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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

SUMMERSVILLE REGIONAL MEDICAL CENTER

Summersville, WV · CCN 511322 · Rates published

Your selected procedure

You selected 59400 (CPT)

This facility hasn’t published a payer-negotiated rate for this exact code. See its full rate list below.

4,901 distinct procedures filed
22 distinct payers
352,930 rate rows
2026-05-22 last MRF observed
Data quality

27,642 of 352,930 rate rows are consumer-grade (7.8%)

325,288 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 323,088
per-diem day rate — not a per-procedure price 1,390
exceeds 10× this hospital's gross charge — excluded from medians 780
placeholder amount (≤ $0.02) — excluded from medians 26
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://wvumedicine.org/wp-content/uploads/2026/04/550650441_West-Virginia-Health-Care-Cooperative-Inc._standardcharges.csv
Found on page https://wvumedicine.org/billing-and-insurance/costs-and-charges/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-03
Content fingerprint 614fbb94cdf797ca… · 26,222,222 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 22 $101,970.00 $101,970.00 $101,970.00 nat. median
$69,291
1.5× median
J9226
HCPCS 		Supprelin La Implant 22 $73,550.30 $73,550.30 $73,550.30 nat. median
$55,200
1.3× median
J0480
HCPCS 		Basiliximab 22 $7,385.85 $7,385.85 $7,385.85 nat. median
$6,687
1.1× median
J2787
HCPCS 		Riboflavin 5'phos Opth<=3ml 22 $4,108.50 $4,108.50 $4,108.50 nat. median
$4,090
1.0× median
58468-0030-01
OTHER 		Thyrogen 22 $3,334.93 $3,334.93 $3,334.93 nat. median
$3,335
1.0× median
J3240
HCPCS 		Thyrotropin Injection 22 $3,334.93 $3,334.93 $3,334.93 nat. median
$2,938
1.1× median
58468-0030-02
OTHER 		Thyrogen 22 $3,334.93 $3,334.93 $3,334.93 nat. median
$3,029
1.1× median
J1950
HCPCS 		Leuprolide Acetate /3.75 Mg 22 $2,581.59 $2,581.59 $2,581.59 nat. median
$3,885
0.7× median
00074-3641-03
OTHER 		Lupron Depot 22 $2,581.59 $2,581.59 $2,581.59 nat. median
$2,173
1.2× median
J7298
HCPCS 		Mirena, 52 Mg 22 $2,290.45 $2,290.45 $2,290.45 nat. median
$1,720
1.3× median
J7296
HCPCS 		Kyleena, 19.5 Mg 22 $2,290.45 $2,290.45 $2,290.45 nat. median
$1,693
1.4× median
00052-4330-01
OTHER 		Nexplanon 22 $2,290.45 $2,290.45 $2,290.45 nat. median
$2,290
1.0× median
50419-0423-01
OTHER 		Mirena 22 $2,290.45 $2,290.45 $2,290.45 nat. median
$2,290
1.0× median
J9357
HCPCS 		Valrubicin Injection 22 $2,250.35 $2,250.35 $2,250.35 nat. median
$1,762
1.3× median
00270-1315-35
OTHER 		Isovue-300 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
00338-0017-11
OTHER 		Dextrose 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,214
1.0× median
00338-0117-04
OTHER 		Lactated Ringer's 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,000
1.1× median
94640
CPT 		Inhalation Treatment For Airway Obstruction Or Sputum Production 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$194
outlier · 11.6×
00270-1411-11
OTHER 		Isovue-m 200 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
100008925
OTHER 		Hchg Isolation Room 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
00338-0049-03
OTHER 		Sodium Chloride 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,000
1.1× median
00270-1316-35
OTHER 		Isovue-370 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,208
1.0× median
94645
CPT 		Cbt Each Addl Hour 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$143
outlier · 15.7×
94003
CPT 		Vent Mgmt Inpat Subq Day 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$824
outlier · 2.7×
00407-1414-91
OTHER 		Omnipaque 350 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$1,297
1.7× median
00270-1111-02
OTHER 		Prohance 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,214
1.0× median
00338-0017-02
OTHER 		Dextrose 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,000
1.1× median
J7060
HCPCS 		5% Dextrose/water (500 Ml = 1 Unit) 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$22
outlier · 103.2×
94002
CPT 		Initial Hospital Inpatient Or Observation Ventilation Assistance And Management 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$920
outlier · 2.4×
94664
CPT 		Evaluate Pt Use Of Inhaler 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$193
outlier · 11.6×
00407-1412-30
OTHER 		Omnipaque 240 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$1
00990-7983-02
OTHER 		Sodium Chloride 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
00338-0017-03
OTHER 		Dextrose 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,000
1.1× median
00338-0017-18
OTHER 		Dextrose 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,214
1.0× median
J3490
HCPCS 		Drugs Unclassified Injection 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$47
outlier · 47.3×
00338-0049-04
OTHER 		Sodium Chloride 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,000
1.1× median
94667
CPT 		Chest Wall Manipulation 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$153
outlier · 14.7×
94660
CPT 		Pos Airway Pressure Cpap 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$367
outlier · 6.1×
00990-7922-03
OTHER 		Dextrose 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
G0239
HCPCS 		Oth Resp Proc, Group 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$79
outlier · 28.2×
94668
CPT 		Chest Wall Manipulation 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$136
outlier · 16.5×
Q9967
HCPCS 		Low Osmolar Contrast Material; 300-399 Mg/ml Iodine Concentration; Per Ml 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$64
outlier · 34.8×
J0573
HCPCS 		Buprenorphine/naloxone; Oral; Greater Than 3 Mg; But Less Than Or Equal To 6 Mg… 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$18
outlier · 127.4×
94644
CPT 		Cbt 1st Hour 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$183
outlier · 12.3×
00270-0445-35
OTHER 		Gastrografin 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$1,297
1.7× median
00990-7922-02
OTHER 		Dextrose 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,000
1.1× median
82075
CPT 		Assay Of Breath Ethanol 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$35
outlier · 63.8×
31720
CPT 		Clearance Of Airways 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$234
outlier · 9.6×
89220
CPT 		Sputum Specimen Collection 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$160
outlier · 14.0×
00990-7983-03
OTHER 		Sodium Chloride 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median

Other procedures at this hospital

Browse this hospital's 4,901 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
             
J9029 HCPCS Instill Adstiladrin, Tx Dose 48 22 $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 48 22 $150,543.00 $75,271.50 50% off $73,550.30 $73,550.30 $73,550.30 2026-05-22
J0480 HCPCS Basiliximab 48 22 $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 48 22 $13,680.00 $6,840.00 50% off $4,108.50 $4,108.50 $4,108.50 2026-05-22
58468-0030-01 OTHER Thyrogen 48 22 $5,931.72 $2,965.86 50% off $3,334.93 $3,334.93 $3,334.93 2026-05-22
58468-0030-02 OTHER Thyrogen 48 22 $5,931.72 $2,965.86 50% off $3,334.93 $3,334.93 $3,334.93 2026-05-22
J3240 HCPCS Thyrotropin Injection 48 22 $6,067.00 $3,033.50 50% off $3,334.93 $3,334.93 $3,334.93 2026-05-22
00074-3641-03 OTHER Lupron Depot 48 22 $4,965.90 $2,482.95 50% off $2,581.59 $2,581.59 $2,581.59 2026-05-22
J1950 HCPCS Leuprolide Acetate /3.75 Mg 48 22 $5,215.00 $2,607.50 50% off $2,581.59 $2,581.59 $2,581.59 2026-05-22
00052-4330-01 OTHER Nexplanon 48 22 $3,471.00 $1,735.50 50% off $2,290.45 $2,290.45 $2,290.45 2026-05-22
50419-0423-01 OTHER Mirena 48 22 $3,643.89 $1,821.95 50% off $2,290.45 $2,290.45 $2,290.45 2026-05-22
J7298 HCPCS Mirena, 52 Mg 48 22 $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 48 22 $3,644.00 $1,822.00 50% off $2,290.45 $2,290.45 $2,290.45 2026-05-22
J9357 HCPCS Valrubicin Injection 48 22 $4,088.00 $2,044.00 50% off $2,250.35 $2,250.35 $2,250.35 2026-05-22
J3490 HCPCS Drugs Unclassified Injection 16 8 $5.00 $2.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
G0239 HCPCS Oth Resp Proc, Group 16 8 $100.00 $50.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00990-7922-03 OTHER Dextrose 16 8 $15.00 $7.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
919608925 OTHER Hchg Triple Antibiotic Ointment (neosporin) Unit Dose Packets 16 8 $1.00 $0.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00338-0049-04 OTHER Sodium Chloride 16 8 $6.00 $3.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110473925 OTHER Hchg Belotero Balance Per 1ml Syringe 16 8 $855.00 $427.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
94667 CPT Chest Wall Manipulation 16 8 $188.00 $94.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
94668 CPT Chest Wall Manipulation 16 8 $188.00 $94.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00270-0445-35 OTHER Gastrografin 16 8 $25.47 $12.74 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00990-7983-09 OTHER Sodium Chloride 16 8 $30.00 $15.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
100022925 OTHER Hchg Telemetry Room 18 8 $2,363.00 $1,181.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00338-0017-03 OTHER Dextrose 16 8 $6.00 $3.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110471925 OTHER Hchg Juvéderm Vollure Per 1ml Syringe 16 8 $1,128.00 $564.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110468925 OTHER Hchg Juvéderm Ultra Plus Xc Per 1ml Syringe 16 8 $1,047.00 $523.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00270-1315-35 OTHER Isovue-300 32 8 $24.60 $12.30 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00338-0017-18 OTHER Dextrose 16 8 $4.80 $2.40 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00407-1414-91 OTHER Omnipaque 350 16 8 $55.56 $27.78 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110333925 OTHER Hchg Sufentanil 50mcg/ml Inj (sufenta) - Per 1ml 16 8 $35.00 $17.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
500330925 OTHER Hchg Hospice Daily 18 8 $666.00 $333.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
100007925 OTHER Hchg Intensive Care Room 18 8 $2,111.00 $1,055.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110251925 OTHER Hchg Pharm Specific Rc 0250 16 8 $5.00 $2.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
100117925 OTHER Hchg Transitional Care Bed 18 8 $411.00 $205.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
J7060 HCPCS 5% Dextrose/water (500 Ml = 1 Unit) 16 8 $6.00 $3.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
94644 CPT Cbt 1st Hour 16 8 $451.00 $225.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
82075 CPT Assay Of Breath Ethanol 16 8 $37.00 $18.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110474925 OTHER Hchg Belotero Balance With Lidocaine Per 1ml Syringe 16 8 $987.00 $493.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00338-0049-03 OTHER Sodium Chloride 16 8 $6.00 $3.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00270-1411-11 OTHER Isovue-m 200 16 8 $38.61 $19.31 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110337925 OTHER Hchg Bupivacaine Hcl Pf (marcaine) 0.25% Inj Per 1ml 16 8 $2.00 $1.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110407925 OTHER Hchg Clindamycin Intravitreal Inj Per 1mg/0.1ml 16 8 $20.00 $10.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110469925 OTHER Hchg Juvéderm Volbella Xc Per (1) 0.55ml Syringe 16 8 $615.00 $307.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110299925 OTHER Hchg Gi Cocktail - Maalox Max 10ml & Lidocane Viscous 2% 5ml- Per 15ml 16 8 $4.00 $2.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
94660 CPT Pos Airway Pressure Cpap 32 8 $391.00 $195.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
919606925 OTHER Hchg Silvadene 1% Cream, Per 1 Gm 16 8 $2.00 $1.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00338-0017-02 OTHER Dextrose 16 8 $2.40 $1.20 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00407-1412-30 OTHER Omnipaque 240 48 8 $107.70 $53.85 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
89220 CPT Sputum Specimen Collection 16 8 $336.00 $168.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00990-7922-02 OTHER Dextrose 16 8 $15.00 $7.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
94003 CPT Vent Mgmt Inpat Subq Day 16 8 $1,415.00 $707.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
919607925 OTHER Hchg Silver Nitrate Swabs - Each 16 8 $3.00 $1.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110348925 OTHER Hchg Inject, Intravitreal Vancomycin, Per Dose 16 8 $1.00 $0.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
31720 CPT Clearance Of Airways 16 8 $420.00 $210.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110283925 OTHER Hchg Sodium Chloride Syringe 16 8 $2.00 $1.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00338-0017-11 OTHER Dextrose 16 8 $24.75 $12.38 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
Q9967 HCPCS Low Osmolar Contrast Material; 300-399 Mg/ml Iodine Concentration; Per Ml 16 8 $24.60 $12.30 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110323925 OTHER Hchg Methotrexate Ophth 400mcg/0.1ml Per Dose 16 8 $1.00 $0.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
J0573 HCPCS Buprenorphine/naloxone; Oral; Greater Than 3 Mg; But Less Than Or Equal To 6 Mg … 16 8 $23.63 $11.82 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00270-1316-35 OTHER Isovue-370 16 8 $27.30 $13.65 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110472925 OTHER Hchg Restylane Per 1ml Syringe 16 8 $899.00 $449.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110467925 OTHER Hchg Juvéderm Ultra Plus Xc Per (1) 0.55ml Syringe 16 8 $861.00 $430.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
94002 CPT Initial Hospital Inpatient Or Observation Ventilation Assistance And Management 48 8 $1,347.00 $673.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00990-7983-03 OTHER Sodium Chloride 16 8 $15.00 $7.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
100020925 OTHER Hchg Routine Room 18 8 $2,004.00 $1,002.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110356925 OTHER Hchg Hydralazine Per 25 Mg Tab 16 8 $1.00 $0.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110480925 OTHER Hchg Sodium Tetradecyl Sulfate (sotradecol) Per 1ml 16 8 $78.00 $39.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
94664 CPT Evaluate Pt Use Of Inhaler 32 8 $321.00 $160.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
919605925 OTHER Hchg Phenol Ez Swabs Each 16 8 $13.00 $6.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
100008925 OTHER Hchg Isolation Room 18 8 $2,720.00 $1,360.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00990-7983-02 OTHER Sodium Chloride 16 8 $15.00 $7.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110334925 OTHER Hchg Ganciclovir Ophth 2mg/0.1ml Per Dose 16 8 $1.00 $0.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110274925 OTHER Hchg 0.9% Ns 250 Ml 16 8 $12.00 $6.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
110470925 OTHER Hchg Juvéderm Volbella Xc Per 1ml Syringe 16 8 $1,128.00 $564.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00338-0117-04 OTHER Lactated Ringer's 16 8 $6.00 $3.00 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
94645 CPT Cbt Each Addl Hour 16 8 $79.00 $39.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
94640 CPT Inhalation Treatment For Airway Obstruction Or Sputum Production 64 8 $313.00 $156.50 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
00270-1111-02 OTHER Prohance 16 8 $57.02 $28.51 50% off $2,242.20 $2,242.20 $2,242.20 2026-05-22
J7300 HCPCS Intra Copp Contra (paragard) 48 22 $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 48 22 $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 48 22 $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 50 22 $1,657.00 $828.50 50% off $1,639.00 $1,657.00 $1,657.00 2026-05-22
89130-2020-01 OTHER Durolane 50 22 $2,962.80 $1,481.40 50% off $10.13 $1,639.00 $1,639.00 2026-05-22
90380 CPT Rsv Monoc Antb Seasn .5ml IM 48 22 $1,578.00 $789.00 50% off $1,578.00 $1,578.00 $1,578.00 2026-05-22
J0178 HCPCS Aflibercept Injection 48 22 $1,694.00 $847.00 50% off $1,422.76 $1,422.76 $1,422.76 2026-05-22
A9562 HCPCS Technetium Tc-99m Mertiatide; Diagnostic; Per Study Dose; Up To 15 Millicuries 48 22 $1,711.00 $855.50 50% off $1,283.16 $1,283.16 $1,283.16 2026-05-22
59676-0820-01 OTHER Monovisc 48 22 $1,740.41 $870.21 50% off $1,178.71 $1,178.71 $1,178.71 2026-05-22
J7327 HCPCS Monovisc Inj Per Dose 48 22 $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 48 22 $2,011.00 $1,005.50 50% off $1,123.35 $1,123.35 $1,123.35 2026-05-22
90870 CPT Electroconvulsive Therapy 46 21 $1,646.00 $823.00 50% off $1,048.58 $1,048.58 $1,048.58 2026-05-22
A2001 HCPCS Innovamatrix Ac, Per Sq Cm 48 22 $1,048.40 $524.20 50% off $1,048.40 $1,048.40 $1,048.40 2026-05-22
J9202 HCPCS Goserelin Acetate Implant 48 22 $3,372.00 $1,686.00 50% off $1,004.87 $1,004.87 $1,004.87 2026-05-22
70720-0950-36 OTHER Zoladex 48 22 $2,978.46 $1,489.23 50% off $1,004.87 $1,004.87 $1,004.87 2026-05-22
90381 CPT Rsv Monoc Antb Seasn 1 Ml IM 48 22 $1,578.00 $789.00 50% off $980.10 $980.10 $980.10 2026-05-22
A9595 HCPCS Piflu F-18, Dia 1 Millicurie 48 22 $1,154.00 $577.00 50% off $957.58 $957.58 $957.58 2026-05-22
Q4282 HCPCS Cygnus Dual Per Sq Cm 48 22 $922.00 $461.00 50% off $922.00 $922.00 $922.00 2026-05-22
J7314 HCPCS Inj., Yutiq, 0.01 Mg 48 22 $1,545.00 $772.50 50% off $872.85 $872.85 $872.85 2026-05-22
J7326 HCPCS Gel-one 48 22 $1,485.00 $742.50 50% off $820.53 $820.53 $820.53 2026-05-22
J7313 HCPCS Inj., Iluvien, 0.01 Mg 48 22 $1,454.00 $727.00 50% off $810.07 $810.07 $810.07 2026-05-22
A9500 HCPCS Technetium Tc-99m Sestamibi; Diagnostic; Per Study Dose 50 22 $1,480.00 $740.00 50% off $740.00 $743.46 $740.00 2026-05-22
G0378 HCPCS Hospital Observation Per Hr 48 22 $84.00 $42.00 50% off $708.61 $708.61 $708.61 2026-05-22
G0379 HCPCS Direct Refer Hospital Observ 48 22 $1,237.00 $618.50 50% off $708.61 $708.61 $708.61 2026-05-22
J3315 HCPCS Triptorelin Pamoate 48 22 $2,316.00 $1,158.00 50% off $682.42 $682.42 $682.42 2026-05-22
A9552 HCPCS Fluorodeoxyglucose F-18 Fdg; Diagnostic; Per Study Dose; Up To 45 Millicuries 48 22 $854.00 $427.00 50% off $647.79 $647.79 $647.79 2026-05-22
J7308 HCPCS Aminolevulinic Acid Hcl Top 48 22 $1,180.00 $590.00 50% off $647.33 $647.33 $647.33 2026-05-22
Q4159 HCPCS Affinity1 Square Cm 48 22 $685.00 $342.50 50% off $593.44 $593.44 $593.44 2026-05-22
90678 CPT Rsv Vacc Pref Bivalent IM 48 22 $812.00 $406.00 50% off $584.10 $584.10 $584.10 2026-05-22
90651 CPT 9vhpv Vaccine 2/3 Dose IM 48 22 $871.00 $435.50 50% off $569.07 $569.07 $569.07 2026-05-22
90378 CPT Rsv Mab IM 50mg 48 22 $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 48 22 $684.00 $342.00 50% off $554.40 $554.40 $554.40 2026-05-22
J3241 HCPCS Inj. Teprotumumab-trbw 10 Mg 48 22 $1,082.00 $541.00 50% off $541.20 $541.20 $541.20 2026-05-22
50632-0010-01 OTHER RabAvert 48 22 $978.96 $489.48 50% off $535.82 $535.82 $535.82 2026-05-22
50632-0013-01 OTHER Rabies Vaccine For Injection Into Muscle 48 22 $978.96 $489.48 50% off $535.82 $535.82 $535.82 2026-05-22
90675 CPT Rabies Vaccine IM 48 22 $1,138.00 $569.00 50% off $535.82 $535.82 $535.82 2026-05-22
Q4210 HCPCS Axolotl Graf Dualgraf Sq Cm 48 22 $515.00 $257.50 50% off $515.00 $515.00 $515.00 2026-05-22
90738 CPT Inactivated Je Vacc IM 48 22 $1,063.00 $531.50 50% off $504.42 $504.42 $504.42 2026-05-22
A9513 HCPCS Lutetium Lu 177 Dotatat Ther 48 22 $556.00 $278.00 50% off $479.23 $479.23 $479.23 2026-05-22
13533-0318-30 OTHER HyperRAB 48 22 $4,556.49 $2,278.25 50% off $478.47 $478.47 $478.47 2026-05-22
13533-0318-03 OTHER HyperRAB 48 22 $3,150.77 $1,575.39 50% off $478.47 $478.47 $478.47 2026-05-22
90677 CPT Pcv20 Vaccine IM 48 22 $727.00 $363.50 50% off $476.29 $476.29 $476.29 2026-05-22
Q4199 HCPCS Cygnus Matrix, Per Sq Cm 52 22 $443.00 $221.50 50% off $207.00 $443.00 $443.00 2026-05-22
90671 CPT Pcv15 Vaccine IM 48 22 $545.00 $272.50 50% off $418.37 $418.37 $418.37 2026-05-22
00006-4329-01 OTHER Pneumococcal Conjugate Vaccine; 15 Valent (pcv15); For Intramuscular Use 48 22 $588.00 $294.00 50% off $418.37 $418.37 $418.37 2026-05-22
00006-4329-03 OTHER Vaxneuvance 50 22 $588.00 $294.00 50% off $220.23 $418.37 $418.37 2026-05-22
90620 CPT Menb-4c Vaccine IM 48 22 $458.00 $229.00 50% off $411.10 $411.10 $411.10 2026-05-22
90621 CPT Menb-fhbp Vacc 2/3 Dose IM 48 22 $509.00 $254.50 50% off $376.46 $376.46 $376.46 2026-05-22
90716 CPT Var Vaccine Live Subq 48 22 $548.00 $274.00 50% off $344.92 $344.92 $344.92 2026-05-22
J7351 HCPCS Inj Bimatoprost Itc Imp1mcg 48 22 $608.00 $304.00 50% off $340.25 $340.25 $340.25 2026-05-22
J7312 HCPCS Dexamethasone Intra Implant 48 22 $589.00 $294.50 50% off $339.26 $339.26 $339.26 2026-05-22
96360 CPT Infusion Into A Vein For Hydration; 31-60 Minutes 50 22 $402.00 $201.00 50% off $60.00 $336.96 $336.96 2026-05-22
90619 CPT Menacwy-tt Vaccine IM 48 22 $441.00 $220.50 50% off $330.38 $330.38 $330.38 2026-05-22
00006-4837-01 OTHER Pneumovax 23 50 22 $313.01 $156.51 50% off $220.23 $313.01 $313.01 2026-05-22
J1610 HCPCS Glucagon Hydrochloride/1 Mg 48 22 $410.00 $205.00 50% off $310.81 $310.81 $310.81 2026-05-22
63323-0596-03 OTHER Glucagon 48 22 $409.29 $204.65 50% off $310.81 $310.81 $310.81 2026-05-22
90734 CPT Menacwyd/menacwycrm Vacc IM 48 22 $313.00 $156.50 50% off $299.95 $299.95 $299.95 2026-05-22
A9509 HCPCS Iodine I-123 Sod Iodide Mil 48 22 $1,482.00 $741.00 50% off $299.31 $299.31 $299.31 2026-05-22
00074-3473-03 OTHER Lupron Depot 48 22 $2,929.29 $1,464.65 50% off $299.15 $299.15 $299.15 2026-05-22
J9217 HCPCS Leuprolide Acetate Suspnsion 48 22 $377.00 $188.50 50% off $299.15 $299.15 $299.15 2026-05-22
J0475 HCPCS Baclofen 10 Mg Injection 48 22 $709.00 $354.50 50% off $293.37 $293.37 $293.37 2026-05-22
J0517 HCPCS Inj., Benralizumab, 1 Mg 48 22 $585.00 $292.50 50% off $279.68 $279.68 $279.68 2026-05-22
J1426 HCPCS Injection, Casimersen, 10 Mg 48 22 $362.00 $181.00 50% off $274.28 $274.28 $274.28 2026-05-22
A9606 HCPCS Radium Ra223 Dichloride Ther 48 22 $317.00 $158.50 50% off $265.91 $265.91 $265.91 2026-05-22
90739 CPT Hepb Vacc 2/4 Dose Adult IM 48 22 $380.00 $190.00 50% off $264.46 $264.46 $264.46 2026-05-22
90717 CPT Yellow Fever Vaccine Subq 48 22 $617.00 $308.50 50% off $263.36 $263.36 $263.36 2026-05-22
50242-0014-03 OTHER TNKase 48 22 $22,863.09 $11,431.55 50% off $252.63 $252.63 $252.63 2026-05-22
50242-0120-47 OTHER TNKase 48 22 $22,868.07 $11,434.04 50% off $252.63 $252.63 $252.63 2026-05-22
50242-0037-06 OTHER Injection; Tenecteplase; 1 Mg 48 22 $10,786.83 $5,393.42 50% off $252.63 $252.63 $252.63 2026-05-22
50242-0176-01 OTHER TNKase 48 22 $11,431.55 $5,715.77 50% off $252.63 $252.63 $252.63 2026-05-22
J2781 HCPCS Inj, Pegcetacoplan, 1mg 48 22 $452.00 $226.00 50% off $249.91 $249.91 $249.91 2026-05-22
91304 CPT Sarscov2 Vac 5mcg/0.5ml IM 48 22 $315.00 $157.50 50% off $244.53 $244.53 $244.53 2026-05-22
91322 CPT Sarscov2 Vac 50 Mcg/0.5ml IM 48 22 $372.00 $186.00 50% off $240.77 $240.77 $240.77 2026-05-22
91321 CPT Sarscov2 Vac 25 Mcg/.25ml IM 48 22 $339.00 $169.50 50% off $240.77 $240.77 $240.77 2026-05-22
90371 CPT Hep B Ig IM 48 22 $498.00 $249.00 50% off $227.52 $227.52 $227.52 2026-05-22
90732 CPT Ppsv23 Vacc 2 Yrs+ Subq/im 48 22 $316.00 $158.00 50% off $220.23 $220.23 $220.23 2026-05-22
00006-4837-03 OTHER Pneumovax 23 48 22 $314.00 $157.00 50% off $220.23 $220.23 $220.23 2026-05-22
00270-0556-15 OTHER Kinevac 48 22 $338.52 $169.26 50% off $219.62 $219.62 $219.62 2026-05-22
90710 CPT Mmrv Vaccine Sc 48 22 $808.00 $404.00 50% off $218.94 $218.94 $218.94 2026-05-22
90698 CPT Dtap-ipv/hib Vaccine IM 48 22 $318.00 $159.00 50% off $217.26 $217.26 $217.26 2026-05-22
91320 CPT Sarscv2 Vac 30mcg Trs-suc IM 48 22 $301.00 $150.50 50% off $216.32 $216.32 $216.32 2026-05-22
59676-0360-01 OTHER Orthovisc 48 22 $386.34 $193.17 50% off $215.56 $215.56 $215.56 2026-05-22
J7324 HCPCS Orthovisc Inj Per Dose 48 22 $360.00 $180.00 50% off $215.56 $215.56 $215.56 2026-05-22
90636 CPT Hep A/hep B Vacc Adult IM 48 22 $286.00 $143.00 50% off $213.39 $213.39 $213.39 2026-05-22
J7323 HCPCS Euflexxa Inj Per Dose 48 22 $1,003.00 $501.50 50% off $210.05 $210.05 $210.05 2026-05-22
55566-4100-01 OTHER Euflexxa 48 22 $1,002.26 $501.13 50% off $210.05 $210.05 $210.05 2026-05-22
90680 CPT Rv5 Vacc 3 Dose Live Oral 48 22 $253.00 $126.50 50% off $189.75 $189.75 $189.75 2026-05-22
90723 CPT Dtap-hep B-ipv Vaccine IM 48 22 $189.00 $94.50 50% off $187.79 $187.79 $187.79 2026-05-22
A9537 HCPCS Technetium Tc-99m Mebrofenin; Diagnostic; Per Study Dose; Up To 15 Millicuries 48 22 $187.00 $93.50 50% off $187.00 $187.00 $187.00 2026-05-22
A9516 HCPCS Iodine I-123 Sodium Iodide; Diagnostic; Per 100 Microcuries; Up To 999 Microcuri… 50 22 $185.00 $92.50 50% off $185.00 $186.40 $185.00 2026-05-22
90681 CPT Rv1 Vacc 2 Dose Live Oral 48 22 $309.00 $154.50 50% off $182.97 $182.97 $182.97 2026-05-22
00006-4681-01 OTHER M-m-r Ii 48 22 $243.04 $121.52 50% off $182.39 $182.39 $182.39 2026-05-22
90707 CPT Mmr Vaccine Sc 48 22 $258.00 $129.00 50% off $182.39 $182.39 $182.39 2026-05-22
90691 CPT Typhoid Vaccine IM 48 22 $425.00 $212.50 50% off $180.23 $180.23 $180.23 2026-05-22
J2778 HCPCS Ranibizumab Injection 48 22 $180.00 $90.00 50% off $180.00 $180.00 $180.00 2026-05-22
Q4196 HCPCS Puraply Am 1 Sq Cm 48 22 $197.00 $98.50 50% off $171.22 $171.22 $171.22 2026-05-22
A9541 HCPCS Technetium Tc-99m Sulfur Colloid; Diagnostic; Per Study Dose; Up To 20 Millicuri… 50 22 $504.00 $252.00 50% off $168.00 $504.00 $168.00 2026-05-22
A9560 HCPCS Technetium Tc-99m Labeled Red Blood Cells; Diagnostic; Per Study Dose; Up To 30 … 48 22 $320.00 $160.00 50% off $166.40 $166.40 $166.40 2026-05-22
J2997 HCPCS Alteplase Recombinant 48 22 $243.00 $121.50 50% off $146.80 $146.80 $146.80 2026-05-22
90696 CPT Dtap-ipv Vaccine 4-6 Yrs IM 50 22 $138.00 $69.00 50% off $138.00 $172.00 $138.00 2026-05-22
91319 CPT Sarscv2 Vac 10mcg Trs-suc IM 48 22 $135.00 $67.50 50% off $135.00 $135.00 $135.00 2026-05-22
00562-7805-01 OTHER RhoGAM Ultra-filtered Plus 48 22 $140.00 $70.00 50% off $133.91 $133.91 $133.91 2026-05-22
J2790 HCPCS Rho D Immune Globulin Inj 48 22 $204.00 $102.00 50% off $133.91 $133.91 $133.91 2026-05-22
63323-0286-30 OTHER Naropin 48 22 $140.00 $70.00 50% off $133.91 $133.91 $133.91 2026-05-22
13533-0631-11 OTHER HyperRHO Full Dose 48 22 $140.00 $70.00 50% off $133.91 $133.91 $133.91 2026-05-22
J2779 HCPCS Inj, Susvimo 0.1 Mg 48 22 $172.00 $86.00 50% off $133.29 $133.29 $133.29 2026-05-22
J1566 HCPCS Immune Globulin, Powder 48 22 $232.00 $116.00 50% off $129.53 $129.53 $129.53 2026-05-22
90743 CPT Hepb Vacc 2 Dose Adolesc IM 48 22 $139.00 $69.50 50% off $124.00 $124.00 $124.00 2026-05-22
49281-0125-65 OTHER Fluzone High-dose 2025-2026 Formula 48 22 $203.00 $101.50 50% off $121.11 $121.11 $121.11 2026-05-22
49281-0124-88 OTHER Fluzone High-dose 2024-2025 Formula 48 22 $203.00 $101.50 50% off $121.11 $121.11 $121.11 2026-05-22
70461-0024-04 OTHER Fluad 2024-2025 Formula 2 1 $202.38 $101.19 50% off $121.11 $121.11 $121.11 2026-05-22
70461-0025-03 OTHER Fluad 2025-2026 Formula 2 1 $174.00 $87.00 50% off $121.11 $121.11 $121.11 2026-05-22
90662 CPT Iiv No Prsv Increased Ag IM 48 22 $238.00 $119.00 50% off $121.11 $121.11 $121.11 2026-05-22
J7321 HCPCS Hyalgan Supartz Visco-3 Dose 48 22 $712.00 $356.00 50% off $120.62 $120.62 $120.62 2026-05-22
89130-4444-01 OTHER Supartz Fx 48 22 $686.73 $343.37 50% off $120.62 $120.62 $120.62 2026-05-22
58160-0821-52 OTHER Engerix-b 48 22 $133.00 $66.50 50% off $116.13 $116.13 $116.13 2026-05-22
43528-0003-05 OTHER Heplisav-b 48 22 $133.00 $66.50 50% off $116.13 $116.13 $116.13 2026-05-22
58160-0821-43 OTHER Engerix-b 48 22 $133.00 $66.50 50% off $116.13 $116.13 $116.13 2026-05-22
90746 CPT Hepb Vaccine 3 Dose Adult IM 48 22 $139.00 $69.50 50% off $116.13 $116.13 $116.13 2026-05-22
90632 CPT Hepa Vaccine Adult IM 48 22 $204.00 $102.00 50% off $115.93 $115.93 $115.93 2026-05-22
J0775 HCPCS Collagenase, Clost Hist Inj 48 22 $247.00 $123.50 50% off $109.35 $109.35 $109.35 2026-05-22
J9280 HCPCS Mitomycin Injection 48 22 $242.00 $121.00 50% off $104.53 $104.53 $104.53 2026-05-22
50242-0150-01 OTHER Ocrevus 48 22 $123,845.76 $61,922.88 50% off $98.59 $98.59 $98.59 2026-05-22
90281 CPT Human Ig IM 48 22 $286.00 $143.00 50% off $92.80 $92.80 $92.80 2026-05-22
00944-0493-03 OTHER Flexbumin 48 22 $261.00 $130.50 50% off $87.58 $87.58 $87.58 2026-05-22
P9047 HCPCS Albumin (human), 25%, 50ml 48 22 $183.00 $91.50 50% off $87.58 $87.58 $87.58 2026-05-22
00944-0493-01 OTHER Flexbumin 48 22 $261.00 $130.50 50% off $87.58 $87.58 $87.58 2026-05-22
49401-0101-01 OTHER Benlysta 48 22 $5,974.08 $2,987.04 50% off $85.80 $85.80 $85.80 2026-05-22
49401-0102-01 OTHER Benlysta 48 22 $7,467.19 $3,733.60 50% off $85.80 $85.80 $85.80 2026-05-22
J0490 HCPCS Belimumab Injection 48 22 $162.00 $81.00 50% off $85.80 $85.80 $85.80 2026-05-22
90713 CPT Poliovirus Ipv Sc/im 48 22 $123.00 $61.50 50% off $84.18 $84.18 $84.18 2026-05-22
J1460 HCPCS Gamma Globulin 1 Cc Inj 48 22 $143.00 $71.50 50% off $83.70 $83.70 $83.70 2026-05-22
55513-0192-01 OTHER Neulasta Onpro 48 22 $12,696.79 $6,348.40 50% off $83.62 $83.62 $83.62 2026-05-22
J1561 HCPCS Gamunex-c/gammaked 48 22 $178.00 $89.00 50% off $82.15 $82.15 $82.15 2026-05-22
57894-0503-01 OTHER Darzalex Faspro 48 22 $29,917.58 $14,958.79 50% off $80.93 $80.93 $80.93 2026-05-22
J3299 HCPCS Inj Xipere 1 Mg 48 22 $124.00 $62.00 50% off $80.16 $80.16 $80.16 2026-05-22
44206-0439-40 OTHER Privigen 48 22 $8,760.00 $4,380.00 50% off $79.68 $79.68 $79.68 2026-05-22
44206-0437-10 OTHER Privigen 48 22 $2,190.00 $1,095.00 50% off $79.68 $79.68 $79.68 2026-05-22
J1459 HCPCS Inj Ivig Privigen 500 Mg 48 22 $110.00 $55.00 50% off $79.68 $79.68 $79.68 2026-05-22
44206-0438-20 OTHER Privigen 48 22 $4,380.00 $2,190.00 50% off $79.68 $79.68 $79.68 2026-05-22
J1455 HCPCS Foscarnet Sodium Injection 48 22 $79.00 $39.50 50% off $79.00 $79.00 $79.00 2026-05-22
96361 CPT Infusion Into A Vein For Hydration; Each Additional Hour 50 22 $124.00 $62.00 50% off $24.00 $74.68 $74.68 2026-05-22
J1569 HCPCS Gammagard Liquid Injection 48 22 $169.00 $84.50 50% off $72.85 $72.85 $72.85 2026-05-22
J1110 HCPCS Inj Dihydroergotamine Mesylt 48 22 $130.00 $65.00 50% off $69.86 $69.86 $69.86 2026-05-22
90633 CPT Hepa Vacc Ped/adol 2 Dose IM 48 22 $98.00 $49.00 50% off $68.72 $68.72 $68.72 2026-05-22
J2406 HCPCS Injection, Oritavancin 10 Mg 48 22 $123.00 $61.50 50% off $67.52 $67.52 $67.52 2026-05-22
J0565 HCPCS Inj, Bezlotoxumab, 10 Mg 48 22 $137.00 $68.50 50% off $65.77 $65.77 $65.77 2026-05-22
J2357 HCPCS Omalizumab Injection 48 22 $148.00 $74.00 50% off $65.11 $65.11 $65.11 2026-05-22
58160-0842-43 OTHER Boostrix 48 22 $102.68 $51.34 50% off $63.21 $63.21 $63.21 2026-05-22
58160-0842-52 OTHER Boostrix 48 22 $133.00 $66.50 50% off $63.21 $63.21 $63.21 2026-05-22
90715 CPT Tdap Vaccine 7 Yrs/> IM 48 22 $106.00 $53.00 50% off $63.21 $63.21 $63.21 2026-05-22
A9503 HCPCS Technetium Tc-99m Medronate; Diagnostic; Per Study Dose; Up To 30 Millicuries 48 22 $320.00 $160.00 50% off $61.59 $61.59 $61.59 2026-05-22
J2777 HCPCS Inj, Faricimab-svoa, 0.1mg 48 22 $72.00 $36.00 50% off $59.55 $59.55 $59.55 2026-05-22
90647 CPT Hib Prp-omp Vacc 3 Dose IM 48 22 $83.00 $41.50 50% off $58.58 $58.58 $58.58 2026-05-22
90700 CPT Dtap Vaccine < 7 Yrs IM 48 22 $64.00 $32.00 50% off $56.96 $56.96 $56.96 2026-05-22
Q2038 HCPCS Fluzone Vacc, 3 Yrs & >, IM 48 22 $54.00 $27.00 50% off $54.00 $54.00 $54.00 2026-05-22
J9334 HCPCS Inj Efgart-alfa 2mg Hya-qvfc 48 22 $98.00 $49.00 50% off $53.20 $53.20 $53.20 2026-05-22
54288-0136-01 OTHER PHENobarbital Sodium 48 22 $192.93 $96.47 50% off $51.86 $51.86 $51.86 2026-05-22
42494-0415-01 OTHER PHENobarbital Sodium 48 22 $143.28 $71.64 50% off $51.86 $51.86 $51.86 2026-05-22
90744 CPT Hepb Vacc 3 Dose Ped/adol IM 48 22 $64.00 $32.00 50% off $50.77 $50.77 $50.77 2026-05-22
J2182 HCPCS Injection, Mepolizumab, 1mg 48 22 $116.00 $58.00 50% off $50.34 $50.34 $50.34 2026-05-22
Q4101 HCPCS Apligraf 48 22 $128.00 $64.00 50% off $50.16 $50.16 $50.16 2026-05-22
49281-0215-88 OTHER Tenivac 48 22 $102.60 $51.30 50% off $50.06 $50.06 $50.06 2026-05-22
90714 CPT Td Vacc No Presv 7 Yrs+ IM 48 22 $117.00 $58.50 50% off $50.06 $50.06 $50.06 2026-05-22
A9539 HCPCS Tc99m Pentetate 48 22 $320.00 $160.00 50% off $49.17 $49.17 $49.17 2026-05-22
J2407 HCPCS Injection, Oritavancin 48 22 $80.00 $40.00 50% off $45.54 $45.54 $45.54 2026-05-22
65597-0406-01 OTHER Enhertu 48 22 $16,551.99 $8,276.00 50% off $44.95 $44.95 $44.95 2026-05-22
J0834 HCPCS Inj., Cosyntropin, 0.25 Mg 48 22 $90.00 $45.00 50% off $44.73 $44.73 $44.73 2026-05-22
00548-5900-00 OTHER Cortrosyn 48 22 $49.62 $24.81 50% off $44.73 $44.73 $44.73 2026-05-22
J9208 HCPCS Ifosfamide Injection 48 22 $83.00 $41.50 50% off $44.14 $44.14 $44.14 2026-05-22
A9540 HCPCS Technetium Tc-99m Macroaggregated Albumin; Diagnostic; Per Study Dose; Up To 10 … 48 22 $43.00 $21.50 50% off $43.00 $43.00 $43.00 2026-05-22
Q5107 HCPCS Inj Mvasi 10 Mg 48 22 $181.00 $90.50 50% off $42.27 $42.27 $42.27 2026-05-22
55513-0670-01 OTHER Avsola 48 22 $4,887.75 $2,443.88 50% off $42.17 $42.17 $42.17 2026-05-22
J0897 HCPCS Denosumab Injection 48 22 $91.00 $45.50 50% off $41.58 $41.58 $41.58 2026-05-22
J2799 HCPCS Inj, Uzedy, 1 Mg 48 22 $68.00 $34.00 50% off $40.76 $40.76 $40.76 2026-05-22
J0561 HCPCS Penicillin G Benzathine Inj 48 22 $85.00 $42.50 50% off $35.85 $35.85 $35.85 2026-05-22
A9567 HCPCS Technetium Tc-99m Pentetate; Diagnostic; Aerosol; Per Study Dose; Up To 75 Milli… 48 22 $243.00 $121.50 50% off $34.04 $34.04 $34.04 2026-05-22
00069-0249-01 OTHER Ruxience 48 22 $13,451.70 $6,725.85 50% off $33.74 $33.74 $33.74 2026-05-22
J1120 HCPCS Acetazolamid Sodium Injectio 48 22 $31.00 $15.50 50% off $31.00 $31.00 $31.00 2026-05-22
J2356 HCPCS Inj Tezepelumab-ekko, 1mg 48 22 $67.00 $33.50 50% off $30.67 $30.67 $30.67 2026-05-22
00009-0825-01 OTHER Solu-cortef 48 22 $40.50 $20.25 50% off $29.45 $29.45 $29.45 2026-05-22
00009-0013-05 OTHER Solu-cortef 250mg Vial 48 22 $82.25 $41.13 50% off $29.45 $29.45 $29.45 2026-05-22
69097-0004-67 OTHER Hydrocortisone Sodium Succinate 48 22 $47.10 $23.55 50% off $29.45 $29.45 $29.45 2026-05-22
J0558 HCPCS Peng Benzathine/procaine Inj 48 22 $56.00 $28.00 50% off $29.01 $29.01 $29.01 2026-05-22
J3304 HCPCS Inj Triamcinolone Ace Xr 1mg 48 22 $65.00 $32.50 50% off $28.94 $28.94 $28.94 2026-05-22
55150-0319-01 OTHER chlorproMAZINE HCl 48 22 $28.88 $14.44 50% off $28.88 $28.88 $28.88 2026-05-22
J0491 HCPCS Inj Anifrolumab-fnia 1mg 48 22 $55.00 $27.50 50% off $28.35 $28.35 $28.35 2026-05-22
90660 CPT Laiv3 Vaccine Intranasal 48 22 $73.00 $36.50 50% off $27.56 $27.56 $27.56 2026-05-22
00074-5015-01 OTHER Skyrizi 600mg/10ml 48 22 $29,296.56 $14,648.28 50% off $25.34 $25.34 $25.34 2026-05-22
J0875 HCPCS Injection, Dalbavancin 48 22 $27.00 $13.50 50% off $25.23 $25.23 $25.23 2026-05-22
57970-0100-01 OTHER Dalvance 48 22 $8,268.30 $4,134.15 50% off $25.23 $25.23 $25.23 2026-05-22
90648 CPT Hib Prp-t Vaccine 4 Dose IM 48 22 $37.00 $18.50 50% off $25.21 $25.21 $25.21 2026-05-22
J2426 HCPCS Inj, Invega Sustenna, 1 Mg 48 22 $43.00 $21.50 50% off $23.63 $23.63 $23.63 2026-05-22
00069-0809-01 OTHER Inflectra 48 22 $5,815.42 $2,907.72 50% off $23.58 $23.58 $23.58 2026-05-22
00469-6501-89 OTHER Lexiscan 48 22 $397.83 $198.92 50% off $23.56 $23.56 $23.56 2026-05-22
Q4102 HCPCS Oasis Wound Matrix 48 22 $207.00 $103.50 50% off $22.13 $22.13 $22.13 2026-05-22
63323-0842-21 OTHER Dicyclomine HCl 48 22 $22.05 $11.03 50% off $22.05 $22.05 $22.05 2026-05-22
90657 CPT Iiv3 Vaccine Splt 0.25 Ml IM 48 22 $27.00 $13.50 50% off $21.62 $21.62 $21.62 2026-05-22
J0587 HCPCS Inj, Rimabotulinumtoxinb 48 22 $39.00 $19.50 50% off $21.50 $21.50 $21.50 2026-05-22
42023-0221-89 OTHER PremierPro Rx Ertapenem Sodium 48 22 $30.17 $15.09 50% off $21.40 $21.40 $21.40 2026-05-22
J1335 HCPCS Ertapenem Injection 48 22 $30.00 $15.00 50% off $21.40 $21.40 $21.40 2026-05-22
43598-0901-11 OTHER Ertapenem 48 22 $67.53 $33.77 50% off $21.40 $21.40 $21.40 2026-05-22
00002-3228-30 OTHER Strattera 48 22 $42.00 $21.00 50% off $21.07 $21.07 $21.07 2026-05-22
58160-0884-41 OTHER Fluarix 2024-2025 Formula 2 1 $42.00 $21.00 50% off $21.07 $21.07 $21.07 2026-05-22
58160-0912-41 OTHER Fluarix 2025-2026 Formula 48 22 $41.07 $20.54 50% off $21.07 $21.07 $21.07 2026-05-22
58160-0912-52 OTHER Fluarix 2025-2026 Formula 2 1 $42.00 $21.00 50% off $21.07 $21.07 $21.07 2026-05-22
58160-0884-52 OTHER Fluarix 2024-2025 Formula 48 22 $42.00 $21.00 50% off $21.07 $21.07 $21.07 2026-05-22
49281-0425-50 OTHER Fluzone 2025-2026 Formula Pfs 48 22 $42.00 $21.00 50% off $21.07 $21.07 $21.07 2026-05-22
90656 CPT Iiv3 Vacc No Prsv 0.5 Ml IM 48 22 $39.00 $19.50 50% off $21.07 $21.07 $21.07 2026-05-22
71288-0201-85 OTHER Regadenoson 48 22 $20.58 $10.29 50% off $20.58 $20.58 $20.58 2026-05-22
J2427 HCPCS Inj, Invega Hafyera/trinza 48 22 $38.00 $19.00 50% off $20.15 $20.15 $20.15 2026-05-22
J2794 HCPCS Inj Risperdal Consta, 0.5 Mg 48 22 $36.00 $18.00 50% off $20.05 $20.05 $20.05 2026-05-22
J1306 HCPCS Injection, Inclisiran, 1 Mg 48 22 $36.00 $18.00 50% off $20.01 $20.01 $20.01 2026-05-22
J2798 HCPCS Inj., Perseris, 0.5 Mg 48 22 $34.00 $17.00 50% off $19.17 $19.17 $19.17 2026-05-22
J3396 HCPCS Verteporfin Injection 48 22 $26.00 $13.00 50% off $19.02 $19.02 $19.02 2026-05-22
J7402 HCPCS Mometasone Sinus Sinuva 48 22 $33.00 $16.50 50% off $18.73 $18.73 $18.73 2026-05-22
J2274 HCPCS Inj Morphine Pf Epid Ithc 48 22 $55.00 $27.50 50% off $18.55 $18.55 $18.55 2026-05-22
55513-0998-02 OTHER Evenity 48 22 $7,511.22 $3,755.61 50% off $17.70 $17.70 $17.70 2026-05-22
J3111 HCPCS Inj. Romosozumab-aqqg 1 Mg 48 22 $38.00 $19.00 50% off $17.70 $17.70 $17.70 2026-05-22
J3030 HCPCS Sumatriptan Succinate / 6 Mg 48 22 $17.00 $8.50 50% off $17.00 $17.00 $17.00 2026-05-22
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