Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

BLACK RIVER MEMORIAL HOSPITAL

Black River Falls, WI · CCN 521333 · Rates published

5,522 distinct procedures filed
27 distinct payers
813,032 rate rows
2026-01-08 last MRF observed
Data quality

607,804 of 813,032 rate rows are consumer-grade (74.8%)

205,228 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
professional (physician) fee — not the facility price 197,838
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 7,168
placeholder amount (≤ $0.02) — excluded from medians 66
exceeds 10× this hospital's gross charge — excluded from medians 64
template filing: same amount across many unrelated codes — excluded 52
per-diem day rate — not a per-procedure price 40
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://blackriverhealth.com/wp-content/uploads/2026/05/391027536_Black-River-Health-Inc_standardcharges.csv
Found on page https://www.blackriverhealth.com/cost-of-care
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-18
Content fingerprint 884972ed5bb6748f… · 128,830,261 bytes · first seen 2026-05-18

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
J2350
HCPCS 		Ocrelizumab 300 Mg/10 Ml Sol [brmh] 23 $63.29 $33,458.12 $31,565.54 nat. median
$712
outlier · 44.3×
64596
CPT 		64596 Ins/replc Eltrd Perf Nerv 1st Ra 23 $13,635.87 $26,469.63 $24,598.04 nat. median
$12,800
1.9× median
J3357
HCPCS 		Ustekinumab 45 Mg/0.5 Ml Sol [brmh] 23 $12,171.30 $33,729.62 $22,672.04 nat. median
$14,306
1.6× median
J2327
HCPCS 		Risankizumab Rzaa 60 mg/mL Sol [brmh] 23 $15.73 $18,484.15 $17,438.58 nat. median
$2,241
outlier · 7.8×
J9022
HCPCS 		Atezolizumab 1200 Mg/20 Ml Sol [brmh] 23 $96.48 $18,438.76 $17,395.76 nat. median
$6,951
outlier · 2.5×
J9043
HCPCS 		Cabazitaxel 60 Mg Sol [brmh] 23 $240.73 $17,058.17 $16,093.26 nat. median
$739
outlier · 21.8×
J9144
HCPCS 		Daratumumab-hyaluronidase 1800 Mg-30,000 Units/15 Ml Sol [brmh] 23 $57.95 $16,249.35 $15,330.19 nat. median
$233
outlier · 65.8×
J3380
HCPCS 		Vedolizumab 300 Mg Pow [brmh] 23 $23.39 $14,569.67 $13,745.52 nat. median
$288
outlier · 47.7×
787
MS_DRG 		Maternity C-section Days 1-4 1 $13,500.00 $13,500.00 $13,500.00 nat. median
$11,413
1.2× median
786
MS_DRG 		Maternity C-section Days 1-4 1 $13,500.00 $13,500.00 $13,500.00 nat. median
$15,316
0.9× median
785
MS_DRG 		Maternity C-section Days 1-4 1 $13,500.00 $13,500.00 $13,500.00 nat. median
$10,028
1.3× median
788
MS_DRG 		Maternity C-section Days 1-4 1 $13,500.00 $13,500.00 $13,500.00 nat. median
$10,164
1.3× median
784
MS_DRG 		Maternity C-section Days 1-4 1 $13,500.00 $13,500.00 $13,500.00 nat. median
$11,116
1.2× median
783
MS_DRG 		Maternity C-section Days 1-4 1 $13,500.00 $13,500.00 $13,500.00 nat. median
$19,235
0.7× median
28640440
LOCAL 		Proact Patient Pack With Implantable Devices 23 $7,446.00 $14,454.00 $13,432.00 nat. median
$13,432
1.0× median
J3101
HCPCS 		Tenecteplase 50 Mg Pow [brmh] 23 $182.25 $14,785.72 $12,995.33 nat. median
$5,949
outlier · 2.2×
J9223
HCPCS 		Lurbinectedin 4 Mg Pow [brmh] 23 $218.49 $13,614.48 $12,844.37 nat. median
$627
outlier · 20.5×
64555
CPT 		Implant Neurostim Perph Nerve Prq 23 $7,051.26 $13,687.74 $12,719.92 nat. median
$6,885
1.8× median
J9299
HCPCS 		Nivolumab 10 mg/mL Sol [brmh] 23 $34.98 $13,076.64 $12,336.95 nat. median
$2,947
outlier · 4.2×
J2506
HCPCS 		Neulasta Onpro Kit Pegfilgrastim 6 Mg/0.6 Ml Sol[BRMH] 23 $61.90 $19,061.44 $11,205.81 nat. median
$2,076
outlier · 5.4×
Q5120
HCPCS 		Pegfilgrastim Bmez 6 Mg/0.6 Ml Sol [brmh] 23 $29.67 $11,658.83 $10,999.34 nat. median
$362
outlier · 30.4×
J9306
HCPCS 		Pertuzumab 420 Mg/14 Ml Sol [brmh] 23 $17.91 $11,630.72 $10,972.82 nat. median
$87
outlier · 126.6×
26023752
LOCAL 		Kit, Esophyx Z+ Device 2 - 7.5mm Fasteners 23 $5,910.90 $11,474.10 $10,662.80 nat. median
$10,663
1.0× median
58575
CPT 		Laps Tot Hyst Resj Mal 23 $5,571.24 $10,814.76 $10,050.08 nat. median
$5,149
2.0× median
78816
CPT 		Pf PET Whole Body With CT Scan 23 $5,439.66 $10,559.34 $9,812.72 nat. median
$2,707
outlier · 3.6×
J9271
HCPCS 		Pembrolizumab 25 mg/mL Sol [brmh] 23 $62.08 $9,903.50 $9,343.30 nat. median
$736
outlier · 12.7×
J2427
HCPCS 		Paliperidone 410 Mg/1.32 Ml Sus [brmh] 23 $13.73 $15,866.99 $8,768.60 nat. median
$4,091
outlier · 2.1×
44144
CPT 		Partial Removal Of Colon 23 $4,817.46 $9,351.54 $8,690.32 nat. median
$3,063
outlier · 2.8×
J1569
HCPCS 		Immune Globulin Intravenous 10% Sol 30gm [brmh] 23 $50.66 $9,062.54 $8,549.91 nat. median
$1,048
outlier · 8.2×
807
MS_DRG 		Maternity Normal Delivery Days 1-4 1 $8,500.00 $8,500.00 $8,500.00 nat. median
$7,387
1.2× median
798
MS_DRG 		Maternity Normal Delivery Days 1-4 1 $8,500.00 $8,500.00 $8,500.00 nat. median
$9,580
0.9× median
768
MS_DRG 		Maternity Normal Delivery Days 1-4 1 $8,500.00 $8,500.00 $8,500.00 nat. median
$10,536
0.8× median
806
MS_DRG 		Maternity Normal Delivery Days 1-4 1 $8,500.00 $8,500.00 $8,500.00 nat. median
$8,000
1.1× median
805
MS_DRG 		Maternity Normal Delivery Days 1-4 1 $8,500.00 $8,500.00 $8,500.00 nat. median
$10,237
0.8× median
797
MS_DRG 		Maternity Normal Delivery Days 1-4 1 $8,500.00 $8,500.00 $8,500.00 nat. median
$9,827
0.9× median
796
MS_DRG 		Maternity Normal Delivery Days 1-4 1 $8,500.00 $8,500.00 $8,500.00 nat. median
$11,671
0.7× median
63650
CPT 		63650 Implant Neuroelectrodes 23 $4,604.28 $8,937.72 $8,305.76 nat. median
$7,241
1.1× median
49618
CPT 		Rpr Aa Hrn Rcr > 10 Ncr/strn 23 $4,587.96 $8,906.04 $8,276.32 nat. median
$4,575
1.8× median
J0717
HCPCS 		Certolizumab 200 Mg Kit [brmh] 23 $4.76 $8,581.32 $8,095.92 nat. median
$1,372
outlier · 5.9×
J2353
HCPCS 		Octreotide 20 Mg Pwd [brmh] 23 $224.93 $7,906.81 $7,459.55 nat. median
$5,975
1.2× median
49596
CPT 		Rpr Aa Hrn 1st > 10 Ncr/strn 23 $3,899.97 $7,570.53 $7,035.24 nat. median
$3,298
outlier · 2.1×
Q5111
HCPCS 		Pegfilgrastim Cbqv 6 Mg/0.6 Ml Sol [brmh] 23 $144.21 $7,439.85 $7,019.01 nat. median
$2,111
outlier · 3.3×
Q5108
HCPCS 		Pegfilgrastim Jmdb 6 Mg/0.6 Ml Sol [brmh] 23 $109.93 $7,439.85 $7,019.01 nat. median
$1,258
outlier · 5.6×
64625
CPT 		Rf Abltj Nrv Nrvtg Si Jt 23 $3,886.20 $7,543.80 $7,010.40 nat. median
$2,553
outlier · 2.7×
95811
CPT 		95811 Split Poly Study Charge 23 $3,586.32 $6,961.68 $6,539.76 nat. median
$2,026
outlier · 3.2×
J0565
HCPCS 		Bezlotoxumab 25 mg/mL Sol [brmh] 23 $42.21 $6,771.60 $6,388.56 nat. median
$144
outlier · 44.4×
28476794
LOCAL 		Balloon, Optilume 18fr X 5cm 23 $3,493.50 $6,781.50 $6,302.00 nat. median
$6,302
1.0× median
28348746
LOCAL 		Balloon, Optilume 30fr 5cm 23 $3,493.50 $6,781.50 $6,302.00 nat. median
$6,302
1.0× median
J9354
HCPCS 		Ado-trastuzumab Emtansine 100 Mg Pow [brmh] 23 $44.37 $6,668.37 $6,291.17 nat. median
$4,302
1.5× median
Q5112
HCPCS 		Trastuzumab Dttb 420 Mg Pow [brmh] 23 $23.30 $6,609.51 $6,235.64 nat. median
$63
outlier · 98.5×

Other procedures at this hospital

Browse this hospital's 5,522 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
             
J2350 HCPCS Ocrelizumab 300 Mg/10 Ml Sol [brmh] 76 23 $33,796.08 $30,416.47 $63.29 $33,458.12 $31,565.54 2026-01-08
64596 CPT 64596 Ins/replc Eltrd Perf Nerv 1st Ra 88 23 $26,737.00 $24,063.30 $13,635.87 $26,469.63 $24,598.04 2026-01-08
J3357 HCPCS Ustekinumab 45 Mg/0.5 Ml Sol [brmh] 88 23 $23,865.30 $21,478.77 $12,171.30 $33,729.62 $22,672.04 2026-01-08
J2327 HCPCS Risankizumab Rzaa 60 mg/mL Sol [brmh] 76 23 $18,670.86 $16,803.77 $15.73 $18,484.15 $17,438.58 2026-01-08
J9022 HCPCS Atezolizumab 1200 Mg/20 Ml Sol [brmh] 76 23 $18,625.01 $16,762.51 $96.48 $18,438.76 $17,395.76 2026-01-08
J9043 HCPCS Cabazitaxel 60 Mg Sol [brmh] 76 23 $17,230.48 $15,507.43 $240.73 $17,058.17 $16,093.26 2026-01-08
J9144 HCPCS Daratumumab-hyaluronidase 1800 Mg-30,000 Units/15 Ml Sol [brmh] 76 23 $16,413.48 $14,772.13 $57.95 $16,249.35 $15,330.19 2026-01-08
J3380 HCPCS Vedolizumab 300 Mg Pow [brmh] 76 23 $14,716.84 $13,245.15 $23.39 $14,569.67 $13,745.52 2026-01-08
785 MS_DRG Maternity C-section Days 1-4 2 1 — — $13,500.00 $13,500.00 $13,500.00 2026-01-08
786 MS_DRG Maternity C-section Days 1-4 2 1 — — $13,500.00 $13,500.00 $13,500.00 2026-01-08
784 MS_DRG Maternity C-section Days 1-4 2 1 — — $13,500.00 $13,500.00 $13,500.00 2026-01-08
787 MS_DRG Maternity C-section Days 1-4 2 1 — — $13,500.00 $13,500.00 $13,500.00 2026-01-08
783 MS_DRG Maternity C-section Days 1-4 2 1 — — $13,500.00 $13,500.00 $13,500.00 2026-01-08
788 MS_DRG Maternity C-section Days 1-4 2 1 — — $13,500.00 $13,500.00 $13,500.00 2026-01-08
28640440 LOCAL Proact Patient Pack With Implantable Devices 88 23 $14,600.00 $13,140.00 $7,446.00 $14,454.00 $13,432.00 2026-01-08
J3101 HCPCS Tenecteplase 50 Mg Pow [brmh] 150 23 $14,935.07 $13,441.56 $182.25 $14,785.72 $12,995.33 2026-01-08
J9223 HCPCS Lurbinectedin 4 Mg Pow [brmh] 76 23 $13,752.00 $12,376.80 $218.49 $13,614.48 $12,844.37 2026-01-08
64555 CPT Implant Neurostim Perph Nerve Prq 88 23 $13,826.00 $12,443.40 $7,051.26 $13,687.74 $12,719.92 2026-01-08
J9299 HCPCS Nivolumab 10 mg/mL Sol [brmh] 150 23 $13,208.72 $11,887.85 $34.98 $13,076.64 $12,336.95 2026-01-08
J2506 HCPCS Neulasta Onpro Kit Pegfilgrastim 6 Mg/0.6 Ml Sol[BRMH] 150 23 $19,253.97 $17,328.58 $61.90 $19,061.44 $11,205.81 2026-01-08
Q5120 HCPCS Pegfilgrastim Bmez 6 Mg/0.6 Ml Sol [brmh] 76 23 $11,776.60 $10,598.94 $29.67 $11,658.83 $10,999.34 2026-01-08
J9306 HCPCS Pertuzumab 420 Mg/14 Ml Sol [brmh] 76 23 $11,748.20 $10,573.38 $17.91 $11,630.72 $10,972.82 2026-01-08
26023752 LOCAL Kit, Esophyx Z+ Device 2 - 7.5mm Fasteners 88 23 $11,590.00 $10,431.00 $5,910.90 $11,474.10 $10,662.80 2026-01-08
58575 CPT Laps Tot Hyst Resj Mal 88 23 $10,924.00 $9,831.60 $5,571.24 $10,814.76 $10,050.08 2026-01-08
78816 CPT Pf PET Whole Body With CT Scan 88 23 $10,666.00 $9,599.40 $5,439.66 $10,559.34 $9,812.72 2026-01-08
J9271 HCPCS Pembrolizumab 25 mg/mL Sol [brmh] 76 23 $10,003.54 $9,003.18 $62.08 $9,903.50 $9,343.30 2026-01-08
J2427 HCPCS Paliperidone 410 Mg/1.32 Ml Sus [brmh] 224 23 $12,053.54 $10,848.18 $13.73 $15,866.99 $8,768.60 2026-01-08
44144 CPT Partial Removal Of Colon 88 23 $9,446.00 $8,501.40 $4,817.46 $9,351.54 $8,690.32 2026-01-08
J1569 HCPCS Immune Globulin Intravenous 10% Sol 30gm [brmh] 76 23 $9,154.08 $8,238.67 $50.66 $9,062.54 $8,549.91 2026-01-08
798 MS_DRG Maternity Normal Delivery Days 1-4 2 1 — — $8,500.00 $8,500.00 $8,500.00 2026-01-08
768 MS_DRG Maternity Normal Delivery Days 1-4 2 1 — — $8,500.00 $8,500.00 $8,500.00 2026-01-08
805 MS_DRG Maternity Normal Delivery Days 1-4 2 1 — — $8,500.00 $8,500.00 $8,500.00 2026-01-08
807 MS_DRG Maternity Normal Delivery Days 1-4 2 1 — — $8,500.00 $8,500.00 $8,500.00 2026-01-08
806 MS_DRG Maternity Normal Delivery Days 1-4 2 1 — — $8,500.00 $8,500.00 $8,500.00 2026-01-08
797 MS_DRG Maternity Normal Delivery Days 1-4 2 1 — — $8,500.00 $8,500.00 $8,500.00 2026-01-08
796 MS_DRG Maternity Normal Delivery Days 1-4 2 1 — — $8,500.00 $8,500.00 $8,500.00 2026-01-08
63650 CPT 63650 Implant Neuroelectrodes 88 23 $9,028.00 $8,125.20 $4,604.28 $8,937.72 $8,305.76 2026-01-08
49618 CPT Rpr Aa Hrn Rcr > 10 Ncr/strn 88 23 $8,996.00 $8,096.40 $4,587.96 $8,906.04 $8,276.32 2026-01-08
J0717 HCPCS Certolizumab 200 Mg Kit [brmh] 76 23 $8,668.01 $7,801.20 $4.76 $8,581.32 $8,095.92 2026-01-08
J2353 HCPCS Octreotide 20 Mg Pwd [brmh] 76 23 $7,986.68 $7,188.01 $224.93 $7,906.81 $7,459.55 2026-01-08
49596 CPT Rpr Aa Hrn 1st > 10 Ncr/strn 88 23 $7,647.00 $6,882.30 $3,899.97 $7,570.53 $7,035.24 2026-01-08
Q5108 HCPCS Pegfilgrastim Jmdb 6 Mg/0.6 Ml Sol [brmh] 76 23 $7,515.00 $6,763.50 $109.93 $7,439.85 $7,019.01 2026-01-08
Q5111 HCPCS Pegfilgrastim Cbqv 6 Mg/0.6 Ml Sol [brmh] 76 23 $7,515.00 $6,763.50 $144.21 $7,439.85 $7,019.01 2026-01-08
64625 CPT Rf Abltj Nrv Nrvtg Si Jt 88 23 $7,620.00 $6,858.00 $3,886.20 $7,543.80 $7,010.40 2026-01-08
95811 CPT 95811 Split Poly Study Charge 164 23 $7,032.00 $6,328.80 $3,586.32 $6,961.68 $6,539.76 2026-01-08
J0565 HCPCS Bezlotoxumab 25 mg/mL Sol [brmh] 76 23 $6,840.00 $6,156.00 $42.21 $6,771.60 $6,388.56 2026-01-08
28348746 LOCAL Balloon, Optilume 30fr 5cm 88 23 $6,850.00 $6,165.00 $3,493.50 $6,781.50 $6,302.00 2026-01-08
28476794 LOCAL Balloon, Optilume 18fr X 5cm 88 23 $6,850.00 $6,165.00 $3,493.50 $6,781.50 $6,302.00 2026-01-08
J9354 HCPCS Ado-trastuzumab Emtansine 100 Mg Pow [brmh] 76 23 $6,735.73 $6,062.15 $44.37 $6,668.37 $6,291.17 2026-01-08
Q5112 HCPCS Trastuzumab Dttb 420 Mg Pow [brmh] 76 23 $6,676.28 $6,008.65 $23.30 $6,609.51 $6,235.64 2026-01-08
49617 CPT Rpr Aa Hrn Rcr > 10 Rdc 88 23 $6,748.00 $6,073.20 $3,441.48 $6,680.52 $6,208.16 2026-01-08
44160 CPT Colectomy-partial Wremoval Term. Ileum 88 23 $6,707.00 $6,036.30 $3,420.57 $6,639.93 $6,170.44 2026-01-08
27827 CPT Treat Lower Leg Fracture 88 23 $6,528.00 $5,875.20 $3,329.28 $6,462.72 $6,005.76 2026-01-08
49616 CPT Rpr Aa Hrn Rcr 3-10 Ncr/strn 88 23 $6,522.00 $5,869.80 $3,326.22 $6,456.78 $6,000.24 2026-01-08
58573 CPT Tlh W/t/o Uterus Over 250 G 88 23 $6,516.00 $5,864.40 $3,323.16 $6,450.84 $5,994.72 2026-01-08
28348740 LOCAL Balloon 24 Fr 5cm 88 23 $6,510.00 $5,859.00 $3,320.10 $6,444.90 $5,989.20 2026-01-08
78815 CPT PET Skull Base To Midthigh With CT Scan 88 23 $6,471.00 $5,823.90 $3,300.21 $6,406.29 $5,953.32 2026-01-08
95810 CPT 95810 Polysomnography < 6 Hrs Charge 164 23 $6,357.00 $5,721.30 $3,242.07 $6,482.52 $5,948.06 2026-01-08
70543 CPT MRI Face Neck Orbit With + Without Cont 160 23 $6,155.00 $5,539.50 $2,857.04 $6,093.45 $5,736.46 2026-01-08
70553 CPT Pf MRI Brain With + Without Cont 86 23 $6,243.00 $5,618.70 $2,857.04 $6,180.57 $5,681.13 2026-01-08
J2182 HCPCS Mepolizumab 100 Mg Pow [brmh] 150 23 $5,960.97 $5,364.87 $33.21 $6,573.49 $5,662.92 2026-01-08
0171 RC Medicare Nursery Inpatient Per Diem Rate 18 6 — — $5,607.49 $5,607.49 $5,607.49 2026-01-08
0122 RC Medicare OB Inpatient Per Diem Rate 18 6 — — $5,607.49 $5,607.49 $5,607.49 2026-01-08
73720 CPT Pf MRI Femur With + Without Cont Lt 160 23 $5,900.00 $5,310.00 $2,857.04 $5,841.00 $5,498.80 2026-01-08
49595 CPT Rpr Aa Hrn 1st > 10 Rdc 88 23 $5,938.00 $5,344.20 $3,028.38 $5,878.62 $5,462.96 2026-01-08
70549 CPT MRA Neck With + Without Cont 86 23 $5,780.00 $5,202.00 $2,947.80 $5,722.20 $5,375.40 2026-01-08
0121 RC Medicare Med/Surg Inpatient Per Diem Rate 36 6 — — $4,949.04 $5,607.49 $5,278.26 2026-01-08
29059100 LOCAL Smart Kit, Rapidintro 2x8mmkit, Smart Ra 88 23 $5,700.00 $5,130.00 $2,907.00 $5,643.00 $5,244.00 2026-01-08
58572 CPT Lap. Hysterectomy For Uterus >250g 88 23 $5,678.00 $5,110.20 $2,895.78 $5,621.22 $5,223.76 2026-01-08
72157 CPT Pf MRI Spine Thoracic With + Without Cont 86 23 $5,708.00 $5,137.20 $2,857.04 $5,650.92 $5,194.28 2026-01-08
27823 CPT Treatment Of Ankle Fracture 88 23 $5,644.00 $5,079.60 $2,878.44 $5,587.56 $5,192.48 2026-01-08
73723 CPT MRI Ankle With + Without Cont Lt 160 23 $5,568.00 $5,011.20 $2,839.68 $5,512.32 $5,189.38 2026-01-08
28429657 LOCAL Dantrolene 250 Mg Pow [brmh] 88 23 $5,628.15 $5,065.34 $2,870.36 $5,571.87 $5,149.76 2026-01-08
73223 CPT MRI Elbow With + Without Cont Lt 160 23 $5,512.00 $4,960.80 $2,811.12 $5,456.88 $5,137.18 2026-01-08
72158 CPT Pf MRI Spine Lumbar With + Without Cont 86 23 $5,630.00 $5,067.00 $2,857.04 $5,573.70 $5,123.30 2026-01-08
72197 CPT MRI Pelvis With + Without Cont 86 23 $5,601.00 $5,040.90 $2,856.51 $5,544.99 $5,096.91 2026-01-08
72156 CPT Pf MRI Spine Cervical With + Without Cont 86 23 $5,585.00 $5,026.50 $2,848.35 $5,529.15 $5,082.35 2026-01-08
28705464 LOCAL Kit, Fracture Eliete 11g 10 Mm 88 23 $5,482.50 $4,934.25 $2,796.08 $5,427.68 $5,043.90 2026-01-08
28705462 LOCAL Kit, Fracture Elite 11g 15mm 88 23 $5,482.50 $4,934.25 $2,796.08 $5,427.68 $5,043.90 2026-01-08
44204 CPT Colectomy Partial Wanastomosis 88 23 $5,432.00 $4,888.80 $2,770.32 $5,377.68 $4,997.44 2026-01-08
70546 CPT MRA Head Venography With + Without Cont 160 23 $5,414.00 $4,872.60 $2,680.56 $5,359.86 $4,941.57 2026-01-08
26951 CPT Amp Finger With Dir Cl 86 23 $5,305.00 $4,774.50 $2,705.55 $5,251.95 $4,933.65 2026-01-08
74178 CPT CT Abdomen +Pelvis With + Without Cont- Report 86 23 $5,289.00 $4,760.10 $2,697.39 $5,236.11 $4,918.77 2026-01-08
44140 CPT Enteroenterostomy Anstomosis Of Intest. 88 23 $5,329.00 $4,796.10 $2,717.79 $5,275.71 $4,902.68 2026-01-08
44205 CPT Colectomy W Removal Terminal Ileum 88 23 $5,314.00 $4,782.60 $2,710.14 $5,260.86 $4,888.88 2026-01-08
28705470 LOCAL Kit, Fracture Omnicurve 11g X 15mm 88 23 $5,306.00 $4,775.40 $2,706.06 $5,252.94 $4,881.52 2026-01-08
28705468 LOCAL Kit, Fracture Omnicurve 11g X 20mm 88 23 $5,306.00 $4,775.40 $2,706.06 $5,252.94 $4,881.52 2026-01-08
28615 CPT Repair Foot Dislocation 88 23 $5,294.00 $4,764.60 $2,699.94 $5,241.06 $4,870.48 2026-01-08
J9177 HCPCS Enfortumab Vedotin Ejfv 20 Mg Pow [brmh] 150 23 $5,056.20 $4,550.58 $38.86 $7,508.46 $4,803.39 2026-01-08
74183 CPT MRI Abdomen With + Without Cont 86 23 $5,244.00 $4,719.60 $2,674.44 $5,191.56 $4,772.04 2026-01-08
81229 CPT Chromosomal Microarray (MicroarrayDX) 88 23 $5,166.00 $4,649.40 $540.00 $5,114.34 $4,752.72 2026-01-08
J0401 HCPCS ARIPiprazole 400 Mg Pwd [brmh] 76 23 $5,075.72 $4,568.14 $7.67 $5,024.96 $4,740.72 2026-01-08
27814 CPT Treatment Of Ankle Fracture 88 23 $5,124.00 $4,611.60 $2,613.24 $5,072.76 $4,714.08 2026-01-08
58180 CPT Supracervical Abdominal Hysterectomy 88 23 $5,090.00 $4,581.00 $2,595.90 $5,039.10 $4,682.80 2026-01-08
25665512 LOCAL Laser Fee (green Light) 88 23 $5,061.00 $4,554.90 $2,581.11 $5,010.39 $4,656.12 2026-01-08
72132 CPT Pf CT Spine Lumbar With Cont 86 23 $5,006.00 $4,505.40 $2,553.06 $4,955.94 $4,655.58 2026-01-08
26236 CPT Ed Partial Exc Bon Distal Phalanx Charge 86 23 $5,000.00 $4,500.00 $2,550.00 $4,950.00 $4,650.00 2026-01-08
49615 CPT Rpr Aa Hrn Rcr 3-10 Rdc 88 23 $5,038.00 $4,534.20 $2,569.38 $4,987.62 $4,634.96 2026-01-08
71552 CPT MRI Brachial Plexus With + Without Cont Lt 160 23 $4,957.00 $4,461.30 $2,528.07 $4,907.43 $4,619.93 2026-01-08
74174 CPT Pf CT Angio Abdomen Pelvis 86 23 $4,952.00 $4,456.80 $2,525.52 $4,902.48 $4,605.36 2026-01-08
72147 CPT Pf MRI Spine Thoracic With Cont 86 23 $5,026.00 $4,523.40 $2,563.26 $4,975.74 $4,573.66 2026-01-08
60220 CPT Partial Removal Of Thyroid 88 23 $4,969.00 $4,472.10 $2,534.19 $4,919.31 $4,571.48 2026-01-08
72142 CPT Pf MRI Spine Cervical With Cont 86 23 $5,019.00 $4,517.10 $2,559.69 $4,968.81 $4,567.29 2026-01-08
28740 CPT Arthrodesis Single Joint 88 23 $4,908.00 $4,417.20 $2,503.08 $4,858.92 $4,515.36 2026-01-08
22684247 LOCAL Colonic Stent System Wall 88 23 $4,900.00 $4,410.00 $2,499.00 $4,851.00 $4,508.00 2026-01-08
73222 CPT MRI Elbow With Cont Lt 308 23 $4,850.00 $4,365.00 $2,401.59 $4,801.50 $4,473.55 2026-01-08
J9358 HCPCS Fam-trastuzumab Deruxtecan 100 Mg Pow [brmh] 76 23 $4,768.00 $4,291.20 $31.80 $4,720.32 $4,453.31 2026-01-08
32550 CPT 32550 Insert Pleural Cath 86 23 $4,773.00 $4,295.70 $2,434.23 $4,725.27 $4,438.89 2026-01-08
27428058 LOCAL Lithotripsy Fee (eswl) 88 23 $4,819.00 $4,337.10 $2,457.69 $4,770.81 $4,433.48 2026-01-08
G0390 HCPCS G0390-811 Preactivation Trauma Response 236 23 $5,061.00 $4,554.90 $2,317.95 $5,160.87 $4,408.65 2026-01-08
J0177 HCPCS Aflibercept Ophthalmic Hd 114.3 mg/mL Sol [brmh] 88 23 $4,725.00 $4,252.50 $338.92 $4,677.75 $4,323.38 2026-01-08
22685058 LOCAL S9 Vpap Auto Adapt 88 23 $4,689.00 $4,220.10 $2,391.39 $4,642.11 $4,313.88 2026-01-08
70542 CPT MRI Face Neck Orbit With Cont 86 23 $4,723.00 $4,250.70 $2,408.73 $4,675.77 $4,297.93 2026-01-08
70552 CPT Pf MRI Brain With Cont 160 23 $4,589.00 $4,130.10 $2,340.39 $4,543.11 $4,276.95 2026-01-08
70548 CPT MRA Neck With Cont 86 23 $4,595.00 $4,135.50 $2,343.45 $4,549.05 $4,273.35 2026-01-08
70545 CPT MRA Head Venography With Cont 86 23 $4,595.00 $4,135.50 $2,343.45 $4,549.05 $4,273.35 2026-01-08
78452 CPT Pf Nm Myocard Perf Spect Mult Rest+Stress 88 23 $4,639.00 $4,175.10 $2,365.89 $4,592.61 $4,267.88 2026-01-08
27654 CPT Repair Of Achilles Tendon 88 23 $4,625.00 $4,162.50 $2,358.75 $4,578.75 $4,255.00 2026-01-08
29897 CPT Ankle Arthroscopy Surgery 88 23 $4,600.00 $4,140.00 $2,346.00 $4,554.00 $4,232.00 2026-01-08
73225 CPT Pf MRA Elbow With Cont Lt 160 23 $4,540.00 $4,086.00 $2,315.40 $4,494.60 $4,231.28 2026-01-08
73725 CPT MRA Ankle With Cont Lt 160 23 $4,540.00 $4,086.00 $2,315.40 $4,494.60 $4,231.28 2026-01-08
J9317 HCPCS Sacituzumab Govitecan Hziy 180 Mg Pow [brmh] 76 23 $4,523.83 $4,071.45 $38.43 $4,478.59 $4,225.26 2026-01-08
52310 CPT Cystoscopy And Treatment 88 23 $4,565.00 $4,108.50 $2,328.15 $4,519.35 $4,199.80 2026-01-08
74175 CPT CT Angio Abdomen With + Without Cont 86 23 $4,496.00 $4,046.40 $2,292.96 $4,451.04 $4,181.28 2026-01-08
72126 CPT Pf CT Spine Cervical With Cont 86 23 $4,494.00 $4,044.60 $2,291.94 $4,449.06 $4,179.42 2026-01-08
J9034 HCPCS Bendamustine 25 mg/mL Sol [brmh] 76 23 $4,452.84 $4,007.56 $13.91 $4,408.31 $4,158.95 2026-01-08
49614 CPT Rpr Aa Hrn Rcr < 3 Ncr/strn 88 23 $4,498.00 $4,048.20 $2,293.98 $4,453.02 $4,138.16 2026-01-08
49521 CPT Repair Rec. Ing. Hernia Incarcerated 88 23 $4,498.00 $4,048.20 $2,293.98 $4,453.02 $4,138.16 2026-01-08
74185 CPT MRA Abdomen With + Without Cont 86 23 $4,426.00 $3,983.40 $2,257.26 $4,381.74 $4,116.18 2026-01-08
27610 CPT Explore/treat Ankle Joint 88 23 $4,456.00 $4,010.40 $2,272.56 $4,411.44 $4,099.52 2026-01-08
45172 CPT Exc Rect Tum Transanal Full 88 23 $4,456.00 $4,010.40 $2,272.56 $4,411.44 $4,099.52 2026-01-08
59151 CPT Lap Trt Of Ectopic Preg Wsalpoophorec 88 23 $4,430.00 $3,987.00 $2,259.30 $4,385.70 $4,075.60 2026-01-08
71551 CPT MRI Brachial Plexus With Cont Lt 234 23 $4,363.00 $3,926.70 $2,225.13 $4,319.37 $4,075.04 2026-01-08
15273 CPT 15273 App Skin Sub Legs 1st 100sq Cm Charge 88 23 $4,422.00 $3,979.80 $2,255.22 $4,377.78 $4,068.24 2026-01-08
22684162 LOCAL Bioflo Picc 5fr Dual Lumen 88 23 $4,410.00 $3,969.00 $2,249.10 $4,365.90 $4,057.20 2026-01-08
28666083 LOCAL Room/bed: ICU Room And Board 54 21 $4,262.00 $3,835.80 $2,599.82 $4,219.38 $4,048.90 2026-01-08
75635 CPT CT Angio Abdomen Aorta +Iliofemoral 86 23 $4,424.00 $3,981.60 $1,068.12 $4,379.76 $4,025.84 2026-01-08
71550 CPT Pf MRI Brachial Plexus Without Cont Lt 234 23 $4,306.00 $3,875.40 $1,933.76 $4,390.65 $4,021.80 2026-01-08
10180 CPT 10180 Complex Drainage Wound 88 23 $4,314.00 $3,882.60 $2,200.14 $4,270.86 $3,968.88 2026-01-08
25653083 LOCAL Lithotripsy Fee (eswl) 88 23 $4,307.00 $3,876.30 $2,196.57 $4,263.93 $3,962.44 2026-01-08
74177 CPT CT Angio Chest PE+Abdomen+Pelvis w/Cont ProFee 160 23 $4,264.00 $3,837.60 $2,111.40 $4,221.36 $3,918.51 2026-01-08
44180 CPT Laparoscopy Surgical Enterolysis 88 23 $4,251.00 $3,825.90 $2,168.01 $4,208.49 $3,910.92 2026-01-08
73221 CPT Pf MRI Elbow Without Cont Lt 160 23 $4,195.00 $3,775.50 $1,933.76 $4,153.05 $3,909.74 2026-01-08
64636 CPT 64636 Destroy L/s Facet Jnt Addl 88 23 $4,245.00 $3,820.50 $2,164.95 $4,202.55 $3,905.40 2026-01-08
44120 CPT Enterectomy Resection Small Intestine 88 23 $4,233.00 $3,809.70 $2,158.83 $4,190.67 $3,894.36 2026-01-08
28348744 LOCAL Balloon, Optilume 24fr 3cm 88 23 $4,190.00 $3,771.00 $2,136.90 $4,148.10 $3,854.80 2026-01-08
28348742 LOCAL Balloon, Optilume 30fr 3 Cm 88 23 $4,190.00 $3,771.00 $2,136.90 $4,148.10 $3,854.80 2026-01-08
73721 CPT Pf MRI Ankle Without Cont Lt 160 23 $4,128.00 $3,715.20 $1,933.76 $4,086.72 $3,847.30 2026-01-08
70488 CPT Pf CT Maxillofacial With + Without Cont 86 23 $4,216.00 $3,794.40 $2,150.16 $4,173.84 $3,836.56 2026-01-08
0611 RC MRI 2 1 — — $3,800.00 $3,800.00 $3,800.00 2026-01-08
0616 RC MRI 2 1 — — $3,800.00 $3,800.00 $3,800.00 2026-01-08
0619 RC MRI 2 1 — — $3,800.00 $3,800.00 $3,800.00 2026-01-08
0612 RC MRI 2 1 — — $3,800.00 $3,800.00 $3,800.00 2026-01-08
0614 RC MRI 2 1 — — $3,800.00 $3,800.00 $3,800.00 2026-01-08
0615 RC MRI 2 1 — — $3,800.00 $3,800.00 $3,800.00 2026-01-08
0610 RC MRI 2 1 — — $3,800.00 $3,800.00 $3,800.00 2026-01-08
0618 RC MRI 2 1 — — $3,800.00 $3,800.00 $3,800.00 2026-01-08
70544 CPT MRA Head Venography Without Cont 86 23 $4,044.00 $3,639.60 $2,062.44 $4,003.56 $3,760.92 2026-01-08
27266 CPT Cl Tx Hip Dis With Gen Anes 86 23 $4,043.00 $3,638.70 $2,061.93 $4,002.57 $3,759.99 2026-01-08
58552 CPT Laparo-vag Hyst Incl T/o 88 23 $4,083.00 $3,674.70 $2,082.33 $4,042.17 $3,756.36 2026-01-08
49553 CPT Rpr Fem Hernia Init Blocked 88 23 $4,083.00 $3,674.70 $2,082.33 $4,042.17 $3,756.36 2026-01-08
C1771 HCPCS Kit, Solyx Sis System 88 23 $4,071.50 $3,664.35 $2,076.47 $4,030.79 $3,745.78 2026-01-08
28715 CPT Arthrodesis; Triple 88 23 $4,059.00 $3,653.10 $2,070.09 $4,018.41 $3,734.28 2026-01-08
J1306 HCPCS Inclisiran 284 Mg/1.5 Ml Sol [brmh] 76 23 $3,998.10 $3,598.29 $13.09 $3,958.12 $3,734.23 2026-01-08
28750 CPT Fusion Of Big Toe Joint 88 23 $4,043.00 $3,638.70 $2,061.93 $4,002.57 $3,719.56 2026-01-08
26765 CPT Open Tx Dist Phalang Fx 86 23 $3,999.00 $3,599.10 $2,039.49 $3,959.01 $3,719.07 2026-01-08
62321 CPT 62321 Njx Interlaminar Crv/thrc 88 23 $4,012.00 $3,610.80 $2,046.12 $3,971.88 $3,691.04 2026-01-08
62323 CPT 62323 Njx Interlaminar Lmbr/sac 88 23 $4,012.00 $3,610.80 $2,046.12 $3,971.88 $3,691.04 2026-01-08
27301 CPT 27301-id Thigh/Knee Abscess/Bursa/Hematoma 160 23 $4,035.00 $3,631.50 $1,997.67 $3,994.65 $3,682.79 2026-01-08
11646 CPT Excision,Malignant Lesion,f,e,e Or Nose Over 4.0 Cm 88 23 $4,000.00 $3,600.00 $2,040.00 $3,960.00 $3,680.00 2026-01-08
64493 CPT 64493 Inj Paravert F Jnt L/s 1 Lev 88 23 $3,987.00 $3,588.30 $2,033.37 $3,947.13 $3,668.04 2026-01-08
73722 CPT MRI Ankle With Cont Lt 456 23 $3,913.00 $3,521.70 $1,937.49 $4,875.75 $3,654.74 2026-01-08
70551 CPT MRI Brain Stem Without Contrast 232 23 $3,877.00 $3,489.30 $1,933.76 $3,953.07 $3,627.38 2026-01-08
64635 CPT 64635 Destroy Lumb/sac Facet Jnt 164 23 $3,797.00 $3,417.30 $1,936.47 $6,357.78 $3,626.14 2026-01-08
28298 CPT Correction Of Bunion 88 23 $3,929.00 $3,536.10 $2,003.79 $3,889.71 $3,614.68 2026-01-08
25082355 LOCAL Sling Mini Arc Pro 88 23 $3,924.00 $3,531.60 $2,001.24 $3,884.76 $3,610.08 2026-01-08
27650 CPT Repair Ruptured Achilles Tendon 88 23 $3,921.00 $3,528.90 $1,999.71 $3,881.79 $3,607.32 2026-01-08
72146 CPT Pf MRI Spine Thoracic Without Cont 86 23 $3,962.00 $3,565.80 $1,933.76 $3,922.38 $3,605.42 2026-01-08
70482 CPT Pf CT Orbit Sella Etc. Or Iac With + Without Cont 86 23 $3,942.00 $3,547.80 $2,010.42 $3,902.58 $3,587.22 2026-01-08
73220 CPT Pf MRI Clavicle With + Without Cont Lt 304 23 $3,783.00 $3,404.70 $1,929.33 $3,857.04 $3,580.61 2026-01-08
72198 CPT Brmh MRA Pelvis 160 23 $3,840.00 $3,456.00 $1,958.40 $3,801.60 $3,578.88 2026-01-08
28297 CPT Lapidus-type Procedure 88 23 $3,874.00 $3,486.60 $1,975.74 $3,835.26 $3,564.08 2026-01-08
70540 CPT Pf MRI Face Neck Orbit Without Cont 86 23 $3,912.00 $3,520.80 $1,933.76 $3,872.88 $3,559.92 2026-01-08
20102 CPT Pen Trauma W/fb Removal 86 23 $3,804.00 $3,423.60 $1,940.04 $3,765.96 $3,537.72 2026-01-08
46040 CPT Id Perirectal Abscess 86 23 $3,777.00 $3,399.30 $1,926.27 $3,739.23 $3,512.61 2026-01-08
57280 CPT Colopexy Abdominal Approach 88 23 $3,806.00 $3,425.40 $1,941.06 $3,767.94 $3,501.52 2026-01-08
19307 CPT Mastectomy Modified Radical 88 23 $3,805.00 $3,424.50 $1,940.55 $3,766.95 $3,500.60 2026-01-08
28296 CPT Bunion. W Metat. Osteotomy 88 23 $3,801.00 $3,420.90 $1,938.51 $3,762.99 $3,496.92 2026-01-08
58660 CPT Laparoscopy W Lysis Of Adhesions 88 23 $3,799.00 $3,419.10 $1,937.49 $3,761.01 $3,495.08 2026-01-08
22682989 LOCAL Reload Endo Gia 45-3.5 88 23 $3,793.00 $3,413.70 $1,934.43 $3,755.07 $3,489.56 2026-01-08
72148 CPT Pf MRI Spine Lumbar Without Cont 86 23 $3,831.00 $3,447.90 $1,933.76 $3,792.69 $3,486.21 2026-01-08
95805 CPT 95805 Multi Sleep Latency Testing Charge 88 23 $3,787.00 $3,408.30 $1,931.37 $3,749.13 $3,484.04 2026-01-08
28879118 LOCAL Speedbridge Implant System 4.75 X 19.1 88 23 $3,772.50 $3,395.25 $1,923.98 $3,734.78 $3,470.70 2026-01-08
74170 CPT CT Chest +Abdomen With + Without Cont 86 23 $3,730.00 $3,357.00 $1,902.30 $3,692.70 $3,468.90 2026-01-08
74182 CPT MRI Abdomen With Cont 86 23 $3,789.00 $3,410.10 $1,932.39 $3,751.11 $3,447.99 2026-01-08
75572 CPT Pf CT Angio Cardiac Non-congenital 86 23 $3,707.00 $3,336.30 $1,890.57 $3,669.93 $3,447.51 2026-01-08
75573 CPT Pf CT Angio Cardiac Congenital 86 23 $3,707.00 $3,336.30 $1,890.57 $3,669.93 $3,447.51 2026-01-08
73202 CPT CT Wrist With + Without Cont Lt 160 23 $3,627.00 $3,264.30 $1,849.77 $3,698.64 $3,432.95 2026-01-08
74181 CPT Pf MRI Abdomen Without Cont 86 23 $3,732.00 $3,358.80 $1,903.32 $3,694.68 $3,396.12 2026-01-08
64520 CPT 64520 N Block Lumbar/thoracic 88 23 $3,690.00 $3,321.00 $1,881.90 $3,653.10 $3,394.80 2026-01-08
Q5114 HCPCS Trastuzumab Dkst 420 Mg Pow [brmh] 224 23 $4,725.09 $4,252.58 $47.27 $6,588.51 $3,394.08 2026-01-08
73218 CPT MRI Clavicle Without Cont Lt 304 23 $3,578.00 $3,220.20 $1,824.78 $3,648.15 $3,386.57 2026-01-08
45378 CPT 45378 Colonoscopy Flex:dx-sep Prpc. 88 23 $3,738.00 $3,364.20 $1,823.42 $3,700.62 $3,382.89 2026-01-08
72195 CPT MRI Pelvis Without Cont 86 23 $3,705.00 $3,334.50 $1,889.55 $3,667.95 $3,371.55 2026-01-08
60210 CPT Partial Thyroid Lobectomy 88 23 $3,663.00 $3,296.70 $1,868.13 $3,626.37 $3,369.96 2026-01-08
93268 CPT Event Recording 88 23 $3,661.00 $3,294.90 $1,867.11 $3,624.39 $3,368.12 2026-01-08
73719 CPT MRI Femur With Cont Lt 160 23 $3,602.00 $3,241.80 $1,837.02 $3,565.98 $3,357.07 2026-01-08
71275 CPT Brmh CT Angio Chest Pe 86 23 $3,595.00 $3,235.50 $1,833.45 $3,559.05 $3,343.35 2026-01-08
72141 CPT Pf MRI Spine Cervical Without Cont 86 23 $3,673.00 $3,305.70 $1,873.23 $3,636.27 $3,342.43 2026-01-08
J7298 HCPCS Levonorgestrel 52 Mg Dev [brmh] 88 23 $3,643.90 $3,279.51 $1,545.01 $3,607.46 $3,334.17 2026-01-08
J7296 HCPCS Levonorgestrel 19.5 Mg Dev Implant [brmh] 88 23 $3,643.89 $3,279.50 $1,545.01 $3,607.45 $3,334.16 2026-01-08
24589316 LOCAL Electrode, Long 15cm Rfe15 88 23 $3,590.00 $3,231.00 $1,830.90 $3,554.10 $3,302.80 2026-01-08
24589314 LOCAL Electrode, Short 10cm Rfe10 88 23 $3,590.00 $3,231.00 $1,830.90 $3,554.10 $3,302.80 2026-01-08
52000 CPT Cystoscopy 88 23 $3,549.00 $3,194.10 $1,809.99 $3,513.51 $3,265.08 2026-01-08
70547 CPT MRA Neck Without Cont 86 23 $3,508.00 $3,157.20 $1,789.08 $3,472.92 $3,262.44 2026-01-08
73219 CPT MRI Clavicle With Cont Lt 160 23 $3,498.00 $3,148.20 $1,783.98 $3,463.02 $3,260.14 2026-01-08
J3358 HCPCS Ustekinumab 5 mg/mL Sol [brmh] 76 23 $3,470.58 $3,123.52 $14.09 $3,435.87 $3,241.52 2026-01-08
78472 CPT Pf Nm Cardiac Blood Pool Gated Spect 88 23 $3,512.00 $3,160.80 $1,791.12 $3,476.88 $3,231.04 2026-01-08
49613 CPT Rpr Aa Hrn Rcr < 3 Rdc 88 23 $3,508.00 $3,157.20 $1,789.08 $3,472.92 $3,227.36 2026-01-08
19302 CPT Mastectomy Par. Axillary Lymph. 88 23 $3,504.00 $3,153.60 $1,787.04 $3,468.96 $3,223.68 2026-01-08
0351 RC CT Scan 2 1 — — $3,200.00 $3,200.00 $3,200.00 2026-01-08
0352 RC CT Scan 2 1 — — $3,200.00 $3,200.00 $3,200.00 2026-01-08
0359 RC CT Scan 2 1 — — $3,200.00 $3,200.00 $3,200.00 2026-01-08
0350 RC CT Scan 2 1 — — $3,200.00 $3,200.00 $3,200.00 2026-01-08
78814 CPT PET Ltd Area With CT Scan 88 23 $3,466.00 $3,119.40 $1,767.66 $3,431.34 $3,188.72 2026-01-08
25082357 LOCAL Sling, Miniarc Precise 88 23 $3,446.00 $3,101.40 $1,757.46 $3,411.54 $3,170.32 2026-01-08
15271 CPT 15271 Skin Sub Graft Trnk/arm/leg 88 23 $3,442.00 $3,097.80 $1,755.42 $3,407.58 $3,166.64 2026-01-08
64633 CPT Destroy Cerv/thor Facet Jnt 164 23 $3,365.00 $3,028.50 $1,716.15 $3,431.34 $3,148.48 2026-01-08
72196 CPT Pf MRI Pelvis With Cont 86 23 $3,456.00 $3,110.40 $1,762.56 $3,421.44 $3,144.96 2026-01-08
19020 CPT Mastotomy Wexploration 86 23 $3,348.00 $3,013.20 $1,707.48 $3,314.52 $3,113.64 2026-01-08
70496 CPT CT Angio Head + Neck With 86 23 $3,314.00 $2,982.60 $1,690.14 $3,280.86 $3,082.02 2026-01-08
70498 CPT Brmh CT Angio Neck 86 23 $3,299.00 $2,969.10 $1,682.49 $3,266.01 $3,068.07 2026-01-08
J0178 HCPCS Aflibercept Ophthalmic 40 mg/mL Sol [brmh] 88 23 $3,330.00 $2,997.00 $837.44 $3,296.70 $3,046.95 2026-01-08
55120 CPT 55120-scrotum 86 23 $3,262.00 $2,935.80 $1,663.62 $3,229.38 $3,033.66 2026-01-08
73718 CPT MRI Femur Without Cont Lt 304 23 $4,149.00 $3,734.10 $1,503.48 $4,107.51 $3,020.64 2026-01-08
64421 CPT Injection(s), Anesthetic Agent(s) And/or Steroid; Intercosta 88 23 $3,264.00 $2,937.60 $1,664.64 $3,231.36 $3,002.88 2026-01-08
J1459 HCPCS Immune Globulin Intravenous 10% Sol 5gm [brmh] 298 23 $3,014.46 $2,713.01 $53.46 $11,937.26 $2,984.32 2026-01-08
70492 CPT Pf CT Neck Soft Tissue With + Without Cont 86 23 $3,199.00 $2,879.10 $1,631.49 $3,167.01 $2,975.07 2026-01-08
27842 CPT Treat Ankle Dislocation 88 23 $3,230.00 $2,907.00 $1,647.30 $3,197.70 $2,971.60 2026-01-08
20999 CPT Musculoskeletal Surgery 88 23 $3,226.00 $2,903.40 $1,645.26 $3,193.74 $2,967.92 2026-01-08
21320 CPT 21320-nasal Bone With Stabilization 86 23 $3,161.00 $2,844.90 $1,612.11 $3,129.39 $2,939.73 2026-01-08
Q5157 HCPCS Denosumab Bmwo 60 mg/mL Sol Prefilled Syr 1mL [brmh] 88 23 $3,206.99 $2,886.29 $1,635.56 $3,174.92 $2,934.39 2026-01-08
64620 CPT 64620 Intercostal Neurolysis Charge 88 23 $3,183.00 $2,864.70 $1,623.33 $3,151.17 $2,928.36 2026-01-08
64999 CPT 64999 Miscellaneous Procedure 88 23 $3,183.00 $2,864.70 $1,623.33 $3,151.17 $2,928.36 2026-01-08
49002 CPT Reopening Recent Laparotomy 88 23 $3,183.00 $2,864.70 $1,623.33 $3,151.17 $2,928.36 2026-01-08
74160 CPT CT Abdomen With Contrast 86 23 $3,148.00 $2,833.20 $1,605.48 $3,116.52 $2,927.64 2026-01-08
72149 CPT Pf MRI Spine Lumbar With Cont 86 23 $3,215.00 $2,893.50 $1,639.65 $3,182.85 $2,925.65 2026-01-08
64417 CPT Injection(s), Anesthetic Agent(s) And/or Steroid; Axillary N 88 23 $3,169.00 $2,852.10 $1,616.19 $3,137.31 $2,915.48 2026-01-08
64530 CPT Injection, Anesthetic Agent; Celiac Plexus, With Or Without 88 23 $3,169.00 $2,852.10 $1,616.19 $3,137.31 $2,915.48 2026-01-08
64510 CPT Injection, Anesthetic Agent; Stellate Ganglion (cervical Sym 88 23 $3,169.00 $2,852.10 $1,616.19 $3,137.31 $2,915.48 2026-01-08
64517 CPT Injection, Anesthetic Agent; Superior Hypogastric Plexus 88 23 $3,169.00 $2,852.10 $1,616.19 $3,137.31 $2,915.48 2026-01-08
J0875 HCPCS Dalbavancin 500 Mg Pow [brmh] 76 23 $3,109.16 $2,798.24 $16.48 $3,078.07 $2,903.95 2026-01-08
70336 CPT Pf MRI Tmj 86 23 $3,189.00 $2,870.10 $1,450.32 $3,157.11 $2,901.99 2026-01-08
64479 CPT 64479 Inj Foramen Epidural C/t 164 23 $3,041.00 $2,736.90 $1,550.91 $3,236.31 $2,882.84 2026-01-08
27695241 LOCAL Sling, Lynx 88 23 $3,123.00 $2,810.70 $1,592.73 $3,091.77 $2,873.16 2026-01-08
78320 CPT Nm Bone Spect 88 23 $3,120.00 $2,808.00 $1,591.20 $3,088.80 $2,870.40 2026-01-08
74176 CPT Pf CT Abdomen + Pelvis Without Contrast 160 23 $3,112.00 $2,800.80 $1,540.71 $3,080.88 $2,859.38 2026-01-08
25348162 LOCAL Novasure 88 23 $3,103.50 $2,793.15 $1,582.79 $3,072.47 $2,855.23 2026-01-08
59612 CPT Vaginal Delivery After Cesarean Delivery 88 23 $3,098.00 $2,788.20 $1,579.98 $3,067.02 $2,850.16 2026-01-08
22903 CPT 22903 Exc Abd Les Sc 3cm/> 88 23 $3,090.00 $2,781.00 $1,575.90 $3,059.10 $2,842.80 2026-01-08
J0897 HCPCS Denosumab 60 mg/mL Sol [brmh] 224 23 $3,375.77 $3,038.20 $30.99 $5,325.04 $2,836.45 2026-01-08
95913 CPT Nerve Cndj Tst 13/> Study 88 23 $3,078.00 $2,770.20 $1,569.78 $3,047.22 $2,831.76 2026-01-08
L3978 HCPCS Coaptation Splint 88 23 $3,066.00 $2,759.40 $1,433.96 $3,035.34 $2,820.72 2026-01-08
64486 CPT 64486 Tap Block Unil By Injection(s) 88 23 $3,060.00 $2,754.00 $1,560.60 $3,029.40 $2,815.20 2026-01-08
72193 CPT Pf CT Pelvis With Cont 86 23 $3,016.00 $2,714.40 $1,538.16 $2,985.84 $2,804.88 2026-01-08
71270 CPT CT Chest With + Without Cont- Report 160 23 $2,940.00 $2,646.00 $1,499.40 $4,257.99 $2,793.00 2026-01-08
64483 CPT 64483 Inj Foramen Epidural L/s 88 23 $3,028.00 $2,725.20 $1,544.28 $2,997.72 $2,785.76 2026-01-08
15277 CPT 15277 App Skin Sub Feet 1st 100sq Cm Charge 88 23 $3,016.00 $2,714.40 $1,538.16 $2,985.84 $2,774.72 2026-01-08
72194 CPT Pf CT Pelvis With + Without Cont 86 23 $2,982.00 $2,683.80 $1,520.82 $2,952.18 $2,773.26 2026-01-08
J7165 HCPCS Prothrombin Complex Lans Pow 500 Iu Vial [brmh] 164 23 $2,835.00 $2,551.50 $1,445.85 $5,613.30 $2,749.95 2026-01-08
75574 CPT Pf CT Angio Heart +Coronary Arteries 86 23 $2,950.00 $2,655.00 $1,504.50 $2,920.50 $2,743.50 2026-01-08
J9303 HCPCS Panitumumab 20 mg/mL Sol [brmh] 162 23 $2,825.03 $2,542.53 $182.90 $11,746.43 $2,740.28 2026-01-08
31525 CPT Laryngoscopy,direct 86 23 $2,942.00 $2,647.80 $1,500.42 $2,912.58 $2,736.06 2026-01-08
73201 CPT Pf CT Elbow With Cont Lt 308 23 $2,942.00 $2,647.80 $1,456.56 $2,912.58 $2,713.20 2026-01-08
99291 CPT 99291 - Critical Care 240 23 $3,025.00 $2,722.50 $1,419.84 $8,900.00 $2,700.48 2026-01-08
28350160 LOCAL Room/bed: Semi-private Bariatric Acute R andB With Tele 54 21 $2,841.00 $2,556.90 $1,733.01 $2,812.59 $2,698.95 2026-01-08
J9264 HCPCS PACLitaxel Protein-bound 100 Mg Pow [Vial][BRMH] 76 23 $2,880.00 $2,592.00 $12.85 $2,851.20 $2,689.92 2026-01-08
70470 CPT Pf CT Head Or Brain With + Without Cont 86 23 $2,881.00 $2,592.90 $1,469.31 $2,852.19 $2,679.33 2026-01-08
J2315 HCPCS Naltrexone 380 Mg Pwd [brmh] 76 23 $2,862.39 $2,576.15 $4.49 $2,833.77 $2,673.47 2026-01-08
45171 CPT Exc Rect Tum Transanal Part 88 23 $2,896.00 $2,606.40 $1,476.96 $2,867.04 $2,664.32 2026-01-08
27659 CPT Repair Of Leg Tendon Each 88 23 $2,886.00 $2,597.40 $1,471.86 $2,857.14 $2,655.12 2026-01-08
88377 CPT M/phmtrc Alys Ishquant/semiq 92 23 $2,924.00 $2,631.60 $26.78 $2,894.76 $2,646.22 2026-01-08
15950 CPT Remove Thigh Pressure Sore 88 23 $2,869.00 $2,582.10 $1,463.19 $2,840.31 $2,639.48 2026-01-08
27810 CPT Reduct Tib/fib Fx W/manip 86 23 $2,812.00 $2,530.80 $1,434.12 $2,783.88 $2,615.16 2026-01-08
21554 CPT Exc. Tumor Neckanterior Thorax 5cm> 88 23 $2,834.00 $2,550.60 $1,445.34 $2,805.66 $2,607.28 2026-01-08
J7168 HCPCS Prothrombin Complex - Pow 500 Unit Vial [brmh] 164 23 $2,685.00 $2,416.50 $1,369.35 $5,316.30 $2,604.45 2026-01-08
26849327 LOCAL Kit, Cooled Radiofrequency 17x50mmx4mm 88 23 $2,822.00 $2,539.80 $1,439.22 $2,793.78 $2,596.24 2026-01-08
25399278 LOCAL Myo Sure Reach 88 23 $2,821.50 $2,539.35 $1,438.97 $2,793.29 $2,595.78 2026-01-08
73701 CPT Pf CT Ankle With Cont Lt 160 23 $2,768.00 $2,491.20 $1,411.68 $2,740.32 $2,585.31 2026-01-08
27711179 LOCAL Mesh, 11x14 Hernia 88 23 $2,801.00 $2,520.90 $1,428.51 $2,772.99 $2,576.92 2026-01-08
22685141 LOCAL Toe Implant, #2s Swanson 88 23 $2,800.00 $2,520.00 $1,428.00 $2,772.00 $2,576.00 2026-01-08
J9055 HCPCS Cetuximab 2 mg/mL 200 Mg Vial [brmh] 76 23 $2,755.29 $2,479.76 $83.18 $2,727.74 $2,573.44 2026-01-08
27658 CPT Repair Of Leg Tendon Each 88 23 $2,789.00 $2,510.10 $1,422.39 $2,761.11 $2,565.88 2026-01-08
49419 CPT Insert Tun Ip Cath W/port 88 23 $2,781.00 $2,502.90 $1,418.31 $2,753.19 $2,558.52 2026-01-08
24287428 LOCAL Level 5 Baby Charge 52 20 $2,686.00 $2,417.40 $1,638.46 $2,659.14 $2,551.70 2026-01-08
24287429 LOCAL Level 6 Baby Charge 52 20 $2,686.00 $2,417.40 $1,638.46 $2,659.14 $2,551.70 2026-01-08
46260 CPT Hemorrhoidectomy Complex Or Extensive 88 23 $2,762.00 $2,485.80 $1,408.62 $2,734.38 $2,541.04 2026-01-08
28119 CPT Ostectomy For Spur 88 23 $2,759.00 $2,483.10 $1,407.09 $2,731.41 $2,538.28 2026-01-08
64454 CPT 64454 Njx Aa/strd Gncler Nrv Brnch 88 23 $2,757.00 $2,481.30 $1,406.07 $2,729.43 $2,536.44 2026-01-08
64451 CPT Nix Aa/strd Nrv Nrvtg Si Jt 88 23 $2,757.00 $2,481.30 $1,406.07 $2,729.43 $2,536.44 2026-01-08
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