Price Transparencybeta Hospital negotiated rates

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

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Hospital

CUMBERLAND MEMORIAL HOSPITAL

Cumberland, WI · CCN 521353 · Rates published

2,238 distinct procedures filed
9 distinct payers
38,833 rate rows
2026-04-16 last MRF observed
Data quality

31,338 of 38,833 rate rows are consumer-grade (80.7%)

7,495 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 7,474
percent-of-charges filed in the dollar field — excluded from medians 21
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://cumberlandhealthcare.com/wp-content/uploads/2024/07/price-transparency-csv-file.csv
Found on page https://cumberlandhealthcare.com/patients-visitors/patient-financial-services/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-03
Content fingerprint 469358ccd109f609… · 1,997,135 bytes · first seen 2026-05-09

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
J3357
HCPCS 		Stelara 90 Mg/ml Syringe 9 $50,342.61 $67,423.14 $59,931.68 nat. median
$20,264
outlier · 3.0×
J2350
HCPCS 		Ocrevus 300 Mg/10 Ml Vial 9 $42,969.76 $57,548.79 $51,154.48 nat. median
$133
outlier · 384.7×
J3241
HCPCS 		Teprotumumab - Trbw 500 Mg 9 $39,719.94 $53,196.35 $47,285.64 nat. median
$709
outlier · 66.7×
J9144
HCPCS 		Daratumumab-hyaluronidase-15ml 9 $25,575.48 $34,252.88 $30,447.00 nat. median
$114
outlier · 265.9×
J9309
HCPCS 		Polatuzumab 140 Mg/7 Ml Sdv 9 $9,475.77 $61,506.99 $29,307.99 nat. median
$399
outlier · 73.5×
J9301
HCPCS 		Gazyva 1,000 Mg/40 Ml Intraven 9 $18,834.61 $25,224.93 $22,422.16 nat. median
$170
outlier · 132.0×
J9022
HCPCS 		Atezolizumab(Tecentriq) 840mg/ 9 $18,686.14 $25,026.08 $22,245.40 nat. median
$1,229
outlier · 18.1×
J2506
HCPCS 		Pegfilgastim 6mg/0.6ml Pfs 9 $9,935.05 $22,729.23 $20,203.76 nat. median
$916
outlier · 22.1×
J9299
HCPCS 		Opdivo 240 Mg/24 Ml Vial 9 $16,890.22 $22,620.83 $20,107.40 nat. median
$1,811
outlier · 11.1×
J2353
HCPCS 		SandoSTATIN Lar Depot 30 Mg In 9 $16,886.92 $22,616.42 $20,103.48 nat. median
$1,956
outlier · 10.3×
J3380
HCPCS 		Entyvio Sdv 300mg/5ml 9 $16,607.54 $22,242.24 $19,770.88 nat. median
$59
outlier · 336.2×
J9306
HCPCS 		Pertuzumab (Perjeta) 420mg/14m 9 $16,268.11 $21,787.65 $19,366.80 nat. median
$43
outlier · 453.9×
J0565
HCPCS 		Bezlotoxumab Ivpb 1,000 Mg/40 9 $13,267.70 $17,769.24 $15,794.88 nat. median
$121
outlier · 131.0×
J9271
HCPCS 		Keytruda 100 Mg/4 Ml Vial 9 $12,479.54 $16,713.67 $14,856.60 nat. median
$127
outlier · 117.0×
J9354
HCPCS 		Ado-trastuzumab (Kadcyla) 160m 9 $9,795.34 $20,182.64 $14,094.23 nat. median
$4,004
outlier · 3.5×
A9608
HCPCS 		Posluma Drug 9 $10,919.40 $14,916.69 $13,259.28 nat. median
$686
outlier · 19.3×
Q5108
HCPCS 		Fulphila 6 Mg/0.6 Ml Syringe 9 $11,040.02 $14,785.74 $13,142.88 nat. median
$418
outlier · 31.5×
Q5113
HCPCS 		Herzuma 420 Mg Intravenous Sol 9 $10,384.18 $13,907.39 $12,362.12 nat. median
$291
outlier · 42.5×
J2356
HCPCS 		Tezepelumab-ekko(tezspire) 210 9 $10,267.42 $13,751.01 $12,223.12 nat. median
$43
outlier · 282.3×
Q5111
HCPCS 		Pegfilgrastim-cbqv On Body 9 $10,100.16 $13,527.00 $12,024.00 nat. median
$665
outlier · 18.1×
J9173
HCPCS 		Durvalumab (imfinzi) 500mg/10m 9 $9,986.52 $13,374.81 $11,888.72 nat. median
$588
outlier · 20.2×
J9308
HCPCS 		Cyramza 100 Mg/10 Ml Vial 9 $3,193.04 $21,381.62 $10,120.67 nat. median
$300
outlier · 33.8×
J1306
HCPCS 		Inclisiran (Leqvio) 284 Mg/1.5 9 $8,428.26 $11,287.84 $10,033.64 nat. median
$25
outlier · 398.2×
29505
HCPCS 		Application Long Leg Splint 9 $80.93 $26,554.50 $9,967.88 nat. median
$202
outlier · 49.3×
J9303
HCPCS 		Panitumumab (Vectibix) 100mg/5 9 $4,147.79 $19,246.99 $9,963.08 nat. median
$869
outlier · 11.5×
87903
HCPCS 		Phenosense Phenotrype Gt Tissu 9 $7,628.81 $10,217.16 $9,081.92 nat. median
$518
outlier · 17.5×
J1943
HCPCS 		Aripiprazole (aristada) 882mg 9 $6,751.62 $10,312.74 $8,911.73 nat. median
$4
outlier · 2339.0×
Q4278
HCPCS 		Epieffect 2x3 9 $4,194.89 $14,045.40 $8,052.69 nat. median
$394
outlier · 20.4×
J1944
HCPCS 		Aripiprazole (Aristada) 662mg 9 $6,751.62 $9,042.34 $8,037.64 nat. median
$894
outlier · 9.0×
J9034
HCPCS 		Bendeka 100 Mg/4 Ml Vial 9 $6,541.55 $8,761.01 $7,787.56 nat. median
$36
outlier · 215.9×
J2426
HCPCS 		Invega Sustenna 78mg (Paliperi 9 $2,731.31 $11,193.39 $7,755.24 nat. median
$2,528
outlier · 3.1×
J2182
HCPCS 		Nucala 100 Mg/ml Syringe 9 $6,511.08 $58,018.55 $7,751.28 nat. median
$80
outlier · 97.3×
J9035
HCPCS 		Bevacizumab 100mg/4ml Sdv 9 $2,809.83 $15,052.59 $7,501.22 nat. median
$319
outlier · 23.5×
78816
HCPCS 		Pet/CT Whole Body,TC 9 $6,236.43 $8,352.36 $7,424.32 nat. median
$1,696
outlier · 4.4×
0275
RC 		9 $3,192.91 $13,870.17 $7,316.31 nat. median
$4,404
1.7× median
J9047
HCPCS 		Carfizomib 60mg Sdv 9 $6,139.26 $8,222.22 $7,308.64 nat. median
$1,392
outlier · 5.3×
Q5114
HCPCS 		Ogivri 150 Mg Vial 150 Mcg 9 $3,502.83 $13,093.83 $7,234.01 nat. median
$133
outlier · 54.4×
Q5115
HCPCS 		Truxima 100 Mg/10 Ml Vial 9 $2,235.98 $14,972.49 $7,087.03 nat. median
$368
outlier · 19.3×
78815
HCPCS 		Pet/CT Skull To Thigh,TC 9 $5,791.97 $7,912.26 $7,033.12 nat. median
$1,679
outlier · 4.2×
58552
HCPCS 		Lap Vaginal Hysterect 9 $5,830.71 $7,808.98 $6,941.32 nat. median
$10,168
0.7× median
66982
HCPCS 		Complex Removal Of Cataract 9 $5,510.40 $7,380.00 $6,560.00 nat. median
$2,790
outlier · 2.4×
J0897
HCPCS 		Denosumab 60mg/ml Pfs 9 $3,223.68 $11,177.19 $6,331.53 nat. median
$86
outlier · 73.6×
J9176
HCPCS 		Empliciti 300 Mg Intravenous S 9 $5,290.49 $7,085.48 $6,298.20 nat. median
$2,022
outlier · 3.1×
J9395
HCPCS 		Fulvestrant 250mg/5ml IM Sol 9 $5,127.46 $6,867.14 $6,104.12 nat. median
$49
outlier · 124.5×
66984
HCPCS 		Removal Of Cataract W/ins Pros 9 $5,040.00 $6,750.00 $6,000.00 nat. median
$2,550
outlier · 2.4×
59510
HCPCS 		Obantepartum Care 9 $4,874.15 $6,527.88 $5,802.56 nat. median
$3,349
1.7× median
J9217
HCPCS 		Eligard 22.5 Mg Syringe Kit 9 $3,583.20 $9,597.87 $5,687.68 nat. median
$2,144
outlier · 2.7×
J1602
HCPCS 		Simponi Aria 50mg/4 Ml Vial 50 9 $4,742.64 $6,351.75 $5,646.00 nat. median
$55
outlier · 103.4×
J0401
HCPCS 		Abilify Maintena ER 300 Mg 9 $4,736.89 $6,344.06 $5,639.16 nat. median
$22
outlier · 251.1×
58290
HCPCS 		Vaginal Hysterectomy 9 $4,455.36 $5,967.00 $5,304.00 nat. median
$7,168
0.7× median

Other procedures at this hospital

Browse this hospital's 2,238 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3357 HCPCS Stelara 90 Mg/ml Syringe 9 9 $74,914.60 $74,914.60 $50,342.61 $67,423.14 $59,931.68 2026-04-16
J2350 HCPCS Ocrevus 300 Mg/10 Ml Vial 9 9 $63,943.10 $63,943.10 $42,969.76 $57,548.79 $51,154.48 2026-04-16
J3241 HCPCS Teprotumumab - Trbw 500 Mg 9 9 $59,107.05 $59,107.05 $39,719.94 $53,196.35 $47,285.64 2026-04-16
J9144 HCPCS Daratumumab-hyaluronidase-15ml 9 9 $38,058.75 $38,058.75 $25,575.48 $34,252.88 $30,447.00 2026-04-16
J9309 HCPCS Polatuzumab 140 Mg/7 Ml Sdv 18 9 $41,220.98 $41,220.98 $9,475.77 $61,506.99 $29,307.99 2026-04-16
J9301 HCPCS Gazyva 1,000 Mg/40 Ml Intraven 9 9 $28,027.70 $28,027.70 $18,834.61 $25,224.93 $22,422.16 2026-04-16
J9022 HCPCS Atezolizumab(Tecentriq) 840mg/ 9 9 $27,806.75 $27,806.75 $18,686.14 $25,026.08 $22,245.40 2026-04-16
J2506 HCPCS Pegfilgastim 6mg/0.6ml Pfs 17 9 $24,519.05 $24,519.05 $9,935.05 $22,729.23 $20,203.76 2026-04-16
J9299 HCPCS Opdivo 240 Mg/24 Ml Vial 9 9 $25,134.25 $25,134.25 $16,890.22 $22,620.83 $20,107.40 2026-04-16
J2353 HCPCS SandoSTATIN Lar Depot 30 Mg In 9 9 $25,129.35 $25,129.35 $16,886.92 $22,616.42 $20,103.48 2026-04-16
J3380 HCPCS Entyvio Sdv 300mg/5ml 9 9 $24,713.60 $24,713.60 $16,607.54 $22,242.24 $19,770.88 2026-04-16
J9306 HCPCS Pertuzumab (Perjeta) 420mg/14m 9 9 $24,208.50 $24,208.50 $16,268.11 $21,787.65 $19,366.80 2026-04-16
J0565 HCPCS Bezlotoxumab Ivpb 1,000 Mg/40 9 9 $19,743.60 $19,743.60 $13,267.70 $17,769.24 $15,794.88 2026-04-16
J9271 HCPCS Keytruda 100 Mg/4 Ml Vial 9 9 $18,570.75 $18,570.75 $12,479.54 $16,713.67 $14,856.60 2026-04-16
J9354 HCPCS Ado-trastuzumab (Kadcyla) 160m 18 9 $18,500.78 $18,500.78 $9,795.34 $20,182.64 $14,094.23 2026-04-16
A9608 HCPCS Posluma Drug 9 9 $16,574.10 $16,574.10 $10,919.40 $14,916.69 $13,259.28 2026-04-16
Q5108 HCPCS Fulphila 6 Mg/0.6 Ml Syringe 9 9 $16,428.60 $16,428.60 $11,040.02 $14,785.74 $13,142.88 2026-04-16
Q5113 HCPCS Herzuma 420 Mg Intravenous Sol 9 9 $15,452.65 $15,452.65 $10,384.18 $13,907.39 $12,362.12 2026-04-16
J2356 HCPCS Tezepelumab-ekko(tezspire) 210 9 9 $15,278.90 $15,278.90 $10,267.42 $13,751.01 $12,223.12 2026-04-16
Q5111 HCPCS Pegfilgrastim-cbqv On Body 9 9 $15,030.00 $15,030.00 $10,100.16 $13,527.00 $12,024.00 2026-04-16
J9173 HCPCS Durvalumab (imfinzi) 500mg/10m 9 9 $14,860.90 $14,860.90 $9,986.52 $13,374.81 $11,888.72 2026-04-16
J9308 HCPCS Cyramza 100 Mg/10 Ml Vial 18 9 $14,254.45 $14,254.45 $3,193.04 $21,381.62 $10,120.67 2026-04-16
J1306 HCPCS Inclisiran (Leqvio) 284 Mg/1.5 9 9 $12,542.05 $12,542.05 $8,428.26 $11,287.84 $10,033.64 2026-04-16
29505 HCPCS Application Long Leg Splint 18 9 $14,812.72 $14,812.72 $80.93 $26,554.50 $9,967.88 2026-04-16
J9303 HCPCS Panitumumab (Vectibix) 100mg/5 18 9 $13,778.92 $13,778.92 $4,147.79 $19,246.99 $9,963.08 2026-04-16
87903 HCPCS Phenosense Phenotrype Gt Tissu 9 9 $11,352.40 $11,352.40 $7,628.81 $10,217.16 $9,081.92 2026-04-16
J1943 HCPCS Aripiprazole (aristada) 882mg 18 9 $10,752.83 $10,752.83 $6,751.62 $10,312.74 $8,911.73 2026-04-16
Q4278 HCPCS Epieffect 2x3 18 9 $10,924.20 $10,924.20 $4,194.89 $14,045.40 $8,052.69 2026-04-16
J1944 HCPCS Aripiprazole (Aristada) 662mg 9 9 $10,047.05 $10,047.05 $6,751.62 $9,042.34 $8,037.64 2026-04-16
J9034 HCPCS Bendeka 100 Mg/4 Ml Vial 9 9 $9,734.45 $9,734.45 $6,541.55 $8,761.01 $7,787.56 2026-04-16
J2426 HCPCS Invega Sustenna 78mg (Paliperi 36 9 $10,161.45 $10,161.45 $2,731.31 $11,193.39 $7,755.24 2026-04-16
J2182 HCPCS Nucala 100 Mg/ml Syringe 9 9 $9,689.10 $9,689.10 $6,511.08 $58,018.55 $7,751.28 2026-04-16
J9035 HCPCS Bevacizumab 100mg/4ml Sdv 18 9 $10,453.20 $10,453.20 $2,809.83 $15,052.59 $7,501.22 2026-04-16
78816 HCPCS Pet/CT Whole Body,TC 9 9 $9,280.40 $9,280.40 $6,236.43 $8,352.36 $7,424.32 2026-04-16
0275 RC — 18 9 $10,081.33 $10,081.33 $3,192.91 $13,870.17 $7,316.31 2026-04-16
J9047 HCPCS Carfizomib 60mg Sdv 9 9 $9,135.80 $9,135.80 $6,139.26 $8,222.22 $7,308.64 2026-04-16
Q5114 HCPCS Ogivri 150 Mg Vial 150 Mcg 18 9 $9,880.62 $9,880.62 $3,502.83 $13,093.83 $7,234.01 2026-04-16
Q5115 HCPCS Truxima 100 Mg/10 Ml Vial 18 9 $9,981.72 $9,981.72 $2,235.98 $14,972.49 $7,087.03 2026-04-16
78815 HCPCS Pet/CT Skull To Thigh,TC 9 9 $8,791.40 $8,791.40 $5,791.97 $7,912.26 $7,033.12 2026-04-16
58552 HCPCS Lap Vaginal Hysterect 9 9 $8,676.65 $8,676.65 $5,830.71 $7,808.98 $6,941.32 2026-04-16
66982 HCPCS Complex Removal Of Cataract 9 9 $8,200.00 $8,200.00 $5,510.40 $7,380.00 $6,560.00 2026-04-16
J0897 HCPCS Denosumab 60mg/ml Pfs 18 9 $8,608.12 $8,608.12 $3,223.68 $11,177.19 $6,331.53 2026-04-16
J9176 HCPCS Empliciti 300 Mg Intravenous S 9 9 $7,872.75 $7,872.75 $5,290.49 $7,085.48 $6,298.20 2026-04-16
J9395 HCPCS Fulvestrant 250mg/5ml IM Sol 9 9 $7,630.15 $7,630.15 $5,127.46 $6,867.14 $6,104.12 2026-04-16
66984 HCPCS Removal Of Cataract W/ins Pros 9 9 $7,500.00 $7,500.00 $5,040.00 $6,750.00 $6,000.00 2026-04-16
59510 HCPCS Obantepartum Care 9 9 $7,253.20 $7,253.20 $4,874.15 $6,527.88 $5,802.56 2026-04-16
J9217 HCPCS Eligard 22.5 Mg Syringe Kit 27 9 $7,109.60 $7,109.60 $3,583.20 $9,597.87 $5,687.68 2026-04-16
J1602 HCPCS Simponi Aria 50mg/4 Ml Vial 50 9 9 $7,057.50 $7,057.50 $4,742.64 $6,351.75 $5,646.00 2026-04-16
J0401 HCPCS Abilify Maintena ER 300 Mg 9 9 $7,048.95 $7,048.95 $4,736.89 $6,344.06 $5,639.16 2026-04-16
58290 HCPCS Vaginal Hysterectomy 9 9 $6,630.00 $6,630.00 $4,455.36 $5,967.00 $5,304.00 2026-04-16
J7168 HCPCS Kcentra 1000 Unit Vial 18 9 $7,099.45 $7,099.45 $3,118.21 $8,602.83 $5,299.82 2026-04-16
J3358 HCPCS Stelara 130 Mg/26 Ml Vial 9 9 $6,604.60 $6,604.60 $4,438.29 $5,944.14 $5,283.68 2026-04-16
43633 HCPCS Gastrectomy Partial 9 9 $6,557.70 $6,557.70 $4,406.77 $5,901.93 $5,246.16 2026-04-16
J0894 HCPCS Decitabine 50mg Vial 9 9 $6,396.10 $6,396.10 $4,298.18 $5,756.49 $5,116.88 2026-04-16
27447 HCPCS Arthroplas Knee Cond Plat 9 9 $6,274.20 $6,274.20 $4,216.26 $5,646.78 $5,019.36 2026-04-16
J0875 HCPCS Dalvance 500 Mg Vial 9 9 $6,220.30 $6,220.30 $4,180.04 $5,598.27 $4,976.24 2026-04-16
J9355 HCPCS Trastuzumab 150mg Vial 9 9 $6,132.45 $6,132.45 $4,121.01 $5,519.20 $4,905.96 2026-04-16
27130 HCPCS Arthroplasty, (total Hip) 9 9 $6,055.60 $6,055.60 $4,069.36 $5,450.04 $4,844.48 2026-04-16
J3490 HCPCS Candida Albicans Inj 18 9 $6,985.30 $6,985.30 $698.34 $11,638.26 $4,812.59 2026-04-16
58563 HCPCS Hysteroscopy W/endometrial Abl 9 9 $6,005.75 $6,005.75 $4,035.86 $5,405.18 $4,804.60 2026-04-16
Q5107 HCPCS Mvasi 100 Mg/4 Ml Vial 18 9 $6,663.98 $6,663.98 $1,791.32 $9,596.07 $4,782.08 2026-04-16
J9264 HCPCS Paclitaxel Protein-bound 100mg 9 9 $5,949.90 $5,949.90 $3,998.33 $5,354.91 $4,759.92 2026-04-16
Q5136 HCPCS Denosumab-bbdz (Jubbonti) 60mg 9 9 $5,774.90 $5,774.90 $3,880.73 $5,197.41 $4,619.92 2026-04-16
J9041 HCPCS Bortezomib 3.5mg Vial 9 9 $5,770.80 $5,770.80 $3,877.98 $5,193.72 $4,616.64 2026-04-16
44143 HCPCS Colectomy, Partial 9 9 $5,624.85 $5,624.85 $3,779.90 $5,062.37 $4,499.88 2026-04-16
Q5118 HCPCS Zirabev 100 Mg/4 Ml Vial 18 9 $6,034.35 $6,034.35 $1,622.04 $8,689.46 $4,330.26 2026-04-16
J9202 HCPCS Goserelin Acetate (Zoladex)3.6 18 9 $5,572.40 $5,572.40 $2,449.88 $6,749.23 $4,160.26 2026-04-16
J2315 HCPCS Naltrexone 380mg/vial 9 9 $5,150.95 $5,150.95 $3,461.44 $4,635.85 $4,120.76 2026-04-16
58661 HCPCS Salpingectomy 9 9 $5,150.55 $5,150.55 $3,461.17 $4,635.49 $4,120.44 2026-04-16
78452 HCPCS Nm Lexiscan Rest And Stress 9 9 $4,961.98 $4,961.98 $2,133.65 $4,549.55 $3,969.58 2026-04-16
72159 HCPCS MRA Spinal Canal With Or W/o,tc 9 9 $4,878.35 $4,878.35 $3,278.25 $4,390.52 $3,902.68 2026-04-16
90375 HCPCS Hyperrab 300 Un Vial 1mcg 1 Ml 36 9 $5,315.23 $5,315.23 $1,772.94 $11,871.76 $3,881.44 2026-04-16
74174 HCPCS CT CTA Abd/pelvis W/post Proc,tc 9 9 $4,848.20 $4,848.20 $3,257.99 $4,363.38 $3,878.56 2026-04-16
J0129 HCPCS Abatacept 250mg Vial 9 9 $4,834.05 $4,834.05 $3,248.48 $4,350.65 $3,867.24 2026-04-16
J3111 HCPCS Romosozumab (Evenity) 105 Mg 9 9 $4,826.70 $4,826.70 $3,243.54 $4,344.03 $3,861.36 2026-04-16
44140 HCPCS Colectomy Part W/anasto 9 9 $4,772.35 $4,772.35 $3,207.02 $4,295.12 $3,817.88 2026-04-16
81162 HCPCS Brca1/brca2 Gene Mutations 9 9 $4,725.20 $4,725.20 $3,175.33 $4,252.68 $3,780.16 2026-04-16
J9145 HCPCS Darzalex 100 Mg/5 Ml Vial 18 9 $5,211.15 $5,211.15 $1,400.78 $7,504.02 $3,739.52 2026-04-16
58554 HCPCS Vag Hyst W/removal Tube/ovary 9 9 $4,625.75 $4,625.75 $3,108.50 $4,163.18 $3,700.60 2026-04-16
58561 HCPCS Hysteroscopic Guided D & C 9 9 $4,623.70 $4,623.70 $3,107.13 $4,161.33 $3,698.96 2026-04-16
72158 HCPCS MRI L-spine Without And W/contrast,tc 9 9 $4,614.55 $4,614.55 $1,945.34 $4,153.10 $3,691.64 2026-04-16
44120 HCPCS Enterectomy Resc Sm Intes Si 18 9 $4,525.20 $4,525.20 $3,024.71 $4,094.42 $3,639.48 2026-04-16
72157 HCPCS MRI T-spine Without And W/contrast,tc 9 9 $4,505.90 $4,505.90 $3,027.96 $4,055.31 $3,604.72 2026-04-16
23472 HCPCS Total Shoulder Replacement 9 9 $4,500.00 $4,500.00 $3,024.00 $4,050.00 $3,600.00 2026-04-16
70553 HCPCS MRI Brain Without And W/contrast,tc 9 9 $4,496.05 $4,496.05 $1,568.00 $4,046.45 $3,596.84 2026-04-16
71552 HCPCS MRI Chest Without And W/contrast,tc 9 9 $4,488.65 $4,488.65 $3,016.37 $4,039.78 $3,590.92 2026-04-16
78630 HCPCS Nm Cisternography,tc 9 9 $4,475.65 $4,475.65 $3,007.64 $4,028.08 $3,580.52 2026-04-16
72156 HCPCS MRI C-spine Without And W/contrast,tc 9 9 $4,462.30 $4,462.30 $2,998.67 $4,016.07 $3,569.84 2026-04-16
Q4151 HCPCS Amnioband Matrix 2x2 Cm 54 9 $4,801.08 $4,801.08 $1,553.80 $9,243.86 $3,557.36 2026-04-16
95811 HCPCS Sleep Study Stage 2,tc 9 9 $4,722.38 $4,722.38 $1,867.74 $4,250.14 $3,541.78 2026-04-16
70543 HCPCS MRI Orbit Face And Neck Without Co,tc 9 9 $4,417.10 $4,417.10 $2,968.29 $3,975.39 $3,533.68 2026-04-16
29806 HCPCS Arthoscopy Shoulder 9 9 $4,413.55 $4,413.55 $2,965.91 $3,972.20 $3,530.84 2026-04-16
70549 HCPCS MRA Neck Without Contrast And W/co,tc 9 9 $4,394.60 $4,394.60 $1,977.57 $3,955.14 $3,515.68 2026-04-16
74178 HCPCS CT Abd/pelvis W And Without Con,tc 9 9 $4,377.70 $4,377.70 $1,100.00 $3,939.93 $3,502.16 2026-04-16
29827 HCPCS Arthroscopy, Shoulder 9 9 $4,352.45 $4,352.45 $2,924.85 $3,917.20 $3,481.96 2026-04-16
78802 HCPCS Nm Gallium/whole Body/abscess,tc 18 9 $4,287.95 $4,287.95 $2,839.33 $3,915.63 $3,480.56 2026-04-16
72147 HCPCS MRI T-spine W/contrast,tc 9 9 $4,307.50 $4,307.50 $2,894.64 $3,876.75 $3,446.00 2026-04-16
78018 HCPCS Nm I131 Whole Body,tc 9 9 $4,303.15 $4,303.15 $2,891.72 $3,872.83 $3,442.52 2026-04-16
73225 HCPCS MRA Upper Extremity R,tc 9 9 $4,177.00 $4,177.00 $2,806.94 $3,759.30 $3,341.60 2026-04-16
71555 HCPCS MRA Chest With Or Without Contrast,tc 9 9 $4,166.50 $4,166.50 $2,799.89 $3,749.85 $3,333.20 2026-04-16
J1569 HCPCS Gammagard Liquid 10% Vial 72 9 $4,387.02 $4,387.02 $366.58 $14,727.01 $3,326.48 2026-04-16
71551 HCPCS MRI Chest W/contrast,tc 9 9 $4,156.00 $4,156.00 $2,792.83 $3,740.40 $3,324.80 2026-04-16
J7326 HCPCS Hyaluronate Sodium 30mg/3ml 9 9 $4,140.00 $4,140.00 $2,782.08 $3,726.00 $3,312.00 2026-04-16
70546 HCPCS MRA Head Without And W/contrast,tc 18 9 $4,089.75 $4,089.75 $2,748.31 $3,680.78 $3,271.80 2026-04-16
J2357 HCPCS Xolair 150 Mg/ml Syringe 150 27 9 $4,143.85 $4,143.85 $1,462.84 $3,917.38 $3,264.49 2026-04-16
95810 HCPCS Sleep Study Stage 1,tc 9 9 $4,334.50 $4,334.50 $1,744.57 $3,901.05 $3,250.88 2026-04-16
27870 HCPCS Arthrodesis,ankle Open 9 9 $4,055.75 $4,055.75 $2,725.46 $3,650.18 $3,244.60 2026-04-16
59514 HCPCS C-section Delivery 18 9 $4,004.70 $4,004.70 $2,664.51 $3,639.91 $3,235.48 2026-04-16
70542 HCPCS MRI Orbit, Face And Neck W/co,tc 9 9 $4,034.25 $4,034.25 $2,711.02 $3,630.82 $3,227.40 2026-04-16
72142 HCPCS MRI C-spine W/contrast,tc 9 9 $4,030.85 $4,030.85 $2,708.73 $3,627.76 $3,224.68 2026-04-16
44160 HCPCS Colectomy 18 9 $4,319.79 $4,319.79 $1,829.30 $5,325.66 $3,213.22 2026-04-16
Q4145 HCPCS Epifix - Micronized 100 Mg 9 9 $4,001.75 $4,001.75 $2,689.18 $3,601.57 $3,201.40 2026-04-16
74177 HCPCS CT Abd/pelvis With Contrast,tc 9 9 $4,259.45 $4,259.45 $780.76 $3,833.51 $3,194.59 2026-04-16
73223 HCPCS MRI Elbow Rt With And Without C,tc 9 9 $3,952.85 $3,952.85 $2,656.32 $3,557.57 $3,162.28 2026-04-16
58571 HCPCS Lap Hyst Uterus 250 W/tube Rem 9 9 $3,950.00 $3,950.00 $2,654.40 $3,555.00 $3,160.00 2026-04-16
27828 HCPCS Open Treat Of Distal Tibia 9 9 $3,871.29 $3,871.29 $2,601.51 $3,484.16 $3,097.03 2026-04-16
72149 HCPCS MRI L-spine W/contrast,tc 9 9 $3,870.65 $3,870.65 $2,601.08 $3,483.59 $3,096.52 2026-04-16
44005 HCPCS Enterolysis (Freeing Of Intest 9 9 $3,858.60 $3,858.60 $2,592.98 $3,472.74 $3,086.88 2026-04-16
Q4101 HCPCS Apligraf 44 Sq Cm 18 9 $4,115.38 $4,115.38 $1,873.10 $4,899.06 $3,083.28 2026-04-16
73222 HCPCS MRI Elbow Rt W/contrast,tc 9 9 $3,837.65 $3,837.65 $2,578.90 $3,453.89 $3,070.12 2026-04-16
73720 HCPCS MRI Tib/fib Rt No Joint W/cont,tc 9 9 $3,821.95 $3,821.95 $2,568.35 $3,439.76 $3,057.56 2026-04-16
Q0138 HCPCS Feraheme 510mg/17ml Vial 8 8 $3,821.25 $3,821.25 $2,567.88 $3,439.12 $3,057.00 2026-04-16
72197 HCPCS MRI Pelvis Without And W/contrast,tc 9 9 $3,804.55 $3,804.55 $2,556.66 $3,424.09 $3,043.64 2026-04-16
72196 HCPCS MRI Pelvis W/contrast,tc 9 9 $3,804.55 $3,804.55 $2,556.66 $3,424.09 $3,043.64 2026-04-16
71550 HCPCS MRI Chest Without Contrast,tc 9 9 $3,790.65 $3,790.65 $2,547.32 $3,411.59 $3,032.52 2026-04-16
19380 HCPCS Revision Of Reconstruct Breast 9 9 $3,779.85 $3,779.85 $2,540.06 $3,401.86 $3,023.88 2026-04-16
Q4196 HCPCS Puraply - Am Com 2x2 63 9 $3,777.65 $3,777.65 $1,377.26 $10,093.23 $3,022.12 2026-04-16
70547 HCPCS MRA Neck Without Contrast,tc 9 9 $3,775.05 $3,775.05 $2,536.83 $3,397.55 $3,020.04 2026-04-16
70552 HCPCS MRI Brain W/contrast,tc 9 9 $3,759.25 $3,759.25 $2,526.22 $3,383.32 $3,007.40 2026-04-16
14301 HCPCS Adjacent Tissue Transfer 9 9 $3,758.15 $3,758.15 $2,525.48 $3,382.34 $3,006.52 2026-04-16
Q4186 HCPCS Epifix - Allograph 18 Mm Disc 54 9 $3,915.95 $3,915.95 $1,258.86 $18,288.81 $2,953.89 2026-04-16
J2783 HCPCS Elitek 1.5 Mg Vial 1.5 Mcg 9 9 $3,677.95 $3,677.95 $2,471.58 $3,310.16 $2,942.36 2026-04-16
58662 HCPCS Cystectomy 9 9 $3,676.30 $3,676.30 $2,470.47 $3,308.67 $2,941.04 2026-04-16
70540 HCPCS MRI Orbit,face And Neck Without Co,tc 9 9 $3,674.00 $3,674.00 $2,468.93 $3,306.60 $2,939.20 2026-04-16
74183 HCPCS MRI Abdomen Without And W/contrast,tc 9 9 $3,670.50 $3,670.50 $1,504.91 $3,303.45 $2,936.40 2026-04-16
74182 HCPCS MRI Abdomen With Contrast,tc 9 9 $3,670.50 $3,670.50 $2,466.58 $3,303.45 $2,936.40 2026-04-16
73219 HCPCS MRI Forearm Rt No Joint W/con,tc 9 9 $3,635.90 $3,635.90 $2,443.32 $3,272.31 $2,908.72 2026-04-16
J0881 HCPCS Aranesp 150 Mcg/0.3ml Syringe 54 9 $3,807.12 $3,807.12 $511.73 $8,223.34 $2,905.60 2026-04-16
Q5103 HCPCS Infliximab Dyyb 100mg Vial 9 9 $3,615.20 $3,615.20 $2,429.41 $3,253.68 $2,892.16 2026-04-16
78803 HCPCS Nm Bone Tomo (spect),tc 45 9 $3,615.10 $3,615.10 $1,798.24 $4,028.08 $2,892.08 2026-04-16
74185 HCPCS MRA Abdomen With Or Without Con,tc 9 9 $3,607.80 $3,607.80 $2,424.44 $3,247.02 $2,886.24 2026-04-16
29828 HCPCS Arthroscopy Shoul Biceps Ten 9 9 $3,607.10 $3,607.10 $2,423.97 $3,246.39 $2,885.68 2026-04-16
73220 HCPCS MRI Forearm Rt Joint Withw/o,tc 9 9 $3,587.75 $3,587.75 $2,410.97 $3,228.97 $2,870.20 2026-04-16
19303 HCPCS Mastectomy Simple Compl 9 9 $3,568.10 $3,568.10 $2,397.76 $3,211.29 $2,854.48 2026-04-16
43610 HCPCS Ex Local Ulcer/b9 Tumor Stom 9 9 $3,568.10 $3,568.10 $2,397.76 $3,211.29 $2,854.48 2026-04-16
70548 HCPCS MRA Neck W/contrast,tc 9 9 $3,549.55 $3,549.55 $2,385.30 $3,194.59 $2,839.64 2026-04-16
25800 HCPCS Total Wrist Fusion 9 9 $3,528.55 $3,528.55 $2,371.19 $3,175.70 $2,822.84 2026-04-16
44180 HCPCS Laparoscopy, Enterolysis 18 9 $3,387.10 $3,387.10 $2,136.69 $3,235.14 $2,820.30 2026-04-16
J1745 HCPCS inFLIXimab 100mg Sdv 18 9 $3,708.68 $3,708.68 $1,896.28 $4,135.95 $2,813.92 2026-04-16
72146 HCPCS MRI T-spine Without Contrast,tc 9 9 $3,505.25 $3,505.25 $2,355.53 $3,154.73 $2,804.20 2026-04-16
26236 HCPCS Arhroplasy, Total Hip 18 9 $3,875.22 $3,875.22 $1,138.94 $5,450.04 $2,797.36 2026-04-16
58660 HCPCS Laporoscropy, w/Lysis Of Adhes 18 9 $3,747.65 $3,747.65 $1,575.67 $4,635.49 $2,785.73 2026-04-16
58150 HCPCS Total Abdom Hysterectomy 9 9 $3,464.80 $3,464.80 $2,328.35 $3,118.32 $2,771.84 2026-04-16
73719 HCPCS MRI Tib/fib Rt No Joint W/cont,tc 9 9 $3,463.65 $3,463.65 $2,327.57 $3,117.28 $2,770.92 2026-04-16
73723 HCPCS MRI Knee Rt Without Than W/contra,tc 9 9 $3,455.00 $3,455.00 $2,321.76 $3,109.50 $2,764.00 2026-04-16
73722 HCPCS MRI Knee Rt W/contrast,tc 9 9 $3,455.00 $3,455.00 $2,321.76 $3,109.50 $2,764.00 2026-04-16
44025 HCPCS Colotomy 9 9 $3,451.15 $3,451.15 $2,319.17 $3,106.03 $2,760.92 2026-04-16
72195 HCPCS MRI Pelvis Without Contrast,tc 9 9 $3,446.15 $3,446.15 $1,452.78 $3,101.54 $2,756.92 2026-04-16
70551 HCPCS MRI Brain Without Contrast,tc 9 9 $3,431.40 $3,431.40 $574.88 $3,088.26 $2,745.12 2026-04-16
70545 HCPCS MRA Head W/contrast,tc 9 9 $3,431.40 $3,431.40 $2,305.90 $3,088.26 $2,745.12 2026-04-16
73221 HCPCS MRI Elbow Rt Without Contras,tc 9 9 $3,391.20 $3,391.20 $1,568.00 $3,052.08 $2,712.96 2026-04-16
73218 HCPCS MRI Forearm Rt Joint Without Cont,tc 9 9 $3,391.20 $3,391.20 $1,390.39 $3,052.08 $2,712.96 2026-04-16
72198 HCPCS MRA Pelvis With Or Without Contras,tc 9 9 $3,390.40 $3,390.40 $2,278.35 $3,051.36 $2,712.32 2026-04-16
70544 HCPCS MRA Head Without Contrast,tc 9 9 $3,354.10 $3,354.10 $1,568.00 $3,018.69 $2,683.28 2026-04-16
29880 HCPCS Arthroscopy,knee, Surgical W/m 9 9 $3,346.60 $3,346.60 $2,248.92 $3,011.94 $2,677.28 2026-04-16
73721 HCPCS MRI Knee Lt Without Contrast,lt 24 9 $3,317.65 $3,317.65 $1,360.24 $2,985.89 $2,654.12 2026-04-16
72141 HCPCS MRI C-spine Without Contrast,tc 9 9 $3,273.75 $3,273.75 $1,407.71 $2,946.38 $2,619.00 2026-04-16
90376 HCPCS Rabies Immune Globulin 150 18 9 $3,244.90 $3,244.90 $2,169.72 $2,934.95 $2,608.84 2026-04-16
73718 HCPCS MRI Tib/fib Rt Joint Without Cont,tc 9 9 $3,256.85 $3,256.85 $2,188.60 $2,931.16 $2,605.48 2026-04-16
20934 HCPCS Allograft, Includes Templating 9 9 $3,238.30 $3,238.30 $2,176.14 $2,914.47 $2,590.64 2026-04-16
44960 HCPCS Appendectomy Open; W/rupt 9 9 $3,236.00 $3,236.00 $2,174.59 $2,912.40 $2,588.80 2026-04-16
74175 HCPCS CT CTA Abdomen,tc 9 9 $3,232.25 $3,232.25 $2,172.07 $2,909.03 $2,585.80 2026-04-16
70496 HCPCS CT CTA Head,tc 9 9 $3,232.25 $3,232.25 $962.27 $2,909.03 $2,585.80 2026-04-16
73706 HCPCS CT CTA L/extremity,tc 9 9 $3,232.25 $3,232.25 $1,362.61 $2,909.03 $2,585.80 2026-04-16
73206 HCPCS CT CTA U/extremity,tc 9 9 $3,232.25 $3,232.25 $2,172.07 $2,909.03 $2,585.80 2026-04-16
72191 HCPCS CT CTA Pelvis,tc 9 9 $3,232.25 $3,232.25 $2,172.07 $2,909.03 $2,585.80 2026-04-16
78582 HCPCS Nm Lung Perfusion And Ventilat,tc 9 9 $3,192.50 $3,192.50 $2,145.36 $2,873.25 $2,554.00 2026-04-16
53899 HCPCS Unlisted Urinary System 9 9 $3,190.65 $3,190.65 $2,144.12 $2,871.59 $2,552.52 2026-04-16
73725 HCPCS MRA Lower Ext R With Or W/o,tc 9 9 $3,172.40 $3,172.40 $2,131.85 $2,855.16 $2,537.92 2026-04-16
58262 HCPCS Vaginal Hysterectomy 9 9 $3,162.00 $3,162.00 $2,124.86 $2,845.80 $2,529.60 2026-04-16
78708 HCPCS Nm Renogram With Captopril,tc 9 9 $3,129.80 $3,129.80 $2,103.23 $2,816.82 $2,503.84 2026-04-16
74181 HCPCS MRI Abdomen Without Contrast,tc 9 9 $3,113.60 $3,113.60 $2,092.34 $2,802.24 $2,490.88 2026-04-16
72148 HCPCS MRI L-spine Without Contrast,tc 9 9 $3,312.90 $3,312.90 $583.50 $2,981.61 $2,484.67 2026-04-16
15273 HCPCS Wt Skin Subt Gft T/a/l >=100 9 9 $3,099.90 $3,099.90 $2,083.13 $2,789.91 $2,479.92 2026-04-16
25608 HCPCS Open Tx Distal Radial Fx Or Se 9 9 $3,077.55 $3,077.55 $2,068.11 $2,769.80 $2,462.04 2026-04-16
Q4106 HCPCS Dermagraft Per Sq Cm 18 9 $3,222.32 $3,222.32 $1,726.23 $3,488.26 $2,458.24 2026-04-16
74176 HCPCS CT Stone Protocol,tc 9 9 $3,259.20 $3,259.20 $780.76 $2,933.28 $2,444.40 2026-04-16
A0434 HCPCS Ambulance Ift Sct 9 9 $3,042.72 $3,042.72 $2,044.71 $2,738.45 $2,434.18 2026-04-16
70498 HCPCS CT CTA Neck,tc 9 9 $3,232.25 $3,232.25 $962.27 $2,909.03 $2,424.19 2026-04-16
71275 HCPCS CT CTA Chest,tc 9 9 $3,232.25 $3,232.25 $1,100.00 $2,909.03 $2,424.19 2026-04-16
70336 HCPCS MRI Temporomandibular Joint(s),tc 9 9 $3,030.10 $3,030.10 $2,036.23 $2,727.09 $2,424.08 2026-04-16
G0121 HCPCS Colonoscopy Screen Non High Ri 9 9 $3,000.00 $3,000.00 $1,111.65 $2,700.00 $2,400.00 2026-04-16
27814 HCPCS Open Treat Of Bimalleolar Ankl 9 9 $2,987.30 $2,987.30 $2,007.47 $2,688.57 $2,389.84 2026-04-16
29881 HCPCS Arthroscopy Knee 9 9 $2,948.00 $2,948.00 $1,981.06 $2,653.20 $2,358.40 2026-04-16
27848 HCPCS Open Treatment Of Ankle Disloc 9 9 $2,941.95 $2,941.95 $1,976.99 $2,647.76 $2,353.56 2026-04-16
27252 HCPCS Hip Dislocation Closed Treatme 9 9 $2,941.75 $2,941.75 $1,976.86 $2,647.57 $2,353.40 2026-04-16
49000 HCPCS Exploratory Laparotomy 9 9 $2,941.15 $2,941.15 $1,976.45 $2,647.03 $2,352.92 2026-04-16
59150 HCPCS Laparoscopic Of Ectopic Preg 9 9 $2,936.65 $2,936.65 $1,973.43 $2,642.99 $2,349.32 2026-04-16
78707 HCPCS Nm Renogram,tc 9 9 $2,934.15 $2,934.15 $1,971.75 $2,640.74 $2,347.32 2026-04-16
52356 HCPCS Lithotripsy Unilateral 9 9 $2,927.85 $2,927.85 $1,967.52 $2,635.07 $2,342.28 2026-04-16
47563 HCPCS Cholecystectomy Laparos 9 9 $2,915.85 $2,915.85 $1,959.45 $2,624.26 $2,332.68 2026-04-16
44800 HCPCS Excision Of Meckel Diverticulu 9 9 $2,891.60 $2,891.60 $1,943.16 $2,602.44 $2,313.28 2026-04-16
44130 HCPCS Enteroenterostmy 9 9 $2,883.43 $2,883.43 $1,937.66 $2,595.09 $2,306.74 2026-04-16
59409 HCPCS Vaginal Delivery 9 9 $2,846.40 $2,846.40 $1,912.78 $2,561.76 $2,277.12 2026-04-16
27691 HCPCS Transplant Of Single Tendon 9 9 $2,838.90 $2,838.90 $1,907.74 $2,555.01 $2,271.12 2026-04-16
J3262 HCPCS Actemra 200 Mg/10 Ml Vial 18 9 $3,055.98 $3,055.98 $1,219.48 $3,867.53 $2,260.49 2026-04-16
27822 HCPCS Open Treat Of Trimalleolar Ank 9 9 $2,789.45 $2,789.45 $1,874.51 $2,510.50 $2,231.56 2026-04-16
Q4159 HCPCS Affinity 2.5 9 9 $2,787.35 $2,787.35 $1,873.10 $2,508.61 $2,229.88 2026-04-16
57288 HCPCS Sling Oper Stress Incontinence 9 9 $2,761.00 $2,761.00 $1,855.39 $2,484.90 $2,208.80 2026-04-16
29877 HCPCS Arthroscopy, Knee Chrondroplas 9 9 $2,756.75 $2,756.75 $1,852.54 $2,481.07 $2,205.40 2026-04-16
J3489 HCPCS Zoledronic Acid 4mg/5ml Vl 15 8 $236.20 $236.20 $158.73 $2,933.86 $2,190.62 2026-04-16
29898 HCPCS Arthroscopy, Ankle 9 9 $2,732.45 $2,732.45 $1,836.21 $2,459.20 $2,185.96 2026-04-16
36561 HCPCS Insert Tunnel Ccad 9 9 $2,704.05 $2,704.05 $1,817.12 $2,433.65 $2,163.24 2026-04-16
25607 HCPCS Distal Radial Fracture 9 9 $2,684.00 $2,684.00 $1,803.65 $2,415.60 $2,147.20 2026-04-16
78451 HCPCS Nm Myocardial Perf Wall Motion,tc 43 9 $2,675.95 $2,675.95 $315.40 $4,549.55 $2,140.76 2026-04-16
99291 HCPCS Critical Care 18 9 $2,609.95 $2,609.95 $1,621.70 $2,525.99 $2,140.55 2026-04-16
59426 HCPCS Antepartum Care Only 7+ Visits 9 9 $2,671.70 $2,671.70 $1,795.38 $2,404.53 $2,137.36 2026-04-16
58558 HCPCS Hysteroscopy Bx Endoment 9 9 $2,646.40 $2,646.40 $1,778.38 $2,381.76 $2,117.12 2026-04-16
59820 HCPCS Missed Abortion Comp 9 9 $2,646.40 $2,646.40 $1,778.38 $2,381.76 $2,117.12 2026-04-16
71270 HCPCS CT Chest Without And W/contrast,tc 9 9 $2,642.15 $2,642.15 $1,775.52 $2,377.93 $2,113.72 2026-04-16
75635 HCPCS CT CTA Abd Aorta And Bil Lower 9 9 $2,631.50 $2,631.50 $1,768.37 $2,368.35 $2,105.20 2026-04-16
L8603 HCPCS Collagen 9 9 $2,629.65 $2,629.65 $1,767.12 $2,366.68 $2,103.72 2026-04-16
49613 HCPCS Repair Of Anterior Abd Hernia/ 9 9 $2,601.00 $2,601.00 $1,747.87 $2,340.90 $2,080.80 2026-04-16
G0390 HCPCS Trauma Activation 9 9 $2,366.60 $2,366.60 $1,590.36 $8,874.75 $2,068.41 2026-04-16
A0433 HCPCS Ambulance 911 Als Ii Base Run 9 9 $2,578.85 $2,578.85 $1,732.99 $2,320.97 $2,063.08 2026-04-16
49255 HCPCS Omentectomy 9 9 $2,574.20 $2,574.20 $1,729.86 $2,316.78 $2,059.36 2026-04-16
58700 HCPCS Salpigectomy C/p Unil/bilate 9 9 $2,564.60 $2,564.60 $1,723.41 $2,308.14 $2,051.68 2026-04-16
64718 HCPCS Cubital Tunnel Release 9 9 $2,557.45 $2,557.45 $1,718.61 $2,301.70 $2,045.96 2026-04-16
41899 HCPCS Dentoalveolar Structures 9 9 $2,550.00 $2,550.00 $1,713.60 $2,295.00 $2,040.00 2026-04-16
23410 HCPCS Repair Rotator Cuff 9 9 $2,550.00 $2,550.00 $1,713.60 $2,295.00 $2,040.00 2026-04-16
V2630 HCPCS Intraocular Lens 9 9 $2,524.25 $2,524.25 $1,696.30 $2,271.82 $2,019.40 2026-04-16
25515 HCPCS Open Treatment Radial Shaft Fr 9 9 $2,519.90 $2,519.90 $1,693.37 $2,267.91 $2,015.92 2026-04-16
29825 HCPCS Arthrosopy,shoulder, W Or Without 9 9 $2,519.90 $2,519.90 $1,693.37 $2,267.91 $2,015.92 2026-04-16
57260 HCPCS Comined Anteroposterior Colpor 9 9 $2,519.90 $2,519.90 $1,693.37 $2,267.91 $2,015.92 2026-04-16
27829 HCPCS Open Treat Of Distal Tebiofibu 9 9 $2,480.80 $2,480.80 $1,667.10 $2,232.72 $1,984.64 2026-04-16
78070 HCPCS Nm Pararthyroid Imaging,tc 9 9 $2,464.95 $2,464.95 $1,656.45 $2,218.46 $1,971.96 2026-04-16
78071 HCPCS Parathyroid Imaging Planar & S,tc 9 9 $2,464.95 $2,464.95 $1,656.45 $2,218.45 $1,971.96 2026-04-16
Q4187 HCPCS Amniocord 3x5 45 9 $2,454.15 $2,454.15 $100.97 $3,438.36 $1,963.32 2026-04-16
44970 HCPCS Appendectomy Laparascopy 18 9 $2,424.38 $2,424.38 $1,609.88 $2,207.79 $1,962.48 2026-04-16
Q4160 HCPCS Nushield 1.6 Cm Disc 36 9 $2,384.25 $2,384.25 $870.44 $2,626.51 $1,951.12 2026-04-16
25605 HCPCS Closed Tx Distal Radial Fx 9 9 $2,430.65 $2,430.65 $1,633.40 $2,187.59 $1,944.52 2026-04-16
28296 HCPCS Bunionectomy With Sesamoldectony 9 9 $2,421.15 $2,421.15 $1,627.01 $2,179.03 $1,936.92 2026-04-16
66821 HCPCS Laser Surgery Bilateral (yag),50 18 9 $2,400.00 $2,400.00 $984.00 $2,160.00 $1,920.00 2026-04-16
23430 HCPCS Anchoring Of Biceps Tendon 9 9 $2,400.00 $2,400.00 $1,612.80 $2,160.00 $1,920.00 2026-04-16
43247 HCPCS Egd w/Removal Of Foreign Body 18 9 $2,657.38 $2,657.38 $681.91 $3,870.00 $1,901.43 2026-04-16
74170 HCPCS CT Abdomen Without And W/contrast,tc 9 9 $2,366.40 $2,366.40 $1,590.22 $2,129.76 $1,893.12 2026-04-16
J0585 HCPCS Onabotulinum Toxina 100 Un Vil 9 9 $2,365.10 $2,365.10 $1,589.35 $2,128.59 $1,892.08 2026-04-16
93268 HCPCS 30 Day EKG Monitor 9 9 $2,362.60 $2,362.60 $1,587.67 $2,126.34 $1,890.08 2026-04-16
46200 HCPCS Fissurectomy, Include Sphincte 9 9 $2,354.90 $2,354.90 $1,582.49 $2,119.41 $1,883.92 2026-04-16
71260 HCPCS CT Chest W/contrast,tc 9 9 $2,506.05 $2,506.05 $1,056.47 $2,255.45 $1,879.54 2026-04-16
49507 HCPCS Repair Init Inguinal Hernia 9 9 $2,341.70 $2,341.70 $1,573.62 $2,107.53 $1,873.36 2026-04-16
58670 HCPCS Laparoscopy W/fulgurat 9 9 $2,340.50 $2,340.50 $1,572.82 $2,106.45 $1,872.40 2026-04-16
J9017 HCPCS Arsenic Trioxide 10mg/10ml Vl 9 9 $2,337.40 $2,337.40 $1,570.73 $2,103.66 $1,869.92 2026-04-16
44950 HCPCS Appendectomy, Open 9 9 $2,334.70 $2,334.70 $1,568.92 $2,101.23 $1,867.76 2026-04-16
72127 HCPCS CT Cervical Spine,tc 9 9 $2,296.00 $2,296.00 $1,542.91 $2,066.40 $1,836.80 2026-04-16
49520 HCPCS Repair Recur Inguin Hernia 9 9 $2,273.20 $2,273.20 $1,527.59 $2,045.88 $1,818.56 2026-04-16
72130 HCPCS CT Thoracic Spine,tc 9 9 $2,237.85 $2,237.85 $1,503.84 $2,014.07 $1,790.28 2026-04-16
70492 HCPCS CT Soft Tissue Neck W-w/o,tc 9 9 $2,237.85 $2,237.85 $1,503.84 $2,014.07 $1,790.28 2026-04-16
72133 HCPCS CT Lumbar Spine,tc 9 9 $2,237.85 $2,237.85 $1,503.84 $2,014.07 $1,790.28 2026-04-16
72126 HCPCS CT Cervical Spine, W/contrast,tc 9 9 $2,237.85 $2,237.85 $1,503.84 $2,014.07 $1,790.28 2026-04-16
93351 HCPCS US Echo w/Cont And Treadmill,TC 9 9 $2,233.05 $2,233.05 $1,500.61 $2,009.75 $1,786.44 2026-04-16
28805 HCPCS Aputation Foot 9 9 $2,220.75 $2,220.75 $1,492.34 $1,998.67 $1,776.60 2026-04-16
0278 RC — 589 9 $2,231.25 $2,231.25 $180.16 $12,929.20 $1,774.80 2026-04-16
27752 HCPCS Closed Tx Tibialshaft Fx 9 9 $2,212.65 $2,212.65 $1,486.90 $1,991.38 $1,770.12 2026-04-16
28292 HCPCS Buionectomy W/sesamoidectomy 9 9 $2,203.40 $2,203.40 $1,480.68 $1,983.06 $1,762.72 2026-04-16
27842 HCPCS Closed Treat Ankle Dislo 9 9 $2,180.20 $2,180.20 $1,465.09 $1,962.18 $1,744.16 2026-04-16
43255 HCPCS Egd w/Control Of Bleeding 18 9 $2,475.00 $2,475.00 $436.80 $3,870.00 $1,737.30 2026-04-16
44389 HCPCS Colonoscopy Stoma w/Biospy 18 9 $2,475.00 $2,475.00 $436.80 $3,870.00 $1,737.30 2026-04-16
45382 HCPCS Colonoscopy w/Controlled Bleed 18 9 $2,475.00 $2,475.00 $436.80 $3,870.00 $1,737.30 2026-04-16
45384 HCPCS Colonoscopy w/Tumor Hot Forcep 18 9 $2,475.00 $2,475.00 $436.80 $3,870.00 $1,737.30 2026-04-16
43249 HCPCS Egd w/Ballon Dilation 18 9 $2,475.00 $2,475.00 $436.80 $3,870.00 $1,737.30 2026-04-16
45388 HCPCS Colonoscopy w/Ablation Of Tumo 18 9 $2,475.00 $2,475.00 $436.80 $3,870.00 $1,737.30 2026-04-16
45398 HCPCS Colonoscopy w/Band Ligation 18 9 $2,475.00 $2,475.00 $436.80 $3,870.00 $1,737.30 2026-04-16
20690 HCPCS Application Of A Uniplane 9 9 $2,139.85 $2,139.85 $1,437.98 $1,925.87 $1,711.88 2026-04-16
44020 HCPCS Enterotony Small Intestine 9 9 $2,133.25 $2,133.25 $1,433.54 $1,919.92 $1,706.60 2026-04-16
78801 HCPCS Nm Bsgi Multiple Areas,tc 9 9 $2,129.95 $2,129.95 $1,431.33 $1,916.95 $1,703.96 2026-04-16
70470 HCPCS CT Head Or Brain Without And W Con,tc 9 9 $2,129.75 $2,129.75 $1,431.19 $1,916.78 $1,703.80 2026-04-16
74160 HCPCS CT Abdomen W/contrast,tc 9 9 $2,129.75 $2,129.75 $1,431.19 $1,916.78 $1,703.80 2026-04-16
78227 HCPCS Nm Hepatobiliary/gb With Ef,tc 9 9 $2,128.20 $2,128.20 $898.63 $1,915.38 $1,702.56 2026-04-16
62323 HCPCS Epidural Steroid Inj-lumber 9 9 $2,123.80 $2,123.80 $1,427.19 $1,911.42 $1,699.04 2026-04-16
62321 HCPCS Epidural Steroid Inje-cervical 9 9 $2,123.80 $2,123.80 $1,427.19 $1,911.42 $1,699.04 2026-04-16
28725 HCPCS Closed Treatment Of Fracture 9 9 $2,120.60 $2,120.60 $1,425.04 $1,908.54 $1,696.48 2026-04-16
27685 HCPCS Length/short Of Tendon Leg/ank 9 9 $2,107.70 $2,107.70 $1,416.37 $1,896.93 $1,686.16 2026-04-16
57250 HCPCS Repair Of Rectocele 9 9 $2,095.00 $2,095.00 $1,407.84 $1,885.50 $1,676.00 2026-04-16
25565 HCPCS Closed Treatme Ulnar Shaft Fx 9 9 $2,094.50 $2,094.50 $1,407.50 $1,885.05 $1,675.60 2026-04-16
36581 HCPCS Replace Cv Complete 18 9 $2,037.50 $2,037.50 $1,335.40 $1,879.02 $1,670.24 2026-04-16
49593 HCPCS Repair Anterior Abd Hernia 9 9 $2,080.00 $2,080.00 $1,397.76 $1,872.00 $1,664.00 2026-04-16
78215 HCPCS Nm Liver/spleen,tc 9 9 $2,073.70 $2,073.70 $1,393.53 $1,866.33 $1,658.96 2026-04-16
72129 HCPCS CT Thoracic Spine W/contrast,tc 9 9 $2,072.00 $2,072.00 $1,392.38 $1,864.80 $1,657.60 2026-04-16
72132 HCPCS CT Lumbar Spine W/contrast,tc 9 9 $2,072.00 $2,072.00 $1,392.38 $1,864.80 $1,657.60 2026-04-16
70491 HCPCS CT Soft Tissue Neck, W/cont,tc 9 9 $2,072.00 $2,072.00 $890.96 $1,864.80 $1,657.60 2026-04-16
27818 HCPCS Closed Faction W/manipulation 9 9 $2,051.20 $2,051.20 $1,378.41 $1,846.08 $1,640.96 2026-04-16
71250 HCPCS CT Chest Without Contrast,tc 9 9 $2,044.60 $2,044.60 $259.23 $1,840.14 $1,635.68 2026-04-16
60240 HCPCS Thyroidectomy - Total/Complete 9 9 $2,043.60 $2,043.60 $1,373.30 $1,839.24 $1,634.88 2026-04-16
27257 HCPCS Treatment Of Hip Dislocation 9 9 $2,036.40 $2,036.40 $1,368.46 $1,832.76 $1,629.12 2026-04-16
49505 HCPCS Inguinal Hernia Repair Open 9 9 $2,035.05 $2,035.05 $1,367.55 $1,831.55 $1,628.04 2026-04-16
29826 HCPCS Arthroscopy Shoulder Decomp 9 9 $2,032.25 $2,032.25 $1,365.67 $1,829.03 $1,625.80 2026-04-16
J7307 HCPCS Nexplanon,tb 9 9 $2,029.00 $2,029.00 $1,363.49 $1,826.10 $1,623.20 2026-04-16
78014 HCPCS Nm Thyroid I123 W/multiple Up,tc 18 9 $2,112.88 $2,112.88 $1,183.26 $2,218.45 $1,620.59 2026-04-16
64520 HCPCS Injection Anesthetic Agen Lumb 9 9 $2,015.90 $2,015.90 $1,354.68 $1,814.31 $1,612.72 2026-04-16
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