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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

SUBLETTE COUNTY HEALTH

Pinedale, WY · CCN 530038 · Rates published

2,329 distinct procedures filed
5 distinct payers
10,625 rate rows
2026-10-07 last MRF observed
Data quality

10,577 of 10,625 rate rows are consumer-grade (99.5%)

48 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
percent-of-charges filed in the dollar field — excluded from medians 28
exceeds 10× this hospital's gross charge — excluded from medians 14
per-diem day rate — not a per-procedure price 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSCHPINEDALEWY&type=CDMWithoutLabel&fileType=CSV
Found on page https://sublettehospitaldistrict.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-12
Content fingerprint 6818ced90b362e53… · 3,833,088 bytes · first seen 2026-10-09

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
29806
HCPCS 		Repair Of Shoulder Joint Capsule Using An Endoscope 4 $15,943.50 $20,165.34 $18,069.30 nat. median
$7,073
outlier · 2.6×
58999
HCPCS 		Other Procedure On Female Genital System (nonobstetrical) 4 $7,450.50 $9,423.39 $8,443.90 nat. median
$289
outlier · 29.2×
G0390
HCPCS 		Trauma Response Team Associated With Hospital Critical Care Service 4 $6,555.00 $8,290.76 $7,429.00 nat. median
$3,280
outlier · 2.3×
66999
HCPCS 		Other Procedure On Front Of Eye 4 $6,299.25 $7,967.29 $7,139.15 nat. median
$2,473
outlier · 2.9×
26350
HCPCS 		Repair Of Finger Tendon Of Under Side Of Hand Other Than Upper Most Part Of Palm… 5 $97.00 $14,280.22 $6,742.75 nat. median
$3,380
2.0× median
26410
HCPCS 		Repair Of Tendon On Top Of Hand 5 $97.00 $14,418.72 $6,584.50 nat. median
$1,950
outlier · 3.4×
78608
HCPCS 		Nuclear Medicine Study Of Brain With Metabolic Evaluation 4 $200.00 $7,234.97 $5,910.93 nat. median
$1,613
outlier · 3.7×
A0434
HCPCS 		Specialty Care Transport (sct) 4 $5,168.25 $6,536.80 $5,857.35 nat. median
$907
outlier · 6.5×
49084
HCPCS 		Irrigation Of Abdominal Cavity 4 $5,049.75 $6,386.92 $5,723.05 nat. median
$1,100
outlier · 5.2×
78815
HCPCS 		Nuclear Medicine Study From Skull Base To Mid-thigh With CT Scan 4 $200.00 $6,462.81 $5,280.07 nat. median
$1,679
outlier · 3.1×
78816
HCPCS 		Nuclear Medicine Study Whole Body With CT Scan 4 $200.00 $6,455.22 $5,273.88 nat. median
$1,696
outlier · 3.1×
49406
HCPCS 		Drainage Of Fluid Collection Of Abdominal Cavity By Tube Using Imaging Guidance 4 $4,639.50 $5,868.04 $5,258.10 nat. median
$1,917
outlier · 2.7×
49405
HCPCS 		Drainage Of Fluid Collection By Tube Through Skin Using Imaging Guidance 4 $4,253.25 $5,379.51 $4,820.35 nat. median
$2,114
outlier · 2.3×
C1776
HCPCS 		Joint Device (implantable) 4 $4,024.50 $5,090.19 $4,561.10 nat. median
$3,543
1.3× median
74183
HCPCS 		MRI Scan Of Abdomen Before And After Contrast 4 $200.00 $5,580.61 $4,559.32 nat. median
$611
outlier · 7.5×
11770
HCPCS 		Simple Removal Of Cyst Of Tailbone 5 $97.00 $10,594.91 $4,408.38 nat. median
$2,914
1.5× median
11772
HCPCS 		Complicated Removal Of Cyst Of Tailbone 5 $97.00 $9,368.37 $4,391.50 nat. median
$2,998
1.5× median
27238
HCPCS 		Closed Treatment Of Broken Below Neck Of Thigh Bone 5 $97.00 $9,323.79 $4,380.88 nat. median
$1,643
outlier · 2.7×
20206
HCPCS 		Needle Biopsy Of Muscle 4 $3,754.50 $4,748.69 $4,255.10 nat. median
$1,740
outlier · 2.4×
3600000005
CDM 		Operating Room Services - General Classification 4 $3,750.00 $4,743.00 $4,250.00 nat. median
$5,512
0.8× median
49411
HCPCS 		Insertion Of Device In Abdominal Cavity Through Skin For Radiation Therapy Guida… 4 $3,683.25 $4,658.57 $4,174.35 nat. median
$1,632
outlier · 2.6×
55700
HCPCS 		Biopsy Of Prostate Gland 4 $3,640.50 $4,604.50 $4,125.90 nat. median
$1,997
outlier · 2.1×
V2785
HCPCS 		Processing, Preserving And Transporting Corneal Tissue 4 $3,562.50 $4,505.85 $4,037.50 nat. median
$4,263
0.9× median
11004
HCPCS 		Removal Of Infected Skin, Tissue Or Muscle Of Genitals 5 $97.00 $8,534.55 $4,035.38 nat. median
$1,664
outlier · 2.4×
20102
HCPCS 		Exploration Of Wound Of Abdomen, Back, Or Flank 5 $97.00 $9,175.81 $3,999.88 nat. median
$2,172
1.8× median
32408
HCPCS 		Core Needle Biopsy Of Lung Or Center Cavity Of Chest (mediastinum), Accessed Thr… 4 $3,483.00 $4,405.30 $3,947.40 nat. median
$1,917
outlier · 2.1×
11626
HCPCS 		Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More Tha… 5 $97.00 $9,330.43 $3,944.50 nat. median
$2,795
1.4× median
73220
HCPCS 		MRI Scan Of Arm Before And After Contrast 4 $200.00 $4,775.25 $3,901.35 nat. median
$737
outlier · 5.3×
74178
HCPCS 		CT Scan Of Abdomen And Pelvis Before And After Contrast 4 $200.00 $4,631.07 $3,783.55 nat. median
$539
outlier · 7.0×
1120000002
CDM 		Room & Board - Private (one Bed) - Obstetrics (ob) 3 $3,150.00 $3,780.00 $3,780.00 —
3600000004
CDM 		Operating Room Services - General Classification 4 $3,300.00 $4,173.84 $3,740.00 nat. median
$5,156
0.7× median
50200
HCPCS 		Needle Biopsy Of Kidney 4 $3,289.50 $4,160.56 $3,728.10 nat. median
$1,728
outlier · 2.2×
78452
HCPCS 		Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 4 $200.00 $4,421.42 $3,612.28 nat. median
$1,464
outlier · 2.5×
73723
HCPCS 		MRI Scan Of Leg Joint Before And After Contrast 4 $200.00 $4,824.58 $3,595.19 nat. median
$756
outlier · 4.8×
78451
HCPCS 		Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 4 $200.00 $4,330.36 $3,537.88 nat. median
$1,355
outlier · 2.6×
74182
HCPCS 		MRI Scan Of Abdomen With Contrast 4 $200.00 $4,318.03 $3,527.80 nat. median
$580
outlier · 6.1×
73223
HCPCS 		MRI Scan Of Arm Joint Before And After Contrast 4 $200.00 $4,312.34 $3,523.15 nat. median
$757
outlier · 4.7×
73722
HCPCS 		MRI Scan Of Leg Joint With Contrast 4 $200.00 $4,300.95 $3,513.85 nat. median
$1,003
outlier · 3.5×
14041
HCPCS 		Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Han… 5 $97.00 $6,609.84 $3,510.50 nat. median
$2,416
1.5× median
49180
HCPCS 		Needle Biopsy Of Growth Of Abdominal Cavity 4 $3,096.75 $3,916.77 $3,509.65 nat. median
$1,805
1.9× median
21337
HCPCS 		Closed Treatment Of Broken Bone Separating Nose Airways 5 $97.00 $7,556.55 $3,428.75 nat. median
$3,332
1.0× median
1120000001
CDM 		Room & Board - Private (one Bed) - Obstetrics (ob) 3 $2,850.00 $3,420.00 $3,420.00 —
74174
HCPCS 		CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 4 $200.00 $4,164.35 $3,402.25 nat. median
$549
outlier · 6.2×
1200000007
CDM 		Room & Board - Semi-private (two Beds) - General Classification 3 $2,775.00 $3,330.00 $3,330.00 —
3600000003
CDM 		Operating Room Services - General Classification 4 $2,925.00 $3,699.54 $3,315.00 nat. median
$3,807
0.9× median
73720
HCPCS 		MRI Scan Of Leg Before And After Contrast 4 $200.00 $4,947.90 $3,299.23 nat. median
$754
outlier · 4.4×
72156
HCPCS 		MRI Scan Of Upper Spinal Canal Before And After Contrast 4 $200.00 $4,024.91 $3,288.32 nat. median
$625
outlier · 5.3×
73219
HCPCS 		MRI Scan Of Arm With Contrast 4 $200.00 $3,984.12 $3,255.00 nat. median
$622
outlier · 5.2×
70553
HCPCS 		MRI Scan Of Brain Before And After Contrast 4 $200.00 $3,951.87 $3,228.65 nat. median
$616
outlier · 5.2×
19083
HCPCS 		Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 4 $2,842.50 $3,595.19 $3,221.50 nat. median
$1,957
1.6× median

Other procedures at this hospital

Browse this hospital's 2,329 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
             
29806 HCPCS Repair Of Shoulder Joint Capsule Using An Endoscope 4 4 $21,258.00 $19,132.20 $15,943.50 $20,165.34 $18,069.30 2026-10-07
58999 HCPCS Other Procedure On Female Genital System (nonobstetrical) 4 4 $9,934.00 $8,940.60 $7,450.50 $9,423.39 $8,443.90 2026-10-07
G0390 HCPCS Trauma Response Team Associated With Hospital Critical Care Service 4 4 $8,740.00 $7,866.00 $6,555.00 $8,290.76 $7,429.00 2026-10-07
66999 HCPCS Other Procedure On Front Of Eye 4 4 $8,399.00 $7,559.10 $6,299.25 $7,967.29 $7,139.15 2026-10-07
26350 HCPCS Repair Of Finger Tendon Of Under Side Of Hand Other Than Upper Most Part Of Palm… 8 5 $8,428.00 $7,585.20 $97.00 $14,280.22 $6,742.75 2026-10-07
26410 HCPCS Repair Of Tendon On Top Of Hand 8 5 $8,325.50 $7,492.95 $97.00 $14,418.72 $6,584.50 2026-10-07
78608 HCPCS Nuclear Medicine Study Of Brain With Metabolic Evaluation 4 4 $7,627.00 $6,864.30 $200.00 $7,234.97 $5,910.93 2026-10-07
A0434 HCPCS Specialty Care Transport (sct) 4 4 $6,891.00 $6,201.90 $5,168.25 $6,536.80 $5,857.35 2026-10-07
49084 HCPCS Irrigation Of Abdominal Cavity 4 4 $6,733.00 $6,059.70 $5,049.75 $6,386.92 $5,723.05 2026-10-07
78815 HCPCS Nuclear Medicine Study From Skull Base To Mid-thigh With CT Scan 4 4 $6,813.00 $6,131.70 $200.00 $6,462.81 $5,280.07 2026-10-07
78816 HCPCS Nuclear Medicine Study Whole Body With CT Scan 4 4 $6,805.00 $6,124.50 $200.00 $6,455.22 $5,273.88 2026-10-07
49406 HCPCS Drainage Of Fluid Collection Of Abdominal Cavity By Tube Using Imaging Guidance 4 4 $6,186.00 $5,567.40 $4,639.50 $5,868.04 $5,258.10 2026-10-07
49405 HCPCS Drainage Of Fluid Collection By Tube Through Skin Using Imaging Guidance 4 4 $5,671.00 $5,103.90 $4,253.25 $5,379.51 $4,820.35 2026-10-07
C1776 HCPCS Joint Device (implantable) 4 4 $5,366.00 $4,829.40 $4,024.50 $5,090.19 $4,561.10 2026-10-07
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 4 4 $5,883.00 $5,294.70 $200.00 $5,580.61 $4,559.32 2026-10-07
11770 HCPCS Simple Removal Of Cyst Of Tailbone 8 5 $5,804.50 $5,224.05 $97.00 $10,594.91 $4,408.38 2026-10-07
11772 HCPCS Complicated Removal Of Cyst Of Tailbone 8 5 $5,631.50 $5,068.35 $97.00 $9,368.37 $4,391.50 2026-10-07
27238 HCPCS Closed Treatment Of Broken Below Neck Of Thigh Bone 8 5 $5,489.00 $4,940.10 $97.00 $9,323.79 $4,380.88 2026-10-07
20206 HCPCS Needle Biopsy Of Muscle 4 4 $5,006.00 $4,505.40 $3,754.50 $4,748.69 $4,255.10 2026-10-07
3600000005 CDM Operating Room Services - General Classification 4 4 $5,000.00 $4,500.00 $3,750.00 $4,743.00 $4,250.00 2026-10-07
49411 HCPCS Insertion Of Device In Abdominal Cavity Through Skin For Radiation Therapy Guida… 4 4 $4,911.00 $4,419.90 $3,683.25 $4,658.57 $4,174.35 2026-10-07
55700 HCPCS Biopsy Of Prostate Gland 4 4 $4,854.00 $4,368.60 $3,640.50 $4,604.50 $4,125.90 2026-10-07
V2785 HCPCS Processing, Preserving And Transporting Corneal Tissue 4 4 $4,750.00 $4,275.00 $3,562.50 $4,505.85 $4,037.50 2026-10-07
11004 HCPCS Removal Of Infected Skin, Tissue Or Muscle Of Genitals 8 5 $5,160.50 $4,644.45 $97.00 $8,534.55 $4,035.38 2026-10-07
20102 HCPCS Exploration Of Wound Of Abdomen, Back, Or Flank 8 5 $5,139.50 $4,625.55 $97.00 $9,175.81 $3,999.88 2026-10-07
32408 HCPCS Core Needle Biopsy Of Lung Or Center Cavity Of Chest (mediastinum), Accessed Thr… 4 4 $4,644.00 $4,179.60 $3,483.00 $4,405.30 $3,947.40 2026-10-07
11626 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More Tha… 8 5 $5,263.50 $4,737.15 $97.00 $9,330.43 $3,944.50 2026-10-07
73220 HCPCS MRI Scan Of Arm Before And After Contrast 4 4 $5,034.00 $4,530.60 $200.00 $4,775.25 $3,901.35 2026-10-07
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 4 4 $4,882.00 $4,393.80 $200.00 $4,631.07 $3,783.55 2026-10-07
1120000002 CDM Room & Board - Private (one Bed) - Obstetrics (ob) 3 3 $4,200.00 $3,780.00 $3,150.00 $3,780.00 $3,780.00 2026-10-07
3600000004 CDM Operating Room Services - General Classification 4 4 $4,400.00 $3,960.00 $3,300.00 $4,173.84 $3,740.00 2026-10-07
50200 HCPCS Needle Biopsy Of Kidney 4 4 $4,386.00 $3,947.40 $3,289.50 $4,160.56 $3,728.10 2026-10-07
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 4 4 $4,661.00 $4,194.90 $200.00 $4,421.42 $3,612.28 2026-10-07
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 7 4 $3,790.00 $3,411.00 $200.00 $4,824.58 $3,595.19 2026-10-07
78451 HCPCS Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 4 4 $4,565.00 $4,108.50 $200.00 $4,330.36 $3,537.88 2026-10-07
74182 HCPCS MRI Scan Of Abdomen With Contrast 4 4 $4,552.00 $4,096.80 $200.00 $4,318.03 $3,527.80 2026-10-07
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 4 4 $4,546.00 $4,091.40 $200.00 $4,312.34 $3,523.15 2026-10-07
73722 HCPCS MRI Scan Of Leg Joint With Contrast 4 4 $4,534.00 $4,080.60 $200.00 $4,300.95 $3,513.85 2026-10-07
14041 HCPCS Repair Of Wound Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Han… 8 5 $4,402.00 $3,961.80 $97.00 $6,609.84 $3,510.50 2026-10-07
49180 HCPCS Needle Biopsy Of Growth Of Abdominal Cavity 4 4 $4,129.00 $3,716.10 $3,096.75 $3,916.77 $3,509.65 2026-10-07
21337 HCPCS Closed Treatment Of Broken Bone Separating Nose Airways 8 5 $4,350.50 $3,915.45 $97.00 $7,556.55 $3,428.75 2026-10-07
1120000001 CDM Room & Board - Private (one Bed) - Obstetrics (ob) 3 3 $3,800.00 $3,420.00 $2,850.00 $3,420.00 $3,420.00 2026-10-07
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 4 4 $4,390.00 $3,951.00 $200.00 $4,164.35 $3,402.25 2026-10-07
1200000007 CDM Room & Board - Semi-private (two Beds) - General Classification 3 3 $3,700.00 $3,330.00 $2,775.00 $3,330.00 $3,330.00 2026-10-07
3600000003 CDM Operating Room Services - General Classification 4 4 $3,900.00 $3,510.00 $2,925.00 $3,699.54 $3,315.00 2026-10-07
73720 HCPCS MRI Scan Of Leg Before And After Contrast 7 4 $3,478.00 $3,130.20 $200.00 $4,947.90 $3,299.23 2026-10-07
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 4 4 $4,243.00 $3,818.70 $200.00 $4,024.91 $3,288.32 2026-10-07
73219 HCPCS MRI Scan Of Arm With Contrast 4 4 $4,200.00 $3,780.00 $200.00 $3,984.12 $3,255.00 2026-10-07
70553 HCPCS MRI Scan Of Brain Before And After Contrast 4 4 $4,166.00 $3,749.40 $200.00 $3,951.87 $3,228.65 2026-10-07
19083 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 4 4 $3,790.00 $3,411.00 $2,842.50 $3,595.19 $3,221.50 2026-10-07
48102 HCPCS Needle Biopsy Of Pancreas 4 4 $3,716.00 $3,344.40 $2,787.00 $3,525.00 $3,158.60 2026-10-07
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 4 4 $4,061.00 $3,654.90 $200.00 $3,852.26 $3,147.28 2026-10-07
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 4 4 $4,049.00 $3,644.10 $200.00 $3,840.88 $3,137.97 2026-10-07
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 4 4 $3,977.00 $3,579.30 $200.00 $3,772.58 $3,082.18 2026-10-07
45389 HCPCS Insertion Of Stent In Large Bowel Using A Flexible Endoscope 8 5 $3,675.50 $3,307.95 $97.00 $6,330.96 $3,075.25 2026-10-07
26418 HCPCS Repair Of Tendon On Top Side Of Finger 8 5 $3,628.00 $3,265.20 $97.00 $5,450.66 $3,074.25 2026-10-07
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 4 4 $3,930.00 $3,537.00 $200.00 $3,728.00 $3,045.75 2026-10-07
71552 HCPCS MRI Scan Of Chest Before And After Contrast 4 4 $3,930.00 $3,537.00 $200.00 $3,728.00 $3,045.75 2026-10-07
73719 HCPCS MRI Scan Of Leg With Contrast 4 4 $3,900.00 $3,510.00 $200.00 $3,699.54 $3,022.50 2026-10-07
74181 HCPCS MRI Scan Of Abdomen Without Contrast 4 4 $3,900.00 $3,510.00 $200.00 $3,699.54 $3,022.50 2026-10-07
73222 HCPCS MRI Scan Of Arm Joint With Contrast 4 4 $3,900.00 $3,510.00 $200.00 $3,699.54 $3,022.50 2026-10-07
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 4 4 $3,888.00 $3,499.20 $200.00 $3,688.16 $3,013.20 2026-10-07
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 4 4 $3,874.00 $3,486.60 $200.00 $3,674.88 $3,002.35 2026-10-07
1200000001 CDM Room & Board - Semi-private (two Beds) - General Classification 3 3 $3,300.00 $2,970.00 $2,475.00 $2,970.00 $2,970.00 2026-10-07
42960 HCPCS Simple Control Of Bleeding Of Throat 8 5 $3,685.00 $3,316.50 $97.00 $6,622.18 $2,944.88 2026-10-07
78472 HCPCS Nuclear Medicine Study Of Heart Pumping Function By Labeling Red Blood Cells Wit… 4 4 $3,789.00 $3,410.10 $200.00 $3,594.25 $2,936.47 2026-10-07
70488 HCPCS CT Scan Of Face Before And After Contrast 4 4 $3,789.00 $3,410.10 $200.00 $3,594.25 $2,936.47 2026-10-07
20225 HCPCS Deep Biopsy Of Bone Using Needle Or Trocar 4 4 $3,429.00 $3,086.10 $2,571.75 $3,252.75 $2,914.65 2026-10-07
45390 HCPCS Removal Of Large Bowel Tissue Using A Flexible Endoscope 8 5 $3,382.00 $3,043.80 $97.00 $5,678.32 $2,901.75 2026-10-07
3600000002 CDM Operating Room Services - General Classification 4 4 $3,400.00 $3,060.00 $2,550.00 $3,225.24 $2,890.00 2026-10-07
57020 HCPCS Removal Of Abdominal Fluid 8 5 $3,795.50 $3,415.95 $66.63 $7,024.38 $2,887.38 2026-10-07
20220 HCPCS Biopsy Of Bone Using Needle Or Trocar 4 4 $3,348.00 $3,013.20 $2,511.00 $3,175.91 $2,845.80 2026-10-07
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 4 4 $3,651.00 $3,285.90 $200.00 $3,463.34 $2,829.53 2026-10-07
24535 HCPCS Closed Treatment Of Upper Arm Bone Broken At Elbow With Manipulation 8 5 $3,326.00 $2,993.40 $97.00 $4,971.61 $2,819.38 2026-10-07
45392 HCPCS Fine Needle Aspiration And/or Biopsy Of Large Bowel With Ultrasound Guidance Usi… 8 5 $3,277.00 $2,949.30 $97.00 $5,541.72 $2,792.25 2026-10-07
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 4 4 $3,584.00 $3,225.60 $200.00 $3,399.78 $2,777.60 2026-10-07
81229 HCPCS Genome-wide Microarray Analysis For Copy Number And Single Nucleotide Polymorphi… 4 4 $3,570.00 $3,213.00 $200.00 $3,386.50 $2,766.75 2026-10-07
35207 HCPCS Repair Of Blood Vessel Of Hand Or Finger 8 5 $3,268.50 $2,941.65 $97.00 $4,478.34 $2,757.38 2026-10-07
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 4 4 $3,500.00 $3,150.00 $200.00 $3,320.10 $2,712.50 2026-10-07
20520 HCPCS Removal Of Foreign Body In Muscle Or Tendon 8 5 $3,486.00 $3,137.40 $97.00 $6,273.09 $2,695.88 2026-10-07
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 4 4 $3,471.00 $3,123.90 $200.00 $3,292.59 $2,690.03 2026-10-07
27532 HCPCS Closed Treatment Of Broken Shin Bone With Traction 8 5 $3,143.00 $2,828.70 $97.00 $4,616.84 $2,683.62 2026-10-07
70481 HCPCS CT Scan Of Cranial Cavity With Contrast 4 4 $3,427.00 $3,084.30 $200.00 $3,250.85 $2,655.93 2026-10-07
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 4 4 $3,400.00 $3,060.00 $200.00 $3,225.24 $2,635.00 2026-10-07
42720 HCPCS Drainage Of Abscess Of Throat From Inside Mouth 8 5 $2,894.00 $2,604.60 $97.00 $4,614.94 $2,602.88 2026-10-07
70552 HCPCS MRI Scan Of Brain With Contrast 4 4 $3,350.00 $3,015.00 $200.00 $3,177.81 $2,596.25 2026-10-07
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 4 4 $3,299.00 $2,969.10 $200.00 $3,129.43 $2,556.72 2026-10-07
1700000001 CDM Nursery - General Classification 3 3 $2,800.00 $2,520.00 $2,100.00 $2,520.00 $2,520.00 2026-10-07
70487 HCPCS CT Scan Of Face With Contrast 4 4 $3,229.00 $2,906.10 $200.00 $3,063.03 $2,502.47 2026-10-07
72196 HCPCS MRI Scan Of Pelvis With Contrast 4 4 $3,200.00 $2,880.00 $200.00 $3,035.52 $2,480.00 2026-10-07
64488 HCPCS Injection Of Local Anesthetic For Abdominal Wall Pain Control On Both Sides Usin… 8 5 $3,226.50 $2,903.85 $55.74 $5,985.67 $2,475.75 2026-10-07
71555 HCPCS MRI Scan Of Blood Vessels Of Chest 4 4 $3,181.00 $2,862.90 $200.00 $3,017.50 $2,465.28 2026-10-07
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 4 4 $3,161.00 $2,844.90 $200.00 $2,998.52 $2,449.78 2026-10-07
71551 HCPCS MRI Scan Of Chest With Contrast 4 4 $3,150.00 $2,835.00 $200.00 $2,988.09 $2,441.25 2026-10-07
45391 HCPCS Ultrasound Exam Of Large Bowel Using A Flexible Endoscope 8 5 $2,875.00 $2,587.50 $97.00 $4,881.50 $2,439.25 2026-10-07
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 4 4 $3,133.00 $2,819.70 $200.00 $2,971.96 $2,428.07 2026-10-07
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 4 4 $3,100.00 $2,790.00 $200.00 $2,940.66 $2,402.50 2026-10-07
3600000001 CDM Operating Room Services - General Classification 4 4 $2,800.00 $2,520.00 $2,100.00 $2,656.08 $2,380.00 2026-10-07
70551 HCPCS MRI Scan Of Brain Without Contrast 4 4 $3,046.00 $2,741.40 $200.00 $2,889.44 $2,360.65 2026-10-07
59510 HCPCS Cesarean Delivery With Care Before And After Delivery 4 4 $6,282.00 $5,653.80 $97.00 $4,917.00 $2,360.44 2026-10-07
23625 HCPCS Closed Treatment Of Upper Arm Bone Broken At Shoulder Joint With Manipulation 8 5 $2,861.50 $2,575.35 $97.00 $4,602.61 $2,351.50 2026-10-07
C8929 HCPCS Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi… 4 4 $2,760.00 $2,484.00 $2,070.00 $2,618.14 $2,346.00 2026-10-07
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 7 4 $2,467.00 $2,220.30 $200.00 $3,509.82 $2,340.20 2026-10-07
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 4 4 $3,000.00 $2,700.00 $200.00 $2,845.80 $2,325.00 2026-10-07
71270 HCPCS CT Scan Of Chest Before And After Contrast 4 4 $3,000.00 $2,700.00 $200.00 $2,845.80 $2,325.00 2026-10-07
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 4 4 $2,981.00 $2,682.90 $200.00 $2,827.78 $2,310.28 2026-10-07
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 4 4 $2,981.00 $2,682.90 $200.00 $2,827.78 $2,310.28 2026-10-07
76940 HCPCS Ultrasound Guidance For Tissue Removal 4 4 $2,978.00 $2,680.20 $200.00 $2,824.93 $2,307.95 2026-10-07
10140 HCPCS Drainage Of Blood Or Fluid Accumulation 8 5 $3,011.50 $2,710.35 $97.00 $5,441.17 $2,291.50 2026-10-07
A0433 HCPCS Advanced Life Support, Level 2 (als 2) 4 4 $2,680.00 $2,412.00 $2,010.00 $2,542.25 $2,278.00 2026-10-07
50390 HCPCS Aspiration And/or Injection Of Cyst Of Kidney 4 4 $2,671.00 $2,403.90 $2,003.25 $2,533.71 $2,270.35 2026-10-07
11624 HCPCS Removal Of Cancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, 3.1-4.0 … 8 5 $3,027.00 $2,724.30 $97.00 $5,204.97 $2,267.12 2026-10-07
81162 HCPCS Gene Analysis (breast Cancer 1 And 2) Of Full Sequence And Analysis For Duplicat… 4 4 $2,916.00 $2,624.40 $200.00 $2,766.12 $2,259.90 2026-10-07
7220000002 CDM Labor Room/delivery - Delivery Room 4 4 $2,650.00 $2,385.00 $1,987.50 $2,513.79 $2,252.50 2026-10-07
7220000005 CDM Labor Room/delivery - Delivery Room 4 4 $2,650.00 $2,385.00 $1,987.50 $2,513.79 $2,252.50 2026-10-07
11044 HCPCS Removal Of Bone, 20.0 Sq Cm Or Less 8 5 $2,876.00 $2,588.40 $97.00 $4,952.64 $2,221.88 2026-10-07
11010 HCPCS Removal Of Foreign Material From Skin And Tissue At Open Broken And/or Dislocate… 8 5 $2,853.00 $2,567.70 $97.00 $4,788.53 $2,217.50 2026-10-07
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 4 4 $2,861.00 $2,574.90 $200.00 $2,713.94 $2,217.28 2026-10-07
95808 HCPCS Sleep Study In Sleep Lab 8 5 $2,954.00 $2,658.60 $80.89 $5,420.30 $2,215.75 2026-10-07
73706 HCPCS CT Scan Of Blood Vessels Of Lower Leg With Contrast 7 4 $2,335.00 $2,101.50 $200.00 $3,322.00 $2,214.98 2026-10-07
10011 HCPCS Fine Needle Aspiration Biopsy Of Growth Using MRI Guidance, First Growth 6 5 $2,858.00 $2,572.20 $97.00 $2,711.10 $2,214.95 2026-10-07
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 8 4 $2,522.00 $2,269.80 $200.00 $3,588.55 $2,204.98 2026-10-07
45386 HCPCS Balloon Dilation Of Large Bowel Using A Flexible Endoscope 8 5 $2,611.00 $2,349.90 $97.00 $4,481.19 $2,191.00 2026-10-07
73218 HCPCS MRI Scan Of Arm Without Contrast 7 4 $2,304.00 $2,073.60 $200.00 $3,277.41 $2,185.57 2026-10-07
45379 HCPCS Removal Of Foreign Bodies In Large Bowel Using A Flexible Endoscope 8 5 $2,556.00 $2,300.40 $97.00 $4,318.98 $2,179.38 2026-10-07
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 4 4 $2,810.00 $2,529.00 $200.00 $2,665.57 $2,177.75 2026-10-07
72195 HCPCS MRI Scan Of Pelvis Without Contrast 4 4 $2,809.00 $2,528.10 $200.00 $2,664.62 $2,176.97 2026-10-07
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 4 4 $2,800.00 $2,520.00 $200.00 $2,656.08 $2,170.00 2026-10-07
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 4 4 $2,542.00 $2,287.80 $1,906.50 $2,411.34 $2,160.70 2026-10-07
78801 HCPCS Nuclear Medicine Study, Multiple Areas 4 4 $2,755.00 $2,479.50 $200.00 $2,613.39 $2,135.12 2026-10-07
59400 HCPCS Vaginal Delivery With Care Before And After Delivery 4 4 $5,676.00 $5,108.40 $97.00 $4,422.00 $2,122.95 2026-10-07
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 4 4 $2,735.00 $2,461.50 $200.00 $2,594.42 $2,119.62 2026-10-07
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 4 4 $2,731.00 $2,457.90 $200.00 $2,590.63 $2,116.53 2026-10-07
71260 HCPCS CT Scan Of Chest With Contrast 4 4 $2,725.00 $2,452.50 $200.00 $2,584.94 $2,111.88 2026-10-07
95811 HCPCS Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 8 5 $2,817.00 $2,535.30 $97.00 $5,068.37 $2,111.62 2026-10-07
38221 HCPCS Biopsy Of Bone Marrow 4 4 $2,477.00 $2,229.30 $1,857.75 $2,349.68 $2,105.45 2026-10-07
11012 HCPCS Removal Of Foreign Material From Skin, Tissue, Muscle, And Bone At Open Broken A… 8 5 $2,644.50 $2,380.05 $97.00 $4,086.57 $2,102.50 2026-10-07
10121 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Complex 8 5 $2,732.00 $2,458.80 $97.00 $4,764.82 $2,100.62 2026-10-07
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 4 4 $2,707.00 $2,436.30 $200.00 $2,567.86 $2,097.93 2026-10-07
70545 HCPCS MRI Scan Of Blood Vessels Of Head With Contrast 4 4 $2,700.00 $2,430.00 $200.00 $2,561.22 $2,092.50 2026-10-07
73718 HCPCS MRI Scan Of Leg Without Contrast 7 4 $2,200.00 $1,980.00 $200.00 $3,130.38 $2,086.92 2026-10-07
45393 HCPCS Decompression Of Twisted Or Abnormally Dilated Large Bowel Using A Flexible Endo… 8 5 $2,359.00 $2,123.10 $97.00 $3,918.67 $2,046.62 2026-10-07
42400 HCPCS Needle Biopsy Of Saliva Gland 4 4 $2,393.00 $2,153.70 $1,794.75 $2,270.00 $2,034.05 2026-10-07
36010 HCPCS Insertion Of Tube Into Vena Cava 8 5 $2,646.00 $2,381.40 $91.63 $4,785.69 $2,029.38 2026-10-07
73702 HCPCS CT Scan Of Leg Before And After Contrast 4 4 $2,609.00 $2,348.10 $200.00 $2,474.90 $2,021.97 2026-10-07
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 4 4 $2,603.00 $2,342.70 $200.00 $2,469.21 $2,017.33 2026-10-07
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 4 4 $2,600.00 $2,340.00 $200.00 $2,466.36 $2,015.00 2026-10-07
72129 HCPCS CT Scan Of Middle Spine With Contrast 4 4 $2,571.00 $2,313.90 $200.00 $2,438.85 $1,992.53 2026-10-07
26705 HCPCS Closed Treatment Of Dislocated Hand Joint At Base Of Finger With Manipulation Un… 8 5 $2,351.00 $2,115.90 $97.00 $3,521.20 $1,988.50 2026-10-07
74261 HCPCS Diagnostic CT Scan Of Large Intestine Without Contrast 4 4 $2,558.00 $2,302.20 $200.00 $2,426.52 $1,982.45 2026-10-07
94002 HCPCS Initial Hospital Inpatient Or Observation Ventilation Assistance And Management 4 4 $2,326.00 $2,093.40 $1,744.50 $2,206.44 $1,977.10 2026-10-07
78803 HCPCS Nuclear Medicine Study, Spect Imaging, 1 Area Or Single Acquisition, Single Day … 4 4 $2,535.00 $2,281.50 $200.00 $2,404.70 $1,964.62 2026-10-07
72126 HCPCS CT Scan Of Upper Spine With Contrast 4 4 $2,517.00 $2,265.30 $200.00 $2,387.63 $1,950.67 2026-10-07
72132 HCPCS CT Scan Of Lower Spine With Contrast 4 4 $2,485.00 $2,236.50 $200.00 $2,357.27 $1,925.88 2026-10-07
73206 HCPCS CT Scan Of Blood Vessels Of Arm With Contrast 4 4 $2,482.00 $2,233.80 $200.00 $2,354.43 $1,923.55 2026-10-07
11450 HCPCS Removal Of Skin And Tissue Of Underarms For Inflamed Sweat Glands With Simple Or… 8 5 $2,725.00 $2,452.50 $97.00 $4,268.70 $1,921.50 2026-10-07
93351 HCPCS Ultrasound Of Heart With Continuous Electrocardiogram (ecg) During Rest, Exercis… 4 4 $2,237.00 $2,013.30 $1,677.75 $2,122.02 $1,901.45 2026-10-07
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 8 5 $2,479.50 $2,231.55 $83.31 $4,494.47 $1,897.75 2026-10-07
36573 HCPCS Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, … 8 5 $2,485.50 $2,236.95 $70.58 $4,530.51 $1,897.00 2026-10-07
25505 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side With Manipulati… 8 5 $2,171.50 $1,954.35 $97.00 $3,035.52 $1,892.00 2026-10-07
P9037 HCPCS Platelets, Pheresis, Leukocytes Reduced, Irradiated, Each Unit 4 4 $2,439.00 $2,195.10 $200.00 $2,313.64 $1,890.22 2026-10-07
59412 HCPCS Turning Of Fetus Through External Manipulation 8 5 $2,504.00 $2,253.60 $89.50 $4,523.87 $1,881.88 2026-10-07
36555 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (younger Than 5 Years… 8 5 $2,459.50 $2,213.55 $77.77 $4,478.34 $1,877.88 2026-10-07
95810 HCPCS Sleep Study In Sleep Lab (6 Years Or Older) 8 5 $2,500.50 $2,250.45 $97.00 $4,479.29 $1,874.75 2026-10-07
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 4 4 $2,416.00 $2,174.40 $200.00 $2,291.82 $1,872.40 2026-10-07
47000 HCPCS Needle Biopsy Of Liver Through Skin 4 4 $2,200.00 $1,980.00 $1,650.00 $2,086.92 $1,870.00 2026-10-07
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 4 4 $2,400.00 $2,160.00 $200.00 $2,276.64 $1,860.00 2026-10-07
62272 HCPCS Removal Of Cerebrospinal Fluid With Lower Back Spinal Tap 8 5 $2,386.50 $2,147.85 $80.76 $4,321.82 $1,857.00 2026-10-07
78215 HCPCS Nuclear Medicine Study Of Liver And Spleen 4 4 $2,389.00 $2,150.10 $200.00 $2,266.21 $1,851.47 2026-10-07
78227 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs 4 4 $2,375.00 $2,137.50 $200.00 $2,252.93 $1,840.62 2026-10-07
45385 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using An Endoscope With Mechanical S… 8 5 $2,073.50 $1,866.15 $97.00 $3,369.43 $1,835.00 2026-10-07
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 4 4 $2,363.00 $2,126.70 $200.00 $2,241.54 $1,831.33 2026-10-07
72128 HCPCS CT Scan Of Middle Spine Without Contrast 4 4 $2,358.00 $2,122.20 $200.00 $2,236.80 $1,827.45 2026-10-07
27230 HCPCS Closed Treatment Of Broken Upper Thigh Bone 8 5 $2,072.50 $1,865.25 $97.00 $2,818.29 $1,825.62 2026-10-07
72193 HCPCS CT Scan Of Pelvis With Contrast 4 4 $2,354.00 $2,118.60 $200.00 $2,233.00 $1,824.35 2026-10-07
24620 HCPCS Closed Treatment Of Broken And Dislocated Forearm Bones At Elbow With Manipulati… 8 5 $1,965.50 $1,768.95 $97.00 $2,357.27 $1,805.38 2026-10-07
A0427 HCPCS Ambulance Service, Advanced Life Support, Emergency Transport, Level 1 (als 1 - … 4 4 $2,121.00 $1,908.90 $1,590.75 $2,011.98 $1,802.85 2026-10-07
74470 HCPCS Review By Radiologist Of Kidney Cyst Image 4 4 $2,310.00 $2,079.00 $200.00 $2,191.27 $1,790.25 2026-10-07
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 4 4 $2,304.00 $2,073.60 $200.00 $2,185.57 $1,785.60 2026-10-07
72125 HCPCS CT Scan Of Upper Spine Without Contrast 4 4 $2,301.00 $2,070.90 $200.00 $2,182.73 $1,783.28 2026-10-07
25635 HCPCS Closed Treatment Of Other Broken Wrist Bone With Manipulation 8 5 $2,035.50 $1,831.95 $97.00 $2,859.08 $1,766.75 2026-10-07
P9035 HCPCS Platelets, Pheresis, Leukocytes Reduced, Each Unit 4 4 $2,275.00 $2,047.50 $200.00 $2,158.07 $1,763.12 2026-10-07
99291 HCPCS Critical Care, First 30-74 Minutes 8 5 $2,500.00 $2,250.00 $97.00 $3,955.66 $1,752.75 2026-10-07
45398 HCPCS Banding Of Hemorrhoids Using A Flexible Endoscope (colonoscope) 8 5 $1,981.00 $1,782.90 $97.00 $3,236.62 $1,746.00 2026-10-07
71550 HCPCS MRI Scan Of Chest Without Contrast 4 4 $2,250.00 $2,025.00 $200.00 $2,134.35 $1,743.75 2026-10-07
72131 HCPCS CT Scan Of Lower Spine Without Contrast 4 4 $2,250.00 $2,025.00 $200.00 $2,134.35 $1,743.75 2026-10-07
92960 HCPCS External Shock To Heart To Regulate Heart Beat 4 4 $2,045.00 $1,840.50 $1,533.75 $1,939.89 $1,738.25 2026-10-07
78466 HCPCS Nuclear Medicine Study Of Heart Muscle Following Heart Attack 4 4 $2,235.00 $2,011.50 $200.00 $2,120.12 $1,732.12 2026-10-07
93350 HCPCS Ultrasound Of Heart During Rest, Exercise And/or Drug-induced Stress With Report 4 4 $2,035.00 $1,831.50 $1,526.25 $1,930.40 $1,729.75 2026-10-07
78606 HCPCS Nuclear Medicine Study Of Brain And Blood Flow, 4 Static Views Or More 4 4 $2,229.00 $2,006.10 $200.00 $2,114.43 $1,727.47 2026-10-07
45380 HCPCS Biopsy Of Large Bowel Using A Flexible Endoscope 8 5 $2,004.50 $1,804.05 $97.00 $3,355.20 $1,723.88 2026-10-07
72191 HCPCS CT Scan Of Blood Vessels Of Pelvis With Contrast 4 4 $2,200.00 $1,980.00 $200.00 $2,086.92 $1,705.00 2026-10-07
31605 HCPCS Emergent Incision Of Windpipe For Insertion Of Breathing Tube 8 5 $2,080.50 $1,872.45 $97.00 $3,215.75 $1,704.25 2026-10-07
73202 HCPCS CT Scan Of Arm Before And After Contrast 4 4 $2,175.00 $1,957.50 $200.00 $2,063.21 $1,685.62 2026-10-07
74160 HCPCS CT Scan Of Abdomen With Contrast 4 4 $2,168.00 $1,951.20 $200.00 $2,056.56 $1,680.20 2026-10-07
64447 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Thigh Nerve (femoral Nerve) 8 5 $2,160.00 $1,944.00 $59.75 $3,954.71 $1,664.38 2026-10-07
78315 HCPCS Nuclear Medicine Study Of Bone Taken At Different Times 4 4 $2,144.00 $1,929.60 $200.00 $2,033.80 $1,661.60 2026-10-07
49423 HCPCS Exchange Of Abdominal Cavity Drainage Tube Using Imaging Guidance 4 4 $1,954.00 $1,758.60 $1,465.50 $1,853.56 $1,660.90 2026-10-07
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 4 4 $2,142.00 $1,927.80 $200.00 $2,031.90 $1,660.05 2026-10-07
81420 HCPCS Test For Detecting Genes Associated With Fetal Disease, Aneuploidy Genomic Seque… 4 4 $2,140.00 $1,926.00 $200.00 $2,030.00 $1,658.50 2026-10-07
70460 HCPCS CT Scan Head Or Brain With Contrast 4 4 $2,122.00 $1,909.80 $200.00 $2,012.93 $1,644.55 2026-10-07
27134 HCPCS Revision Of Thigh Bone And Hip Joint Prosthesis 4 4 $4,516.00 $4,064.40 $97.00 $5,510.00 $1,640.89 2026-10-07
38505 HCPCS Needle Biopsy Or Removal Of Surface Lymph Nodes 4 4 $1,925.00 $1,732.50 $1,443.75 $1,826.06 $1,636.25 2026-10-07
25690 HCPCS Closed Treatment Of Dislocated Wrist (lunate) Bone With Manipulation 8 5 $1,808.50 $1,627.65 $97.00 $2,277.59 $1,635.38 2026-10-07
44141 HCPCS Partial Removal Of Large Bowel With Creation Of Opening To Skin 4 4 $4,242.00 $3,817.80 $97.00 $7,272.00 $1,628.91 2026-10-07
1200000003 CDM Room & Board - Semi-private (two Beds) - General Classification 3 3 $1,800.00 $1,620.00 $1,350.00 $1,620.00 $1,620.00 2026-10-07
91035 HCPCS Monitoring And Recording Of Esophageal Function Through A Capsule Attached To Th… 4 4 $1,903.00 $1,712.70 $1,427.25 $1,805.19 $1,617.55 2026-10-07
7220000004 CDM Labor Room/delivery - Delivery Room 4 4 $1,900.00 $1,710.00 $1,425.00 $1,802.34 $1,615.00 2026-10-07
7220000003 CDM Labor Room/delivery - Delivery Room 4 4 $1,900.00 $1,710.00 $1,425.00 $1,802.34 $1,615.00 2026-10-07
10180 HCPCS Complex Drainage Of Wound Infection After Surgery 8 5 $2,081.00 $1,872.90 $97.00 $3,541.12 $1,611.88 2026-10-07
77012 HCPCS Review By Radiologist Of CT Guidance For Needle Placement 4 4 $2,072.00 $1,864.80 $200.00 $1,965.50 $1,605.80 2026-10-07
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 4 4 $2,060.00 $1,854.00 $200.00 $1,954.12 $1,596.50 2026-10-07
78700 HCPCS Nuclear Medicine Study Of Kidney 4 4 $2,055.00 $1,849.50 $200.00 $1,949.37 $1,592.62 2026-10-07
27752 HCPCS Closed Treatment Of Middle Part Of Broken Shin Bone With Manipulation 8 5 $1,749.50 $1,574.55 $97.00 $2,178.93 $1,590.88 2026-10-07
73701 HCPCS CT Scan Of Leg With Contrast Material 7 4 $1,674.00 $1,506.60 $200.00 $2,381.93 $1,587.96 2026-10-07
45378 HCPCS Diagnostic Exam Of Large Bowel Using A Flexible Endoscope 8 5 $1,845.00 $1,660.50 $97.00 $3,088.64 $1,587.00 2026-10-07
95805 HCPCS Sleep Study, Multiple Trials 8 5 $2,115.00 $1,903.50 $57.35 $3,884.52 $1,586.12 2026-10-07
15851 HCPCS Removal Of Sutures Or Staples Under Anesthesia 8 5 $2,078.50 $1,870.65 $57.32 $3,794.40 $1,576.50 2026-10-07
79005 HCPCS Radioactive Drug Therapy By Mouth 4 4 $2,031.00 $1,827.90 $200.00 $1,926.61 $1,574.03 2026-10-07
78582 HCPCS Nuclear Medicine Study Of Lung Ventilation And Circulation 4 4 $2,019.00 $1,817.10 $200.00 $1,915.22 $1,564.72 2026-10-07
45382 HCPCS Control Of Bleeding Of Upper Large Bowel Using A Flexible Endoscope 8 5 $1,688.00 $1,519.20 $97.00 $2,626.67 $1,549.88 2026-10-07
40650 HCPCS Repair Of Lip And Border 8 5 $1,588.00 $1,429.20 $97.00 $2,281.38 $1,547.88 2026-10-07
45384 HCPCS Removal Of Polyps Or Growths Of Large Bowel Using A Flexible Endoscope With Elec… 8 5 $1,716.00 $1,544.40 $97.00 $2,749.04 $1,539.25 2026-10-07
27487 HCPCS Revision Of Thigh And Lower Leg Bone Components Of Total Knee Joint Prosthesis 4 4 $4,169.00 $3,752.10 $97.00 $5,082.00 $1,525.89 2026-10-07
78306 HCPCS Nuclear Medicine Study Of Bone And/or Joint Whole Body 4 4 $1,962.00 $1,765.80 $200.00 $1,861.15 $1,520.55 2026-10-07
23474 HCPCS Revision Of Total Shoulder Repair, Total Shoulder 4 4 $4,131.00 $3,717.90 $97.00 $5,035.00 $1,505.42 2026-10-07
78708 HCPCS Nuclear Medicine Study Of Kidney, Blood, Flow, And Function With Drug Administra… 4 4 $1,939.00 $1,745.10 $200.00 $1,839.34 $1,502.72 2026-10-07
12020 HCPCS Simple Closure Of Surface Wound Reopening 8 5 $1,954.50 $1,759.05 $97.00 $3,278.36 $1,495.00 2026-10-07
70480 HCPCS CT Scan Of Cranial Cavity Without Contrast 4 4 $1,920.00 $1,728.00 $200.00 $1,821.31 $1,488.00 2026-10-07
70486 HCPCS CT Scan Of Face Without Contrast 4 4 $1,908.00 $1,717.20 $200.00 $1,809.93 $1,478.70 2026-10-07
81422 HCPCS Test For Detecting Genes Associated With Fetal Disease, Microdeletion(s) Genomic… 4 4 $1,898.00 $1,708.20 $200.00 $1,800.44 $1,470.95 2026-10-07
11646 HCPCS Removal Of Cancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More… 8 5 $1,961.50 $1,765.35 $97.00 $2,845.80 $1,467.00 2026-10-07
44227 HCPCS Closure Of Opening From Large Or Small Bowel To Skin Using An Endoscope 4 4 $3,878.00 $3,490.20 $97.00 $6,628.00 $1,465.56 2026-10-07
44145 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum 3 3 $619.00 $557.10 $97.00 $1,461.82 $1,461.82 2026-10-07
27132 HCPCS Total Hip Replacement After Previous Hip Surgery 4 4 $3,977.00 $3,579.30 $97.00 $4,845.00 $1,457.93 2026-10-07
A0426 HCPCS Ambulance Service, Advanced Life Support, Non-emergency Transport, Level 1 (als … 4 4 $1,702.00 $1,531.80 $1,276.50 $1,614.52 $1,446.70 2026-10-07
78018 HCPCS Nuclear Medicine Study Of Whole Body For Thyroid Cancer 4 4 $1,863.00 $1,676.70 $200.00 $1,767.24 $1,443.83 2026-10-07
95816 HCPCS Measurement Of Brain Wave Activity (eeg), Awake And Drowsy 4 4 $1,691.00 $1,521.90 $1,268.25 $1,604.08 $1,437.35 2026-10-07
78290 HCPCS Nuclear Medicine Study Of Intestine 4 4 $1,851.00 $1,665.90 $200.00 $1,755.86 $1,434.53 2026-10-07
73201 HCPCS CT Scan Of Arm With Contrast 4 4 $1,850.00 $1,665.00 $200.00 $1,754.91 $1,433.75 2026-10-07
49020 HCPCS Drainage Of Abdominal Abscess Or Infection 4 4 $3,752.00 $3,376.80 $97.00 $6,416.00 $1,432.95 2026-10-07
71250 HCPCS CT Scan Of Chest Without Contrast 4 4 $1,846.00 $1,661.40 $200.00 $1,751.12 $1,430.65 2026-10-07
73700 HCPCS CT Scan Of Leg Without Contrast 7 4 $2,250.00 $2,025.00 $200.00 $2,134.35 $1,422.90 2026-10-07
72192 HCPCS CT Scan Of Pelvis Without Contrast 4 4 $1,836.00 $1,652.40 $200.00 $1,741.63 $1,422.90 2026-10-07
32400 HCPCS Needle Biopsy Of Lining Of Lung 4 4 $1,669.00 $1,502.10 $1,251.75 $1,583.21 $1,418.65 2026-10-07
15946 HCPCS Removal Of Pressure Sore And Lower Pelvic Bone In Preparation Of Muscle Flap Or … 4 4 $3,814.00 $3,432.60 $97.00 $3,799.00 $1,418.24 2026-10-07
20611 HCPCS Aspiration And/or Injection Of Fluid Large Joint Using Ultrasound Guidance 8 5 $1,835.50 $1,651.95 $48.89 $3,349.51 $1,409.12 2026-10-07
C1713 HCPCS Anchor/screw For Opposing Bone-to-bone Or Soft Tissue-to-bone (implantable) 4 4 $1,655.00 $1,489.50 $1,241.25 $1,569.93 $1,406.75 2026-10-07
11446 HCPCS Removal Of Noncancer Skin Growth Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, M… 8 5 $1,883.00 $1,694.70 $97.00 $2,845.80 $1,406.00 2026-10-07
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 4 4 $1,814.00 $1,632.60 $200.00 $1,720.76 $1,405.85 2026-10-07
70490 HCPCS CT Scan Of Soft Tissue Of Neck Without Contrast 4 4 $1,811.00 $1,629.90 $200.00 $1,717.91 $1,403.53 2026-10-07
12047 HCPCS Intermediate Repair Of Wound Of Neck, Hands, Feet, Or Genitals, More Than 30.0 C… 8 5 $1,790.50 $1,611.45 $97.00 $2,602.96 $1,403.00 2026-10-07
70450 HCPCS CT Scan Head Or Brain Without Contrast 4 4 $1,809.00 $1,628.10 $200.00 $1,716.02 $1,401.97 2026-10-07
78014 HCPCS Nuclear Medicine Study Of Thyroid And Thyroid Function 4 4 $1,809.00 $1,628.10 $200.00 $1,716.02 $1,401.97 2026-10-07
23473 HCPCS Revision Of Total Shoulder Repair 4 4 $3,829.00 $3,446.10 $97.00 $4,665.00 $1,397.78 2026-10-07
27091 HCPCS Removal Of Hip Prosthesis, Complicated 4 4 $3,795.00 $3,415.50 $97.00 $4,621.00 $1,393.56 2026-10-07
70336 HCPCS MRI Scan Of Jaw Joint 4 4 $1,798.00 $1,618.20 $200.00 $1,705.58 $1,393.45 2026-10-07
27550 HCPCS Closed Treatment Of Dislocated Knee 8 5 $1,498.00 $1,348.20 $97.00 $1,743.53 $1,390.25 2026-10-07
78226 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System 4 4 $1,786.00 $1,607.40 $200.00 $1,694.20 $1,384.15 2026-10-07
40831 HCPCS Repair Of Lacerated Mouth, More Than 2.5 Cm 8 5 $1,544.50 $1,390.05 $97.00 $2,464.46 $1,379.25 2026-10-07
32551 HCPCS Removal Of Fluid From Between Lung And Chest Cavity 8 5 $1,734.50 $1,561.05 $97.00 $2,947.30 $1,368.12 2026-10-07
47001 HCPCS Needle Biopsy Of Liver 4 4 $1,608.00 $1,447.20 $1,206.00 $1,525.35 $1,366.80 2026-10-07
43281 HCPCS Repair Of Hernia Of Muscle At Esophagus And Stomach Using An Endoscope 4 4 $3,588.00 $3,229.20 $97.00 $6,168.00 $1,366.26 2026-10-07
44204 HCPCS Partial Removal Of Large Bowel Using An Endoscope 4 4 $3,601.00 $3,240.90 $97.00 $6,149.00 $1,363.26 2026-10-07
11426 HCPCS Removal Of Noncancer Skin Growth Of Scalp, Neck, Hands, Feet, Or Genitals, More … 8 5 $1,823.50 $1,641.15 $97.00 $2,845.80 $1,362.50 2026-10-07
7220000001 CDM Labor Room/delivery - Delivery Room 4 4 $1,600.00 $1,440.00 $1,200.00 $1,517.76 $1,360.00 2026-10-07
36002 HCPCS Injection To Cause Blood Clot In Diseased Or Pseudoaneurysm Of Arm Or Leg 4 4 $1,591.00 $1,431.90 $1,193.25 $1,509.22 $1,352.35 2026-10-07
78278 HCPCS Nuclear Medicine Study To Assess Blood Loss 4 4 $1,735.00 $1,561.50 $200.00 $1,645.82 $1,344.62 2026-10-07
15734 HCPCS Creation Of Muscle Graft To Trunk 4 4 $3,561.00 $3,204.90 $97.00 $3,537.00 $1,343.56 2026-10-07
60100 HCPCS Needle Biopsy Of Thyroid Through Skin 4 4 $1,570.00 $1,413.00 $1,177.50 $1,489.30 $1,334.50 2026-10-07
78264 HCPCS Nuclear Medicine Study Of Stomach To Assess Emptying 4 4 $1,720.00 $1,548.00 $200.00 $1,631.59 $1,333.00 2026-10-07
76497 HCPCS Other CT Scan 4 4 $1,717.00 $1,545.30 $200.00 $1,628.75 $1,330.67 2026-10-07
P9036 HCPCS Platelets, Pheresis, Irradiated, Each Unit 4 4 $1,715.00 $1,543.50 $200.00 $1,626.85 $1,329.12 2026-10-07
27138 HCPCS Revision Of Thigh Bone Prosthesis 4 4 $3,622.00 $3,259.80 $97.00 $4,412.00 $1,324.55 2026-10-07
93930 HCPCS Ultrasound Of Arm Arteries Or Artery Grafts 4 4 $1,700.00 $1,530.00 $200.00 $1,612.62 $1,317.50 2026-10-07
10009 HCPCS Fine Needle Aspiration Biopsy Of Growth Using CT Guidance, First Growth 8 5 $1,692.50 $1,523.25 $91.19 $2,969.12 $1,299.25 2026-10-07
74150 HCPCS CT Scan Of Abdomen Without Contrast 4 4 $1,660.00 $1,494.00 $200.00 $1,574.68 $1,286.50 2026-10-07
G0259 HCPCS Injection Procedure For Sacroiliac Joint; Arthrography 4 4 $1,512.00 $1,360.80 $1,134.00 $1,434.28 $1,285.20 2026-10-07
78195 HCPCS Nuclear Medicine Study Of Lymphatic System 4 4 $1,657.00 $1,491.30 $200.00 $1,571.83 $1,284.17 2026-10-07
11042 HCPCS Removal Of Skin And Tissue, 20.0 Sq Cm Or Less 8 5 $1,683.00 $1,514.70 $54.65 $3,056.39 $1,279.25 2026-10-07
25624 HCPCS Closed Treatment Of Broken Wrist Bone Near Base Of Thumb With Manipulation 8 5 $1,380.50 $1,242.45 $97.00 $1,563.29 $1,277.20 2026-10-07
27502 HCPCS Closed Treatment Of Broken Thigh Bone At Midportion With Manipulation 8 5 $1,730.50 $1,557.45 $97.00 $2,207.00 $1,277.20 2026-10-07
27762 HCPCS Closed Treatment Of Inside Portion Of Shin Bone At Ankle With Manipulation 8 5 $1,364.50 $1,228.05 $97.00 $1,563.29 $1,277.20 2026-10-07
78070 HCPCS Nuclear Medicine Study Of Parathyroid 4 4 $1,636.00 $1,472.40 $200.00 $1,551.91 $1,267.90 2026-10-07
P9039 HCPCS Red Blood Cells, Deglycerolized, Each Unit 4 4 $1,634.00 $1,470.60 $200.00 $1,550.01 $1,266.35 2026-10-07
23472 HCPCS Prosthetic Repair Of Shoulder Joint, Total Shoulder 4 4 $3,446.00 $3,101.40 $97.00 $4,195.00 $1,262.43 2026-10-07
23520 HCPCS Closed Treatment Of Dislocated Joint Between Collar And Chest Bone 8 5 $1,503.50 $1,353.15 $97.00 $2,277.59 $1,262.38 2026-10-07
G0260 HCPCS Injection Procedure For Sacroiliac Joint; Provision Of Anesthetic, Steroid And/o… 4 4 $1,481.00 $1,332.90 $1,110.75 $1,404.88 $1,258.85 2026-10-07
P9034 HCPCS Platelets, Pheresis, Each Unit 4 4 $1,616.00 $1,454.40 $200.00 $1,532.94 $1,252.40 2026-10-07
38220 HCPCS Aspiration Of Bone Marrow Sample For Diagnosis 8 5 $1,591.00 $1,431.90 $54.66 $2,993.78 $1,252.00 2026-10-07
12057 HCPCS Intermediate Repair Of Wound Of Face, Ears, Eyelids, Nose, Lips, Or Mouth, More … 8 5 $1,552.00 $1,396.80 $97.00 $1,992.06 $1,230.00 2026-10-07
24655 HCPCS Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow With Manipulation 8 5 $1,328.50 $1,195.65 $97.00 $1,563.29 $1,229.50 2026-10-07
41805 HCPCS Removal Of Embedded Foreign Body In Soft Tissue Of Tooth Bearing Bone 8 5 $1,345.00 $1,210.50 $97.00 $2,107.79 $1,226.75 2026-10-07
43840 HCPCS Suture Of Perforated Ulcer, Wound, Or Injury Of Stomach Or Upper Small Bowel 4 4 $3,200.00 $2,880.00 $97.00 $5,477.00 $1,222.81 2026-10-07
27415 HCPCS Implantation Of Donor Cartilage Cells Into Knee Joint 4 4 $3,290.00 $2,961.00 $97.00 $3,999.00 $1,222.51 2026-10-07
75989 HCPCS Review By Radiologist Of Image For Drainage Of Fluid 4 4 $1,572.00 $1,414.80 $200.00 $1,491.20 $1,218.30 2026-10-07
26080 HCPCS Incision Of Finger Joint For Exploration, Fluid Drainage, Or Removal Of Foreign … 8 5 $1,317.50 $1,185.75 $97.00 $1,563.29 $1,211.50 2026-10-07
23665 HCPCS Closed Treatment Of Dislocated Shoulder And Broken Upper Arm Bone At Shoulder Jo… 8 5 $1,310.50 $1,179.45 $97.00 $1,541.48 $1,211.38 2026-10-07
44140 HCPCS Partial Removal Of Large Bowel With Connection 4 4 $3,154.00 $2,838.60 $97.00 $5,394.00 $1,203.30 2026-10-07
A9562 HCPCS Technetium Tc-99m Mertiatide, Diagnostic, Per Study Dose, Up To 15 Millicuries 4 4 $1,415.00 $1,273.50 $1,061.25 $1,342.27 $1,202.75 2026-10-07
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