Price Transparencybeta Hospital negotiated rates

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

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Hospital

HOT SPRINGS COUNTY MEMORIAL HOSPITAL

Thermopolis, WY · CCN 531304 · Rates published

Your selected procedure

You selected 93350 (HCPCS)

Ultrasound of heart during rest, exercise and/or drug-induced stress with report

This hospital’s price: $781 across 5 payers · range $67-$1,427

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbHSCMHTHERMOPOLISWY&type=CDMWithoutLabel&fileType=CSV · observed 2026-04-17

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.

3,228 distinct procedures filed
5 distinct payers
18,506 rate rows
2026-04-17 last MRF observed
Data quality

17,857 of 18,506 rate rows are consumer-grade (96.5%)

649 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-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 292
per-diem day rate — not a per-procedure price 226
template filing: same amount across many unrelated codes — excluded 91
percent-of-charges filed in the dollar field — excluded from medians 40
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbHSCMHTHERMOPOLISWY&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/HotSprings.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-18
Content fingerprint fd239229c60fe06b… · 9,248,628 bytes · first seen 2026-05-17

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
J1951
HCPCS 		Injection, Leuprolide Acetate For Depot Suspension (fensolvi), 0.25 Mg 5 $17,732.76 $33,031.61 $32,683.91 nat. median
$173
outlier · 188.4×
J2350
HCPCS 		Injection, Ocrelizumab, 1 Mg 5 $15,483.67 $28,842.14 $28,538.54 nat. median
$414
outlier · 68.9×
J3241
HCPCS 		Injection, Teprotumumab-trbw, 10 Mg 5 $12,151.39 $22,634.95 $22,396.68 nat. median
$718
outlier · 31.2×
J9298
HCPCS 		Injection, Nivolumab And Relatlimab-rmbw, 3 Mg/1 Mg 5 $11,190.00 $20,844.12 $20,624.71 nat. median
$559
outlier · 36.9×
9598152_1
CDM 		Interstim X Ssmri Ins 97800 5 $10,415.73 $19,401.85 $19,197.62 nat. median
$19,198
1.0× median
J9144
HCPCS 		Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 5 $7,574.87 $14,110.05 $13,961.52 nat. median
$211
outlier · 66.0×
J2267
HCPCS 		Injection, Mirikizumab-mrkz, 1 Mg 5 $7,534.52 $14,034.88 $13,887.15 nat. median
$90
outlier · 154.1×
J9119
HCPCS 		Injection, Cemiplimab-rwlc, 1 Mg 5 $7,254.35 $13,513.00 $13,370.76 nat. median
$91
outlier · 146.9×
J2323
HCPCS 		Injection, Natalizumab, 1 Mg 5 $6,447.62 $12,010.28 $11,883.86 nat. median
$180
outlier · 66.1×
J9228
HCPCS 		Injection, Ipilimumab, 1 Mg 5 $6,301.69 $11,738.44 $11,614.88 nat. median
$8,966
1.3× median
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 5 $5,266.74 $9,810.60 $9,707.33 nat. median
$3,787
outlier · 2.6×
J9306
HCPCS 		Injection, Pertuzumab, 1 Mg 5 $4,837.94 $9,011.84 $8,916.98 nat. median
$75
outlier · 118.8×
J9332
HCPCS 		Injection, Efgartigimod Alfa-fcab, 2mg 5 $4,766.59 $8,878.95 $8,785.48 nat. median
$112
outlier · 78.6×
J2783
HCPCS 		Injection, Rasburicase, 0.5 Mg 5 $4,177.84 $7,782.26 $7,700.34 nat. median
$1,590
outlier · 4.8×
J9271
HCPCS 		Injection, Pembrolizumab, 1 Mg 5 $3,957.62 $7,372.03 $7,294.43 nat. median
$275
outlier · 26.6×
9598154_1
CDM 		Interstim Lead Kit 4.32mmx28cm 5 $3,464.94 $6,454.30 $6,386.36 nat. median
$6,386
1.0× median
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 5 $3,281.37 $6,140.68 $6,062.03 nat. median
$1,659
outlier · 3.7×
J1162
HCPCS 		Injection, Digoxin Immune Fab (ovine), Per Vial 5 $3,248.01 $6,050.21 $5,986.52 nat. median
$7,165
0.8× median
J9305
HCPCS 		Injection, Pemetrexed, Not Otherwise Specified, 10 Mg 5 $3,069.95 $5,718.53 $5,658.34 nat. median
$209
outlier · 27.1×
J9173
HCPCS 		Injection, Durvalumab, 10 Mg 5 $3,021.27 $5,627.86 $5,568.62 nat. median
$1,119
outlier · 5.0×
6239479_1
CDM 		Labor Room/delivery - General Classification 5 $2,954.43 $5,503.35 $5,445.42 nat. median
$5,445
1.0× median
J9299
HCPCS 		Injection, Nivolumab, 1 Mg 5 $2,803.04 $10,386.00 $5,398.49 nat. median
$2,849
1.9× median
J9227
HCPCS 		Injection, Isatuximab-irfc, 10 Mg 5 $2,886.28 $5,376.41 $5,319.82 nat. median
$380
outlier · 14.0×
64635
HCPCS 		Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 5 $170.50 $8,132.95 $4,909.01 nat. median
$2,392
outlier · 2.1×
90375
HCPCS 		Rabies Immune Globulin For Injection 5 $2,509.89 $4,675.28 $4,626.07 nat. median
$1,052
outlier · 4.4×
6239478_1
CDM 		Labor Room/delivery - General Classification 5 $2,487.78 $4,634.10 $4,585.32 nat. median
$4,585
1.0× median
8104361_1
CDM 		Rfa 3-17-150-4 Lumbar 5 $2,474.01 $4,608.45 $4,559.94 nat. median
$4,560
1.0× median
J0840
HCPCS 		Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 5 $2,427.94 $4,522.63 $4,475.02 nat. median
$3,452
1.3× median
26665
HCPCS 		Treatment Of Broken Thumb At Wrist 5 $566.37 $8,052.20 $4,409.22 nat. median
$3,765
1.2× median
19020
HCPCS 		Drainage Of Abscess Of Breast 5 $2,385.78 $4,444.10 $4,397.32 nat. median
$1,990
outlier · 2.2×
8339183_1
CDM 		Ryanodex 250 Mg Vial 5 $2,293.57 $4,272.33 $4,227.36 nat. median
$6,751
0.6× median
9490959_1
CDM 		Mesh Vicryl Woven Vwml 5 $2,250.12 $4,191.40 $4,147.28 nat. median
$4,147
1.0× median
8028189_1
CDM 		Coronary Care Unit - Myocardial Infarction 3 $3,958.34 $4,000.45 $4,000.45 nat. median
$4,297
0.9× median
8028141_1
CDM 		Room & Board - Other - Sterile Environment 3 $3,915.10 $3,956.75 $3,956.75 nat. median
$3,498
1.1× median
64633
HCPCS 		Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 5 $170.08 $7,110.75 $3,893.70 nat. median
$2,325
1.7× median
7363650_1
CDM 		Speedbrg Imp Sys W/bio-comp Sw 5 $2,054.79 $3,827.55 $3,787.26 nat. median
$3,787
1.0× median
J9303
HCPCS 		Injection, Panitumumab, 10 Mg 5 $1,251.19 $9,322.57 $3,667.69 nat. median
$1,789
outlier · 2.1×
9598153_1
CDM 		Comm Handset Istim X 5 $1,989.00 $3,705.00 $3,666.00 nat. median
$3,666
1.0× median
J9358
HCPCS 		Injection, Fam-trastuzumab Deruxtecan-nxki, 1 Mg 5 $1,948.32 $3,629.22 $3,591.02 nat. median
$95
outlier · 37.7×
6074331_1
CDM 		Gastro - Intestinal (gi) Services - General Classification 5 $1,935.96 $3,606.20 $3,568.24 nat. median
$2,284
1.6× median
6971095_1
CDM 		Labor Room/delivery - General Classification 5 $1,884.96 $3,511.20 $3,474.24 nat. median
$3,474
1.0× median
7363257_1
CDM 		Rfa 3-17-75-4 Lumbar 5 $1,860.48 $3,465.60 $3,429.12 nat. median
$3,429
1.0× median
7363261_1
CDM 		Rfa 3-17-100-4 Lumbar 5 $1,860.48 $3,465.60 $3,429.12 nat. median
$3,429
1.0× median
9170685_1
CDM 		Duraseal Exact Spine Sealant 5 $1,804.38 $3,361.10 $3,325.72 nat. median
$3,326
1.0× median
66982
HCPCS 		Complex Removal Of Cataract With Insertion Of Prosthetic Lens 5 $623.75 $6,015.40 $3,293.91 nat. median
$2,954
1.1× median
J9317
HCPCS 		Injection, Sacituzumab Govitecan-hziy, 2.5 Mg 5 $1,767.32 $3,292.07 $3,257.42 nat. median
$109
outlier · 29.8×
J3262
HCPCS 		Injection, Tocilizumab, 1 Mg 5 $1,765.71 $3,289.06 $3,254.44 nat. median
$1,413
outlier · 2.3×
8028232_1
CDM 		Coronary Care Unit - General Classification 3 $3,203.52 $3,237.60 $3,237.60 nat. median
$3,148
1.0× median
64493
HCPCS 		Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Single Le… 5 $80.28 $5,326.65 $3,215.24 nat. median
$1,287
outlier · 2.5×
J1459
HCPCS 		Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui… 5 $1,742.56 $3,245.94 $3,211.77 nat. median
$1,371
outlier · 2.3×

Other procedures at this hospital

Browse this hospital's 3,228 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
             
J1951 HCPCS Injection, Leuprolide Acetate For Depot Suspension (fensolvi), 0.25 Mg 5 5 $34,770.12 $34,770.12 $17,732.76 $33,031.61 $32,683.91 2026-04-17
J2350 HCPCS Injection, Ocrelizumab, 1 Mg 5 5 $30,360.15 $30,360.15 $15,483.67 $28,842.14 $28,538.54 2026-04-17
J3241 HCPCS Injection, Teprotumumab-trbw, 10 Mg 5 5 $23,826.26 $23,826.26 $12,151.39 $22,634.95 $22,396.68 2026-04-17
J9298 HCPCS Injection, Nivolumab And Relatlimab-rmbw, 3 Mg/1 Mg 5 5 $21,941.18 $21,941.18 $11,190.00 $20,844.12 $20,624.71 2026-04-17
9598152_1 CDM Interstim X Ssmri Ins 97800 5 5 $20,423.00 $20,423.00 $10,415.73 $19,401.85 $19,197.62 2026-04-17
J9144 HCPCS Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 5 5 $14,852.68 $14,852.68 $7,574.87 $14,110.05 $13,961.52 2026-04-17
J2267 HCPCS Injection, Mirikizumab-mrkz, 1 Mg 5 5 $14,773.56 $14,773.56 $7,534.52 $14,034.88 $13,887.15 2026-04-17
J9119 HCPCS Injection, Cemiplimab-rwlc, 1 Mg 5 5 $14,224.21 $14,224.21 $7,254.35 $13,513.00 $13,370.76 2026-04-17
J2323 HCPCS Injection, Natalizumab, 1 Mg 5 5 $12,642.40 $12,642.40 $6,447.62 $12,010.28 $11,883.86 2026-04-17
J9228 HCPCS Injection, Ipilimumab, 1 Mg 5 5 $12,356.25 $12,356.25 $6,301.69 $11,738.44 $11,614.88 2026-04-17
J3101 HCPCS Injection, Tenecteplase, 1 Mg 5 5 $10,326.95 $10,326.95 $5,266.74 $9,810.60 $9,707.33 2026-04-17
J9306 HCPCS Injection, Pertuzumab, 1 Mg 5 5 $9,486.15 $9,486.15 $4,837.94 $9,011.84 $8,916.98 2026-04-17
J9332 HCPCS Injection, Efgartigimod Alfa-fcab, 2mg 5 5 $9,346.26 $9,346.26 $4,766.59 $8,878.95 $8,785.48 2026-04-17
J2783 HCPCS Injection, Rasburicase, 0.5 Mg 5 5 $8,191.85 $8,191.85 $4,177.84 $7,782.26 $7,700.34 2026-04-17
J9271 HCPCS Injection, Pembrolizumab, 1 Mg 5 5 $7,760.03 $7,760.03 $3,957.62 $7,372.03 $7,294.43 2026-04-17
9598154_1 CDM Interstim Lead Kit 4.32mmx28cm 5 5 $6,794.00 $6,794.00 $3,464.94 $6,454.30 $6,386.36 2026-04-17
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 10 5 $6,448.97 $6,448.97 $3,281.37 $6,140.68 $6,062.03 2026-04-17
J1162 HCPCS Injection, Digoxin Immune Fab (ovine), Per Vial 5 5 $6,368.64 $6,368.64 $3,248.01 $6,050.21 $5,986.52 2026-04-17
J9305 HCPCS Injection, Pemetrexed, Not Otherwise Specified, 10 Mg 5 5 $6,019.51 $6,019.51 $3,069.95 $5,718.53 $5,658.34 2026-04-17
J9173 HCPCS Injection, Durvalumab, 10 Mg 5 5 $5,924.06 $5,924.06 $3,021.27 $5,627.86 $5,568.62 2026-04-17
6239479_1 CDM Labor Room/delivery - General Classification 5 5 $5,793.00 $5,793.00 $2,954.43 $5,503.35 $5,445.42 2026-04-17
J9299 HCPCS Injection, Nivolumab, 1 Mg 10 5 $8,214.39 $8,214.39 $2,803.04 $10,386.00 $5,398.49 2026-04-17
J9227 HCPCS Injection, Isatuximab-irfc, 10 Mg 5 5 $5,659.38 $5,659.38 $2,886.28 $5,376.41 $5,319.82 2026-04-17
64635 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 12 5 $5,707.00 $5,707.00 $170.50 $8,132.95 $4,909.01 2026-04-17
90375 HCPCS Rabies Immune Globulin For Injection 5 5 $4,921.35 $4,921.35 $2,509.89 $4,675.28 $4,626.07 2026-04-17
6239478_1 CDM Labor Room/delivery - General Classification 5 5 $4,878.00 $4,878.00 $2,487.78 $4,634.10 $4,585.32 2026-04-17
8104361_1 CDM Rfa 3-17-150-4 Lumbar 5 5 $4,851.00 $4,851.00 $2,474.01 $4,608.45 $4,559.94 2026-04-17
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 5 5 $4,760.66 $4,760.66 $2,427.94 $4,522.63 $4,475.02 2026-04-17
26665 HCPCS Treatment Of Broken Thumb At Wrist 7 5 $8,476.00 $8,476.00 $566.37 $8,052.20 $4,409.22 2026-04-17
19020 HCPCS Drainage Of Abscess Of Breast 5 5 $4,678.00 $4,678.00 $2,385.78 $4,444.10 $4,397.32 2026-04-17
8339183_1 CDM Ryanodex 250 Mg Vial 5 5 $4,497.19 $4,497.19 $2,293.57 $4,272.33 $4,227.36 2026-04-17
9490959_1 CDM Mesh Vicryl Woven Vwml 5 5 $4,412.00 $4,412.00 $2,250.12 $4,191.40 $4,147.28 2026-04-17
8028189_1 CDM Coronary Care Unit - Myocardial Infarction 3 3 $4,211.00 $4,211.00 $3,958.34 $4,000.45 $4,000.45 2026-04-17
8028141_1 CDM Room & Board - Other - Sterile Environment 3 3 $4,165.00 $4,165.00 $3,915.10 $3,956.75 $3,956.75 2026-04-17
64633 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 7 5 $7,485.00 $7,485.00 $170.08 $7,110.75 $3,893.70 2026-04-17
7363650_1 CDM Speedbrg Imp Sys W/bio-comp Sw 5 5 $4,029.00 $4,029.00 $2,054.79 $3,827.55 $3,787.26 2026-04-17
J9303 HCPCS Injection, Panitumumab, 10 Mg 10 5 $6,133.27 $6,133.27 $1,251.19 $9,322.57 $3,667.69 2026-04-17
9598153_1 CDM Comm Handset Istim X 5 5 $3,900.00 $3,900.00 $1,989.00 $3,705.00 $3,666.00 2026-04-17
J9358 HCPCS Injection, Fam-trastuzumab Deruxtecan-nxki, 1 Mg 5 5 $3,820.23 $3,820.23 $1,948.32 $3,629.22 $3,591.02 2026-04-17
6074331_1 CDM Gastro - Intestinal (gi) Services - General Classification 5 5 $3,796.00 $3,796.00 $1,935.96 $3,606.20 $3,568.24 2026-04-17
6971095_1 CDM Labor Room/delivery - General Classification 5 5 $3,696.00 $3,696.00 $1,884.96 $3,511.20 $3,474.24 2026-04-17
7363261_1 CDM Rfa 3-17-100-4 Lumbar 5 5 $3,648.00 $3,648.00 $1,860.48 $3,465.60 $3,429.12 2026-04-17
7363257_1 CDM Rfa 3-17-75-4 Lumbar 5 5 $3,648.00 $3,648.00 $1,860.48 $3,465.60 $3,429.12 2026-04-17
9170685_1 CDM Duraseal Exact Spine Sealant 5 5 $3,538.00 $3,538.00 $1,804.38 $3,361.10 $3,325.72 2026-04-17
66982 HCPCS Complex Removal Of Cataract With Insertion Of Prosthetic Lens 7 5 $6,332.00 $6,332.00 $623.75 $6,015.40 $3,293.91 2026-04-17
J9317 HCPCS Injection, Sacituzumab Govitecan-hziy, 2.5 Mg 5 5 $3,465.34 $3,465.34 $1,767.32 $3,292.07 $3,257.42 2026-04-17
J3262 HCPCS Injection, Tocilizumab, 1 Mg 5 5 $3,462.17 $3,462.17 $1,765.71 $3,289.06 $3,254.44 2026-04-17
8028232_1 CDM Coronary Care Unit - General Classification 3 3 $3,408.00 $3,408.00 $3,203.52 $3,237.60 $3,237.60 2026-04-17
64493 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Single Le… 12 5 $3,738.00 $3,738.00 $80.28 $5,326.65 $3,215.24 2026-04-17
J1459 HCPCS Injection, Immune Globulin (privigen), Intravenous, Non-lyophilized (e.g., Liqui… 5 5 $3,416.78 $3,416.78 $1,742.56 $3,245.94 $3,211.77 2026-04-17
57200 HCPCS Suture Of Nonobstetrical Injury Of Vagina 7 5 $6,116.00 $6,116.00 $297.67 $5,810.20 $3,181.54 2026-04-17
G0390 HCPCS Trauma Response Team Associated With Hospital Critical Care Service 10 5 $4,615.00 $4,615.00 $1,706.46 $5,589.80 $3,161.97 2026-04-17
64490 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Single Le… 12 5 $3,556.00 $3,556.00 $92.71 $5,066.35 $3,058.43 2026-04-17
64483 HCPCS Injection Of Anesthetic And/or Steroid Drug Into Sacral Spine Nerve Root Using I… 12 5 $3,548.00 $3,548.00 $98.06 $5,056.85 $3,052.07 2026-04-17
J9176 HCPCS Injection, Elotuzumab, 1 Mg 10 5 $3,720.24 $3,720.24 $1,626.28 $4,039.11 $3,013.40 2026-04-17
81162 HCPCS Gene Analysis (breast Cancer 1 And 2) Of Full Sequence And Analysis For Duplicat… 5 5 $3,169.00 $3,169.00 $1,616.19 $3,010.55 $2,978.86 2026-04-17
J1950 HCPCS Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg 10 5 $4,806.75 $4,806.75 $1,181.42 $6,932.15 $2,961.07 2026-04-17
J9036 HCPCS Injection, Bendamustine Hydrochloride, (belrapzo/bendamustine), 1 Mg 5 5 $3,132.54 $3,132.54 $1,597.60 $2,975.91 $2,944.59 2026-04-17
8028199_1 CDM Room & Board - Other - Sterile Environment 3 3 $3,095.00 $3,095.00 $2,909.30 $2,940.25 $2,940.25 2026-04-17
8028202_1 CDM Room & Board - Other - Sterile Environment 3 3 $3,095.00 $3,095.00 $2,909.30 $2,940.25 $2,940.25 2026-04-17
8028225_1 CDM Room & Board - Other - Sterile Environment 3 3 $3,095.00 $3,095.00 $2,909.30 $2,940.25 $2,940.25 2026-04-17
10140 HCPCS Drainage Of Blood Or Fluid Accumulation 7 5 $5,535.00 $5,535.00 $113.74 $5,258.25 $2,879.31 2026-04-17
7363201_1 CDM Rfa 2-17-100-4 Lumbar 5 5 $3,039.00 $3,039.00 $1,549.89 $2,887.05 $2,856.66 2026-04-17
7363236_1 CDM Rfa 2-17-75-4 Lumbar 5 5 $3,039.00 $3,039.00 $1,549.89 $2,887.05 $2,856.66 2026-04-17
7363226_1 CDM Rfa 2-17-75-2 Cervical 5 5 $3,039.00 $3,039.00 $1,549.89 $2,887.05 $2,856.66 2026-04-17
7363207_1 CDM Rfa 2-17-50-2 Cervical 5 5 $3,039.00 $3,039.00 $1,549.89 $2,887.05 $2,856.66 2026-04-17
7363216_1 CDM Rfa 2-17-50-4 Lumbar 5 5 $3,039.00 $3,039.00 $1,549.89 $2,887.05 $2,856.66 2026-04-17
7363247_1 CDM Rfa 2-17-75-5.5 Knee 5 5 $3,039.00 $3,039.00 $1,549.89 $2,887.05 $2,856.66 2026-04-17
6079497_1 CDM Hsmh Misc Supply 5 5 $2,918.47 $2,918.47 $1,488.42 $2,772.54 $2,743.36 2026-04-17
J3358 HCPCS Ustekinumab, For Intravenous Injection, 1 Mg 5 5 $2,895.15 $2,895.15 $1,476.53 $2,750.39 $2,721.44 2026-04-17
7361028_1 CDM Rfa 2-17-150-4 Lumbar 5 5 $2,895.00 $2,895.00 $1,476.45 $2,750.25 $2,721.30 2026-04-17
77021 HCPCS Review By Radiologist Of MRI Guidance For Needle Placement 5 5 $2,888.00 $2,888.00 $1,472.88 $2,743.60 $2,714.72 2026-04-17
7363648_1 CDM Meniscal Root Kit 5 5 $2,880.00 $2,880.00 $1,468.80 $2,736.00 $2,707.20 2026-04-17
5770872_1 CDM CT Neck Angiography 5 5 $2,849.00 $2,849.00 $1,452.99 $2,706.55 $2,678.06 2026-04-17
94002 HCPCS Initial Hospital Inpatient Or Observation Ventilation Assistance And Management 5 5 $2,836.00 $2,836.00 $1,446.36 $2,694.20 $2,665.84 2026-04-17
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 10 5 $3,073.00 $3,073.00 $1,433.10 $3,169.20 $2,655.45 2026-04-17
9484106_1 CDM Ascope 5 Uretero 5 5 $2,790.00 $2,790.00 $1,422.90 $2,650.50 $2,622.60 2026-04-17
15823 HCPCS Removal Of Excessive Skin And Fat Of Upper Eyelid 5 5 $2,786.00 $2,786.00 $1,420.86 $2,646.70 $2,618.84 2026-04-17
64999 HCPCS Other Procedure On Nervous System 6 5 $3,577.00 $3,577.00 $294.00 $3,398.15 $2,611.57 2026-04-17
J9312 HCPCS Injection, Rituximab, 10 Mg 10 5 $4,340.57 $4,340.57 $737.88 $6,872.59 $2,531.99 2026-04-17
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 5 5 $2,679.97 $2,679.97 $1,366.78 $2,545.97 $2,519.17 2026-04-17
P9037 HCPCS Platelets, Pheresis, Leukocytes Reduced, Irradiated, Each Unit 5 5 $2,664.00 $2,664.00 $1,358.64 $2,530.80 $2,504.16 2026-04-17
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 7 5 $4,774.00 $4,774.00 $73.96 $4,535.30 $2,483.43 2026-04-17
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 7 5 $4,773.00 $4,773.00 $97.82 $4,534.35 $2,482.91 2026-04-17
73220 HCPCS MRI Scan Of Arm Before And After Contrast 12 5 $3,314.00 $3,314.00 $98.49 $3,299.35 $2,460.90 2026-04-17
59510 HCPCS Cesarean Delivery With Care Before And After Delivery 2 2 $5,217.00 $5,217.00 $2,360.44 $2,407.65 $2,384.05 2026-04-17
8028197_1 CDM Room & Board - Private (one Bed) - Obstetrics (ob) 3 3 $2,505.00 $2,505.00 $2,354.70 $2,379.75 $2,379.75 2026-04-17
8028201_1 CDM Room & Board - Private (one Bed) - General Classification 3 3 $2,505.00 $2,505.00 $2,354.70 $2,379.75 $2,379.75 2026-04-17
8028224_1 CDM Room & Board - Private (one Bed) - General Classification 3 3 $2,505.00 $2,505.00 $2,354.70 $2,379.75 $2,379.75 2026-04-17
21315 HCPCS Closed Treatment Of Broken Nose Bone With Manipulation 7 5 $4,515.00 $4,515.00 $52.39 $4,289.25 $2,348.70 2026-04-17
93306 HCPCS Ultrasound Of Heart With Color-depicted Blood Flow, Rate, Direction And Valve Fu… 12 5 $3,112.00 $3,112.00 $67.04 $3,125.50 $2,318.37 2026-04-17
5599866_1 CDM Operating Room Services - General Classification 5 5 $2,445.00 $2,445.00 $1,246.95 $2,322.75 $2,298.30 2026-04-17
5378707_1 CDM Operating Room Services - General Classification 5 5 $2,445.00 $2,445.00 $1,246.95 $2,322.75 $2,298.30 2026-04-17
5010466_1 CDM Operating Room Services - General Classification 5 5 $2,445.00 $2,445.00 $1,246.95 $2,322.75 $2,298.30 2026-04-17
78451 HCPCS Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 7 5 $4,386.00 $4,386.00 $62.69 $4,166.70 $2,281.60 2026-04-17
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 7 5 $4,382.00 $4,382.00 $104.42 $4,162.90 $2,279.52 2026-04-17
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 7 5 $4,370.00 $4,370.00 $104.42 $4,151.50 $2,273.27 2026-04-17
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 7 5 $4,367.00 $4,367.00 $104.42 $4,148.65 $2,271.71 2026-04-17
66984 HCPCS Removal Of Cataract With Insertion Of Prosthetic Lens 7 5 $4,353.00 $4,353.00 $457.91 $4,135.35 $2,264.43 2026-04-17
8028231_1 CDM Room & Board - Other - Sterile Environment 3 3 $2,380.00 $2,380.00 $2,237.20 $2,261.00 $2,261.00 2026-04-17
73706 HCPCS CT Scan Of Blood Vessels Of Lower Leg With Contrast 8 5 $3,096.00 $3,096.00 $85.80 $2,941.20 $2,260.39 2026-04-17
J9355 HCPCS Injection, Trastuzumab, Excludes Biosimilar, 10 Mg 5 5 $2,399.97 $2,399.97 $1,223.98 $2,279.97 $2,255.97 2026-04-17
8580045_1 CDM Werewolf Coblation Wand 5 5 $2,380.00 $2,380.00 $1,213.80 $2,261.00 $2,237.20 2026-04-17
27266 HCPCS Closed Treatment Of Dislocated Hip Prosthesis Under Anesthesia 7 5 $4,285.00 $4,285.00 $543.73 $4,070.75 $2,229.06 2026-04-17
12037 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, More Tha… 5 5 $2,358.00 $2,358.00 $1,202.58 $2,240.10 $2,216.52 2026-04-17
7362823_1 CDM Ventralex Hernia Patch M 6.4cm 5 5 $2,347.00 $2,347.00 $1,196.97 $2,229.65 $2,206.18 2026-04-17
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 8 5 $3,009.00 $3,009.00 $82.55 $2,858.55 $2,196.87 2026-04-17
70553 HCPCS MRI Scan Of Brain Before And After Contrast 7 5 $4,221.00 $4,221.00 $104.08 $4,009.95 $2,195.76 2026-04-17
J0897 HCPCS Injection, Denosumab, 1 Mg 10 5 $3,337.30 $3,337.30 $1,135.22 $4,226.23 $2,191.73 2026-04-17
24605 HCPCS Repair Of Dislocated Elbow Under Anesthesia 12 5 $2,741.00 $2,741.00 $277.50 $3,233.80 $2,173.65 2026-04-17
46040 HCPCS Drainage Of Deep Abscess In Rectum 7 5 $4,161.00 $4,161.00 $424.46 $3,952.95 $2,164.55 2026-04-17
59400 HCPCS Vaginal Delivery With Care Before And After Delivery 2 2 $4,536.00 $4,536.00 $2,122.95 $2,165.41 $2,144.18 2026-04-17
7363148_1 CDM Rfa Single 75-5.5 5 5 $2,280.00 $2,280.00 $1,162.80 $2,166.00 $2,143.20 2026-04-17
7363137_1 CDM Rfa Single 75-4 5 5 $2,280.00 $2,280.00 $1,162.80 $2,166.00 $2,143.20 2026-04-17
7363083_1 CDM Rfa Single100-4 5 5 $2,280.00 $2,280.00 $1,162.80 $2,166.00 $2,143.20 2026-04-17
7363094_1 CDM Rfa Single 150-4 5 5 $2,280.00 $2,280.00 $1,162.80 $2,166.00 $2,143.20 2026-04-17
7363126_1 CDM Rfa Single 75-2 5 5 $2,280.00 $2,280.00 $1,162.80 $2,166.00 $2,143.20 2026-04-17
7363115_1 CDM Rfa Single 50-4 5 5 $2,280.00 $2,280.00 $1,162.80 $2,166.00 $2,143.20 2026-04-17
7363105_1 CDM Rfa Single 50-2 5 5 $2,280.00 $2,280.00 $1,162.80 $2,166.00 $2,143.20 2026-04-17
7361151_1 CDM Parietex Composite Patch 8.6cm 5 5 $2,266.00 $2,266.00 $1,155.66 $2,152.70 $2,130.04 2026-04-17
71552 HCPCS MRI Scan Of Chest Before And After Contrast 7 5 $4,086.00 $4,086.00 $102.75 $3,881.70 $2,125.54 2026-04-17
64495 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Third And… 12 5 $2,469.00 $2,469.00 $44.40 $3,518.80 $2,123.84 2026-04-17
J9264 HCPCS Injection, Paclitaxel Protein-bound Particles, 1 Mg 5 5 $2,252.37 $2,252.37 $1,148.71 $2,139.75 $2,117.23 2026-04-17
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 7 5 $4,069.00 $4,069.00 $100.41 $3,865.55 $2,116.69 2026-04-17
64492 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Third And… 12 5 $2,455.00 $2,455.00 $50.32 $3,498.85 $2,111.80 2026-04-17
J7327 HCPCS Hyaluronan Or Derivative, Monovisc, For Intra-articular Injection, Per Dose 5 5 $2,234.08 $2,234.08 $1,139.38 $2,122.38 $2,100.04 2026-04-17
43247 HCPCS Removal Of Foreign Bodies Of Esophagus, Stomach, And/or Upper Small Bowel Using … 7 5 $4,027.00 $4,027.00 $154.02 $3,825.65 $2,094.85 2026-04-17
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 7 5 $4,027.00 $4,027.00 $81.72 $3,825.65 $2,094.85 2026-04-17
P9035 HCPCS Platelets, Pheresis, Leukocytes Reduced, Each Unit 5 5 $2,216.00 $2,216.00 $1,130.16 $2,105.20 $2,083.04 2026-04-17
73219 HCPCS MRI Scan Of Arm With Contrast 12 5 $2,820.00 $2,820.00 $74.12 $2,731.25 $2,073.19 2026-04-17
7363330_1 CDM Thunderbeat 9cm Open Fine Jaw 5 5 $2,205.00 $2,205.00 $1,124.55 $2,094.75 $2,072.70 2026-04-17
64417 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Upper Arm And Shoulder Nerve (… 7 5 $3,947.00 $3,947.00 $60.33 $3,749.65 $2,053.23 2026-04-17
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 7 5 $3,935.00 $3,935.00 $98.49 $3,738.25 $2,046.99 2026-04-17
64640 HCPCS Destruction Of Peripheral Nerve Or Branch 7 5 $3,899.00 $3,899.00 $109.65 $3,704.05 $2,028.26 2026-04-17
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 7 5 $3,846.00 $3,846.00 $108.25 $3,653.70 $2,000.69 2026-04-17
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 7 5 $3,843.00 $3,843.00 $100.41 $3,650.85 $1,999.13 2026-04-17
64520 HCPCS Injection Of Anesthetic Agent Into Middle Or Lower Spine Sympathetic Nerve 7 5 $3,827.00 $3,827.00 $75.78 $3,635.65 $1,990.81 2026-04-17
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 7 5 $3,821.00 $3,821.00 $67.11 $3,629.95 $1,987.68 2026-04-17
7362824_1 CDM Ventralex Hernia Patch 8.0cm 5 5 $2,111.00 $2,111.00 $1,076.61 $2,005.45 $1,984.34 2026-04-17
64624 HCPCS Destruction Of Nerve Branches Of Knee Using Imaging Guidance 7 5 $3,759.00 $3,759.00 $131.36 $3,571.05 $1,955.43 2026-04-17
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 7 5 $3,741.00 $3,741.00 $81.88 $3,553.95 $1,946.07 2026-04-17
64445 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Lower Back And Leg Nerve (scia… 7 5 $3,721.00 $3,721.00 $64.83 $3,534.95 $1,935.66 2026-04-17
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 7 5 $3,692.00 $3,692.00 $98.16 $3,507.40 $1,920.58 2026-04-17
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 7 5 $3,671.00 $3,671.00 $81.38 $3,487.45 $1,909.65 2026-04-17
7362822_1 CDM Ventralex Hernia Patch 4.3cm 5 5 $2,025.00 $2,025.00 $1,032.75 $1,923.75 $1,903.50 2026-04-17
6239480_1 CDM Labor Room/delivery - General Classification 5 5 $2,017.00 $2,017.00 $1,028.67 $1,916.15 $1,895.98 2026-04-17
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 7 5 $3,641.00 $3,641.00 $81.38 $3,458.95 $1,894.05 2026-04-17
73720 HCPCS MRI Scan Of Leg Before And After Contrast 7 5 $3,635.00 $3,635.00 $98.16 $3,453.25 $1,890.93 2026-04-17
Q5117 HCPCS Injection, Trastuzumab-anns, Biosimilar, (kanjinti), 10 Mg 5 5 $1,999.66 $1,999.66 $1,019.83 $1,899.68 $1,879.68 2026-04-17
7361810_1 CDM Anchor Y-knot 1.3mm 5 5 $1,992.00 $1,992.00 $1,015.92 $1,892.40 $1,872.48 2026-04-17
43235 HCPCS Diagnostic Exam Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible… 12 5 $2,228.00 $2,228.00 $108.47 $2,977.30 $1,862.32 2026-04-17
74182 HCPCS MRI Scan Of Abdomen With Contrast 7 5 $3,575.00 $3,575.00 $78.38 $3,396.25 $1,859.72 2026-04-17
64510 HCPCS Injection Of Anesthetic Agent Into Sympathetic Nerve Bundle 7 5 $3,555.00 $3,555.00 $68.85 $3,377.25 $1,849.31 2026-04-17
99291 HCPCS Critical Care, First 30-74 Minutes 7 5 $3,530.00 $3,530.00 $195.07 $3,353.50 $1,836.31 2026-04-17
7363664_1 CDM Proximal Tenodesis Implant Sys 5 5 $1,953.00 $1,953.00 $996.03 $1,855.35 $1,835.82 2026-04-17
J9035 HCPCS Injection, Bevacizumab, 10 Mg 10 5 $3,068.22 $3,068.22 $625.92 $4,663.69 $1,834.80 2026-04-17
J2802 HCPCS Injection, Romiplostim, 1 Microgram 10 5 $2,754.38 $2,754.38 $936.50 $3,488.86 $1,808.71 2026-04-17
8748060_1 CDM Carpal Tunnel Release Kit 4m 5 5 $1,917.00 $1,917.00 $977.67 $1,821.15 $1,801.98 2026-04-17
64494 HCPCS Injection Of Lower Or Sacral Spine Facet Joint Using Imaging Guidance, Second Le… 12 5 $2,090.00 $2,090.00 $43.06 $2,978.25 $1,797.71 2026-04-17
64421 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Multiple Rib Nerves For Region… 7 5 $3,444.00 $3,444.00 $21.28 $3,271.80 $1,791.57 2026-04-17
8028212_1 CDM Room & Board - Other - Sterile Environment 3 3 $1,885.00 $1,885.00 $1,771.90 $1,790.75 $1,790.75 2026-04-17
J0129 HCPCS Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere… 5 5 $1,903.64 $1,903.64 $970.86 $1,808.46 $1,789.42 2026-04-17
74181 HCPCS MRI Scan Of Abdomen Without Contrast 7 5 $3,423.00 $3,423.00 $65.86 $3,251.85 $1,780.64 2026-04-17
73218 HCPCS MRI Scan Of Arm Without Contrast 12 5 $2,418.00 $2,418.00 $62.19 $2,307.55 $1,768.24 2026-04-17
64636 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 7 5 $3,378.00 $3,378.00 $49.81 $3,209.10 $1,757.24 2026-04-17
7363296_1 CDM Powerport Implant 9.6f 5 5 $1,862.00 $1,862.00 $949.62 $1,768.90 $1,750.28 2026-04-17
72195 HCPCS MRI Scan Of Pelvis Without Contrast 12 5 $2,129.00 $2,129.00 $66.19 $2,697.05 $1,739.05 2026-04-17
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 7 5 $3,329.00 $3,329.00 $57.51 $3,162.55 $1,731.75 2026-04-17
70552 HCPCS MRI Scan Of Brain With Contrast 7 5 $3,292.00 $3,292.00 $81.05 $3,127.40 $1,712.50 2026-04-17
64491 HCPCS Injection Of Upper Or Middle Spine Facet Joint Using Imaging Guidance, Second Le… 12 5 $1,963.00 $1,963.00 $49.81 $2,797.75 $1,688.61 2026-04-17
8102086_1 CDM Prevena Wound Vac Kit 5 5 $1,793.00 $1,793.00 $914.43 $1,703.35 $1,685.42 2026-04-17
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 7 5 $3,236.00 $3,236.00 $57.51 $3,074.20 $1,683.37 2026-04-17
73722 HCPCS MRI Scan Of Leg Joint With Contrast 7 5 $3,227.00 $3,227.00 $74.46 $3,065.65 $1,678.69 2026-04-17
72159 HCPCS MRI Scan Of Blood Vessels Of Spinal Canal 7 5 $3,219.00 $3,219.00 $81.72 $3,058.05 $1,674.52 2026-04-17
7361150_1 CDM Parietex Composite Patch 6.6cm 5 5 $1,764.00 $1,764.00 $899.64 $1,675.80 $1,658.16 2026-04-17
27134 HCPCS Revision Of Thigh Bone And Hip Joint Prosthesis 2 2 $27,560.00 $27,560.00 $1,640.89 $1,673.71 $1,657.30 2026-04-17
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 7 5 $3,170.00 $3,170.00 $63.52 $3,011.50 $1,649.03 2026-04-17
64625 HCPCS Destruction Of Nerves Supplying Joint Between Spine And Pelvis Using Imaging Gui… 7 5 $3,154.00 $3,154.00 $173.82 $2,996.30 $1,640.71 2026-04-17
73222 HCPCS MRI Scan Of Arm Joint With Contrast 7 5 $3,141.00 $3,141.00 $74.46 $2,983.95 $1,633.95 2026-04-17
7362273_1 CDM Gelport 5 5 $1,733.00 $1,733.00 $883.83 $1,646.35 $1,629.02 2026-04-17
8028229_1 CDM Room & Board - Semi-private (two Beds) - Other 3 3 $1,707.00 $1,707.00 $1,604.58 $1,621.65 $1,621.65 2026-04-17
78278 HCPCS Nuclear Medicine Study To Assess Blood Loss 7 5 $3,104.00 $3,104.00 $44.66 $2,948.80 $1,614.70 2026-04-17
72191 HCPCS CT Scan Of Blood Vessels Of Pelvis With Contrast 7 5 $3,092.00 $3,092.00 $81.54 $2,937.40 $1,608.46 2026-04-17
32408 HCPCS Core Needle Biopsy Of Lung Or Center Cavity Of Chest (mediastinum), Accessed Thr… 12 5 $1,933.00 $1,933.00 $127.64 $2,505.15 $1,594.39 2026-04-17
48102 HCPCS Needle Biopsy Of Pancreas 10 5 $2,008.50 $2,008.50 $851.19 $2,230.60 $1,577.20 2026-04-17
Q0138 HCPCS Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd … 5 5 $1,676.14 $1,676.14 $854.83 $1,592.33 $1,575.57 2026-04-17
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 7 5 $3,023.00 $3,023.00 $67.78 $2,871.85 $1,572.56 2026-04-17
73202 HCPCS CT Scan Of Arm Before And After Contrast 7 5 $3,012.00 $3,012.00 $55.17 $2,861.40 $1,566.84 2026-04-17
43239 HCPCS Biopsy Of Esophagus, Stomach, And/or Upper Small Bowel Using A Flexible Endoscop… 7 5 $3,002.00 $3,002.00 $121.24 $2,851.90 $1,561.64 2026-04-17
73719 HCPCS MRI Scan Of Leg With Contrast 7 5 $3,000.00 $3,000.00 $73.46 $2,850.00 $1,560.60 2026-04-17
72198 HCPCS MRI Scan Of Blood Vessels Of Pelvis 7 5 $2,990.00 $2,990.00 $81.05 $2,840.50 $1,555.40 2026-04-17
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 7 5 $2,982.00 $2,982.00 $67.44 $2,832.90 $1,551.24 2026-04-17
22551 HCPCS Fusion Of Upper Spine Bone With Removal Of Disc And Release Of Spinal Cord Or Ne… 2 2 $4,105.00 $4,105.00 $1,533.36 $1,564.03 $1,548.69 2026-04-17
27487 HCPCS Revision Of Thigh And Lower Leg Bone Components Of Total Knee Joint Prosthesis 2 2 $12,078.00 $12,078.00 $1,525.89 $1,556.41 $1,541.15 2026-04-17
Q5107 HCPCS Injection, Bevacizumab-awwb, Biosimilar, (mvasi), 10 Mg 10 5 $2,571.08 $2,571.08 $524.50 $3,908.03 $1,537.51 2026-04-17
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 7 5 $2,944.00 $2,944.00 $57.84 $2,796.80 $1,531.47 2026-04-17
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 7 5 $2,937.00 $2,937.00 $67.44 $2,790.15 $1,527.83 2026-04-17
64420 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Rib Nerve 7 5 $2,923.00 $2,923.00 $51.66 $2,776.85 $1,520.54 2026-04-17
Q5115 HCPCS Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg 10 5 $2,578.60 $2,578.60 $463.24 $4,036.45 $1,514.91 2026-04-17
64488 HCPCS Injection Of Local Anesthetic For Abdominal Wall Pain Control On Both Sides Usin… 7 5 $2,894.00 $2,894.00 $55.74 $2,749.30 $1,505.46 2026-04-17
64454 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Knee Nerve Branch Using Imagin… 7 5 $2,891.00 $2,891.00 $72.02 $2,746.45 $1,503.90 2026-04-17
19287 HCPCS Placement Of Locating Device In Breast Using MRI Guidance, First Growth 7 5 $2,888.00 $2,888.00 $103.88 $2,743.60 $1,502.34 2026-04-17
19085 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Mri, First Growth 7 5 $2,888.00 $2,888.00 $148.27 $2,743.60 $1,502.34 2026-04-17
78582 HCPCS Nuclear Medicine Study Of Lung Ventilation And Circulation 7 5 $2,877.00 $2,877.00 $47.91 $2,733.15 $1,496.62 2026-04-17
73221 HCPCS MRI Scan Of Arm Joint Without Contrast 7 5 $2,875.00 $2,875.00 $62.52 $2,731.25 $1,495.58 2026-04-17
70551 HCPCS MRI Scan Of Brain Without Contrast 7 5 $2,867.00 $2,867.00 $67.11 $2,723.65 $1,491.41 2026-04-17
44143 HCPCS Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin 2 2 $7,932.00 $7,932.00 $1,473.45 $1,502.92 $1,488.18 2026-04-17
78803 HCPCS Nuclear Medicine Study, Spect Imaging, 1 Area Or Single Acquisition, Single Day … 7 5 $2,855.00 $2,855.00 $48.67 $2,712.25 $1,485.17 2026-04-17
71270 HCPCS CT Scan Of Chest Before And After Contrast 7 5 $2,852.00 $2,852.00 $56.84 $2,709.40 $1,483.61 2026-04-17
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 7 5 $2,851.00 $2,851.00 $57.84 $2,708.45 $1,483.09 2026-04-17
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 7 5 $2,849.00 $2,849.00 $79.38 $2,706.55 $1,482.05 2026-04-17
7362819_1 CDM Patch Hrnia Compsx Ovl Kugel S 5 5 $1,572.00 $1,572.00 $801.72 $1,493.40 $1,477.68 2026-04-17
22856 HCPCS Insertion Of Artificial Upper Spine Disc, Anterior Approach 2 2 $3,924.00 $3,924.00 $1,457.82 $1,486.98 $1,472.40 2026-04-17
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 5 5 $1,562.46 $1,562.46 $796.85 $1,484.34 $1,468.71 2026-04-17
73225 HCPCS MRI Scan Of Blood Vessels Of Arm 7 5 $2,822.00 $2,822.00 $77.20 $2,680.90 $1,468.00 2026-04-17
94003 HCPCS Follow-up Inpatient Or Observation Ventilation Assistance And Management 5 5 $1,561.00 $1,561.00 $796.11 $1,482.95 $1,467.34 2026-04-17
J1561 HCPCS Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)… 15 5 $1,556.23 $1,556.23 $396.06 $3,008.57 $1,462.86 2026-04-17
22630 HCPCS Fusion Of Lower Spine Bone And Partial Removal Of Spine Bone Or Disc Through Bac… 2 2 $3,772.00 $3,772.00 $1,442.29 $1,471.14 $1,456.72 2026-04-17
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 7 5 $2,786.00 $2,786.00 $68.11 $2,646.70 $1,449.28 2026-04-17
64634 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 7 5 $2,768.00 $2,768.00 $56.74 $2,629.60 $1,439.91 2026-04-17
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 7 5 $2,765.00 $2,765.00 $57.84 $2,626.75 $1,438.35 2026-04-17
70488 HCPCS CT Scan Of Face Before And After Contrast 7 5 $2,763.00 $2,763.00 $57.84 $2,624.85 $1,437.31 2026-04-17
47532 HCPCS Injection Of Bile Duct For X-ray Through New Skin Access Using Imaging Guidance … 5 5 $1,528.00 $1,528.00 $779.28 $1,451.60 $1,436.32 2026-04-17
22612 HCPCS Fusion Of Spine In Lower Back 2 2 $3,831.00 $3,831.00 $1,410.15 $1,438.35 $1,424.25 2026-04-17
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 7 5 $2,737.00 $2,737.00 $79.38 $2,600.15 $1,423.79 2026-04-17
70471 HCPCS Computed Tomographic Angiography (cta), Head And Neck, With Contrast Material(s)… 7 5 $2,737.00 $2,737.00 $116.94 $2,600.15 $1,423.79 2026-04-17
45378 HCPCS Diagnostic Exam Of Large Bowel Using A Flexible Endoscope 7 5 $2,735.00 $2,735.00 $161.11 $2,598.25 $1,422.75 2026-04-17
46221 HCPCS Removal Of External Hemorrhoids By Rubber Banding 12 5 $1,573.00 $1,573.00 $193.94 $2,485.20 $1,419.73 2026-04-17
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 7 5 $2,724.00 $2,724.00 $73.79 $2,587.80 $1,417.02 2026-04-17
87633 HCPCS Detection Test By Nucleic Acid For Multiple Types Of Respiratory Virus, Multiple… 5 5 $1,505.00 $1,505.00 $767.55 $1,429.75 $1,414.70 2026-04-17
J1569 HCPCS Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),… 5 5 $1,504.19 $1,504.19 $767.14 $1,428.98 $1,413.94 2026-04-17
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 7 5 $2,713.00 $2,713.00 $73.12 $2,577.35 $1,411.30 2026-04-17
8316161_1 CDM Curosurf 240 Mg/3 Ml Vial 5 5 $1,491.37 $1,491.37 $760.60 $1,416.80 $1,401.89 2026-04-17
72129 HCPCS CT Scan Of Middle Spine With Contrast 7 5 $2,693.00 $2,693.00 $55.51 $2,558.35 $1,400.90 2026-04-17
73206 HCPCS CT Scan Of Blood Vessels Of Arm With Contrast 7 5 $2,692.00 $2,692.00 $81.54 $2,557.40 $1,400.38 2026-04-17
22325 HCPCS Treatment Of Broken Or Dislocated Lower Spine Bone 2 2 $3,593.00 $3,593.00 $1,385.20 $1,412.90 $1,399.05 2026-04-17
72132 HCPCS CT Scan Of Lower Spine With Contrast 7 5 $2,683.00 $2,683.00 $55.51 $2,548.85 $1,395.70 2026-04-17
7361149_1 CDM Parietex Composite Patch 4.6cm 5 5 $1,473.00 $1,473.00 $751.23 $1,399.35 $1,384.62 2026-04-17
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 7 5 $2,658.00 $2,658.00 $54.50 $2,525.10 $1,382.69 2026-04-17
75572 HCPCS CT Scan Of Heart Structure With Contrast 7 5 $2,657.00 $2,657.00 $79.55 $2,524.15 $1,382.17 2026-04-17
44204 HCPCS Partial Removal Of Large Bowel Using An Endoscope 2 2 $5,616.00 $5,616.00 $1,363.26 $1,390.53 $1,376.89 2026-04-17
64451 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Spine And Pelvis Nerve Using I… 7 5 $2,642.00 $2,642.00 $71.26 $2,509.90 $1,374.37 2026-04-17
77012 HCPCS Review By Radiologist Of CT Guidance For Needle Placement 7 5 $2,627.00 $2,627.00 $66.35 $2,495.65 $1,366.57 2026-04-17
78195 HCPCS Nuclear Medicine Study Of Lymphatic System 7 5 $2,619.00 $2,619.00 $52.92 $2,488.05 $1,362.40 2026-04-17
7362821_1 CDM Patch Hernia Composix Kugel L 5 5 $1,445.00 $1,445.00 $736.95 $1,372.75 $1,358.30 2026-04-17
J3424 HCPCS Injection, Hydroxocobalamin, Intravenous, 25 Mg 5 5 $1,442.72 $1,442.72 $735.79 $1,370.58 $1,356.16 2026-04-17
72196 HCPCS MRI Scan Of Pelvis With Contrast 7 5 $2,601.00 $2,601.00 $78.71 $2,470.95 $1,353.04 2026-04-17
7362830_1 CDM Mesh Composix 3x6 5 5 $1,432.00 $1,432.00 $730.32 $1,360.40 $1,346.08 2026-04-17
72126 HCPCS CT Scan Of Upper Spine With Contrast 7 5 $2,575.00 $2,575.00 $55.51 $2,446.25 $1,339.52 2026-04-17
A0427 HCPCS Ambulance Service, Advanced Life Support, Emergency Transport, Level 1 (als 1 - … 5 5 $1,424.00 $1,424.00 $726.24 $1,352.80 $1,338.56 2026-04-17
78227 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs 7 5 $2,573.00 $2,573.00 $40.65 $2,444.35 $1,338.47 2026-04-17
J1439 HCPCS Injection, Ferric Carboxymaltose, 1 Mg 5 5 $1,423.16 $1,423.16 $725.81 $1,352.00 $1,337.77 2026-04-17
73702 HCPCS CT Scan Of Leg Before And After Contrast 7 5 $2,564.00 $2,564.00 $55.17 $2,435.80 $1,333.79 2026-04-17
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 7 5 $2,564.00 $2,564.00 $62.19 $2,435.80 $1,333.79 2026-04-17
12036 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 20.1-30.… 5 5 $1,417.00 $1,417.00 $722.67 $1,346.15 $1,331.98 2026-04-17
73718 HCPCS MRI Scan Of Leg Without Contrast 7 5 $2,556.00 $2,556.00 $61.52 $2,428.20 $1,329.63 2026-04-17
47000 HCPCS Needle Biopsy Of Liver Through Skin 15 5 $1,921.00 $1,921.00 $352.92 $2,452.90 $1,316.82 2026-04-17
70487 HCPCS CT Scan Of Face With Contrast 7 5 $2,531.00 $2,531.00 $51.50 $2,404.45 $1,316.63 2026-04-17
27752 HCPCS Closed Treatment Of Middle Part Of Broken Shin Bone With Manipulation 7 5 $2,529.00 $2,529.00 $489.04 $2,402.55 $1,315.59 2026-04-17
64461 HCPCS Injection Of Anesthetic Agent Into Thoracic Vertebra Using Imaging Guidance, Sin… 7 5 $2,524.00 $2,524.00 $70.42 $2,397.80 $1,312.98 2026-04-17
78070 HCPCS Nuclear Medicine Study Of Parathyroid 7 5 $2,519.00 $2,519.00 $36.06 $2,393.05 $1,310.38 2026-04-17
75573 HCPCS CT Scan Of Congenital Heart Disease With Contrast 7 5 $2,510.00 $2,510.00 $117.11 $2,384.50 $1,305.70 2026-04-17
38792 HCPCS Injection Of Radioactive Material For X-ray Identification Of Lymph Node 5 5 $1,388.00 $1,388.00 $707.88 $1,318.60 $1,304.72 2026-04-17
7362916_1 CDM Dissector Lap Dsp 5mm 5 5 $1,382.00 $1,382.00 $704.82 $1,312.90 $1,299.08 2026-04-17
93017 HCPCS Exercise Or Drug-induced Heart Stress Test With Electrocardiogram (ecg) 5 5 $1,379.00 $1,379.00 $703.29 $1,310.05 $1,296.26 2026-04-17
41010 HCPCS Incision Of Tissue Connecting Tongue And Floor Of Mouth 7 5 $2,489.00 $2,489.00 $101.15 $2,364.55 $1,294.78 2026-04-17
78580 HCPCS Nuclear Medicine Study Of Lung Circulation 7 5 $2,473.00 $2,473.00 $33.39 $2,349.35 $1,286.45 2026-04-17
71260 HCPCS CT Scan Of Chest With Contrast 7 5 $2,470.00 $2,470.00 $53.17 $2,346.50 $1,284.89 2026-04-17
70545 HCPCS MRI Scan Of Blood Vessels Of Head With Contrast 7 5 $2,465.00 $2,465.00 $54.50 $2,341.75 $1,282.29 2026-04-17
71551 HCPCS MRI Scan Of Chest With Contrast 7 5 $2,456.00 $2,456.00 $78.71 $2,333.20 $1,277.61 2026-04-17
23472 HCPCS Prosthetic Repair Of Shoulder Joint, Total Shoulder 2 2 $11,030.00 $11,030.00 $1,262.43 $1,287.68 $1,275.06 2026-04-17
64425 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Lower Abdomen And Groin Nerve 7 5 $2,451.00 $2,451.00 $48.99 $2,328.45 $1,275.01 2026-04-17
7360534_1 CDM Staple Reload Egia Vasc 45mm 5 5 $1,353.00 $1,353.00 $690.03 $1,285.35 $1,271.82 2026-04-17
J0490 HCPCS Injection, Belimumab, 10 Mg 10 5 $2,076.32 $2,076.32 $488.75 $3,034.59 $1,269.75 2026-04-17
7362820_1 CDM Patch Hernia Composix Kugel M 5 5 $1,349.00 $1,349.00 $687.99 $1,281.55 $1,268.06 2026-04-17
7362818_1 CDM Patch Hrnia Compsx Cir Kugel S 5 5 $1,349.00 $1,349.00 $687.99 $1,281.55 $1,268.06 2026-04-17
64418 HCPCS Injection Of Anesthetic Agent And/or Steroid Into Suprascapular Shoulder Nerve 7 5 $2,429.00 $2,429.00 $47.14 $2,307.55 $1,263.57 2026-04-17
44202 HCPCS Partial Removal And Reconnection Of Small Bowel Using An Endoscope 2 2 $7,523.00 $7,523.00 $1,240.40 $1,265.21 $1,252.81 2026-04-17
78709 HCPCS Nuclear Medicine Studies Of Kidney, Blood Flow, And Function 7 5 $2,401.00 $2,401.00 $62.52 $2,280.95 $1,249.00 2026-04-17
8836640_1 CDM Reload Purple - Egia45amt 5 5 $1,328.00 $1,328.00 $677.28 $1,261.60 $1,248.32 2026-04-17
78315 HCPCS Nuclear Medicine Study Of Bone Taken At Different Times 7 5 $2,399.00 $2,399.00 $45.66 $2,279.05 $1,247.96 2026-04-17
43840 HCPCS Suture Of Perforated Ulcer, Wound, Or Injury Of Stomach Or Upper Small Bowel 2 2 $7,249.00 $7,249.00 $1,222.81 $1,247.27 $1,235.04 2026-04-17
24200 HCPCS Removal Of Foreign Body Of Upper Arm Or Elbow Area, Accessed Beneath The Skin 7 5 $2,371.00 $2,371.00 $140.16 $2,252.45 $1,233.39 2026-04-17
8028211_1 CDM Nursery - General Classification 3 3 $1,295.00 $1,295.00 $1,217.30 $1,230.25 $1,230.25 2026-04-17
78472 HCPCS Nuclear Medicine Study Of Heart Pumping Function By Labeling Red Blood Cells Wit… 7 5 $2,362.00 $2,362.00 $44.41 $2,243.90 $1,228.71 2026-04-17
A0434 HCPCS Specialty Care Transport (sct) 5 5 $1,305.00 $1,305.00 $665.55 $1,239.75 $1,226.70 2026-04-17
72192 HCPCS CT Scan Of Pelvis Without Contrast 17 5 $2,354.00 $2,354.00 $49.25 $3,738.25 $1,224.55 2026-04-17
22610 HCPCS Fusion Of Spine In Upper Back 2 2 $3,276.00 $3,276.00 $1,205.34 $1,229.45 $1,217.39 2026-04-17
78226 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System 7 5 $2,340.00 $2,340.00 $33.39 $2,223.00 $1,217.27 2026-04-17
13152 HCPCS Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 2.6-7.5 Cm 7 5 $2,339.00 $2,339.00 $273.27 $2,222.05 $1,216.75 2026-04-17
44140 HCPCS Partial Removal Of Large Bowel With Connection 2 2 $4,973.00 $4,973.00 $1,203.30 $1,227.37 $1,215.34 2026-04-17
72128 HCPCS CT Scan Of Middle Spine Without Contrast 7 5 $2,314.00 $2,314.00 $45.91 $2,198.30 $1,203.74 2026-04-17
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 12 5 $2,113.00 $2,113.00 $277.50 $4,664.50 $1,203.20 2026-04-17
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 7 5 $2,310.00 $2,310.00 $62.85 $2,194.50 $1,201.66 2026-04-17
70486 HCPCS CT Scan Of Face Without Contrast 7 5 $2,310.00 $2,310.00 $39.31 $2,194.50 $1,201.66 2026-04-17
73701 HCPCS CT Scan Of Leg With Contrast Material 7 5 $2,308.00 $2,308.00 $52.83 $2,192.60 $1,200.62 2026-04-17
71550 HCPCS MRI Scan Of Chest Without Contrast 7 5 $2,303.00 $2,303.00 $65.86 $2,187.85 $1,198.02 2026-04-17
70336 HCPCS MRI Scan Of Jaw Joint 7 5 $2,301.00 $2,301.00 $66.19 $2,185.95 $1,196.98 2026-04-17
27096 HCPCS Injection Of Anesthetic Or Steroid Into Joint Between Lower Spine And Hip Bone U… 7 5 $2,300.00 $2,300.00 $72.60 $2,185.00 $1,196.46 2026-04-17
23665 HCPCS Closed Treatment Of Dislocated Shoulder And Broken Upper Arm Bone At Shoulder Jo… 7 5 $2,299.00 $2,299.00 $407.82 $2,184.05 $1,195.94 2026-04-17
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