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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

Your selected procedure

You selected 93306 (HCPCS)

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This hospital’s price: $2,161 across 4 payers · range $1,906-$2,411

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSCHPINEDALEWY&type=CDMWithoutLabel&fileType=CSV · observed 2026-10-07

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

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 · 2026-10-27
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
$7,171
outlier · 2.5×
58999
HCPCS 		Other Procedure On Female Genital System (nonobstetrical) 4 $7,450.50 $9,423.39 $8,443.90 nat. median
$363
outlier · 23.2×
G0390
HCPCS 		Trauma Response Team Associated With Hospital Critical Care Service 4 $6,555.00 $8,290.76 $7,429.00 nat. median
$3,197
outlier · 2.3×
66999
HCPCS 		Other Procedure On Front Of Eye 4 $6,299.25 $7,967.29 $7,139.15 nat. median
$2,528
outlier · 2.8×
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
$3,390
2.0× median
26410
HCPCS 		Repair Of Tendon On Top Of Hand 5 $97.00 $14,418.72 $6,584.50 nat. median
$1,973
outlier · 3.3×
78608
HCPCS 		Nuclear Medicine Study Of Brain With Metabolic Evaluation 4 $200.00 $7,234.97 $5,910.93 nat. median
$2,450
outlier · 2.4×
A0434
HCPCS 		Specialty Care Transport (sct) 4 $5,168.25 $6,536.80 $5,857.35 nat. median
$1,266
outlier · 4.6×
49084
HCPCS 		Irrigation Of Abdominal Cavity 4 $5,049.75 $6,386.92 $5,723.05 nat. median
$1,080
outlier · 5.3×
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
$2,820
1.9× median
78816
HCPCS 		Nuclear Medicine Study Whole Body With CT Scan 4 $200.00 $6,455.22 $5,273.88 nat. median
$2,788
1.9× median
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
$2,185
outlier · 2.4×
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
$2,238
outlier · 2.2×
C1776
HCPCS 		Joint Device (implantable) 4 $4,024.50 $5,090.19 $4,561.10 nat. median
$3,394
1.3× median
74183
HCPCS 		MRI Scan Of Abdomen Before And After Contrast 4 $200.00 $5,580.61 $4,559.32 nat. median
$1,100
outlier · 4.1×
11770
HCPCS 		Simple Removal Of Cyst Of Tailbone 5 $97.00 $10,594.91 $4,408.38 nat. median
$2,837
1.6× median
11772
HCPCS 		Complicated Removal Of Cyst Of Tailbone 5 $97.00 $9,368.37 $4,391.50 nat. median
$3,009
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
$1,665
outlier · 2.6×
20206
HCPCS 		Needle Biopsy Of Muscle 4 $3,754.50 $4,748.69 $4,255.10 nat. median
$1,689
outlier · 2.5×
3600000005
CDM 		Operating Room Services - General Classification 4 $3,750.00 $4,743.00 $4,250.00 nat. median
$4,562
0.9× 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
$1,739
outlier · 2.4×
55700
HCPCS 		Biopsy Of Prostate Gland 4 $3,640.50 $4,604.50 $4,125.90 nat. median
$2,097
2.0× median
V2785
HCPCS 		Processing, Preserving And Transporting Corneal Tissue 4 $3,562.50 $4,505.85 $4,037.50 nat. median
$5,107
0.8× median
11004
HCPCS 		Removal Of Infected Skin, Tissue Or Muscle Of Genitals 5 $97.00 $8,534.55 $4,035.38 nat. median
$1,626
outlier · 2.5×
20102
HCPCS 		Exploration Of Wound Of Abdomen, Back, Or Flank 5 $97.00 $9,175.81 $3,999.88 nat. median
$2,183
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
$2,057
1.9× median
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
$2,833
1.4× median
73220
HCPCS 		MRI Scan Of Arm Before And After Contrast 4 $200.00 $4,775.25 $3,901.35 nat. median
$1,130
outlier · 3.5×
74178
HCPCS 		CT Scan Of Abdomen And Pelvis Before And After Contrast 4 $200.00 $4,631.07 $3,783.55 nat. median
$1,024
outlier · 3.7×
1120000002
CDM 		Room & Board - Private (one Bed) - Obstetrics (ob) 3 $3,150.00 $3,780.00 $3,780.00 nat. median
$557
outlier · 6.8×
3600000004
CDM 		Operating Room Services - General Classification 4 $3,300.00 $4,173.84 $3,740.00 nat. median
$1,041
outlier · 3.6×
50200
HCPCS 		Needle Biopsy Of Kidney 4 $3,289.50 $4,160.56 $3,728.10 nat. median
$1,880
2.0× median
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
$1,816
2.0× median
73723
HCPCS 		MRI Scan Of Leg Joint Before And After Contrast 4 $200.00 $4,824.58 $3,595.19 nat. median
$1,192
outlier · 3.0×
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
$1,546
outlier · 2.3×
74182
HCPCS 		MRI Scan Of Abdomen With Contrast 4 $200.00 $4,318.03 $3,527.80 nat. median
$971
outlier · 3.6×
73223
HCPCS 		MRI Scan Of Arm Joint Before And After Contrast 4 $200.00 $4,312.34 $3,523.15 nat. median
$1,158
outlier · 3.0×
73722
HCPCS 		MRI Scan Of Leg Joint With Contrast 4 $200.00 $4,300.95 $3,513.85 nat. median
$1,279
outlier · 2.7×
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
$2,259
1.6× median
49180
HCPCS 		Needle Biopsy Of Growth Of Abdominal Cavity 4 $3,096.75 $3,916.77 $3,509.65 nat. median
$1,775
2.0× median
21337
HCPCS 		Closed Treatment Of Broken Bone Separating Nose Airways 5 $97.00 $7,556.55 $3,428.75 nat. median
$3,235
1.1× median
1120000001
CDM 		Room & Board - Private (one Bed) - Obstetrics (ob) 3 $2,850.00 $3,420.00 $3,420.00 nat. median
$1,196
outlier · 2.9×
74174
HCPCS 		CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 4 $200.00 $4,164.35 $3,402.25 nat. median
$988
outlier · 3.4×
1200000007
CDM 		Room & Board - Semi-private (two Beds) - General Classification 3 $2,775.00 $3,330.00 $3,330.00 nat. median
$644
outlier · 5.2×
3600000003
CDM 		Operating Room Services - General Classification 4 $2,925.00 $3,699.54 $3,315.00 nat. median
$4,271
0.8× median
73720
HCPCS 		MRI Scan Of Leg Before And After Contrast 4 $200.00 $4,947.90 $3,299.23 nat. median
$1,129
outlier · 2.9×
72156
HCPCS 		MRI Scan Of Upper Spinal Canal Before And After Contrast 4 $200.00 $4,024.91 $3,288.32 nat. median
$1,103
outlier · 3.0×
73219
HCPCS 		MRI Scan Of Arm With Contrast 4 $200.00 $3,984.12 $3,255.00 nat. median
$955
outlier · 3.4×
70553
HCPCS 		MRI Scan Of Brain Before And After Contrast 4 $200.00 $3,951.87 $3,228.65 nat. median
$1,133
outlier · 2.8×
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
$2,142
1.5× 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.

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
             
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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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