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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

CROSSING RIVERS HEALTH MEDICAL CENTER

Prairie Du Chien, WI · CCN 521330 · Rates published

1,861 distinct procedures filed
26 distinct payers
110,274 rate rows
2026-04-02 last MRF observed
Data quality

109,810 of 110,274 rate rows are consumer-grade (99.6%)

464 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
exceeds 10× this hospital's gross charge — excluded from medians 212
percent-of-charges filed in the dollar field — excluded from medians 144
per-diem day rate — not a per-procedure price 108
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbPrairieduChien&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/CrossingRivers_V2.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 90aad5c2b4810c4b… · 19,947,639 bytes · first seen 2026-05-08

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
78815
HCPCS 		Nuclear Medicine Study From Skull Base To Mid-thigh With CT Scan 26 $3,051.34 $7,690.16 $7,531.60 nat. median
$2,793
outlier · 2.7×
78816
HCPCS 		Nuclear Medicine Study Whole Body With CT Scan 26 $3,051.34 $7,653.30 $7,495.50 nat. median
$2,707
outlier · 2.8×
70543
HCPCS 		MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 26 $858.72 $6,460.20 $6,327.00 nat. median
$1,079
outlier · 5.9×
70546
HCPCS 		MRI Scan Of Blood Vessels Of Head Before And After Contrast 26 $1,012.53 $6,159.50 $6,032.50 nat. median
$1,043
outlier · 5.8×
73723
HCPCS 		MRI Scan Of Leg Joint Before And After Contrast 26 $858.72 $5,888.87 $5,767.45 nat. median
$1,264
outlier · 4.6×
72157
HCPCS 		MRI Scan Of Middle Spinal Canal Before And After Contrast 26 $858.72 $5,858.80 $5,738.00 nat. median
$1,094
outlier · 5.2×
72197
HCPCS 		MRI Scan Of Pelvis Before And After Contrast 26 $858.72 $5,797.69 $5,678.15 nat. median
$1,065
outlier · 5.3×
J7327
HCPCS 		Hyaluronan Or Derivative, Monovisc, For Intra-articular Injection, Per Dose 26 $970.47 $5,784.11 $5,664.85 nat. median
$921
outlier · 6.2×
70553
HCPCS 		MRI Scan Of Brain Before And After Contrast 26 $858.72 $5,720.09 $5,602.15 nat. median
$1,122
outlier · 5.0×
72156
HCPCS 		MRI Scan Of Upper Spinal Canal Before And After Contrast 26 $858.72 $5,670.62 $5,553.70 nat. median
$1,092
outlier · 5.1×
73223
HCPCS 		MRI Scan Of Arm Joint Before And After Contrast 26 $858.72 $5,452.37 $5,339.95 nat. median
$1,225
outlier · 4.4×
73720
HCPCS 		MRI Scan Of Leg Before And After Contrast 26 $858.72 $5,438.79 $5,326.65 nat. median
$1,190
outlier · 4.5×
74178
HCPCS 		CT Scan Of Abdomen And Pelvis Before And After Contrast 26 $697.76 $5,366.04 $5,255.40 nat. median
$979
outlier · 5.4×
70549
HCPCS 		MRI Scan Of Blood Vessels Of Neck Before And After Contrast 26 $1,012.53 $5,365.07 $5,254.45 nat. median
$1,051
outlier · 5.0×
72158
HCPCS 		MRI Scan Of Lower Spinal Canal Before And After Contrast 26 $858.72 $5,335.00 $5,225.00 nat. median
$1,081
outlier · 4.8×
73220
HCPCS 		MRI Scan Of Arm Before And After Contrast 26 $858.72 $5,332.09 $5,222.15 nat. median
$1,185
outlier · 4.4×
95811
HCPCS 		Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 26 $1,611.26 $5,224.42 $5,116.70 nat. median
$2,026
outlier · 2.5×
74183
HCPCS 		MRI Scan Of Abdomen Before And After Contrast 26 $858.72 $5,025.57 $4,921.95 nat. median
$1,102
outlier · 4.5×
74177
HCPCS 		CT Scan Of Abdomen And Pelvis With Contrast 26 $697.76 $4,976.10 $4,873.50 nat. median
$928
outlier · 5.3×
74174
HCPCS 		CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 26 $861.47 $4,869.40 $4,769.00 nat. median
$959
outlier · 5.0×
C8908
HCPCS 		Magnetic Resonance Imaging Without Contrast Followed By With Contrast, Breast; B… 26 $858.72 $4,754.94 $4,656.90 nat. median
$928
outlier · 5.0×
78452
HCPCS 		Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 26 $1,895.03 $4,692.86 $4,596.10 nat. median
$1,767
outlier · 2.6×
95810
HCPCS 		Sleep Study In Sleep Lab (6 Years Or Older) 26 $1,611.26 $4,655.03 $4,559.05 nat. median
$1,870
outlier · 2.4×
70552
HCPCS 		MRI Scan Of Brain With Contrast 26 $858.72 $4,655.03 $4,559.05 nat. median
$960
outlier · 4.7×
75574
HCPCS 		CT Scan Of Blood Vessels And Grafts Of Heart With Contrast 26 $861.47 $4,602.65 $4,507.75 nat. median
$570
outlier · 7.9×
73222
HCPCS 		MRI Scan Of Arm Joint With Contrast 26 $858.72 $4,516.32 $4,423.20 nat. median
$1,313
outlier · 3.4×
70544
HCPCS 		MRI Scan Of Blood Vessels Of Head Without Contrast 26 $1,012.53 $4,490.13 $4,397.55 nat. median
$817
outlier · 5.4×
73722
HCPCS 		MRI Scan Of Leg Joint With Contrast 26 $858.72 $4,478.49 $4,386.15 nat. median
$1,302
outlier · 3.4×
J7326
HCPCS 		Hyaluronan Or Derivative, Gel-one, For Intra-articular Injection, Per Dose 26 $347.47 $4,443.09 $4,351.48 nat. median
$787
outlier · 5.5×
70551
HCPCS 		MRI Scan Of Brain Without Contrast 26 $516.44 $4,432.90 $4,341.50 nat. median
$772
outlier · 5.6×
73706
HCPCS 		CT Scan Of Blood Vessels Of Lower Leg With Contrast 26 $861.47 $4,398.95 $4,308.25 nat. median
$760
outlier · 5.7×
75635
HCPCS 		CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 26 $861.47 $4,384.40 $4,294.00 nat. median
$706
outlier · 6.1×
72142
HCPCS 		MRI Scan Of Upper Spinal Canal With Contrast 26 $858.72 $4,273.82 $4,185.70 nat. median
$959
outlier · 4.4×
74175
HCPCS 		CT Scan Of Blood Vessels Of Abdomen With Contrast 26 $861.47 $4,259.27 $4,171.45 nat. median
$710
outlier · 5.9×
70540
HCPCS 		MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 26 $516.44 $4,058.48 $3,974.80 nat. median
$785
outlier · 5.1×
74176
HCPCS 		CT Scan Of Abdomen And Pelvis Without Contrast 26 $697.76 $4,001.25 $3,918.75 nat. median
$685
outlier · 5.7×
72195
HCPCS 		MRI Scan Of Pelvis Without Contrast 26 $516.44 $3,935.29 $3,854.15 nat. median
$787
outlier · 4.9×
72146
HCPCS 		MRI Scan Of Middle Spinal Canal Without Contrast 26 $516.44 $3,929.47 $3,848.45 nat. median
$772
outlier · 5.0×
70547
HCPCS 		MRI Scan Of Blood Vessels Of Neck Without Contrast 26 $1,012.53 $3,927.53 $3,846.55 nat. median
$751
outlier · 5.1×
74181
HCPCS 		MRI Scan Of Abdomen Without Contrast 26 $516.44 $3,897.46 $3,817.10 nat. median
$820
outlier · 4.7×
72141
HCPCS 		MRI Scan Of Upper Spinal Canal Without Contrast 26 $516.44 $3,879.03 $3,799.05 nat. median
$766
outlier · 5.0×
29001042
CDM 		Room & Board - Private (one Bed) - Medical/surgical/gyn 20 $3,150.40 $3,819.86 $3,780.48 nat. median
$3,741
1.0× median
72148
HCPCS 		MRI Scan Of Lower Spinal Canal Without Contrast 26 $516.44 $3,826.65 $3,747.75 nat. median
$770
outlier · 4.9×
70496
HCPCS 		CT Scan Of Blood Vessels Of Head With Contrast 26 $861.47 $3,726.74 $3,649.90 nat. median
$729
outlier · 5.0×
73221
HCPCS 		MRI Scan Of Arm Joint Without Contrast 26 $516.44 $3,670.48 $3,594.80 nat. median
$880
outlier · 4.1×
73718
HCPCS 		MRI Scan Of Leg Without Contrast 26 $516.44 $3,670.48 $3,594.80 nat. median
$917
outlier · 3.9×
J9202
HCPCS 		Goserelin Acetate Implant, Per 3.6 Mg 26 $1,586.11 $3,663.16 $3,587.63 nat. median
$1,879
1.9× median
74170
HCPCS 		CT Scan Of Abdomen Before And After Contrast 26 $697.76 $3,610.34 $3,535.90 nat. median
$703
outlier · 5.0×
73721
HCPCS 		MRI Scan Of Leg Joint Without Contrast 26 $516.44 $3,541.47 $3,468.45 nat. median
$899
outlier · 3.9×
29006010
CDM 		Room & Board - Private (one Bed) - Obstetrics (ob) 20 $2,886.40 $3,499.76 $3,463.68 nat. median
$3,464
1.0× median

Other procedures at this hospital

Browse this hospital's 1,861 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
             
78815 HCPCS Nuclear Medicine Study From Skull Base To Mid-thigh With CT Scan 52 26 $7,928.00 $7,928.00 $3,051.34 $7,690.16 $7,531.60 2026-04-02
78816 HCPCS Nuclear Medicine Study Whole Body With CT Scan 52 26 $7,890.00 $7,890.00 $3,051.34 $7,653.30 $7,495.50 2026-04-02
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 52 26 $6,660.00 $6,660.00 $858.72 $6,460.20 $6,327.00 2026-04-02
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 52 26 $6,350.00 $6,350.00 $1,012.53 $6,159.50 $6,032.50 2026-04-02
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 52 26 $6,071.00 $6,071.00 $858.72 $5,888.87 $5,767.45 2026-04-02
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 52 26 $6,040.00 $6,040.00 $858.72 $5,858.80 $5,738.00 2026-04-02
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 52 26 $5,977.00 $5,977.00 $858.72 $5,797.69 $5,678.15 2026-04-02
J7327 HCPCS Hyaluronan Or Derivative, Monovisc, For Intra-articular Injection, Per Dose 52 26 $5,963.00 $5,963.00 $970.47 $5,784.11 $5,664.85 2026-04-02
70553 HCPCS MRI Scan Of Brain Before And After Contrast 52 26 $5,897.00 $5,897.00 $858.72 $5,720.09 $5,602.15 2026-04-02
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 52 26 $5,846.00 $5,846.00 $858.72 $5,670.62 $5,553.70 2026-04-02
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 52 26 $5,621.00 $5,621.00 $858.72 $5,452.37 $5,339.95 2026-04-02
73720 HCPCS MRI Scan Of Leg Before And After Contrast 52 26 $5,607.00 $5,607.00 $858.72 $5,438.79 $5,326.65 2026-04-02
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 52 26 $5,532.00 $5,532.00 $697.76 $5,366.04 $5,255.40 2026-04-02
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 52 26 $5,531.00 $5,531.00 $1,012.53 $5,365.07 $5,254.45 2026-04-02
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 52 26 $5,500.00 $5,500.00 $858.72 $5,335.00 $5,225.00 2026-04-02
73220 HCPCS MRI Scan Of Arm Before And After Contrast 52 26 $5,497.00 $5,497.00 $858.72 $5,332.09 $5,222.15 2026-04-02
95811 HCPCS Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 52 26 $5,386.00 $5,386.00 $1,611.26 $5,224.42 $5,116.70 2026-04-02
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 52 26 $5,181.00 $5,181.00 $858.72 $5,025.57 $4,921.95 2026-04-02
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 52 26 $5,130.00 $5,130.00 $697.76 $4,976.10 $4,873.50 2026-04-02
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 52 26 $5,020.00 $5,020.00 $861.47 $4,869.40 $4,769.00 2026-04-02
C8908 HCPCS Magnetic Resonance Imaging Without Contrast Followed By With Contrast, Breast; B… 52 26 $4,902.00 $4,902.00 $858.72 $4,754.94 $4,656.90 2026-04-02
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 52 26 $4,838.00 $4,838.00 $1,895.03 $4,692.86 $4,596.10 2026-04-02
95810 HCPCS Sleep Study In Sleep Lab (6 Years Or Older) 52 26 $4,799.00 $4,799.00 $1,611.26 $4,655.03 $4,559.05 2026-04-02
70552 HCPCS MRI Scan Of Brain With Contrast 52 26 $4,799.00 $4,799.00 $858.72 $4,655.03 $4,559.05 2026-04-02
75574 HCPCS CT Scan Of Blood Vessels And Grafts Of Heart With Contrast 52 26 $4,745.00 $4,745.00 $861.47 $4,602.65 $4,507.75 2026-04-02
73222 HCPCS MRI Scan Of Arm Joint With Contrast 52 26 $4,656.00 $4,656.00 $858.72 $4,516.32 $4,423.20 2026-04-02
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 52 26 $4,629.00 $4,629.00 $1,012.53 $4,490.13 $4,397.55 2026-04-02
73722 HCPCS MRI Scan Of Leg Joint With Contrast 52 26 $4,617.00 $4,617.00 $858.72 $4,478.49 $4,386.15 2026-04-02
J7326 HCPCS Hyaluronan Or Derivative, Gel-one, For Intra-articular Injection, Per Dose 52 26 $4,580.50 $4,580.50 $347.47 $4,443.09 $4,351.48 2026-04-02
70551 HCPCS MRI Scan Of Brain Without Contrast 52 26 $4,570.00 $4,570.00 $516.44 $4,432.90 $4,341.50 2026-04-02
73706 HCPCS CT Scan Of Blood Vessels Of Lower Leg With Contrast 52 26 $4,535.00 $4,535.00 $861.47 $4,398.95 $4,308.25 2026-04-02
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 52 26 $4,520.00 $4,520.00 $861.47 $4,384.40 $4,294.00 2026-04-02
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 52 26 $4,406.00 $4,406.00 $858.72 $4,273.82 $4,185.70 2026-04-02
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 52 26 $4,391.00 $4,391.00 $861.47 $4,259.27 $4,171.45 2026-04-02
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 52 26 $4,184.00 $4,184.00 $516.44 $4,058.48 $3,974.80 2026-04-02
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 52 26 $4,125.00 $4,125.00 $697.76 $4,001.25 $3,918.75 2026-04-02
72195 HCPCS MRI Scan Of Pelvis Without Contrast 52 26 $4,057.00 $4,057.00 $516.44 $3,935.29 $3,854.15 2026-04-02
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 52 26 $4,051.00 $4,051.00 $516.44 $3,929.47 $3,848.45 2026-04-02
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 52 26 $4,049.00 $4,049.00 $1,012.53 $3,927.53 $3,846.55 2026-04-02
74181 HCPCS MRI Scan Of Abdomen Without Contrast 52 26 $4,018.00 $4,018.00 $516.44 $3,897.46 $3,817.10 2026-04-02
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 52 26 $3,999.00 $3,999.00 $516.44 $3,879.03 $3,799.05 2026-04-02
29001042 CDM Room & Board - Private (one Bed) - Medical/surgical/gyn 40 20 $3,938.00 $3,938.00 $3,150.40 $3,819.86 $3,780.48 2026-04-02
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 52 26 $3,945.00 $3,945.00 $516.44 $3,826.65 $3,747.75 2026-04-02
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 52 26 $3,842.00 $3,842.00 $861.47 $3,726.74 $3,649.90 2026-04-02
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 52 26 $3,784.00 $3,784.00 $516.44 $3,670.48 $3,594.80 2026-04-02
73718 HCPCS MRI Scan Of Leg Without Contrast 52 26 $3,784.00 $3,784.00 $516.44 $3,670.48 $3,594.80 2026-04-02
J9202 HCPCS Goserelin Acetate Implant, Per 3.6 Mg 52 26 $3,776.45 $3,776.45 $1,586.11 $3,663.16 $3,587.63 2026-04-02
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 52 26 $3,722.00 $3,722.00 $697.76 $3,610.34 $3,535.90 2026-04-02
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 52 26 $3,651.00 $3,651.00 $516.44 $3,541.47 $3,468.45 2026-04-02
29006010 CDM Room & Board - Private (one Bed) - Obstetrics (ob) 40 20 $3,608.00 $3,608.00 $2,886.40 $3,499.76 $3,463.68 2026-04-02
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 52 26 $3,559.00 $3,559.00 $861.47 $3,452.23 $3,381.05 2026-04-02
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 52 26 $3,521.00 $3,521.00 $697.76 $3,415.37 $3,344.95 2026-04-02
73702 HCPCS CT Scan Of Leg Before And After Contrast 52 26 $3,453.00 $3,453.00 $697.76 $3,349.41 $3,280.35 2026-04-02
73218 HCPCS MRI Scan Of Arm Without Contrast 52 26 $3,436.00 $3,436.00 $516.44 $3,332.92 $3,264.20 2026-04-02
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 52 26 $3,426.00 $3,426.00 $861.47 $3,323.22 $3,254.70 2026-04-02
G0390 HCPCS Trauma Response Team Associated With Hospital Critical Care Service 46 23 $3,300.00 $3,300.00 $1,386.00 $3,201.00 $3,168.00 2026-04-02
G0260 HCPCS Injection Procedure For Sacroiliac Joint; Provision Of Anesthetic, Steroid And/o… 52 26 $3,276.77 $3,276.77 $977.75 $3,178.46 $3,112.93 2026-04-02
71270 HCPCS CT Scan Of Chest Before And After Contrast 52 26 $3,195.00 $3,195.00 $697.76 $3,099.15 $3,035.25 2026-04-02
70481 HCPCS CT Scan Of Cranial Cavity With Contrast 52 26 $3,159.00 $3,159.00 $697.76 $3,064.23 $3,001.05 2026-04-02
99291 HCPCS Critical Care, First 30-74 Minutes 48 24 $3,137.40 $3,137.40 $1,317.71 $3,043.28 $2,996.22 2026-04-02
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 52 26 $3,128.00 $3,128.00 $1,008.80 $3,034.16 $2,971.60 2026-04-02
75572 HCPCS CT Scan Of Heart Structure With Contrast 52 26 $3,114.00 $3,114.00 $697.76 $3,020.58 $2,958.30 2026-04-02
29001010 CDM Room & Board - Private (one Bed) - Medical/surgical/gyn 40 20 $2,980.00 $2,980.00 $2,384.00 $2,890.60 $2,860.80 2026-04-02
29006000 CDM Room & Board - Private (one Bed) - Obstetrics (ob) 40 20 $2,980.00 $2,980.00 $2,384.00 $2,890.60 $2,860.80 2026-04-02
74160 HCPCS CT Scan Of Abdomen With Contrast 52 26 $3,006.00 $3,006.00 $697.76 $2,915.82 $2,855.70 2026-04-02
73701 HCPCS CT Scan Of Leg With Contrast Material 52 26 $3,003.00 $3,003.00 $697.76 $2,912.91 $2,852.85 2026-04-02
78227 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs 52 26 $2,990.00 $2,990.00 $799.36 $2,900.30 $2,840.50 2026-04-02
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 52 26 $2,967.00 $2,967.00 $697.76 $2,877.99 $2,818.65 2026-04-02
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 52 26 $2,949.00 $2,949.00 $697.76 $2,860.53 $2,801.55 2026-04-02
70488 HCPCS CT Scan Of Face Before And After Contrast 52 26 $2,905.00 $2,905.00 $697.76 $2,817.85 $2,759.75 2026-04-02
J7298 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System (mirena), 52 Mg 52 26 $2,892.00 $2,892.00 $970.47 $2,805.24 $2,747.40 2026-04-02
78582 HCPCS Nuclear Medicine Study Of Lung Ventilation And Circulation 52 26 $2,861.00 $2,861.00 $1,201.62 $2,775.17 $2,717.95 2026-04-02
72126 HCPCS CT Scan Of Upper Spine With Contrast 52 26 $2,805.00 $2,805.00 $697.76 $2,720.85 $2,664.75 2026-04-02
73201 HCPCS CT Scan Of Arm With Contrast 52 26 $2,790.00 $2,790.00 $697.76 $2,706.30 $2,650.50 2026-04-02
72193 HCPCS CT Scan Of Pelvis With Contrast 52 26 $2,790.00 $2,790.00 $697.76 $2,706.30 $2,650.50 2026-04-02
J7307 HCPCS Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 52 26 $2,731.00 $2,731.00 $970.47 $2,649.07 $2,594.45 2026-04-02
90375 HCPCS Rabies Immune Globulin For Injection 52 26 $2,692.52 $2,692.52 $1,130.86 $2,651.54 $2,584.82 2026-04-02
71260 HCPCS CT Scan Of Chest With Contrast 52 26 $2,690.00 $2,690.00 $697.76 $2,609.30 $2,555.50 2026-04-02
72132 HCPCS CT Scan Of Lower Spine With Contrast 52 26 $2,677.00 $2,677.00 $697.76 $2,596.69 $2,543.15 2026-04-02
49020 HCPCS Drainage Of Abdominal Abscess Or Infection 44 22 $4,193.00 $4,193.00 $1,324.34 $4,067.21 $2,516.53 2026-04-02
20006428 CDM Labor Room/delivery - Labor 48 24 $2,593.00 $2,593.00 $1,089.06 $2,515.21 $2,476.32 2026-04-02
70487 HCPCS CT Scan Of Face With Contrast 52 26 $2,585.00 $2,585.00 $697.76 $2,507.45 $2,455.75 2026-04-02
14060 HCPCS Repair Of Wound Of Eyelids, Nose, Ears, Or Lips By Transferring Skin, 10.0 Sq Cm… 96 26 $2,555.00 $2,555.00 $538.80 $4,194.57 $2,427.25 2026-04-02
44204 HCPCS Partial Removal Of Large Bowel Using An Endoscope 44 22 $7,232.00 $7,232.00 $1,038.10 $7,015.04 $2,418.47 2026-04-02
70460 HCPCS CT Scan Head Or Brain With Contrast 52 26 $2,489.00 $2,489.00 $697.76 $2,414.33 $2,364.55 2026-04-02
72125 HCPCS CT Scan Of Upper Spine Without Contrast 52 26 $2,472.00 $2,472.00 $227.47 $2,397.84 $2,348.40 2026-04-02
C8928 HCPCS Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi… 52 26 $2,465.00 $2,465.00 $1,008.80 $2,391.05 $2,341.75 2026-04-02
38505 HCPCS Needle Biopsy Or Removal Of Surface Lymph Nodes 52 26 $2,436.00 $2,436.00 $1,023.12 $2,628.25 $2,338.56 2026-04-02
78315 HCPCS Nuclear Medicine Study Of Bone Taken At Different Times 52 26 $2,440.00 $2,440.00 $799.36 $2,366.80 $2,318.00 2026-04-02
27266 HCPCS Closed Treatment Of Dislocated Hip Prosthesis Under Anesthesia 96 26 $4,973.00 $4,973.00 $484.83 $4,823.81 $2,310.34 2026-04-02
74150 HCPCS CT Scan Of Abdomen Without Contrast 52 26 $2,422.00 $2,422.00 $227.47 $2,349.34 $2,300.90 2026-04-02
71250 HCPCS CT Scan Of Chest Without Contrast 52 26 $2,410.00 $2,410.00 $227.47 $2,337.70 $2,289.50 2026-04-02
72128 HCPCS CT Scan Of Middle Spine Without Contrast 52 26 $2,408.00 $2,408.00 $227.47 $2,335.76 $2,287.60 2026-04-02
72131 HCPCS CT Scan Of Lower Spine Without Contrast 52 26 $2,360.00 $2,360.00 $227.47 $2,289.20 $2,242.00 2026-04-02
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 52 26 $2,352.00 $2,352.00 $697.76 $2,281.44 $2,234.40 2026-04-02
78264 HCPCS Nuclear Medicine Study Of Stomach To Assess Emptying 52 26 $2,338.00 $2,338.00 $799.36 $2,267.86 $2,221.10 2026-04-02
21931 HCPCS Removal Of Growth Under Skin Of Back Or Lower Sides, 3.0 Cm Or More 96 26 $3,846.00 $3,846.00 $68.07 $3,951.08 $2,186.38 2026-04-02
29010435 CDM Room & Board - Private (one Bed) - Hospice 36 18 $2,259.75 $2,259.75 $1,807.80 $2,191.96 $2,180.66 2026-04-02
44140 HCPCS Partial Removal Of Large Bowel With Connection 44 22 $6,304.00 $6,304.00 $305.74 $6,114.88 $2,117.61 2026-04-02
72192 HCPCS CT Scan Of Pelvis Without Contrast 52 26 $2,211.00 $2,211.00 $227.47 $2,144.67 $2,100.45 2026-04-02
29002000 CDM Room & Board - Private (one Bed) - Pediatric 40 20 $2,181.00 $2,181.00 $1,744.80 $2,115.57 $2,093.76 2026-04-02
29001000 CDM Room & Board - Private (one Bed) - Medical/surgical/gyn 40 20 $2,181.00 $2,181.00 $1,744.80 $2,115.57 $2,093.76 2026-04-02
70450 HCPCS CT Scan Head Or Brain Without Contrast 52 26 $2,196.00 $2,196.00 $697.76 $2,130.12 $2,086.20 2026-04-02
73700 HCPCS CT Scan Of Leg Without Contrast 52 26 $2,193.00 $2,193.00 $227.47 $2,127.21 $2,083.35 2026-04-02
J7300 HCPCS Intrauterine Copper Contraceptive 52 26 $2,165.00 $2,165.00 $220.08 $2,100.05 $2,056.75 2026-04-02
76998 HCPCS Ultrasonic Guidance During Surgery 52 26 $2,135.00 $2,135.00 $232.67 $2,070.95 $2,028.25 2026-04-02
27130 HCPCS Replacement Of Thigh Bone And Hip Joint With Prosthesis 44 22 $6,167.00 $6,167.00 $249.81 $5,981.99 $2,025.28 2026-04-02
27447 HCPCS Replacement Of Knee Joint, Both Sides Of Knee 44 22 $6,159.00 $6,159.00 $1,050.18 $5,974.23 $2,021.59 2026-04-02
70486 HCPCS CT Scan Of Face Without Contrast 52 26 $2,126.00 $2,126.00 $227.47 $2,062.22 $2,019.70 2026-04-02
70480 HCPCS CT Scan Of Cranial Cavity Without Contrast 52 26 $2,125.00 $2,125.00 $227.47 $2,061.25 $2,018.75 2026-04-02
70490 HCPCS CT Scan Of Soft Tissue Of Neck Without Contrast 52 26 $2,114.00 $2,114.00 $227.47 $2,050.58 $2,008.30 2026-04-02
64635 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 96 26 $4,770.91 $4,770.91 $164.00 $4,627.78 $2,003.78 2026-04-02
44160 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 44 22 $5,717.00 $5,717.00 $188.01 $5,545.49 $1,960.78 2026-04-02
C1781 HCPCS Mesh (implantable) 48 24 $2,045.06 $2,045.06 $858.93 $1,983.71 $1,953.03 2026-04-02
73200 HCPCS CT Scan Of Arm Without Contrast 52 26 $2,045.00 $2,045.00 $227.47 $1,983.65 $1,942.75 2026-04-02
41112 HCPCS Removal Of Growth Of Front 2/3 Of Tongue With Switches 96 26 $4,603.00 $4,603.00 $139.23 $4,464.91 $1,933.26 2026-04-02
C1788 HCPCS Port, Indwelling (implantable) 48 24 $2,019.05 $2,019.05 $848.00 $1,958.48 $1,928.19 2026-04-02
27245 HCPCS Treatment Of Broken Neck Of Thigh Bone With Bone Implant 44 22 $5,912.00 $5,912.00 $195.47 $5,734.64 $1,928.05 2026-04-02
44120 HCPCS Partial Removal Of Small Bowel With Reconnection 44 22 $5,722.00 $5,722.00 $877.03 $5,550.34 $1,926.32 2026-04-02
87507 HCPCS Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S… 52 26 $1,991.00 $1,991.00 $328.65 $1,931.27 $1,891.45 2026-04-02
78306 HCPCS Nuclear Medicine Study Of Bone And/or Joint Whole Body 52 26 $1,973.00 $1,973.00 $799.36 $1,913.81 $1,874.35 2026-04-02
20006427 CDM Labor Room/delivery - Labor 48 24 $1,950.00 $1,950.00 $819.00 $1,891.50 $1,862.25 2026-04-02
20001635 CDM Operating Room Services - General Classification 48 24 $1,922.00 $1,922.00 $807.24 $1,864.34 $1,835.51 2026-04-02
71271 HCPCS Low Dose CT Scan Of Chest For Lung Cancer Screening 52 26 $1,888.00 $1,888.00 $227.47 $1,831.36 $1,793.60 2026-04-02
78580 HCPCS Nuclear Medicine Study Of Lung Circulation 52 26 $1,862.00 $1,862.00 $782.04 $1,895.03 $1,787.52 2026-04-02
99292 HCPCS Critical Care, Each Additional 30 Minutes 48 24 $1,845.90 $1,845.90 $775.28 $1,790.52 $1,762.84 2026-04-02
64493 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Single Le… 96 26 $4,480.84 $4,480.84 $77.11 $4,346.42 $1,755.81 2026-04-02
20001636 CDM Operating Room Services - General Classification 48 24 $1,811.76 $1,811.76 $760.94 $1,757.41 $1,730.23 2026-04-02
21555 HCPCS Removal Of Growth Under Skin Of Neck Or Front Of Chest, Less Than 3.0 Cm 96 26 $4,107.00 $4,107.00 $75.37 $5,038.07 $1,724.94 2026-04-02
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 52 26 $1,790.51 $1,790.51 $725.21 $1,736.79 $1,700.98 2026-04-02
93975 HCPCS Complete Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 52 26 $1,772.00 $1,772.00 $355.12 $1,718.84 $1,683.40 2026-04-02
93970 HCPCS Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers 52 26 $1,767.00 $1,767.00 $355.12 $1,713.99 $1,678.65 2026-04-02
36410 HCPCS Insertion Of Needle Into Vein (3 Years Or Older) 52 26 $1,751.00 $1,751.00 $158.27 $1,698.47 $1,663.45 2026-04-02
44310 HCPCS Creation Of Opening From Small Bowel To Skin 44 22 $2,748.00 $2,748.00 $203.39 $2,665.56 $1,644.63 2026-04-02
90675 HCPCS Rabies Vaccine For Injection Into Muscle 52 26 $1,672.95 $1,672.95 $281.33 $1,622.76 $1,589.30 2026-04-02
21012 HCPCS Removal Of Growth Under Skin Of Face Or Scalp, 2.0 Cm Or More 96 26 $3,287.00 $3,287.00 $49.10 $3,951.08 $1,574.31 2026-04-02
64490 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Single Le… 96 26 $3,725.40 $3,725.40 $89.03 $3,613.64 $1,564.67 2026-04-02
29005001 CDM Nursery - Newborn - Level I 40 20 $1,621.25 $1,621.25 $1,297.00 $1,572.61 $1,556.40 2026-04-02
69540 HCPCS Removal Of Polyp Of Outer Ear 96 26 $3,703.00 $3,703.00 $113.00 $3,591.91 $1,555.26 2026-04-02
87902 HCPCS Analysis Test By Nucleic Acid For Hepatitis C Virus 52 26 $1,635.00 $1,635.00 $273.02 $1,585.95 $1,553.25 2026-04-02
64420 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Rib Nerve 96 26 $5,212.00 $5,212.00 $45.18 $5,055.64 $1,538.00 2026-04-02
78707 HCPCS Nuclear Medicine Study Of Kidney, Blood Flow, And Function 52 26 $1,602.00 $1,602.00 $672.84 $1,553.94 $1,521.90 2026-04-02
27252 HCPCS Closed Treatment Of Dislocated Hip Under Anesthesia 96 26 $1,577.00 $1,577.00 $652.12 $2,677.20 $1,513.92 2026-04-02
19081 HCPCS Biopsy Of Breast And Placement Of Locating Device Using X-ray With Needle, First… 96 26 $3,602.00 $3,602.00 $117.87 $3,493.94 $1,512.84 2026-04-02
27818 HCPCS Closed Treatment Of 3 Broken Lower Leg Bones At Ankle With Manipulation 96 26 $2,345.00 $2,345.00 $436.94 $2,274.65 $1,501.26 2026-04-02
93880 HCPCS Ultrasound Of Both Sides Of Head And Neck Blood Flow 52 26 $1,578.00 $1,578.00 $355.12 $1,530.66 $1,499.10 2026-04-02
25565 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation 96 26 $1,577.00 $1,577.00 $389.13 $2,252.34 $1,498.15 2026-04-02
27762 HCPCS Closed Treatment Of Inside Portion Of Shin Bone At Ankle With Manipulation 96 26 $1,577.00 $1,577.00 $415.38 $1,899.26 $1,498.15 2026-04-02
49450 HCPCS Replacement Of Stomach Or Large Bowel Tube Using Fluoroscopic Guidance With Cont… 52 26 $1,518.00 $1,518.00 $637.56 $1,472.46 $1,442.10 2026-04-02
94002 HCPCS Initial Hospital Inpatient Or Observation Ventilation Assistance And Management 52 26 $1,499.00 $1,499.00 $629.58 $2,962.15 $1,439.04 2026-04-02
93925 HCPCS Ultrasound Of Leg Arteries Or Artery Grafts 52 26 $1,510.00 $1,510.00 $355.12 $1,464.70 $1,434.50 2026-04-02
J7323 HCPCS Hyaluronan Or Derivative, Euflexxa, For Intra-articular Injection, Per Dose 52 26 $1,462.50 $1,462.50 $262.68 $1,418.63 $1,389.38 2026-04-02
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 96 26 $3,296.00 $3,296.00 $71.64 $3,197.12 $1,384.32 2026-04-02
19083 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 96 26 $3,291.00 $3,291.00 $121.97 $3,337.37 $1,382.22 2026-04-02
20006426 CDM Labor Room/delivery - Labor 48 24 $1,432.00 $1,432.00 $601.44 $1,389.04 $1,367.56 2026-04-02
20001637 CDM Operating Room Services - General Classification 48 24 $1,428.92 $1,428.92 $600.15 $1,386.05 $1,364.62 2026-04-02
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 52 26 $1,341.49 $1,341.49 $563.43 $3,809.69 $1,287.83 2026-04-02
36430 HCPCS Transfusion Of Blood Or Blood Products 52 26 $1,292.55 $1,292.55 $542.87 $1,308.04 $1,227.92 2026-04-02
27814 HCPCS Treatment Of Both Broken Lower Leg Bones At Ankle 44 22 $3,735.00 $3,735.00 $119.12 $3,622.95 $1,216.45 2026-04-02
13132 HCPCS Complicated Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, G… 96 26 $1,379.00 $1,379.00 $236.09 $1,338.60 $1,207.03 2026-04-02
94660 HCPCS Therapy Procedure Using A Positive Pressure Ventilator 52 26 $1,250.00 $1,250.00 $333.41 $1,212.50 $1,187.50 2026-04-02
64625 HCPCS Destruction Of Nerves Supplying Joint Between Spine And Pelvis Using Imaging Gui… 96 26 $2,806.00 $2,806.00 $65.00 $2,966.86 $1,178.52 2026-04-02
L8699 HCPCS Prosthetic Implant, Not Otherwise Specified 96 24 $2,594.02 $2,594.02 $135.62 $4,719.18 $1,178.28 2026-04-02
76700 HCPCS Complete Ultrasound Scan Of Abdomen 52 26 $1,238.00 $1,238.00 $355.12 $1,200.86 $1,176.10 2026-04-02
11406 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, More Than 4.0 Cm 96 26 $1,591.00 $1,591.00 $209.14 $3,952.86 $1,170.79 2026-04-02
95806 HCPCS Sleep Study Including Heart Rate, Breathing, Airflow, And Effort 52 26 $1,223.00 $1,223.00 $322.65 $1,186.31 $1,161.85 2026-04-02
47563 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 44 22 $3,391.00 $3,391.00 $607.49 $3,289.27 $1,141.20 2026-04-02
P9073 HCPCS Platelets, Pheresis, Pathogen-reduced, Each Unit 52 26 $1,195.00 $1,195.00 $501.90 $1,159.15 $1,135.25 2026-04-02
0202U HCPCS Test For Detection Of Respiratory Disease-causing Organisms From Back Of Nose An… 62 26 $1,192.00 $1,192.00 $500.64 $1,156.24 $1,132.40 2026-04-02
36589 HCPCS Removal Of Tunneled Central Venous Tube 52 26 $1,179.00 $1,179.00 $495.18 $1,602.45 $1,131.84 2026-04-02
20103 HCPCS Exploration Of Wound Of Arm Or Leg 96 26 $1,591.00 $1,591.00 $288.29 $1,543.27 $1,120.21 2026-04-02
27788 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle With Manipulation 96 26 $1,195.60 $1,195.60 $226.00 $1,236.94 $1,118.22 2026-04-02
76376 HCPCS 3d Radiographic Procedure 48 24 $1,163.00 $1,163.00 $488.46 $1,128.11 $1,110.66 2026-04-02
24605 HCPCS Repair Of Dislocated Elbow Under Anesthesia 96 26 $1,577.00 $1,577.00 $414.14 $2,246.23 $1,102.10 2026-04-02
A9552 HCPCS Fluorodeoxyglucose F-18 Fdg, Diagnostic, Per Study Dose, Up To 45 Millicuries 48 24 $1,150.00 $1,150.00 $483.00 $1,115.50 $1,098.25 2026-04-02
49622 HCPCS Repair Of Entrapped Hernia Next To Stoma 42 21 $4,266.00 $4,266.00 $748.35 $4,138.02 $1,097.28 2026-04-02
88309 HCPCS Pathology Examination Of Tissue Using A Microscope, High Complexity 52 26 $1,147.00 $1,147.00 $336.23 $1,112.59 $1,089.65 2026-04-02
99215 HCPCS Established Patient Office Or Other Outpatient Visit With High Level Of Medical … 82 26 $2,593.00 $2,593.00 $119.68 $2,515.21 $1,089.06 2026-04-02
74240 HCPCS Single Contrast X-ray Of Upper Digestive Tract 52 26 $1,141.00 $1,141.00 $253.09 $1,106.77 $1,083.95 2026-04-02
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 96 26 $2,268.00 $2,268.00 $342.62 $2,199.96 $1,065.86 2026-04-02
96416 HCPCS Administration Of Prolonged Chemotherapy Into Vein 52 26 $1,106.00 $1,106.00 $464.52 $1,090.35 $1,061.76 2026-04-02
82955 HCPCS G6pd (enzyme) Level 52 26 $1,115.00 $1,115.00 $9.23 $1,081.55 $1,059.25 2026-04-02
93017 HCPCS Exercise Or Drug-induced Heart Stress Test With Electrocardiogram (ecg) 52 26 $1,112.00 $1,112.00 $365.75 $1,078.64 $1,056.40 2026-04-02
47562 HCPCS Removal Of Gallbladder Using An Endoscope 44 22 $3,121.00 $3,121.00 $561.76 $3,027.37 $1,050.84 2026-04-02
28010 HCPCS Repair Of Toe Tendon 96 26 $2,495.00 $2,495.00 $67.79 $4,765.48 $1,047.90 2026-04-02
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 96 26 $1,577.00 $1,577.00 $187.47 $2,246.23 $1,047.69 2026-04-02
93926 HCPCS Ultrasound Of One Leg Arteries Or Artery Grafts 52 26 $1,092.00 $1,092.00 $235.48 $1,059.24 $1,037.40 2026-04-02
93247 HCPCS Heart Rhythm Analysis And Report Of Continuous External EKG Over 8-15 Days 52 26 $1,092.00 $1,092.00 $120.12 $1,059.24 $1,037.40 2026-04-02
93971 HCPCS Ultrasound Study Of One Arm Or Leg Veins With Compression And Maneuvers 52 26 $1,075.00 $1,075.00 $235.48 $1,042.75 $1,021.25 2026-04-02
76811 HCPCS Ultrasound Scan Of Pregnant Uterus With Detailed Fetal Anatomic Examination, Sin… 52 26 $1,074.00 $1,074.00 $211.94 $1,041.78 $1,020.30 2026-04-02
11755 HCPCS Biopsy Of Fingernail Or Toenail 52 26 $1,065.00 $1,065.00 $447.30 $1,033.05 $1,011.75 2026-04-02
64417 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Upper Arm And Shoulder Nerve (… 96 26 $2,670.00 $2,670.00 $45.18 $2,589.90 $1,004.18 2026-04-02
64483 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I… 96 26 $2,388.10 $2,388.10 $94.26 $2,316.46 $1,003.00 2026-04-02
92950 HCPCS Manual Attempt To Restore Blood Circulation And Breathing 52 26 $1,038.00 $1,038.00 $435.96 $1,601.54 $996.48 2026-04-02
64624 HCPCS Destruction Of Nerve Branches Of Knee Using Imaging Guidance 96 26 $2,349.42 $2,349.42 $65.00 $3,236.14 $986.76 2026-04-02
J1611 HCPCS Injection, Glucagon Hydrochloride (fresenius Kabi), Not Therapeutically Equivale… 52 26 $1,034.79 $1,034.79 $262.68 $1,005.02 $983.67 2026-04-02
A9272 HCPCS Wound Suction, Disposable, Includes Dressing, All Accessories And Components, An… 96 24 $1,239.38 $1,239.38 $425.88 $1,420.81 $983.58 2026-04-02
93976 HCPCS Ultrasound Of Abdomen And Pelvis Artery And Vein Blood Flow 52 26 $1,035.00 $1,035.00 $355.12 $1,003.95 $983.25 2026-04-02
24655 HCPCS Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow With Manipulation 96 26 $2,093.00 $2,093.00 $226.00 $2,030.21 $982.08 2026-04-02
74420 HCPCS Imaging Of Urinary Tract Following Injection Of A Contrast Agent 52 26 $1,032.94 $1,032.94 $253.09 $1,001.95 $981.29 2026-04-02
86849 HCPCS Immunology Procedures 52 26 $1,029.00 $1,029.00 $18.58 $998.13 $977.55 2026-04-02
76942 HCPCS Ultrasonic Guidance For Needle Placement 52 26 $1,029.00 $1,029.00 $232.67 $998.13 $977.55 2026-04-02
77845_ERX CDM Duovisc Viscoelastic System 48 24 $1,015.76 $1,015.76 $426.62 $985.29 $970.05 2026-04-02
87154 HCPCS Amplifed Nucleic Acid Probe Typing Of Disease Agent In Blood Culture Specimen 52 26 $1,020.00 $1,020.00 $328.65 $989.40 $969.00 2026-04-02
44970 HCPCS Removal Of Appendix Using An Endoscope 44 22 $2,856.00 $2,856.00 $495.88 $2,770.32 $959.87 2026-04-02
24530 HCPCS Closed Treatment Of Upper Arm Bone Broken At Elbow 96 26 $999.00 $999.00 $106.18 $1,724.66 $949.05 2026-04-02
74300 HCPCS Review By Radiologist Of Bile And/or Pancreatic Duct Image During Surgery 52 26 $995.00 $995.00 $417.90 $965.15 $945.25 2026-04-02
76706 HCPCS Ultrasound Scan Of Abdominal Aorta 52 26 $994.00 $994.00 $235.48 $964.18 $944.30 2026-04-02
62323 HCPCS Injection Of Substance Into Lower Spine Canal Using Imaging Guidance 96 26 $2,244.00 $2,244.00 $84.21 $2,176.68 $942.48 2026-04-02
30220 HCPCS Insertion Of Implant To Close Nasal Passage 96 26 $2,225.00 $2,225.00 $108.43 $2,981.04 $934.50 2026-04-02
202892_ERX CDM Bridion 500 Mg/5 Ml Vial 48 24 $976.15 $976.15 $409.98 $946.87 $932.22 2026-04-02
76870 HCPCS Ultrasound Scan Of Scrotum 52 26 $968.00 $968.00 $235.48 $938.96 $919.60 2026-04-02
76805 HCPCS Ultrasound Scan Of Pregnant Uterus (14 Weeks Or More), Single Or First Fetus 52 26 $963.00 $963.00 $211.94 $934.11 $914.85 2026-04-02
96413 HCPCS Administration Of Chemotherapy Into Vein, 1 Hour Or Less 52 26 $962.00 $962.00 $404.04 $933.14 $913.90 2026-04-02
76641 HCPCS Complete Ultrasound Scan Of 1 Breast 52 26 $955.20 $955.20 $235.48 $926.54 $907.44 2026-04-02
64418 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Suprascapular Shoulder Nerve 96 26 $2,184.00 $2,184.00 $45.19 $2,118.48 $902.12 2026-04-02
J0675 HCPCS Injection, Carboprost Tromethamine, 0.1 Mg 48 24 $941.05 $941.05 $395.24 $912.82 $898.70 2026-04-02
94003 HCPCS Follow-up Inpatient Or Observation Ventilation Assistance And Management 52 26 $935.00 $935.00 $392.70 $2,962.15 $897.60 2026-04-02
93931 HCPCS Ultrasound Of One Arm Arteries Or Artery Grafts 52 26 $941.00 $941.00 $235.48 $912.77 $893.95 2026-04-02
74270 HCPCS Single Contrast X-ray Of Large Intestine 52 26 $939.00 $939.00 $253.09 $910.83 $892.05 2026-04-02
51600 HCPCS Injection Procedure For Imaging Of Bladder During Voiding 52 26 $937.44 $937.44 $393.72 $909.32 $890.57 2026-04-02
76770 HCPCS Complete Ultrasound Scan Behind Abdominal Cavity 52 26 $934.00 $934.00 $355.12 $905.98 $887.30 2026-04-02
74230 HCPCS Imaging For Evaluation Of Swallowing Function 52 26 $932.00 $932.00 $253.09 $904.04 $885.40 2026-04-02
76881 HCPCS Complete Ultrasound Scan Of Joint 52 26 $926.00 $926.00 $235.48 $898.22 $879.70 2026-04-02
25600 HCPCS Closed Treatment Of Broken Forearm (radius) Bone At The Wrist Area On The Thumb … 96 26 $923.00 $923.00 $168.48 $1,602.44 $876.85 2026-04-02
G0416 HCPCS Surgical Pathology, Gross And Microscopic Examinations, For Prostate Needle Biop… 52 26 $916.00 $916.00 $336.23 $888.52 $870.20 2026-04-02
62321 HCPCS Injection Of Substance Into Middle Or Upper Spine Canal Using Imaging Guidance 96 26 $2,066.00 $2,066.00 $90.27 $2,004.02 $867.72 2026-04-02
13121 HCPCS Complicated Repair Of Wound Of Scalp, Arms, Or Legs, 2.6-7.5 Cm 96 26 $2,040.00 $2,040.00 $202.31 $1,978.80 $856.80 2026-04-02
23600 HCPCS Closed Treatment Of Broken Top Of Upper Arm Bone 96 26 $901.00 $901.00 $216.96 $1,557.82 $855.95 2026-04-02
A9562 HCPCS Technetium Tc-99m Mertiatide, Diagnostic, Per Study Dose, Up To 15 Millicuries 48 24 $880.00 $880.00 $369.60 $853.60 $840.40 2026-04-02
99285 HCPCS Emergency Department Visit With High Level Of Medical Decision Making 92 26 $1,835.00 $1,835.00 $59.56 $1,779.95 $839.55 2026-04-02
93243 HCPCS Heart Rhythm Analysis And Report Of Continuous External EKG Over More Than 48 Ho… 52 26 $882.00 $882.00 $120.12 $855.54 $837.90 2026-04-02
55250 HCPCS Removal Of Sperm Duct 96 26 $1,009.00 $1,009.00 $204.44 $4,997.24 $836.65 2026-04-02
87631 HCPCS Detection Test By Nucleic Acid For Multiple Types Of Respiratory Virus, Multiple… 52 26 $878.00 $878.00 $328.65 $851.66 $834.10 2026-04-02
76856 HCPCS Complete Ultrasound Scan Of Pelvis 52 26 $872.00 $872.00 $355.12 $845.84 $828.40 2026-04-02
76830 HCPCS Ultrasound Scan Of Uterus, Ovaries, Tubes, Cervix And Pelvic Area Through Vagina 52 26 $867.00 $867.00 $235.48 $840.99 $823.65 2026-04-02
87505 HCPCS Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S… 52 26 $866.00 $866.00 $328.65 $840.02 $822.70 2026-04-02
27530 HCPCS Closed Treatment Of Broken Shin Bone 96 26 $857.00 $857.00 $106.18 $1,412.32 $814.15 2026-04-02
J1303 HCPCS Injection, Ravulizumab-cwvz, 10 Mg 48 24 $843.30 $843.30 $354.19 $818.00 $805.35 2026-04-02
19084 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, Each Additio… 96 26 $1,907.00 $1,907.00 $59.82 $2,899.00 $800.94 2026-04-02
36593 HCPCS Declotting Of Central Venous Tube 52 26 $829.00 $829.00 $348.18 $804.13 $787.55 2026-04-02
49083 HCPCS Drainage Of Fluid From Abdominal Cavity Using Imaging Guidance 96 26 $1,873.00 $1,873.00 $87.13 $1,816.81 $786.66 2026-04-02
64421 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Multiple Rib Nerves For Region… 96 26 $1,857.60 $1,857.60 $20.40 $3,236.14 $780.19 2026-04-02
29001362 CDM Room & Board - Private (one Bed) - General Classification 40 20 $811.00 $811.00 $648.80 $786.67 $778.56 2026-04-02
26600 HCPCS Closed Treatment Of Broken Hand Bone 96 26 $817.00 $817.00 $152.29 $1,418.14 $776.15 2026-04-02
77080 HCPCS Dxa Bone Density Measurement Of Hip, Pelvis, Spine 52 26 $817.00 $817.00 $157.97 $792.49 $776.15 2026-04-02
77002 HCPCS Fluoroscopic Guidance For Needle Placement 52 26 $814.00 $814.00 $341.88 $789.58 $773.30 2026-04-02
12053 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 5.1-7… 96 26 $810.00 $810.00 $150.66 $1,031.11 $769.50 2026-04-02
L3763 HCPCS Elbow Wrist Hand Orthosis, Rigid, Without Joints, May Include Soft Interface, St… 48 24 $804.00 $804.00 $337.68 $779.88 $767.82 2026-04-02
76872 HCPCS Ultrasound Scan Of Pelvic Region Through Rectum 52 26 $808.00 $808.00 $235.48 $783.76 $767.60 2026-04-02
20001638 CDM Operating Room Services - General Classification 48 24 $795.75 $795.75 $334.22 $771.88 $759.94 2026-04-02
11646 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More… 44 22 $1,630.00 $1,630.00 $306.95 $1,581.10 $755.36 2026-04-02
93242 HCPCS Heart Rhythm Recording Continuous External EKG Over More Than 48 Hours Up To 7 D… 52 26 $795.00 $795.00 $120.12 $771.15 $755.25 2026-04-02
93246 HCPCS Heart Rhythm Recording Of Continuous External EKG Over 8-15 Days 52 26 $795.00 $795.00 $120.12 $771.15 $755.25 2026-04-02
76819 HCPCS Ultrasound Scan Of Fetus 52 26 $794.00 $794.00 $211.94 $770.18 $754.30 2026-04-02
20001799 CDM Recovery Room - General Classification 48 24 $779.87 $779.87 $327.54 $756.47 $744.77 2026-04-02
74250 HCPCS Single Contrast X-ray Of Small Intestine 52 26 $769.00 $769.00 $253.09 $745.93 $730.55 2026-04-02
72110 HCPCS X-ray Of Lower And Sacral Spine, Minimum Of 4 Views 52 26 $769.00 $769.00 $120.00 $745.93 $730.55 2026-04-02
76705 HCPCS Limited Ultrasound Scan Of Abdomen 52 26 $768.00 $768.00 $235.48 $744.96 $729.60 2026-04-02
12054 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 7.6-1… 96 26 $767.00 $767.00 $182.50 $1,093.19 $728.65 2026-04-02
72190 HCPCS X-ray Of Pelvis, Minimum Of 3 Views 52 26 $765.00 $765.00 $120.00 $742.05 $726.75 2026-04-02
20606 HCPCS Aspiration And/or Injection Of Fluid From Medium Joint Using Ultrasound Guidance 96 26 $1,694.28 $1,694.28 $41.65 $1,696.47 $723.08 2026-04-02
76775 HCPCS Limited Ultrasound Scan Behind Abdominal Cavity 52 26 $758.00 $758.00 $235.48 $735.26 $720.10 2026-04-02
A9500 HCPCS Technetium Tc-99m Sestamibi, Diagnostic, Per Study Dose 48 24 $753.00 $753.00 $316.26 $730.41 $719.12 2026-04-02
32551 HCPCS Removal Of Fluid From Between Lung And Chest Cavity 96 26 $1,121.00 $1,121.00 $129.16 $2,126.66 $718.77 2026-04-02
76801 HCPCS Ultrasound Scan Of Pregnant Uterus (less Than 14 Weeks), Single Or First Fetus 52 26 $755.00 $755.00 $211.94 $732.35 $717.25 2026-04-02
24021339 CDM Hchg Crh Lifeflow Blood/fluid Infuser 48 24 $746.50 $746.50 $313.53 $724.11 $712.91 2026-04-02
92611 HCPCS Evaluation Of Swallowing Function Image 52 26 $742.00 $742.00 $253.09 $719.74 $704.90 2026-04-02
23620 HCPCS Closed Treatment Of Upper Arm Bone Broken At Shoulder Joint 96 26 $742.00 $742.00 $120.52 $1,282.34 $704.90 2026-04-02
23500 HCPCS Closed Treatment Of Broken Collar Bone 96 26 $741.00 $741.00 $61.66 $1,124.23 $703.95 2026-04-02
20611 HCPCS Aspiration And/or Injection Of Fluid Large Joint Using Ultrasound Guidance 96 26 $1,668.14 $1,668.14 $46.46 $2,665.09 $700.62 2026-04-02
64721 HCPCS Release And/or Relocation Of Hand Nerve 44 22 $2,163.00 $2,163.00 $348.76 $2,098.11 $696.69 2026-04-02
76536 HCPCS Ultrasound Scan Of Head And Neck Soft Tissue 52 26 $729.00 $729.00 $235.48 $707.13 $692.55 2026-04-02
24650000 CDM Hchg Or Supply 278 48 24 $722.23 $722.23 $303.34 $700.57 $689.73 2026-04-02
64494 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Second Le… 96 26 $1,641.82 $1,641.82 $10.94 $1,629.66 $689.57 2026-04-02
76000 HCPCS Imaging Guidance For Procedure, 60 Minutes Or Less 52 26 $724.00 $724.00 $253.09 $702.28 $687.80 2026-04-02
76817 HCPCS Vaginal Ultrasound Of Pregnant Uterus 52 26 $724.00 $724.00 $211.94 $702.28 $687.80 2026-04-02
10005 HCPCS Fine Needle Aspiration Biopsy Using Ultrasound Guidance, First Growth 96 26 $1,637.00 $1,637.00 $58.14 $1,587.89 $687.54 2026-04-02
76604 HCPCS Ultrasound Scan Of Chest 52 26 $721.00 $721.00 $235.48 $699.37 $684.95 2026-04-02
87536 HCPCS Detection Test By Nucleic Acid For HIV-1 Virus, Quantification 52 26 $720.00 $720.00 $91.09 $698.40 $684.00 2026-04-02
92523 HCPCS Evaluation Of Speech Sound Production With Evaluation Of Language Comprehension … 52 26 $720.00 $720.00 $302.40 $698.40 $684.00 2026-04-02
12044 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, 7.6-12.5 Cm 96 26 $716.00 $716.00 $135.57 $1,148.48 $680.20 2026-04-02
J2785 HCPCS Injection, Regadenoson, 0.1 Mg 48 24 $709.29 $709.29 $297.90 $688.02 $677.38 2026-04-02
76816 HCPCS Follow-up Ultrasound Scan Of Pregnant Uterus 52 26 $711.00 $711.00 $211.94 $689.67 $675.45 2026-04-02
27337 HCPCS Removal Of Growth Under Skin Of Thigh Or Knee, Less Than 3.0 Cm 44 22 $1,989.00 $1,989.00 $67.40 $1,929.33 $672.87 2026-04-02
12035 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 12.6-20.… 96 26 $708.00 $708.00 $196.77 $1,171.76 $672.60 2026-04-02
24650 HCPCS Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow 96 26 $703.00 $703.00 $106.18 $1,214.44 $667.85 2026-04-02
74455 HCPCS Review By Radiologist Of Urinary Bladder And Urethra Images With Contrast And Af… 52 26 $700.35 $700.35 $253.09 $679.34 $665.33 2026-04-02
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 52 26 $690.30 $690.30 $289.93 $2,651.54 $662.69 2026-04-02
31500 HCPCS Emergent Insertion Of Breathing Tube Into Windpipe Using An Endoscope 96 26 $750.00 $750.00 $121.04 $1,601.54 $659.10 2026-04-02
77001 HCPCS Fluoroscopic Guidance For Insertion Or Removal Of Central Vein Access Device 96 26 $1,982.00 $1,982.00 $16.61 $1,922.54 $659.10 2026-04-02
11642 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 1.1-… 96 26 $690.00 $690.00 $106.18 $904.14 $655.50 2026-04-02
11604 HCPCS Removal Of Cancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 96 26 $690.00 $690.00 $169.08 $2,628.25 $655.50 2026-04-02
10081 HCPCS Complicated Drainage Of Cyst Of Tailbone 96 26 $690.00 $690.00 $154.59 $2,425.17 $655.50 2026-04-02
11422 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 1.1-2… 96 26 $887.00 $887.00 $116.77 $2,628.25 $654.75 2026-04-02
10061 HCPCS Complicated Or Multiple Drainage Of Skin Abscess 96 26 $806.00 $806.00 $106.18 $781.82 $654.42 2026-04-02
12052 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 2.6-5… 96 26 $688.00 $688.00 $148.62 $872.03 $653.60 2026-04-02
76815 HCPCS Limited Ultrasound Of Pregnant Uterus 52 26 $684.00 $684.00 $211.94 $663.48 $649.80 2026-04-02
11641 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, 0.6-… 96 26 $680.00 $680.00 $106.18 $904.14 $646.00 2026-04-02
10140 HCPCS Drainage Of Blood Or Fluid Accumulation 96 26 $1,538.00 $1,538.00 $44.46 $2,425.17 $645.96 2026-04-02
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