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

JOHNSON COUNTY HEALTHCARE CENTER

Buffalo, WY · CCN 531308 · Rates published

1,990 distinct procedures filed
12 distinct payers
29,358 rate rows
2026-10-09 last MRF observed
Data quality

11,171 of 29,358 rate rows are consumer-grade (38.1%)

18,187 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 18,172
per-diem day rate — not a per-procedure price 12
exceeds 10× this hospital's gross charge — excluded from medians 3
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.jchealthcare.com/830249721_johnson-county-healthcare-center_standardcharges.csv
Found on page https://www.jchealthcare.com/for-patients/financial-information/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-09
Content fingerprint aa520b9fbf2a799b… · 11,857,386 bytes · first seen 2026-08-17

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
0360
RC 		2 $2,395.43 $10,086.00 $6,240.72 nat. median
$2,000
outlier · 3.1×
J1162
HCPCS 		Digifab Solution 40mg Vial (nf) 11 $4,777.44 $4,777.44 $4,777.44 nat. median
$7,141
0.7× median
0210
RC 		8 $3,441.85 $5,013.15 $3,605.00 nat. median
$3,854
0.9× median
J2507
HCPCS 		Krystexxa 8mg Vial 11 $3,447.06 $3,447.06 $3,447.06 nat. median
$9,200
outlier · 0.4×
0170
RC 		8 $898.74 $2,913.00 $2,913.00 nat. median
$1,348
outlier · 2.2×
0180
RC 		8 $2,913.00 $2,913.00 $2,913.00 nat. median
$1,768
1.6× median
0120
RC 		8 $2,071.95 $3,697.54 $2,913.00 nat. median
$983
outlier · 3.0×
0112
RC 		8 $2,519.40 $3,465.00 $2,913.00 nat. median
$914
outlier · 3.2×
73706
HCPCS 		G Pro Fee CTA Lower Ext Complete,pro Fee 1 $2,773.05 $2,773.05 $2,773.05 nat. median
$743
outlier · 3.7×
70471
HCPCS 		G Pro Fee CTA Head & Neck,pro Fee 3 $579.50 $3,961.50 $2,697.16 nat. median
$830
outlier · 3.3×
32551
HCPCS 		Tube Thoracostomy 1 $2,471.90 $2,471.90 $2,471.90 nat. median
$1,574
1.6× median
28575
HCPCS 		Clsd Trmt Of Talotarsal Jt Dislocation 1 $804.65 $3,900.70 $2,352.67 nat. median
$3,245
0.7× median
27810
HCPCS 		Clsd Reduction Ankle Fracture 1 $2,348.40 $2,348.40 $2,348.40 nat. median
$1,642
1.4× median
23655
HCPCS 		Shoulder Dislocation Reduction W/anesthe 1 $2,348.40 $2,348.40 $2,348.40 nat. median
$1,762
1.3× median
74174
HCPCS 		G Pro Fee CTA Abd And Pelvis Complete,pro Fee 1 $433.00 $3,935.85 $2,184.43 nat. median
$988
outlier · 2.2×
72193
HCPCS 		G Pro Fee CT Pelvis W,pro Fee 1 $2,115.65 $2,115.65 $2,115.65 nat. median
$637
outlier · 3.3×
J3240
HCPCS 		Thyrogen 0.9mg Vial 11 $2,065.84 $2,065.84 $2,065.84 nat. median
$2,980
0.7× median
J0840
HCPCS 		Crotalidae Imm Fab (crofab) 1 Vial 11 $2,056.35 $2,056.35 $2,056.35 nat. median
$3,445
0.6× median
73720
HCPCS 		G Pro Fee Mr Lower Ext Not Jt W/wo Con,pro Fee 1 $319.00 $3,570.10 $1,944.55 nat. median
$1,129
1.7× median
64635
HCPCS 		Anesthesia Dest Facet Jt Lumbar W/guid 2 $302.96 $3,501.07 $1,942.00 nat. median
$2,392
0.8× median
0683
RC 		2 $1,819.25 $1,819.25 $1,819.25 nat. median
$3,396
0.5× median
74177
HCPCS 		G Pro Fee CT Abd And Pelvis With,pro Fee 5 $81.22 $4,733.85 $1,793.75 nat. median
$974
1.8× median
73721
HCPCS 		G Pro Fee Mr Lower Ext Any Jt Without Con,pro Fee 3 $186.45 $2,474.75 $1,783.16 nat. median
$856
outlier · 2.1×
45385
HCPCS 		Colonoscopy; Removal Polyp (snare Tech) 2 $1,769.47 $1,769.47 $1,769.47 nat. median
$1,669
1.1× median
45380
HCPCS 		Colonoscopy W/biopsy 3 $1,264.97 $1,769.47 $1,769.47 nat. median
$1,565
1.1× median
45388
HCPCS 		Colonoscopy W/ablation Of Tumor/polyp 3 $1,769.47 $1,769.47 $1,769.47 nat. median
$1,879
0.9× median
27510
HCPCS 		Clsd Trmt Femoral Fx Distal End W/manipu 1 $1,573.20 $1,931.35 $1,752.28 nat. median
$1,703
1.0× median
45378
HCPCS 		Colonoscopy / Or Time 3 $1,266.06 $1,769.47 $1,732.80 nat. median
$1,342
1.3× median
74178
HCPCS 		G Pro Fee CT Abd And Pelvis W - W/o,pro Fee 4 $88.89 $4,992.25 $1,699.74 nat. median
$1,024
1.7× median
92960
HCPCS 		Cardioversion 1 $1,687.20 $1,687.20 $1,687.20 nat. median
$986
1.7× median
0722
RC 		2 $1,673.90 $1,673.90 $1,673.90 nat. median
$3,298
0.5× median
70553
HCPCS 		G Pro Fee Mr Brain W/wo Con,pro Fee 3 $102.00 $4,038.45 $1,605.08 nat. median
$1,133
1.4× median
72148
HCPCS 		G Pro Fee Mr Lumbar Spine Without Cont Limit,pro Fee, Reduced Services 1 $277.00 $2,875.65 $1,576.33 nat. median
$805
2.0× median
46040
HCPCS 		I&d Ischiorectal Abscess(sep Proc) 1 $1,573.20 $1,573.20 $1,573.20 nat. median
$1,693
0.9× median
L0486
HCPCS 		Vista 464 Tlso 11 $1,530.88 $1,530.88 $1,530.88 nat. median
$2,644
0.6× median
43270
HCPCS 		Egd With Polyp Removal 1 $1,503.85 $1,503.85 $1,503.85 nat. median
$2,296
0.7× median
72131
HCPCS 		G Pro Fee CT L Spine Without Con,pro Fee 3 $44.99 $2,269.55 $1,474.97 nat. median
$457
outlier · 3.2×
74160
HCPCS 		G Pro Fee CT Abdomen W,pro Fee 1 $237.00 $2,598.25 $1,417.62 nat. median
$652
outlier · 2.2×
73221
HCPCS 		G Pro Fee Mr Upr Ext Any Jt Without Cont,pro Fee 1 $253.00 $2,550.75 $1,401.88 nat. median
$844
1.7× median
74176
HCPCS 		G Pro Fee CT Abd & Pelvis Without Stone,pro Fee 4 $77.47 $3,751.55 $1,395.06 nat. median
$694
outlier · 2.0×
J0630
HCPCS 		Calcitonin-salmon Mdv 400 Iu/2ml 11 $1,366.44 $1,366.44 $1,366.44 nat. median
$1,894
0.7× median
73218
HCPCS 		G Pro Fee Mr Upr Ext Not Jt Without Cont,pro Fee 1 $253.00 $2,345.55 $1,299.28 nat. median
$864
1.5× median
43239
HCPCS 		Egd With Biopsy 4 $1,007.31 $1,540.52 $1,293.55 nat. median
$1,375
0.9× median
L1844
HCPCS 		Knee Brace Townsend Custom 11 $1,270.04 $1,270.04 $1,270.04 nat. median
$1,998
0.6× median
73200
HCPCS 		G Pro Fee CT Upper Extre Without Left,pro Fee, Left 2 $45.91 $1,730.90 $1,226.57 nat. median
$521
outlier · 2.4×
70470
HCPCS 		G Pro Fee CT Head/brain W-w/o,pro Fee 1 $94.05 $2,312.30 $1,203.17 nat. median
$622
1.9× median
G0121
HCPCS 		Colonoscopy Scrn Non High Risk Med/adv 2 $1,149.98 $1,228.83 $1,189.40 nat. median
$1,292
0.9× median
71275
HCPCS 		G Pro Fee CTA Chest Complete,pro Fee 4 $84.95 $3,325.95 $1,162.95 nat. median
$754
1.5× median
64483
HCPCS 		Anesthesia Steroid Inj Lumbar/sacral 1 $288.00 $2,035.89 $1,161.95 nat. median
$1,302
0.9× median
92950
HCPCS 		Cpr 1 $1,155.20 $1,155.20 $1,155.20 nat. median
$582
2.0× median

Other procedures at this hospital

Browse this hospital's 1,990 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
             
0112 RC — 8 8 $2,652.00 $2,652.00 $2,519.40 $3,465.00 $2,913.00 2026-10-09
0120 RC — 8 8 $414.00 $414.00 $2,071.95 $3,697.54 $2,913.00 2026-10-09
0170 RC — 8 8 $3,308.00 $3,308.00 $898.74 $2,913.00 $2,913.00 2026-10-09
0180 RC — 8 8 $171.00 $171.00 $2,913.00 $2,913.00 $2,913.00 2026-10-09
0210 RC — 8 8 $1,575.00 $1,575.00 $3,441.85 $5,013.15 $3,605.00 2026-10-09
0300 RC — 3 3 $100.00 $100.00 $91.41 $130.15 $125.49 2026-10-09
0360 RC — 2 2 $4,491.00 $4,491.00 $2,395.43 $10,086.00 $6,240.72 2026-10-09
0420 RC — 2 2 $31.25 $31.25 $29.69 $199.18 $114.44 2026-10-09
0683 RC — 2 2 $2,788.00 $2,788.00 $1,819.25 $1,819.25 $1,819.25 2026-10-09
0710 RC — 4 4 $221.00 $221.00 $129.65 $989.90 $396.97 2026-10-09
0721 RC — 3 3 $925.00 $925.00 $376.52 $1,064.00 $512.53 2026-10-09
0722 RC — 2 2 $1,850.00 $1,850.00 $1,673.90 $1,673.90 $1,673.90 2026-10-09
10005 HCPCS Fna W US Guidance 24 11 $386.00 $386.00 $142.67 $872.10 $142.67 2026-10-09
10060 HCPCS I & D Abscess Simple 5 3 $185.00 $185.00 $148.50 $256.50 $167.20 2026-10-09
11200 HCPCS Removal Skin Tag Up To 15 1 1 $275.00 $275.00 $248.90 $248.90 $248.90 2026-10-09
12001 HCPCS Simple Laceration 2.5cm Or Less 10 6 $209.00 $209.00 $43.77 $367.65 $316.49 2026-10-09
12002 HCPCS Simple Laceration 2.6cm To 7.5cm 7 4 $417.00 $417.00 $58.14 $377.15 $275.12 2026-10-09
12004 HCPCS Simple Laceration 7.5-12.5cm 3 2 $485.00 $485.00 $183.35 $438.90 $438.90 2026-10-09
12011 HCPCS Simple Laceration Of Face 2.5cm Or Less 3 2 $422.00 $422.00 $43.53 $381.90 $249.20 2026-10-09
12013 HCPCS Simple Laceration Of Face 2.6-5.0cm 1 1 $351.00 $351.00 $317.30 $317.30 $317.30 2026-10-09
12015 HCPCS Simple Lac Of Face 7.6-12.5cm 2 1 $318.00 $318.00 $134.03 $287.85 $210.94 2026-10-09
12031 HCPCS Intermediate Repair 2.5 Cm Or Less 4 2 $611.00 $611.00 $206.54 $552.90 $436.45 2026-10-09
12032 HCPCS Intermediate Laceration Repair 2.6-7.5cm 1 1 $642.00 $642.00 $580.45 $580.45 $580.45 2026-10-09
12035 HCPCS Intermediate Repair 12.6-20cm 1 1 $611.00 $611.00 $552.90 $552.90 $552.90 2026-10-09
19000 HCPCS G Pro Fee US Breast Asp Cyst Left,pro Fee, Left 71 11 $270.00 $270.00 $106.65 $106.65 $106.65 2026-10-09
19083 HCPCS Biopsy Breast Left W/us Guidence,left Side 36 11 $2,382.00 $2,382.00 $526.36 $526.36 $526.36 2026-10-09
19084 HCPCS Biopsy Breast Additional Lesion 23 11 $182.00 $182.00 $400.23 $400.23 $400.23 2026-10-09
19120 HCPCS Prof Exc Cyst/tumor Breast 1+ Lesions 13 11 $473.00 $473.00 $548.99 $548.99 $548.99 2026-10-09
19125 HCPCS Prof Exc Breast Lesion Id By Preoperativ 13 11 $522.00 $522.00 $604.16 $604.16 $604.16 2026-10-09
19281 HCPCS G Pro Fee Mammo Localization/breast,pro Fee 35 11 $1,286.00 $1,286.00 $256.24 $256.24 $256.24 2026-10-09
19285 HCPCS G Pro Fee US Loc Wire Breast W/us Guid,pro Fee, Left 61 11 $629.00 $629.00 $388.70 $388.70 $388.70 2026-10-09
19286 HCPCS G Pro Fee US Add Lesion Localization Bre,pro Fee 24 11 $117.00 $117.00 $317.89 $317.89 $317.89 2026-10-09
1967 OTHER Anesthesia Labor Analgesia Vag Delivery,crna 15 10 $21.00 $21.00 $10.00 $658.13 $658.13 2026-10-09
23655 HCPCS Shoulder Dislocation Reduction W/anesthe 1 1 $2,596.00 $2,596.00 $2,348.40 $2,348.40 $2,348.40 2026-10-09
24600 HCPCS Reduction Elbow Dislocation 2 1 $296.00 $296.00 $304.57 $448.43 $376.50 2026-10-09
25605 HCPCS Clsd Trmt Distal Radius Fx W/manipulatio 2 1 $2,596.00 $2,596.00 $526.80 $1,598.89 $1,062.85 2026-10-09
27096 HCPCS Anesthesia Injection Sacroiliac Joint 2 1 $690.00 $690.00 $215.00 $926.08 $570.54 2026-10-09
27510 HCPCS Clsd Trmt Femoral Fx Distal End W/manipu 2 1 $2,135.00 $2,135.00 $1,573.20 $1,931.35 $1,752.28 2026-10-09
27560 HCPCS Reduction Patellar Dislocation 1 1 $296.00 $296.00 $267.90 $267.90 $267.90 2026-10-09
27562 HCPCS Clsd Trmt Patellar Disloc W/anesthesia 2 1 $374.00 $374.00 $374.87 $659.38 $517.12 2026-10-09
27810 HCPCS Clsd Reduction Ankle Fracture 1 1 $2,596.00 $2,596.00 $2,348.40 $2,348.40 $2,348.40 2026-10-09
28575 HCPCS Clsd Trmt Of Talotarsal Jt Dislocation 2 1 $4,311.00 $4,311.00 $804.65 $3,900.70 $2,352.67 2026-10-09
30901 HCPCS Control Nasal Hemorrhage Simple 3 2 $247.00 $247.00 $171.95 $223.25 $223.25 2026-10-09
32551 HCPCS Tube Thoracostomy 1 1 $406.00 $406.00 $2,471.90 $2,471.90 $2,471.90 2026-10-09
36430 HCPCS Blood Transfusion 1 Unit 1 1 $767.00 $767.00 $495.77 $495.77 $495.77 2026-10-09
36573 HCPCS G Pro Fee Picc Line Placement,pro Fee 1 1 $1,294.00 $1,294.00 $212.00 $212.00 $212.00 2026-10-09
43239 HCPCS Egd With Biopsy 4 4 $1,662.00 $1,662.00 $1,007.31 $1,540.52 $1,293.55 2026-10-09
43270 HCPCS Egd With Polyp Removal 1 1 $1,662.00 $1,662.00 $1,503.85 $1,503.85 $1,503.85 2026-10-09
44386 HCPCS Small Intestinal Pouch Endoscopy W/biops 1 1 $417.00 $417.00 $377.15 $377.15 $377.15 2026-10-09
45338 HCPCS Sigmoidoscopy W/removal Tumor/polyps 1 1 $417.00 $417.00 $298.86 $298.86 $298.86 2026-10-09
45378 HCPCS Colonoscopy / Or Time 3 3 $1,915.00 $1,915.00 $1,266.06 $1,769.47 $1,732.80 2026-10-09
45380 HCPCS Colonoscopy W/biopsy 3 3 $1,915.00 $1,915.00 $1,264.97 $1,769.47 $1,769.47 2026-10-09
45381 HCPCS Prof Fee Colonoscopy Tattoo,multiple Procedure Were Performed By The Same Provid… 1 1 $223.00 $223.00 $212.40 $212.40 $212.40 2026-10-09
45385 HCPCS Colonoscopy; Removal Polyp (snare Tech) 2 2 $1,915.00 $1,915.00 $1,769.47 $1,769.47 $1,769.47 2026-10-09
45388 HCPCS Colonoscopy W/ablation Of Tumor/polyp 3 3 $2,724.00 $2,724.00 $1,769.47 $1,769.47 $1,769.47 2026-10-09
46040 HCPCS I&d Ischiorectal Abscess(sep Proc) 1 1 $1,739.00 $1,739.00 $1,573.20 $1,573.20 $1,573.20 2026-10-09
46221 HCPCS Hemorrhoidectomy By Banding 1 1 $974.00 $974.00 $918.27 $918.27 $918.27 2026-10-09
49083 HCPCS G Pro Fee Paracentesis,pro Fee 2 1 $281.00 $281.00 $98.20 $927.81 $513.00 2026-10-09
49591 HCPCS Prof Fee Rpr Anterior Abd Hernia <3cm 13 11 $380.00 $380.00 $301.80 $301.80 $301.80 2026-10-09
49592 HCPCS Prof Fee Rpr Anterior Abd Hernia 13 11 $1,176.00 $1,176.00 $419.45 $419.45 $419.45 2026-10-09
49593 HCPCS Prof Fee Rpr Abd Hernia 3-10 Cm Reducibl 13 11 $635.00 $635.00 $505.33 $505.33 $505.33 2026-10-09
49594 HCPCS Prof Fee Rpr Abd Hernia Any Approach 13 11 $1,750.00 $1,750.00 $657.52 $657.52 $657.52 2026-10-09
51702 HCPCS Insert Of Temporary Indwelling Cath 3 3 $261.00 $261.00 $169.11 $236.55 $236.55 2026-10-09
57452 HCPCS Colposcopy Cervix 13 11 $317.00 $317.00 $139.48 $139.48 $139.48 2026-10-09
57454 HCPCS Colposcopy With Biopsy 13 11 $561.00 $561.00 $185.18 $185.18 $185.18 2026-10-09
57500 HCPCS Biopsy Of Cervix 13 11 $448.00 $448.00 $170.67 $170.67 $170.67 2026-10-09
64415 HCPCS Anesthesia Brachial Plexus Block,distinct 2 2 $1,295.00 $1,295.00 $64.86 $223.00 $143.93 2026-10-09
64450 HCPCS G Pro Fee Inj Perpheral Nerve,pro Fee 2 1 $538.00 $538.00 $61.60 $922.17 $491.88 2026-10-09
64483 HCPCS Anesthesia Steroid Inj Lumbar/sacral 2 1 $1,527.00 $1,527.00 $288.00 $2,035.89 $1,161.95 2026-10-09
64635 HCPCS Anesthesia Dest Facet Jt Lumbar W/guid 4 2 $487.00 $487.00 $302.96 $3,501.07 $1,942.00 2026-10-09
64636 HCPCS Anesthesia Lumbar / Sacral +facet Joint 4 2 $1,050.00 $1,050.00 $81.33 $950.00 $555.00 2026-10-09
70360 HCPCS G Pro Fee Neck 2v Soft Tissue,pro Fee 2 1 $49.00 $49.00 $39.90 $297.35 $168.63 2026-10-09
70450 HCPCS G Pro Fee CT Head Brain W/o,pro Fee 8 4 $222.00 $222.00 $38.20 $1,962.70 $766.50 2026-10-09
70470 HCPCS G Pro Fee CT Head/brain W-w/o,pro Fee 2 1 $330.00 $330.00 $94.05 $2,312.30 $1,203.17 2026-10-09
70471 HCPCS G Pro Fee CTA Head & Neck,pro Fee 3 3 $641.00 $641.00 $579.50 $3,961.50 $2,697.16 2026-10-09
70486 HCPCS G Pro Fee CT Maxilloface W/o,pro Fee 8 4 $305.00 $305.00 $40.45 $1,962.70 $720.27 2026-10-09
70487 HCPCS G Pro Fee CT Maxilloface W,pro Fee 1 1 $348.00 $348.00 $211.00 $211.00 $211.00 2026-10-09
70490 HCPCS G Pro Fee CT Neck (st) W/o,pro Fee 2 1 $343.00 $343.00 $255.00 $2,015.90 $1,135.45 2026-10-09
70491 HCPCS G Pro Fee CT Neck (st) W,pro Fee 1 1 $350.00 $350.00 $257.00 $257.00 $257.00 2026-10-09
70496 HCPCS G Pro Fee CTA Head Complete,pro Fee 6 3 $407.00 $407.00 $77.33 $2,511.80 $857.05 2026-10-09
70498 HCPCS G Pro Fee CTA Neck Complete,pro Fee 4 2 $427.00 $427.00 $73.47 $2,771.15 $939.93 2026-10-09
70551 HCPCS G Pro Fee Mr Brain Without Con,pro Fee 6 3 $481.00 $481.00 $65.36 $2,638.15 $1,010.01 2026-10-09
70553 HCPCS G Pro Fee Mr Brain W/wo Con,pro Fee 6 3 $470.00 $470.00 $102.00 $4,038.45 $1,605.08 2026-10-09
71045 HCPCS G Pro Fee Chest 1v Frontal,pro Fee 8 4 $130.00 $130.00 $8.17 $254.60 $141.63 2026-10-09
71046 HCPCS G Pro Fee Chest 2v Frontal & Lat,pro Fee 11 6 $130.00 $130.00 $9.73 $370.50 $240.79 2026-10-09
71100 HCPCS G Pro Fee Ribs Unil 2 V Left,pro Fee, Left 4 1 $66.00 $66.00 $42.00 $416.10 $197.78 2026-10-09
71101 HCPCS G Pro Fee Ribs Unil With Pa Chest Right,pro Fee, Right 8 3 $81.00 $81.00 $42.35 $456.00 $264.58 2026-10-09
71250 HCPCS G Pro Fee CT Thorax W/o,pro Fee 6 3 $302.00 $302.00 $47.93 $1,986.45 $802.25 2026-10-09
71260 HCPCS G Pro Fee CT Thorax W,pro Fee 8 4 $317.00 $317.00 $51.98 $3,151.15 $1,011.48 2026-10-09
71275 HCPCS G Pro Fee CTA Chest Complete,pro Fee 8 4 $3,256.00 $3,256.00 $84.95 $3,325.95 $1,162.95 2026-10-09
72050 HCPCS G Pro Fee C-spine 4v,pro Fee 5 3 $156.00 $156.00 $12.28 $780.90 $148.20 2026-10-09
72070 HCPCS G Pro Fee Thoracic Spine 2v,pro Fee 6 3 $49.00 $49.00 $9.12 $322.05 $124.10 2026-10-09
72072 HCPCS G Pro Fee Thoracic Spine 3v,pro Fee 4 2 $156.00 $156.00 $10.56 $479.75 $194.38 2026-10-09
72080 HCPCS G Pro Fee Thoracic Lumbar Junction,pro Fee 2 1 $54.00 $54.00 $42.00 $264.10 $153.05 2026-10-09
72081 HCPCS G Pro Fee Scoliosis Study 1v Spine Entir,pro Fee 2 1 $62.00 $62.00 $52.00 $605.15 $328.57 2026-10-09
72100 HCPCS G Pro Fee Lumbar Spine 2v Or 3v,pro Fee 10 5 $149.00 $149.00 $10.39 $283.10 $162.77 2026-10-09
72110 HCPCS G Pro Fee Lumbar Spine 4v+,pro Fee 8 4 $156.00 $156.00 $11.97 $606.10 $267.73 2026-10-09
72125 HCPCS G Pro Fee CT C Spine W/o,pro Fee 8 4 $295.00 $295.00 $47.25 $2,252.45 $903.12 2026-10-09
72128 HCPCS G Pro Fee CT T Spine W/o,pro Fee 3 2 $280.00 $280.00 $44.87 $2,305.65 $196.00 2026-10-09
72131 HCPCS G Pro Fee CT L Spine Without Con,pro Fee 5 3 $293.00 $293.00 $44.99 $2,269.55 $1,474.97 2026-10-09
72141 HCPCS G Pro Fee Mr Cervical Spine Without Cont,pro Fee 4 3 $440.00 $440.00 $119.42 $1,752.97 $262.73 2026-10-09
72146 HCPCS G Pro Fee Mr Thoracic Spine W/o,pro Fee 1 1 $374.00 $374.00 $295.00 $295.00 $295.00 2026-10-09
72148 HCPCS G Pro Fee Mr Lumbar Spine Without Cont Limit,pro Fee, Reduced Services 2 1 $360.00 $360.00 $277.00 $2,875.65 $1,576.33 2026-10-09
72158 HCPCS G Pro Fee Mr L Sp W/wo Contras,pro Fee 1 1 $419.00 $419.00 $399.00 $399.00 $399.00 2026-10-09
72170 HCPCS G Pro Fee Pelvis 1v Or 2v,pro Fee 4 2 $156.00 $156.00 $35.00 $342.00 $157.40 2026-10-09
72192 HCPCS G Pro Fee CT Pelvis W/o,pro Fee 2 1 $245.00 $245.00 $216.00 $1,982.65 $1,099.33 2026-10-09
72193 HCPCS G Pro Fee CT Pelvis W,pro Fee 1 1 $267.00 $267.00 $2,115.65 $2,115.65 $2,115.65 2026-10-09
72202 HCPCS G Pro Fee Sacroiliac Joints 3v+,pro Fee 2 1 $57.00 $57.00 $42.00 $479.75 $260.88 2026-10-09
72220 HCPCS G Pro Fee Sacrum/coccyx Min 2v +,pro Fee 2 2 $47.00 $47.00 $35.00 $342.00 $188.50 2026-10-09
73020 HCPCS G Pro Fee Shoulder 1v Left,pro Fee, Left 1 1 $331.00 $331.00 $299.25 $299.25 $299.25 2026-10-09
73030 HCPCS G Pro Fee Shoulder 2v+ Left,pro Fee, Left 15 4 $130.00 $130.00 $8.48 $456.00 $296.36 2026-10-09
73060 HCPCS G Pro Fee Humerus 2v+ Right,pro Fee, Right 6 2 $327.00 $327.00 $7.22 $295.45 $129.26 2026-10-09
73070 HCPCS G Pro Fee Elbow 2v Right,pro Fee, Right 3 2 $345.00 $345.00 $37.05 $312.55 $312.55 2026-10-09
73080 HCPCS G Pro Fee Elbow 3v+ Right,pro Fee, Right 8 3 $130.00 $130.00 $8.50 $412.30 $206.67 2026-10-09
73090 HCPCS G Pro Fee Forearm 2v Left,pro Fee, Left 12 4 $362.00 $362.00 $7.82 $327.75 $137.78 2026-10-09
73110 HCPCS G Pro Fee Wrist 3v + Left,pro Fee, Left 16 5 $130.00 $130.00 $7.84 $351.50 $173.12 2026-10-09
73120 HCPCS G Pro Fee Hand 2 Views Left,pro Fee, Left 6 3 $331.00 $331.00 $21.45 $299.25 $299.25 2026-10-09
73130 HCPCS G Pro Fee Hand 3v+ Right,pro Fee, Right 11 4 $130.00 $130.00 $8.85 $347.70 $249.37 2026-10-09
73140 HCPCS G Pro Fee Fingers 2v+ Right,pro Fee, Right 12 3 $216.00 $216.00 $6.46 $264.10 $151.00 2026-10-09
73200 HCPCS G Pro Fee CT Upper Extre Without Left,pro Fee, Left 5 2 $271.00 $271.00 $45.91 $1,730.90 $1,226.57 2026-10-09
73218 HCPCS G Pro Fee Mr Upr Ext Not Jt Without Cont,pro Fee 2 1 $330.00 $330.00 $253.00 $2,345.55 $1,299.28 2026-10-09
73221 HCPCS G Pro Fee Mr Upr Ext Any Jt Without Cont,pro Fee 2 1 $339.00 $339.00 $253.00 $2,550.75 $1,401.88 2026-10-09
73501 HCPCS G Pro Fee Hip 1v Left,pro Fee, Left 2 1 $46.00 $46.00 $38.00 $306.85 $172.43 2026-10-09
73502 HCPCS G Pro Fee Hip 2-3v Left,pro Fee, Left 16 4 $130.00 $130.00 $10.07 $225.15 $132.06 2026-10-09
73523 HCPCS G Pro Fee Hips W Pelvis,pro Fee 2 1 $155.00 $155.00 $63.00 $430.35 $246.68 2026-10-09
73560 HCPCS G Pro Fee Knee 1v Or 2v Right,pro Fee, Right 11 4 $338.00 $338.00 $7.78 $305.90 $219.67 2026-10-09
73562 HCPCS G Pro Fee Knee 3v Left,pro Fee, Left 18 5 $130.00 $130.00 $9.09 $372.40 $179.91 2026-10-09
73564 HCPCS G Pro Fee Knee 4v+ Left,pro Fee, Left 18 4 $156.00 $156.00 $10.38 $1,128.60 $313.85 2026-10-09
73590 HCPCS G Pro Fee Tib/fib-2v Left,pro Fee, Left 12 3 $384.00 $384.00 $7.22 $347.70 $171.88 2026-10-09
73600 HCPCS G Pro Fee Ankle 2v Left,pro Fee, Left 6 2 $343.00 $343.00 $31.00 $310.65 $183.35 2026-10-09
73610 HCPCS G Pro Fee Ankle 3v+ Left,pro Fee, Left 12 3 $130.00 $130.00 $35.00 $456.00 $286.90 2026-10-09
73620 HCPCS G Pro Fee Foot 2v Left,pro Fee, Left 13 3 $324.00 $324.00 $20.90 $293.55 $293.55 2026-10-09
73630 HCPCS G Pro Fee Foot 3v+ Left,pro Fee, Left 14 4 $130.00 $130.00 $7.53 $456.00 $207.33 2026-10-09
73700 HCPCS G Pro Fee CT Lower Extre Without Right,pro Fee, Right 4 2 $266.00 $266.00 $132.19 $2,149.85 $962.39 2026-10-09
73706 HCPCS G Pro Fee CTA Lower Ext Complete,pro Fee 1 1 $3,065.00 $3,065.00 $2,773.05 $2,773.05 $2,773.05 2026-10-09
73718 HCPCS G Pro Fee Mr Lower Ext Not Jt Without Con,pro Fee 3 2 $359.00 $359.00 $97.47 $2,345.55 $268.00 2026-10-09
73720 HCPCS G Pro Fee Mr Lower Ext Not Jt W/wo Con,pro Fee 2 1 $335.00 $335.00 $319.00 $3,570.10 $1,944.55 2026-10-09
73721 HCPCS G Pro Fee Mr Lower Ext Any Jt Without Con,pro Fee 5 3 $356.00 $356.00 $186.45 $2,474.75 $1,783.16 2026-10-09
74018 HCPCS G Pro Fee Abdomen 1v,pro Fee 8 4 $130.00 $130.00 $8.85 $312.55 $171.02 2026-10-09
74019 HCPCS G Pro Fee Abdomen 2v,pro Fee 2 1 $78.00 $78.00 $46.00 $462.65 $254.32 2026-10-09
74022 HCPCS G Pro Fee Abdomen Acute Series Inc Cxr,pro Fee 2 1 $156.00 $156.00 $65.00 $374.30 $219.65 2026-10-09
74150 HCPCS G Pro Fee CT Abdomen W/o,pro Fee 2 1 $361.00 $361.00 $98.04 $1,917.10 $1,007.57 2026-10-09
74160 HCPCS G Pro Fee CT Abdomen W,pro Fee 2 1 $349.00 $349.00 $237.00 $2,598.25 $1,417.62 2026-10-09
74170 HCPCS G Pro Fee CT Abdomen W-w/o,pro Fee 4 2 $490.00 $490.00 $62.25 $2,309.45 $936.22 2026-10-09
74174 HCPCS G Pro Fee CTA Abd And Pelvis Complete,pro Fee 2 1 $729.00 $729.00 $433.00 $3,935.85 $2,184.43 2026-10-09
74175 HCPCS G Pro Fee CTA Abd Complete,pro Fee 1 1 $522.00 $522.00 $340.00 $340.00 $340.00 2026-10-09
74176 HCPCS G Pro Fee CT Abd & Pelvis Without Stone,pro Fee 8 4 $675.00 $675.00 $77.47 $3,751.55 $1,395.06 2026-10-09
74177 HCPCS G Pro Fee CT Abd And Pelvis With,pro Fee 10 5 $525.00 $525.00 $81.22 $4,733.85 $1,793.75 2026-10-09
74178 HCPCS G Pro Fee CT Abd And Pelvis W - W/o,pro Fee 8 4 $550.00 $550.00 $88.89 $4,992.25 $1,699.74 2026-10-09
74300 HCPCS G Pro Fee Cholangio (opr),pro Fee 2 1 $106.00 $106.00 $52.00 $661.20 $356.60 2026-10-09
76536 HCPCS G Pro Fee US Soft Tissue Head/neck,pro Fee 6 3 $149.00 $149.00 $25.61 $721.05 $328.91 2026-10-09
76604 HCPCS G Pro Fee US Chest,pro Fee 5 3 $181.00 $181.00 $49.02 $606.10 $115.00 2026-10-09
76641 HCPCS G Pro Fee US Breast / Ax.complete Left,pro Fee, Left 58 11 $327.00 $327.00 $109.71 $138.00 $109.71 2026-10-09
76700 HCPCS G Pro Fee US Abd Comp,pro Fee 3 2 $209.00 $209.00 $59.57 $1,032.65 $151.00 2026-10-09
76705 HCPCS G Pro Fee US Abd Limited,pro Fee 6 3 $333.00 $333.00 $26.59 $751.45 $324.24 2026-10-09
76706 HCPCS G Pro Fee US Aaa Screen,pro Fee 2 1 $236.00 $236.00 $109.00 $606.10 $357.55 2026-10-09
76770 HCPCS G Pro Fee US Retroperitoneal Comp,pro Fee 1 1 $188.00 $188.00 $146.00 $146.00 $146.00 2026-10-09
76775 HCPCS G Pro Fee US Retroperitoneal Lmt,pro Fee 4 2 $236.00 $236.00 $109.00 $635.55 $379.65 2026-10-09
76801 HCPCS G Pro Fee US Preg<14 Wks,pro Fee 25 11 $228.00 $228.00 $114.85 $549.10 $114.85 2026-10-09
76802 HCPCS G Pro Fee US Preg<14 Add Fetus,pro Fee 24 11 $156.00 $156.00 $131.81 $131.81 $131.81 2026-10-09
76805 HCPCS G Pro Fee US Preg>14 Wks,pro Fee 29 11 $228.00 $228.00 $119.35 $824.60 $127.37 2026-10-09
76810 HCPCS G Pro Fee US Preg>14 Add Fetus,pro Fee 24 11 $156.00 $156.00 $210.90 $210.90 $210.90 2026-10-09
76819 HCPCS G Pro Fee US Biophysical Profile,pro Fee 3 2 $225.00 $225.00 $143.00 $694.45 $203.30 2026-10-09
76830 HCPCS G Pro Fee US Pelvic Trans V,pro Fee 4 2 $200.00 $200.00 $130.00 $620.35 $400.43 2026-10-09
76856 HCPCS G Pro Fee US Pelvic Comp(non-ob),pro Fee 6 3 $166.00 $166.00 $47.31 $693.50 $415.25 2026-10-09
76857 HCPCS G Pro Fee US Pelvis Limited Non-ob,pro Fee 6 3 $100.00 $100.00 $22.98 $525.35 $229.31 2026-10-09
76870 HCPCS G Pro Fee US Scrotum & Content,pro Fee 10 5 $151.00 $151.00 $30.23 $635.55 $299.20 2026-10-09
76882 HCPCS G Pro Fee US Extremity Nonvascular Lt A,pro Fee, Left 6 3 $141.00 $141.00 $127.30 $283.10 $206.55 2026-10-09
76942 HCPCS Anesthesia Ultra Sound Guidance Pro Fee 2 1 $366.00 $366.00 $244.00 $609.90 $426.95 2026-10-09
77065 HCPCS G Pro Fee Mg Diagnostic Unilat Implant,pro Fee 25 11 $155.00 $155.00 $36.56 $398.05 $134.04 2026-10-09
77066 HCPCS G Pro Fee Mg Diagnostic Bilateral,pro Fee 25 11 $131.00 $131.00 $124.45 $482.60 $169.63 2026-10-09
77067 HCPCS G Pro Fee Mg Screening Bilateral,pro Fee 53 11 $98.00 $98.00 $16.96 $297.35 $136.90 2026-10-09
77080 HCPCS G Pro Fee Dexa / Bone Density,pro Fee 8 4 $156.00 $156.00 $8.80 $619.40 $241.35 2026-10-09
80047 HCPCS Epoc-basic Metabolic Panel 2 2 $172.00 $172.00 $163.40 $163.40 $163.40 2026-10-09
80053 HCPCS Cmp 11 11 $253.00 $253.00 $12.96 $240.35 $156.21 2026-10-09
80235 HCPCS Lacosamide (lc007012) 2 2 $327.00 $327.00 $310.65 $310.65 $310.65 2026-10-09
81220 HCPCS Cystic Fibrosis Profile DNA (lc480533) 11 11 $755.00 $755.00 $487.03 $487.03 $487.03 2026-10-09
81256 HCPCS Hereditary Hemochrom. (lc 511345) 1 1 $845.00 $845.00 $802.75 $802.75 $802.75 2026-10-09
81374 HCPCS Hla-b27 (lc006924) 1 1 $258.00 $258.00 $245.10 $245.10 $245.10 2026-10-09
81420 HCPCS Zzharmony Prenat (triscomy)(lcp 550749) 11 11 $50,394.97 $50,394.97 $759.05 $759.05 $759.05 2026-10-09
81517 HCPCS Enhanced Livn Fibrosis (lc550659) 1 1 $520.00 $520.00 $494.00 $494.00 $494.00 2026-10-09
82653 HCPCS Pancreatic Elastase Fecal Quant(lc123234 1 1 $373.00 $373.00 $354.35 $354.35 $354.35 2026-10-09
86870 HCPCS Vitalant Antibody Id 11 11 $205.00 $205.00 $140.65 $260.27 $260.27 2026-10-09
86922 HCPCS Vitalant Compatibility Screen Per Unit 1 1 $139.00 $139.00 $126.23 $126.23 $126.23 2026-10-09
87153 HCPCS Organism Id By Sequence(lc 183757) 11 11 $536.00 $536.00 $144.98 $144.98 $144.98 2026-10-09
87506 HCPCS Gi Stool Panel Pcr 11 11 $600.00 $600.00 $254.87 $254.87 $254.87 2026-10-09
87507 HCPCS Gi Profile Stool Pcr (lc 183480) 11 11 $1,027.00 $1,027.00 $497.70 $975.65 $497.70 2026-10-09
87633 HCPCS Respiratory Virus Panel Wysl 11 11 $217.00 $217.00 $502.73 $502.73 $502.73 2026-10-09
87637 HCPCS Pcr Respiratory Panel-covid/flu/rsv 11 11 $400.00 $400.00 $142.63 $380.00 $142.63 2026-10-09
87902 HCPCS Hep C Genotype (lc 550475) 11 11 $904.00 $904.00 $315.63 $315.63 $315.63 2026-10-09
88230 HCPCS Chromo Anal Blood (lcp 511035) 11 11 $951.00 $951.00 $142.83 $142.83 $142.83 2026-10-09
88233 HCPCS Prod Of Conception Profile (lc510288) 11 11 $704.00 $704.00 $172.55 $172.55 $172.55 2026-10-09
88237 HCPCS Tissue Culture Blood/bone Marrow 11 11 $621.00 $621.00 $154.85 $154.85 $154.85 2026-10-09
88262 HCPCS Count 15-20 Cells 2 Karyotypes 11 11 $236.00 $236.00 $152.81 $152.81 $152.81 2026-10-09
88264 HCPCS Chromosome Analysis 20-25 Cells 11 11 $256.00 $256.00 $152.81 $152.81 $152.81 2026-10-09
88342 HCPCS Immunohistochemistry Initial Sgl Stain,distinct 11 11 $106.00 $106.00 $113.57 $113.57 $113.57 2026-10-09
88368 HCPCS Cytogenetics Fish Manual 11 11 $227.00 $227.00 $158.55 $158.55 $158.55 2026-10-09
88369 HCPCS Cytogenetics Fish Manual Sngl Probe 11 11 $80.00 $80.00 $137.54 $137.54 $137.54 2026-10-09
88374 HCPCS Fish Auto-tc(multiplex Probe) 11 11 $527.00 $527.00 $308.53 $308.53 $308.53 2026-10-09
88377 HCPCS Cytogenetics Fish Manual Multiplex 11 11 $244.00 $244.00 $423.89 $423.89 $423.89 2026-10-09
90375 HCPCS Rabies Immu Glob (imogam) 300iu/2ml 11 11 $929.74 $929.74 $277.74 $277.74 $277.74 2026-10-09
90649 HCPCS Gardasil Hpv VACCINATION,statutorily Excluded From Medicare - Cms Coverage 11 11 $424.00 $424.00 $156.17 $156.17 $156.17 2026-10-09
90670 HCPCS Pneumoccocal Conj Vac 13 (prevnar13) 11 11 $226.80 $226.80 $257.99 $257.99 $257.99 2026-10-09
90675 HCPCS Rabies Vaccine (rabavert) 1ml 11 11 $556.53 $556.53 $433.19 $528.71 $433.19 2026-10-09
90677 HCPCS Prevnar 20 11 11 $382.00 $382.00 $288.66 $288.66 $288.66 2026-10-09
90691 HCPCS Typhoid Vaccine, IM 11 11 $188.00 $188.00 $123.68 $123.68 $123.68 2026-10-09
90732 HCPCS Pneumococcal Polysac Vac (pneumovax 23) 11 11 $110.90 $110.90 $133.47 $133.47 $133.47 2026-10-09
90733 HCPCS Meningococcal Vaccine Sub Q 11 11 $254.00 $254.00 $106.49 $106.49 $106.49 2026-10-09
90839 HCPCS Psyco Trpy For Crisis, First 60 Min 11 11 $538.00 $538.00 $126.54 $126.54 $126.54 2026-10-09
92523 HCPCS St Evaluation Of Speech Language 11 11 $740.00 $740.00 $164.01 $164.01 $164.01 2026-10-09
92950 HCPCS Cpr 1 1 $810.00 $810.00 $1,155.20 $1,155.20 $1,155.20 2026-10-09
92960 HCPCS Cardioversion 1 1 $1,116.00 $1,116.00 $1,687.20 $1,687.20 $1,687.20 2026-10-09
93005 HCPCS EKG For Outpatient /er / Observation 5 5 $296.00 $296.00 $174.11 $267.90 $267.90 2026-10-09
93017 HCPCS Exercise Stress Test 1 1 $1,582.74 $1,582.74 $706.86 $706.86 $706.86 2026-10-09
93225 HCPCS Holter 2 2 $480.00 $480.00 $434.15 $434.15 $434.15 2026-10-09
93226 HCPCS Holter Scan 2 2 $1,710.02 $1,710.02 $614.65 $614.65 $614.65 2026-10-09
93798 HCPCS Cardiac Rehab W/ecg Monitoring 2 2 $289.00 $289.00 $187.37 $261.25 $224.31 2026-10-09
93880 HCPCS G Pro Fee US Carotid Dup Bilat,pro Fee 4 2 $254.00 $254.00 $35.01 $1,033.60 $371.43 2026-10-09
93970 HCPCS G Pro Fee US Extr.venous Bilat,pro Fee 2 1 $176.00 $176.00 $58.00 $1,631.15 $844.58 2026-10-09
93971 HCPCS G Pro Fee US Extremity Venous Lft Arm,pro Fee, Left 10 4 $170.00 $170.00 $20.70 $905.35 $400.96 2026-10-09
94625 HCPCS Pulmonary Rehab Without Cont Oximetry Monito 2 2 $308.00 $308.00 $181.20 $193.80 $187.50 2026-10-09
94640 HCPCS Prof Fee Airway Inhalation Trmt,pro Fee 4 4 $21.00 $21.00 $125.34 $192.85 $165.36 2026-10-09
94664 HCPCS Demo/eval Utilization Of Breathing Devic 1 1 $305.00 $305.00 $182.70 $182.70 $182.70 2026-10-09
94762 HCPCS Overnight Oximetry 3 3 $1,073.61 $1,073.61 $150.02 $209.00 $209.00 2026-10-09
95800 HCPCS Home Sleep Study 11 11 $567.00 $567.00 $135.33 $135.33 $135.33 2026-10-09
96132 HCPCS Neuropsychological Eval By Nurse 11 11 $496.00 $496.00 $116.99 $116.99 $116.99 2026-10-09
96360 HCPCS IV Therapy Hydration First Hour 3 3 $491.00 $491.00 $291.65 $444.60 $308.76 2026-10-09
96365 HCPCS Anest Ketamine Treatment For Pain 7 5 $290.00 $290.00 $380.91 $585.20 $410.54 2026-10-09
96366 HCPCS IV Infusion Each Additonal Hr 2 2 $141.00 $141.00 $161.50 $161.50 $161.50 2026-10-09
96367 HCPCS IV Sequential Infusion Up To 1 Hr 1 1 $384.00 $384.00 $225.97 $225.97 $225.97 2026-10-09
96374 HCPCS IV Push Injection First One 4 4 $222.00 $222.00 $132.48 $200.45 $169.83 2026-10-09
96375 HCPCS IV Push Each New Drug 4 4 $130.00 $130.00 $82.49 $117.80 $114.64 2026-10-09
97112 HCPCS Pt Neuromuscular Re-education 15 Min 2 1 $118.00 $118.00 $106.40 $132.05 $119.23 2026-10-09
97140 HCPCS Manual Therapy 15 Minutes 4 3 $140.00 $140.00 $126.35 $132.05 $126.35 2026-10-09
97161 HCPCS Pt Evaluation 20 Minutes 2 2 $267.00 $267.00 $241.30 $241.30 $241.30 2026-10-09
97162 HCPCS Pt Evaluation 30 Minutes 2 2 $306.00 $306.00 $276.45 $276.45 $276.45 2026-10-09
97164 HCPCS Pt Re- Evaluation 20 Minutes 1 1 $162.00 $162.00 $146.30 $146.30 $146.30 2026-10-09
97165 HCPCS Ot Evaluation 30 Minutes 1 1 $267.00 $267.00 $241.30 $241.30 $241.30 2026-10-09
97166 HCPCS Ot Evaluation 45 Minutes 2 2 $306.00 $306.00 $276.45 $276.45 $276.45 2026-10-09
97530 HCPCS Therapeutic/functional Activity15min 3 2 $118.00 $118.00 $106.40 $126.35 $126.35 2026-10-09
97597 HCPCS Wound Care With Debridement Select 1 1 $340.00 $340.00 $307.80 $307.80 $307.80 2026-10-09
97605 HCPCS Negative Pressure Wound Therapy Small 2 2 $340.00 $340.00 $307.80 $307.80 $307.80 2026-10-09
97606 HCPCS Negative Press. Wound Therapy Lrg 1 1 $420.00 $420.00 $380.00 $380.00 $380.00 2026-10-09
97799 HCPCS Dressing Change 2 1 $112.50 $112.50 $109.25 $109.25 $109.25 2026-10-09
99152 HCPCS Anesthesia Mod Sedation First 15 Min 1 1 $168.00 $168.00 $152.00 $152.00 $152.00 2026-10-09
99195 HCPCS Therapeutic Phleboto 3 3 $181.00 $181.00 $111.75 $171.95 $171.95 2026-10-09
99203 HCPCS Prof Fee New Patient Limited 13 11 $96.00 $96.00 $118.35 $118.35 $118.35 2026-10-09
99204 HCPCS Prof Fee New Patient Intermediate 13 11 $156.00 $156.00 $177.33 $177.33 $177.33 2026-10-09
99205 HCPCS Prof Fee New Patient Comprehensive 13 11 $205.00 $205.00 $233.74 $233.74 $233.74 2026-10-09
99214 HCPCS Prof Fee Telemed Est Patient Detailed,tele-health 38 11 $170.00 $170.00 $81.63 $136.42 $136.42 2026-10-09
99215 HCPCS Crna Pm Office Visit Est Patient Compreh 37 11 $220.00 $220.00 $130.10 $130.10 $130.10 2026-10-09
99281 HCPCS ER Dr Visit Level I With PROCEDURE,indicate A Significant, Separately Identifiable… 1 1 $245.00 $245.00 $199.50 $199.50 $199.50 2026-10-09
99282 HCPCS ER Dr Visit Level Ii W/PROCEDURE,indicate A Significant, Separately Identifiable… 12 5 $380.00 $380.00 $38.67 $403.75 $233.75 2026-10-09
99283 HCPCS ER Dr Visit Level Iii W/PROCEDURE,indicate A Significant, Separately Identifiabl… 15 6 $564.00 $564.00 $66.39 $613.70 $600.40 2026-10-09
99284 HCPCS ER Dr Visit Level IV W/PROCEDURE,indicate A Significant, Separately Identifiable… 16 6 $949.00 $949.00 $111.72 $1,319.55 $785.95 2026-10-09
99285 HCPCS ER Level V 8 6 $1,599.00 $1,599.00 $161.92 $2,379.75 $1,028.76 2026-10-09
99291 HCPCS ER Dr Critical Care 30 To 74 MINUTES,indicate A Significant, Separately Identifi… 2 2 $1,239.00 $1,239.00 $378.00 $1,121.00 $749.50 2026-10-09
99292 HCPCS ER Dr Critical Addition 30 Minutes - GF,indicate A Significant, Separately Ident… 2 2 $543.00 $543.00 $500.74 $721.05 $610.89 2026-10-09
99348 HCPCS Rn Visit W/c & Comm Insu Patients 1 1 $131.00 $131.00 $118.75 $118.75 $118.75 2026-10-09
99495 HCPCS Transitional Care Mgmt W/in 14 Days 13 11 $238.00 $238.00 $181.62 $181.62 $181.62 2026-10-09
99496 HCPCS Transitional Care Mgmt W/in 7 Days 13 11 $368.00 $368.00 $245.70 $245.70 $245.70 2026-10-09
C1781 HCPCS Ultrapro Mesh 3x6 1 1 $571.00 $571.00 $556.18 $556.18 $556.18 2026-10-09
G0108 HCPCS Diabetic Self Mgmt Outpatient 30 Minutes,registered Dietitian 2 2 $106.00 $106.00 $68.60 $181.60 $125.10 2026-10-09
G0121 HCPCS Colonoscopy Scrn Non High Risk Med/adv 2 2 $1,915.00 $1,915.00 $1,149.98 $1,228.83 $1,189.40 2026-10-09
J0180 HCPCS Agalsidase (fabrazyme) Vial 5mg 11 11 $1,271.75 $1,271.75 $222.93 $222.93 $222.93 2026-10-09
J0630 HCPCS Calcitonin-salmon Mdv 400 Iu/2ml 11 11 $1,235.00 $1,235.00 $1,366.44 $1,366.44 $1,366.44 2026-10-09
J0840 HCPCS Crotalidae Imm Fab (crofab) 1 Vial 11 11 $3,872.60 $3,872.60 $2,056.35 $2,056.35 $2,056.35 2026-10-09
J0841 HCPCS Crotalidae Equine (anavip) 1 Vial 11 11 $1,619.00 $1,619.00 $1,083.26 $1,083.26 $1,083.26 2026-10-09
J1162 HCPCS Digifab Solution 40mg Vial (nf) 11 11 $3,535.20 $3,535.20 $4,777.44 $4,777.44 $4,777.44 2026-10-09
J1610 HCPCS Glucagon 1 Mg Vial 11 11 $370.76 $370.76 $195.18 $352.23 $195.18 2026-10-09
J1670 HCPCS Tetanus Immune Globulin Hum 250unit 11 11 $814.00 $814.00 $564.92 $564.92 $564.92 2026-10-09
J2507 HCPCS Krystexxa 8mg Vial 11 11 $32,790.24 $32,790.24 $3,447.06 $3,447.06 $3,447.06 2026-10-09
J2690 HCPCS Procainamide (pronestyl) 1gm/10ml(dsc) 11 11 $58.00 $58.00 $412.74 $412.74 $412.74 2026-10-09
J3101 HCPCS Tenecteplase (TNKase) Stroke 50mg Vial 11 11 $9,991.71 $9,991.71 $157.47 $157.47 $157.47 2026-10-09
J3240 HCPCS Thyrogen 0.9mg Vial 11 11 $2,461.55 $2,461.55 $2,065.84 $2,065.84 $2,065.84 2026-10-09
J3241 HCPCS Tepezza 500mg Vial 11 11 $19,128.36 $19,128.36 $336.14 $336.14 $336.14 2026-10-09
J7307 HCPCS Etonogestrel Implant System 11 11 $1,178.00 $1,178.00 $1,092.48 $1,092.48 $1,092.48 2026-10-09
J9207 HCPCS Ixempra IV 1mg 11 11 $115.24 $115.24 $133.16 $133.16 $133.16 2026-10-09
J9217 HCPCS Nf-eligard SubQ PwdforSusp, 3 Month 22.5 11 11 $1,626.00 $1,626.00 $180.54 $180.54 $180.54 2026-10-09
L0466 HCPCS Orthosis California Small Compression 11 11 $597.00 $597.00 $293.72 $293.72 $293.72 2026-10-09
L0486 HCPCS Vista 464 Tlso 11 11 $450.00 $450.00 $1,530.88 $1,530.88 $1,530.88 2026-10-09
L1832 HCPCS Brace Sportsmax X X-large Black 11 11 $476.00 $476.00 $310.65 $477.96 $477.96 2026-10-09
L1844 HCPCS Knee Brace Townsend Custom 11 11 $855.00 $855.00 $1,270.04 $1,270.04 $1,270.04 2026-10-09
L1845 HCPCS Brace Legend Acl Left Large Black/blue 11 11 $432.00 $432.00 $510.60 $642.57 $642.57 2026-10-09
L1906 HCPCS Malleoloc Ankle Brace Right Small 11 11 $259.87 $259.87 $113.45 $113.45 $113.45 2026-10-09
L2999 HCPCS Pto Airmesh Brace (sm Left) 11 11 $145.80 $145.80 $120.00 $120.00 $120.00 2026-10-09
L3675 HCPCS Clavicle Brace Small Heavy Padded 11 11 $41.88 $41.88 $122.18 $122.18 $122.18 2026-10-09
L3760 HCPCS Brace Tscope Elbow Brace Right 11 11 $304.80 $304.80 $348.17 $348.17 $348.17 2026-10-09
L3761 HCPCS Brace Tscope Elbow Brace Left 11 11 $321.97 $321.97 $391.87 $391.87 $391.87 2026-10-09
L3807 HCPCS Titan Thumb Orthosis Right 11 11 $121.65 $121.65 $115.57 $174.07 $174.07 2026-10-09
L3808 HCPCS Titan Wrist Brace Xs Left 11 11 $86.12 $86.12 $254.75 $254.75 $254.75 2026-10-09
L4360 HCPCS Walker Pneumatic Medium(boot) 13 11 $289.50 $289.50 $219.30 $282.15 $219.30 2026-10-09
L4386 HCPCS Boot Bledsoe High Top X-small 11 11 $170.00 $170.00 $125.80 $125.80 $125.80 2026-10-09
L4387 HCPCS Bledsoe Wee Walker Boot S/m 11 11 $301.50 $301.50 $132.63 $132.63 $132.63 2026-10-09
L4396 HCPCS Nightsplint/plantar Fascutis Small 11 11 $170.00 $170.00 $130.77 $153.90 $130.77 2026-10-09
P9016 HCPCS Leukocyte Reduced PRBCs (ubs) 2 2 $840.00 $840.00 $798.00 $1,140.96 $969.48 2026-10-09
P9040 HCPCS Packed Rbc,irrad. 1 1 $874.00 $874.00 $593.57 $593.57 $593.57 2026-10-09
Q5001 HCPCS Hospice Rhc Day 61 + 1 1 $191.00 $191.00 $220.40 $220.40 $220.40 2026-10-09
Q5005 HCPCS Hospice Respite Care 1 1 $562.00 $562.00 $1,146.65 $1,146.65 $1,146.65 2026-10-09
Q5111 HCPCS Pegfilgrastim-cbqv (udenyca) Syr 6mg 11 11 $5,045.00 $5,045.00 $166.05 $166.05 $166.05 2026-10-09
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