 $28.35 $28.35 2026-05-13
J0491 HCPCS Inj Anifrolumab-fnia 1mg 32 30 $55.00 $27.50 50% off $28.35 $28.35 $28.35 2026-05-13
J3304 HCPCS Inj Triamcinolone Ace Xr 1mg 32 30 $65.00 $32.50 50% off $28.94 $28.94 $28.94 2026-05-13
J0558 HCPCS Peng Benzathine/procaine Inj 32 30 $56.00 $28.00 50% off $29.01 $29.01 $29.01 2026-05-13
00009-0011-03 OTHER Solu-cortef 100mg Vial 32 30 $82.62 $41.31 50% off $29.45 $29.45 $29.45 2026-05-13
00009-0011-04 OTHER Solu-cortef 100mg Vial 32 30 $56.09 $28.05 50% off $29.45 $29.45 $29.45 2026-05-13
J2356 HCPCS Inj Tezepelumab-ekko, 1mg 32 30 $67.00 $33.50 50% off $30.67 $30.67 $30.67 2026-05-13
J1120 HCPCS Acetazolamid Sodium Injectio 32 30 $31.00 $15.50 50% off $31.00 $31.00 $31.00 2026-05-13
A9567 HCPCS Technetium Tc-99m Aerosol 32 30 $253.00 $126.50 50% off $34.04 $34.04 $34.04 2026-05-13
J0561 HCPCS Penicillin G Benzathine Inj 32 30 $85.00 $42.50 50% off $35.85 $35.85 $35.85 2026-05-13
J2799 HCPCS Inj, Uzedy, 1 Mg 32 30 $68.00 $34.00 50% off $40.76 $40.76 $40.76 2026-05-13
J0897 HCPCS Denosumab Injection 32 30 $91.00 $45.50 50% off $41.58 $41.58 $41.58 2026-05-13
55513-0670-01 OTHER Avsola 32 30 $4,189.50 $2,094.75 50% off $42.17 $42.17 $42.17 2026-05-13
60505-6097-00 OTHER Ibandronate Sodium 32 30 $195.57 $97.79 50% off $42.24 $42.24 $42.24 2026-05-13
67457-0524-33 OTHER Ibandronate Sodium 32 30 $179.43 $89.72 50% off $42.24 $42.24 $42.24 2026-05-13
Q5107 HCPCS Inj Mvasi 10 Mg 32 30 $181.00 $90.50 50% off $42.27 $42.27 $42.27 2026-05-13
J9208 HCPCS Ifosfamide Injection 32 30 $83.00 $41.50 50% off $44.14 $44.14 $44.14 2026-05-13
J0834 HCPCS Inj., Cosyntropin, 0.25 Mg 32 30 $90.00 $45.00 50% off $44.73 $44.73 $44.73 2026-05-13
J2407 HCPCS Injection, Oritavancin 32 30 $80.00 $40.00 50% off $45.54 $45.54 $45.54 2026-05-13
A9539 HCPCS Tc99m Pentetate 32 30 $165.00 $82.50 50% off $49.17 $49.17 $49.17 2026-05-13
49281-0215-88 OTHER Tenivac 32 30 $102.59 $51.30 50% off $50.06 $50.06 $50.06 2026-05-13
90714 CPT Td Vacc No Presv 7 Yrs+ IM 32 30 $139.00 $69.50 50% off $50.06 $50.06 $50.06 2026-05-13
Q4101 HCPCS Apligraf 32 30 $584.00 $292.00 50% off $50.16 $50.16 $50.16 2026-05-13
J2182 HCPCS Injection, Mepolizumab, 1mg 32 30 $116.00 $58.00 50% off $50.34 $50.34 $50.34 2026-05-13
90744 CPT Hepb Vacc 3 Dose Ped/adol IM 32 30 $66.00 $33.00 50% off $50.77 $50.77 $50.77 2026-05-13
A9540 HCPCS Tc99m Maa 32 30 $491.00 $245.50 50% off $52.95 $52.95 $52.95 2026-05-13
J9334 HCPCS Inj Efgart-alfa 2mg Hya-qvfc 32 30 $98.00 $49.00 50% off $53.20 $53.20 $53.20 2026-05-13
Q2038 HCPCS Fluzone Vacc, 3 Yrs & >, IM 32 30 $54.00 $27.00 50% off $54.00 $54.00 $54.00 2026-05-13
58160-0842-43 OTHER Boostrix 34 30 $62.00 $31.00 50% off $56.96 $299.95 $56.96 2026-05-13
58160-0810-43 OTHER Infanrix 32 30 $79.00 $39.50 50% off $56.96 $56.96 $56.96 2026-05-13
90700 CPT Dtap Vaccine < 7 Yrs IM 32 30 $64.00 $32.00 50% off $56.96 $56.96 $56.96 2026-05-13
90647 CPT Hib Prp-omp Vacc 3 Dose IM 32 30 $83.00 $41.50 50% off $58.58 $58.58 $58.58 2026-05-13
J2777 HCPCS Inj, Faricimab-svoa, 0.1mg 32 30 $72.00 $36.00 50% off $59.55 $59.55 $59.55 2026-05-13
A9503 HCPCS Technetium Tc-99m Medronate; Diagnostic; Per Study Dose; Up To 30 Millicuries 32 30 $129.00 $64.50 50% off $61.59 $61.59 $61.59 2026-05-13
58160-0842-52 OTHER Boostrix 32 30 $102.68 $51.34 50% off $63.21 $63.21 $63.21 2026-05-13
90715 CPT Tdap Vaccine 7 Yrs/> IM 32 30 $136.00 $68.00 50% off $63.21 $63.21 $63.21 2026-05-13
J2357 HCPCS Omalizumab Injection 32 30 $148.00 $74.00 50% off $65.11 $65.11 $65.11 2026-05-13
J0565 HCPCS Inj, Bezlotoxumab, 10 Mg 32 30 $137.00 $68.50 50% off $65.77 $65.77 $65.77 2026-05-13
J2406 HCPCS Injection, Oritavancin 10 Mg 32 30 $123.00 $61.50 50% off $67.52 $67.52 $67.52 2026-05-13
58160-0825-43 OTHER Havrix Pediatric 32 30 $79.00 $39.50 50% off $68.72 $68.72 $68.72 2026-05-13
90633 CPT Hepa Vacc Ped/adol 2 Dose IM 32 30 $98.00 $49.00 50% off $68.72 $68.72 $68.72 2026-05-13
J1110 HCPCS Inj Dihydroergotamine Mesylt 32 30 $130.00 $65.00 50% off $69.86 $69.86 $69.86 2026-05-13
J1569 HCPCS Gammagard Liquid Injection 32 30 $169.00 $84.50 50% off $72.85 $72.85 $72.85 2026-05-13
96361 CPT Infusion Into A Vein For Hydration; Each Additional Hour 33 30 $656.00 $328.00 50% off $24.00 $74.68 $74.68 2026-05-13
J1455 HCPCS Foscarnet Sodium Injection 32 30 $79.00 $39.50 50% off $79.00 $79.00 $79.00 2026-05-13
J1459 HCPCS Inj Ivig Privigen 500 Mg 32 30 $110.00 $55.00 50% off $79.68 $79.68 $79.68 2026-05-13
J3299 HCPCS Inj Xipere 1 Mg 32 30 $124.00 $62.00 50% off $80.16 $80.16 $80.16 2026-05-13
J1561 HCPCS Gamunex-c/gammaked 32 30 $178.00 $89.00 50% off $82.15 $82.15 $82.15 2026-05-13
Q4152 HCPCS Dermapure 1 Square Cm 32 30 $94.00 $47.00 50% off $83.19 $83.19 $83.19 2026-05-13
55513-0190-01 OTHER Neulasta 32 30 $12,696.78 $6,348.39 50% off $83.62 $83.62 $83.62 2026-05-13
J1460 HCPCS Gamma Globulin 1 Cc Inj 32 30 $143.00 $71.50 50% off $83.70 $83.70 $83.70 2026-05-13
90713 CPT Poliovirus Ipv Sc/im 32 30 $123.00 $61.50 50% off $84.18 $84.18 $84.18 2026-05-13
49401-0102-01 OTHER Benlysta 32 30 $13,192.04 $6,596.02 50% off $85.80 $85.80 $85.80 2026-05-13
J0490 HCPCS Belimumab Injection 32 30 $2,570.07 $1,285.04 50% off $85.80 $85.80 $85.80 2026-05-13
P9047 HCPCS Albumin (human), 25%, 50ml 32 30 $105.00 $52.50 50% off $87.58 $87.58 $87.58 2026-05-13
68516-5216-03 OTHER Albutein 32 30 $246.00 $123.00 50% off $87.58 $87.58 $87.58 2026-05-13
68516-5216-01 OTHER Albutein 32 30 $307.50 $153.75 50% off $87.58 $87.58 $87.58 2026-05-13
90281 CPT Human Ig IM 32 30 $286.00 $143.00 50% off $92.80 $92.80 $92.80 2026-05-13
00143-9192-01 OTHER Foscarnet Sodium 32 30 $344.62 $172.31 50% off $97.96 $97.96 $97.96 2026-05-13
50242-0150-01 OTHER Ocrevus 32 30 $61,922.88 $30,961.44 50% off $98.59 $98.59 $98.59 2026-05-13
J9280 HCPCS Mitomycin Injection 32 30 $242.00 $121.00 50% off $104.53 $104.53 $104.53 2026-05-13
J0775 HCPCS Collagenase, Clost Hist Inj 32 30 $247.00 $123.50 50% off $109.35 $109.35 $109.35 2026-05-13
58160-0826-43 OTHER Havrix 32 30 $198.00 $99.00 50% off $115.93 $115.93 $115.93 2026-05-13
90632 CPT Hepa Vaccine Adult IM 32 30 $195.00 $97.50 50% off $115.93 $115.93 $115.93 2026-05-13
58160-0821-43 OTHER Engerix-b 32 30 $133.00 $66.50 50% off $116.13 $116.13 $116.13 2026-05-13
58160-0821-52 OTHER Engerix-b 32 30 $133.00 $66.50 50% off $116.13 $116.13 $116.13 2026-05-13
90746 CPT Hepb Vaccine 3 Dose Adult IM 32 30 $139.00 $69.50 50% off $116.13 $116.13 $116.13 2026-05-13
J7321 HCPCS Hyalgan Supartz Visco-3 Dose 32 30 $712.00 $356.00 50% off $120.62 $120.62 $120.62 2026-05-13
90662 CPT Iiv No Prsv Increased Ag IM 32 30 $238.00 $119.00 50% off $121.11 $121.11 $121.11 2026-05-13
90743 CPT Hepb Vacc 2 Dose Adolesc IM 32 30 $139.00 $69.50 50% off $124.00 $124.00 $124.00 2026-05-13
A9541 HCPCS Technetium Tc-99m Sulfur Colloid; Diagnostic; Per Study Dose; Up To 20 Millicuri… 32 30 $129.00 $64.50 50% off $129.00 $129.00 $129.00 2026-05-13
J1566 HCPCS Immune Globulin, Powder 32 30 $232.00 $116.00 50% off $129.53 $129.53 $129.53 2026-05-13
J2779 HCPCS Inj, Susvimo 0.1 Mg 32 30 $172.00 $86.00 50% off $133.29 $133.29 $133.29 2026-05-13
J2790 HCPCS Rho D Immune Globulin Inj 32 30 $204.00 $102.00 50% off $133.91 $133.91 $133.91 2026-05-13
91319 CPT Sarscv2 Vac 10mcg Trs-suc IM 32 30 $135.00 $67.50 50% off $135.00 $135.00 $135.00 2026-05-13
90696 CPT Dtap-ipv Vaccine 4-6 Yrs IM 34 30 $138.00 $69.00 50% off $138.00 $172.00 $138.00 2026-05-13
J2997 HCPCS Alteplase Recombinant 32 30 $243.00 $121.50 50% off $146.80 $146.80 $146.80 2026-05-13
Q4201 HCPCS Matrion 1 Sq Cm 33 30 $155.00 $77.50 50% off $155.00 $171.96 $155.00 2026-05-13
Q4160 HCPCS Nushield 1 Square Cm 32 30 $554.00 $277.00 50% off $161.68 $161.68 $161.68 2026-05-13
58160-0812-43 OTHER Kinrix 32 30 $166.00 $83.00 50% off $166.00 $166.00 $166.00 2026-05-13
A9560 HCPCS Technetium Tc-99m Labeled Red Blood Cells; Diagnostic; Per Study Dose; Up To 30 … 32 30 $444.00 $222.00 50% off $166.40 $166.40 $166.40 2026-05-13
Q4122 HCPCS Dermacell, Awm, Porous Sq Cm 40 30 $170.00 $85.00 50% off $133.00 $199.70 $170.00 2026-05-13
Q4196 HCPCS Puraply Am 1 Sq Cm 33 30 $186.00 $93.00 50% off $131.00 $171.22 $171.22 2026-05-13
J2778 HCPCS Ranibizumab Injection 32 30 $180.00 $90.00 50% off $180.00 $180.00 $180.00 2026-05-13
90691 CPT Typhoid Vaccine IM 32 30 $425.00 $212.50 50% off $180.23 $180.23 $180.23 2026-05-13
00006-4681-01 OTHER M-m-r Ii 32 30 $251.00 $125.50 50% off $182.39 $182.39 $182.39 2026-05-13
58160-0831-03 OTHER Priorix 32 30 $251.00 $125.50 50% off $182.39 $182.39 $182.39 2026-05-13
90707 CPT Mmr Vaccine Sc 32 30 $258.00 $129.00 50% off $182.39 $182.39 $182.39 2026-05-13
58160-0740-02 OTHER Rotarix 32 30 $300.00 $150.00 50% off $182.97 $182.97 $182.97 2026-05-13
90681 CPT Rv1 Vacc 2 Dose Live Oral 32 30 $309.00 $154.50 50% off $182.97 $182.97 $182.97 2026-05-13
A9516 HCPCS Iodine I-123 Sod Iodide Mic 32 30 $185.00 $92.50 50% off $185.00 $185.00 $185.00 2026-05-13
A9537 HCPCS Technetium Tc-99m Mebrofenin; Diagnostic; Per Study Dose; Up To 15 Millicuries 32 30 $187.00 $93.50 50% off $187.00 $187.00 $187.00 2026-05-13
58160-0811-43 OTHER Pediarix 32 30 $366.00 $183.00 50% off $187.79 $187.79 $187.79 2026-05-13
90723 CPT Dtap-hep B-ipv Vaccine IM 32 30 $189.00 $94.50 50% off $187.79 $187.79 $187.79 2026-05-13
00006-4047-01 OTHER RotaTeq 33 30 $243.00 $121.50 50% off $182.97 $189.75 $189.75 2026-05-13
00006-4047-02 OTHER Rotavirus Vaccine; Pentavalent 32 30 $243.00 $121.50 50% off $189.75 $189.75 $189.75 2026-05-13
90680 CPT Rv5 Vacc 3 Dose Live Oral 32 30 $253.00 $126.50 50% off $189.75 $189.75 $189.75 2026-05-13
Q4197 HCPCS Puraply Xt 1 Sq Cm 32 30 $240.00 $120.00 50% off $202.92 $202.92 $202.92 2026-05-13
J7323 HCPCS Euflexxa Inj Per Dose 32 30 $1,003.00 $501.50 50% off $210.05 $210.05 $210.05 2026-05-13
55566-4100-01 OTHER Euflexxa 32 30 $1,503.38 $751.69 50% off $210.05 $210.05 $210.05 2026-05-13
90636 CPT Hep A/hep B Vacc Adult IM 32 30 $286.00 $143.00 50% off $213.39 $213.39 $213.39 2026-05-13
J7324 HCPCS Orthovisc Inj Per Dose 32 30 $360.00 $180.00 50% off $215.56 $215.56 $215.56 2026-05-13
59676-0360-01 OTHER Orthovisc 32 30 $431.35 $215.68 50% off $215.56 $215.56 $215.56 2026-05-13
91320 CPT Sarscv2 Vac 30mcg Trs-suc IM 32 30 $301.00 $150.50 50% off $216.32 $216.32 $216.32 2026-05-13
49281-0561-01 OTHER Pentacel-dtap/ipv Component 32 30 $303.00 $151.50 50% off $217.26 $217.26 $217.26 2026-05-13
90698 CPT Dtap-ipv/hib Vaccine IM 32 30 $318.00 $159.00 50% off $217.26 $217.26 $217.26 2026-05-13
00006-4171-01 OTHER ProQuad 32 30 $777.00 $388.50 50% off $218.94 $218.94 $218.94 2026-05-13
90710 CPT Mmrv Vaccine Sc 32 30 $808.00 $404.00 50% off $218.94 $218.94 $218.94 2026-05-13
00006-4837-01 OTHER Pneumovax 23 32 30 $314.00 $157.00 50% off $220.23 $220.23 $220.23 2026-05-13
90732 CPT Ppsv23 Vacc 2 Yrs+ Subq/im 32 30 $316.00 $158.00 50% off $220.23 $220.23 $220.23 2026-05-13
90371 CPT Hep B Ig IM 32 30 $464.00 $232.00 50% off $227.52 $227.52 $227.52 2026-05-13
91322 CPT Sarscov2 Vac 50 Mcg/0.5ml IM 32 30 $372.00 $186.00 50% off $240.77 $240.77 $240.77 2026-05-13
91321 CPT Sarscov2 Vac 25 Mcg/.25ml IM 32 30 $339.00 $169.50 50% off $240.77 $240.77 $240.77 2026-05-13
91304 CPT Sarscov2 Vac 5mcg/0.5ml IM 32 30 $315.00 $157.50 50% off $244.53 $244.53 $244.53 2026-05-13
J2781 HCPCS Inj, Pegcetacoplan, 1mg 32 30 $452.00 $226.00 50% off $249.91 $249.91 $249.91 2026-05-13
Q4199 HCPCS Cygnus Matrix, Per Sq Cm 34 30 $258.00 $129.00 50% off $207.00 $443.00 $258.00 2026-05-13
90717 CPT Yellow Fever Vaccine Subq 32 30 $617.00 $308.50 50% off $263.36 $263.36 $263.36 2026-05-13
90739 CPT Hepb Vacc 2/4 Dose Adult IM 32 30 $380.00 $190.00 50% off $264.46 $264.46 $264.46 2026-05-13
A9606 HCPCS Radium Ra223 Dichloride Ther 32 30 $317.00 $158.50 50% off $265.91 $265.91 $265.91 2026-05-13
J1426 HCPCS Injection, Casimersen, 10 Mg 32 30 $362.00 $181.00 50% off $274.28 $274.28 $274.28 2026-05-13
J0517 HCPCS Inj., Benralizumab, 1 Mg 32 30 $585.00 $292.50 50% off $279.68 $279.68 $279.68 2026-05-13
J0475 HCPCS Baclofen 10 Mg Injection 32 30 $709.00 $354.50 50% off $293.37 $293.37 $293.37 2026-05-13
J9217 HCPCS Leuprolide Acetate Suspnsion 32 30 $377.00 $188.50 50% off $299.15 $299.15 $299.15 2026-05-13
A9509 HCPCS Iodine I-123 Sod Iodide Mil 32 30 $741.00 $370.50 50% off $299.31 $299.31 $299.31 2026-05-13
90734 CPT Menacwyd/menacwycrm Vacc IM 32 30 $313.00 $156.50 50% off $299.95 $299.95 $299.95 2026-05-13
58160-0955-09 OTHER Menveo 32 30 $304.00 $152.00 50% off $299.95 $299.95 $299.95 2026-05-13
58160-0827-03 OTHER Menveo 32 30 $304.00 $152.00 50% off $299.95 $299.95 $299.95 2026-05-13
58160-0958-01 OTHER Menveo 32 30 $304.00 $152.00 50% off $299.95 $299.95 $299.95 2026-05-13
00597-0053-01 OTHER Glucagen 32 30 $1,013.16 $506.58 50% off $310.81 $310.81 $310.81 2026-05-13
00548-5850-00 OTHER Glucagon Emergency Kit 32 30 $759.03 $379.51 50% off $310.81 $310.81 $310.81 2026-05-13
J1610 HCPCS Glucagon Hydrochloride/1 Mg 32 30 $410.00 $205.00 50% off $310.81 $310.81 $310.81 2026-05-13
00548-5905-00 OTHER Injection; Glucagon Hydrochloride; Per 1 Mg 32 30 $759.87 $379.94 50% off $310.81 $310.81 $310.81 2026-05-13
49281-0590-58 OTHER MenQuadfi 33 30 $429.00 $214.50 50% off $299.95 $330.38 $330.38 2026-05-13
58160-0959-01 OTHER Menveo 34 30 $429.00 $214.50 50% off $63.21 $330.38 $330.38 2026-05-13
90619 CPT Menacwy-tt Vaccine IM 32 30 $441.00 $220.50 50% off $330.38 $330.38 $330.38 2026-05-13
96360 CPT Infusion Into A Vein For Hydration; 31-60 Minutes 33 30 $451.00 $225.50 50% off $60.00 $336.96 $336.96 2026-05-13
J7312 HCPCS Dexamethasone Intra Implant 32 30 $589.00 $294.50 50% off $339.26 $339.26 $339.26 2026-05-13
J7351 HCPCS Inj Bimatoprost Itc Imp1mcg 32 30 $608.00 $304.00 50% off $340.25 $340.25 $340.25 2026-05-13
90716 CPT Var Vaccine Live Subq 32 30 $548.00 $274.00 50% off $344.92 $344.92 $344.92 2026-05-13
00006-4827-01 OTHER Varivax 32 30 $522.00 $261.00 50% off $344.92 $344.92 $344.92 2026-05-13
Q4195 HCPCS Puraply; Per Square Centimeter 32 30 $2,560.00 $1,280.00 50% off $349.59 $349.59 $349.59 2026-05-13
90621 CPT Menb-fhbp Vacc 2/3 Dose IM 32 30 $509.00 $254.50 50% off $376.46 $376.46 $376.46 2026-05-13
90620 CPT Menb-4c Vaccine IM 32 30 $458.00 $229.00 50% off $411.10 $411.10 $411.10 2026-05-13
90671 CPT Pcv15 Vaccine IM 32 30 $545.00 $272.50 50% off $418.37 $418.37 $418.37 2026-05-13
00005-2000-01 OTHER Prevnar 20 33 30 $588.00 $294.00 50% off $418.37 $476.29 $418.37 2026-05-13
58160-0820-43 OTHER Engerix-b 34 30 $588.00 $294.00 50% off $50.77 $418.37 $418.37 2026-05-13
00006-4329-01 OTHER Pneumococcal Conjugate Vaccine; 15 Valent (pcv15); For Intramuscular Use 32 30 $588.00 $294.00 50% off $418.37 $418.37 $418.37 2026-05-13
90677 CPT Pcv20 Vaccine IM 32 30 $727.00 $363.50 50% off $476.29 $476.29 $476.29 2026-05-13
A9513 HCPCS Lutetium Lu 177 Dotatat Ther 32 30 $556.00 $278.00 50% off $479.23 $479.23 $479.23 2026-05-13
90738 CPT Inactivated Je Vacc IM 32 30 $1,063.00 $531.50 50% off $504.42 $504.42 $504.42 2026-05-13
Q4210 HCPCS Axolotl Graf Dualgraf Sq Cm 32 30 $515.00 $257.50 50% off $515.00 $515.00 $515.00 2026-05-13
50632-0010-01 OTHER RabAvert 32 30 $978.96 $489.48 50% off $535.82 $535.82 $535.82 2026-05-13
90675 CPT Rabies Vaccine IM 32 30 $1,138.00 $569.00 50% off $535.82 $535.82 $535.82 2026-05-13
J3241 HCPCS Inj. Teprotumumab-trbw 10 Mg 32 30 $1,082.00 $541.00 50% off $541.20 $541.20 $541.20 2026-05-13
90679 CPT Rsv Vacc Pref Recomb Adjt IM 32 30 $684.00 $342.00 50% off $554.40 $554.40 $554.40 2026-05-13
90378 CPT Rsv Mab IM 50mg 32 30 $5,462.00 $2,731.00 50% off $560.47 $560.47 $560.47 2026-05-13
90651 CPT 9vhpv Vaccine 2/3 Dose IM 32 30 $871.00 $435.50 50% off $569.07 $569.07 $569.07 2026-05-13
00006-4121-01 OTHER Gardasil 9 32 30 $823.00 $411.50 50% off $569.07 $569.07 $569.07 2026-05-13
90678 CPT Rsv Vacc Pref Bivalent IM 32 30 $812.00 $406.00 50% off $584.10 $584.10 $584.10 2026-05-13
Q4159 HCPCS Affinity1 Square Cm 32 30 $970.00 $485.00 50% off $593.44 $593.44 $593.44 2026-05-13
J7308 HCPCS Aminolevulinic Acid Hcl Top 32 30 $1,180.00 $590.00 50% off $647.33 $647.33 $647.33 2026-05-13
A9552 HCPCS F18 Fdg 32 30 $854.00 $427.00 50% off $647.79 $647.79 $647.79 2026-05-13
J3315 HCPCS Triptorelin Pamoate 32 30 $2,316.00 $1,158.00 50% off $682.42 $682.42 $682.42 2026-05-13
G0378 HCPCS Hospital Observation Per Hr 31 30 $51.00 $25.50 50% off $708.61 $708.61 $708.61 2026-05-13
A9500 HCPCS Technetium Tc-99m Sestamibi; Diagnostic; Per Study Dose 33 30 $1,480.00 $740.00 50% off $740.00 $743.46 $740.00 2026-05-13
J7313 HCPCS Inj., Iluvien, 0.01 Mg 32 30 $1,454.00 $727.00 50% off $810.07 $810.07 $810.07 2026-05-13
J7326 HCPCS Gel-one 32 30 $1,485.00 $742.50 50% off $820.53 $820.53 $820.53 2026-05-13
J7314 HCPCS Inj., Yutiq, 0.01 Mg 32 30 $1,545.00 $772.50 50% off $872.85 $872.85 $872.85 2026-05-13
Q4282 HCPCS Cygnus Dual Per Sq Cm 32 30 $922.00 $461.00 50% off $922.00 $922.00 $922.00 2026-05-13
A9595 HCPCS Piflu F-18, Dia 1 Millicurie 32 30 $1,154.00 $577.00 50% off $957.58 $957.58 $957.58 2026-05-13
49281-0574-88 OTHER Beyfortus 32 30 $1,475.00 $737.50 50% off $980.10 $980.10 $980.10 2026-05-13
90381 CPT Rsv Monoc Antb Seasn 1 Ml IM 32 30 $1,578.00 $789.00 50% off $980.10 $980.10 $980.10 2026-05-13
J9202 HCPCS Goserelin Acetate Implant 32 30 $3,372.00 $1,686.00 50% off $1,004.87 $1,004.87 $1,004.87 2026-05-13
A2001 HCPCS Innovamatrix Ac, Per Sq Cm 32 30 $1,048.40 $524.20 50% off $1,048.40 $1,048.40 $1,048.40 2026-05-13
90870 CPT Electroconvulsive Therapy 31 29 $995.00 $497.50 50% off $1,048.58 $1,048.58 $1,048.58 2026-05-13
J1212 HCPCS Dimethyl Sulfoxide 50% 50 Ml 32 30 $2,011.00 $1,005.50 50% off $1,123.35 $1,123.35 $1,123.35 2026-05-13
J7327 HCPCS Monovisc Inj Per Dose 32 30 $1,802.00 $901.00 50% off $1,178.71 $1,178.71 $1,178.71 2026-05-13
A9562 HCPCS Technetium Tc-99m Mertiatide; Diagnostic; Per Study Dose; Up To 15 Millicuries 32 30 $1,711.00 $855.50 50% off $1,283.16 $1,283.16 $1,283.16 2026-05-13
J0178 HCPCS Aflibercept Injection 32 30 $1,694.00 $847.00 50% off $1,422.76 $1,422.76 $1,422.76 2026-05-13
49281-0575-00 OTHER Beyfortus 32 30 $1,475.00 $737.50 50% off $1,475.00 $1,475.00 $1,475.00 2026-05-13
Q4194 HCPCS Novachor; Per Square Centimeter 32 30 $1,516.00 $758.00 50% off $1,516.00 $1,516.00 $1,516.00 2026-05-13
90380 CPT Rsv Monoc Antb Seasn .5ml IM 32 30 $1,578.00 $789.00 50% off $1,578.00 $1,578.00 $1,578.00 2026-05-13
J7307 HCPCS Etonogestrel Implant System 32 30 $1,657.00 $828.50 50% off $1,657.00 $1,657.00 $1,657.00 2026-05-13
J7297 HCPCS Liletta, 52 Mg 32 30 $2,796.00 $1,398.00 50% off $1,756.97 $1,756.97 $1,756.97 2026-05-13
50419-0422-01 OTHER Skyla 32 30 $3,034.14 $1,517.07 50% off $1,907.17 $1,907.17 $1,907.17 2026-05-13
J7301 HCPCS Skyla, 13.5 Mg 32 30 $3,035.00 $1,517.50 50% off $1,907.17 $1,907.17 $1,907.17 2026-05-13
59365-5128-01 OTHER ParaGard T380a 32 30 $2,929.50 $1,464.75 50% off $2,148.30 $2,148.30 $2,148.30 2026-05-13
J7300 HCPCS Intra Copp Contra (paragard) 32 30 $3,127.00 $1,563.50 50% off $2,148.30 $2,148.30 $2,148.30 2026-05-13
919606928 OTHER Hchg Silvadene 1% Cream, Per 1 Gm 11 11 $2.00 $1.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
100020928 OTHER Hchg Routine Room 12 11 $1,205.00 $602.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110323928 OTHER Hchg Methotrexate Ophth 400mcg/0.1ml Per Dose 11 11 $1.00 $0.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110333928 OTHER Hchg Sufentanil 50mcg/ml Inj (sufenta) - Per 1ml 11 11 $35.00 $17.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00264-7750-00 OTHER Lactated Ringer's 11 11 $9.00 $4.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110337928 OTHER Hchg Bupivacaine Hcl Pf (marcaine) 0.25% Inj Per 1ml 11 11 $2.00 $1.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00264-7800-00 OTHER Sodium Chloride 11 11 $9.00 $4.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
94667 CPT Initial Therapy Service To Facilitate Lung Function 11 11 $180.00 $90.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00270-1316-35 OTHER Isovue-370 33 11 $21.84 $10.92 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00338-0017-04 OTHER Dextrose 11 11 $6.00 $3.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00264-7510-20 OTHER Dextrose 11 11 $9.75 $4.88 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00407-1412-33 OTHER Omnipaque 240 11 11 $12.49 $6.25 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
100022928 OTHER Hchg Telemetry Room 12 11 $3,463.00 $1,731.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
A9270 HCPCS Non-covered Item Or Service 22 11 $3.13 $1.57 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00338-0017-48 OTHER Dextrose 11 11 $5.10 $2.55 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110473928 OTHER Hchg Belotero Balance Per 1ml Syringe 11 11 $855.00 $427.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00264-7510-10 OTHER Dextrose 11 11 $10.50 $5.25 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
94640 CPT Inhalation Treatment For Airway Obstruction Or Sputum Production 55 11 $230.00 $115.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110472928 OTHER Hchg Restylane Per 1ml Syringe 11 11 $899.00 $449.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
G0239 HCPCS Oth Resp Proc, Group 11 11 $166.00 $83.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
500330928 OTHER Hchg Hospice Daily 12 11 $771.00 $385.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110467928 OTHER Hchg Juv Derm Ultra Plus Xc Per (1) 0.55ml Syringe 11 11 $861.00 $430.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
J3490 HCPCS Drugs Unclassified Injection 11 11 $7.00 $3.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00990-7983-09 OTHER Sodium Chloride 11 11 $60.00 $30.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
919607928 OTHER Hchg Silver Nitrate Swabs - Each 11 11 $3.00 $1.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
100021928 OTHER Hchg Step Down Room 12 11 $5,241.00 $2,620.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00270-1315-35 OTHER Isovue-300 33 11 $24.60 $12.30 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110274928 OTHER Hchg 0.9% Ns 250 Ml 11 11 $12.00 $6.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
94644 CPT Cbt 1st Hour 11 11 $493.00 $246.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
Q9967 HCPCS Low Osmolar Contrast Material; 300-399 Mg/ml Iodine Concentration; Per Ml 11 11 $16.38 $8.19 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
94664 CPT Evaluate Pt Use Of Inhaler 11 11 $225.00 $112.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00338-0049-04 OTHER Sodium Chloride 11 11 $6.00 $3.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110471928 OTHER Hchg Juv Derm Vollure Per 1ml Syringe 11 11 $1,128.00 $564.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
919608928 OTHER Hchg Triple Antibiotic Ointment (neosporin) Unit Dose Packets 11 11 $1.00 $0.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00270-0445-40 OTHER Gastrografin 22 11 $19.26 $9.63 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110334928 OTHER Hchg Ganciclovir Ophth 2mg/0.1ml Per Dose 11 11 $1.00 $0.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110480928 OTHER Hchg Sodium Tetradecyl Sulfate (sotradecol) Per 1ml 11 11 $78.00 $39.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
94002 CPT Vent Mgmt Inpat Init Day 11 11 $1,243.00 $621.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
94660 CPT Therapy Procedure Using A Positive Pressure Ventilator 33 11 $459.00 $229.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110469928 OTHER Hchg Juv Derm Volbella Xc Per (1) 0.55ml Syringe 11 11 $615.00 $307.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
919605928 OTHER Hchg Phenol Ez Swabs Each 11 11 $13.00 $6.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
J7060 HCPCS 5% Dextrose/water (500 Ml = 1 Unit) 11 11 $15.00 $7.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00264-7800-10 OTHER Sodium Chloride 11 11 $9.00 $4.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
100008928 OTHER Hchg Isolation Room 12 11 $1,205.00 $602.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110470928 OTHER Hchg Juv Derm Volbella Xc Per 1ml Syringe 11 11 $1,128.00 $564.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110407928 OTHER Hchg Clindamycin Intravitreal Inj Per 1mg/0.1ml 11 11 $20.00 $10.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
94003 CPT Follow-up Inpatient Or Observation Ventilation Assistance And Management 11 11 $1,638.00 $819.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
100117928 OTHER Hchg Transitional Care Bed 12 11 $804.00 $402.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
38205 CPT Harvest Allogeneic Stem Cell 11 11 $5,800.00 $2,900.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110299928 OTHER Hchg Gi Cocktail - Maalox Max 10ml & Lidocane Viscous 2% 5ml- Per 15ml 11 11 $4.00 $2.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110356928 OTHER Hchg Hydralazine Per 25 Mg Tab 11 11 $1.00 $0.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00990-7922-09 OTHER Dextrose 11 11 $15.00 $7.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
89220 CPT Sputum Specimen Collection 11 11 $83.00 $41.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00264-7510-00 OTHER Dextrose 11 11 $12.00 $6.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00990-7983-03 OTHER Sodium Chloride 11 11 $15.00 $7.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
100003928 OTHER Hchg Cardiac Care Room 12 11 $2,716.00 $1,358.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
94668 CPT Chest Wall Manipulation 11 11 $180.00 $90.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00270-1111-03 OTHER Prohance 11 11 $76.02 $38.01 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110474928 OTHER Hchg Belotero Balance With Lidocaine Per 1ml Syringe 11 11 $987.00 $493.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00264-7800-20 OTHER Sodium Chloride 11 11 $8.25 $4.13 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110283928 OTHER Hchg Sodium Chloride Syringe 11 11 $2.00 $1.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00990-7953-09 OTHER Lactated Ringer's 11 11 $15.00 $7.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00990-7983-02 OTHER Sodium Chloride 11 11 $15.00 $7.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110468928 OTHER Hchg Juv Derm Ultra Plus Xc Per 1ml Syringe 11 11 $1,047.00 $523.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
110348928 OTHER Hchg Inject, Intravitreal Vancomycin, Per Dose 11 11 $1.00 $0.50 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
00338-0117-04 OTHER Lactated Ringer's 11 11 $6.00 $3.00 50% off $2,224.96 $2,224.96 $2,224.96 2026-05-13
J9357 HCPCS Valrubicin Injection 32 30 $4,088.00 $2,044.00 50% off $2,250.35 $2,250.35 $2,250.35 2026-05-13
78206-0145-01 OTHER Nexplanon 32 30 $2,804.46 $1,402.23 50% off $2,289.44 $2,289.44 $2,289.44 2026-05-13
J7298 HCPCS Mirena, 52 Mg 32 30 $3,644.00 $1,822.00 50% off $2,290.45 $2,290.45 $2,290.45 2026-05-13
50419-0423-01 OTHER Mirena 32 30 $3,643.89 $1,821.95 50% off $2,290.45 $2,290.45 $2,290.45 2026-05-13
J7296 HCPCS Kyleena, 19.5 Mg 32 30 $3,644.00 $1,822.00 50% off $2,290.45 $2,290.45 $2,290.45 2026-05-13
50419-0424-01 OTHER Kyleena 32 30 $3,470.37 $1,735.19 50% off $2,290.45 $2,290.45 $2,290.45 2026-05-13
J1950 HCPCS Leuprolide Acetate /3.75 Mg 32 30 $5,215.00 $2,607.50 50% off $2,581.59 $2,581.59 $2,581.59 2026-05-13
Q4113 HCPCS Graftjacket Xpress 32 30 $5,732.00 $2,866.00 50% off $3,295.88 $3,295.88 $3,295.88 2026-05-13
J3240 HCPCS Thyrotropin Injection 32 30 $6,067.00 $3,033.50 50% off $3,334.93 $3,334.93 $3,334.93 2026-05-13
J2787 HCPCS Riboflavin 5'phos Opth<=3ml 32 30 $13,680.00 $6,840.00 50% off $4,108.50 $4,108.50 $4,108.50 2026-05-13
J0480 HCPCS Basiliximab 32 30 $13,463.00 $6,731.50 50% off $7,385.85 $7,385.85 $7,385.85 2026-05-13
J9226 HCPCS Supprelin La Implant 32 30 $150,543.00 $75,271.50 50% off $73,550.30 $73,550.30 $73,550.30 2026-05-13
J9029 HCPCS Instill Adstiladrin, Tx Dose 32 30 $138,420.00 $69,210.00 50% off $101,970.00 $101,970.00 $101,970.00 2026-05-13
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