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 →

Export CSV
Hospital

SUMMERSVILLE REGIONAL MEDICAL CENTER

Summersville, WV · CCN 511322 · Rates published

Your selected procedure

You selected 93350 (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 Latest re-check couldn't be parsed — showing last good data · 2026-10-21
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
$68,423
1.5× median
J9226
HCPCS 		Supprelin La Implant 22 $73,550.30 $73,550.30 $73,550.30 nat. median
$55,159
1.3× median
J0480
HCPCS 		Basiliximab 22 $7,385.85 $7,385.85 $7,385.85 nat. median
$6,695
1.1× median
J2787
HCPCS 		Riboflavin 5'phos Opth<=3ml 22 $4,108.50 $4,108.50 $4,108.50 nat. median
$4,061
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
58468-0030-02
OTHER 		Thyrogen 22 $3,334.93 $3,334.93 $3,334.93 nat. median
$3,029
1.1× median
J3240
HCPCS 		Thyrotropin Injection 22 $3,334.93 $3,334.93 $3,334.93 nat. median
$2,980
1.1× median
00074-3641-03
OTHER 		Lupron Depot 22 $2,581.59 $2,581.59 $2,581.59 nat. median
$2,173
1.2× median
J1950
HCPCS 		Leuprolide Acetate /3.75 Mg 22 $2,581.59 $2,581.59 $2,581.59 nat. median
$3,902
0.7× 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
J7298
HCPCS 		Mirena, 52 Mg 22 $2,290.45 $2,290.45 $2,290.45 nat. median
$1,679
1.4× median
J7296
HCPCS 		Kyleena, 19.5 Mg 22 $2,290.45 $2,290.45 $2,290.45 nat. median
$1,654
1.4× median
J9357
HCPCS 		Valrubicin Injection 22 $2,250.35 $2,250.35 $2,250.35 nat. median
$1,804
1.2× median
J3490
HCPCS 		Drugs Unclassified Injection 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$47
outlier · 47.4×
G0239
HCPCS 		Oth Resp Proc, Group 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$79
outlier · 28.4×
00990-7922-03
OTHER 		Dextrose 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
919608925
OTHER 		Hchg Triple Antibiotic Ointment (neosporin) Unit Dose Packets 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
00338-0049-04
OTHER 		Sodium Chloride 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,000
1.1× median
110473925
OTHER 		Hchg Belotero Balance Per 1ml Syringe 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
94667
CPT 		Chest Wall Manipulation 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$153
outlier · 14.7×
94668
CPT 		Chest Wall Manipulation 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$136
outlier · 16.5×
00270-0445-35
OTHER 		Gastrografin 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$1,297
1.7× median
00990-7983-09
OTHER 		Sodium Chloride 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
100022925
OTHER 		Hchg Telemetry Room 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
110471925
OTHER 		Hchg Juvéderm Vollure Per 1ml Syringe 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
110468925
OTHER 		Hchg Juvéderm Ultra Plus Xc Per 1ml Syringe 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
00270-1315-35
OTHER 		Isovue-300 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
00338-0017-18
OTHER 		Dextrose 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,214
1.0× median
00407-1414-91
OTHER 		Omnipaque 350 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$1,297
1.7× median
110333925
OTHER 		Hchg Sufentanil 50mcg/ml Inj (sufenta) - Per 1ml 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
500330925
OTHER 		Hchg Hospice Daily 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
100007925
OTHER 		Hchg Intensive Care Room 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
110251925
OTHER 		Hchg Pharm Specific Rc 0250 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
100117925
OTHER 		Hchg Transitional Care Bed 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
J7060
HCPCS 		5% Dextrose/water (500 Ml = 1 Unit) 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$22
outlier · 101.9×
94644
CPT 		Cbt 1st Hour 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$183
outlier · 12.3×
82075
CPT 		Assay Of Breath Ethanol 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$35
outlier · 63.9×
110474925
OTHER 		Hchg Belotero Balance With Lidocaine Per 1ml Syringe 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
00270-1411-11
OTHER 		Isovue-m 200 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
110337925
OTHER 		Hchg Bupivacaine Hcl Pf (marcaine) 0.25% Inj Per 1ml 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
110407925
OTHER 		Hchg Clindamycin Intravitreal Inj Per 1mg/0.1ml 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
110469925
OTHER 		Hchg Juvéderm Volbella Xc Per (1) 0.55ml Syringe 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
110299925
OTHER 		Hchg Gi Cocktail - Maalox Max 10ml & Lidocane Viscous 2% 5ml- Per 15ml 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
1.0× median
94660
CPT 		Pos Airway Pressure Cpap 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$363
outlier · 6.2×
919606925
OTHER 		Hchg Silvadene 1% Cream, Per 1 Gm 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$2,242
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
00407-1412-30
OTHER 		Omnipaque 240 8 $2,242.20 $2,242.20 $2,242.20 nat. median
$1

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.

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 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 46 21 $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
See an error in this hospital's data? Submit a correction