University Hospitals Samaritan Medical Center
1025 Center St, Ashland, OH · University Hospitals · · NPI 1902882939
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| #_benzodiazconfur CPT 80346 | $161.25 | $215.00 | not published | 0 |
| #_fet/norfentcnfrmur CPT 80354 | $153.75 | $205.00 | not published | 0 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $132.75 | $177.00 | $12.01 – $21.62 | 17 |
| #acylcarnitineprfl CPT 82017 | $98.25 | $131.00 | $16.87 – $30.37 | 17 |
| #cbg+cort-cbg CPT 84449 | $141.00 | $188.00 | $18.00 – $32.40 | 17 |
| #celiac hla-dq8 CPT 81383 | $126.00 | $168.00 | $109.13 – $196.43 | 17 |
| #cf-97variants CPT 81220 | $1,046.25 | $1,395.00 | $556.60 – $1,001.88 | 17 |
| #cms hgb-sulfhemoglobin CPT 83060 | $132.75 | $177.00 | $8.80 – $15.84 | 17 |
| #cmvcul-virus inoculation shell CPT 87254 | $48.00 | $64.00 | $19.56 – $35.21 | 17 |
| #covid19rsv-rsv CPT 87634 | $60.00 | $80.00 | $70.20 – $126.36 | 17 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $178.50 | $238.00 | $13.03 – $23.45 | 17 |
| #creutz-prot.,western blot CPT 84182 | $676.50 | $902.00 | $29.21 – $52.58 | 17 |
| #fecal-sodium CPT 84302 | $86.25 | $115.00 | $4.86 – $8.75 | 17 |
| #mec-opiates CPT 80356 | $27.75 | $37.00 | not published | 0 |
| #pnh-flow cytometry interp CPT 88187 | $181.50 | $242.00 | $34.21 – $61.57 | 16 |
| (both sides) smear without diff wbc count CPT 85008 | $170.25 | $227.00 | $3.43 – $6.17 | 17 |
| 11-desoxycortisol - sendout CPT 82634 | $141.75 | $189.00 | $29.28 – $52.70 | 17 |
| 17-hydroxypregnenolone CPT 84143 | $112.50 | $150.00 | $22.81 – $41.06 | 17 |
| 24 hr ambulatory b/p monitor CPT 93786 | $195.75 | $261.00 | $129.03 – $232.25 | 16 |
| 2d tee w or without fol w/con,in HCPCS C8925 | $1,724.25 | $2,299.00 | $760.25 – $1,368.44 | 16 |
| 2d tte w or without fol w/con,co HCPCS C8923 | $1,137.75 | $1,517.00 | $760.25 – $1,368.44 | 16 |
| 2nd order venous cath CPT 36012 | $2,354.25 | $3,139.00 | $749.88 – $1,349.79 | 16 |
| 3d ech img cgen car anomal CPT 93319 | $1,164.00 | $1,552.00 | $52.48 – $94.46 | 16 |
| 3d recon without postprocess indpndt CPT 76376 | $638.25 | $851.00 | $23.82 – $42.88 | 16 |
| 5' nucleotidase - sendout CPT 83915 | $252.75 | $337.00 | $11.15 – $20.07 | 17 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $108.00 | $144.00 | $51.19 – $92.15 | 16 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | $106.50 | $142.00 | $108.30 – $194.93 | 16 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $111.00 | $148.00 | $113.19 – $203.75 | 16 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $111.00 | $148.00 | $118.43 – $213.17 | 16 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $102.75 | $137.00 | $97.85 – $176.14 | 16 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $100.50 | $134.00 | $104.03 – $187.25 | 16 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $111.00 | $148.00 | $103.72 – $186.70 | 16 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $121.50 | $162.00 | $114.16 – $205.48 | 16 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $75.75 | $101.00 | $133.05 – $239.49 | 16 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $5,313.35 | $7,084.46 | $44.72 – $108.29 | 17 |
| Abd aorta w/runoff s&i CPT 75630 | $3,160.50 | $4,214.00 | $3,062.12 – $5,511.82 | 17 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $747.00 | $996.00 | $879.59 – $1,583.27 | 16 |
| Abd/low ext cath 1st CPT 36245 | $2,412.00 | $3,216.00 | $1,110.36 – $1,998.65 | 16 |
| Abd/low ext cath 2nd CPT 36246 | $2,407.50 | $3,210.00 | $746.07 – $1,342.92 | 16 |
| Abd/low ext cath 3rd CPT 36247 | $328.50 | $438.00 | $1,258.35 – $2,265.04 | 16 |
| Abd/low ext cath addl CPT 36248 | $1,131.00 | $1,508.00 | $105.69 – $190.25 | 16 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $2,047.50 | $2,730.00 | $170.10 – $306.19 | 16 |
| Abdominal CT scan (with contrast) CPT 74160 | $1,704.75 | $2,273.00 | $170.10 – $306.19 | 16 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,475.25 | $1,967.00 | $101.39 – $182.50 | 16 |
| Abdominal MRI (with and without contrast) CPT 74183 | $2,854.50 | $3,806.00 | $338.34 – $609.01 | 16 |
| Abdominal MRI (with contrast) CPT 74182 | $3,013.50 | $4,018.00 | $338.34 – $609.01 | 16 |
| Abdominal MRI (without contrast) CPT 74181 | $2,439.75 | $3,253.00 | $231.40 – $416.51 | 16 |
| Abdominal Ultrasound (complete) CPT 76700 | $998.25 | $1,331.00 | $101.39 – $182.50 | 17 |
| Abdominal Ultrasound (limited) CPT 76705 | $735.75 | $981.00 | $101.39 – $182.50 | 17 |
| Abdominal paracentesis w/image guidance CPT 49083 | $823.50 | $1,098.00 | $879.59 – $1,583.27 | 16 |
| Abl1 gene CPT 81170 | $364.50 | $486.00 | $300.00 – $540.00 | 17 |
| Ablate bone tumor(s) cryo perq 20983 CPT 20983 | $5,246.25 | $6,995.00 | $7,037.08 – $12,666.74 | 16 |
| Ablate bone tumor(s) perq CPT 20982 | $5,092.50 | $6,790.00 | $17,004.30 – $30,607.73 | 16 |
| Ablate heart dysrhythm focus CPT 93650 | $16,052.25 | $21,403.00 | $7,564.11 – $13,615.41 | 16 |
| Ablate pulm tumor perq crybl CPT 32994 | $10,443.00 | $13,924.00 | $10,308.81 – $18,555.86 | 16 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $573.75 | $765.00 | $124.79 – $224.62 | 16 |
| Ablation cryo abd perit om CPT 49999 | $6,964.50 | $9,286.00 | $879.59 – $1,583.27 | 16 |
| Ablation cryo adrenal tumor CPT 60699 | $5,790.75 | $7,721.00 | $5,862.95 – $10,553.31 | 16 |
| Ablation cryo pq chest wall tumor(s) w/guid CPT 23929 | $234.00 | $312.00 | $239.22 – $430.59 | 16 |
| Ablation cryo pq liver tumor(s) CPT 47383 | $8,080.50 | $10,774.00 | $10,308.81 – $18,555.86 | 16 |
| Ablation cryo retro lymph node CPT 38999 | $418.50 | $558.00 | $427.85 – $770.13 | 16 |
| Ablation cryo thigh/knee CPT 27599 | $228.00 | $304.00 | $239.22 – $430.59 | 16 |
| Ablation of upper extremity nerves rf CPT 64999 | $2,425.50 | $3,234.00 | $297.68 – $535.83 | 16 |
| Abobotulinumtoxina HCPCS J0586 | $3,255.66 | $4,340.87 | $8.90 – $22.32 | 17 |
| Abscess drain retroperitoneal surg code CPT 49406 | $4,681.50 | $6,242.00 | $1,601.72 – $2,883.09 | 16 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | $5,877.00 | $7,836.00 | $109.63 – $197.33 | 16 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $147.54 | $196.71 | $0.12 – $0.45 | 2 |
| Acetaminophen level CPT 80143 | $180.00 | $240.00 | $18.64 – $33.55 | 16 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $137.07 | $182.76 | $41.91 – $253.08 | 2 |
| Acetylcholine receptor modulating antibody CPT 86043 | $489.00 | $652.00 | $12.05 – $21.69 | 16 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $406.77 | $542.35 | $0.88 – $6.30 | 2 |
| Acetylcysteine non-comp unit HCPCS J7608 | $87.97 | $117.29 | $21.64 – $61.47 | 2 |
| Acne surgery 10040 CPT 10040 | $295.50 | $394.00 | $194.58 – $350.24 | 16 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | $243.00 | $324.00 | $167.28 – $301.10 | 16 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | $160.50 | $214.00 | $131.63 – $236.94 | 16 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $65.25 | $87.00 | $16.31 – $29.36 | 16 |
| Actinotherapy uv light CPT 96900 | $138.75 | $185.00 | $36.22 – $65.20 | 16 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | $45.75 | $61.00 | $28.05 – $50.49 | 16 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | $45.75 | $61.00 | $28.05 – $50.49 | 16 |
| Acute hepatitis panel CPT 80074 | $409.50 | $546.00 | $47.63 – $85.73 | 17 |
| Acute venous thrombus image CPT 78456 | $308.25 | $411.00 | $1,255.55 – $2,259.99 | 17 |
| Acyclovir 400 mg tablet HCPCS J8499 | $100,424.10 | $133,898.80 | not published | 0 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $77.65 | $103.53 | $0.05 – $0.54 | 2 |
| Adapter b 8 channel 10cm HCPCS C1883 | $29,250.00 | $39,000.00 | not published | 0 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $528.78 | $705.04 | $1.10 – $5.40 | 2 |
| Adenovirus antibody,serum - quest CPT 86603 | $49.50 | $66.00 | $12.87 – $23.17 | 17 |
| Adh-sendout CPT 84588 | $663.75 | $885.00 | $33.94 – $61.09 | 17 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $5,046.43 | $6,728.57 | $2.17 – $5.04 | 2 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $420.75 | $561.00 | $69.83 – $125.69 | 16 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $863.25 | $1,151.00 | $69.83 – $125.69 | 16 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $762.00 | $1,016.00 | $320.33 – $576.59 | 16 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $1,003.50 | $1,338.00 | $320.33 – $576.59 | 16 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $559.50 | $746.00 | $69.83 – $125.69 | 16 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $573.75 | $765.00 | $69.83 – $125.69 | 16 |
| Administration immunization 1 vaccine CPT 90471 | $36.75 | $49.00 | $69.83 – $125.69 | 16 |
| Administration immunization each additional component CPT 90461 | $67.50 | $90.00 | $8.48 – $15.27 | 16 |
| Administration immunization each additional vaccine CPT 90472 | $36.75 | $49.00 | $15.11 – $27.19 | 16 |
| Administration immunization first component each vaccine CPT 90460 | $67.50 | $90.00 | $22.08 – $39.74 | 16 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $47.25 | $63.00 | $69.83 – $125.69 | 16 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $44.25 | $59.00 | $11.75 – $21.15 | 16 |
| Administration vaccine hepatitis b HCPCS G0010 | $41.25 | $55.00 | $45.41 – $81.74 | 16 |
| Administration vaccine influenza virus HCPCS G0008 | $41.25 | $55.00 | $45.41 – $81.74 | 16 |
| Administration vaccine pneumococcal HCPCS G0009 | $41.25 | $55.00 | $45.41 – $81.74 | 16 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $23,602.63 | $31,470.17 | $42.20 – $101.86 | 17 |
| Aep neurodiagnostic i&r CPT 92653 | $1,471.50 | $1,962.00 | $209.40 – $376.92 | 16 |
| Aep thrshld est mlt freq i&r CPT 92652 | $867.00 | $1,156.00 | $209.40 – $376.92 | 16 |
| Aflibercept injection HCPCS J0178 | not published | not published | $1,922.93 – $1,922.93 | 1 |
| After cataract laser surgery CPT 66821 | $1,459.50 | $1,946.00 | $533.39 – $960.10 | 16 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | $28,942.08 | $38,589.43 | $227.58 – $560.45 | 17 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | $425.25 | $567.00 | $124.79 – $224.62 | 16 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $295.80 | $394.40 | $53.08 – $129.17 | 17 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $295.80 | $394.40 | $53.08 – $129.17 | 17 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $47.25 | $63.00 | $5.78 – $10.40 | 17 |
| Albumin body fluid quantitative each specimen CPT 82042 | $29.25 | $39.00 | $7.78 – $14.00 | 17 |
| Albumin serum plasma or whole blood CPT 82040 | $35.25 | $47.00 | $4.95 – $8.91 | 17 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $51.67 – $51.67 | 1 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $25.82 – $25.82 | 1 |
| Albuterol ipratrop non-comp HCPCS J7620 | $2.43 | $3.23 | $0.49 – $1.53 | 2 |
| Albuterol non-comp con HCPCS J7611 | $44.56 | $59.41 | $0.39 – $1.35 | 2 |
| Albuterol non-comp unit HCPCS J7613 | $2.43 | $3.23 | $0.17 – $0.36 | 2 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $60.75 | $81.00 | $17.27 – $31.09 | 16 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $12,083.86 – $12,083.86 | 1 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | $112,036.08 | $149,381.43 | $2,440.42 – $5,940.66 | 17 |
| Alkaline phosphatase CPT 84075 | $38.25 | $51.00 | $5.18 – $9.32 | 17 |
| Allergen alpha lactalbumin ige CPT 86008 | $113.25 | $151.00 | $17.93 – $32.27 | 17 |
| Allergen egg white ige CPT 86003 | $82.50 | $110.00 | $5.22 – $9.40 | 17 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | not published | not published | $41.50 – $41.50 | 1 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $13,768.09 | $18,357.45 | $120.69 – $217.24 | 17 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | $13,478.20 | $17,970.93 | $120.69 – $245.13 | 17 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $911.25 | $1,215.00 | not published | 0 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $9,702.00 | $12,936.00 | $120.69 – $217.24 | 16 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $30,615.48 | $40,820.64 | $74.70 – $217.24 | 17 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $10,046.28 | $13,395.03 | $120.69 – $365.90 | 17 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $6,367.50 | $8,490.00 | $120.69 – $217.24 | 16 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $1,887.75 | $2,517.00 | not published | 0 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $6,075.00 | $8,100.00 | $120.69 – $306.83 | 17 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $4,038.75 | $5,385.00 | $120.69 – $588.69 | 17 |
| Alloskin HCPCS Q4115 | not published | not published | $35.22 – $35.22 | 1 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | not published | not published | $12.61 – $12.61 | 1 |
| Alpha-fetoprotein amniotic CPT 82106 | $36.00 | $48.00 | $17.00 – $30.60 | 17 |
| Alpha-fetoprotein tumor marker CPT 82105 | $138.75 | $185.00 | $16.77 – $30.19 | 17 |
| Alprostadil for injection HCPCS J0270 | $800.48 | $1,067.30 | $3.96 – $3.96 | 1 |
| Alt/sgpt CPT 84460 | $48.00 | $64.00 | $5.30 – $9.54 | 17 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $31,563.16 | $42,084.21 | $95.09 – $229.16 | 17 |
| Aluminum - quest CPT 82108 | $150.00 | $200.00 | $25.48 – $45.86 | 17 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | $932.25 | $1,243.00 | $92.20 – $165.96 | 16 |
| Amantadine (symmetrel)-sendout CPT 80375 | $174.75 | $233.00 | not published | 0 |
| Ambl bp mntr w/sw a/r CPT 93788 | $199.50 | $266.00 | $129.03 – $232.25 | 16 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $79.87 | $106.49 | $1.48 – $7.47 | 2 |
| Amino acids quant 2-5 CPT 82136 | $239.25 | $319.00 | $19.61 – $35.30 | 17 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $35.21 | $46.94 | not published | 0 |
| Aminolevulinic acid delta CPT 82135 | $511.50 | $682.00 | $16.45 – $29.61 | 17 |
| Aminolevulinic acid hcl top HCPCS J7308 | not published | not published | $958.68 – $958.68 | 1 |
| Aminolevulinic acid, 10% gel HCPCS J7345 | not published | not published | $4.41 – $4.41 | 1 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $65.64 | $87.51 | $20.18 – $46.17 | 2 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $119.07 | $158.75 | $58.23 – $58.23 | 1 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $50.85 | $67.80 | $1.22 – $7.38 | 2 |
| Amitriptyline (elavil) -sendout CPT 80335 | $234.75 | $313.00 | not published | 0 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | $14,075.19 | $18,766.92 | $22.63 – $54.03 | 17 |
| Ammonia CPT 82140 | $123.00 | $164.00 | $14.57 – $26.23 | 17 |
| Amniocentesis therapeutic CPT 59001 | $747.75 | $997.00 | $295.53 – $531.95 | 16 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $423.00 | $564.00 | $893.23 – $1,607.82 | 16 |
| Amphetamine confirm urine -sendout CPT 80324 | $79.50 | $106.00 | not published | 0 |
| Amphetamines 5 or more CPT 80326 | $414.75 | $553.00 | not published | 0 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $130.08 | $173.44 | $83.05 – $85.86 | 2 |
| Amphotericin b lipid complex HCPCS J0287 | $360.00 | $479.99 | $25.05 – $100.17 | 2 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $434.39 | $579.18 | $22.81 – $55.03 | 17 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $114.78 | $153.03 | $1.17 – $9.09 | 2 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $18.87 | $25.16 | $3.63 – $15.93 | 2 |
| Amylase CPT 82150 | $120.75 | $161.00 | $6.48 – $11.66 | 17 |
| An cholangiogram percutaneous compl CPT 47531 | $5,156.25 | $6,875.00 | $3,472.27 – $6,250.09 | 16 |
| An fluoro guide for cvp CPT 77001 | $808.50 | $1,078.00 | $91.19 – $164.15 | 16 |
| Anal/urinary muscle study CPT 51784 | $1,095.75 | $1,461.00 | $124.79 – $224.62 | 16 |
| Anal/urinary muscle study CPT 51785 | $981.00 | $1,308.00 | $242.30 – $436.15 | 16 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | $70.50 | $94.00 | not published | 0 |
| Analysis complx cranial nerve pulse gen prgrmg 95977 CPT 95977 | $1,124.25 | $1,499.00 | $92.20 – $165.96 | 16 |
| Analysis gene f2 20210g>a variant CPT 81240 | $333.75 | $445.00 | $65.69 – $118.24 | 17 |
| Analysis gene f5 leiden variant CPT 81241 | $426.00 | $568.00 | $73.37 – $132.07 | 17 |
| Analysis; simple cranial nerv pulse gen prgrmg 95976 CPT 95976 | $1,058.25 | $1,411.00 | $36.19 – $65.15 | 16 |
| Analyze neurostimulator simple w/reprogramming 95971 CPT 95971 | $1,263.75 | $1,685.00 | $92.20 – $165.96 | 16 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $105.00 | $140.00 | $35.09 – $63.16 | 16 |
| Anca screen with reflex to titer -quest CPT 86021 | $202.50 | $270.00 | $15.05 – $27.09 | 17 |
| Angio balloon ctrl dialysis seg add-on CPT 36907 | $1,703.25 | $2,271.00 | $538.12 – $968.61 | 16 |
| Angio trnslmnl balloon same artery ea addl CPT 37247 | $1,617.00 | $2,156.00 | $558.96 – $1,006.12 | 16 |
| Angio trnslmnl balloon same artery ini CPT 37246 | $4,995.00 | $6,660.00 | $5,519.68 – $9,935.42 | 16 |
| Angio trnslmnl balloon same vein ea addl CPT 37249 | $4,024.50 | $5,366.00 | $400.48 – $720.86 | 16 |
| Angio trnslmnl balloon same vein ini CPT 37248 | $4,485.75 | $5,981.00 | $5,519.68 – $9,935.42 | 16 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $59,352.27 | $79,136.36 | not published | 0 |
| Anidulafungin injection HCPCS J0348 | $116.22 | $154.95 | $1.17 – $4.14 | 2 |
| Ankle X-ray CPT 73610 | $236.25 | $315.00 | $84.40 – $151.91 | 17 |
| Anl sp inf pmp w/mdreprg&fil CPT 62370 | $429.00 | $572.00 | $297.86 – $536.15 | 16 |
| Annual Physical, Established Patient (age 18-39) CPT 99395 | $64.50 | $86.00 | $116.44 – $209.59 | 16 |
| Annual Physical, Established Patient (age 40-64) CPT 99396 | $70.50 | $94.00 | $123.61 – $222.50 | 16 |
| Annual Physical, New Patient (age 18-39) CPT 99385 | $167.25 | $223.00 | $128.85 – $231.94 | 16 |
| Annual Physical, New Patient (age 40-64) CPT 99386 | $148.50 | $198.00 | $149.35 – $268.84 | 16 |
| Anoscopy ablation lesion 46615 CPT 46615 | $1,365.00 | $1,820.00 | $2,691.84 – $4,845.30 | 16 |
| Anoscopy control bleeding 46614 CPT 46614 | $1,982.25 | $2,643.00 | $1,160.50 – $2,088.91 | 16 |
| Anoscopy remove fb 46608 CPT 46608 | $1,611.75 | $2,149.00 | $901.87 – $1,623.37 | 16 |
| Anoscopy remove lesion 46610 CPT 46610 | $2,770.50 | $3,694.00 | $2,691.84 – $4,845.30 | 16 |
| Ans parasymp & symp w/tilt CPT 95924 | $1,104.75 | $1,473.00 | $209.40 – $376.92 | 16 |
| Anti mog serum - sendout CPT 86362 | $355.50 | $474.00 | $12.05 – $21.69 | 16 |
| Anti-inhibitor HCPCS J7198 | $18,764.82 | $25,019.75 | $2.42 – $5.96 | 17 |
| Anti-thymocyte glob (equine)(1:1000) intradermal test dose HCPCS J7504 | $17,349.88 | $23,133.17 | $5,292.43 – $12,201.91 | 17 |
| Antibody bacterium, not elsewhere specified CPT 86609 | $118.50 | $158.00 | $12.88 – $23.18 | 17 |
| Antibody elution rbc reference CPT 86860 | $147.75 | $197.00 | $165.22 – $297.40 | 16 |
| Antibody htlv-i CPT 86687 | $210.75 | $281.00 | $9.09 – $16.36 | 17 |
| Antibody htlv-ii CPT 86688 | $210.75 | $281.00 | $14.00 – $25.20 | 17 |
| Antibody htlv/hiv confirm test CPT 86689 | $289.50 | $386.00 | $19.35 – $34.83 | 17 |
| Antibody id rbc panel CPT 86870 | $277.50 | $370.00 | $347.62 – $625.72 | 16 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $694.50 | $926.00 | $18.37 – $33.07 | 17 |
| Antibody lymphocytic choriomeningitis CPT 86727 | $159.00 | $212.00 | $12.87 – $23.17 | 17 |
| Antibody screen rbc CPT 86850 | $102.75 | $137.00 | $11.04 – $90.97 | 17 |
| Antidepressant not specified CPT 80338 | $198.75 | $265.00 | not published | 0 |
| Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 | $5,102.55 | $6,803.40 | $1.49 – $3.60 | 17 |
| Antihemophilic viii/vwf comp HCPCS J7186 | not published | not published | $2.97 – $2.97 | 1 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | $117.00 | $156.00 | $12.05 – $21.69 | 16 |
| Antinuclear antibodies CPT 86038 | $97.50 | $130.00 | $12.09 – $21.76 | 17 |
| Antinuclear antibodies titer CPT 86039 | $81.75 | $109.00 | $11.16 – $20.09 | 17 |
| Antiphosphatidylserine antibody CPT 86148 | $62.25 | $83.00 | $16.07 – $28.93 | 17 |
| Antistreptolysin o titer CPT 86060 | $84.75 | $113.00 | $7.30 – $13.14 | 17 |
| Antithrombin iii activity CPT 85300 | $222.75 | $297.00 | $11.85 – $21.33 | 17 |
| Antithrombin iii injection HCPCS J7197 | $6,858.87 | $9,145.15 | $4.10 – $9.93 | 17 |
| Antithymocyte globuln rabbit HCPCS J7511 | $4,139.25 | $5,518.99 | $1,023.12 – $2,425.21 | 17 |
| Apl(pml-rara) quant - sendout CPT 81315 | $1,187.25 | $1,583.00 | $207.31 – $373.16 | 17 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | $557.25 | $743.00 | $32.45 – $58.40 | 16 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | $1,990.50 | $2,654.00 | $2,000.97 – $3,601.74 | 16 |
| App high cost ss f/n/g/h/f >100sq cm addl 100sq cm CPT 15278 | $1,130.25 | $1,507.00 | $95.88 – $172.59 | 16 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | $545.25 | $727.00 | $24.57 – $44.23 | 16 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | $2,133.75 | $2,845.00 | $2,000.97 – $3,601.74 | 16 |
| App high cost ss t/a/l >100sq cm addl 100sq cm CPT 15274 | $1,417.50 | $1,890.00 | $82.09 – $147.77 | 16 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $84.75 | $113.00 | $5.70 – $10.25 | 16 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | $106.50 | $142.00 | $11.53 – $20.76 | 16 |
| Appl multlay comprs arm/hand CPT 29584 | $378.75 | $505.00 | $157.59 – $283.67 | 16 |
| Application finger splntstatic 29130 CPT 29130 | $153.75 | $205.00 | $129.03 – $232.25 | 16 |
| Application long leg splint 29505 CPT 29505 | $129.75 | $173.00 | $157.59 – $283.67 | 16 |
| Application lower leg splint 29515 CPT 29515 | $112.50 | $150.00 | $157.59 – $283.67 | 16 |
| Application multi layer compression below knee (both sides) CPT 29581 | $377.25 | $503.00 | $157.59 – $283.67 | 16 |
| Application of forearm cast 29075 CPT 29075 | $300.75 | $401.00 | $271.25 – $488.24 | 16 |
| Application of long arm cast 29065 CPT 29065 | $342.00 | $456.00 | $271.25 – $488.24 | 16 |
| Application of long leg cast CPT 29355 | $480.75 | $641.00 | $271.25 – $488.24 | 16 |
| Application of long leg cast 29345 CPT 29345 | $420.75 | $561.00 | $271.25 – $488.24 | 16 |
| Application of paste boot 29580 CPT 29580 | $199.50 | $266.00 | $157.59 – $283.67 | 16 |
| Application short leg cast 29405 CPT 29405 | $359.25 | $479.00 | $271.25 – $488.24 | 16 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $1,682.25 | $2,243.00 | $716.75 – $1,290.15 | 16 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | $1,441.50 | $1,922.00 | $716.75 – $1,290.15 | 16 |
| Applicator tag rfid localizer 12gx7cm HCPCS C1819 | $470.25 | $627.00 | not published | 0 |
| Apply hand/wrist cast 29085 CPT 29085 | $249.00 | $332.00 | $157.59 – $283.67 | 16 |
| Apply rigid leg cast 29445 CPT 29445 | $270.75 | $361.00 | $271.25 – $488.24 | 16 |
| Apply short leg castambul type 29425 CPT 29425 | $323.25 | $431.00 | $271.25 – $488.24 | 16 |
| Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 | not published | not published | $4.31 – $4.31 | 1 |
| Aqaprn-4 antb flo cytmtry ea CPT 86053 | $405.75 | $541.00 | $37.73 – $67.91 | 16 |
| Aqua therapy w/exercise/ea 15 min 97113 CPT 97113 | $122.25 | $163.00 | $35.28 – $63.50 | 16 |
| Aquatic exercise - group charge CPT 97150 | $96.00 | $128.00 | $17.34 – $31.22 | 16 |
| Argatroban nonesrd (auromed) HCPCS J0898 | $668.52 | $891.35 | $37.17 – $37.17 | 1 |
| Argatroban nonesrd use 1mg HCPCS J0883 | $881.10 | $1,174.79 | $1.01 – $1.82 | 17 |
| Aripiprazole 441 mg/1.6 ml inj HCPCS J1944 | $11,842.72 | $15,790.29 | $3.32 – $8.11 | 17 |
| Arsenic trioxide 2 mg/ml intravenous solution HCPCS J9017 | $4,375.05 | $5,833.39 | $14.24 – $142.02 | 2 |
| Arterial blood draw/perc 36620 CPT 36620 | $350.25 | $467.00 | $40.31 – $72.55 | 16 |
| Artery x-rays adrenal gland CPT 75731 | $2,823.75 | $3,765.00 | $863.01 – $5,511.82 | 17 |
| Artery x-rays adrenals CPT 75733 | $2,965.50 | $3,954.00 | $3,062.12 – $5,511.82 | 17 |
| Artery x-rays arm/leg 75710-26 CPT 75710 | $3,217.50 | $4,290.00 | $3,062.12 – $5,511.82 | 17 |
| Artery x-rays arms/legs 75716-26 CPT 75716 | $3,619.50 | $4,826.00 | $3,062.12 – $5,511.82 | 17 |
| Artery x-rays chest CPT 75756 | $7,113.00 | $9,484.00 | $3,062.12 – $5,511.82 | 17 |
| Artery x-rays lung CPT 75741 | $2,046.75 | $2,729.00 | $3,062.12 – $5,511.82 | 17 |
| Artery x-rays lungs CPT 75743 | $2,846.25 | $3,795.00 | $3,062.12 – $5,511.82 | 17 |
| Artery x-rays spine CPT 75705 | $10,069.50 | $13,426.00 | $5,396.44 – $9,713.59 | 17 |
| Artery xray each vessel 7577426 CPT 75774 | $2,130.00 | $2,840.00 | $90.01 – $162.02 | 16 |
| Artery xray of abdomen 75726-26 CPT 75726 | $3,710.25 | $4,947.00 | $5,396.44 – $9,713.59 | 17 |
| Artery xrays of pelvis 75736 26 CPT 75736 | $3,333.00 | $4,444.00 | $5,396.44 – $9,713.59 | 17 |
| Artery-vein nonautograft CPT 36830 | $5,272.50 | $7,030.00 | $5,396.44 – $9,713.59 | 16 |
| Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 CPT 20604 | $501.00 | $668.00 | $297.68 – $535.83 | 16 |
| Arthrocentesis/aspiration/inj major joint/bursa without Ultrasound guidance (both sides) CPT 20610 | $794.25 | $1,059.00 | $297.68 – $535.83 | 16 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa w/ultrasound guidance (both sides) CPT 20606 | $486.75 | $649.00 | $684.56 – $1,232.21 | 16 |
| Arthrocentesis/aspiration/injection intermediate joint/bursa without ultrasound guidance right CPT 20605 | $624.00 | $832.00 | $297.68 – $535.83 | 16 |
| Arthrocentesis/aspiration/injection major joint/bursa w/ultrasound guidance (both sides) CPT 20611 | $564.75 | $753.00 | $297.68 – $535.83 | 16 |
| Arthrocentesis/aspiration/injection small joint/bursa without ultrasound guidance CPT 20600 | $543.75 | $725.00 | $297.68 – $535.83 | 16 |
| Artiss fibrin sealant HCPCS C9250 | $3,217.53 | $4,290.04 | $143.70 – $258.66 | 16 |
| Ascenda two piece catheter HCPCS C1772 | $32,280.75 | $43,041.00 | not published | 0 |
| Asp & inj w/heparin pleurx cath CPT 32999 | $1,135.50 | $1,514.00 | $608.36 – $1,095.05 | 16 |
| Aspir/inj thyroid cyst 60300 CPT 60300 | $680.25 | $907.00 | $686.75 – $1,236.14 | 16 |
| Aspirate bladder/sprapubic cath 51102 CPT 51102 | $2,259.75 | $3,013.00 | $2,027.25 – $3,649.06 | 16 |
| Aspirate pleura without imaging 32554 CPT 32554 | $914.25 | $1,219.00 | $608.36 – $1,095.05 | 16 |
| Aspirate/inj ganglion cyst 20612 CPT 20612 | $485.25 | $647.00 | $297.68 – $535.83 | 16 |
| Aspiration fine needle (fna) biopsy w/ultrasound guidance 1st lesion CPT 10005 | $840.75 | $1,121.00 | $686.75 – $1,236.14 | 16 |
| Aspiration peritonsillar abscess CPT 42999 | $236.25 | $315.00 | $229.70 – $413.45 | 16 |
| Assay acid phosphatase CPT 84060 | $62.25 | $83.00 | $7.64 – $13.75 | 17 |
| Assay alkaline phosphatase CPT 84078 | $63.00 | $84.00 | $8.26 – $14.87 | 17 |
| Assay dir meas fr estradiol CPT 82681 | $281.25 | $375.00 | $27.94 – $50.29 | 16 |
| Assay duodenal fluid trypsin CPT 84485 | $195.00 | $260.00 | $7.20 – $12.96 | 17 |
| Assay of adp & amp CPT 82030 | $246.75 | $329.00 | $25.80 – $46.44 | 17 |
| Assay of breath ethanol CPT 82075 | $105.00 | $140.00 | $30.00 – $54.00 | 17 |
| Assay of digoxin free CPT 80163 | $27.00 | $36.00 | $13.28 – $23.90 | 17 |
| Assay of fluoride CPT 82735 | $241.50 | $322.00 | $18.54 – $33.37 | 17 |
| Assay of galactose CPT 82760 | $307.50 | $410.00 | $11.20 – $20.16 | 17 |
| Assay of glucosidase CPT 82963 | $1,008.00 | $1,344.00 | $21.48 – $38.66 | 17 |
| Assay of glutathione CPT 82978 | $252.75 | $337.00 | $15.45 – $27.81 | 17 |
| Assay of interleukin-6 (il-6) CPT 83529 | $45.00 | $60.00 | $17.27 – $31.09 | 16 |
| Assay of leflunomide CPT 80193 | $153.00 | $204.00 | $38.57 – $69.43 | 16 |
| Assay of lrh hormone CPT 83727 | $602.25 | $803.00 | $17.19 – $30.94 | 17 |
| Assay of osteocalcin CPT 83937 | $117.00 | $156.00 | $29.85 – $53.73 | 17 |
| Assay of procainamide w/metab CPT 80192 | $63.00 | $84.00 | $16.75 – $30.15 | 17 |
| Assay of prostaglandin CPT 84150 | $93.75 | $125.00 | $41.77 – $75.19 | 17 |
| Assay of salicylate CPT 80179 | $175.50 | $234.00 | $18.64 – $33.55 | 16 |
| Assay of sialic acid CPT 84275 | $342.00 | $456.00 | $13.44 – $24.19 | 17 |
| Assay of somatostatin CPT 84307 | $450.00 | $600.00 | $18.28 – $32.90 | 17 |
| Assay of thiocyanate CPT 84430 | $239.25 | $319.00 | $11.63 – $20.93 | 17 |
| Assay of urine sulfate CPT 84392 | $44.25 | $59.00 | $5.49 – $9.88 | 17 |
| Assay phosphohexose enzymes CPT 84087 | $252.75 | $337.00 | $10.73 – $19.31 | 17 |
| Assay toxin or antitoxin CPT 87230 | $47.25 | $63.00 | $19.74 – $35.53 | 17 |
| Assess aphasia/interp/rpt/per hr 96105 CPT 96105 | $396.75 | $529.00 | $93.98 – $169.17 | 16 |
| Assess cyst contrast inject CPT 49424 | $315.00 | $420.00 | $158.51 – $285.31 | 16 |
| Ast/sgot CPT 84450 | $41.25 | $55.00 | $5.18 – $9.32 | 17 |
| Atezolizumab 60 mg/ml intravenous solution (wrapper) HCPCS J9022 | $42,851.67 | $57,135.55 | $94.00 – $221.54 | 17 |
| Atropine 0.1 mg/ml injection syringe HCPCS J0461 | $39.35 | $52.46 | $0.15 – $0.72 | 2 |
| Augment injectable kit 3.0cc HCPCS C1734 | $8,645.34 | $11,527.11 | not published | 0 |
| Augumentation percutaneous vertebral inc cavity creation ea addl thoracic/lumbar vertebral body CPT 22515 | $9,145.50 | $12,194.00 | $2,732.47 – $4,918.45 | 16 |
| Augumentation percutaneous vertebral including cavity creation 1 vertebral body thoracic CPT 22513 | $9,145.50 | $12,194.00 | $7,037.08 – $12,666.74 | 16 |
| Autoimmune rheumatoid arthr anl 12 mrk ia CPT 81490 | $802.50 | $1,070.00 | $840.65 – $1,513.17 | 17 |
| Autonomic nrv syst funj test CPT 95923 | $880.50 | $1,174.00 | $129.03 – $232.25 | 16 |
| Avelumab 20 mg/ml intravenous solution HCPCS J9023 | $7,742.64 | $10,323.52 | $105.55 – $244.11 | 17 |
| Avul nail plate addl CPT 11732 | $295.50 | $394.00 | $30.75 – $55.35 | 16 |
| Avulsion nail plate partial/complete simple single nail plate CPT 11730 | $236.25 | $315.00 | $194.58 – $350.24 | 16 |
| Axicabtagene ciloleucel car+ HCPCS Q2041 | $1,861,987.05 | $2,482,649.40 | $531,849.12 – $957,328.41 | 16 |
| Azacitidine injection HCPCS J9025 | $2,163.93 | $2,885.24 | $0.49 – $3.15 | 2 |
| Azathioprine 50 mg tablet HCPCS J7500 | $7,093.66 | $9,458.21 | $5.21 – $41.04 | 2 |
| Azathioprine parenteral HCPCS J7501 | $771.30 | $1,028.40 | $254.76 – $645.01 | 17 |
| Azithromycin 500 mg intravenous solution HCPCS J0456 | $22.93 | $30.57 | $6.35 – $23.40 | 2 |
| Aztreonam 1 gram solution for injection HCPCS J0457 | $203.80 | $271.73 | $22.86 – $22.86 | 1 |
| B cells total count CPT 86355 | $84.75 | $113.00 | $37.73 – $67.91 | 17 |
| B-hexosaminidase ea assay CPT 83080 | $104.25 | $139.00 | $16.87 – $30.37 | 17 |
| Baclofen 2,000 mcg/ml intrathecal solution (wrapper) HCPCS J0475 | not published | not published | $427.92 – $427.92 | 1 |
| Baclofen 50 mcg/ml intrathecal solution (wrapper) HCPCS J0476 | not published | not published | $163.56 – $163.56 | 1 |
| Baclofen eval charges CPT 97750 | $121.50 | $162.00 | $32.14 – $57.85 | 16 |
| Bacterial meningitis antigen CPT 86403 | $52.50 | $70.00 | $11.54 – $20.77 | 17 |
| Bacterial vaginosis pcr CPT 87801 | $1,973.25 | $2,631.00 | $70.20 – $126.36 | 17 |
| Bartonella dna pcr-sendout CPT 87471 | $1,113.00 | $1,484.00 | $35.09 – $63.16 | 17 |
| Basiliximab HCPCS J0480 | $15,941.19 | $21,254.91 | $4,812.31 – $11,372.77 | 17 |
| Bausch health Ultrasound surg HCPCS V2788 | $2,238.75 | $2,985.00 | not published | 0 |
| Bcg live 50 mg intravesical suspension HCPCS J9030 | $605.43 | $807.24 | $3.39 – $7.59 | 17 |
| Belatacept 250 mg intravenous solution HCPCS J0485 | $3,406.85 | $4,542.46 | $3.89 – $9.44 | 17 |
| Belimumab 120 mg intravenous solution HCPCS J0490 | $7,979.25 | $10,638.99 | $57.19 – $136.30 | 17 |
| Bendamustine 100 mg intravenous powder for solution HCPCS J9033 | not published | not published | $4.50 – $4.50 | 1 |
| Bendamustine 25 mg/ml intravenous solution (belrapzo) HCPCS J9036 | not published | not published | $29.18 – $29.18 | 1 |
| Bendamustine 25 mg/ml intravenous solution (bendeka) HCPCS J9034 | $6,784.08 | $9,045.43 | $12.90 – $31.93 | 17 |
| Benign lesion paring 2-4 CPT 11056 | $295.50 | $394.00 | $194.58 – $350.24 | 16 |
| Benign lesion paring 4+ CPT 11057 | $368.25 | $491.00 | $194.58 – $350.24 | 16 |
| Benztropine 1 mg/ml injection solution HCPCS J0515 | $102.90 | $137.19 | $42.01 – $147.96 | 2 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $133.50 | $178.00 | $25.45 – $45.81 | 17 |
| Beta-2 microglobulin CPT 82232 | $84.75 | $113.00 | $16.18 – $29.12 | 17 |
| Beta-amyloid 1-42 CPT 82234 | $504.00 | $672.00 | $128.92 – $232.06 | 16 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $149.68 | $199.57 | $16.75 – $61.38 | 2 |
| Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 | $2,946.69 | $3,928.92 | $74.36 – $177.78 | 17 |
| Bevacizumab-awwb 25 mg/ml intravenous solution HCPCS Q5107 | $10,009.76 | $13,346.34 | $23.74 – $70.20 | 17 |
| Bevacizumab-bvzr 25 mg/ml intravenous solution HCPCS Q5118 | not published | not published | $58.25 – $58.25 | 1 |
| Bilateral n blobk inj pudendal 64430 CPT 64430 | $1,726.50 | $2,302.00 | $857.76 – $1,543.97 | 16 |
| Bilateral n block inj occipital 64405 CPT 64405 | $1,176.75 | $1,569.00 | $297.68 – $535.83 | 16 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | $885.75 | $1,181.00 | $297.68 – $535.83 | 16 |
| Biliary endo perq dx w/speci CPT 47552 | $6,068.25 | $8,091.00 | $6,278.31 – $11,300.96 | 16 |
| Biliary endoscopy thru skin CPT 47553 | $6,068.25 | $8,091.00 | $6,278.31 – $11,300.96 | 16 |
| Biliary endoscopy thru skin CPT 47555 | $6,887.25 | $9,183.00 | $6,278.31 – $11,300.96 | 16 |
| Biliary endoscopy thru skin CPT 47556 | $10,884.75 | $14,513.00 | $10,308.81 – $18,555.86 | 16 |
| Bilicheck CPT 88720 | $38.25 | $51.00 | $5.02 – $9.04 | 17 |
| Bilirubin direct CPT 82248 | $39.00 | $52.00 | $5.02 – $9.04 | 17 |
| Bilirubin total CPT 82247 | $36.75 | $49.00 | $5.02 – $9.04 | 17 |
| Biofeedback, pt CPT 90901 | $189.00 | $252.00 | $38.73 – $69.72 | 16 |
| Biopsy abdominal mass CPT 49180 | $4,548.00 | $6,064.00 | $1,601.72 – $2,883.09 | 16 |
| Biopsy bone trocar/needle superficial CPT 20220 | $2,203.50 | $2,938.00 | $1,601.72 – $2,883.09 | 16 |
| Biopsy cervixsingle/multiple 57500 CPT 57500 | $1,365.00 | $1,820.00 | $893.23 – $1,607.82 | 16 |
| Biopsy muscle percutaneous needle CPT 20206 | $1,662.00 | $2,216.00 | $1,601.72 – $2,883.09 | 16 |
| Biopsy needle liver percutaneous CPT 47000 | $2,104.50 | $2,806.00 | $1,601.72 – $2,883.09 | 16 |
| Biopsy needle lymph node superficial CPT 38505 | $1,296.00 | $1,728.00 | $1,601.72 – $2,883.09 | 16 |
| Biopsy of heart lining CPT 93505 | $3,693.75 | $4,925.00 | $3,062.12 – $5,511.82 | 16 |
| Biopsy of ovary(s) 58900 CPT 58900 | $2,203.50 | $2,938.00 | $3,139.36 – $5,650.86 | 16 |
| Biopsy of salivary gland 42400 CPT 42400 | $1,057.50 | $1,410.00 | $686.75 – $1,236.14 | 16 |
| Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 | $2,666.25 | $3,555.00 | $1,601.72 – $2,883.09 | 16 |
| Biopsy skin incisional single lesion CPT 11106 | $2,979.00 | $3,972.00 | $716.75 – $1,290.15 | 16 |
| Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) CPT 38222 | $1,733.25 | $2,311.00 | $2,816.99 – $5,070.59 | 16 |
| Biopsy/removal lymph nodes CPT 38525 | $5,625.00 | $7,500.00 | $3,797.19 – $6,834.94 | 16 |
| Biotinidase - quest CPT 82261 | $298.50 | $398.00 | $16.87 – $30.37 | 17 |
| Bis xtracell fluid analysis CPT 93702 | $123.00 | $164.00 | $124.79 – $224.62 | 16 |
| Bivalirudin HCPCS J0583 | $18,344.51 | $24,459.34 | $0.39 – $1.89 | 2 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $384.00 | $512.00 | $242.30 – $436.15 | 16 |
| Bld prd mix CPT 86965 | $130.50 | $174.00 | $165.22 – $297.40 | 16 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | $172.13 | $229.50 | $50.85 – $189.18 | 2 |
| Blinatumomab 35 mcg intravenous solution HCPCS J9039 | $20,544.09 | $27,392.12 | $163.96 – $397.23 | 17 |
| Blink reflex test CPT 95933 | $441.75 | $589.00 | $57.21 – $102.98 | 16 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $10,575.00 | $14,100.00 | not published | 0 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $10,800.00 | $14,400.00 | not published | 0 |
| Bln dil 900ml preperitnl HCPCS C1727 | $1,241.51 | $1,655.34 | not published | 0 |
| Bln inpact admiral 4x150x130cm HCPCS C2623 | $38,250.00 | $51,000.00 | not published | 0 |
| Bln press regulation 71-80cm HCPCS C1815 | $17,775.00 | $23,700.00 | not published | 0 |
| Bln stent lg 19mm diam 10-12mm palmaz gen trnshpat unmtd HCPCS C1877 | $5,175.00 | $6,900.00 | not published | 0 |
| Block femoral nerve cont infusion cath w/img CPT 64448 | $774.75 | $1,033.00 | $857.76 – $1,543.97 | 16 |
| Block paracervical nrv CPT 64435 | $1,021.50 | $1,362.00 | $684.56 – $1,232.21 | 16 |
| Block tap inj(s) w/wo img uni CPT 64486 | $1,095.00 | $1,460.00 | $118.35 – $213.02 | 16 |
| Blood Clotting (PT/INR) Test CPT 85610 | $36.75 | $49.00 | $4.29 – $7.72 | 17 |
| Blood Clotting (PTT) Test CPT 85730 | $58.50 | $78.00 | $6.01 – $10.82 | 17 |
| Blood Count (CBC) Test CPT 85025 | $66.75 | $89.00 | $7.77 – $13.99 | 17 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $66.75 | $89.00 | $6.47 – $11.65 | 17 |
| Blood Culture Test CPT 87040 | $135.75 | $181.00 | $10.32 – $18.58 | 17 |
| Blood draw capillary 36416 CPT 36416 | $23.25 | $31.00 | not published | 0 |
| Blood gases o2 saturation direct measurement CPT 82805 | $161.25 | $215.00 | $78.77 – $141.79 | 17 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $46.50 | $62.00 | $15.92 – $28.66 | 17 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $26.25 | $35.00 | $4.38 – $7.88 | 17 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $16.50 | $22.00 | $5.32 – $9.58 | 17 |
| Blood smear interpretation CPT 85060 | $252.75 | $337.00 | $18.72 – $33.70 | 16 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $129.75 | $173.00 | $3.80 – $6.84 | 17 |
| Blood split unit HCPCS P9011 | $595.50 | $794.00 | $155.84 – $280.51 | 16 |
| Blood typing abo CPT 86900 | $186.75 | $249.00 | $4.17 – $232.25 | 17 |
| Blood typing ag donor ea ag CPT 86902 | $322.50 | $430.00 | $7.18 – $625.72 | 17 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $328.50 | $438.00 | $5.34 – $625.72 | 17 |
| Blood typing rh (d) CPT 86901 | $126.00 | $168.00 | $4.17 – $65.20 | 17 |
| Blood typing rh phenotype complete reference CPT 86906 | $53.25 | $71.00 | $10.81 – $65.20 | 17 |
| Bone Density Scan (DEXA) CPT 77080 | $277.50 | $370.00 | $101.39 – $182.50 | 17 |
| Bone acellular derm matrix 2x4cm 0.4-1.0mm allomend-cost per sq cm-8sq cm HCPCS Q4433 | $19,830.72 | $26,440.95 | $120.69 – $217.24 | 16 |
| Bone filler cerament 10cc HCPCS C1602 | $5,163.75 | $6,885.00 | not published | 0 |
| Bone marrow biopsyneedle/trocar 38221 CPT 38221 | $1,200.00 | $1,600.00 | $1,601.72 – $2,883.09 | 16 |
| Bone marrow harvest allogen CPT 38230 | $91,568.25 | $122,091.00 | $1,510.39 – $2,718.71 | 16 |
| Bone marrow;aspiration only 38220 CPT 38220 | $4,220.25 | $5,627.00 | $1,601.72 – $2,883.09 | 16 |
| Bone survey-lead poisoning CPT 77074 | $259.50 | $346.00 | $101.39 – $182.50 | 17 |
| Bone tendon board add on HCPCS C9356 | $9,547.14 | $12,729.51 | not published | 0 |
| Boot mlti podous univ xlg HCPCS L4396 | $318.36 | $424.47 | $245.21 – $441.38 | 16 |
| Boot softgait shrt m HCPCS L4387 | $113.72 | $151.61 | $232.08 – $417.74 | 16 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | $179.82 | $239.76 | $424.24 – $763.63 | 16 |
| Boot walker genesis mid-calf full shell s HCPCS L4361 | $308.33 | $411.10 | $424.24 – $763.63 | 16 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $102.75 | $137.00 | $17.03 – $30.65 | 17 |
| Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection HCPCS J9041 | not published | not published | $3.85 – $3.85 | 1 |
| Bowel imaging CPT 78290 | $610.50 | $814.00 | $387.70 – $697.86 | 17 |
| Br punct aspir ea add, l CPT 19001 | $348.75 | $465.00 | $25.44 – $45.79 | 16 |
| Brace afo lg left 6607 HCPCS L1930 | $70.65 | $94.19 | $362.45 – $652.41 | 16 |
| Brace ank air stirrup univ HCPCS L4350 | $55.92 | $74.56 | $136.95 – $246.51 | 16 |
| Brace ankle stablizing lg HCPCS L1902 | $35.15 | $46.86 | $122.31 – $220.16 | 16 |
| Brace back epic lso 637 HCPCS L0650 | $608.40 | $811.19 | $1,257.43 – $2,263.37 | 16 |
| Brace cust back lso HCPCS L0631 | $417.67 | $556.89 | $1,503.10 – $2,705.58 | 16 |
| Brace knee extender plus 22-30in HCPCS L1832 | $257.51 | $343.34 | $931.51 – $1,676.72 | 16 |
| Brace knee hing pat open med HCPCS L1820 | $433.29 | $577.71 | $198.66 – $357.59 | 16 |
| Brace knee playmaker ii x-rom hook and loop xl HCPCS L1833 | $188.51 | $251.34 | $701.41 – $1,262.54 | 16 |
| Brace m arm board HCPCS L3809 | $110.54 | $147.38 | $333.11 – $599.60 | 16 |
| Brace oths wrist hnd fngr without HCPCS L3807 | $82.50 | $110.00 | $333.11 – $599.60 | 16 |
| Brace wrist classic lft sm HCPCS L3908 | $99.75 | $133.00 | $89.82 – $161.68 | 16 |
| Brach/thor cath 1st CPT 36215 | $1,533.75 | $2,045.00 | $985.37 – $1,773.66 | 16 |
| Brach/thor cath 2nd CPT 36216 | $1,425.00 | $1,900.00 | $1,005.04 – $1,809.06 | 16 |
| Brach/thor cath 3rd CPT 36217 | $1,777.50 | $2,370.00 | $1,826.75 – $3,288.16 | 16 |
| Brach/thor cath addl CPT 36218 | $1,083.00 | $1,444.00 | $213.32 – $383.98 | 16 |
| Braf gene CPT 81210 | $189.00 | $252.00 | $175.40 – $315.72 | 17 |
| Brain MRA (blood vessel MRI, with and without contrast) CPT 70546 | $2,919.75 | $3,893.00 | $338.34 – $609.01 | 16 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $2,449.50 | $3,266.00 | $338.34 – $609.01 | 16 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $2,682.75 | $3,577.00 | $231.40 – $416.51 | 16 |
| Brain MRI (with and without contrast) CPT 70553 | $2,919.75 | $3,893.00 | $338.34 – $609.01 | 16 |
| Brain MRI (with contrast) CPT 70552 | $2,854.50 | $3,806.00 | $338.34 – $609.01 | 16 |
| Brain MRI (without contrast) CPT 70551 | $2,682.00 | $3,576.00 | $231.40 – $416.51 | 16 |
| Brain flow imaging only CPT 78610 | $627.00 | $836.00 | $526.57 – $947.83 | 17 |
| Breast Biopsy (ultrasound-guided, percutaneous) CPT 19083 | $1,984.50 | $2,646.00 | $1,601.72 – $2,883.09 | 16 |
| Breast punct aspir cyst, bil CPT 19000 | $1,611.00 | $2,148.00 | $686.75 – $1,236.14 | 16 |
| Breath hydrogen test 91065 CPT 91065 | $333.00 | $444.00 | $209.40 – $376.92 | 16 |
| Brentuximab vedotin 50 mg intravenous solution HCPCS J9042 | $46,868.78 | $62,491.70 | $268.73 – $629.21 | 17 |
| Brexucabtagene car pos t HCPCS Q2053 | $1,475,302.50 | $1,967,070.00 | $489,290.60 – $1,191,978.48 | 17 |
| Bronch ebus samplng 1/2 node CPT 31652 | $3,189.00 | $4,252.00 | $3,615.75 – $6,508.35 | 16 |
| Bronch ebus samplng 3/> node CPT 31653 | $3,189.00 | $4,252.00 | $3,615.75 – $6,508.35 | 16 |
| Bronch thermoplsty 1 lobe CPT 31660 | $7,346.25 | $9,795.00 | $6,844.32 – $12,319.78 | 16 |
| Bronch thermoplsty 2/> lobes CPT 31661 | $7,765.50 | $10,354.00 | $6,844.32 – $12,319.78 | 16 |
| Bronch w/balloon occlusion CPT 31634 | $7,870.50 | $10,494.00 | $6,844.32 – $12,319.78 | 16 |
| Bronchial allergy tests CPT 95070 | $320.25 | $427.00 | $361.89 – $651.40 | 16 |
| Bronchial challenge CPT 94070 | $697.50 | $930.00 | $361.89 – $651.40 | 16 |
| Bronchial valve remov addl CPT 31649 | $1,639.50 | $2,186.00 | $1,726.15 – $3,107.06 | 16 |
| Bronchial valve remov init CPT 31648 | $3,618.00 | $4,824.00 | $3,615.75 – $6,508.35 | 16 |
| Bronchoscopy clear airways 31645 CPT 31645 | $1,812.00 | $2,416.00 | $1,726.15 – $3,107.06 | 16 |
| Bronchoscopy dilate w/stent CPT 31631 | $10,329.00 | $13,772.00 | $6,844.32 – $12,319.78 | 16 |
| Bronchoscopy w/biopsy(s) 31625 CPT 31625 | $1,678.50 | $2,238.00 | $1,726.15 – $3,107.06 | 16 |
| Bronchoscopy w/fb removal 31635 CPT 31635 | $1,683.00 | $2,244.00 | $1,726.15 – $3,107.06 | 16 |
| Bronchoscopy w/markers CPT 31626 | $11,334.75 | $15,113.00 | $6,844.32 – $12,319.78 | 16 |
| Bronchoscopy/lung bx addl 31632 CPT 31632 | $1,079.25 | $1,439.00 | $65.98 – $118.76 | 16 |
| Budesonide non-comp unit HCPCS J7626 | $32.78 | $43.70 | $3.09 – $9.09 | 2 |
| Bundled special stain group 1 microorganisms CPT 88312 | $81.00 | $108.00 | $50.54 – $90.97 | 16 |
| Bundled special stain group 2 CPT 88313 | $131.25 | $175.00 | $129.03 – $232.25 | 16 |
| Bupivacaine 0.1 % epidural pca - 1 hour dose limit HCPCS J0665 | $44.19 | $58.92 | $0.09 – $0.09 | 1 |
| Buprenorph X-ray 100 mg or less HCPCS Q9991 | $7,360.99 | $9,814.65 | $1,996.56 – $4,810.92 | 17 |
| Buprenorphine 2 mg-naloxone 0.5 mg sublingual tablet HCPCS J0572 | $545.43 | $727.23 | $64.08 – $64.08 | 1 |
| Buprenorphine 8 mg-naloxone 2 mg sublingual tablet HCPCS J0574 | $621.18 | $828.24 | $105.03 – $105.03 | 1 |
| Buprenorphine X-ray over 100 mg HCPCS Q9992 | $7,360.99 | $9,814.65 | $1,996.56 – $4,810.92 | 17 |
| Buprenorphine and metabolite - sendout CPT 80348 | $136.50 | $182.00 | not published | 0 |
| Buprenorphine hydrochloride HCPCS J0592 | $52.01 | $69.34 | $10.05 – $37.17 | 2 |
| Buprenorphine oral 1mg HCPCS J0571 | $715.66 | $954.21 | $12.60 – $12.60 | 1 |
| Bur rotalink 2.15mm HCPCS C1724 | $11,463.75 | $15,285.00 | not published | 0 |
| Busulfan injection HCPCS J0594 | $783.10 | $1,044.13 | $0.68 – $4.45 | 17 |
| Butorphanol tartrate 1 mg HCPCS J0595 | $63.62 | $84.82 | $12.29 – $25.20 | 2 |
| Bx bone trocar/ndl deep CPT 20225 | $2,938.50 | $3,918.00 | $1,601.72 – $2,883.09 | 16 |
| Bx breast 1st lesion mr imag CPT 19085 | $4,323.75 | $5,765.00 | $1,601.72 – $2,883.09 | 16 |
| Bx breast 1st lesion strtctc CPT 19081 | $3,438.75 | $4,585.00 | $1,601.72 – $2,883.09 | 16 |
| Bx breast add lesion Ultrasound imag CPT 19084 | $2,523.00 | $3,364.00 | $331.19 – $596.15 | 16 |
| Bx breast add lesion mr imag CPT 19086 | $4,135.50 | $5,514.00 | $510.68 – $919.22 | 16 |
| Bx breast add lesion strtctc CPT 19082 | $3,056.25 | $4,075.00 | $337.00 – $606.61 | 16 |
| Bx liver with other CPT 47001 | $2,265.00 | $3,020.00 | $91.34 – $164.41 | 16 |
| Bx of cervix w/scope leep 57460 CPT 57460 | $4,245.75 | $5,661.00 | $3,139.36 – $5,650.86 | 16 |
| Bx pancreas pq ndl CPT 48102 | $1,900.50 | $2,534.00 | $1,601.72 – $2,883.09 | 16 |
| Bx perianal mass CPT 46999 | $882.75 | $1,177.00 | $901.87 – $1,623.37 | 16 |
| Bx pleura pq ndl CPT 32400 | $1,900.50 | $2,534.00 | $1,601.72 – $2,883.09 | 16 |
| Bx prostate trnsrctl u/s guid CPT 55707 | $3,375.75 | $4,501.00 | $3,418.53 – $6,153.35 | 16 |
| Bx skin incisnl ea sep/add l les CPT 11107 | $336.00 | $448.00 | $66.38 – $119.48 | 16 |
| Bx skin punch ea sep/ addl les CPT 11105 | $255.75 | $341.00 | $56.70 – $102.05 | 16 |
| Bx skin tangential ea sep/ addl les CPT 11103 | $259.50 | $346.00 | $45.72 – $82.30 | 16 |
| Bx thigh/knee soft tiss supf 27323 CPT 27323 | $1,566.00 | $2,088.00 | $1,601.72 – $2,883.09 | 16 |
| Bx thyroid/percutan core needle 60100 CPT 60100 | $1,434.00 | $1,912.00 | $686.75 – $1,236.14 | 16 |
| Bx vag mucos smpl (sep proc) CPT 57100 | $1,729.50 | $2,306.00 | $893.23 – $1,607.82 | 16 |
| Bx vulva or perineum/1 lesion 56605 CPT 56605 | $2,765.25 | $3,687.00 | $893.23 – $1,607.82 | 16 |
| Bx vulva or perineum/ea add lesion 56606 CPT 56606 | $1,365.00 | $1,820.00 | $37.53 – $67.56 | 16 |
| Bx/curett of cervix w/scope 57454 CPT 57454 | $885.75 | $1,181.00 | $295.53 – $531.95 | 16 |
| Bypass temp external fem-fem CPT 37799 | $2,664.75 | $3,553.00 | $608.36 – $1,095.05 | 16 |
| C motor evoked lwr limbs CPT 95929 | $480.75 | $641.00 | $361.89 – $651.40 | 16 |
| C motor evoked uppr limbs CPT 95928 | $4,662.75 | $6,217.00 | $832.81 – $1,499.05 | 16 |
| C motor evoked upr&lwr limbs CPT 95939 | $849.75 | $1,133.00 | $832.81 – $1,499.05 | 16 |
| C-1 esterase, berinert HCPCS J0597 | $13,165.77 | $17,554.35 | $76.05 – $184.64 | 17 |
| C-1 esterase, cinryze HCPCS J0598 | not published | not published | $159.96 – $159.96 | 1 |
| C-peptide CPT 84681 | $101.25 | $135.00 | $20.81 – $37.46 | 17 |
| C-reactive protein CPT 86140 | $126.00 | $168.00 | $5.18 – $9.32 | 17 |
| C-reactive protein high sensitivity CPT 86141 | $99.00 | $132.00 | $12.95 – $23.31 | 17 |
| C-reactive protein, quantitative CPT 86406 | $147.00 | $196.00 | $10.64 – $19.15 | 17 |
| C1 esterase inhibitor func - sendout CPT 86161 | $132.75 | $177.00 | $12.00 – $21.60 | 17 |
| CT 3d report other modality w/workstation CPT 76377 | $775.50 | $1,034.00 | $74.43 – $133.97 | 16 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $3,652.50 | $4,870.00 | $338.34 – $609.01 | 16 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $1,899.75 | $2,533.00 | $170.10 – $306.19 | 16 |
| CT Angiogram of the Head CPT 70496 | $1,899.75 | $2,533.00 | $170.10 – $306.19 | 16 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $3,610.50 | $4,814.00 | $338.34 – $609.01 | 16 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $3,180.75 | $4,241.00 | $338.34 – $609.01 | 16 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,865.75 | $3,821.00 | $231.40 – $416.51 | 16 |
| CT angio hrt w/3d image CPT 75574 | $2,749.50 | $3,666.00 | $338.34 – $609.01 | 16 |
| CT angio pelvis CPT 72191 | $2,965.50 | $3,954.00 | $170.10 – $306.19 | 16 |
| CT cerebral perf w cont & prcssng CPT 70473 | $775.50 | $1,034.00 | $170.10 – $306.19 | 16 |
| CT colonography dx CPT 74261 | $2,616.00 | $3,488.00 | $101.39 – $182.50 | 16 |
| CT guid cryo ablat intramuscular CPT 20999 | $879.75 | $1,173.00 | $239.22 – $430.59 | 16 |
| CT guid parench tis ablat CPT 77013 | $1,573.50 | $2,098.00 | not published | 0 |
| CT guidance for needle placement CPT 77012 | $1,476.00 | $1,968.00 | $116.78 – $210.21 | 16 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,377.75 | $1,837.00 | $106.42 – $191.56 | 16 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $2,514.75 | $3,353.00 | $84.40 – $151.91 | 16 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | $2,965.50 | $3,954.00 | $338.34 – $609.01 | 16 |
| CT hrt w/3d image CPT 75572 | $3,534.00 | $4,712.00 | $338.34 – $609.01 | 16 |
| CT limited or localized follow-up study CPT 76380 | $787.50 | $1,050.00 | $84.40 – $151.91 | 16 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $1,555.50 | $2,074.00 | $170.10 – $306.19 | 16 |
| CT lower extremity without contrast (both sides) CPT 73700 | $1,169.25 | $1,559.00 | $101.39 – $182.50 | 16 |
| CT lwr extremity w/o&w/dye CPT 73702 | $1,983.75 | $2,645.00 | $170.10 – $306.19 | 16 |
| CT neck soft tissue w/contrast CPT 70491 | $1,953.00 | $2,604.00 | $170.10 – $306.19 | 16 |
| CT neck soft tissue without & w/contrast CPT 70492 | $2,149.50 | $2,866.00 | $170.10 – $306.19 | 16 |
| CT neck soft tissue without contrast CPT 70490 | $1,689.75 | $2,253.00 | $101.39 – $182.50 | 16 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $1,834.50 | $2,446.00 | $170.10 – $306.19 | 16 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $1,651.50 | $2,202.00 | $101.39 – $182.50 | 16 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,923.00 | $2,564.00 | $170.10 – $306.19 | 16 |
| CT t-spine w /wo contrast CPT 72130 | $2,228.25 | $2,971.00 | $170.10 – $306.19 | 16 |
| CT thoracic spine w/contrast CPT 72129 | $1,293.00 | $1,724.00 | $170.10 – $306.19 | 16 |
| CT thoracic spine without contrast CPT 72128 | $944.25 | $1,259.00 | $101.39 – $182.50 | 16 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $101.25 | $135.00 | $101.39 – $182.50 | 16 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $1,536.75 | $2,049.00 | $338.34 – $609.01 | 16 |
| CT upper extremity without contrast (both sides) CPT 73200 | $1,476.00 | $1,968.00 | $101.39 – $182.50 | 16 |
| CT uppr extremity w/o&w/dye CPT 73202 | $2,726.25 | $3,635.00 | $170.10 – $306.19 | 16 |
| Ca screen;flexi sigmoidscope HCPCS G0104 | $1,296.00 | $1,728.00 | $901.87 – $1,623.37 | 16 |
| Cabazitaxel 10 mg/ml (first dilution) intravenous solution HCPCS J9043 | $53,887.78 | $71,850.37 | $231.05 – $552.76 | 17 |
| Cabergoline, oral 0.25mg HCPCS J8515 | $173.02 | $230.69 | $164.97 – $164.97 | 1 |
| Cable cath 22-pin diag HCPCS C1730 | $5,737.50 | $7,650.00 | not published | 0 |
| Cable centrimag pressure HCPCS Q0508 | $371.25 | $495.00 | not published | 0 |
| Cabotegravir ER 400 mg/2 ml-rilpivirine ER 600 mg/2ml im suspension,er HCPCS J0741 | not published | not published | $57.49 – $57.49 | 1 |
| Cacna1a gene full gene seq CPT 81185 | $635.25 | $847.00 | $846.27 – $1,523.29 | 16 |
| Caffeine citrate 20 mg/ml inj for po HCPCS J0706 | $106.71 | $142.28 | $4.50 – $20.16 | 2 |
| Calaspargase pegol-mknl 750 unit/ml intravenous solution HCPCS J9118 | not published | not published | $199.34 – $199.34 | 1 |
| Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 | $9,840.35 | $13,120.46 | $2,780.63 – $9,625.50 | 2 |
| Calcium 24 hour urine CPT 82340 | $63.00 | $84.00 | $6.03 – $10.85 | 17 |
| Calcium chloride 100 mg/ml (10 %) intravenous syringe HCPCS J0618 | $71.82 | $95.75 | not published | 0 |
| Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 | $62.13 | $82.83 | $0.45 – $0.45 | 1 |
| Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution HCPCS J0613 | $61.76 | $82.34 | $0.81 – $0.81 | 1 |
| Calcium ionized CPT 82330 | $75.75 | $101.00 | $13.68 – $24.62 | 17 |
| Calcium total CPT 82310 | $36.75 | $49.00 | $5.16 – $9.29 | 17 |
| Calprotectin fecal CPT 83993 | $261.00 | $348.00 | $19.63 – $35.33 | 17 |
| Canakinumab injection HCPCS J0638 | $79,068.64 | $105,424.85 | $149.57 – $343.17 | 17 |
| Cannula declotting 36861 CPT 36861 | $18,891.00 | $25,188.00 | $5,396.44 – $9,713.59 | 16 |
| Cannula ercp contour 5-4-3 tip HCPCS C1889 | $235,532.25 | $314,043.00 | not published | 0 |
| Canthotomy 67715 CPT 67715 | $2,256.75 | $3,009.00 | $2,305.69 – $4,150.23 | 16 |
| Cap nerve 2x15mm HCPCS C1763 | $28,177.88 | $37,570.50 | not published | 0 |
| Cap trach decann 15mm HCPCS C1750 | $5,400.00 | $7,200.00 | not published | 0 |
| Capecitabine, oral, 50 mg HCPCS J8522 | $20,888.96 | $27,851.94 | $0.03 – $0.05 | 16 |
| Capsaicin 8% patch HCPCS J7336 | not published | not published | $8.23 – $8.23 | 1 |
| Carbamazepine free CPT 80157 | $100.50 | $134.00 | $13.25 – $23.85 | 17 |
| Carbamazepine free -sendout CPT 80161 | $129.00 | $172.00 | $18.64 – $33.55 | 16 |
| Carbamazepine total therapeutic drug level CPT 80156 | $104.25 | $139.00 | $14.57 – $26.23 | 17 |
| Carbidopa levodopa ent 100ml HCPCS J7340 | not published | not published | $591.80 – $591.80 | 1 |
| Carbohydrate deficient transf - sendout CPT 82373 | $144.75 | $193.00 | $18.06 – $32.51 | 17 |
| Carbohydrate urine - sendout CPT 84377 | $936.00 | $1,248.00 | $5.50 – $9.90 | 17 |
| Carbon dioxide CPT 82374 | $104.25 | $139.00 | $4.88 – $8.78 | 17 |
| Carboplatin 10 mg/ml desensitization HCPCS J9045 | $45.78 | $61.04 | $5.14 – $32.40 | 2 |
| Carboprost tromethamine 250 mcg/ml intramuscular solution HCPCS J0675 | $334.92 | $446.55 | $15.56 – $28.01 | 16 |
| Carboxyhemoglobin quantitative CPT 82375 | $77.25 | $103.00 | $12.32 – $22.18 | 17 |
| Carcinoembryonic ag (cea) CPT 82378 | $128.25 | $171.00 | $18.96 – $34.13 | 17 |
| Card MRI veloc flow mapping CPT 75565 | $1,801.50 | $2,402.00 | $42.20 – $75.96 | 16 |
| Cardiac MRI w/stress img CPT 75559 | $5,208.00 | $6,944.00 | $529.91 – $953.84 | 16 |
| Cardiac perf planar mult/ef/wm CPT 78454 | $2,607.75 | $3,477.00 | $1,255.55 – $2,259.99 | 17 |
| Cardiac perf planar sgl/ef/wm CPT 78453 | $1,778.25 | $2,371.00 | $1,255.55 – $2,259.99 | 17 |
| Cardiac perf spect sgl/ef/wm rst/strs CPT 78451 | $2,148.75 | $2,865.00 | $1,255.55 – $2,259.99 | 17 |
| Cardiac rehabilitation op phase 2 w/continous ecg monitoring CPT 93798 | $268.50 | $358.00 | $125.01 – $225.03 | 16 |
| Cardiolipin antibody iga CPT 86147 | $211.50 | $282.00 | $25.45 – $45.81 | 17 |
| Cardioversion elective electrical conversion arrhythmia external CPT 92960 | $1,461.75 | $1,949.00 | $640.98 – $1,153.77 | 16 |
| Carfilzomib 10 mg intravenous solution HCPCS J9047 | $13,992.87 | $18,657.15 | $56.24 – $134.09 | 17 |
| Carmustine 100 mg intravenous powder for solution HCPCS J9050 | $9,719.27 | $12,959.02 | $241.80 – $435.25 | 17 |
| Carotene CPT 82380 | $66.00 | $88.00 | $9.22 – $16.60 | 17 |
| Carotid Artery Ultrasound (Duplex) CPT 93880 | $762.00 | $1,016.00 | $231.40 – $416.51 | 16 |
| Caspofungin acetate HCPCS J0637 | $1,158.18 | $1,544.23 | $5.50 – $48.87 | 2 |
| Cath 2lum 14.5frx43cm maxid kt mahurkar HCPCS C1752 | $1,115.83 | $1,487.76 | not published | 0 |
| Cath ablat bi-d d-d 8fr 115cm HCPCS C2630 | $27,000.00 | $36,000.00 | not published | 0 |
| Cath ablt clsfast 7fx100cmx HCPCS C1888 | $1,687.50 | $2,250.00 | not published | 0 |
| Cath ablt rx lasr 2.0mm turbo HCPCS C1885 | $7,380.00 | $9,840.00 | not published | 0 |
| Cath access del ds spyscop 2.0 HCPCS C1748 | $4,500.00 | $6,000.00 | not published | 0 |
| Cath acuity innr ic130 6f 63cm HCPCS C1887 | $64,496.25 | $85,995.00 | not published | 0 |
| Cath acunav ge 10frx90cm HCPCS C1759 | $7,951.50 | $10,602.00 | not published | 0 |
| Cath adherent clot 10mm 6f 10 HCPCS C1757 | $27,000.00 | $36,000.00 | not published | 0 |
| Cath baloon occl urnry 34f 7x2x65 HCPCS C2628 | $7,256.82 | $9,675.75 | not published | 0 |
| Cath bi-dir df smarttouch HCPCS C1732 | $8,813.25 | $11,751.00 | not published | 0 |
| Cath blazer dx/20 2-10-2 space HCPCS C1731 | $5,062.50 | $6,750.00 | not published | 0 |
| Cath combo lt&rt heart w/inj/s CPT 93453 | $9,202.50 | $12,270.00 | $3,144.03 – $5,659.25 | 16 |
| Cath cv dl inj 7fx16cm HCPCS C1751 | $6,738.75 | $8,985.00 | not published | 0 |
| Cath del ampltz 12f 45d 80cm HCPCS C1893 | $2,463.75 | $3,285.00 | not published | 0 |
| Cath epdrl brevi-stf 12in .043 HCPCS C1755 | $2,295.00 | $3,060.00 | not published | 0 |
| Cath groshong MRI 8fr plstc port HCPCS C1788 | $5,309.87 | $7,079.82 | not published | 0 |
| Cath hawkone s directional HCPCS C1714 | $7,076.25 | $9,435.00 | not published | 0 |
| Cath imag ivus pv 8.5fx90 .035 HCPCS C1753 | $6,378.75 | $8,505.00 | not published | 0 |
| Cath intrdsc spnecth 8 pin HCPCS C1754 | $2,463.75 | $3,285.00 | not published | 0 |
| Cath left heart transseptal punc CPT 93462 | $7,291.50 | $9,722.00 | $199.33 – $358.79 | 16 |
| Cath left heart/lv gram CPT 93452 | $8,518.50 | $11,358.00 | $3,144.03 – $5,659.25 | 16 |
| Cath lt/rt pulm art CPT 36014 | $1,504.50 | $2,006.00 | $695.59 – $1,252.07 | 16 |
| Cath malecot 28fr 4-wing ltx HCPCS C1729 | $6,845.92 | $9,127.89 | not published | 0 |
| Cath occl flo-rester 2.25x12mm cor internal vessel occluder HCPCS C1817 | $38,250.00 | $51,000.00 | not published | 0 |
| Cath place 1st order venous 36011 CPT 36011 | $2,137.50 | $2,850.00 | $724.49 – $1,304.09 | 16 |
| Cath plc art ang/grft lt/rt hr CPT 93461 | $11,483.25 | $15,311.00 | $3,144.03 – $5,659.25 | 16 |
| Cath plc art/angio/rt hrt cath CPT 93456 | $8,979.00 | $11,972.00 | $3,144.03 – $5,659.25 | 16 |
| Cath plc art/grft/angio right hrt CPT 93457 | $8,859.00 | $11,812.00 | $3,144.03 – $5,659.25 | 16 |
| Cath ptca pcltxl agent 3x20mm HCPCS C9610 | $12,732.75 | $16,977.00 | not published | 0 |
| Cath right heart w/o2 sat & card CPT 93451 | $3,668.25 | $4,891.00 | $3,144.03 – $5,659.25 | 16 |
| Cath right hrt mnpul art CPT 36013 | $1,174.50 | $1,566.00 | $716.21 – $1,289.17 | 16 |
| Cath segmntl pulm art CPT 36015 | $1,250.25 | $1,667.00 | $736.66 – $1,326.00 | 16 |
| Cath steerable flex adv 12f HCPCS C1766 | $2,925.00 | $3,900.00 | not published | 0 |
| Cath stripping venous s&i CPT 75901 | $1,578.00 | $2,104.00 | $209.56 – $377.21 | 16 |
| Cath symplicity spyral HCPCS C1735 | $36,000.00 | $48,000.00 | not published | 0 |
| Cath temp pace flo bipol 5fr electrd HCPCS C1779 | $1,408.39 | $1,877.85 | not published | 0 |
| Cath uret open tp 6fx70cm HCPCS C1758 | $32,626.80 | $43,502.40 | not published | 0 |
| Cath/saline/contrast/sis/hysteosal 58340 CPT 58340 | $358.50 | $478.00 | $219.15 – $394.48 | 16 |
| Catheter declot mechanical CPT 36596 | $1,523.25 | $2,031.00 | $1,526.62 – $2,747.91 | 16 |
| Catheter stripping venous CPT 36595 | $2,877.75 | $3,837.00 | $3,062.12 – $5,511.82 | 16 |
| Catheterization collection of specimen single patient all places of service HCPCS P9612 | $33.75 | $45.00 | $3.39 – $16.81 | 17 |
| Cauterization chemical granulation tissue CPT 17250 | $375.75 | $501.00 | $194.58 – $350.24 | 16 |
| Cdna analysis for variants CPT 81403 | $1,540.50 | $2,054.00 | $185.20 – $333.36 | 17 |
| Cebpa gene full sequence CPT 81218 | $328.50 | $438.00 | $241.90 – $435.42 | 17 |
| Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr HCPCS J0690 | $7.78 | $10.37 | $2.02 – $6.84 | 2 |
| Cefepime 1 gram solution for injection HCPCS J0692 | $39.95 | $53.26 | $2.99 – $11.34 | 2 |
| Cefotaxime sodium injection HCPCS J0698 | $43.10 | $57.46 | $54.36 – $54.36 | 1 |
| Cefoxitin 1 gram intravenous solution HCPCS J0694 | $94.59 | $126.11 | $12.49 – $45.72 | 2 |
| Ceftaroline fosamil 600 mg intravenous solution HCPCS J0712 | $738.72 | $984.96 | $4.25 – $10.32 | 17 |
| Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr HCPCS J0713 | $107.85 | $143.80 | $3.99 – $15.21 | 2 |
| Ceftazidime and avibactam HCPCS J0714 | $1,418.10 | $1,890.79 | $104.75 – $255.45 | 17 |
| Ceftriaxone 1 gram solution for injection HCPCS J0696 | $123.72 | $164.96 | $1.17 – $4.41 | 2 |
| Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr HCPCS J0697 | $18.04 | $24.05 | $5.57 – $18.27 | 2 |
| Cell count body fluid CPT 89050 | $65.25 | $87.00 | $4.72 – $8.50 | 17 |
| Cell count w differential body fluid CPT 89051 | $106.50 | $142.00 | $5.60 – $10.08 | 17 |
| Cell function assay w/stim CPT 86352 | $949.50 | $1,266.00 | $135.86 – $244.55 | 17 |
| Cell marker study CPT 88182 | $1,170.00 | $1,560.00 | $50.54 – $90.97 | 16 |
| Cemiplimab-rwlc 50 mg/ml intravenous solution HCPCS J9119 | $40,395.06 | $53,860.07 | $29.76 – $69.83 | 17 |
| Cerclage of uterine cervix nonob 57700 CPT 57700 | $2,596.50 | $3,462.00 | $3,139.36 – $5,650.86 | 16 |
| Cerebrospinal fld flw imag CPT 78645 | $612.00 | $816.00 | $526.57 – $947.83 | 17 |
| Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit HCPCS J0717 | $22,182.90 | $29,577.19 | $3.79 – $10.90 | 17 |
| Cervical or vaginal cancer screening g0101 HCPCS G0101 | $123.75 | $165.00 | $98.52 – $177.34 | 16 |
| Cesarean section delivery only 59514 CPT 59514 | $1,705.50 | $2,274.00 | $814.78 – $1,466.60 | 16 |
| Cetuximab 100 mg/50 ml intravenous solution HCPCS J9055 | $5,734.83 | $7,646.43 | $80.46 – $190.97 | 17 |
| Cftr gene dup/delet variants CPT 81222 | $918.00 | $1,224.00 | $435.07 – $783.13 | 17 |
| Cftr gene intron poly t CPT 81224 | $285.75 | $381.00 | $168.75 – $303.75 | 17 |
| Change cystostomy tube simple CPT 51705 | $303.00 | $404.00 | $242.30 – $436.15 | 16 |
| Change g-tube to g-j perc CPT 49446 | $1,122.00 | $1,496.00 | $1,860.96 – $3,349.72 | 16 |
| Change nephroureteral cath CPT 50387 | $2,247.75 | $2,997.00 | $2,027.25 – $3,649.06 | 16 |
| Change of windpipe airway 31502 CPT 31502 | $225.75 | $301.00 | $229.70 – $413.45 | 16 |
| Change ureter stent percut CPT 50382 | $4,067.25 | $5,423.00 | $2,027.25 – $3,649.06 | 16 |
| Chemo adm cns w/lmbr punct CPT 96450 | $1,323.75 | $1,765.00 | $320.33 – $576.59 | 16 |
| Chemo ia push tecnique CPT 96420 | $540.75 | $721.00 | $320.33 – $576.59 | 16 |
| Chemo intralesional over 7 CPT 96406 | $246.75 | $329.00 | $206.28 – $371.30 | 16 |
| Chemo intralesional up to 7 96405 CPT 96405 | $83.25 | $111.00 | $69.83 – $125.69 | 16 |
| Chemodener muscle larynx emg CPT 64617 | $668.25 | $891.00 | $684.56 – $1,232.21 | 16 |
| Chemodenerv musc migraine 64615 CPT 64615 | $762.75 | $1,017.00 | $297.68 – $535.83 | 16 |
| Chemodenerv musc neck dyston 64616 CPT 64616 | $825.75 | $1,101.00 | $297.68 – $535.83 | 16 |
| Chemodenerv saliv glands bilat 64611 CPT 64611 | $484.50 | $646.00 | $297.68 – $535.83 | 16 |
| Chemodenerv trunk musc 1-5 64646 CPT 64646 | $787.50 | $1,050.00 | $684.56 – $1,232.21 | 16 |
| Chemodenervation/face muscl/unilat 64612 CPT 64612 | $843.00 | $1,124.00 | $297.68 – $535.83 | 16 |
| Chemotherapy injection 96542 CPT 96542 | $665.25 | $887.00 | $320.33 – $576.59 | 16 |
| Chemotx admn pertl cav impl CPT 96446 | $642.75 | $857.00 | $320.33 – $576.59 | 16 |
| Chest 2 vws w oblique CPT 71048 | $357.00 | $476.00 | $101.39 – $182.50 | 17 |
| Chest CT scan (with and without contrast) CPT 71270 | $2,241.75 | $2,989.00 | $170.10 – $306.19 | 16 |
| Chest CT scan (with contrast) CPT 71260 | $1,730.25 | $2,307.00 | $170.10 – $306.19 | 16 |
| Chest CT scan (without contrast) CPT 71250 | $1,557.00 | $2,076.00 | $101.39 – $182.50 | 16 |
| Chest X-ray CPT 71046 | $309.00 | $412.00 | $84.40 – $151.91 | 17 |
| Chest X-ray (single view) CPT 71045 | $246.00 | $328.00 | $84.40 – $151.91 | 17 |
| Chest apical lordotic proj CPT 71047 | $347.25 | $463.00 | $84.40 – $151.91 | 17 |
| Chg pr pul rehab for copd patients CPT 94626 | $134.25 | $179.00 | $57.21 – $102.98 | 16 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $759.00 | $1,012.00 | $170.10 – $306.19 | 16 |
| Chimerism anal no cell selec CPT 81267 | $951.75 | $1,269.00 | $207.46 – $373.43 | 17 |
| Chimerism anal w/cell select CPT 81268 | $524.25 | $699.00 | $260.79 – $469.42 | 17 |
| Chlamydia culture CPT 87110 | $90.75 | $121.00 | $19.60 – $35.28 | 17 |
| Chlnggrphy intraop addl s&i CPT 74301 | $402.75 | $537.00 | not published | 0 |
| Chloramphenicol sodium injec HCPCS J0720 | $143.40 | $191.20 | $122.33 – $525.42 | 2 |
| Chloride CPT 82435 | $30.00 | $40.00 | $4.60 – $8.28 | 17 |
| Chloride 24 hour urine CPT 82436 | $42.75 | $57.00 | $5.75 – $10.35 | 17 |
| Chloroprocaine hcl injection HCPCS J2401 | $69.08 | $92.10 | $0.36 – $0.36 | 1 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $221.85 | $295.80 | $98.28 – $1,092.15 | 2 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $91.92 | $122.55 | $65.89 – $268.11 | 2 |
| Cholangiogram percutaneous compl CPT 47532 | $7,869.75 | $10,493.00 | $3,472.27 – $6,250.09 | 16 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $629.25 | $839.00 | not published | 0 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $3,041.25 | $4,055.00 | $3,472.27 – $6,250.09 | 16 |
| Cholesterol CPT 82465 | $45.75 | $61.00 | $4.35 – $7.83 | 17 |
| Cholesterol (Lipid) Test CPT 80061 | $109.50 | $146.00 | $13.39 – $24.10 | 17 |
| Cholinesterase CPT 82480 | $94.50 | $126.00 | $7.87 – $14.17 | 17 |
| Chorionic gonadotropin/1000u HCPCS J0725 | $788.58 | $1,051.43 | $42.62 – $208.53 | 2 |
| Chrom analysis CPT 88273 | $330.75 | $441.00 | $34.81 – $62.66 | 17 |
| Chromatography CPT 83021 | $252.75 | $337.00 | $18.06 – $32.51 | 17 |
| Chromo high res and frag x - sendout CPT 81243 | $264.75 | $353.00 | $57.04 – $102.67 | 17 |
| Chromogenic substrate assay CPT 85130 | $382.50 | $510.00 | $11.89 – $21.40 | 17 |
| Chromosome analys placenta CPT 88267 | $642.00 | $856.00 | $188.57 – $339.43 | 17 |
| Chromosome analysis 100 CPT 88249 | $519.00 | $692.00 | $173.17 – $311.71 | 17 |
| Chromosome analysis 15-20 cell count CPT 88262 | $1,092.75 | $1,457.00 | $125.49 – $225.88 | 17 |
| Chromosome analysis 45 CPT 88263 | $1,692.75 | $2,257.00 | $150.29 – $270.52 | 17 |
| Chromosome analysis 5 CPT 88261 | $955.50 | $1,274.00 | $264.34 – $475.81 | 17 |
| Chromosome analysis 50-100 CPT 88248 | $519.00 | $692.00 | $173.17 – $311.71 | 17 |
| Chromosome count additional CPT 88285 | $105.75 | $141.00 | $26.91 – $48.44 | 17 |
| Chromosome karyotype study CPT 88280 | $210.75 | $281.00 | $33.47 – $60.25 | 17 |
| Chromosome study additional CPT 88289 | $140.25 | $187.00 | $34.43 – $61.97 | 17 |
| Chylomicron screen, bf - sendout CPT 82664 | $301.50 | $402.00 | $61.50 – $110.70 | 17 |
| Cidofovir injection HCPCS J0740 | $1,615.67 | $2,154.22 | $560.79 – $1,288.49 | 17 |
| Cilastatin sodium injection HCPCS J0743 | $36.62 | $48.82 | $16.96 – $72.90 | 2 |
| Cinacalcet 30 mg tablet HCPCS J0604 | $5,641.98 | $7,522.64 | $8.91 – $8.91 | 1 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $23.67 | $31.56 | $5.62 – $17.37 | 2 |
| Ciprofloxacin otic susp 6 mg HCPCS J7342 | not published | not published | $73.04 – $73.04 | 1 |
| Circumcision (newborn) CPT 54150 | $84.75 | $113.00 | $2,027.25 – $3,649.06 | 16 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | not published | not published | $4.72 – $4.72 | 1 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $355.41 | $473.88 | $8.73 – $23.66 | 17 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $19,012.50 | $25,350.00 | not published | 0 |
| Clearance of airways CPT 31720 | $166.50 | $222.00 | $212.36 – $382.26 | 16 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $49.74 | $66.31 | $17.10 – $17.10 | 1 |
| Clip ligating vesolock lg HCPCS C1760 | $38,250.00 | $51,000.00 | not published | 0 |
| Cllr miami j sm HCPCS L0174 | $112.39 | $149.85 | $420.89 – $757.60 | 16 |
| Clofarabine 1 mg/ml intravenous solution HCPCS J9027 | $11,963.49 | $15,951.32 | $10.94 – $35.80 | 17 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $361.14 | $481.52 | $43.01 – $173.43 | 2 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | $262.50 | $350.00 | $229.70 – $413.45 | 16 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | $228.00 | $304.00 | $239.22 – $430.59 | 16 |
| Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 | $1,815.75 | $2,421.00 | $1,559.43 – $2,806.97 | 16 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $1,110.75 | $1,481.00 | $1,559.43 – $2,806.97 | 16 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $2,448.00 | $3,264.00 | $1,559.43 – $2,806.97 | 16 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $217.50 | $290.00 | $239.22 – $430.59 | 16 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | $487.50 | $650.00 | $1,559.43 – $2,806.97 | 16 |
| Closed tx/acetabululm without manip 27220 CPT 27220 | $261.75 | $349.00 | $239.22 – $430.59 | 16 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | $531.00 | $708.00 | $523.04 – $941.47 | 16 |
| Closure paravalvlr leak pq CPT 33999 | $18,614.25 | $24,819.00 | $608.36 – $1,095.05 | 16 |
| Clot factor fletcher fact CPT 85292 | $335.25 | $447.00 | $18.93 – $34.07 | 17 |
| Clot factor wght kininogen CPT 85293 | $335.25 | $447.00 | $18.93 – $34.07 | 17 |
| Clot factor xii hageman CPT 85280 | $220.50 | $294.00 | $19.35 – $34.83 | 17 |
| Clot factor xiii fibrin scrn CPT 85291 | $39.00 | $52.00 | $9.11 – $16.40 | 17 |
| Clot factor xiii fibrin stab CPT 85290 | $292.50 | $390.00 | $16.34 – $29.41 | 17 |
| Clozapine, 25 mg HCPCS S0136 | $242.19 | $322.92 | not published | 0 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $262.50 | $350.00 | $239.22 – $430.59 | 16 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $1,513.50 | $2,018.00 | $1,559.43 – $2,806.97 | 16 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $333.00 | $444.00 | $239.22 – $430.59 | 16 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $525.75 | $701.00 | $239.22 – $430.59 | 16 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | $1,553.25 | $2,071.00 | $1,559.43 – $2,806.97 | 16 |
| Clsd tx fracture of radius 25500 CPT 25500 | $442.50 | $590.00 | $239.22 – $430.59 | 16 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $2,890.50 | $3,854.00 | $1,559.43 – $2,806.97 | 16 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $342.75 | $457.00 | $239.22 – $430.59 | 16 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $3,063.75 | $4,085.00 | $1,559.43 – $2,806.97 | 16 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $218.25 | $291.00 | $239.22 – $430.59 | 16 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | $373.50 | $498.00 | $239.22 – $430.59 | 16 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $1,815.75 | $2,421.00 | $1,559.43 – $2,806.97 | 16 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $218.25 | $291.00 | $239.22 – $430.59 | 16 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $1,553.25 | $2,071.00 | $1,559.43 – $2,806.97 | 16 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $1,513.50 | $2,018.00 | $1,559.43 – $2,806.97 | 16 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $1,513.50 | $2,018.00 | $1,559.43 – $2,806.97 | 16 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $1,553.25 | $2,071.00 | $1,559.43 – $2,806.97 | 16 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $218.25 | $291.00 | $239.22 – $430.59 | 16 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $217.50 | $290.00 | $239.22 – $430.59 | 16 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $1,362.75 | $1,817.00 | $1,559.43 – $2,806.97 | 16 |
| Clsd tx trimall ankle fx without manip 27816 CPT 27816 | $279.00 | $372.00 | $239.22 – $430.59 | 16 |
| Clsd tx vert body fx without manip req &w/csting/bracing CPT 22310 | $756.75 | $1,009.00 | $239.22 – $430.59 | 16 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $342.00 | $456.00 | $239.22 – $430.59 | 16 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | $259.50 | $346.00 | $239.22 – $430.59 | 16 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $1,513.50 | $2,018.00 | $1,559.43 – $2,806.97 | 16 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $279.00 | $372.00 | $239.22 – $430.59 | 16 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $342.75 | $457.00 | $239.22 – $430.59 | 16 |
| Clsd tx/metacar/interphal artic fx 26740 CPT 26740 | $529.50 | $706.00 | $239.22 – $430.59 | 16 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $350.25 | $467.00 | $239.22 – $430.59 | 16 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $426.00 | $568.00 | $239.22 – $430.59 | 16 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $3,064.50 | $4,086.00 | $3,215.33 – $5,787.60 | 16 |
| Clsd tx/prox/mid phalnx fx/no manp 26720 CPT 26720 | $260.25 | $347.00 | $239.22 – $430.59 | 16 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $1,513.50 | $2,018.00 | $1,559.43 – $2,806.97 | 16 |
| Clsd tx/ulnar shaft fx without manip 25530 CPT 25530 | $370.50 | $494.00 | $239.22 – $430.59 | 16 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $600.00 | $800.00 | $239.22 – $430.59 | 16 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $1,815.75 | $2,421.00 | $1,559.43 – $2,806.97 | 16 |
| Cltx mndblr fx ntrdntl fixj CPT 21453 | $5,658.00 | $7,544.00 | $5,741.05 – $10,333.89 | 16 |
| Cltx mndblr fx w/mnpj CPT 21451 | $1,463.25 | $1,951.00 | $1,504.73 – $2,708.51 | 16 |
| Cltx mndblr/max alv ridge fx CPT 21440 | $3,600.75 | $4,801.00 | $3,215.33 – $5,787.60 | 16 |
| Cltx palatal/max fx wire fix CPT 21421 | $3,162.00 | $4,216.00 | $3,215.33 – $5,787.60 | 16 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | $1,815.75 | $2,421.00 | $1,559.43 – $2,806.97 | 16 |
| Cmptr ophth img optic nerve CPT 92133 | $130.50 | $174.00 | $57.21 – $102.98 | 16 |
| Cmv pcr-sendout CPT 87496 | $501.00 | $668.00 | $35.09 – $63.16 | 17 |
| Co-treatment - group 15 mins, st CPT 92508 | $108.00 | $144.00 | $22.95 – $41.30 | 16 |
| Co2 monitor per day CPT 94681 | $337.50 | $450.00 | $361.89 – $651.40 | 16 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $16,994.46 | $22,659.27 | $2.64 – $6.43 | 17 |
| Coagulation time activated teg CPT 85347 | $63.75 | $85.00 | $4.28 – $7.70 | 17 |
| Cold agglutinin titer CPT 86157 | $119.25 | $159.00 | $8.06 – $14.51 | 17 |
| Colistimethate sodium inj HCPCS J0770 | $39.42 | $52.56 | $27.70 – $125.28 | 2 |
| Collagenase, clost hist inj HCPCS J0775 | $26,281.91 | $35,042.54 | $78.35 – $178.07 | 17 |
| Collar cerv adlt perfit ace extric HCPCS L0140 | $29.25 | $38.99 | $98.08 – $176.54 | 16 |
| Collar cerv ascend 172 reg HCPCS L0172 | $318.51 | $424.68 | $194.52 – $350.14 | 16 |
| Collection blood specimen from completely implantable venous access device CPT 36591 | $131.25 | $175.00 | $129.03 – $232.25 | 16 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $255.00 | $340.00 | $129.03 – $232.25 | 16 |
| Collection of venous blood by venipuncture CPT 36415 | $24.75 | $33.00 | $3.39 – $16.81 | 17 |
| Colonoscopy (diagnostic) CPT 45378 | $2,029.50 | $2,706.00 | $901.87 – $1,623.37 | 16 |
| Colonoscopy (with biopsy) CPT 45380 | $1,800.75 | $2,401.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy (with polyp removal) CPT 45385 | $1,875.00 | $2,500.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah) CPT 45384 | $2,568.00 | $3,424.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy flex with decompression 45393 CPT 45393 | $1,946.25 | $2,595.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy for foreign body CPT 44390 | $1,861.50 | $2,482.00 | $901.87 – $1,623.37 | 16 |
| Colonoscopy stoma w/endo mucosal rescj 44403 CPT 44403 | $1,139.25 | $1,519.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy stoma w/snare 44394 CPT 44394 | $1,139.25 | $1,519.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy submucous njx CPT 45381 | $1,865.25 | $2,487.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy thru stoma spx CPT 44388 | $883.50 | $1,178.00 | $901.87 – $1,623.37 | 16 |
| Colonoscopy w/ablation CPT 45388 | $2,571.00 | $3,428.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy w/balloon dilat CPT 45386 | $1,146.75 | $1,529.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy w/band ligation CPT 45398 | $1,946.25 | $2,595.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy w/control bleed CPT 45382 | $1,909.50 | $2,546.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy w/dilation CPT 44405 | $1,439.25 | $1,919.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy w/endoscope Ultrasound CPT 45391 | $2,496.00 | $3,328.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy w/endoscopic fnb CPT 45392 | $2,496.00 | $3,328.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy w/fb removal CPT 45379 | $2,370.75 | $3,161.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy w/injection CPT 44404 | $1,439.25 | $1,919.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy w/ndl aspir/bx CPT 44407 | $1,439.25 | $1,919.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy w/resection CPT 45390 | $2,712.75 | $3,617.00 | $2,691.84 – $4,845.30 | 16 |
| Colonoscopy w/stent plcmt CPT 44402 | $1,439.25 | $1,919.00 | $5,887.56 – $10,597.60 | 16 |
| Colonoscopy w/ultrasound CPT 44406 | $1,439.25 | $1,919.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy with ablation CPT 44401 | $1,617.00 | $2,156.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy with biopsy CPT 44389 | $1,139.25 | $1,519.00 | $1,160.50 – $2,088.91 | 16 |
| Colonoscopy/w endoscopic stent 45389 CPT 45389 | $6,714.00 | $8,952.00 | $5,887.56 – $10,597.60 | 16 |
| Colposcopy vulva 56820 CPT 56820 | $489.00 | $652.00 | $196.07 – $352.92 | 16 |
| Colposcopy w/biopsy of cervix 57455 CPT 57455 | $1,147.50 | $1,530.00 | $295.53 – $531.95 | 16 |
| Colposcopy/cervix/ conization 57461 CPT 57461 | $4,866.75 | $6,489.00 | $3,139.36 – $5,650.86 | 16 |
| Colposcopy/cervix/bx vagina/cervix 57421 CPT 57421 | $1,446.00 | $1,928.00 | $893.23 – $1,607.82 | 16 |
| Colposcopy/cervix/inc up/adjacent vag 57452 CPT 57452 | $851.25 | $1,135.00 | $196.07 – $352.92 | 16 |
| Comp cystometrogram/void presssure 51728 CPT 51728 | $668.25 | $891.00 | $676.24 – $1,217.23 | 16 |
| Comp cystometrogram/void/uret pres 51729 CPT 51729 | $1,216.50 | $1,622.00 | $676.24 – $1,217.23 | 16 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $125.25 | $167.00 | $165.22 – $297.40 | 16 |
| Compatibility test each unit electronic CPT 86923 | $317.25 | $423.00 | $165.22 – $297.40 | 16 |
| Compatibility test each unit immediate spin technique CPT 86920 | $293.25 | $391.00 | $165.22 – $297.40 | 16 |
| Complement antigen each component c3 CPT 86160 | $489.00 | $652.00 | $12.00 – $21.60 | 17 |
| Complex cystometrogram 51726 CPT 51726 | $239.25 | $319.00 | $242.30 – $436.15 | 16 |
| Complex uroflowmetry (electronic) 51741 CPT 51741 | $468.00 | $624.00 | $209.40 – $376.92 | 16 |
| Complx repair enel 1.1-2.5 cm 13151 CPT 13151 | $3,168.00 | $4,224.00 | $716.75 – $1,290.15 | 16 |
| Complx repair enel 2.6-7.5 cm 13152 CPT 13152 | $3,255.75 | $4,341.00 | $716.75 – $1,290.15 | 16 |
| Complx repair enel addl 5cm/< 13153 CPT 13153 | $424.50 | $566.00 | $180.49 – $324.87 | 16 |
| Complx repair fccmnaxghf 13131 CPT 13131 | $357.75 | $477.00 | $394.24 – $709.63 | 16 |
| Complx repair fccmnaxghf 13132 CPT 13132 | $884.25 | $1,179.00 | $394.24 – $709.63 | 16 |
| Complx repair fccmnaxghf 13133 CPT 13133 | $282.00 | $376.00 | $160.47 – $288.84 | 16 |
| Complx repair sal addl 5 cm/> 13122 CPT 13122 | $2,126.25 | $2,835.00 | $121.84 – $219.30 | 16 |
| Computed tomographic angiography head and neck with contrast CPT 70471 | $1,899.75 | $2,533.00 | $338.34 – $609.01 | 16 |
| Concentration infection agents any type CPT 87015 | $27.75 | $37.00 | $6.68 – $12.02 | 17 |
| Conditioning play audiometry 92582 CPT 92582 | $123.00 | $164.00 | $124.79 – $224.62 | 16 |
| Condylomata destruction 56420 CPT 56420 | $1,000.50 | $1,334.00 | $196.07 – $352.92 | 16 |
| Conization of cervix CPT 57520 | $9,071.25 | $12,095.00 | $3,139.36 – $5,650.86 | 16 |
| Conization/cerv/loop electrode exc 57522 CPT 57522 | $4,198.50 | $5,598.00 | $3,139.36 – $5,650.86 | 16 |
| Conjugated estrogens 25 mg solution for injection HCPCS J1410 | $1,291.95 | $1,722.60 | $391.72 – $951.06 | 17 |
| Connect omega .5mm HCPCS L8613 | $1,185.42 | $1,580.55 | $419.73 – $755.51 | 16 |
| Connector tis 2x10mm HCPCS C9352 | $7,960.44 | $10,613.91 | not published | 0 |
| Consultation pathology during surgery CPT 88329 | $141.75 | $189.00 | $57.21 – $102.98 | 16 |
| Consultation pathology during surgery cytological exam initial site CPT 88333 | $1,059.75 | $1,413.00 | $781.35 – $1,406.43 | 16 |
| Consultation pathology during surgery frozen section each additional block CPT 88332 | $122.25 | $163.00 | $50.54 – $90.97 | 16 |
| Consultation pathology during surgery frozen section first tissue block CPT 88331 | $126.00 | $168.00 | $165.22 – $297.40 | 16 |
| Cont intraop neuro monitor HCPCS G0453 | $335.25 | $447.00 | $26.91 – $48.43 | 16 |
| Contrast exam abdominl aorta 75625-26 CPT 75625 | $3,006.75 | $4,009.00 | $3,062.12 – $5,511.82 | 17 |
| Contrast exam thoracic aorta 75605-26 CPT 75605 | $8,066.25 | $10,755.00 | $5,396.44 – $9,713.59 | 17 |
| Contrast x-ray of ankle CPT 73615 | $1,136.25 | $1,515.00 | $338.34 – $642.95 | 17 |
| Contrast x-ray of elbow CPT 73085 | $1,155.00 | $1,540.00 | $338.34 – $642.95 | 17 |
| Contrast x-ray of hip CPT 73525 | $506.25 | $675.00 | $338.34 – $642.95 | 17 |
| Contrast x-ray of knee joint CPT 73580 | $686.25 | $915.00 | $338.34 – $642.95 | 17 |
| Contrast x-ray of wrist CPT 73115 | $417.75 | $557.00 | $338.34 – $609.01 | 17 |
| Control nosebleed pack+caut 30905 CPT 30905 | $473.25 | $631.00 | $129.03 – $232.25 | 16 |
| Control of nosebleed ant comp 30903 CPT 30903 | $162.00 | $216.00 | $129.03 – $232.25 | 16 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $150.75 | $201.00 | $129.03 – $232.25 | 16 |
| Controler lvad heartmate 3 includes ebb HCPCS Q0481 | $13,218.75 | $17,625.00 | $21,317.37 – $38,371.27 | 16 |
| Controller infinity pt dbs HCPCS C1787 | $10,901.25 | $14,535.00 | not published | 0 |
| Conv gtube to jtube CPT 44373 | $2,011.50 | $2,682.00 | $1,860.96 – $3,349.72 | 16 |
| Conversion ext bil drg cath CPT 47535 | $8,671.50 | $11,562.00 | $3,472.27 – $6,250.09 | 16 |
| Convert nephrostomy catheter CPT 50434 | $5,360.25 | $7,147.00 | $2,027.25 – $3,649.06 | 16 |
| Coombs direct CPT 86880 | $97.50 | $130.00 | $7.51 – $102.98 | 17 |
| Coombs indirect qualitative each reagent red cell reference CPT 86885 | $214.50 | $286.00 | $7.99 – $297.40 | 17 |
| Coombs indirect titer reference CPT 86886 | $186.75 | $249.00 | $7.22 – $297.40 | 17 |
| Copper intrauterine device HCPCS J7300 | $4,211.46 | $5,615.27 | $11,718.00 – $11,718.00 | 1 |
| Core ndl bx lng/med perq CPT 32408 | $1,428.00 | $1,904.00 | $1,601.72 – $2,883.09 | 16 |
| Cornea pre-cut midwest eye cornea pre-cut midwest eye HCPCS V2785 | $9,900.00 | $13,200.00 | not published | 0 |
| Coronary angio/cath placement bypass graft/lv gram/lt heart CPT 93459 | $10,920.00 | $14,560.00 | $3,144.03 – $5,659.25 | 16 |
| Coronary angio/lv gram/lt heart CPT 93458 | $8,016.75 | $10,689.00 | $3,144.03 – $5,659.25 | 16 |
| Coronary angio/lv gram/rt< heart CPT 93460 | $9,322.50 | $12,430.00 | $3,144.03 – $5,659.25 | 16 |
| Coronary art/grft angio s&i CPT 93455 | $8,006.25 | $10,675.00 | $3,144.03 – $5,659.25 | 16 |
| Coronary catheterization w/angiography supervision & interpretation CPT 93454 | $6,600.00 | $8,800.00 | $3,144.03 – $5,659.25 | 16 |
| Correct skin color 6.0 cm/< CPT 11920 | $876.00 | $1,168.00 | $716.75 – $1,290.15 | 16 |
| Cortisol acth stimulation test - sendout CPT 80400 | $66.00 | $88.00 | $32.62 – $58.72 | 17 |
| Cortisol total am CPT 82533 | $162.00 | $216.00 | $16.30 – $29.34 | 17 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $296.55 | $395.39 | $68.20 – $243.99 | 2 |
| Counseling smoke cess interm >10mins CPT 99407 | $174.75 | $233.00 | $36.34 – $65.41 | 16 |
| Coveredge 32 lead kit 40cm 48 HCPCS C1897 | $8,100.00 | $10,800.00 | not published | 0 |
| Crbrospnl fld flw imag cistern CPT 78630 | $904.50 | $1,206.00 | $526.57 – $947.83 | 17 |
| Creatine - sendout CPT 82540 | $52.50 | $70.00 | $4.64 – $8.35 | 17 |
| Creatine kinase CPT 82550 | $60.75 | $81.00 | $6.51 – $11.72 | 17 |
| Creatine kinase isoenzymes CPT 82552 | $47.25 | $63.00 | $13.39 – $24.10 | 17 |
| Creatine kinase mb CPT 82553 | $93.75 | $125.00 | $11.55 – $20.79 | 17 |
| Creatinine CPT 82565 | $44.25 | $59.00 | $5.12 – $9.22 | 17 |
| Creatinine 24 hour urine CPT 82570 | $51.75 | $69.00 | $5.18 – $9.32 | 17 |
| Creatinine clearance urine CPT 82575 | $151.50 | $202.00 | $9.46 – $17.03 | 17 |
| Critical care 30-74 minutes CPT 99291 | $1,246.50 | $1,662.00 | $801.08 – $1,441.95 | 16 |
| Critical care each additional 30 minutes CPT 99292 | $357.75 | $477.00 | $129.55 – $233.20 | 16 |
| Crizanlizumab-tmca 10 mg/ml intravenous solution HCPCS J0791 | $9,069.75 | $12,093.00 | $129.94 – $315.37 | 17 |
| Cromolyn sodium noncomp unit HCPCS J7631 | $48.14 | $64.18 | $0.68 – $9.27 | 2 |
| Crotalidae poly immune fab HCPCS J0840 | not published | not published | $4,529.99 – $4,529.99 | 1 |
| Crtj pericardial window/prtl resecj w/drg/bx CPT 33025 | $4,747.50 | $6,330.00 | $723.26 – $1,301.87 | 16 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $40.50 | $54.00 | $14.14 – $25.45 | 17 |
| Cryoprecipitate each unit HCPCS P9012 | $182.25 | $243.00 | $71.95 – $129.51 | 16 |
| Cryosurgery penis lesion(s) 54056 CPT 54056 | $192.00 | $256.00 | $194.58 – $350.24 | 16 |
| Cryptococcus abs qn - sendout CPT 86641 | $184.50 | $246.00 | $14.41 – $25.94 | 17 |
| Crystal identification light microscopy CPT 89060 | $39.75 | $53.00 | $7.33 – $13.19 | 17 |
| Csf leakage imaging CPT 78650 | $1,371.75 | $1,829.00 | $1,255.55 – $2,259.99 | 17 |
| Cta abdomen without & /or w/contrast CPT 74175 | $1,899.75 | $2,533.00 | $170.10 – $306.19 | 16 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $1,899.75 | $2,533.00 | $170.10 – $306.19 | 16 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $1,899.75 | $2,533.00 | $170.10 – $306.19 | 16 |
| Cta neck without &/or w/contrast CPT 70498 | $1,899.75 | $2,533.00 | $170.10 – $306.19 | 16 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $2,025.75 | $2,701.00 | $170.10 – $306.19 | 16 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $226.50 | $302.00 | $229.70 – $413.45 | 16 |
| Culture aerobic additional method definitive id each CPT 87077 | $81.00 | $108.00 | $8.08 – $14.54 | 17 |
| Culture afb any source CPT 87116 | $159.00 | $212.00 | $10.80 – $19.44 | 17 |
| Culture anaerobic except blood CPT 87075 | $182.25 | $243.00 | $9.47 – $17.05 | 17 |
| Culture body fluid CPT 87070 | $126.00 | $168.00 | $8.62 – $15.52 | 17 |
| Culture fungi definitive id mold CPT 87107 | $66.00 | $88.00 | $10.32 – $18.58 | 17 |
| Culture fungi definitive id yeast CPT 87106 | $46.50 | $62.00 | $10.32 – $18.58 | 17 |
| Culture fungi other (except blood) CPT 87102 | $130.50 | $174.00 | $8.41 – $15.14 | 17 |
| Culture fungi skin/hair/nail CPT 87101 | $90.75 | $121.00 | $7.71 – $13.88 | 17 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $84.75 | $113.00 | $14.61 – $26.30 | 17 |
| Culture mycoplasma any source CPT 87109 | $130.50 | $174.00 | $15.39 – $27.70 | 17 |
| Culture quantitative aerobic other source CPT 87071 | $82.50 | $110.00 | $9.89 – $17.80 | 17 |
| Culture screening strep group a CPT 87081 | $108.00 | $144.00 | $6.63 – $11.93 | 17 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $408.75 | $545.00 | $218.06 – $392.51 | 16 |
| Cutter lead HCPCS C1773 | $22,020.89 | $29,361.18 | not published | 0 |
| Cv line/pic reposition CPT 36597 | $1,629.75 | $2,173.00 | $1,526.62 – $2,747.91 | 16 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $25.86 | $34.47 | $2.29 – $12.96 | 2 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $60.75 | $81.00 | $14.32 – $25.78 | 17 |
| Cyclic citrullinated peptide antibody CPT 86200 | $178.50 | $238.00 | $12.95 – $23.31 | 17 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $4,143.90 | $5,525.20 | $0.77 – $1.39 | 16 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $2,769.06 | $3,692.08 | $4.82 – $5.58 | 2 |
| Cyclosporine 2 hour CPT 80158 | $96.00 | $128.00 | $18.05 – $32.49 | 17 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $243.99 | $325.31 | $176.90 – $555.21 | 2 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $470.55 | $627.40 | $1.85 – $7.56 | 2 |
| Cyclosporine oral 100 mg HCPCS J7502 | $2,865.39 | $3,820.51 | $5.01 – $20.34 | 2 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $42,849.57 | $57,132.75 | not published | 0 |
| Cyp2c19 gene com variants CPT 81225 | $613.50 | $818.00 | $291.36 – $524.45 | 17 |
| Cyp2c9 gene com variants CPT 81227 | $368.25 | $491.00 | $174.81 – $314.66 | 17 |
| Cyp2d6 gene com variants CPT 81226 | $949.50 | $1,266.00 | $450.91 – $811.64 | 17 |
| Cyp3a4 gene common variants CPT 81230 | $328.50 | $438.00 | $174.81 – $314.66 | 17 |
| Cyp3a5 gene common variants CPT 81231 | $328.50 | $438.00 | $174.81 – $314.66 | 17 |
| Cystatin c CPT 82610 | $61.50 | $82.00 | $18.52 – $33.34 | 17 |
| Cystic fibrosis cftr CPT 81223 | $6,271.50 | $8,362.00 | $499.00 – $898.20 | 17 |
| Cystine urine quantitative CPT 82131 | $171.75 | $229.00 | $22.98 – $41.36 | 17 |
| Cysto/uretero w/lithotripsy CPT 52356 | $17,490.00 | $23,320.00 | $5,199.87 – $9,359.77 | 16 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $633.00 | $844.00 | $338.34 – $609.01 | 17 |
| Cystoscopy & ureter catheter CPT 52005 | $1,997.25 | $2,663.00 | $2,027.25 – $3,649.06 | 16 |
| Cystoscopy (Bladder Scope) CPT 52000 | $2,335.50 | $3,114.00 | $676.24 – $1,217.23 | 16 |
| Cystoscopy and treatment CPT 52310 | $1,579.50 | $2,106.00 | $2,027.25 – $3,649.06 | 16 |
| Cystoscopy chemodenervation CPT 52287 | $322.50 | $430.00 | $2,027.25 – $3,649.06 | 16 |
| Cystouretero w/lithotripsy CPT 52353 | $11,789.25 | $15,719.00 | $5,199.87 – $9,359.77 | 16 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $64.71 | $86.28 | $1.95 – $8.73 | 2 |
| Cytogenetics 25-99 CPT 88274 | $188.25 | $251.00 | $42.38 – $76.28 | 17 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $100.50 | $134.00 | $14.39 – $25.90 | 17 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $113.25 | $151.00 | $16.85 – $30.33 | 17 |
| Cytomegalovirus imm IV /vial HCPCS J0850 | $6,333.64 | $8,444.85 | $1,808.61 – $4,404.18 | 17 |
| Cytopath smear other source CPT 88160 | $82.50 | $110.00 | $28.05 – $50.49 | 16 |
| Cytopath tbs c/v manual CPT 88164 | $168.75 | $225.00 | $16.55 – $33.37 | 17 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $240.75 | $321.00 | $50.54 – $90.97 | 16 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $153.00 | $204.00 | $26.61 – $47.90 | 17 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $195.75 | $261.00 | $20.26 – $36.47 | 17 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $67.50 | $90.00 | $36.22 – $65.20 | 16 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $111.00 | $148.00 | $36.22 – $65.20 | 16 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $141.00 | $188.00 | $165.22 – $297.40 | 16 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $163.50 | $218.00 | $50.54 – $90.97 | 16 |
| Cytotoxic antibody screening CPT 86808 | $363.75 | $485.00 | $29.68 – $53.42 | 17 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $907.50 | $1,210.00 | $165.22 – $297.40 | 16 |
| D&c after delivery 59160 CPT 59160 | $792.00 | $1,056.00 | $3,139.36 – $5,650.86 | 16 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | $358.50 | $478.00 | $3,139.36 – $5,650.86 | 16 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $53.55 | $71.39 | $9.27 – $33.57 | 2 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $10,014.84 | $13,353.11 | $337.67 – $737.31 | 17 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $6,061.91 | $8,082.54 | $15.00 – $37.85 | 17 |
| Dalteparin sodium HCPCS J1645 | not published | not published | $43.91 – $43.91 | 1 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | not published | not published | $0.07 – $0.07 | 1 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $38,894.03 | $51,858.70 | $55.03 – $133.04 | 17 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $5,546.48 | $7,395.30 | $3.07 – $7.28 | 17 |
| Darbepoetin alfa, esrd use HCPCS J0882 | not published | not published | $7.28 – $7.28 | 1 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | $38,568.63 | $51,424.83 | $261.20 – $620.89 | 17 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $300.73 | $400.97 | $48.10 – $321.03 | 2 |
| Dch glucoscan CPT 82948 | $19.50 | $26.00 | $5.04 – $9.07 | 17 |
| Dch pulmonary stress test CPT 94621 | $1,923.75 | $2,565.00 | $361.89 – $651.40 | 16 |
| Dch validity tests CPT 81002 | $18.00 | $24.00 | $3.48 – $6.26 | 17 |
| Dcm pq ndl dsk sgl/mlt lv lmbr w/guide CPT 62287 | $1,809.00 | $2,412.00 | $1,893.75 – $3,408.76 | 16 |
| Deamidated gliadin antibody iga CPT 86258 | $30.00 | $40.00 | $12.05 – $21.69 | 16 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $997.50 | $1,330.00 | $716.75 – $1,290.15 | 16 |
| Debride nail1-5 11720 CPT 11720 | $222.75 | $297.00 | $57.21 – $102.98 | 16 |
| Debride nail6 or more 11721 CPT 11721 | $308.25 | $411.00 | $57.21 – $102.98 | 16 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $798.75 | $1,065.00 | $39.76 – $71.58 | 16 |
| Debridement (>20 cm) charge pt CPT 97598 | $319.50 | $426.00 | $45.22 – $81.40 | 16 |
| Debridement bone <= 20 sq cm CPT 11044 | $3,915.75 | $5,221.00 | $1,601.72 – $2,883.09 | 16 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $778.50 | $1,038.00 | $394.24 – $709.63 | 16 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $915.75 | $1,221.00 | $73.34 – $132.02 | 16 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $2,160.00 | $2,880.00 | $123.63 – $222.54 | 16 |
| Decalcification CPT 88311 | $35.25 | $47.00 | $18.72 – $33.70 | 16 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $634.17 | $845.55 | $3.87 – $15.21 | 2 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $609.75 | $813.00 | $320.33 – $576.59 | 16 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $102.84 | $137.12 | $21.93 – $77.40 | 2 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $3,396.16 | $4,528.21 | $4.46 – $10.59 | 17 |
| Delivery of placenta 59414 CPT 59414 | $924.75 | $1,233.00 | $3,139.36 – $5,650.86 | 16 |
| Delivery transcath fxtn dvc to endogrft w/s&i CPT 34712 | $6,758.25 | $9,011.00 | $585.43 – $1,053.78 | 16 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $196.50 | $262.00 | $212.36 – $382.26 | 16 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $12,371.55 | $16,495.39 | $29.51 – $71.15 | 17 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $168.00 | $224.00 | $129.03 – $232.25 | 16 |
| Depo-estradiol cypionate inj HCPCS J1000 | not published | not published | $114.18 – $114.18 | 1 |
| Dermagraft HCPCS Q4106 | $100.50 | $134.00 | $109.38 – $404.46 | 2 |
| Des thora aorta rpr without left sub art 33881 CPT 33881 | $6,309.00 | $8,412.00 | $1,068.08 – $1,922.55 | 16 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $172.46 | $229.94 | $9.47 – $56.97 | 2 |
| Desoxycorticosterone CPT 82633 | $84.00 | $112.00 | $30.98 – $55.76 | 17 |
| Destroy cervthor facet jnt 64633 CPT 64633 | $1,967.25 | $2,623.00 | $1,893.75 – $3,408.76 | 16 |
| Destroy cth facet jnt addl 64634 CPT 64634 | $1,535.25 | $2,047.00 | $247.48 – $445.46 | 16 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | $199.50 | $266.00 | $194.58 – $350.24 | 16 |
| Destroy vulva lesion simple 56501 CPT 56501 | $3,215.25 | $4,287.00 | $2,000.97 – $3,601.74 | 16 |
| Destruct ben lesion 15/> 17111 CPT 17111 | $228.00 | $304.00 | $194.58 – $350.24 | 16 |
| Destruction 2-14 lesions 17003 CPT 17003 | $83.25 | $111.00 | $5.91 – $10.64 | 16 |
| Destruction anal lesion(s) CPT 46910 | $1,783.50 | $2,378.00 | $2,000.97 – $3,601.74 | 16 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | $468.00 | $624.00 | $394.24 – $709.63 | 16 |
| Destruction benign lesions < 14 lesions CPT 17110 | $268.50 | $358.00 | $194.58 – $350.24 | 16 |
| Destruction by injection tx of nerve 64630 CPT 64630 | $2,203.50 | $2,938.00 | $857.76 – $1,543.97 | 16 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $2,343.75 | $3,125.00 | $1,893.75 – $3,408.76 | 16 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $1,463.25 | $1,951.00 | $233.26 – $419.87 | 16 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | $1,170.00 | $1,560.00 | $394.24 – $709.63 | 16 |
| Detect agnt mult dna direc CPT 87800 | $115.50 | $154.00 | $43.67 – $78.61 | 17 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | $183.00 | $244.00 | $54.70 – $98.46 | 16 |
| Devel tst phys/qhp 1st hr CPT 96112 | $439.50 | $586.00 | $124.79 – $224.62 | 16 |
| Device ablt adv novasure HCPCS C1886 | $11,239.88 | $14,986.50 | not published | 0 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $5,175.00 | $6,900.00 | not published | 0 |
| Device intraute mirena HCPCS J7298 | $4,491.10 | $5,988.13 | $12,493.35 – $12,493.35 | 1 |
| Device sut capio slim opn HCPCS C2631 | $1,454.07 | $1,938.75 | not published | 0 |
| Device tiss remov myosure reach HCPCS C1782 | $1,070.85 | $1,427.80 | not published | 0 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $412.50 | $550.00 | $84.40 – $151.91 | 17 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $247.00 – $247.00 | 1 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $3,070.25 – $3,070.25 | 1 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $554.26 | $739.01 | $0.02 – $0.72 | 2 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $16.28 | $21.70 | $0.27 – $1.08 | 2 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $499.63 – $499.63 | 1 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $465.34 | $620.45 | $49.74 – $89.53 | 17 |
| Dextran 40 infusion HCPCS J7100 | $225.55 | $300.73 | $68.78 – $421.65 | 2 |
| Dextrose 5 % IV bolus HCPCS J7070 | $22.19 | $29.58 | $7.40 – $34.74 | 2 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $22.19 | $29.58 | $3.29 – $14.31 | 2 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $22.19 | $29.58 | $53.55 – $53.55 | 1 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $36.98 | $49.30 | $4.92 – $17.37 | 2 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $204.00 | $272.00 | $22.23 – $40.01 | 17 |
| Diab manage trn ind/group HCPCS G0109 | $57.75 | $77.00 | $15.40 – $27.71 | 16 |
| Diabetes (HbA1c) Test CPT 83036 | $89.25 | $119.00 | $9.71 – $17.48 | 17 |
| Diag bronchoscope/catheter CPT 31643 | $2,379.00 | $3,172.00 | $1,726.15 – $3,107.06 | 16 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $524.25 | $699.00 | $146.43 – $263.57 | 16 |
| Diagnostic Mammogram (one breast) CPT 77065 | $418.50 | $558.00 | $115.62 – $208.12 | 16 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $249.00 | $332.00 | $129.03 – $232.25 | 16 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $196.50 | $262.00 | not published | 0 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $164.25 | $219.00 | not published | 0 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $422.25 | $563.00 | $193.58 – $348.44 | 16 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $58.24 | $77.65 | $0.17 – $0.72 | 2 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $143.84 | $191.78 | $15.02 – $49.23 | 2 |
| Dicyclomine injection HCPCS J0500 | $310.41 | $413.88 | $28.40 – $224.73 | 2 |
| Diffusing capacity CPT 94729 | $211.50 | $282.00 | $58.56 – $105.40 | 16 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $472.14 | $629.51 | $9.74 – $84.69 | 2 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $17,050.66 | $22,734.21 | $5,166.99 – $12,093.52 | 17 |
| Digoxin total therapeutic drug level CPT 80162 | $104.25 | $139.00 | $13.28 – $23.90 | 17 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $297.86 | $397.14 | $236.27 – $381.06 | 2 |
| Dilate esophagus 1/mult pass CPT 43450 | $1,208.25 | $1,611.00 | $879.59 – $1,583.27 | 16 |
| Dilation of rectal stricture 45910 CPT 45910 | $1,146.00 | $1,528.00 | $1,160.50 – $2,088.91 | 16 |
| Dilator fascial 10fx20cm HCPCS C2627 | $291.87 | $389.16 | not published | 0 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $107.23 | $142.97 | not published | 0 |
| Dimenhydrinate injection HCPCS J1240 | $17.32 | $23.09 | $18.84 – $80.55 | 2 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $2,501.55 | $3,335.40 | $748.98 – $1,808.19 | 17 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $36.98 | $49.30 | $11.43 – $11.43 | 1 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $5.92 | $7.89 | $2.19 – $7.20 | 2 |
| Disability dlco CPT 94727 | $207.75 | $277.00 | $209.40 – $376.92 | 16 |
| Disaccharidases CPT 82657 | $1,265.25 | $1,687.00 | $22.17 – $39.91 | 17 |
| Discography cerv/thor spine CPT 72285 | $2,062.50 | $2,750.00 | $1,893.75 – $3,408.76 | 17 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $3,828.75 | $5,105.00 | $262.85 – $473.13 | 16 |
| Dmd dup/delet analysis CPT 81161 | $2,106.00 | $2,808.00 | $279.00 – $502.20 | 17 |
| Dmpk gene detc abnor allele CPT 81234 | $442.50 | $590.00 | $137.00 – $246.60 | 16 |
| Dna antibody native/double stranded CPT 86225 | $135.75 | $181.00 | $13.74 – $24.73 | 17 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $130.35 | $173.79 | $19.40 – $88.65 | 2 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $1,164.72 | $1,552.95 | $0.90 – $9.00 | 2 |
| Dolasetron mesylate HCPCS J1260 | not published | not published | $15.12 – $15.12 | 1 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $98.91 | $131.88 | $1.58 – $6.93 | 2 |
| Doppler echo complete CPT 93320 | $443.25 | $591.00 | $48.10 – $86.58 | 16 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $1,826.25 | $2,435.00 | not published | 0 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $591.00 | $788.00 | $209.40 – $376.92 | 16 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $358.50 | $478.00 | $129.03 – $232.25 | 16 |
| Dornase alfa non-comp unit HCPCS J7639 | $479.80 | $639.73 | $134.24 – $468.72 | 2 |
| Dornhoffer fixed part w/window HCPCS L8614 | $77,636.25 | $103,515.00 | $28,368.90 – $51,064.02 | 16 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | not published | not published | $593.46 – $593.46 | 1 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $901.65 | $1,202.19 | $6.62 – $29.52 | 2 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | not published | not published | $265.99 – $265.99 | 1 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $89.34 | $119.11 | not published | 0 |
| Dpyd gene common variants CPT 81232 | $354.00 | $472.00 | $174.81 – $314.66 | 17 |
| Drain blood from under nail 11740 CPT 11740 | $435.00 | $580.00 | $129.03 – $232.25 | 16 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $3,169.50 | $4,226.00 | $1,601.72 – $2,883.09 | 16 |
| Drain cath image guided visceral pq CPT 49405 | $3,458.25 | $4,611.00 | $1,601.72 – $2,883.09 | 16 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $977.25 | $1,303.00 | $684.56 – $1,232.21 | 16 |
| Drain finger abscess;simple 26010 CPT 26010 | $190.50 | $254.00 | $194.58 – $350.24 | 16 |
| Drain lower leg lesion 27603 CPT 27603 | $3,269.25 | $4,359.00 | $2,816.99 – $5,070.59 | 16 |
| Drain neck/chest lesion 21501 CPT 21501 | $2,745.00 | $3,660.00 | $2,816.99 – $5,070.59 | 16 |
| Drain ovarn cyst abd CPT 58805 | $3,572.25 | $4,763.00 | $3,139.36 – $5,650.86 | 16 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $684.00 | $912.00 | $686.75 – $1,236.14 | 16 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $681.00 | $908.00 | $686.75 – $1,236.14 | 16 |
| Drainage external ear complex 69005 CPT 69005 | $4,074.75 | $5,433.00 | $1,601.72 – $2,883.09 | 16 |
| Drainage external ear simple 69000 CPT 69000 | $709.50 | $946.00 | $686.75 – $1,236.14 | 16 |
| Drainage mouth roof lesion CPT 42000 | $235.50 | $314.00 | $229.70 – $413.45 | 16 |
| Drainage of eye CPT 65810 | $2,250.75 | $3,001.00 | $2,238.13 – $4,028.63 | 16 |
| Drainage of kidney lesion CPT 50390 | $2,676.00 | $3,568.00 | $686.75 – $1,236.14 | 16 |
| Drainage of mouth lesion CPT 41008 | $3,108.75 | $4,145.00 | $3,215.33 – $5,787.60 | 16 |
| Drainage of mouth lesion CPT 41017 | $3,288.75 | $4,385.00 | $3,215.33 – $5,787.60 | 16 |
| Drainage of nose lesion int 30000 CPT 30000 | $236.25 | $315.00 | $229.70 – $413.45 | 16 |
| Drainage of nose lesion sept 30020 CPT 30020 | $531.00 | $708.00 | $523.04 – $941.47 | 16 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $639.75 | $853.00 | $394.24 – $709.63 | 16 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $423.75 | $565.00 | $194.58 – $350.24 | 16 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $633.00 | $844.00 | $194.58 – $350.24 | 16 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | $9,875.23 | $13,166.97 | $119.53 – $217.24 | 17 |
| Drng of eyelid abscess 67700 CPT 67700 | $747.00 | $996.00 | $307.82 – $554.08 | 16 |
| Drng of finger abscess comp 26011 CPT 26011 | $1,000.50 | $1,334.00 | $1,601.72 – $2,883.09 | 16 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | $3,624.75 | $4,833.00 | $3,139.36 – $5,650.86 | 16 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,580.25 | $2,107.00 | $1,601.72 – $2,883.09 | 16 |
| Drng salivary gland submax/subling 42310 CPT 42310 | $496.50 | $662.00 | $523.04 – $941.47 | 16 |
| Dronabinol 2.5mg oral HCPCS Q0167 | $1,907.03 | $2,542.70 | $4.06 – $7.29 | 2 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | not published | not published | $13.05 – $13.05 | 1 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $1,956.48 | $2,608.64 | not published | 0 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | not published | not published | $30.13 – $30.13 | 1 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $530.83 | $707.76 | $28.48 – $217.24 | 17 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $983.03 | $1,310.70 | $6.04 – $217.24 | 17 |
| Drsg sht 5.625x4.625in std HCPCS A6025 | $639.00 | $852.00 | not published | 0 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | not published | not published | $41.16 – $41.16 | 1 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $26,932.05 | $35,909.40 | $120.69 – $217.24 | 17 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | $22,027.50 | $29,370.00 | $120.69 – $217.24 | 16 |
| Drug admin & hemodynmic meas CPT 93463 | $1,843.50 | $2,458.00 | $93.63 – $168.54 | 16 |
| Drug assay caffeine CPT 80155 | $42.00 | $56.00 | $38.57 – $69.43 | 17 |
| Drug assay posaconazole CPT 80187 | $186.00 | $248.00 | $27.11 – $48.80 | 16 |
| Drug assay rufinamide CPT 80210 | $135.75 | $181.00 | $27.11 – $48.80 | 16 |
| Drug assay vedolizumab CPT 80280 | $949.50 | $1,266.00 | $38.57 – $69.43 | 16 |
| Drug assay voriconazole CPT 80285 | $186.00 | $248.00 | $27.11 – $48.80 | 16 |
| Drug asy hydroxychloroquine CPT 80220 | $531.75 | $709.00 | $18.64 – $33.55 | 16 |
| Drug of abuse screen urine CPT 80305 | $45.00 | $60.00 | $12.60 – $22.68 | 17 |
| Drug screen quant tiagabine CPT 80199 | $188.25 | $251.00 | $27.11 – $48.80 | 17 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $539.25 | $719.00 | $62.14 – $111.85 | 17 |
| Drvvt confirm - quest CPT 85597 | $195.00 | $260.00 | $17.98 – $32.36 | 17 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $1,746.75 | $2,329.00 | $1,893.75 – $3,408.76 | 16 |
| Ductogram sgl duct CPT 77053 | $691.50 | $922.00 | $231.40 – $416.51 | 16 |
| Duodenal motility study CPT 91022 | $1,347.75 | $1,797.00 | $361.89 – $651.40 | 16 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $747.75 | $997.00 | $101.39 – $182.50 | 16 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $1,150.50 | $1,534.00 | $209.40 – $376.92 | 16 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $576.75 | $769.00 | $231.40 – $416.51 | 16 |
| Duplex scan unilateral study 93986 CPT 93986 | $103.50 | $138.00 | $101.39 – $182.50 | 16 |
| Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm HCPCS Q4432 | $23,482.80 | $31,310.40 | $120.69 – $217.24 | 16 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | not published | not published | $207.50 – $207.50 | 1 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | $153.00 | $204.00 | $124.79 – $224.62 | 16 |
| Dx bronchoscope/brush 31623 CPT 31623 | $1,329.00 | $1,772.00 | $1,726.15 – $3,107.06 | 16 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $1,663.50 | $2,218.00 | $1,726.15 – $3,107.06 | 16 |
| Dx bronchoscope/wash 31622 CPT 31622 | $2,028.75 | $2,705.00 | $1,726.15 – $3,107.06 | 16 |
| Dxa bone density axl vrt fx CPT 77085 | $510.00 | $680.00 | $101.39 – $182.50 | 17 |
| E equine encephalitis igg CPT 86652 | $122.25 | $163.00 | $13.19 – $23.74 | 17 |
| ER Visit (level 1, minor) CPT 99281 | $126.00 | $168.00 | $81.78 – $147.20 | 16 |
| ER Visit (level 2) CPT 99282 | $216.75 | $289.00 | $148.91 – $268.03 | 16 |
| ER Visit (level 3) CPT 99283 | $362.25 | $483.00 | $264.73 – $476.52 | 16 |
| ER Visit (level 4) CPT 99284 | $567.00 | $756.00 | $404.66 – $728.39 | 16 |
| ER Visit (level 5, high severity) CPT 99285 | $890.25 | $1,187.00 | $577.55 – $1,039.58 | 16 |
| Ear irrigation 69209 CPT 69209 | $126.00 | $168.00 | $57.21 – $102.98 | 16 |
| Ecallantide injection HCPCS J1290 | not published | not published | $1,411.67 – $1,411.67 | 1 |
| Ecg 12 lead tracing only CPT 93005 | $167.25 | $223.00 | $57.21 – $102.98 | 16 |
| Ecg < 30 days transmission & analysis CPT 93271 | $581.25 | $775.00 | $92.20 – $165.96 | 16 |
| Ecg external < 48 hours recording CPT 93225 | $280.50 | $374.00 | $129.03 – $232.25 | 16 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $459.00 | $612.00 | $57.21 – $102.98 | 16 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $238.50 | $318.00 | $36.22 – $65.20 | 16 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $238.50 | $318.00 | $36.22 – $65.20 | 16 |
| Echo exam of fetal heart CPT 76825 | $532.50 | $710.00 | $529.91 – $953.84 | 17 |
| Echo exam of fetal heart CPT 76826 | $398.25 | $531.00 | $231.40 – $416.51 | 17 |
| Echo exam of fetal heart CPT 76827 | $479.25 | $639.00 | $101.39 – $182.50 | 17 |
| Echo exam of fetal heart CPT 76828 | $250.50 | $334.00 | $101.39 – $182.50 | 17 |
| Echo exam uterus 76831- CPT 76831 | $595.50 | $794.00 | $231.40 – $416.51 | 17 |
| Echo guide for amniocentesis CPT 76946 | $564.75 | $753.00 | $32.28 – $58.10 | 16 |
| Echo guide for artery repair CPT 76936 | $1,208.25 | $1,611.00 | $209.40 – $376.92 | 17 |
| Echo guide for transfusion CPT 76941 | $303.00 | $404.00 | not published | 0 |
| Echo guide villus sampling CPT 76945 | $574.50 | $766.00 | not published | 0 |
| Echo stress CPT 93350 | $1,369.50 | $1,826.00 | $529.91 – $953.84 | 16 |
| Echo tee guidance CPT 93355 | $2,007.00 | $2,676.00 | $189.62 – $341.31 | 16 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $1,724.25 | $2,299.00 | $529.91 – $953.84 | 16 |
| Echo transesophageal CPT 93315 | $1,626.00 | $2,168.00 | $529.91 – $953.84 | 16 |
| Echo transesophageal intraop CPT 93318 | $523.50 | $698.00 | $529.91 – $953.84 | 16 |
| Echo transthoracic CPT 93303 | $1,142.25 | $1,523.00 | $529.91 – $953.84 | 16 |
| Echo transthoracic CPT 93304 | $693.75 | $925.00 | $529.91 – $953.84 | 16 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $1,137.75 | $1,517.00 | $231.40 – $416.51 | 16 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $1,691.25 | $2,255.00 | $529.91 – $953.84 | 16 |
| Echocardiography doppler color flow mapping CPT 93325 | $485.25 | $647.00 | $21.85 – $39.34 | 16 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $1,691.25 | $2,255.00 | $760.25 – $1,368.44 | 16 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $512.25 | $683.00 | $231.40 – $416.51 | 16 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $512.25 | $683.00 | $338.34 – $609.01 | 16 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $204.00 | $272.00 | $23.64 – $42.56 | 16 |
| Ecmo/ecls daily mgmt artery 33949 CPT 33949 | $1,790.25 | $2,387.00 | $206.33 – $371.39 | 16 |
| Ecmo/ecls daily mgmt-venous 33948 CPT 33948 | $4,324.50 | $5,766.00 | $214.18 – $385.53 | 16 |
| Ecmo/ecls initiation artery 33947 CPT 33947 | $1,826.25 | $2,435.00 | $304.72 – $548.49 | 16 |
| Ecmo/ecls initiation venous 33946 CPT 33946 | $3,767.25 | $5,023.00 | $276.24 – $497.23 | 16 |
| Ecmo/ecls insj prph cannula 6yrs&older perq 33952 CPT 33952 | $9,378.75 | $12,505.00 | $380.18 – $684.32 | 16 |
| Eculizumab 300 mg/30 ml intravenous solution HCPCS J1299 | $22,430.49 | $29,907.31 | $44.70 – $80.46 | 16 |
| Edetate calcium disodium inj HCPCS J0600 | $20,833.61 | $27,778.14 | $6,102.87 – $15,710.40 | 17 |
| Eeg 41-60 minutes 95812-26 CPT 95812 | $1,081.50 | $1,442.00 | $209.40 – $376.92 | 16 |
| Eeg during surgery CPT 95955 | $1,488.75 | $1,985.00 | $183.54 – $330.37 | 16 |
| Eeg monitor/record/awake/drowsy 95816 CPT 95816 | $1,283.25 | $1,711.00 | $209.40 – $376.92 | 16 |
| Eeg monitoring/function test CPT 95958 | $2,440.50 | $3,254.00 | $832.81 – $1,499.05 | 16 |
| Eeg over 1 hour 95813 - 26 CPT 95813 | $1,440.75 | $1,921.00 | $209.40 – $376.92 | 16 |
| Eeg recording awake and asleep CPT 95819 | $1,283.25 | $1,711.00 | $209.40 – $376.92 | 16 |
| Eeg without vid 2-12 hr unmntr CPT 95705 | $303.75 | $405.00 | $209.40 – $376.92 | 16 |
| Eeg without vid 2-12hr cont mntr CPT 95707 | $2,025.00 | $2,700.00 | $209.40 – $376.92 | 16 |
| Eeg without vid ea 12-26hr cont CPT 95710 | $4,050.00 | $5,400.00 | $361.89 – $651.40 | 16 |
| Eeg without vid ea 12-26hr intmt CPT 95709 | $2,361.75 | $3,149.00 | $361.89 – $651.40 | 16 |
| Eeg wo vid 2-12hr intmt mntr CPT 95706 | $1,181.25 | $1,575.00 | $209.40 – $376.92 | 16 |
| Eeg wo vid ea 12-26hr unmntr CPT 95708 | $303.75 | $405.00 | $361.89 – $651.40 | 16 |
| Eeg/cerebral death evaluation only 95824 -26 CPT 95824 | $1,605.75 | $2,141.00 | $361.89 – $651.40 | 16 |
| Eeg/record in coma or sleep only 95822 CPT 95822 | $1,283.25 | $1,711.00 | $209.40 – $376.92 | 16 |
| Egd Ultrasound exam duodenum/jejunum CPT 43259 | $2,562.75 | $3,417.00 | $1,860.96 – $3,349.72 | 16 |
| Egd Ultrasound fine needle bx/aspir CPT 43238 | $3,322.50 | $4,430.00 | $1,860.96 – $3,349.72 | 16 |
| Egd Ultrasound fine needle bx/aspir CPT 43242 | $3,033.00 | $4,044.00 | $1,860.96 – $3,349.72 | 16 |
| Egd Ultrasound transmural injxn/mark CPT 43253 | $3,127.50 | $4,170.00 | $1,860.96 – $3,349.72 | 16 |
| Egd balloon dil esoph30 mm/> CPT 43233 | $1,903.50 | $2,538.00 | $1,860.96 – $3,349.72 | 16 |
| Egd control bleeding any CPT 43255 | $1,987.50 | $2,650.00 | $1,860.96 – $3,349.72 | 16 |
| Egd dilate stricture CPT 43245 | $2,455.50 | $3,274.00 | $1,860.96 – $3,349.72 | 16 |
| Egd endoscopic stent place CPT 43266 | $3,395.25 | $4,527.00 | $5,887.56 – $10,597.60 | 16 |
| Egd esophagogastrc fndoplsty CPT 43210 | $9,945.00 | $13,260.00 | $10,308.81 – $18,555.86 | 16 |
| Egd flx trnsorl rmvl balo CPT 43291 | $876.00 | $1,168.00 | $879.59 – $1,583.27 | 16 |
| Egd guide wire insertion CPT 43248 | $2,250.00 | $3,000.00 | $879.59 – $1,583.27 | 16 |
| Egd injection varices CPT 43243 | $2,004.75 | $2,673.00 | $1,860.96 – $3,349.72 | 16 |
| Egd lesion ablation CPT 43270 | $2,865.00 | $3,820.00 | $1,860.96 – $3,349.72 | 16 |
| Egd remove foreign body CPT 43247 | $2,046.00 | $2,728.00 | $879.59 – $1,583.27 | 16 |
| Egd remove lesion snare CPT 43251 | $1,914.75 | $2,553.00 | $1,860.96 – $3,349.72 | 16 |
| Egd varices ligation CPT 43244 | $2,376.75 | $3,169.00 | $1,860.96 – $3,349.72 | 16 |
| Egd w/thrml txmnt gerd CPT 43257 | $5,043.00 | $6,724.00 | $3,739.04 – $6,730.27 | 16 |
| Egd w/transmural drain cyst CPT 43240 | $5,831.25 | $7,775.00 | $5,887.56 – $10,597.60 | 16 |
| Egd/remov tum/polyp/hot bx forcep 43250 CPT 43250 | $2,198.25 | $2,931.00 | $1,860.96 – $3,349.72 | 16 |
| Ehrlicha chaffeensis amp prb CPT 87484 | $105.00 | $140.00 | $35.09 – $63.16 | 16 |
| Elec analys infus pump w/reprog 62368 CPT 62368 | $300.00 | $400.00 | $297.86 – $536.15 | 16 |
| Elect analysis of infusion pump 62367 CPT 62367 | $508.50 | $678.00 | $297.86 – $536.15 | 16 |
| Electrd sq emblem s-icd HCPCS C1896 | $12,127.50 | $16,170.00 | not published | 0 |
| Electrical stimulation/unattended 97014 CPT 97014 | $109.50 | $146.00 | $12.14 – $21.86 | 16 |
| Electrocorticography durng sx CPT 95829 | $1,450.50 | $1,934.00 | $1,820.56 – $3,277.01 | 16 |
| Electrode stimulation brain CPT 95961 | $1,605.75 | $2,141.00 | $832.81 – $1,499.05 | 16 |
| Electrolyte panel CPT 80051 | $61.50 | $82.00 | $7.01 – $12.62 | 17 |
| Electron microscopy diagnostic CPT 88348 | $2,127.75 | $2,837.00 | $781.35 – $1,406.43 | 16 |
| Electronic analysis with brain program ea add 15 min 95984 CPT 95984 | $513.00 | $684.00 | $43.72 – $78.69 | 16 |
| Electronic analysis with brain program first 15 min 95983 CPT 95983 | $990.75 | $1,321.00 | $92.20 – $165.96 | 16 |
| Electrophysiology evaluation CPT 93620 | $16,433.25 | $21,911.00 | $7,564.11 – $13,615.41 | 16 |
| Electrophysiology evaluation CPT 93641 | $2,056.50 | $2,742.00 | not published | 0 |
| Elosulfase alfa, injection HCPCS J1322 | not published | not published | $746.73 – $746.73 | 1 |
| Elotuzumab 300 mg intravenous solution HCPCS J9176 | $11,443.25 | $15,257.66 | $8.04 – $19.16 | 17 |
| Emb w/colposcopy 58110 CPT 58110 | $1,077.00 | $1,436.00 | $49.28 – $88.71 | 16 |
| Emb without cervical dilation 58100 CPT 58100 | $2,115.00 | $2,820.00 | $196.07 – $352.92 | 16 |
| Embo or occlude vascular arterial s&i CPT 37242 | $25,183.50 | $33,578.00 | $17,778.02 – $32,000.44 | 16 |
| Embo or occlude vascular hemorrhage s&i CPT 37244 | $9,402.75 | $12,537.00 | $11,195.55 – $20,152.00 | 16 |
| Embo or occlude vascular tumor/organ/infarct s&i CPT 37243 | $9,811.50 | $13,082.00 | $11,195.55 – $20,152.00 | 16 |
| Embo or occlude vascular venous s&i CPT 37241 | $8,421.00 | $11,228.00 | $11,195.55 – $20,152.00 | 16 |
| Embolization s&i CPT 75894 | $4,145.25 | $5,527.00 | $297.07 – $534.73 | 16 |
| Emg 2 ext w-w/o paraspinal area 95861 CPT 95861 | $687.75 | $917.00 | $129.03 – $232.25 | 16 |
| Emg 3 ext w-w/o paraspinal area 95863 CPT 95863 | $913.50 | $1,218.00 | $124.79 – $224.62 | 16 |
| Emg cranial nerve bilateral CPT 95868 | $768.00 | $1,024.00 | $209.40 – $376.92 | 16 |
| Emg needle test 1-extremity CPT 95860 | $362.25 | $483.00 | $129.03 – $232.25 | 16 |
| Emg needle test 4-extremities CPT 95864 | $1,110.00 | $1,480.00 | $124.79 – $224.62 | 16 |
| Emg thor paraspinal without t1/t2 CPT 95869 | $397.50 | $530.00 | $209.40 – $376.92 | 16 |
| Encephalitis, california igg/igm CPT 86651 | $122.25 | $163.00 | $13.19 – $23.74 | 17 |
| Encephalitis, st louis igg/igm CPT 86653 | $122.25 | $163.00 | $13.19 – $23.74 | 17 |
| Encephalitis, western equine igg/igm CPT 86654 | $122.25 | $163.00 | $13.19 – $23.74 | 17 |
| Endo abl/incom vein/ext/laser/#1 36478 CPT 36478 | $3,891.00 | $5,188.00 | $3,062.12 – $5,511.82 | 16 |
| Endo abl/incom vein/ext/rad fre/#1 36475 CPT 36475 | $4,779.00 | $6,372.00 | $3,062.12 – $5,511.82 | 16 |
| Endo cath bile duct s&i CPT 74328 | $857.25 | $1,143.00 | not published | 0 |
| Endo cath panc duct s&i CPT 74329 | $810.75 | $1,081.00 | not published | 0 |
| Endo cholangiopancreatograph CPT 43261 | $2,763.75 | $3,685.00 | $3,739.04 – $6,730.27 | 16 |
| Endo cholangiopancreatograph CPT 43262 | $3,171.75 | $4,229.00 | $3,739.04 – $6,730.27 | 16 |
| Endocerv curettage w/scope 57456 CPT 57456 | $585.00 | $780.00 | $295.53 – $531.95 | 16 |
| Endocervical curettage 57505 CPT 57505 | $956.25 | $1,275.00 | $893.23 – $1,607.82 | 16 |
| Endoluminal bx urtr rnl plvs CPT 50606 | $1,202.25 | $1,603.00 | $444.47 – $800.04 | 16 |
| Endoluminl ivus oct c 1st CPT 92978 | $4,050.00 | $5,400.00 | not published | 0 |
| Endoluminl ivus oct c ea CPT 92979 | $4,043.25 | $5,391.00 | not published | 0 |
| Endoscopic Ultrasound exam esoph CPT 43237 | $2,517.00 | $3,356.00 | $1,860.96 – $3,349.72 | 16 |
| Endoscopy of bowel pouch 44385 CPT 44385 | $1,319.25 | $1,759.00 | $901.87 – $1,623.37 | 16 |
| Endoscopy swallow (fees) vid CPT 92612 | $551.25 | $735.00 | $186.12 – $335.02 | 16 |
| Endovasc tempory vessel occl CPT 61623 | $15,514.50 | $20,686.00 | $11,195.55 – $20,152.00 | 16 |
| Endoven ther chem adhes sbsq 36483 CPT 36483 | $3,375.75 | $4,501.00 | $135.23 – $243.42 | 16 |
| Endovenous laser vein addon 36479 CPT 36479 | $1,836.00 | $2,448.00 | $292.51 – $526.52 | 16 |
| Endovenous rf abl vein addl CPT 36476 | $3,603.00 | $4,804.00 | $263.94 – $475.09 | 16 |
| Enfortumab vedotin-ejfv 20 mg intravenous solution HCPCS J9177 | $15,579.42 | $20,772.56 | $36.71 – $89.23 | 17 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $109.71 | $146.28 | $1.36 – $6.12 | 2 |
| Entamoeba histolytica ag eia - sendout CPT 87337 | $89.25 | $119.00 | $11.98 – $21.56 | 17 |
| Enzyme cell activity ra CPT 82658 | $752.25 | $1,003.00 | $44.03 – $79.25 | 17 |
| Enzyme histochemistry CPT 88319 | $772.50 | $1,030.00 | $781.35 – $1,406.43 | 16 |
| Epidural/lumbar/sacral/ea add level64484 CPT 64484 | $1,711.50 | $2,282.00 | $110.44 – $198.80 | 16 |
| Epinephrine 0.1 mg/ml injection syringe HCPCS J0168 | $831.94 | $1,109.25 | not published | 0 |
| Epinephrine 1 mg/ml im kit - adult HCPCS J0169 | $424.18 | $565.57 | not published | 0 |
| Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution HCPCS J0166 | $46.16 | $61.54 | not published | 0 |
| Epirubicin 200 mg/100 ml intravenous solution HCPCS J9178 | $161.59 | $215.45 | $3.85 – $12.42 | 2 |
| Episiotomy/vag rpr oth/thn attending phys 59300 CPT 59300 | $2,952.75 | $3,937.00 | $3,139.36 – $5,650.86 | 16 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $379.58 | $506.10 | $7.31 – $18.67 | 17 |
| Epoetin alfa-epbx 40,000 unit/ml injection solution HCPCS Q5106 | $336.66 | $448.88 | $7.88 – $18.40 | 17 |
| Epoetin beta non esrd HCPCS J0888 | not published | not published | $3.43 – $3.43 | 1 |
| Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 | $208.65 | $278.20 | $39.43 – $143.64 | 2 |
| Epstein barr early antigen antibody CPT 86663 | $105.00 | $140.00 | $13.12 – $23.62 | 17 |
| Epstein barr nuclear antigen antibody CPT 86664 | $124.50 | $166.00 | $15.29 – $27.52 | 17 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $106.50 | $142.00 | $18.14 – $32.65 | 17 |
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | $924.38 | $1,232.50 | $3.26 – $60.61 | 17 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | $7,173.42 | $9,564.55 | $20.55 – $48.29 | 17 |
| Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 | $3,624.75 | $4,833.00 | $5,887.56 – $10,597.60 | 16 |
| Ercp biliary & pancreas CPT 74330 | $975.00 | $1,300.00 | not published | 0 |
| Ercp ea duct/ampulla dilate CPT 43277 | $3,276.00 | $4,368.00 | $3,739.04 – $6,730.27 | 16 |
| Ercp lesion ablate w/dilate 43278 CPT 43278 | $4,640.25 | $6,187.00 | $3,739.04 – $6,730.27 | 16 |
| Ercp lithotripsy calculi CPT 43265 | $9,178.50 | $12,238.00 | $5,887.56 – $10,597.60 | 16 |
| Ercp remove duct calculi 43264 CPT 43264 | $3,084.00 | $4,112.00 | $3,739.04 – $6,730.27 | 16 |
| Ercp remove forgn body duct 43275 CPT 43275 | $2,906.25 | $3,875.00 | $1,860.96 – $3,349.72 | 16 |
| Ercp sphincter pressure meas CPT 43263 | $2,771.25 | $3,695.00 | $1,860.96 – $3,349.72 | 16 |
| Ercp stent exchange w/dilate CPT 43276 | $3,507.75 | $4,677.00 | $5,887.56 – $10,597.60 | 16 |
| Ercp w/specimen collection CPT 43260 | $3,335.25 | $4,447.00 | $3,739.04 – $6,730.27 | 16 |
| Ergonovine 0.2 mg/ml inj HCPCS J1330 | not published | not published | $10.08 – $10.08 | 1 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | $5,213.48 | $6,951.30 | $76.76 – $254.55 | 17 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $107.31 | $143.08 | $21.95 – $116.73 | 2 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $209.75 | $279.66 | $182.67 – $727.02 | 2 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $240.34 | $320.45 | $2.34 – $2.34 | 1 |
| Esoph balloon distension tst CPT 91040 | $519.00 | $692.00 | $361.89 – $651.40 | 16 |
| Esoph egd dilation <30 mm CPT 43249 | $1,914.75 | $2,553.00 | $1,860.96 – $3,349.72 | 16 |
| Esoph endoscopy dilation CPT 43226 | $1,838.25 | $2,451.00 | $1,860.96 – $3,349.72 | 16 |
| Esoph imped funct test > 1hr CPT 91038 | $817.50 | $1,090.00 | $361.89 – $651.40 | 16 |
| Esoph imped function test CPT 91037 | $1,190.25 | $1,587.00 | $209.40 – $376.92 | 16 |
| Esoph scope w/sclerosis inj CPT 43204 | $1,536.00 | $2,048.00 | $1,860.96 – $3,349.72 | 16 |
| Esoph scope w/submucous inj CPT 43201 | $2,550.00 | $3,400.00 | $1,860.96 – $3,349.72 | 16 |
| Esophageal dilat s&i CPT 74360 | $798.00 | $1,064.00 | not published | 0 |
| Esophagosc dilate balloon 30 CPT 43214 | $1,638.75 | $2,185.00 | $1,860.96 – $3,349.72 | 16 |
| Esophagosc flex trnsn biopsy CPT 43198 | $1,739.25 | $2,319.00 | $879.59 – $1,583.27 | 16 |
| Esophagoscop mucosal resect CPT 43211 | $2,992.50 | $3,990.00 | $1,860.96 – $3,349.72 | 16 |
| Esophagoscop stent placement CPT 43212 | $5,814.75 | $7,753.00 | $5,887.56 – $10,597.60 | 16 |
| Esophagoscop ultrasound exam CPT 43231 | $3,069.75 | $4,093.00 | $1,860.96 – $3,349.72 | 16 |
| Esophagoscopy balloon <30mm CPT 43220 | $2,598.75 | $3,465.00 | $1,860.96 – $3,349.72 | 16 |
| Esophagoscopy control bleed CPT 43227 | $2,598.75 | $3,465.00 | $1,860.96 – $3,349.72 | 16 |
| Esophagoscopy flex biopsy CPT 43202 | $1,968.75 | $2,625.00 | $1,860.96 – $3,349.72 | 16 |
| Esophagoscopy flex dx brush CPT 43197 | $1,239.75 | $1,653.00 | $879.59 – $1,583.27 | 16 |
| Esophagoscopy flex remove fb CPT 43215 | $231.75 | $309.00 | $1,860.96 – $3,349.72 | 16 |
| Esophagoscopy lesion ablate CPT 43229 | $2,301.00 | $3,068.00 | $3,739.04 – $6,730.27 | 16 |
| Esophagoscopy lesion removal CPT 43216 | $2,946.75 | $3,929.00 | $1,860.96 – $3,349.72 | 16 |
| Esophagoscopy retro balloon CPT 43213 | $1,638.75 | $2,185.00 | $1,860.96 – $3,349.72 | 16 |
| Esophagoscopy snare les remv CPT 43217 | $2,680.50 | $3,574.00 | $1,860.96 – $3,349.72 | 16 |
| Esophagoscopy w/us needle bx CPT 43232 | $3,261.75 | $4,349.00 | $1,860.96 – $3,349.72 | 16 |
| Esophagus endoscopy/ligation CPT 43205 | $2,640.00 | $3,520.00 | $1,860.96 – $3,349.72 | 16 |
| Esophagus motility study CPT 91010 | $817.50 | $1,090.00 | $361.89 – $651.40 | 16 |
| Esophgl motil w/stim/perfus CPT 91013 | $872.25 | $1,163.00 | $26.48 – $47.66 | 16 |
| Establish access to aorta CPT 36160 | $969.75 | $1,293.00 | $506.27 – $911.29 | 16 |
| Establish access to artery CPT 36100 | $1,155.75 | $1,541.00 | $481.91 – $867.44 | 16 |
| Established Patient Office Visit (level 1) CPT 99211 | $108.00 | $144.00 | $22.82 – $41.07 | 16 |
| Established Patient Office Visit (level 2) CPT 99212 | $168.75 | $225.00 | $56.51 – $101.71 | 16 |
| Established Patient Office Visit (level 3) CPT 99213 | $210.75 | $281.00 | $90.97 – $163.75 | 16 |
| Established Patient Office Visit (level 4) CPT 99214 | $231.75 | $309.00 | $129.83 – $233.70 | 16 |
| Established Patient Office Visit (level 5) CPT 99215 | $247.50 | $330.00 | $184.45 – $332.02 | 16 |
| Estradiol total CPT 82670 | $162.00 | $216.00 | $27.94 – $50.29 | 17 |
| Estradiol valerate 10 mg inj HCPCS J1380 | not published | not published | $18.77 – $18.77 | 1 |
| Etanercept injection HCPCS J1438 | $7,314.47 | $9,752.62 | $7,117.02 – $7,117.02 | 1 |
| Ethanolamine oleate 100 mg HCPCS J1430 | $1,622.73 | $2,163.63 | $518.63 – $1,264.49 | 17 |
| Ethylene glycol -sendout CPT 82693 | $63.75 | $85.00 | $14.90 – $26.82 | 17 |
| Etonogestrel implant system HCPCS J7307 | $4,715.65 | $6,287.53 | $12,487.86 – $12,487.86 | 1 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $213.17 | $284.22 | $3.16 – $8.91 | 2 |
| Etoposide 50 mg cap HCPCS J8560 | $5,934.05 | $7,912.06 | $86.84 – $184.40 | 17 |
| Euflexxa inj per dose HCPCS J7323 | $1,186.77 | $1,582.36 | $105.58 – $278.64 | 17 |
| Evacuate mole of uterus CPT 59870 | $5,835.00 | $7,780.00 | $3,139.36 – $5,650.86 | 16 |
| Eval/fit voice prosthesis iii, st CPT 92607 | $431.25 | $575.00 | $117.02 – $210.63 | 16 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $83.25 | $111.00 | $98.11 – $176.60 | 17 |
| Evaluation heart device CPT 93640 | $2,001.00 | $2,668.00 | not published | 0 |
| Evaluation of speech fluency 92521 CPT 92521 | $274.50 | $366.00 | $128.22 – $230.79 | 16 |
| Evasc prlng admn rx agnt 1st CPT 61650 | $1,467.75 | $1,957.00 | $516.31 – $929.36 | 16 |
| Evasc prlng admn rx agnt add CPT 61651 | $187.50 | $250.00 | $220.69 – $397.25 | 16 |
| Evasc repair of iliac artery; endograft 34718 CPT 34718 | $14,656.50 | $19,542.00 | $1,102.48 – $1,984.46 | 16 |
| Evasc rpr a-ao ndgft 34701 CPT 34701 | $1,723.50 | $2,298.00 | $1,104.36 – $1,987.85 | 16 |
| Evasc rpr a-ao ndgft rpt 34702 CPT 34702 | $1,723.50 | $2,298.00 | $1,616.54 – $2,909.78 | 16 |
| Evasc rpr a-biiliac ndgft rptr CPT 34706 | $8,535.75 | $11,381.00 | $2,035.06 – $3,663.11 | 16 |
| Evasc rpr a-iliac ndgft 34717 CPT 34717 | $14,656.50 | $19,542.00 | $394.81 – $710.65 | 16 |
| Evasc rpr a-unilac ndgft 34703 CPT 34703 | $1,723.50 | $2,298.00 | $1,225.88 – $2,206.59 | 16 |
| Evasc rpr a-unilac ndgft rpt CPT 34704 | $6,066.00 | $8,088.00 | $2,006.94 – $3,612.49 | 16 |
| Evasc rpr ilio-iliac ndgft CPT 34707 | $1,020.00 | $1,360.00 | $1,039.72 – $1,871.49 | 16 |
| Evasc rpr ilio-iliac rpt CPT 34708 | $1,020.00 | $1,360.00 | $1,638.20 – $2,948.77 | 16 |
| Event monitor CPT 93270 | $279.00 | $372.00 | $36.19 – $65.15 | 16 |
| Evoked oa emissions ltd CPT 92587 | $63.00 | $84.00 | $209.40 – $376.92 | 16 |
| Evoked potential visual not glaucoma CPT 95930 | $1,685.25 | $2,247.00 | $209.40 – $376.92 | 16 |
| Evoked potentials upper limbs CPT 95925 | $1,692.00 | $2,256.00 | $209.40 – $376.92 | 16 |
| Exam of vagina w/scope 57420 CPT 57420 | $1,230.00 | $1,640.00 | $295.53 – $531.95 | 16 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $522.00 | $696.00 | $686.75 – $1,236.14 | 16 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | $2,901.00 | $3,868.00 | $2,816.99 – $5,070.59 | 16 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $1,501.50 | $2,002.00 | $394.24 – $709.63 | 16 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $1,743.00 | $2,324.00 | $686.75 – $1,236.14 | 16 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | $2,910.75 | $3,881.00 | $1,601.72 – $2,883.09 | 16 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $1,488.00 | $1,984.00 | $686.75 – $1,236.14 | 16 |
| Exc forearm les sc 3 cm/> CPT 25071 | $3,778.50 | $5,038.00 | $1,601.72 – $2,883.09 | 16 |
| Exc im tumor/shoulder area 5cm/> 23073 CPT 23073 | $2,745.00 | $3,660.00 | $2,816.99 – $5,070.59 | 16 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | $1,521.75 | $2,029.00 | $394.24 – $709.63 | 16 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | $1,521.75 | $2,029.00 | $686.75 – $1,236.14 | 16 |
| Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 | $1,891.50 | $2,522.00 | $686.75 – $1,236.14 | 16 |
| Exc malig tal 0.6-1.0cm 11601 CPT 11601 | $1,407.75 | $1,877.00 | $686.75 – $1,236.14 | 16 |
| Exc malig tal <0.5cm 11600 CPT 11600 | $1,407.75 | $1,877.00 | $686.75 – $1,236.14 | 16 |
| Exc prtl bn phlnx toe CPT 28124 | $3,126.75 | $4,169.00 | $3,173.19 – $5,711.73 | 16 |
| Exc sq tumor/forearm/wrist/<3cm 25075 CPT 25075 | $4,101.00 | $5,468.00 | $1,601.72 – $2,883.09 | 16 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | $1,533.75 | $2,045.00 | $1,160.50 – $2,088.91 | 16 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | $2,577.75 | $3,437.00 | $1,601.72 – $2,883.09 | 16 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | $9,215.25 | $12,287.00 | $2,816.99 – $5,070.59 | 16 |
| Exchange biliary drg cath CPT 47536 | $7,521.75 | $10,029.00 | $3,472.27 – $6,250.09 | 16 |
| Exchange drainage catheter CPT 49423 | $2,516.25 | $3,355.00 | $1,860.96 – $3,349.72 | 16 |
| Exchange nephrostomy cath CPT 50435 | $1,725.00 | $2,300.00 | $2,027.25 – $3,649.06 | 16 |
| Excise lip or cheek fold CPT 40819 | $687.00 | $916.00 | $1,504.73 – $2,708.51 | 16 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $4,858.50 | $6,478.00 | $1,601.72 – $2,883.09 | 16 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $561.00 | $748.00 | $686.75 – $1,236.14 | 16 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $3,510.75 | $4,681.00 | $1,601.72 – $2,883.09 | 16 |
| Excision of anal lesion(s) CPT 46922 | $2,658.75 | $3,545.00 | $2,691.84 – $4,845.30 | 16 |
| Excision of penis lesion(s) 54060 CPT 54060 | $1,976.25 | $2,635.00 | $2,000.97 – $3,601.74 | 16 |
| Exercise tst brncspsm w/ecg CPT 94617 | $484.50 | $646.00 | $129.03 – $232.25 | 16 |
| Exercise w/hemodynamic meas CPT 93464 | $1,791.00 | $2,388.00 | $209.04 – $376.28 | 16 |
| Exome sequence analysis CPT 81415 | $7,002.00 | $9,336.00 | $4,780.00 – $8,604.00 | 17 |
| Expander breast 300cc mod hght extra proj smth natrelle HCPCS L8600 | $4,848.75 | $6,465.00 | $1,019.30 – $1,834.74 | 16 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $7,852.50 | $10,470.00 | not published | 0 |
| Explore woundchest 20101 CPT 20101 | $1,761.00 | $2,348.00 | $2,000.97 – $3,601.74 | 16 |
| Explore/treat knee joint CPT 27331 | $3,918.75 | $5,225.00 | $3,173.19 – $5,711.73 | 16 |
| Ext ecg>48hr<7d scan a/r CPT 93243 | $238.50 | $318.00 | $129.03 – $232.25 | 16 |
| External cannula declotting CPT 36860 | $2,181.75 | $2,909.00 | $1,526.62 – $2,747.91 | 16 |
| External chromosome analysis 20-25 cells CPT 88264 | $345.75 | $461.00 | $144.61 – $260.30 | 17 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $903.75 | $1,205.00 | $143.75 – $258.75 | 17 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $234.00 | $312.00 | $17.93 – $32.27 | 17 |
| Extrnl counterpulse, per tx HCPCS G0166 | $573.75 | $765.00 | $129.03 – $232.25 | 16 |
| Eye implant band 40 HCPCS C1784 | $356.07 | $474.75 | not published | 0 |
| F-18 fdg pet diag HCPCS A9552 | $2,773.11 | $3,697.47 | $3,533.40 – $3,533.40 | 1 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | $5,679.38 | $7,572.50 | $1,825.64 – $3,286.15 | 16 |
| Facial bones <3 CPT 70140 | $256.50 | $342.00 | $84.40 – $151.91 | 17 |
| Factor ix CPT 85250 | $186.75 | $249.00 | $19.04 – $34.27 | 17 |
| Factor ix alprolix recomb HCPCS J7201 | $38,712.83 | $51,617.10 | $3.58 – $8.81 | 17 |
| Factor ix complex HCPCS J7194 | $4,991.63 | $6,655.50 | $1.70 – $4.14 | 17 |
| Factor ix idelvion inj HCPCS J7202 | $36,235.50 | $48,314.00 | $5.32 – $13.00 | 17 |
| Factor ix non-recombinant HCPCS J7193 | not published | not published | $3.24 – $3.24 | 1 |
| Factor ix recomb gly rebinyn HCPCS J7203 | not published | not published | $11.12 – $11.12 | 1 |
| Factor ix recombinant nos HCPCS J7195 | $7,321.05 | $9,761.40 | $1.84 – $4.55 | 17 |
| Factor viii CPT 85240 | $201.75 | $269.00 | $17.90 – $32.22 | 17 |
| Factor viii HCPCS J7190 | not published | not published | $2.75 – $2.75 | 1 |
| Factor viii fc fusion recomb HCPCS J7205 | $17,969.85 | $23,959.80 | $2.46 – $5.89 | 17 |
| Factor viii nuwiq recomb 1iu HCPCS J7209 | not published | not published | $2.85 – $2.85 | 1 |
| Factor viii pegylated recomb HCPCS J7207 | $11.10 | $14.79 | $2.14 – $5.23 | 17 |
| Factor viii recomb novoeight HCPCS J7182 | not published | not published | $3.68 – $3.68 | 1 |
| Factor viii recomb obizur HCPCS J7188 | $5,435.33 | $7,247.10 | $3.24 – $7.84 | 17 |
| Factor viii recombinant nos HCPCS J7192 | $11.10 | $14.79 | $1.57 – $3.72 | 17 |
| Factor xiii anti-hem factor HCPCS J7180 | not published | not published | $26.21 – $26.21 | 1 |
| Factor xiii recomb a-subunit HCPCS J7181 | $68.26 | $91.01 | $18.33 – $44.52 | 17 |
| Fallopian tube recnl CPT 58345 | $3,020.25 | $4,027.00 | $3,139.36 – $5,650.86 | 16 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | not published | not published | $73.02 – $73.02 | 1 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $8.88 | $11.84 | not published | 0 |
| Fatty acids nonesterified CPT 82725 | $108.75 | $145.00 | $18.77 – $33.79 | 17 |
| Fda ide #g240020 carry bag HCPCS Q0499 | $956.25 | $1,275.00 | $244.84 – $440.71 | 16 |
| Fecal microbiota prep instil HCPCS G0455 | $883.50 | $1,178.00 | $901.87 – $1,623.37 | 16 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | not published | not published | $155.85 – $155.85 | 1 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $75.00 | $100.00 | $18.64 – $33.55 | 16 |
| Feno poc CPT 95012 | $220.50 | $294.00 | $36.22 – $65.20 | 16 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $35.94 | $47.92 | $2.34 – $8.73 | 2 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $3,736.68 | $4,982.24 | $1.10 – $2.77 | 17 |
| Ferritin CPT 82728 | $242.25 | $323.00 | $13.63 – $24.53 | 17 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $4,030.11 | $5,373.48 | $0.23 – $0.73 | 17 |
| Ferumoxytol, esrd use HCPCS Q0139 | not published | not published | $0.73 – $0.73 | 1 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $656.25 | $875.00 | $101.39 – $182.50 | 17 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $102.00 | $136.00 | $196.07 – $352.92 | 16 |
| Fetal hemoglobin rosette CPT 85461 | $128.25 | $171.00 | $9.36 – $16.85 | 17 |
| Fetal non stress test CPT 59025 | $391.50 | $522.00 | $196.07 – $352.92 | 16 |
| Fetal shunt placement w/us CPT 59076 | $296.25 | $395.00 | $295.53 – $531.95 | 16 |
| Fibrin degradation d dimer quantitative CPT 85379 | $77.25 | $103.00 | $10.18 – $18.32 | 17 |
| Fibrin degradation products CPT 85362 | $184.50 | $246.00 | $6.89 – $12.40 | 17 |
| Fibrinogen activity CPT 85384 | $50.25 | $67.00 | $9.72 – $17.50 | 17 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $72.00 | $96.00 | $15.48 – $27.86 | 17 |
| Fibrinolytic antiplasmin CPT 85410 | $84.00 | $112.00 | $7.71 – $13.88 | 17 |
| Fibrinolytic plasminogen CPT 85415 | $567.75 | $757.00 | $17.19 – $30.94 | 17 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $416.25 | $555.00 | $6.53 – $11.75 | 17 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | $1,964.97 | $2,619.96 | $1.02 – $2.39 | 17 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $492.48 | $656.64 | $0.28 – $0.68 | 17 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $1,504.82 | $2,006.42 | $0.35 – $0.88 | 17 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $8,212.50 | $10,950.00 | not published | 0 |
| Filter vena cava fem denali HCPCS C1880 | $4,659.75 | $6,213.00 | not published | 0 |
| Fine needle asp without image guide 10021 CPT 10021 | $723.00 | $964.00 | $394.24 – $709.63 | 16 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | $621.75 | $829.00 | $132.81 – $239.06 | 16 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $621.75 | $829.00 | $686.75 – $1,236.14 | 16 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $702.75 | $937.00 | $58.09 – $104.56 | 16 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | $168.00 | $224.00 | $51.17 – $92.10 | 16 |
| Fl exam g/colon tube w contrast CPT 49465 | $414.00 | $552.00 | $231.40 – $416.51 | 16 |
| Flebogamma injection HCPCS J1572 | $3,562.92 | $4,750.55 | $90.74 – $163.33 | 17 |
| Flecainide (tambocor)-sendout CPT 80181 | $54.75 | $73.00 | $18.64 – $33.55 | 16 |
| Flexible Sigmoidoscopy CPT 45330 | $1,336.50 | $1,782.00 | $901.87 – $1,623.37 | 16 |
| Flow cytometry marker each additional CPT 88185 | $181.50 | $242.00 | $21.04 – $37.87 | 16 |
| Flow cytometry one marker technical component CPT 88184 | $270.75 | $361.00 | $347.62 – $625.72 | 16 |
| Floxuridine injection HCPCS J9200 | $14,923.11 | $19,897.48 | $4,250.97 – $10,041.59 | 17 |
| Flt3 gene CPT 81245 | $177.00 | $236.00 | $165.51 – $297.92 | 17 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $24.41 | $32.54 | $5.48 – $25.20 | 2 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $601.96 | $802.61 | $174.37 – $1,565.73 | 2 |
| Fluidotherapy charges pt CPT 97022 | $121.50 | $162.00 | $14.86 – $26.75 | 16 |
| Fluocinol acet intravit imp HCPCS J7313 | not published | not published | $1,211.62 – $1,211.62 | 1 |
| Fluocinolone acetonide implt HCPCS J7311 | $70,344.94 | $93,793.25 | $338.79 – $826.98 | 17 |
| Fluorescent antibody titer dna CPT 86256 | $324.75 | $433.00 | $12.05 – $21.69 | 17 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $822.00 | $1,096.00 | $97.32 – $175.18 | 16 |
| Fluoroguide needle placement CPT 77002 | $354.00 | $472.00 | $112.36 – $202.26 | 16 |
| Fluoroscopy up to 1 hour CPT 76000 | $492.75 | $657.00 | $231.40 – $416.51 | 17 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $203.74 | $271.65 | $4.16 – $28.98 | 2 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | $380.85 | $507.79 | $18.33 – $82.35 | 2 |
| Fmri brain by tech CPT 70554 | $1,337.25 | $1,783.00 | $231.40 – $416.51 | 16 |
| Fna bx w/ct gdn 1st les CPT 10009 | $1,270.50 | $1,694.00 | $686.75 – $1,236.14 | 16 |
| Fna bx w/ct gdn ea addl CPT 10010 | $900.00 | $1,200.00 | $220.03 – $396.05 | 16 |
| Fna bx w/mr gdn 1st les CPT 10011 | $900.00 | $1,200.00 | $686.75 – $1,236.14 | 16 |
| Fna bx w/mr gdn ea addl CPT 10012 | $846.75 | $1,129.00 | not published | 0 |
| Folic acid CPT 82746 | $135.75 | $181.00 | $14.70 – $26.46 | 17 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $78.99 | $105.31 | not published | 0 |
| Follow-up angiography CPT 75898 | $4,329.00 | $5,772.00 | $1,384.84 – $5,511.82 | 17 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $1,261.49 | $1,681.98 | $6.54 – $27.63 | 17 |
| Fondaparinux sodium HCPCS J1652 | $121.83 | $162.44 | $1.73 – $9.81 | 2 |
| Foot X-ray CPT 73630 | $236.25 | $315.00 | $84.40 – $151.91 | 17 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $237.00 | $316.00 | $242.30 – $436.15 | 16 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $1,233.17 | $1,644.22 | $0.27 – $1.26 | 2 |
| Foscarnet sodium injection HCPCS J1455 | $1,101.86 | $1,469.14 | $37.92 – $534.33 | 2 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $94.85 | $126.46 | $1.33 – $1,255.94 | 17 |
| Fracture assessment via dxa CPT 77086 | $530.25 | $707.00 | $84.40 – $151.91 | 17 |
| Fragmenting of kidney stone CPT 50590 | $11,301.75 | $15,069.00 | $3,418.53 – $6,153.35 | 16 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $167.25 | $223.00 | $85.98 – $154.76 | 16 |
| Fresh frozen plasma thawing ea un CPT 86927 | $240.75 | $321.00 | $165.22 – $297.40 | 16 |
| Fructosamine glycated protein CPT 82985 | $61.50 | $82.00 | $16.76 – $30.17 | 17 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $19.53 | $26.04 | not published | 0 |
| G-esoph reflx tst w/electrod CPT 91035 | $971.25 | $1,295.00 | $832.81 – $1,499.05 | 16 |
| G-tube reposition CPT 43761 | $865.50 | $1,154.00 | $242.30 – $436.15 | 16 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $156.00 | $208.00 | $49.63 – $89.33 | 16 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $177.43 | $236.57 | $0.63 – $3.06 | 2 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | not published | not published | $3.58 – $3.58 | 1 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $119.29 | $159.05 | $0.27 – $1.17 | 2 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $486.60 | $648.79 | $35.78 – $132.66 | 2 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $85.50 | $114.00 | $21.07 – $37.93 | 17 |
| Galectin-3 CPT 82777 | $280.50 | $374.00 | $44.25 – $79.65 | 17 |
| Gamma globulin 1 cc inj HCPCS J1460 | not published | not published | $117.85 – $117.85 | 1 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $406.62 – $406.62 | 1 |
| Gamma glutamyltransferase CPT 82977 | $57.00 | $76.00 | $7.20 – $12.96 | 17 |
| Gammaglobulin iga CPT 82784 | $144.00 | $192.00 | $9.30 – $16.74 | 17 |
| Gammaglobulin ige CPT 82785 | $117.00 | $156.00 | $16.46 – $29.63 | 17 |
| Gammaplex injection HCPCS J1557 | not published | not published | $152.03 – $152.03 | 1 |
| Gamunex-c/gammaked HCPCS J1561 | $8,519.04 | $11,358.72 | $49.73 – $116.91 | 17 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $94.28 | $125.70 | $96.41 – $404.28 | 2 |
| Gastric motility studies CPT 91020 | $1,317.00 | $1,756.00 | $361.89 – $651.40 | 16 |
| Gastrin test CPT 82938 | $106.50 | $142.00 | $17.69 – $31.84 | 17 |
| Gastroesophageal reflux study CPT 78262 | $553.50 | $738.00 | $387.70 – $697.86 | 17 |
| Gastroesophageal reflux test CPT 91034 | $943.50 | $1,258.00 | $361.89 – $651.40 | 16 |
| Gel-one HCPCS J7326 | not published | not published | $1,275.44 – $1,275.44 | 1 |
| Gel-syn injection 0.1 mg HCPCS J7328 | $1,330.04 | $1,773.38 | $0.68 – $1.58 | 17 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $168.02 | $224.02 | $7.18 – $32.85 | 2 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | $37,698.54 | $50,264.71 | $240.17 – $575.91 | 17 |
| Generator barostim neo2 2014 HCPCS C1767 | $83,687.18 | $111,582.90 | not published | 0 |
| Generator emblem MRI sicd subq HCPCS C1722 | $61,875.00 | $82,500.00 | not published | 0 |
| Genetic tstg severe inh cond CPT 81443 | $11,208.75 | $14,945.00 | $2,448.56 – $4,407.41 | 16 |
| Genome sequence analysis CPT 81425 | $8,306.25 | $11,075.00 | $5,031.20 – $9,056.16 | 16 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $85.57 | $114.09 | $6.35 – $24.21 | 2 |
| Gentamicin peak therapeutic drug level CPT 80170 | $120.00 | $160.00 | $16.38 – $29.48 | 17 |
| Genvisc 850, inj, 1mg HCPCS J7320 | not published | not published | $14.65 – $14.65 | 1 |
| Ghs HIV antibody CPT 86703 | $99.75 | $133.00 | $13.71 – $24.68 | 17 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | $151.50 | $202.00 | $45.41 – $81.74 | 16 |
| Ghs IV infusion bamlanivimab/etesevimab HCPCS M0245 | $784.50 | $1,046.00 | not published | 0 |
| Ghs IV infusion casirivimab/imdevimab HCPCS M0243 | $784.50 | $1,046.00 | not published | 0 |
| Ghs IV infusion sotrovimab HCPCS M0247 | $784.50 | $1,046.00 | not published | 0 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $333.75 | $445.00 | $320.33 – $576.59 | 16 |
| Ghs abscess perianal iandd CPT 46050 | $3,801.00 | $5,068.00 | $901.87 – $1,623.37 | 16 |
| Ghs abscess postoperative iandd complex CPT 10180 | $8,836.50 | $11,782.00 | $2,816.99 – $5,070.59 | 16 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $119.25 | $159.00 | $9.81 – $17.66 | 17 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $858.00 | $1,144.00 | $17.11 – $30.80 | 17 |
| Ghs analysis neurostim without reprogramming CPT 95970 | $612.00 | $816.00 | $129.03 – $232.25 | 16 |
| Ghs antibodies (torch) igm CPT 86694 | $131.25 | $175.00 | $14.39 – $25.90 | 17 |
| Ghs bladder cath - complex-foley CPT 51703 | $277.50 | $370.00 | $124.79 – $224.62 | 16 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $1,470.75 | $1,961.00 | $684.56 – $1,232.21 | 16 |
| Ghs central line insert < age 5, failed CPT 36555 | $3,696.00 | $4,928.00 | $3,062.12 – $5,511.82 | 16 |
| Ghs change cysto/gastrost CPT 43762 | $591.75 | $789.00 | $242.30 – $436.15 | 16 |
| Ghs chemo >8 hrs CPT 96416 | $1,028.25 | $1,371.00 | $320.33 – $576.59 | 16 |
| Ghs chemo IV push, ea addtl CPT 96411 | $174.75 | $233.00 | $69.83 – $125.69 | 16 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $535.50 | $714.00 | $35.09 – $63.16 | 17 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | $218.25 | $291.00 | $239.22 – $430.59 | 16 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $281.25 | $375.00 | $239.22 – $430.59 | 16 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $630.00 | $840.00 | $239.22 – $430.59 | 16 |
| Ghs closed reduction ankle dislocation CPT 27840 | $732.75 | $977.00 | $239.22 – $430.59 | 16 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $2,730.00 | $3,640.00 | $1,559.43 – $2,806.97 | 16 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | $227.25 | $303.00 | $239.22 – $430.59 | 16 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $1,138.50 | $1,518.00 | $1,559.43 – $2,806.97 | 16 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $1,681.50 | $2,242.00 | $3,436.70 – $6,186.07 | 16 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $1,955.25 | $2,607.00 | $1,559.43 – $2,806.97 | 16 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $255.75 | $341.00 | $239.22 – $430.59 | 16 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $1,513.50 | $2,018.00 | $1,559.43 – $2,806.97 | 16 |
| Ghs community re-entry 15 minutes CPT 97537 | $101.25 | $135.00 | $30.70 – $55.26 | 16 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $740.25 | $987.00 | $433.23 – $779.82 | 16 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $131.25 | $175.00 | $129.03 – $232.25 | 16 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $180.75 | $241.00 | $129.03 – $232.25 | 16 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $422.25 | $563.00 | $433.23 – $779.82 | 16 |
| Ghs cricothyroidotomy CPT 31605 | $226.50 | $302.00 | $229.70 – $413.45 | 16 |
| Ghs dislocation elbow closed treatment CPT 24600 | $525.75 | $701.00 | $239.22 – $430.59 | 16 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | $2,061.75 | $2,749.00 | $879.59 – $1,583.27 | 16 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | $843.75 | $1,125.00 | $209.40 – $376.92 | 16 |
| Ghs excision ingrown nail CPT 11765 | $1,468.50 | $1,958.00 | $394.24 – $709.63 | 16 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | $291.75 | $389.00 | $307.82 – $554.08 | 16 |
| Ghs fat & muscle CPT 89160 | $33.00 | $44.00 | $4.85 – $8.73 | 17 |
| Ghs fb removal - incisional CPT 10121 | $3,480.00 | $4,640.00 | $1,601.72 – $2,883.09 | 16 |
| Ghs fb removal - non-incisional CPT 20520 | $1,551.00 | $2,068.00 | $1,601.72 – $2,883.09 | 16 |
| Ghs fb removal foot - deep - left CPT 28192 | $2,347.50 | $3,130.00 | $1,601.72 – $2,883.09 | 16 |
| Ghs febrile agglutinns(mayo) CPT 86000 | $76.50 | $102.00 | $6.98 – $12.56 | 17 |
| Ghs fish cytogen CPT 88271 | $1,133.25 | $1,511.00 | $21.42 – $38.56 | 17 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $566.25 | $755.00 | $51.19 – $92.14 | 17 |
| Ghs flow volume loop CPT 94375 | $303.75 | $405.00 | $209.40 – $376.92 | 16 |
| Ghs gastric intub aspiration lavage CPT 43753 | $209.25 | $279.00 | $209.40 – $376.92 | 16 |
| Ghs hcv amplificaiton CPT 87521 | $254.25 | $339.00 | $35.09 – $63.16 | 17 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | $596.25 | $795.00 | $15.49 – $27.88 | 17 |
| Ghs hgb stability-thal CPT 83068 | $252.75 | $337.00 | $9.47 – $17.05 | 17 |
| Ghs histoplasma antigen CPT 87385 | $354.00 | $472.00 | $13.25 – $23.85 | 17 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | $4,134.00 | $5,512.00 | $2,027.25 – $3,649.06 | 16 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $873.00 | $1,164.00 | $1,160.50 – $2,088.91 | 16 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $2,337.75 | $3,117.00 | $686.75 – $1,236.14 | 16 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $825.00 | $1,100.00 | $686.75 – $1,236.14 | 16 |
| Ghs immun0electrophoresis CPT 86320 | $178.50 | $238.00 | $29.92 – $53.86 | 17 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $526.50 | $702.00 | $242.30 – $436.15 | 16 |
| Ghs inf midline insertion CPT 36140 | $1,638.00 | $2,184.00 | $462.38 – $832.28 | 16 |
| Ghs inhibitor screen CPT 85335 | $405.75 | $541.00 | $12.87 – $23.17 | 17 |
| Ghs init tx 1st degree burn CPT 16000 | $485.25 | $647.00 | $194.58 – $350.24 | 16 |
| Ghs inj neurolytic intercostal nerve CPT 64620 | $3,021.75 | $4,029.00 | $857.76 – $1,543.97 | 16 |
| Ghs inj neurolytic other perph nerve CPT 64640 | $2,224.50 | $2,966.00 | $857.76 – $1,543.97 | 16 |
| Ghs inj tendon origin/insertion CPT 20551 | $291.00 | $388.00 | $297.68 – $535.83 | 16 |
| Ghs inj transforaminal cerv ea add bil CPT 64480 | $1,319.25 | $1,759.00 | $134.27 – $241.68 | 16 |
| Ghs inj transforaminal cerv single bil CPT 64479 | $1,636.50 | $2,182.00 | $857.76 – $1,543.97 | 16 |
| Ghs insertion of needle - bone CPT 36680 | $780.75 | $1,041.00 | $433.23 – $779.82 | 16 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $876.00 | $1,168.00 | $394.24 – $709.63 | 16 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $876.00 | $1,168.00 | $716.75 – $1,290.15 | 16 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | $5,194.50 | $6,926.00 | $2,000.97 – $3,601.74 | 16 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | $186.00 | $248.00 | $29.25 – $52.65 | 16 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $238.50 | $318.00 | $242.30 – $436.15 | 16 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $397.50 | $530.00 | $433.23 – $779.82 | 16 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $368.25 | $491.00 | $394.24 – $709.63 | 16 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $1,428.75 | $1,905.00 | $394.24 – $709.63 | 16 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $288.00 | $384.00 | $394.24 – $709.63 | 16 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $1,967.25 | $2,623.00 | $394.24 – $709.63 | 16 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $2,092.50 | $2,790.00 | $394.24 – $709.63 | 16 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $2,133.00 | $2,844.00 | $394.24 – $709.63 | 16 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $876.00 | $1,168.00 | $394.24 – $709.63 | 16 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $2,151.00 | $2,868.00 | $716.75 – $1,290.15 | 16 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $393.00 | $524.00 | $394.24 – $709.63 | 16 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $2,315.25 | $3,087.00 | $394.24 – $709.63 | 16 |
| Ghs layered repair 20.1 - 30.0 cm -12056 CPT 12056 | $2,315.25 | $3,087.00 | $394.24 – $709.63 | 16 |
| Ghs layered repair over 3.0 cm -12057 CPT 12057 | $471.75 | $629.00 | $394.24 – $709.63 | 16 |
| Ghs mbp CPT 83873 | $96.75 | $129.00 | $17.20 – $30.96 | 17 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $816.00 | $1,088.00 | $58.27 – $104.88 | 16 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $654.00 | $872.00 | $80.69 – $145.24 | 16 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $67.50 | $90.00 | $53.48 – $96.26 | 16 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $640.50 | $854.00 | $70.35 – $126.63 | 16 |
| Ghs musc test done w/n test comp CPT 95886 | $435.00 | $580.00 | $93.72 – $168.69 | 16 |
| Ghs musc tst done w/n tst non ext CPT 95887 | $305.25 | $407.00 | $82.61 – $148.69 | 16 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $340.50 | $454.00 | $59.88 – $107.78 | 16 |
| Ghs myocardial strain img spckl track CPT 93356 | $81.75 | $109.00 | $34.28 – $61.70 | 16 |
| Ghs nailbed repair/nail removal CPT 11760 | $2,355.75 | $3,141.00 | $716.75 – $1,290.15 | 16 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $1,741.50 | $2,322.00 | $857.76 – $1,543.97 | 16 |
| Ghs nerve blk intercostal, single level CPT 64420 | $1,470.75 | $1,961.00 | $684.56 – $1,232.21 | 16 |
| Ghs nerve block axillary nerve CPT 64417 | $1,271.25 | $1,695.00 | $857.76 – $1,543.97 | 16 |
| Ghs nerve block brachial plexus CPT 64415 | $1,368.00 | $1,824.00 | $857.76 – $1,543.97 | 16 |
| Ghs nerve block celiac plexus CPT 64530 | $2,299.50 | $3,066.00 | $857.76 – $1,543.97 | 16 |
| Ghs nerve block interscaline CPT 64510 | $1,926.00 | $2,568.00 | $857.76 – $1,543.97 | 16 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $2,299.50 | $3,066.00 | $857.76 – $1,543.97 | 16 |
| Ghs nerve block sciatic nerve CPT 64445 | $1,214.25 | $1,619.00 | $684.56 – $1,232.21 | 16 |
| Ghs nerve block suprascapular CPT 64418 | $1,131.00 | $1,508.00 | $684.56 – $1,232.21 | 16 |
| Ghs ng placement w fluoro guidance CPT 43752 | $507.00 | $676.00 | $433.23 – $779.82 | 16 |
| Ghs o2 saturation CPT 82810 | $106.50 | $142.00 | $9.77 – $17.59 | 17 |
| Ghs o2 uptake rest & indirect CPT 94690 | $433.50 | $578.00 | $57.21 – $102.98 | 16 |
| Ghs opcc repair cvp w subq port CPT 36576 | $4,080.00 | $5,440.00 | $1,526.62 – $2,747.91 | 16 |
| Ghs opcc repair cvp without subq port CPT 36575 | $1,521.00 | $2,028.00 | $608.36 – $1,095.05 | 16 |
| Ghs ot prosthetic training/15 min CPT 97761 | $106.50 | $142.00 | $38.38 – $69.09 | 16 |
| Ghs ot sensory integrative tech/15min CPT 97533 | $119.25 | $159.00 | $56.93 – $102.47 | 16 |
| Ghs pacing - transcutaneous CPT 92953 | $940.50 | $1,254.00 | $640.98 – $1,153.77 | 16 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $1,791.00 | $2,388.00 | $96.88 – $174.39 | 16 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $1,525.50 | $2,034.00 | $93.37 – $168.06 | 16 |
| Ghs peritonsillar abscess i andd CPT 42700 | $1,080.75 | $1,441.00 | $229.70 – $413.45 | 16 |
| Ghs phenylketonurid CPT 84030 | $128.25 | $171.00 | $5.50 – $9.90 | 17 |
| Ghs picc line insert < 5 CPT 36568 | $4,977.75 | $6,637.00 | $1,526.62 – $2,747.91 | 16 |
| Ghs plngl fx pm cl CPT 26725 | $308.25 | $411.00 | $239.22 – $430.59 | 16 |
| Ghs ppd (tb intradermal) CPT 86580 | $57.75 | $77.00 | $28.05 – $50.49 | 16 |
| Ghs pr without cont pulse ox CPT 94625 | $134.25 | $179.00 | $57.21 – $102.98 | 16 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $75.75 | $101.00 | $9.66 – $17.39 | 17 |
| Ghs protoporphyrins fract CPT 84202 | $51.75 | $69.00 | $14.35 – $25.83 | 17 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $122.25 | $163.00 | $12.25 – $22.05 | 17 |
| Ghs refill of implantable pump CPT 95990 | $774.00 | $1,032.00 | $320.33 – $576.59 | 16 |
| Ghs removal intranasal foreign body CPT 30300 | $473.25 | $631.00 | $129.03 – $232.25 | 16 |
| Ghs removal pharyngeal foreign body CPT 42809 | $397.50 | $530.00 | $433.23 – $779.82 | 16 |
| Ghs sensitivity (per antimicro) CPT 87184 | $60.75 | $81.00 | $7.48 – $13.46 | 17 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $1,050.00 | $1,400.00 | $394.24 – $709.63 | 16 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $1,311.75 | $1,749.00 | $394.24 – $709.63 | 16 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $1,149.75 | $1,533.00 | $394.24 – $709.63 | 16 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $1,097.25 | $1,463.00 | $394.24 – $709.63 | 16 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $135.00 | $180.00 | $194.58 – $350.24 | 16 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $142.50 | $190.00 | $194.58 – $350.24 | 16 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $135.00 | $180.00 | $194.58 – $350.24 | 16 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $159.00 | $212.00 | $194.58 – $350.24 | 16 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $159.00 | $212.00 | $194.58 – $350.24 | 16 |
| Ghs somatosensory testing lower extremit CPT 95926 | $1,692.00 | $2,256.00 | $209.40 – $376.92 | 16 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | $2,091.75 | $2,789.00 | $832.81 – $1,499.05 | 16 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $316.50 | $422.00 | $98.01 – $176.42 | 16 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $229.50 | $306.00 | $45.64 – $82.16 | 16 |
| Ghs st - re-eval for alt comm CPT 92597 | $410.25 | $547.00 | $68.59 – $123.47 | 16 |
| Ghs strapping shoulder - 29240 CPT 29240 | $257.25 | $343.00 | $129.03 – $232.25 | 16 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $894.00 | $1,192.00 | $394.24 – $709.63 | 16 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $606.75 | $809.00 | $716.75 – $1,290.15 | 16 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $403.50 | $538.00 | $239.22 – $430.59 | 16 |
| Ghs urine, porphyrins quant CPT 84120 | $447.00 | $596.00 | $14.71 – $26.48 | 17 |
| Ghs vaginal delivery only CPT 59409 | $773.25 | $1,031.00 | $3,139.36 – $5,650.86 | 16 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $2,699.25 | $3,599.00 | $361.89 – $651.40 | 16 |
| Gi inhouse confirmation CPT 87045 | $70.50 | $94.00 | $9.44 – $16.99 | 17 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $1,582.50 | $2,110.00 | $879.59 – $1,583.27 | 16 |
| Giardia lamblia antibody CPT 86674 | $114.00 | $152.00 | $14.72 – $26.50 | 17 |
| Glassia injection HCPCS J0257 | $2,551.28 | $3,401.70 | $5.66 – $13.90 | 17 |
| Glove finger flexion right lg xl HCPCS L3912 | $36.75 | $49.00 | $142.19 – $255.94 | 16 |
| Glucagon 1 mg solution for injection HCPCS J1610 | not published | not published | $476.55 – $476.55 | 1 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $509.06 | $678.74 | $135.00 – $243.00 | 16 |
| Glucagon plasma - sendout CPT 82943 | $52.50 | $70.00 | $14.29 – $25.72 | 17 |
| Glucose 1 hr post dose CPT 82950 | $86.25 | $115.00 | $4.75 – $8.55 | 17 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $30.00 | $40.00 | $3.28 – $5.90 | 17 |
| Glucose blood quantitative CPT 82947 | $45.00 | $60.00 | $3.93 – $7.07 | 17 |
| Glucose body fluid CPT 82945 | $59.25 | $79.00 | $3.93 – $7.07 | 17 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $147.00 | $196.00 | $12.87 – $23.17 | 17 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $44.25 | $59.00 | $3.92 – $7.06 | 17 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $57.75 | $77.00 | $6.05 – $10.89 | 17 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $102.50 | $136.66 | $5.58 – $5.58 | 1 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $7,166.65 | $9,555.53 | $11.29 – $26.82 | 17 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $147.00 | $196.00 | $18.58 – $33.44 | 17 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $96.75 | $129.00 | $18.52 – $33.34 | 17 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $11,433.78 | $15,245.04 | $1,786.92 – $5,481.09 | 2 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $3,026.25 | $4,035.00 | $73.75 – $217.24 | 17 |
| Graft axiofill 1000mg HCPCS J3590 | $675,000.00 | $900,000.00 | not published | 0 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $2,897.51 – $2,897.51 | 1 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $17,736.75 | $23,649.00 | $120.69 – $217.24 | 17 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $31,488.75 | $41,985.00 | $120.69 – $217.24 | 16 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $27,652.41 | $36,869.88 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $78,750.00 | $105,000.00 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $29,670.10 | $39,560.13 | $120.69 – $217.24 | 17 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $6,187.50 | $8,250.00 | $120.69 – $239.85 | 17 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $6,075.00 | $8,100.00 | $120.69 – $331.44 | 17 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $7,746.75 | $10,329.00 | $118.90 – $217.24 | 17 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | not published | not published | $394.48 – $394.48 | 1 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $66,548.25 | $88,731.00 | $120.69 – $217.24 | 16 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $2,227.50 | $2,970.00 | $120.69 – $217.24 | 17 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $99,296.10 | $132,394.80 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $6,187.50 | $8,250.00 | not published | 0 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $0.54 – $0.54 | 1 |
| Great toe with reduction 28495 CPT 28495 | $581.25 | $775.00 | $239.22 – $430.59 | 16 |
| Growth stimulation gene 2 CPT 83006 | $1,637.25 | $2,183.00 | $75.60 – $136.08 | 17 |
| Gu dilat ureter/urethra s&i CPT 74485 | $1,476.75 | $1,969.00 | $2,027.25 – $3,649.06 | 17 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $2,108.25 | $2,811.00 | $817.79 – $1,472.02 | 16 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $20,413.63 | $27,218.17 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $3,593.25 | $4,791.00 | not published | 0 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,959.50 | $3,946.00 | $686.75 – $1,236.14 | 16 |
| Gw stiffened micro access kit HCPCS C1894 | $101,250.00 | $135,000.00 | not published | 0 |
| H pylori (c-13) breath CPT 83013 | $342.00 | $456.00 | $67.36 – $121.25 | 17 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $120.02 | $160.02 | $11.39 – $79.02 | 2 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $8.58 | $11.44 | $2.02 – $12.78 | 2 |
| Hand X-ray CPT 73130 | $236.25 | $315.00 | $84.40 – $151.91 | 17 |
| Haptoglobin quantitative CPT 83010 | $83.25 | $111.00 | $12.58 – $22.64 | 17 |
| Hast w/i&r phys/qhp CPT 94452 | $351.00 | $468.00 | $129.03 – $232.25 | 16 |
| Hast w/oxygen titrate CPT 94453 | $422.25 | $563.00 | $129.03 – $232.25 | 16 |
| Hba1/hba2 full gene sequence CPT 81259 | $1,051.50 | $1,402.00 | $600.00 – $1,080.00 | 17 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $743.25 | $991.00 | $202.40 – $364.32 | 17 |
| Hbot, full body chamber, 30m HCPCS G0277 | $615.75 | $821.00 | $133.45 – $240.22 | 16 |
| Hc nm fusion spect CT unlisted CPT 78999 | $680.25 | $907.00 | $387.70 – $697.86 | 17 |
| Hc nm kidney imaging with flow CPT 78701 | $638.25 | $851.00 | $387.70 – $697.86 | 17 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $471.75 | $629.00 | $526.57 – $1,694.37 | 17 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $2,528.25 | $3,371.00 | $1,255.55 – $2,259.99 | 16 |
| Hc transcatheter placement and sbsq removal cepd perq CPT 33370 | $2,175.00 | $2,900.00 | $114.72 – $206.49 | 16 |
| Hcg qualitative CPT 84703 | $60.75 | $81.00 | $7.52 – $13.54 | 17 |
| Hcg quantitative CPT 84702 | $145.50 | $194.00 | $15.05 – $27.09 | 17 |
| Head CT scan (with and without contrast) CPT 70470 | $1,720.50 | $2,294.00 | $170.10 – $306.19 | 16 |
| Head CT scan (with contrast) CPT 70460 | $1,833.75 | $2,445.00 | $170.10 – $306.19 | 16 |
| Head CT scan (without contrast) CPT 70450 | $1,557.00 | $2,076.00 | $101.39 – $182.50 | 16 |
| Heart first pass add-on CPT 78496 | $522.00 | $696.00 | $40.25 – $72.45 | 16 |
| Hematocrit CPT 85014 | $33.00 | $44.00 | $2.37 – $4.27 | 17 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $41,382.91 | $55,177.21 | $35.31 – $83.15 | 17 |
| Hemoglobin CPT 85018 | $28.50 | $38.00 | $2.37 – $4.27 | 17 |
| Hemoglobin fetal qualitative CPT 83033 | $43.50 | $58.00 | $8.00 – $14.40 | 17 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $132.75 | $177.00 | $8.20 – $14.76 | 17 |
| Hemoglobin plasma CPT 83051 | $187.50 | $250.00 | $7.31 – $13.16 | 17 |
| Hepagam b im injection HCPCS J1571 | $2,543.59 | $3,391.45 | $70.23 – $174.42 | 17 |
| Hepagam b intravenous, inj HCPCS J1573 | not published | not published | $174.42 – $174.42 | 1 |
| Heparin assay CPT 85520 | $134.25 | $179.00 | $13.09 – $23.56 | 17 |
| Heparin bolus from bag HCPCS J1644 | $57.46 | $76.61 | $0.51 – $2.43 | 2 |
| Heparin neutralization CPT 85525 | $187.50 | $250.00 | $11.84 – $21.31 | 17 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $6.20 | $8.26 | $0.02 – $0.18 | 2 |
| Hepatitis a antibody igm CPT 86709 | $82.50 | $110.00 | $11.26 – $20.27 | 17 |
| Hepatitis b core antibody igm CPT 86705 | $131.25 | $175.00 | $11.77 – $21.19 | 17 |
| Hepatitis b core antibody total CPT 86704 | $78.75 | $105.00 | $12.05 – $21.69 | 17 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $1,890.21 | $2,520.27 | $140.21 – $318.03 | 17 |
| Hepatitis b surface antibody CPT 86706 | $81.00 | $108.00 | $10.74 – $19.33 | 17 |
| Hepatitis b vaccine 40 mcg/ml inj-adult CPT 90747 | not published | not published | $342.59 – $342.59 | 1 |
| Hepatitis c antibody CPT 86803 | $105.75 | $141.00 | $14.27 – $25.69 | 17 |
| Hepatitis d quantification CPT 87523 | $1,161.75 | $1,549.00 | $42.84 – $77.11 | 16 |
| Hepatobiliary system imaging CPT 78226 | $716.25 | $955.00 | $387.70 – $697.86 | 17 |
| Herpes simplex type 1 antibody igg CPT 86695 | $102.75 | $137.00 | $13.19 – $23.74 | 17 |
| Herpes simplex type 2 antibody igg CPT 86696 | $66.00 | $88.00 | $19.35 – $34.83 | 17 |
| Herpes simplex virus isolation CPT 87255 | $54.75 | $73.00 | $33.86 – $60.95 | 17 |
| Heterophile antibodies screening CPT 86308 | $99.75 | $133.00 | $5.18 – $9.32 | 17 |
| Hhv-6 dna quant CPT 87533 | $469.50 | $626.00 | $41.76 – $75.17 | 17 |
| Hip X-ray CPT 73502 | $319.50 | $426.00 | $84.40 – $151.91 | 17 |
| Histamine CPT 83088 | $140.25 | $187.00 | $29.53 – $53.15 | 17 |
| Hizentra injection HCPCS J1559 | $4,991.26 | $6,655.01 | $14.52 – $34.37 | 17 |
| Hla class i high defin qual CPT 86832 | $551.25 | $735.00 | $323.75 – $582.75 | 17 |
| Hla class i semiquant panel CPT 86834 | $502.50 | $670.00 | $357.56 – $643.61 | 17 |
| Hla class i/ii antibody qual CPT 86829 | $435.00 | $580.00 | $64.19 – $115.54 | 17 |
| Hla class ii high defin qual CPT 86833 | $471.00 | $628.00 | $325.80 – $586.44 | 17 |
| Hla class ii semiquant panel CPT 86835 | $534.00 | $712.00 | $322.96 – $581.33 | 17 |
| Hla i & ii type verify lr CPT 81371 | $365.25 | $487.00 | $404.52 – $728.14 | 17 |
| Hla i low res one antigen equiv ea CPT 81374 | $197.25 | $263.00 | $74.33 – $133.79 | 17 |
| Hla i typing 1 locus hr CPT 81380 | $150.00 | $200.00 | $177.25 – $319.05 | 17 |
| Hla i typing complete hr CPT 81379 | $386.25 | $515.00 | $335.38 – $603.68 | 17 |
| Hla i typing complete lr CPT 81372 | $488.25 | $651.00 | $403.59 – $726.46 | 17 |
| Hla i typing high res 1 allele grp ea CPT 81381 | $201.75 | $269.00 | $169.90 – $305.82 | 17 |
| Hla ii typing 1 loc hr CPT 81382 | $637.50 | $850.00 | $123.68 – $222.62 | 17 |
| Hla ii typing ag equiv lr CPT 81375 | $186.75 | $249.00 | $220.74 – $397.33 | 17 |
| Hla x-match noncytotoxc addl CPT 86826 | $145.50 | $194.00 | $36.53 – $65.75 | 17 |
| Hla x-math non-cytotoxic CPT 86825 | $342.75 | $457.00 | $109.49 – $197.08 | 17 |
| Hlth bhv assmt/reassessment CPT 96156 | $144.75 | $193.00 | $98.52 – $177.34 | 16 |
| Hlth bhv ivntj fam 1st 30 CPT 96167 | $115.50 | $154.00 | $36.34 – $65.41 | 16 |
| Hlth bhv ivntj grp 1st 30 CPT 96164 | $117.00 | $156.00 | $36.34 – $65.41 | 16 |
| Hlth bhv ivntj indiv 1st 30 CPT 96158 | $115.50 | $154.00 | $172.14 – $309.84 | 16 |
| Hocm 250-299mg/ml iodine,1ml HCPCS Q9961 | $52.51 | $70.01 | $0.68 – $2.52 | 2 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | not published | not published | $0.51 – $0.51 | 1 |
| Homocysteine CPT 83090 | $72.00 | $96.00 | $17.92 – $32.26 | 17 |
| Homovanillic acid (hva) CPT 83150 | $166.50 | $222.00 | $22.41 – $40.34 | 17 |
| Hpa-1 genotyping CPT 81105 | $165.00 | $220.00 | $122.22 – $220.00 | 17 |
| Hpa-15 genotyping CPT 81112 | $165.00 | $220.00 | $122.22 – $220.00 | 17 |
| Hpa-2 genotyping CPT 81106 | $165.00 | $220.00 | $122.22 – $220.00 | 17 |
| Hpa-3 genotyping CPT 81107 | $165.00 | $220.00 | $122.22 – $220.00 | 17 |
| Hpa-4 genotyping CPT 81108 | $165.00 | $220.00 | $122.22 – $220.00 | 17 |
| Hpa-5 genotyping CPT 81109 | $165.00 | $220.00 | $122.22 – $220.00 | 17 |
| Hpa-6 genotyping CPT 81110 | $165.00 | $220.00 | $122.22 – $220.00 | 17 |
| Hpa-9 genotyping CPT 81111 | $165.00 | $220.00 | $122.22 – $220.00 | 17 |
| Htt gene detc abnor alleles CPT 81271 | $345.75 | $461.00 | $137.00 – $246.60 | 16 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | not published | not published | $76.79 – $76.79 | 1 |
| Hyaluronidase 200 units/ml inj HCPCS J3471 | $414.18 | $552.24 | $1.19 – $4.50 | 2 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | not published | not published | $0.88 – $0.88 | 1 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $51.42 | $68.56 | $12.61 – $50.31 | 2 |
| Hydration IV infusion each additional hour CPT 96361 | $156.00 | $208.00 | $45.41 – $81.74 | 16 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $422.25 | $563.00 | $206.28 – $371.30 | 16 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $569.91 | $759.87 | $51.60 – $160.65 | 2 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $72.63 | $96.83 | not published | 0 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $277.32 | $369.75 | not published | 0 |
| Hydroxocobalamin im 10mcg HCPCS J3425 | $83.64 | $111.52 | $0.09 – $0.09 | 1 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $87.60 | $116.79 | $41.18 – $89.19 | 2 |
| Hymovis injection 1 mg HCPCS J7322 | $2,459.97 | $3,279.95 | $18.13 – $42.45 | 17 |
| Hyoscyamine sulfate inj HCPCS J1980 | $308.52 | $411.36 | $86.31 – $319.14 | 2 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $44.74 – $44.74 | 1 |
| Hysterosalpingography s&i CPT 74740 | $682.50 | $910.00 | $231.40 – $416.51 | 17 |
| Hysteroscopy ablation CPT 58563 | $4,888.50 | $6,518.00 | $4,851.38 – $8,732.48 | 16 |
| Hysteroscopy biopsy CPT 58558 | $5,110.50 | $6,814.00 | $3,139.36 – $5,650.86 | 16 |
| Hysteroscopy dx sep proc CPT 58555 | $3,568.50 | $4,758.00 | $3,139.36 – $5,650.86 | 16 |
| Hysteroscopy remove fb CPT 58562 | $5,843.25 | $7,791.00 | $3,139.36 – $5,650.86 | 16 |
| Hysteroscopy remove myoma CPT 58561 | $4,302.75 | $5,737.00 | $4,851.38 – $8,732.48 | 16 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $650.11 | $866.81 | not published | 0 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | $3,134.25 | $4,179.00 | $3,173.19 – $5,711.73 | 16 |
| I&d lacrimal sac CPT 68420 | $2,274.75 | $3,033.00 | $2,305.69 – $4,150.23 | 16 |
| I-123 iobenguane diag HCPCS A9582 | $17,222.25 | $22,963.00 | $2,317.50 – $4,171.50 | 16 |
| I-123 ioflupane diag HCPCS A9584 | $9,058.88 | $12,078.50 | $1,387.74 – $2,497.93 | 16 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $383.25 | $511.00 | $69.83 – $125.69 | 16 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $355.50 | $474.00 | $19.43 – $34.98 | 16 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $114.75 | $153.00 | $45.41 – $81.74 | 16 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $611.25 | $815.00 | $206.28 – $371.30 | 16 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | $48.00 | $64.00 | $18.09 – $32.56 | 17 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $236.25 | $315.00 | $35.09 – $63.16 | 17 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | $839.85 | $1,119.80 | $74.97 – $230.40 | 2 |
| Ibuprofen injection HCPCS J1741 | $86.20 | $114.93 | $7.40 – $33.12 | 2 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | $1,022.55 | $1,363.40 | $219.22 – $394.59 | 16 |
| Icatibant injection HCPCS J1744 | $3,697.02 | $4,929.36 | $305.00 – $1,537.65 | 2 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $48,847.50 | $65,130.00 | not published | 0 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $44,003.25 | $58,671.00 | not published | 0 |
| Icd crtp serena MRI HCPCS C2621 | $15,759.00 | $21,012.00 | not published | 0 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $6,463.81 | $8,618.40 | not published | 0 |
| Idarubicin hcl injection HCPCS J9211 | $249.51 | $332.68 | $90.16 – $386.37 | 2 |
| Idecabtagene vicleucel car HCPCS Q2055 | not published | not published | $1,317,427.91 – $1,317,427.91 | 1 |
| Idursulfase injection HCPCS J1743 | $11,942.56 | $15,923.41 | $558.22 – $1,359.54 | 17 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $294.81 | $393.07 | $57.17 – $240.75 | 2 |
| Igh gene rearrange amp meth CPT 81261 | $305.25 | $407.00 | $197.99 – $356.38 | 17 |
| Igh@ var region somatic mutation analy CPT 81263 | $607.50 | $810.00 | $294.52 – $530.14 | 17 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $309.75 | $413.00 | $87.63 – $157.73 | 16 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $291.00 | $388.00 | $347.62 – $625.72 | 16 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $312.00 | $416.00 | $165.22 – $297.40 | 16 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $134.01 | $178.67 | $169.54 – $305.17 | 16 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | $67.77 | $90.35 | $89.73 – $161.51 | 16 |
| Immobilizer shldr sling med HCPCS L3660 | $29.14 | $38.85 | $154.10 – $277.38 | 16 |
| Immune complex assay CPT 86332 | $60.00 | $80.00 | $24.37 – $43.87 | 17 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $2,613.77 | $3,485.02 | $49.08 – $116.32 | 17 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | $3,486.01 | $4,648.01 | $47.04 – $117.73 | 17 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | $2,778.42 | $3,704.55 | $80.40 – $198.86 | 17 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $87.00 | $116.00 | $20.81 – $37.46 | 17 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $121.50 | $162.00 | $20.81 – $37.46 | 17 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $77.25 | $103.00 | $11.98 – $21.56 | 17 |
| Immunodiffusion nes CPT 86329 | $170.25 | $227.00 | $14.05 – $25.29 | 17 |
| Immunofixation electrophoresis serum CPT 86334 | $237.75 | $317.00 | $22.34 – $40.21 | 17 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $367.50 | $490.00 | $99.33 – $178.80 | 16 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $407.25 | $543.00 | $165.22 – $297.40 | 16 |
| Immunoglobulin assay CPT 86023 | $231.75 | $309.00 | $12.46 – $22.43 | 17 |
| Impl neurostim electr perc CPT 63650 | $6,807.00 | $9,076.00 | $6,180.53 – $11,124.95 | 16 |
| Implant 11 volt lithium-ion backup battery for controller pocket HCPCS Q0506 | $1,518.75 | $2,025.00 | $1,253.04 – $2,255.47 | 16 |
| Implant cartilage 10mm synthetic HCPCS L8699 | $101,250.00 | $135,000.00 | not published | 0 |
| Implant cochlear osia osi300 HCPCS L8690 | $20,655.00 | $27,540.00 | $6,978.96 – $12,562.13 | 16 |
| Implant hormone pellet(s) 11980 CPT 11980 | $519.00 | $692.00 | $433.23 – $779.82 | 16 |
| Implant neuroelectrodes CPT 64553 | $10,672.50 | $14,230.00 | $10,806.19 – $19,451.13 | 16 |
| Implant neuroelectrodes CPT 64555 | $7,279.50 | $9,706.00 | $6,180.53 – $11,124.95 | 16 |
| Implant neuroelectrodes CPT 64561 | $6,447.00 | $8,596.00 | $6,180.53 – $11,124.95 | 16 |
| Implant power module patient cable cable 14 volt HCPCS Q0477 | $2,812.50 | $3,750.00 | $1,138.18 – $2,048.72 | 16 |
| Implant pulse generator remede el HCPCS C1823 | $57,375.00 | $76,500.00 | not published | 0 |
| Implant ureth bulk agent HCPCS L8606 | $2,587.50 | $3,450.00 | $322.77 – $580.99 | 16 |
| Implnt spinl canal catheter 62350 CPT 62350 | $7,722.75 | $10,297.00 | $8,510.82 – $15,319.47 | 16 |
| Imported lipodox inj HCPCS Q2049 | not published | not published | $1,237.49 – $1,237.49 | 1 |
| Imuglucerase injection HCPCS J1786 | not published | not published | $105.37 – $105.37 | 1 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | $435.00 | $580.00 | $117.62 – $211.71 | 16 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $492.75 | $657.00 | $165.22 – $297.40 | 16 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $2,808.00 | $3,744.00 | $831.46 – $1,496.63 | 16 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $2,156.25 | $2,875.00 | $745.62 – $1,342.12 | 16 |
| In-111 pentetreotide HCPCS A9572 | $47,542.46 | $63,389.94 | $2,000.94 – $3,601.69 | 16 |
| Incise/drain eyelid lining CPT 68020 | $3,291.75 | $4,389.00 | $966.77 – $1,740.19 | 16 |
| Incision & drainage hematoma/seroma/fluid collection CPT 10140 | $2,496.00 | $3,328.00 | $1,601.72 – $2,883.09 | 16 |
| Incision of breast lesion CPT 19020 | $1,959.00 | $2,612.00 | $1,601.72 – $2,883.09 | 16 |
| Incision of hip tendons CPT 27006 | $3,126.75 | $4,169.00 | $3,173.19 – $5,711.73 | 16 |
| Incisn of toe tndn CPT 28010 | $2,176.50 | $2,902.00 | $1,559.43 – $2,806.97 | 16 |
| Incobotulinumtoxin a HCPCS J0588 | $1,889.43 | $2,519.23 | $5.29 – $12.90 | 17 |
| Indigotindisulfonate 8 mg/ml soln 5 ml ampule HCPCS J9220 | $586.73 | $782.30 | $9.30 – $16.74 | 16 |
| Induced abortion dilat&evac CPT 59841 | $7,136.25 | $9,515.00 | $3,139.36 – $5,650.86 | 16 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | $234.75 | $313.00 | $70.20 – $126.36 | 16 |
| Infect ag drug suscept pheno predict CPT 87900 | $378.00 | $504.00 | $130.35 – $234.63 | 17 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $1,863.00 | $2,484.00 | $257.45 – $463.41 | 17 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $301.50 | $402.00 | $128.73 – $231.71 | 17 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $603.75 | $805.00 | $257.45 – $463.41 | 17 |
| Infect ag ia optc obs influenza CPT 87804 | $109.50 | $146.00 | $16.55 – $29.79 | 17 |
| Infect ag if hep delta agent CPT 87380 | $136.50 | $182.00 | $18.36 – $33.05 | 17 |
| Infect ag if legionella pneumophila CPT 87278 | $60.75 | $81.00 | $15.60 – $28.08 | 17 |
| Infect ag na herpes simplex quant CPT 87530 | $225.75 | $301.00 | $42.84 – $77.11 | 17 |
| Infect ag na hpv high-risk types CPT 87624 | $247.50 | $330.00 | $35.09 – $63.16 | 17 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $228.75 | $305.00 | $95.80 – $172.44 | 17 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $180.00 | $240.00 | $51.31 – $92.36 | 16 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $812.25 | $1,083.00 | $416.78 – $750.20 | 17 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $108.00 | $144.00 | $488.66 – $879.59 | 17 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $1,288.50 | $1,718.00 | $26.07 – $46.93 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $203.25 | $271.00 | $11.98 – $21.56 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | $60.75 | $81.00 | $13.42 – $24.16 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $69.00 | $92.00 | $13.82 – $24.88 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $90.00 | $120.00 | $11.98 – $21.56 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $48.00 | $64.00 | $10.33 – $18.59 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $60.75 | $81.00 | $24.08 – $43.34 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $303.00 | $404.00 | $11.98 – $21.56 | 17 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $130.50 | $174.00 | $11.98 – $21.56 | 17 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $357.75 | $477.00 | $76.77 – $138.19 | 16 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $751.50 | $1,002.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $186.00 | $248.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $202.50 | $270.00 | $37.27 – $67.09 | 17 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $836.25 | $1,115.00 | $416.78 – $750.20 | 17 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $310.50 | $414.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $147.00 | $196.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $670.50 | $894.00 | $41.68 – $75.02 | 17 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $186.00 | $248.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $141.00 | $188.00 | $51.31 – $92.36 | 16 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $299.25 | $399.00 | $142.63 – $256.73 | 16 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $299.25 | $399.00 | $142.63 – $256.73 | 16 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $78.75 | $105.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $108.75 | $145.00 | $35.09 – $63.16 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $984.00 | $1,312.00 | $416.78 – $750.20 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $436.50 | $582.00 | $128.29 – $230.92 | 17 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $255.00 | $340.00 | $262.99 – $473.38 | 17 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $1,008.75 | $1,345.00 | $42.84 – $77.11 | 17 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $305.25 | $407.00 | $42.84 – $77.11 | 17 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $934.50 | $1,246.00 | $42.84 – $77.11 | 17 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $680.25 | $907.00 | $85.10 – $153.18 | 17 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $358.50 | $478.00 | $142.63 – $256.73 | 17 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $1,702.78 | $2,270.37 | $31.04 – $75.87 | 17 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $50.82 – $50.82 | 1 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $1,713.99 | $2,285.31 | $26.04 – $47.88 | 17 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $203.21 – $203.21 | 1 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $70.27 – $70.27 | 1 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $322.50 | $430.00 | $212.36 – $382.26 | 16 |
| Initiation & management bipap/cpap initial day CPT 94660 | $306.75 | $409.00 | $212.36 – $382.26 | 16 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | $5,937.23 | $7,916.30 | $3.81 – $6.86 | 16 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | $20,116.77 | $26,822.36 | $18.31 – $44.06 | 17 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $196.55 – $196.55 | 1 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | $7,487.44 | $9,983.25 | $214.02 – $516.88 | 17 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $22.16 | $29.54 | $1.92 – $9.63 | 2 |
| Inj ceftolozane tazobactam HCPCS J0695 | $597.69 | $796.91 | $8.84 – $22.20 | 17 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $459.75 | $613.00 | $168.33 – $302.99 | 16 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | not published | not published | $2,541.41 – $2,541.41 | 1 |
| Inj cuvitru, 100 mg HCPCS J1555 | not published | not published | $42.79 – $42.79 | 1 |
| Inj cyclophosphamd auromedic HCPCS J9071 | not published | not published | $1.90 – $1.90 | 1 |
| Inj disk cerv-thor ea lev CPT 62291 | $2,326.50 | $3,102.00 | $317.01 – $570.63 | 16 |
| Inj dx for sinogram CPT 20501 | $1,089.00 | $1,452.00 | $126.18 – $227.13 | 16 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $2,184.75 | $2,913.00 | $684.56 – $1,232.21 | 16 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $1,623.75 | $2,165.00 | $857.76 – $1,543.97 | 16 |
| Inj fensolvi 0.25 mg HCPCS J1951 | not published | not published | $341.78 – $341.78 | 1 |
| Inj for ext venography CPT 36005 | $1,731.75 | $2,309.00 | $226.43 – $407.58 | 16 |
| Inj for mammo ductogram CPT 19030 | $633.00 | $844.00 | $150.27 – $270.48 | 16 |
| Inj fosnetupitant, palonoset HCPCS J1454 | not published | not published | $1,475.86 – $1,475.86 | 1 |
| Inj givosiran 0.5 mg HCPCS J0223 | $162,298.07 | $216,397.42 | $120.98 – $285.24 | 17 |
| Inj herzuma 10 mg HCPCS Q5113 | not published | not published | $188.61 – $188.61 | 1 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | $930.75 | $1,241.00 | $44.85 – $80.73 | 16 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | $1,038.00 | $1,384.00 | $49.40 – $88.93 | 16 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | $666.75 | $889.00 | $52.43 – $94.37 | 16 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | $693.75 | $925.00 | $25.90 – $46.61 | 16 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | $648.00 | $864.00 | $24.85 – $44.74 | 16 |
| Inj human fibrinogen con nos HCPCS J7178 | $4,326.08 | $5,768.10 | $1.52 – $3.68 | 17 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | $1,083.72 | $1,444.95 | $6.35 – $22.14 | 2 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $427.50 | $570.00 | $194.58 – $350.24 | 16 |
| Inj intralesional > 7 lsns CPT 11901 | $222.75 | $297.00 | $194.58 – $350.24 | 16 |
| Inj ivig privigen 500 mg HCPCS J1459 | $4,194.45 | $5,592.60 | $49.53 – $122.75 | 17 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $122.28 | $163.04 | $59.12 – $317.88 | 2 |
| Inj lwr xtr fscl pln blk uni w/wo image CPT 64473 | $1,471.50 | $1,962.00 | $127.08 – $228.75 | 16 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | $1,713.99 | $2,285.31 | $120.67 – $262.95 | 17 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $28.41 | $37.87 | $9.30 – $29.61 | 2 |
| Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 | $17,682.90 | $23,577.19 | $253.47 – $604.82 | 17 |
| Inj multihance HCPCS A9577 | $166.47 | $221.95 | $4.24 – $16.56 | 2 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $441.00 | $588.00 | $676.24 – $1,217.23 | 16 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | $1,976.25 | $2,635.00 | $2,000.97 – $3,601.74 | 16 |
| Inj ogivri 10 mg HCPCS Q5114 | $8,661.59 | $11,548.78 | $35.78 – $108.53 | 17 |
| Inj ontruzant 10 mg HCPCS Q5112 | not published | not published | $53.50 – $53.50 | 1 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | $12,400.57 | $16,534.09 | $68.10 – $215.35 | 17 |
| Inj proc ankle arthr CPT 27648 | $159.00 | $212.00 | $191.94 – $345.49 | 16 |
| Inj proc elbow arthro CPT 24220 | $108.75 | $145.00 | $174.29 – $313.73 | 16 |
| Inj proc lumbr disk ea lvl CPT 62290 | $2,326.50 | $3,102.00 | $347.22 – $625.00 | 16 |
| Inj proc myelogram lumbar CPT 62284 | $1,300.50 | $1,734.00 | $169.23 – $304.62 | 16 |
| Inj progesterone per 50 mg HCPCS J2675 | $123.09 | $164.12 | $1.51 – $8.19 | 2 |
| Inj prohance multipack HCPCS A9576 | not published | not published | $3.43 – $3.43 | 1 |
| Inj recombin esperoct per iu HCPCS J7204 | not published | not published | $5.50 – $5.50 | 1 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | not published | not published | $1.83 – $1.83 | 1 |
| Inj retro urethrocysto CPT 51610 | $391.50 | $522.00 | $120.45 – $216.80 | 16 |
| Inj romidepsin non-lyo 0.1mg HCPCS J9318 | not published | not published | $69.39 – $69.39 | 1 |
| Inj scleros sol mult veins CPT 36471 | $454.50 | $606.00 | $394.24 – $709.63 | 16 |
| Inj scleros sol sgl vein CPT 36470 | $454.50 | $606.00 | $394.24 – $709.63 | 16 |
| Inj sebelipase alfa 1 mg HCPCS J2840 | not published | not published | $1,317.11 – $1,317.11 | 1 |
| Inj secretin synthetic human HCPCS J2850 | $2,444.05 | $3,258.73 | $40.23 – $72.41 | 17 |
| Inj sulf hexa lipid microsph HCPCS Q9950 | $336.56 | $448.74 | $45.25 – $170.19 | 2 |
| Inj tedizolid phosphate HCPCS J3090 | not published | not published | $4.65 – $4.65 | 1 |
| Inj testostero enanthate 1mg HCPCS J3121 | not published | not published | $0.12 – $0.12 | 1 |
| Inj testosterone cypionate HCPCS J1071 | $473.66 | $631.54 | $0.07 – $0.27 | 2 |
| Inj thiotepa nos 1 mg HCPCS J9342 | $8,689.13 | $11,585.50 | $5.74 – $10.33 | 16 |
| Inj thrc fascial pln blk bi w/wo image CPT 64468 | $2,207.25 | $2,943.00 | $155.25 – $279.45 | 16 |
| Inj thrc fascial pln blk uni w/wo image CPT 64466 | $1,471.50 | $1,962.00 | $134.29 – $241.72 | 16 |
| Inj triamcinolone ace X-ray 1mg HCPCS J3304 | not published | not published | $44.30 – $44.30 | 1 |
| Inj w/fluor eval cv device CPT 36598 | $711.00 | $948.00 | $206.28 – $371.30 | 16 |
| Inj(s) sclerosant spider veins limb/trunk CPT 36468 | $389.25 | $519.00 | $394.24 – $709.63 | 16 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $9,281.66 | $12,375.54 | $7.27 – $17.60 | 17 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $14.53 – $14.53 | 1 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $3.82 – $3.82 | 1 |
| Inj, artesunate, 1mg HCPCS J0391 | $39,774.01 | $53,032.01 | $51.83 – $93.29 | 16 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $134.58 – $134.58 | 1 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $96.92 – $96.92 | 1 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $842.63 – $842.63 | 1 |
| Inj, bupivacaine liposome HCPCS J0666 | $1,326.75 | $1,768.99 | $1.34 – $2.41 | 16 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $846.06 | $1,128.08 | $2.42 – $5.84 | 17 |
| Inj, durolane 1 mg HCPCS J7318 | $4,122.72 | $5,496.96 | $6.73 – $16.26 | 17 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | not published | not published | $461.85 – $461.85 | 1 |
| Inj, factor x, (human), 1iu HCPCS J7175 | $33.28 | $44.37 | $9.95 – $24.12 | 17 |
| Inj, fulvestrant (fresenius) HCPCS J9394 | $1,713.99 | $2,285.31 | $27.11 – $48.80 | 16 |
| Inj, granisetron, xr, 0.1 mg HCPCS J1627 | not published | not published | $12.07 – $12.07 | 1 |
| Inj, kovaltry, 1 i.u HCPCS J7211 | not published | not published | $3.85 – $3.85 | 1 |
| Inj, levothyroxine, freskabi HCPCS J0651 | $244.63 | $326.17 | $6.96 – $12.53 | 16 |
| Inj, moxifloxacin 100 mg HCPCS J2280 | not published | not published | $21.20 – $21.20 | 1 |
| Inj, pasireotide long acting HCPCS J2502 | not published | not published | $1,372.26 – $1,372.26 | 1 |
| Inj, rimabotulinumtoxinb HCPCS J0587 | $2,348.22 | $3,130.95 | $13.28 – $32.47 | 17 |
| Inj, taliglucerace alfa 10 u HCPCS J3060 | not published | not published | $99.94 – $99.94 | 1 |
| Inj, trivisc 1 mg HCPCS J7329 | not published | not published | $13.24 – $13.24 | 1 |
| Inj. asceniv HCPCS J1554 | not published | not published | $1,208.48 – $1,208.48 | 1 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $151.27 – $151.27 | 1 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $39.89 – $39.89 | 1 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | not published | not published | $46.12 – $46.12 | 1 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | $17,286.71 | $23,048.94 | $59.91 – $153.27 | 17 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | $172,856.28 | $230,475.04 | $495.55 – $1,203.44 | 17 |
| Inj. jivi 1 iu HCPCS J7208 | not published | not published | $6.45 – $6.45 | 1 |
| Inj. lumasiran, 0.5 mg HCPCS J0224 | not published | not published | $801.03 – $801.03 | 1 |
| Inj. mycophenolate mofetil HCPCS J7519 | $387.27 | $516.36 | $6.57 – $6.57 | 1 |
| Inj. naxitamab-gqgk, 1 mg HCPCS J9348 | $96,378.67 | $128,504.89 | $686.09 – $1,669.48 | 17 |
| Inj. pemetrexed, 10 mg HCPCS J9304 | not published | not published | $128.37 – $128.37 | 1 |
| Inj. tagraxofusp-erzs 10 mcg HCPCS J9269 | $124,816.51 | $166,422.01 | $357.28 – $848.52 | 17 |
| Inj. teprotumumab-trbw 10 mg HCPCS J3241 | $66,625.08 | $88,833.43 | $367.91 – $874.00 | 17 |
| Inj. xembify, 100 mg HCPCS J1558 | not published | not published | $36.29 – $36.29 | 1 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $7.91 – $7.91 | 1 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $19,707.27 | $26,276.36 | $163.36 – $409.23 | 17 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | not published | not published | $928.91 – $928.91 | 1 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | $58,842.17 | $78,456.22 | $55.64 – $139.78 | 17 |
| Inj., evomela, 1 mg HCPCS J9246 | not published | not published | $42.28 – $42.28 | 1 |
| Inj., fibryga, 1 mg HCPCS J7177 | not published | not published | $2.92 – $2.92 | 1 |
| Inj., guselkumab, 1 mg HCPCS J1628 | not published | not published | $182.21 – $182.21 | 1 |
| Inj., ibalizumab-uiyk, 10 mg HCPCS J1746 | not published | not published | $193.21 – $193.21 | 1 |
| Inj., lumoxiti, 0.01 mg HCPCS J9313 | not published | not published | $56.93 – $56.93 | 1 |
| Inj., meropenem, vaborbactam HCPCS J2186 | $759.87 | $1,013.15 | $2.17 – $3.91 | 16 |
| Inj., omadacycline, 1 mg HCPCS J0121 | not published | not published | $9.76 – $9.76 | 1 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | $36,180.04 | $48,240.05 | $100.90 – $242.94 | 17 |
| Inj., perseris, 0.5 mg HCPCS J2798 | not published | not published | $29.52 – $29.52 | 1 |
| Inj., plazomicin, 5 mg HCPCS J0291 | not published | not published | $8.69 – $8.69 | 1 |
| Inj., tildrakizumab, 1 mg HCPCS J3245 | not published | not published | $307.24 – $307.24 | 1 |
| Inj., triluron, 1 mg HCPCS J7332 | not published | not published | $24.73 – $24.73 | 1 |
| Inj., triptorelin X-ray 3.75 mg HCPCS J3316 | not published | not published | $9,183.12 – $9,183.12 | 1 |
| Inj., yutiq, 0.01 mg HCPCS J7314 | not published | not published | $1,296.30 – $1,296.30 | 1 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | $2,231.25 | $2,975.00 | $857.76 – $1,543.97 | 16 |
| Inject sacroiliac joint CPT 27096 | $250.50 | $334.00 | $165.03 – $297.06 | 16 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | $678.75 | $905.00 | $684.56 – $1,232.21 | 16 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $217.50 | $290.00 | $216.41 – $389.54 | 16 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | $593.25 | $791.00 | $297.68 – $535.83 | 16 |
| Injection during cath supravalvular aortography CPT 93567 | $353.25 | $471.00 | $36.03 – $64.85 | 16 |
| Injection epidural blood patch or clot CPT 62273 | $1,115.25 | $1,487.00 | $684.56 – $1,232.21 | 16 |
| Injection eye drug CPT 67028 | $322.50 | $430.00 | $320.33 – $576.59 | 16 |
| Injection for arthrography wrist (both sides) CPT 25246 | $281.25 | $375.00 | $175.92 – $316.66 | 16 |
| Injection for bladder x-ray CPT 51600 | $357.75 | $477.00 | $192.16 – $345.89 | 16 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $405.00 | $540.00 | $146.46 – $263.63 | 16 |
| Injection for ureter x-ray CPT 50690 | $545.25 | $727.00 | $110.40 – $198.71 | 16 |
| Injection glatiramer acetate HCPCS J1595 | $1,749.29 | $2,332.38 | $1,403.82 – $1,403.82 | 1 |
| Injection jugular CPT 36299 | $1,539.75 | $2,053.00 | not published | 0 |
| Injection px peyronie ds CPT 54200 | $239.25 | $319.00 | $242.30 – $436.15 | 16 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $269.25 | $359.00 | $387.70 – $697.86 | 16 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $201.75 | $269.00 | $206.28 – $371.30 | 16 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $510.00 | $680.00 | $45.41 – $81.74 | 16 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $132.00 | $176.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $99.75 | $133.00 | $69.83 – $125.69 | 16 |
| Injection treatment of nerve CPT 64605 | $1,866.00 | $2,488.00 | $1,893.75 – $3,408.76 | 16 |
| Injection treatment of nerve CPT 64681 | $2,706.75 | $3,609.00 | $857.76 – $1,543.97 | 16 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | $1,021.50 | $1,362.00 | $684.56 – $1,232.21 | 16 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | $710.25 | $947.00 | $684.56 – $1,232.21 | 16 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | $1,513.50 | $2,018.00 | $857.76 – $1,543.97 | 16 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $1,791.00 | $2,388.00 | $96.64 – $173.96 | 16 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $1,791.00 | $2,388.00 | $857.76 – $1,543.97 | 16 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $1,791.00 | $2,388.00 | $90.62 – $163.12 | 16 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $2,289.00 | $3,052.00 | $857.76 – $1,543.97 | 16 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $2,250.00 | $3,000.00 | $684.56 – $1,232.21 | 16 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,959.00 | $2,612.00 | $684.56 – $1,232.21 | 16 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | $216.75 | $289.00 | $297.68 – $535.83 | 16 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | $699.00 | $932.00 | $297.68 – $535.83 | 16 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $856.50 | $1,142.00 | $297.68 – $535.83 | 16 |
| Injection, belinostat, 10mg HCPCS J9032 | $9,355.72 | $12,474.29 | $53.11 – $126.67 | 17 |
| Injection, burosumab-twza 1m HCPCS J0584 | not published | not published | $1,172.12 – $1,172.12 | 1 |
| Injection, cangrelor HCPCS C9460 | $3,425.21 | $4,566.94 | $20.02 – $36.04 | 16 |
| Injection, daratumumab 10 mg HCPCS J9145 | not published | not published | $169.97 – $169.97 | 1 |
| Injection, doxercalciferol HCPCS J1270 | $23.86 | $31.81 | $0.90 – $3.42 | 2 |
| Injection, edaravone, 1 mg HCPCS J1301 | not published | not published | $45.83 – $45.83 | 1 |
| Injection, fulvestrant HCPCS J9395 | $3,584.82 | $4,779.76 | $16.96 – $76.05 | 2 |
| Injection, isavuconazonium HCPCS J1833 | $1,350.22 | $1,800.29 | $1.01 – $2.17 | 17 |
| Injection, necitumumab, 1 mg HCPCS J9295 | not published | not published | $13.95 – $13.95 | 1 |
| Injection, peramivir HCPCS J2547 | $1,257.68 | $1,676.90 | $1.68 – $4.06 | 17 |
| Injection, renflexis HCPCS Q5104 | $2,582.56 | $3,443.41 | $26.80 – $60.97 | 17 |
| Injection, ruconest HCPCS J0596 | not published | not published | $89.40 – $89.40 | 1 |
| Injection, siltuximab HCPCS J2860 | $23,535.37 | $31,380.49 | $174.08 – $394.19 | 17 |
| Injection,onabotulinumtoxina HCPCS J0585 | $4,814.15 | $6,418.86 | $6.51 – $15.82 | 17 |
| Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln HCPCS J9229 | $88,429.23 | $117,905.64 | $2,816.77 – $6,567.05 | 17 |
| Ins cath ren art 1st bi CPT 36252 | $4,677.00 | $6,236.00 | $3,062.12 – $5,511.82 | 16 |
| Ins cath ren art 1st uni CPT 36251 | $4,084.50 | $5,446.00 | $3,062.12 – $5,511.82 | 16 |
| Ins cath ren art 2nd+ bi CPT 36254 | $6,376.50 | $8,502.00 | $3,062.12 – $5,511.82 | 16 |
| Ins cath ren art 2nd+ uni CPT 36253 | $4,172.25 | $5,563.00 | $5,396.44 – $9,713.59 | 16 |
| Ins icd gen exist sgl lead CPT 33240 | $74,721.00 | $99,628.00 | $21,571.82 – $38,829.28 | 16 |
| Ins lv lead exist pm/icd CPT 33224 | $5,679.00 | $7,572.00 | $10,136.35 – $18,245.42 | 16 |
| Ins mark abd/pel for right perq CPT 49411 | $2,523.00 | $3,364.00 | $1,342.33 – $2,416.19 | 16 |
| Ins mark thor for right perq CPT 32553 | $1,326.00 | $1,768.00 | $1,342.33 – $2,416.19 | 16 |
| Ins picad w subq port 5yr> CPT 36571 | $3,510.75 | $4,681.00 | $3,062.12 – $5,511.82 | 16 |
| Ins picc wo subq prt/pmp w image guidnc <5yr CPT 36572 | $728.25 | $971.00 | $608.36 – $1,095.05 | 16 |
| Ins pq tunnld ip cath w/img CPT 49418 | $5,122.50 | $6,830.00 | $3,472.27 – $6,250.09 | 16 |
| Ins tun cv cath wo subq prt/pm CPT 36557 | $6,372.00 | $8,496.00 | $5,396.44 – $9,713.59 | 16 |
| Ins tun cv cath wo subq prt/pm CPT 36558 | $3,582.00 | $4,776.00 | $3,062.12 – $5,511.82 | 16 |
| Ins tun intraperit dia cath CPT 49421 | $4,317.75 | $5,757.00 | $3,472.27 – $6,250.09 | 16 |
| Ins/rpl pm gen exist dual lead CPT 33213 | $6,548.25 | $8,731.00 | $10,136.35 – $18,245.42 | 16 |
| Ins/rpl pm gen exist sgl lead CPT 33212 | $22,272.00 | $29,696.00 | $8,025.47 – $14,445.85 | 16 |
| Ins/rpl pm w/tv ld atrl CPT 33206 | $25,282.50 | $33,710.00 | $10,136.35 – $18,245.42 | 16 |
| Ins/rpl prph sac/gstr npg/r CPT 64590 | $21,134.25 | $28,179.00 | $18,814.23 – $33,865.62 | 16 |
| Ins/rpl wireless pulm art sensor incl s&i CPT 33289 | $65,752.50 | $87,670.00 | $27,817.12 – $50,070.81 | 16 |
| Ins/rplc spi npg/rcvr pocket CPT 63685 | $29,999.25 | $39,999.00 | $29,925.80 – $53,866.43 | 16 |
| Insert abdomen-venous drain CPT 49425 | $5,264.25 | $7,019.00 | $726.26 – $1,307.27 | 16 |
| Insert cath pleura with image CPT 32557 | $1,842.00 | $2,456.00 | $1,526.62 – $2,747.91 | 16 |
| Insert cath pleura without image CPT 32556 | $1,492.50 | $1,990.00 | $1,860.96 – $3,349.72 | 16 |
| Insert drug delivery implant CPT 11981 | $377.25 | $503.00 | $129.03 – $232.25 | 16 |
| Insert hepatic shunt (tips) CPT 37182 | $6,123.00 | $8,164.00 | $17,778.02 – $32,000.44 | 16 |
| Insert intrauterine device iud CPT 58300 | $271.50 | $362.00 | $99.56 – $179.21 | 16 |
| Insert pessary/other device CPT 57160 | $290.25 | $387.00 | $196.07 – $352.92 | 16 |
| Insert picvad cath CPT 36570 | $2,007.00 | $2,676.00 | $3,062.12 – $5,511.82 | 16 |
| Insert pm/icd lead dual CPT 33217 | $16,456.50 | $21,942.00 | $8,025.47 – $14,445.85 | 16 |
| Insert swan-ganz cath CPT 93503 | $5,181.00 | $6,908.00 | $1,526.62 – $2,747.91 | 16 |
| Insert tunneled cv 2cath 2sits without port/pmp 36565 CPT 36565 | $4,040.25 | $5,387.00 | $3,062.12 – $5,511.82 | 16 |
| Insert tunneled cv cath CPT 36560 | $6,887.25 | $9,183.00 | $3,062.12 – $5,511.82 | 16 |
| Insert vad art access left hrt art & vein access CPT 33991 | $9,195.00 | $12,260.00 | $411.25 – $740.25 | 16 |
| Insertion catheter bladder non indwelling CPT 51701 | $162.75 | $217.00 | $129.03 – $232.25 | 16 |
| Insertion catheter bladder temporary simple CPT 51702 | $221.25 | $295.00 | $129.03 – $232.25 | 16 |
| Insertion catheter pleural indwelling tunneled with cuff CPT 32550 | $5,079.00 | $6,772.00 | $3,472.27 – $6,250.09 | 16 |
| Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance CPT 37191 | $6,646.50 | $8,862.00 | $5,396.44 – $9,713.59 | 16 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $1,966.50 | $2,622.00 | $3,062.12 – $5,511.82 | 16 |
| Insertion of catheter vein CPT 36481 | $1,761.75 | $2,349.00 | $1,517.83 – $2,732.10 | 16 |
| Insertion of catheter vein CPT 36500 | $1,422.75 | $1,897.00 | $158.44 – $285.19 | 16 |
| Insertion of heart electrode 33211 CPT 33211 | $20,065.50 | $26,754.00 | $8,025.47 – $14,445.85 | 16 |
| Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular CPT 33208 | $10,317.00 | $13,756.00 | $10,136.35 – $18,245.42 | 16 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $3,077.25 | $4,103.00 | $1,526.62 – $2,747.91 | 16 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $3,558.00 | $4,744.00 | $1,526.62 – $2,747.91 | 16 |
| Insertion single tranvenous electrode/ppm/implantable defibrillator CPT 33216 | $4,551.75 | $6,069.00 | $8,025.47 – $14,445.85 | 16 |
| Insertion subcutaneous cardiac rhythm monitor CPT 33285 | $7,037.25 | $9,383.00 | $8,025.47 – $14,445.85 | 16 |
| Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides) CPT 36561 | $3,831.00 | $5,108.00 | $3,062.12 – $5,511.82 | 16 |
| Insertion/replacement temporary single chamber electrode/pacemaker catheter CPT 33210 | $3,691.50 | $4,922.00 | $8,025.47 – $14,445.85 | 16 |
| Insitu hybridization (fish) CPT 88366 | $907.50 | $1,210.00 | $165.22 – $297.40 | 16 |
| Insitu hybridization manual CPT 88368 | $585.75 | $781.00 | $347.62 – $625.72 | 16 |
| Insj phrnc nrv stim sys CPT 33276 | $30,000.00 | $40,000.00 | $42,716.27 – $76,889.29 | 16 |
| Insj stablj dev without dcmprn CPT 22869 | $12,715.50 | $16,954.00 | $12,450.95 – $22,411.72 | 16 |
| Insole orthotic freedom sz6 6816 HCPCS L3060 | $38.25 | $51.00 | $107.96 – $194.33 | 16 |
| Inst fibrinolysis agent sbsq d CPT 32562 | $1,025.25 | $1,367.00 | $608.36 – $1,095.05 | 16 |
| Inst via cath agent pleurds CPT 32560 | $1,861.50 | $2,482.00 | $608.36 – $1,095.05 | 16 |
| Insti hexaminolevulinate hcl HCPCS A9589 | not published | not published | $3,466.82 – $3,466.82 | 1 |
| Instillation anticarcinogenic agent bladder CPT 51720 | $862.50 | $1,150.00 | $676.24 – $1,217.23 | 16 |
| Insulin total CPT 83525 | $81.75 | $109.00 | $11.43 – $20.57 | 17 |
| Int hrhc lig 1 hroid without img CPT 46945 | $2,572.50 | $3,430.00 | $2,691.84 – $4,845.30 | 16 |
| Int hrhc lig 2+hroid without img CPT 46946 | $2,682.00 | $3,576.00 | $2,691.84 – $4,845.30 | 16 |
| Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm HCPCS Q4114 | $9,970.16 | $13,293.54 | $3,753.81 – $13,563.00 | 2 |
| Integra meshed bil wound mat HCPCS C9363 | $35,280.97 | $47,041.29 | $120.69 – $217.24 | 16 |
| Integra os putty 2.5cc - cost per 0.5cc HCPCS C9359 | $6,018.75 | $8,025.00 | not published | 0 |
| Interdental fixation CPT 21110 | $1,443.75 | $1,925.00 | $1,504.73 – $2,708.51 | 16 |
| Interdiscal perq aspir dx CPT 62267 | $685.50 | $914.00 | $686.75 – $1,236.14 | 16 |
| Interferon alfa-2b inj HCPCS J9214 | not published | not published | $79.28 – $79.28 | 1 |
| Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper) HCPCS Q3027 | $29,609.96 | $39,479.94 | $135.38 – $483.21 | 2 |
| Interrog dev eval icpms ip CPT 93290 | $112.50 | $150.00 | $36.19 – $65.15 | 16 |
| Interrog dev eval scrms ip CPT 93291 | $176.25 | $235.00 | $28.05 – $50.49 | 16 |
| Interrog device eval heart CPT 93289 | $181.50 | $242.00 | $36.19 – $65.15 | 16 |
| Interrog evl pm/ldls pm ip CPT 93288 | $113.25 | $151.00 | $36.19 – $65.15 | 16 |
| Interrog without prgrmg ipnss CPT 93153 | $90.00 | $120.00 | $92.20 – $165.96 | 16 |
| Interrog&prgrmg ipnss CPT 93151 | $90.00 | $120.00 | $92.20 – $165.96 | 16 |
| Interrogate subq defib CPT 93261 | $420.75 | $561.00 | $36.19 – $65.15 | 16 |
| Intracard echo interv w/s&i CPT 93662 | $3,290.25 | $4,387.00 | not published | 0 |
| Intracranial angioplasty CPT 61630 | $7,578.00 | $10,104.00 | $1,229.57 – $2,213.22 | 16 |
| Intracranial complete study CPT 93886 | $1,215.75 | $1,621.00 | $231.40 – $416.51 | 16 |
| Intracranial limited study CPT 93888 | $905.25 | $1,207.00 | $101.39 – $182.50 | 16 |
| Intrapul surf admin endo tube CPT 94610 | $256.50 | $342.00 | $212.36 – $382.26 | 16 |
| Intrauterine transfusion ftl CPT 36460 | $645.00 | $860.00 | $427.85 – $770.13 | 16 |
| Intrinsic factor antibody CPT 86340 | $57.00 | $76.00 | $15.08 – $27.14 | 17 |
| Intro cath dialysis circuit CPT 36901 | $8,576.25 | $11,435.00 | $1,526.62 – $2,747.91 | 16 |
| Intro cath dialysis circuit w/pta CPT 36902 | $6,781.50 | $9,042.00 | $5,519.68 – $9,935.42 | 16 |
| Intro cath dialysis circuit w/stent plcmnt CPT 36903 | $10,578.00 | $14,104.00 | $11,195.55 – $20,152.00 | 16 |
| Intro cath svc/ivc CPT 36010 | $1,134.00 | $1,512.00 | $475.28 – $855.51 | 16 |
| Intro catheter aorta CPT 36200 | $2,110.50 | $2,814.00 | $527.01 – $948.62 | 16 |
| Intro long gi tube CPT 44500 | $647.25 | $863.00 | $879.59 – $1,583.27 | 16 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $1,968.75 | $2,625.00 | $823.86 – $1,482.95 | 16 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $822.75 | $1,097.00 | $159.87 – $287.77 | 16 |
| Intubation endotracheal emergency procedure CPT 31500 | $422.25 | $563.00 | $229.70 – $413.45 | 16 |
| Ionm in operatng room 15 min CPT 95940 | $320.25 | $427.00 | $26.23 – $47.22 | 16 |
| Ionm remote/>1 pt or per hr CPT 95941 | $1,070.25 | $1,427.00 | not published | 0 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $199.60 | $266.13 | $1.07 – $3.33 | 2 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $244.04 | $325.38 | $0.37 – $1.08 | 2 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $133,919.31 | $178,559.08 | $187.17 – $446.42 | 17 |
| Ipratropium bromide non-comp HCPCS J7644 | $2.43 | $3.23 | $0.95 – $2.88 | 2 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $378.32 | $504.42 | $3.38 – $17.55 | 2 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | $11,014.86 | $14,686.47 | $66.37 – $158.82 | 17 |
| Iron CPT 83540 | $309.00 | $412.00 | $6.47 – $11.65 | 17 |
| Iron binding capacity CPT 83550 | $72.75 | $97.00 | $8.74 – $15.73 | 17 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $140.34 | $187.12 | $18.11 – $43.86 | 17 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $133.11 | $177.48 | $0.54 – $1.98 | 2 |
| Irradiation of blood product each unit reference CPT 86945 | $138.75 | $185.00 | $36.22 – $65.20 | 16 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $227.25 | $303.00 | $57.21 – $102.98 | 16 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $15,760.97 | $21,014.62 | $83.58 – $201.68 | 17 |
| Ivc venogram s&i CPT 75825 | $3,076.50 | $4,102.00 | $3,062.12 – $5,511.82 | 17 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $22,346.52 | $29,795.35 | $139.75 – $337.52 | 17 |
| J-tube placement CPT 44015 | $462.00 | $616.00 | $124.95 – $224.92 | 16 |
| Jejunstmy tube plcmt CPT 44372 | $2,244.75 | $2,993.00 | $1,860.96 – $3,349.72 | 16 |
| Ketamine and metabolite screen - quest CPT 80357 | $136.50 | $182.00 | not published | 0 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $285.75 | $381.00 | $8.17 – $14.71 | 17 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $17.11 | $22.81 | $0.32 – $0.83 | 17 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $806.25 | $1,075.00 | $101.39 – $182.50 | 17 |
| Kidney function study CPT 78725 | $549.75 | $733.00 | $387.70 – $697.86 | 17 |
| Kidney imaging morphology CPT 78700 | $627.00 | $836.00 | $387.70 – $697.86 | 17 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $704.25 | $939.00 | $526.57 – $947.83 | 17 |
| Kit case 4.2mm spinejack HCPCS C1062 | $9,652.39 | $12,869.85 | not published | 0 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $10,575.00 | $14,100.00 | not published | 0 |
| Kit gene analys d816 variant CPT 81273 | $268.50 | $358.00 | $124.87 – $224.77 | 17 |
| Kit hfx iq ipg bundle HCPCS C1822 | $58,500.00 | $78,000.00 | not published | 0 |
| Kit ipg optimizer smart HCPCS C1824 | $51,750.00 | $69,000.00 | not published | 0 |
| Kit lead specify 5-6-5 HCPCS C1778 | $73,912.50 | $98,550.00 | not published | 0 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $801.57 | $1,068.75 | not published | 0 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | not published | not published | $63.48 – $63.48 | 1 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $2,836.08 | $3,781.44 | not published | 0 |
| Knee MRI (with and without contrast) CPT 73723 | $2,854.50 | $3,806.00 | $338.34 – $609.01 | 16 |
| Knee MRI (with contrast) CPT 73722 | $2,682.75 | $3,577.00 | $760.25 – $1,368.44 | 16 |
| Knee MRI (without contrast) CPT 73721 | $2,854.50 | $3,806.00 | $231.40 – $416.51 | 16 |
| Knee X-ray CPT 73564 | $267.75 | $357.00 | $101.39 – $182.50 | 17 |
| Kyleena, 19.5 mg HCPCS J7296 | $4,491.10 | $5,988.13 | $2,460.09 – $12,493.35 | 2 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $22.19 | $29.58 | $1.71 – $1.71 | 1 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $237.75 | $317.00 | not published | 0 |
| Lactate dehydrogenase (ldh) CPT 83615 | $52.50 | $70.00 | $6.04 – $10.87 | 17 |
| Lactated ringers intravenous solution HCPCS J7120 | $22.19 | $29.58 | $5.99 – $23.31 | 2 |
| Lactic acid CPT 83605 | $164.25 | $219.00 | $11.57 – $20.83 | 17 |
| Lactoferrin fecal qualitative CPT 83630 | $33.75 | $45.00 | $19.70 – $35.46 | 17 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $35,355.50 | $47,140.66 | $35.72 – $89.21 | 17 |
| Lanthanum carbonate oral 5mg HCPCS J0607 | $2,066.54 | $2,755.38 | not published | 0 |
| Laparoscopye procstom 43659 CPT 43659 | $5,688.75 | $7,585.00 | $5,862.95 – $10,553.31 | 16 |
| Laronidase injection HCPCS J1931 | $4,116.73 | $5,488.97 | $39.95 – $97.07 | 17 |
| Laryngeal function studies CPT 92520 | $359.25 | $479.00 | $129.03 – $232.25 | 16 |
| Laryngoscope w/vc inj CPT 31570 | $3,737.25 | $4,983.00 | $3,615.75 – $6,508.35 | 16 |
| Laryngoscopy telescopic CPT 31579 | $725.25 | $967.00 | $379.31 – $682.75 | 16 |
| Laryngoscopy w/exc of tumor CPT 31540 | $7,290.00 | $9,720.00 | $3,615.75 – $6,508.35 | 16 |
| Laryngoscopy w/fb removal CPT 31530 | $1,681.50 | $2,242.00 | $1,726.15 – $3,107.06 | 16 |
| Laryngoscopy w/w/o tracheoscopy aspiration CPT 31515 | $473.25 | $631.00 | $379.31 – $682.75 | 16 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $4,863.24 | $6,484.32 | not published | 0 |
| Lead capillary CPT 83655 | $79.50 | $106.00 | $12.11 – $21.80 | 17 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $7,616.25 | $10,155.00 | not published | 0 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $13,488.75 | $17,985.00 | not published | 0 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $832.50 | $1,110.00 | $231.40 – $416.51 | 16 |
| Leishmania antibody CPT 86717 | $182.25 | $243.00 | $12.25 – $22.05 | 17 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $2,238.75 | $2,985.00 | not published | 0 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $1,136.25 | $1,515.00 | $145.73 – $262.31 | 16 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $191.25 | $255.00 | $145.73 – $262.31 | 16 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $83.13 | $110.83 | $9.59 – $40.23 | 2 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $42,325.47 | $56,433.96 | $1,765.57 – $4,228.08 | 17 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $30,791.46 | $41,055.27 | $176.20 – $378.27 | 17 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $125.11 – $125.11 | 1 |
| Levalbuterol non-comp unit HCPCS J7614 | $5.40 | $7.19 | $0.19 – $0.45 | 2 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $97.62 | $130.16 | $0.10 – $0.54 | 2 |
| Levetiracetam therapeutic drug level CPT 80177 | $155.25 | $207.00 | $13.25 – $23.85 | 17 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $47.70 | $63.60 | $4.75 – $8.19 | 2 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $652.50 | $870.00 | not published | 0 |
| Liberta rc ipg HCPCS C1820 | $63,376.43 | $84,501.90 | not published | 0 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $25.89 | $34.51 | not published | 0 |
| Lidocaine therapeutic drug level CPT 80176 | $63.75 | $85.00 | $14.69 – $26.44 | 17 |
| Lig/band angioaccess av fistula CPT 37607 | $2,678.25 | $3,571.00 | $3,062.12 – $5,511.82 | 16 |
| Liletta, 52 mg HCPCS J7297 | $3,445.08 | $4,593.43 | $9,583.47 – $9,583.47 | 1 |
| Lincomycin injection HCPCS J2010 | not published | not published | $13.65 – $13.65 | 1 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $119.81 | $159.74 | $8.45 – $29.70 | 2 |
| Lipase CPT 83690 | $127.50 | $170.00 | $6.89 – $12.40 | 17 |
| Lipoprotein blood quant CPT 83704 | $175.50 | $234.00 | $34.19 – $61.54 | 17 |
| Lipoprotein direct measurement hdl CPT 83718 | $63.75 | $85.00 | $8.19 – $14.74 | 17 |
| Lipoprotein direct measurement ldl CPT 83721 | $75.00 | $100.00 | $10.50 – $18.90 | 17 |
| Lithium therapeutic drug level CPT 80178 | $69.75 | $93.00 | $6.61 – $11.90 | 17 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $3,042.00 | $4,056.00 | $120.71 – $217.27 | 16 |
| Liver Function Test CPT 80076 | $55.50 | $74.00 | $8.17 – $14.71 | 17 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $812.25 | $1,083.00 | $176.19 – $317.14 | 16 |
| Liver imaging CPT 78201 | $558.75 | $745.00 | $526.57 – $1,694.37 | 17 |
| Liver/spleen imag static only CPT 78215 | $726.00 | $968.00 | $387.70 – $697.86 | 17 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | not published | not published | $4.38 – $4.38 | 1 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $104,719.60 | $139,626.13 | $221.49 – $527.55 | 17 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $49.14 | $65.52 | $3.19 – $10.08 | 2 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,228.25 | $2,971.00 | $170.10 – $306.19 | 16 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,241.75 | $2,989.00 | $338.34 – $609.01 | 16 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,797.00 | $2,396.00 | $101.39 – $182.50 | 16 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,919.75 | $3,893.00 | $338.34 – $609.01 | 16 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,994.00 | $3,992.00 | $338.34 – $609.01 | 16 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,854.50 | $3,806.00 | $231.40 – $416.51 | 16 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $293.25 | $391.00 | $101.39 – $182.50 | 17 |
| Lumbar diskogram s&i CPT 72295 | $2,409.75 | $3,213.00 | $1,893.75 – $3,408.76 | 17 |
| Lumizyme injection HCPCS J0221 | $3,672.96 | $4,897.27 | $207.51 – $502.89 | 17 |
| Lung Function Test (Spirometry) CPT 94010 | $162.75 | $217.00 | $209.40 – $376.92 | 16 |
| Lung function test (mbc/mvv) CPT 94200 | $102.75 | $137.00 | $57.21 – $102.98 | 16 |
| Lung perfusion imaging CPT 78580 | $700.50 | $934.00 | $387.70 – $697.86 | 17 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $30,504.38 | $40,672.50 | $212.10 – $501.70 | 17 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $45,624.83 | $60,833.10 | $42.75 – $102.13 | 17 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $686.92 – $686.92 | 1 |
| Lvad shower bag heartmate HCPCS Q0501 | $1,059.75 | $1,413.00 | $749.20 – $1,348.56 | 16 |
| Lymph vessel x-ray arm/leg CPT 75801 | $2,379.00 | $3,172.00 | $608.36 – $1,095.05 | 17 |
| Lymph vessel x-ray arms/legs CPT 75803 | $1,302.00 | $1,736.00 | $863.01 – $2,747.91 | 17 |
| Lymph vessel x-ray trunk CPT 75805 | $3,555.75 | $4,741.00 | $1,384.84 – $5,511.82 | 17 |
| Lymph vessel x-ray trunk CPT 75807 | $2,179.50 | $2,906.00 | $3,062.12 – $5,511.82 | 17 |
| Lymphatics/lymph node imaging CPT 78195 | $730.50 | $974.00 | $526.57 – $947.83 | 17 |
| Lymphocyte transformation mitogen CPT 86353 | $858.75 | $1,145.00 | $49.03 – $88.25 | 17 |
| M.avium-intra dna amp prob CPT 87561 | $489.75 | $653.00 | $35.09 – $63.16 | 17 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $435.00 | $580.00 | $165.22 – $297.40 | 16 |
| MRA abdomen post contrast CPT 74185 | $2,733.00 | $3,644.00 | $312.07 – $561.72 | 16 |
| MRA aorta thoracic w/wo contrast CPT 71555 | $2,600.25 | $3,467.00 | $310.78 – $559.41 | 16 |
| MRA ext low(run-off)pst cntrst CPT 73725 | $2,733.00 | $3,644.00 | $313.31 – $563.97 | 16 |
| MRA pelvis CPT 72198 | $2,733.00 | $3,644.00 | $312.31 – $562.15 | 16 |
| MRA spinal canal CPT 72159 | $1,618.50 | $2,158.00 | $313.53 – $564.35 | 16 |
| MRA upper extremity post contrast-bil CPT 73225 | $1,929.00 | $2,572.00 | $300.88 – $541.59 | 16 |
| MRI brain without & w/dye CPT 70559 | $3,198.00 | $4,264.00 | $170.10 – $306.19 | 16 |
| MRI brain without dye CPT 70557 | $1,714.50 | $2,286.00 | $529.91 – $953.84 | 16 |
| MRI breast c-+ w/cad uni CPT 77048 | $351.00 | $468.00 | $311.38 – $560.49 | 16 |
| MRI breast w IV cont bi CPT 77049 | $351.00 | $468.00 | $317.15 – $570.87 | 16 |
| MRI breast without cont bi CPT 77047 | $262.50 | $350.00 | $231.40 – $416.51 | 16 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $2,917.50 | $3,890.00 | $231.40 – $416.51 | 16 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $3,611.25 | $4,815.00 | $338.34 – $609.01 | 16 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | $4,758.75 | $6,345.00 | $760.25 – $1,368.44 | 16 |
| MRI chest w IV cont CPT 71551 | $2,580.00 | $3,440.00 | $760.25 – $1,368.44 | 16 |
| MRI chest without & w/contrast CPT 71552 | $2,919.75 | $3,893.00 | $338.34 – $609.01 | 16 |
| MRI chest without contrast CPT 71550 | $2,439.75 | $3,253.00 | $231.40 – $416.51 | 16 |
| MRI guid ndl plc s&i CPT 77021 | $1,781.25 | $2,375.00 | $394.22 – $709.60 | 16 |
| MRI loex nonjt w IV cont CPT 73719 | $2,769.75 | $3,693.00 | $338.34 – $609.01 | 16 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $2,854.50 | $3,806.00 | $338.34 – $609.01 | 16 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $2,439.75 | $3,253.00 | $231.40 – $416.51 | 16 |
| MRI orbit fac&nck w IV cont CPT 70542 | $3,403.50 | $4,538.00 | $338.34 – $609.01 | 16 |
| MRI orbit/face/neck without & w/contrast CPT 70543 | $2,919.75 | $3,893.00 | $338.34 – $609.01 | 16 |
| MRI orbit/face/neck without contrast CPT 70540 | $2,307.75 | $3,077.00 | $231.40 – $416.51 | 16 |
| MRI tmj CPT 70336 | $2,280.75 | $3,041.00 | $231.40 – $416.51 | 16 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $2,854.50 | $3,806.00 | $338.34 – $609.01 | 16 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $2,682.75 | $3,577.00 | $231.40 – $416.51 | 16 |
| MRI upper extremity w/dye CPT 73219 | $3,126.75 | $4,169.00 | $338.34 – $609.01 | 16 |
| Magnesium CPT 83735 | $78.00 | $104.00 | $6.70 – $12.06 | 17 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $23.30 | $31.06 | $1.19 – $6.21 | 2 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $70.44 – $70.44 | 1 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $216.75 | $289.00 | $129.03 – $232.25 | 16 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $113.25 | $151.00 | $129.03 – $232.25 | 16 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $5.43 – $5.43 | 1 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $1,536.75 | $2,049.00 | $291.63 – $524.94 | 16 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $9,885.94 | $13,181.25 | $53.27 – $122.80 | 17 |
| Marker biop eviva buckle ss HCPCS A4648 | $819.00 | $1,092.00 | not published | 0 |
| Mastoids complete CPT 70130 | $361.50 | $482.00 | $101.39 – $182.50 | 17 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $192.82 – $192.82 | 1 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | not published | not published | $50.72 – $50.72 | 1 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $66.75 | $89.00 | $14.46 – $26.03 | 17 |
| Mayo aathr protein s free CPT 85306 | $167.25 | $223.00 | $15.32 – $27.58 | 17 |
| Mayo activated protein c resistance assay CPT 85307 | $125.25 | $167.00 | $15.32 – $27.58 | 17 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $2,744.25 | $3,659.00 | $38.57 – $69.43 | 16 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $63.00 | $84.00 | not published | 0 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $564.75 | $753.00 | not published | 0 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $153.75 | $205.00 | $14.78 – $26.60 | 17 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $270.75 | $361.00 | not published | 0 |
| Mayo alpha 1 antitrypsin CPT 82103 | $276.00 | $368.00 | $13.44 – $24.19 | 17 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $186.00 | $248.00 | $15.08 – $27.14 | 17 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $72.00 | $96.00 | not published | 0 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $89.25 | $119.00 | not published | 0 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $215.25 | $287.00 | $91.66 – $164.99 | 17 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $241.50 | $322.00 | $137.00 – $246.60 | 16 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $1,242.00 | $1,656.00 | $1,160.00 – $2,088.00 | 17 |
| Mayo androstenedione CPT 82157 | $195.75 | $261.00 | $29.28 – $52.70 | 17 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $56.25 | $75.00 | $14.60 – $26.28 | 17 |
| Mayo antithrombin iii antigen CPT 85301 | $73.50 | $98.00 | $10.81 – $19.46 | 17 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $77.25 | $103.00 | $15.05 – $27.09 | 17 |
| Mayo avwpr vw factor activity CPT 85397 | $911.25 | $1,215.00 | $30.86 – $55.55 | 17 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $105.00 | $140.00 | $35.09 – $63.16 | 16 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $450.00 | $600.00 | not published | 0 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $66.75 | $89.00 | $10.18 – $18.32 | 17 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $239.25 | $319.00 | $144.84 – $260.71 | 17 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $189.75 | $253.00 | $12.90 – $23.22 | 17 |
| Mayo bnzu sedative hypnotics definitive urine CPT 80368 | $92.25 | $123.00 | not published | 0 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $122.25 | $163.00 | $13.19 – $23.74 | 17 |
| Mayo brcmg brucella antibody igm CPT 86622 | $210.75 | $281.00 | $8.93 – $16.07 | 17 |
| Mayo c1 esterase inhibitor CPT 83883 | $149.25 | $199.00 | $13.60 – $24.48 | 17 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $300.00 | $400.00 | not published | 0 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $78.75 | $105.00 | $16.87 – $30.37 | 17 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $773.25 | $1,031.00 | $26.78 – $48.20 | 17 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $333.00 | $444.00 | $122.22 – $220.00 | 17 |
| Mayo ceruloplasmin CPT 82390 | $93.00 | $124.00 | $10.74 – $19.33 | 17 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $377.25 | $503.00 | $14.12 – $25.42 | 17 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $423.00 | $564.00 | $12.88 – $23.18 | 17 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $114.75 | $153.00 | $11.82 – $21.28 | 17 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $82.50 | $110.00 | $12.68 – $22.82 | 17 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $519.00 | $692.00 | $116.49 – $209.68 | 17 |
| Mayo chromium CPT 82495 | $89.25 | $119.00 | $20.28 – $36.50 | 17 |
| Mayo cocaine definitive assay confirmation urine CPT 80353 | $267.00 | $356.00 | not published | 0 |
| Mayo coccidioides antibody CPT 86635 | $128.25 | $171.00 | $11.47 – $20.65 | 17 |
| Mayo cocou cortisone urine CPT 82542 | $1,213.50 | $1,618.00 | $24.09 – $43.36 | 17 |
| Mayo cortisol free CPT 82530 | $131.25 | $175.00 | $16.71 – $30.08 | 17 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $122.25 | $163.00 | $42.13 – $75.83 | 16 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $90.75 | $121.00 | $12.12 – $21.82 | 17 |
| Mayo csmpu benzodiazepines definitive assay >=13 urine CPT 80347 | $140.25 | $187.00 | not published | 0 |
| Mayo csmpu opiod/analogs definitive assay >=5 urine CPT 80364 | $123.00 | $164.00 | not published | 0 |
| Mayo cyanide CPT 82600 | $170.25 | $227.00 | $19.40 – $34.92 | 17 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $82.50 | $110.00 | $13.25 – $23.85 | 17 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $191.25 | $255.00 | $25.27 – $45.49 | 17 |
| Mayo dihydrotestosterone CPT 82642 | $122.25 | $163.00 | $29.28 – $52.70 | 16 |
| Mayo efpo chloride stool CPT 82438 | $90.75 | $121.00 | $5.00 – $9.00 | 17 |
| Mayo estriol CPT 82677 | $138.00 | $184.00 | $24.18 – $43.52 | 17 |
| Mayo estrone CPT 82679 | $110.25 | $147.00 | $24.95 – $44.91 | 17 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $123.75 | $165.00 | $16.34 – $29.41 | 17 |
| Mayo everolimus therapeutic drug level CPT 80169 | $245.25 | $327.00 | $13.73 – $24.71 | 17 |
| Mayo factor ii CPT 85210 | $171.00 | $228.00 | $12.98 – $23.36 | 17 |
| Mayo factor v CPT 85220 | $189.00 | $252.00 | $17.65 – $31.77 | 17 |
| Mayo factor vii CPT 85230 | $150.00 | $200.00 | $17.90 – $32.22 | 17 |
| Mayo factor viii vw factor antigen CPT 85246 | $114.75 | $153.00 | $22.94 – $41.29 | 17 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $378.75 | $505.00 | $22.94 – $41.29 | 17 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $305.25 | $407.00 | $22.94 – $41.29 | 17 |
| Mayo factor x CPT 85260 | $191.25 | $255.00 | $17.90 – $32.22 | 17 |
| Mayo factor xi CPT 85270 | $201.00 | $268.00 | $17.90 – $32.22 | 17 |
| Mayo fat/lipids feces quantitative CPT 82710 | $33.75 | $45.00 | $16.80 – $30.24 | 17 |
| Mayo fbl culture fungi blood CPT 87103 | $128.25 | $171.00 | $20.46 – $36.83 | 17 |
| Mayo ffspg allergen clam igg CPT 86001 | $45.00 | $60.00 | $7.82 – $14.08 | 17 |
| Mayo fibrinogen antigen CPT 85385 | $168.75 | $225.00 | $14.46 – $26.03 | 17 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $109.50 | $146.00 | $21.67 – $39.01 | 17 |
| Mayo gamma-globin full gene sequencing CPT 81479 | $7,125.00 | $9,500.00 | not published | 0 |
| Mayo hemosiderin qualitative urine CPT 83070 | $45.00 | $60.00 | $4.75 – $8.55 | 17 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $202.50 | $270.00 | $35.09 – $63.16 | 17 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $161.25 | $215.00 | $13.79 – $24.82 | 17 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $274.50 | $366.00 | $8.89 – $16.00 | 17 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $117.75 | $157.00 | $27.17 – $48.91 | 17 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | $1,192.50 | $1,590.00 | $17.27 – $31.09 | 17 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | $108.75 | $145.00 | $14.99 – $26.98 | 17 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | $65.25 | $87.00 | $20.81 – $37.46 | 17 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | $175.50 | $234.00 | $20.81 – $37.46 | 17 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | $153.75 | $205.00 | $16.07 – $28.93 | 17 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $252.75 | $337.00 | $11.98 – $21.56 | 17 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $500.25 | $667.00 | $35.09 – $63.16 | 17 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $98.25 | $131.00 | $35.09 – $63.16 | 16 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $535.50 | $714.00 | $35.09 – $63.16 | 17 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | $292.50 | $390.00 | $35.09 – $63.16 | 16 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $433.50 | $578.00 | $42.84 – $77.11 | 17 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $258.75 | $345.00 | $72.19 – $129.94 | 16 |
| Mayo infliximab therapeutic drug level CPT 80230 | $2,965.50 | $3,954.00 | $38.57 – $69.43 | 16 |
| Mayo inhab inhibin a CPT 86336 | $267.75 | $357.00 | $15.59 – $28.06 | 17 |
| Mayo insft insulin free CPT 83527 | $39.00 | $52.00 | $12.95 – $23.31 | 17 |
| Mayo insulin antibodies CPT 86337 | $77.25 | $103.00 | $21.41 – $38.54 | 17 |
| Mayo iodine CPT 83789 | $411.75 | $549.00 | $24.11 – $43.40 | 17 |
| Mayo itraconazole therapeutic drug level CPT 80189 | $120.75 | $161.00 | $27.11 – $48.80 | 16 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $183.00 | $244.00 | $27.11 – $48.80 | 16 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $125.25 | $167.00 | $13.25 – $23.85 | 17 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $93.75 | $125.00 | $12.79 – $23.02 | 17 |
| Mayo legionella antibody CPT 86713 | $73.50 | $98.00 | $15.30 – $27.54 | 17 |
| Mayo leptospira antibody igm CPT 86720 | $60.75 | $81.00 | $16.20 – $29.16 | 17 |
| Mayo lipoprotein electrophoresis CPT 83700 | $45.75 | $61.00 | $11.26 – $20.27 | 17 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | $148.50 | $198.00 | $15.49 – $27.88 | 17 |
| Mayo manganese CPT 83785 | $117.00 | $156.00 | $26.65 – $47.97 | 17 |
| Mayo metanephrines plasma CPT 83835 | $556.50 | $742.00 | $16.94 – $30.49 | 17 |
| Mayo methadone definitive assay confirmation urine CPT 80358 | $114.00 | $152.00 | not published | 0 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $365.25 | $487.00 | $12.05 – $21.69 | 16 |
| Mayo microsomal antibody liver-kidney CPT 86376 | $122.25 | $163.00 | $14.55 – $26.19 | 17 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | $476.25 | $635.00 | $18.64 – $33.55 | 17 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $886.50 | $1,182.00 | $137.00 – $246.60 | 17 |
| Mayo muramidase CPT 85549 | $69.00 | $92.00 | $18.75 – $33.75 | 17 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $1,833.00 | $2,444.00 | $18.40 – $33.12 | 16 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $418.50 | $558.00 | $18.05 – $32.49 | 17 |
| Mayo myoglobin CPT 83874 | $129.75 | $173.00 | $12.92 – $23.26 | 17 |
| Mayo nickel CPT 83885 | $57.75 | $77.00 | $24.51 – $44.12 | 17 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | $87.00 | $116.00 | not published | 0 |
| Mayo opatu opioid/analogs definitive assay 1 or 2 CPT 80362 | $62.25 | $83.00 | not published | 0 |
| Mayo opatu oxycodone definitive assay CPT 80365 | $98.25 | $131.00 | not published | 0 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $375.75 | $501.00 | $21.21 – $38.18 | 17 |
| Mayo oxalate 24 hour urine CPT 83945 | $163.50 | $218.00 | $14.45 – $26.01 | 17 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | $123.00 | $164.00 | $15.03 – $27.05 | 17 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | $1,833.00 | $2,444.00 | $12.05 – $21.69 | 17 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $660.75 | $881.00 | $35.09 – $63.16 | 17 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $195.00 | $260.00 | $17.98 – $32.36 | 17 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $92.25 | $123.00 | $13.76 – $24.77 | 17 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $118.50 | $158.00 | $8.44 – $15.19 | 17 |
| Mayo pregnenolone CPT 84140 | $101.25 | $135.00 | $20.67 – $37.21 | 17 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $108.75 | $145.00 | $16.59 – $29.86 | 17 |
| Mayo proinsulin CPT 84206 | $147.75 | $197.00 | $26.69 – $48.04 | 17 |
| Mayo psaft prostate specific antigen free CPT 84154 | $90.75 | $121.00 | $18.39 – $33.10 | 17 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | $1,768.50 | $2,358.00 | $18.40 – $33.12 | 17 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | $277.50 | $370.00 | $13.36 – $24.05 | 17 |
| Mayo receptor assay transferrin soluble CPT 84238 | $114.00 | $152.00 | $36.57 – $65.83 | 17 |
| Mayo renin CPT 84244 | $117.00 | $156.00 | $21.99 – $39.58 | 17 |
| Mayo repu protein electrophoresis urine CPT 84166 | $69.00 | $92.00 | $17.83 – $32.09 | 17 |
| Mayo selenium CPT 84255 | $122.25 | $163.00 | $25.53 – $45.95 | 17 |
| Mayo serotonin CPT 84260 | $209.25 | $279.00 | $30.98 – $55.76 | 17 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | $109.50 | $146.00 | $19.35 – $34.83 | 17 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $173.25 | $231.00 | $13.73 – $24.71 | 17 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | $137.25 | $183.00 | $92.03 – $165.65 | 16 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | $51.75 | $69.00 | $4.27 – $7.69 | 17 |
| Mayo tau phosphorylated 217 each CPT 84393 | $504.00 | $672.00 | $128.92 – $232.06 | 16 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | $501.75 | $669.00 | $208.92 – $376.06 | 17 |
| Mayo tgrp testosterone free CPT 84402 | $93.75 | $125.00 | $25.47 – $45.85 | 17 |
| Mayo tgrp testosterone total CPT 84403 | $175.50 | $234.00 | $25.81 – $46.46 | 17 |
| Mayo thyroglobulin CPT 84432 | $665.25 | $887.00 | $16.06 – $28.91 | 17 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | $131.25 | $175.00 | $10.18 – $18.32 | 17 |
| Mayo ticks babesia microti antibody igg CPT 86753 | $126.00 | $168.00 | $12.39 – $22.30 | 17 |
| Mayo tramadol definitive assay w metabolite quantitative urine CPT 80373 | $47.25 | $63.00 | not published | 0 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $47.25 | $63.00 | $14.16 – $25.49 | 17 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $126.00 | $168.00 | $13.54 – $24.37 | 17 |
| Mayo vasoactive intestinal peptide CPT 84586 | $234.75 | $313.00 | $35.33 – $63.59 | 17 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $77.25 | $103.00 | $20.24 – $36.43 | 17 |
| Mayo vitamin b3 (niacin) CPT 84591 | $210.75 | $281.00 | $17.06 – $30.71 | 17 |
| Mayo vitamin k CPT 84597 | $317.25 | $423.00 | $13.72 – $24.70 | 17 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $207.75 | $277.00 | $13.25 – $23.85 | 17 |
| Measurement post void urine by ultrasound CPT 51798 | $140.25 | $187.00 | $57.21 – $102.98 | 16 |
| Med physic dos eval rad exps CPT 76145 | $621.00 | $828.00 | $361.89 – $651.40 | 16 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $252.10 | $336.13 | $1.39 – $4.77 | 2 |
| Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm HCPCS Q4159 | $3,037.50 | $4,050.00 | $120.69 – $572.40 | 17 |
| Membrane amnio clarix 4x3cm 1k -cost per sq cm HCPCS Q4155 | $4,218.75 | $5,625.00 | $66.47 – $306.90 | 2 |
| Membrane amnioband 2x2cm -cost per sq cm HCPCS Q4151 | not published | not published | $333.92 – $333.92 | 1 |
| Membrane amniotic barrier 4x4cm-q4163-cost per sq cm HCPCS Q4163 | not published | not published | $443.43 – $443.43 | 1 |
| Membrane collgn porcine maci w/autologous cult chondrocytes HCPCS J7330 | $235,134.00 | $313,512.00 | $606,646.80 – $606,646.80 | 1 |
| Membrane placenta tiss biodfence g3 2x2cm-4sqcm-q4116-cost per sq cm HCPCS Q4140 | not published | not published | $401.20 – $401.20 | 1 |
| Membrane placenta tiss enverse sheet 2x3cm-cost per sq cm HCPCS Q4258 | not published | not published | $200.59 – $200.59 | 1 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $23.88 | $31.84 | $38.19 – $65.70 | 2 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | $11,523.04 | $15,364.05 | $31.82 – $76.23 | 17 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | $102.84 | $137.11 | $1.05 – $4.05 | 2 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $73.95 | $98.60 | $3.24 – $12.33 | 2 |
| Metabolic Blood Panel (Basic) CPT 80048 | $62.25 | $83.00 | $8.46 – $15.23 | 17 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $90.75 | $121.00 | $10.56 – $19.01 | 17 |
| Metabolic panel ionized ca CPT 80047 | $132.75 | $177.00 | $13.73 – $24.71 | 17 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | $2,776.62 | $3,702.15 | $4.19 – $7.74 | 2 |
| Methadone injection HCPCS J1230 | $725.09 | $966.78 | $55.76 – $177.03 | 2 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $38.39 | $51.18 | $11.63 – $50.94 | 2 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | $215.83 | $287.77 | $5.50 – $27.27 | 2 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $466.63 | $622.17 | $0.46 – $2.43 | 2 |
| Methotrexate therapeutic drug level CPT 80204 | $54.75 | $73.00 | $38.57 – $69.43 | 16 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | $4,037.33 | $5,383.10 | $10.29 – $18.52 | 16 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $76.59 | $102.12 | $53.67 – $176.40 | 2 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | $582.48 | $776.63 | $10.80 – $10.80 | 1 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $685.89 | $914.52 | $0.56 – $2.07 | 2 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $67.62 | $90.15 | not published | 0 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | $306.72 | $408.95 | not published | 0 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $12.40 | $16.53 | $2.41 – $9.81 | 2 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | $7.59 | $10.11 | not published | 0 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $11.84 | $15.78 | $0.18 – $0.18 | 1 |
| Mgmt promoter methylation analysis CPT 81287 | $189.00 | $252.00 | $124.64 – $224.35 | 17 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | $691.44 | $921.91 | $0.73 – $6.84 | 2 |
| Microdissection manual CPT 88381 | $222.75 | $297.00 | $173.05 – $311.49 | 16 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $102.80 | $137.06 | $2.52 – $2.52 | 1 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | $97.25 | $129.66 | $0.37 – $1.26 | 2 |
| Middle cerebral artery echo CPT 76821 | $645.75 | $861.00 | $101.39 – $182.50 | 17 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | $58.43 | $77.90 | $3.41 – $14.04 | 2 |
| Minocycline hydrochloride HCPCS J2265 | $884.76 | $1,179.68 | $2.66 – $4.80 | 16 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | $4,332.81 | $5,777.08 | $28.46 – $68.81 | 17 |
| Mitomycin instillation HCPCS J9281 | not published | not published | $772.60 – $772.60 | 1 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $437.16 | $582.88 | $38.61 – $72.05 | 17 |
| Mlh1 gene CPT 81288 | $292.50 | $390.00 | $192.32 – $346.18 | 17 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | $665.25 | $887.00 | $37.73 – $67.91 | 16 |
| Mometasone sinus sinuva HCPCS J7402 | not published | not published | $27.60 – $27.60 | 1 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $10,575.00 | $14,100.00 | not published | 0 |
| Monovisc inj per dose HCPCS J7327 | $2,155.28 | $2,873.70 | $655.34 – $1,286.54 | 17 |
| Mopath procedure level 1 CPT 81400 | $873.75 | $1,165.00 | $63.96 – $115.13 | 17 |
| Mopath procedure level 5 CPT 81404 | $1,825.50 | $2,434.00 | $274.83 – $494.69 | 17 |
| Mopath procedure level 6 CPT 81405 | $2,340.75 | $3,121.00 | $301.35 – $542.43 | 17 |
| Mopath procedure level 7 CPT 81406 | $2,340.75 | $3,121.00 | $282.88 – $509.18 | 17 |
| Mopath procedure level 8 CPT 81407 | $1,587.00 | $2,116.00 | $846.27 – $1,523.29 | 17 |
| Mopath procedure level 9 CPT 81408 | $2,250.00 | $3,000.00 | $2,000.00 – $3,600.00 | 17 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | $1,132.55 | $1,510.06 | $26.26 – $101.16 | 2 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $46.08 | $61.43 | $11.05 – $42.03 | 2 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | $8.37 | $11.16 | $66.87 – $66.87 | 1 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $398.25 | $531.00 | $347.62 – $625.72 | 16 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $398.25 | $531.00 | $165.22 – $297.40 | 16 |
| Mr safety determination physician/other qhp CPT 76016 | $85.50 | $114.00 | $84.40 – $151.91 | 16 |
| Mr safety implant elec prepj CPT 76018 | $90.00 | $120.00 | $92.20 – $165.96 | 16 |
| Mr safety implt pos&/immoblj CPT 76019 | $58.50 | $78.00 | $57.21 – $102.98 | 16 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $24.00 | $32.00 | $28.05 – $50.49 | 16 |
| Mr sfty med physics xm cstmz CPT 76017 | $235.50 | $314.00 | $231.40 – $416.51 | 16 |
| Mr spectroscopy CPT 76390 | $1,974.00 | $2,632.00 | $84.40 – $151.91 | 16 |
| Mra, w/dye, upper extremity HCPCS C8934 | $2,424.00 | $3,232.00 | $338.34 – $609.01 | 16 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | $348.00 | $464.00 | $338.34 – $609.01 | 16 |
| Mthfr gene analy common variants CPT 81291 | $852.00 | $1,136.00 | $65.34 – $117.61 | 17 |
| Mucopolysaccharides CPT 83864 | $1,138.50 | $1,518.00 | $28.50 – $51.30 | 17 |
| Multi family grp psychotherapy CPT 90849 | $370.50 | $494.00 | $172.14 – $309.84 | 16 |
| Multiple sleep latency test CPT 95805 | $4,164.75 | $5,553.00 | $832.81 – $1,499.05 | 16 |
| Mumps antibody igg CPT 86735 | $147.00 | $196.00 | $13.05 – $23.49 | 17 |
| Muscle test cran nerv unilat CPT 95867 | $751.50 | $1,002.00 | $209.40 – $376.92 | 16 |
| Muscle test hemidiaphragm CPT 95866 | $735.00 | $980.00 | $124.79 – $224.62 | 16 |
| Muscle test larynx CPT 95865 | $768.00 | $1,024.00 | $129.03 – $232.25 | 16 |
| Muscle test one fiber CPT 95872 | $750.00 | $1,000.00 | $209.40 – $376.92 | 16 |
| Mycobacteria dna amp probe CPT 87551 | $444.75 | $593.00 | $48.24 – $86.83 | 17 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $6,452.88 | $8,603.84 | $0.37 – $1.71 | 2 |
| Mycophenolic acid HCPCS J7518 | $6,135.49 | $8,180.65 | $0.88 – $5.67 | 2 |
| Mycoplasma antibody igm CPT 86738 | $112.50 | $150.00 | $13.24 – $23.83 | 17 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $370.50 | $494.00 | $175.40 – $315.72 | 16 |
| Myelography via inj w/s&i 2+ regions CPT 62305 | $3,226.50 | $4,302.00 | $760.25 – $1,368.44 | 16 |
| Myelography via inj w/s&i cervical CPT 62302 | $3,226.50 | $4,302.00 | $760.25 – $1,368.44 | 16 |
| Myelography via inj w/s&i lumbosacral CPT 62304 | $2,914.50 | $3,886.00 | $760.25 – $1,368.44 | 16 |
| Myelography via inj w/s&i thoracic CPT 62303 | $3,226.50 | $4,302.00 | $760.25 – $1,368.44 | 16 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $911.25 | $1,215.00 | $11.53 – $20.75 | 17 |
| Myocrd img pet 1std rst/strs CPT 78491 | $2,425.50 | $3,234.00 | $1,386.76 – $2,496.17 | 16 |
| N block inj hypogas plxs CPT 64517 | $2,616.00 | $3,488.00 | $857.76 – $1,543.97 | 16 |
| N-invas est c ffr sw aly cta CPT 75580 | $1,010.25 | $1,347.00 | $832.81 – $1,499.05 | 16 |
| Nafcillin 2 gram solution for injection HCPCS J2290 | $79.98 | $106.63 | not published | 0 |
| Nalbuphine 10 mg/ml injection solution HCPCS J2300 | $178.93 | $238.57 | $8.54 – $25.29 | 2 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $116.48 | $155.30 | not published | 0 |
| Naltrexone, depot form HCPCS J2315 | $5,794.40 | $7,725.86 | $4.25 – $10.30 | 17 |
| Nasal endoscopy dx uni/bi separate proc CPT 31231 | $582.00 | $776.00 | $193.58 – $348.44 | 16 |
| Nasal endoscopy with removal of nasal foreign body CPT 30999 | $236.25 | $315.00 | $229.70 – $413.45 | 16 |
| Nasopharyngoscopy w/endoscope CPT 92511 | $303.75 | $405.00 | $193.58 – $348.44 | 16 |
| Natalizumab 300 mg/15 ml intravenous solution HCPCS J2323 | $32,830.92 | $43,774.56 | $24.32 – $58.71 | 17 |
| Natriuretic peptide CPT 83880 | $273.00 | $364.00 | $39.26 – $70.67 | 17 |
| Natural killer cells total count CPT 86357 | $262.50 | $350.00 | $37.73 – $67.91 | 17 |
| Ndl emg musc 1 xtr/non-limb CPT 95870 | $339.75 | $453.00 | $129.03 – $232.25 | 16 |
| Ndl insj without njx 1 or 2 musc CPT 20560 | $22.50 | $30.00 | $28.05 – $50.49 | 16 |
| Ndl insj without njx 3+ musc CPT 20561 | $34.50 | $46.00 | $28.05 – $50.49 | 16 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $2,125.50 | $2,834.00 | $338.34 – $609.01 | 16 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $1,345.50 | $1,794.00 | $101.39 – $182.50 | 16 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $2,919.75 | $3,893.00 | $338.34 – $609.01 | 16 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $2,439.75 | $3,253.00 | $338.34 – $609.01 | 16 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $2,854.50 | $3,806.00 | $231.40 – $416.51 | 16 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $2,733.00 | $3,644.00 | $338.34 – $609.01 | 16 |
| Neck MRA (blood vessel MRI, with contrast) CPT 70548 | $2,449.50 | $3,266.00 | $338.34 – $609.01 | 16 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $2,451.00 | $3,268.00 | $231.40 – $416.51 | 16 |
| Needle emg guid w/chemodenervation add-on CPT 95874 | $192.00 | $256.00 | $74.57 – $134.23 | 16 |
| Neisseria meningitidis CPT 86741 | $433.50 | $578.00 | $13.19 – $23.74 | 17 |
| Nelarabine injection HCPCS J9261 | $2,265.28 | $3,020.37 | $52.71 – $154.24 | 17 |
| Neostigmine methylsulfate 1 mg/ml injection (wrapper) HCPCS J2710 | $99.51 | $132.67 | $17.19 – $17.19 | 1 |
| Nerobehav stas exam by psy/md f2f 1st hr CPT 96116 | $336.00 | $448.00 | $209.40 – $376.92 | 16 |
| Nerve conduction 7-8 studies CPT 95910 | $2,094.75 | $2,793.00 | $361.89 – $651.40 | 16 |
| Nerve conduction studies 1-2 CPT 95907 | $744.00 | $992.00 | $209.40 – $376.92 | 16 |
| Nerve conduction studies 11-12 CPT 95912 | $3,394.50 | $4,526.00 | $361.89 – $651.40 | 16 |
| Nerve conduction studies 13+ CPT 95913 | $4,359.00 | $5,812.00 | $361.89 – $651.40 | 16 |
| Nerve conduction studies 3-4 CPT 95908 | $1,488.00 | $1,984.00 | $209.40 – $376.92 | 16 |
| Nerve conduction studies 5-6 CPT 95909 | $1,732.50 | $2,310.00 | $209.40 – $376.92 | 16 |
| Nerve conduction studies 9-10 CPT 95911 | $2,871.75 | $3,829.00 | $361.89 – $651.40 | 16 |
| Neuroeltrd stim post tibial CPT 64566 | $510.75 | $681.00 | $297.68 – $535.83 | 16 |
| Neurolysis celiac plexus CPT 64680 | $3,786.75 | $5,049.00 | $857.76 – $1,543.97 | 16 |
| Neurolysis trigeminal nerve CPT 64600 | $880.50 | $1,174.00 | $857.76 – $1,543.97 | 16 |
| Neuromuscular junction testing ea nerve any 1 method CPT 95937 | $441.75 | $589.00 | $124.79 – $224.62 | 16 |
| Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous HCPCS J2305 | $74.88 | $99.84 | $11.61 – $11.61 | 1 |
| Nivolumab 10 mg/ml intravenous solution (wrapper) HCPCS J9299 | $29,956.95 | $39,942.59 | $33.62 – $80.32 | 17 |
| Njx aa&/strd nrv nrvtg si jt CPT 64451 | $668.25 | $891.00 | $684.56 – $1,232.21 | 16 |
| Njx aa&/strd vagus nrv CPT 64408 | $288.00 | $384.00 | $297.68 – $535.83 | 16 |
| Njx cath slct p angrph mapca CPT 93575 | $1,301.25 | $1,735.00 | $88.18 – $158.73 | 16 |
| Njx cath slct p-art angrp bi CPT 93573 | $1,951.50 | $2,602.00 | $59.75 – $107.55 | 16 |
| Njx cath slct pulm vn angrph CPT 93574 | $1,301.25 | $1,735.00 | $65.65 – $118.17 | 16 |
| Njx cth slct p-art angrp uni CPT 93569 | $1,301.25 | $1,735.00 | $36.25 – $65.25 | 16 |
| Njx interlaminar crv/thrc CPT 62324 | $1,843.50 | $2,458.00 | $857.76 – $1,543.97 | 16 |
| Njx interlaminar crv/thrc CPT 62325 | $2,067.00 | $2,756.00 | $857.76 – $1,543.97 | 16 |
| Njx interlaminar lmbr/sac CPT 62326 | $1,953.00 | $2,604.00 | $857.76 – $1,543.97 | 16 |
| Njx interlaminar lmbr/sac CPT 62327 | $1,970.25 | $2,627.00 | $857.76 – $1,543.97 | 16 |
| Njx px nfrosgrm &/urtrgrm CPT 50430 | $423.00 | $564.00 | $676.24 – $1,217.23 | 16 |
| Nm imaging bone/joint 3 phase study CPT 78315 | $1,161.00 | $1,548.00 | $387.70 – $697.86 | 17 |
| Nm imaging bone/joint whole body CPT 78306 | $773.25 | $1,031.00 | $387.70 – $697.86 | 17 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $1,031.25 | $1,375.00 | $387.70 – $697.86 | 17 |
| Nm imaging gastric emptying study CPT 78264 | $616.50 | $822.00 | $387.70 – $697.86 | 17 |
| Nm imaging gastrointestinal acute blood loss CPT 78278 | $873.00 | $1,164.00 | $387.70 – $697.86 | 17 |
| Nm imaging hepatobiliary system w/pharmacologic intervention CPT 78227 | $1,245.75 | $1,661.00 | $526.57 – $947.83 | 17 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $722.25 | $963.00 | $526.57 – $947.83 | 17 |
| Nm imaging pulmonary ventilation/perfusion CPT 78582 | $1,221.00 | $1,628.00 | $526.57 – $947.83 | 17 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $675.00 | $900.00 | $387.70 – $697.86 | 17 |
| Nm radiopharmaceutical therapy oral administration CPT 79005 | $546.00 | $728.00 | $226.29 – $407.32 | 17 |
| Non-card vasc flow imaging CPT 78445 | $411.75 | $549.00 | $387.70 – $697.86 | 17 |
| Noonan spectrum disorders CPT 81442 | $2,412.00 | $3,216.00 | $2,143.60 – $3,858.48 | 17 |
| Npm1 gene CPT 81310 | $270.00 | $360.00 | $246.52 – $443.74 | 17 |
| Npsy fam hlth interv ea addl 15 min CPT 96168 | $115.50 | $154.00 | $27.78 – $50.01 | 16 |
| Npsy grp hlth intrv ea addl 15 min CPT 96165 | $117.00 | $156.00 | $4.89 – $8.81 | 16 |
| Npsy indiv hlth intrv ea addl 15 min CPT 96159 | $115.50 | $154.00 | $24.83 – $44.70 | 16 |
| Npsy tst eval phsy/qhp 1st hr CPT 96132 | $316.50 | $422.00 | $361.89 – $651.40 | 16 |
| Npsy tst eval phsy/qhp ea l hr CPT 96133 | $153.75 | $205.00 | $95.11 – $171.20 | 16 |
| Nuclear Stress Test (Heart) CPT 78452 | $2,765.25 | $3,687.00 | $1,255.55 – $2,259.99 | 17 |
| Nuclear exam of tear flow CPT 78660 | $428.25 | $571.00 | $387.70 – $697.86 | 17 |
| Nuclear rx IV admin CPT 79101 | $504.00 | $672.00 | $226.29 – $407.32 | 17 |
| Nuclear rx intra-arterial CPT 79445 | $487.50 | $650.00 | $226.29 – $407.32 | 17 |
| Nuclear rx intra-articular CPT 79440 | $240.00 | $320.00 | $226.29 – $407.32 | 17 |
| Nuclear rx intracav admin CPT 79200 | $789.00 | $1,052.00 | $226.29 – $407.32 | 17 |
| Nushield 1 square cm HCPCS Q4160 | $462.75 | $617.00 | $120.69 – $1,290.02 | 17 |
| Nusinersen (pf) 12 mg/5 ml intrathecal solution HCPCS J2326 | $492,978.44 | $657,304.58 | $1,285.78 – $2,741.29 | 17 |
| Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 | $33,278.55 | $44,371.39 | $81.81 – $190.97 | 17 |
| Observation direct referral from physician office for admission HCPCS G0379 | $465.75 | $621.00 | $577.55 – $1,039.58 | 16 |
| Observation per hour HCPCS G0378 | $1,123.50 | $1,498.00 | not published | 0 |
| Obtaining screen pap smear HCPCS Q0091 | $21.75 | $29.00 | $28.05 – $50.49 | 16 |
| Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 | $76,319.96 | $101,759.94 | $59.60 – $145.31 | 17 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $887.40 | $1,183.20 | $1.46 – $10.71 | 2 |
| Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 | $23,458.95 | $31,278.59 | $188.35 – $516.47 | 17 |
| Ofatumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9302 | $2,224.00 | $2,965.33 | $62.23 – $112.02 | 16 |
| Oil silicone ophth 8.5ml silikon 1000 HCPCS C1814 | $857.48 | $1,143.30 | not published | 0 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $172.31 | $229.74 | $8.55 – $8.55 | 1 |
| Olanzapine long-acting inj HCPCS J2358 | not published | not published | $7.08 – $7.08 | 1 |
| Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 | $5,445.54 | $7,260.71 | $41.82 – $98.72 | 17 |
| Oncology prostate prob score CPT 81539 | $1,623.75 | $2,165.00 | $760.00 – $1,368.00 | 17 |
| Oncoprotein dcp CPT 83951 | $537.00 | $716.00 | $64.41 – $115.94 | 17 |
| Oncoprotein her-2/neu CPT 83950 | $141.75 | $189.00 | $64.41 – $115.94 | 17 |
| Ondansetron 8 mg disintegrating tablet HCPCS Q0162 | not published | not published | $0.02 – $0.02 | 1 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $34.32 | $45.76 | $0.22 – $0.90 | 2 |
| Oph Ultrasound dx quan a-scan only CPT 76511 | $105.75 | $141.00 | $101.39 – $182.50 | 17 |
| Ophthalmic mitomycin HCPCS J7315 | $1,327.41 | $1,769.87 | not published | 0 |
| Oral aprepitant HCPCS J8501 | $3,616.34 | $4,821.78 | $6.60 – $38.07 | 2 |
| Oral everolimus HCPCS J7527 | $2,255.34 | $3,007.11 | $4.82 – $24.75 | 2 |
| Oral netupitant, palonosetro HCPCS J8655 | not published | not published | $996.77 – $996.77 | 1 |
| Organic acids total quant ea spec CPT 83918 | $457.50 | $610.00 | $23.60 – $42.48 | 17 |
| Oritavancin 1,200 mg intravenous solution HCPCS J2406 | not published | not published | $100.77 – $100.77 | 1 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | $11,913.61 | $15,884.81 | $28.57 – $69.42 | 17 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $31.68 | $42.24 | $22.98 – $87.39 | 2 |
| Ortho elbow without jnt cstm w/fit&adj HCPCS L3702 | $129.00 | $172.00 | $384.69 – $692.44 | 16 |
| Ortho hnd without jnt w/fit&adj HCPCS L3919 | $52.50 | $70.00 | $360.81 – $649.46 | 16 |
| Ortho hnd/fngr w/jnt cstm w/fit&adj HCPCS L3921 | $389.25 | $519.00 | $427.91 – $770.24 | 16 |
| Ortho hnd/fngr without jnt cstm w/fit&adj HCPCS L3913 | $97.50 | $130.00 | $360.81 – $649.46 | 16 |
| Ortho whf rigd without jnt cstm w/fit&adj HCPCS L3808 | $153.00 | $204.00 | $496.49 – $893.68 | 16 |
| Ortho wrst/hnd w/jnt cstm w/fit&adj HCPCS L3905 | $72.75 | $97.00 | $1,321.16 – $2,378.09 | 16 |
| Orthopantogram CPT 70355 | $163.50 | $218.00 | $84.40 – $151.91 | 17 |
| Orthovisc inj per dose HCPCS J7324 | $443.85 | $591.80 | $109.09 – $237.78 | 17 |
| Oscillation chest wall mechanical per session CPT 94669 | $390.75 | $521.00 | $212.36 – $382.26 | 16 |
| Osmolality blood CPT 83930 | $52.50 | $70.00 | $6.61 – $11.90 | 17 |
| Osmolality urine CPT 83935 | $59.25 | $79.00 | $6.82 – $12.28 | 17 |
| Ot evaluation high complexity patient/family CPT 97167 | $285.75 | $381.00 | $96.30 – $173.33 | 16 |
| Ot evaluation low complexity patient/family CPT 97165 | $272.25 | $363.00 | $96.30 – $173.33 | 16 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $285.75 | $381.00 | $96.30 – $173.33 | 16 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $119.25 | $159.00 | $47.17 – $84.90 | 16 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $108.00 | $144.00 | $43.57 – $78.42 | 16 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $114.00 | $152.00 | $26.59 – $47.87 | 16 |
| Ot re-evaluation patient/family CPT 97168 | $184.50 | $246.00 | $65.34 – $117.61 | 16 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $114.75 | $153.00 | $33.33 – $59.99 | 16 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $98.25 | $131.00 | $20.61 – $37.09 | 16 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $98.25 | $131.00 | $21.92 – $39.45 | 16 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $117.00 | $156.00 | $27.87 – $50.17 | 16 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $117.00 | $156.00 | $31.37 – $56.47 | 16 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $106.50 | $142.00 | $30.92 – $55.66 | 16 |
| Oth resp proc, group HCPCS G0239 | $184.50 | $246.00 | $36.22 – $65.20 | 16 |
| Other immunoelectrophoresis CPT 86325 | $128.25 | $171.00 | $23.13 – $41.63 | 17 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | not published | not published | $2.00 – $2.00 | 1 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $342.84 | $457.11 | $0.22 – $0.63 | 2 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $35.06 | $46.74 | $2.21 – $17.46 | 2 |
| PSA (Prostate) Test CPT 84153 | $168.75 | $225.00 | $18.39 – $33.10 | 17 |
| Pacemaker leadless 19.5f 32.2mm ra HCPCS C1605 | $57,937.50 | $77,250.00 | not published | 0 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $34.43 | $45.90 | $0.24 – $0.99 | 2 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $5,416.36 | $7,221.81 | $6.02 – $29.50 | 17 |
| Palifermin injection HCPCS J2425 | $11,767.98 | $15,690.63 | $36.72 – $87.40 | 17 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $6,272.41 | $8,363.21 | $15.08 – $36.70 | 17 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $9,797.53 | $13,063.37 | $436.75 – $786.15 | 16 |
| Palonosetron hcl HCPCS J2469 | $184.88 | $246.50 | $1.07 – $7.65 | 2 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $148.35 | $197.80 | $27.16 – $79.83 | 2 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | $27,287.26 | $36,383.01 | $174.39 – $419.96 | 17 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $18.49 | $24.65 | not published | 0 |
| Papaverin hcl injection HCPCS J2440 | $143.71 | $191.61 | $413.46 – $413.46 | 1 |
| Parathormone (pth) intact CPT 83970 | $500.25 | $667.00 | $41.28 – $74.30 | 17 |
| Parathyrd planar w/spect&ct CPT 78072 | $1,072.50 | $1,430.00 | $526.57 – $947.83 | 17 |
| Parathyroid planar imaging CPT 78070 | $641.25 | $855.00 | $387.70 – $697.86 | 17 |
| Parathyroid planar img w/tomo spect CPT 78071 | $948.75 | $1,265.00 | $387.70 – $697.86 | 17 |
| Paricalcitol HCPCS J2501 | $35.52 | $47.35 | $1.63 – $6.03 | 2 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $222.75 | $297.00 | $194.58 – $350.24 | 16 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $7,702.14 | $10,269.51 | $6.21 – $22.95 | 2 |
| Passy muir valve metal trach HCPCS L8501 | $1,016.73 | $1,355.64 | $197.18 – $354.92 | 16 |
| Pd hl 3.5in 4d med rbr mld 6432 HCPCS L3350 | $7.50 | $10.00 | $33.50 – $60.30 | 16 |
| Pdgfra gene CPT 81314 | $618.00 | $824.00 | $329.51 – $593.12 | 17 |
| Pegaspargase injection HCPCS J9266 | $82,241.50 | $109,655.33 | $28,424.06 – $69,184.14 | 17 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $16,623.78 | $22,165.04 | $127.38 – $229.28 | 17 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | not published | not published | $321.36 – $321.36 | 1 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $11,163.13 | $14,884.17 | $135.89 – $331.12 | 17 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $6,455.84 | $8,607.78 | $79.50 – $252.41 | 17 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | $113,672.22 | $151,562.95 | $3,824.52 – $8,856.99 | 17 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $2,305.50 | $3,074.00 | $170.10 – $306.19 | 16 |
| Pelvic CT scan (with contrast) CPT 72193 | $1,602.75 | $2,137.00 | $170.10 – $306.19 | 16 |
| Pelvic CT scan (without contrast) CPT 72192 | $1,505.25 | $2,007.00 | $101.39 – $182.50 | 16 |
| Pelvic MRI (with and without contrast) CPT 72197 | $2,919.75 | $3,893.00 | $338.34 – $609.01 | 16 |
| Pelvic MRI (with contrast) CPT 72196 | $2,909.25 | $3,879.00 | $338.34 – $609.01 | 16 |
| Pelvic MRI (without contrast) CPT 72195 | $2,682.75 | $3,577.00 | $231.40 – $416.51 | 16 |
| Pelvic Ultrasound (complete) CPT 76856 | $736.50 | $982.00 | $101.39 – $182.50 | 17 |
| Pelvic Ultrasound (limited) CPT 76857 | $590.25 | $787.00 | $101.39 – $182.50 | 17 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $21,806.82 | $29,075.76 | $61.25 – $142.54 | 17 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $13,859.24 | $18,478.98 | $4.04 – $9.08 | 17 |
| Peng benzathine/procaine inj HCPCS J0558 | not published | not published | $42.25 – $42.25 | 1 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $2,592.13 | $3,456.17 | $31.47 – $71.32 | 17 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $203.37 | $271.15 | $2.12 – $6.93 | 2 |
| Penicillin g procaine inj HCPCS J2510 | not published | not published | $105.56 – $105.56 | 1 |
| Penile injection CPT 54235 | $345.00 | $460.00 | $242.30 – $436.15 | 16 |
| Penile rear tip xtnd 0.5cm HCPCS C2622 | $26,765.44 | $35,687.25 | not published | 0 |
| Penile vascular study CPT 93980 | $948.75 | $1,265.00 | $101.39 – $182.50 | 16 |
| Penile vascular study CPT 93981 | $435.00 | $580.00 | $101.39 – $182.50 | 16 |
| Pentamidine 300 mg solution for injection HCPCS J2516 | $572.10 | $762.79 | not published | 0 |
| Pentamidine non-comp unit HCPCS J2545 | $396.65 | $528.86 | $200.49 – $469.98 | 2 |
| Pentobarbital sodium inj HCPCS J2515 | $3,170.80 | $4,227.73 | $36.84 – $66.31 | 17 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | $8,715.64 | $11,620.85 | $2,626.33 – $6,191.83 | 17 |
| Perc cryo ablate renal tum CPT 50593 | $8,862.75 | $11,817.00 | $10,308.81 – $18,555.86 | 16 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $23,011.50 | $30,682.00 | not published | 0 |
| Perc d-e cor stent ather br HCPCS C9603 | $16,909.50 | $22,546.00 | not published | 0 |
| Perc d-e cor stent ather s HCPCS C9602 | $23,085.00 | $30,780.00 | $17,778.02 – $32,000.44 | 16 |
| Perc drug-el cor stent bran HCPCS C9601 | $11,075.25 | $14,767.00 | not published | 0 |
| Perc drug-el cor stent sing HCPCS C9600 | $11,380.50 | $15,174.00 | $11,195.55 – $20,152.00 | 16 |
| Perc rf ablate renal tumor CPT 50592 | $5,871.75 | $7,829.00 | $5,862.95 – $10,553.31 | 16 |
| Percut ablate liver rf CPT 47382 | $9,437.25 | $12,583.00 | $5,862.95 – $10,553.31 | 16 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $321.71 | $428.94 | $100.28 – $379.44 | 2 |
| Peri-proc device eval icd CPT 93287 | $378.00 | $504.00 | $48.64 – $87.55 | 16 |
| Peri-proc device eval pm CPT 93286 | $202.50 | $270.00 | $41.46 – $74.64 | 16 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | $2,676.75 | $3,569.00 | $177.52 – $319.54 | 16 |
| Peripheral vascular rehab CPT 93668 | $139.50 | $186.00 | $57.21 – $102.98 | 16 |
| Perq art m-thrombect &/nfs CPT 61645 | $9,473.25 | $12,631.00 | $746.29 – $1,343.32 | 16 |
| Perq clsr tcat l atr apndge CPT 33340 | $7,520.25 | $10,027.00 | $601.25 – $1,082.26 | 16 |
| Perq dev breast 1st mr guide CPT 19287 | $4,495.50 | $5,994.00 | $686.75 – $1,236.14 | 16 |
| Perq dev breast 1st strtctc CPT 19283 | $2,148.75 | $2,865.00 | $686.75 – $1,236.14 | 16 |
| Perq p-art revsc 1 abnor bi CPT 33903 | $27,235.50 | $36,314.00 | $11,195.55 – $20,152.00 | 16 |
| Perq p-art revsc 1 abnor uni CPT 33902 | $44,278.50 | $59,038.00 | $17,778.02 – $32,000.44 | 16 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | $27,235.50 | $36,314.00 | $11,195.55 – $20,152.00 | 16 |
| Perq p-art revsc 1 nm nt uni CPT 33900 | $27,235.50 | $36,314.00 | $11,195.55 – $20,152.00 | 16 |
| Perq p-art revsc each addl CPT 33904 | $13,844.25 | $18,459.00 | $254.60 – $458.28 | 16 |
| Perq plmt bile duct stent CPT 47538 | $12,221.25 | $16,295.00 | $5,862.95 – $10,553.31 | 16 |
| Perq plmt bile duct stent CPT 47539 | $9,694.50 | $12,926.00 | $5,862.95 – $10,553.31 | 16 |
| Perq plmt bile duct stent CPT 47540 | $12,561.75 | $16,749.00 | $5,862.95 – $10,553.31 | 16 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $591.75 | $789.00 | $242.30 – $436.15 | 16 |
| Perq transcath closure each CPT 93592 | $10,098.75 | $13,465.00 | $322.93 – $581.27 | 16 |
| Perq transcath septal reduxn CPT 93583 | $8,844.00 | $11,792.00 | $634.32 – $1,141.78 | 16 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | $51,456.39 | $68,608.52 | $60.23 – $154.27 | 17 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $25,218.78 | $33,625.03 | $17.02 – $41.11 | 17 |
| Pet CT skull-mid thgh initial CPT 78815 | $2,581.50 | $3,442.00 | $1,386.76 – $2,496.17 | 16 |
| Pet CT whole body initial CPT 78816 | $2,999.25 | $3,999.00 | $1,386.76 – $2,496.17 | 16 |
| Pet fdg brain metoblic eval sb CPT 78608 | $3,126.75 | $4,169.00 | $1,386.76 – $2,496.17 | 16 |
| Pet image ltd area CPT 78811 | $2,478.75 | $3,305.00 | $1,255.55 – $2,259.99 | 16 |
| Pet image w/ct lmtd CPT 78814 | $2,528.25 | $3,371.00 | $1,386.76 – $2,496.17 | 16 |
| Pet scan brain perf study CPT 78609 | $2,343.00 | $3,124.00 | $69.63 – $125.33 | 16 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $1,024,537.50 | $1,366,050.00 | not published | 0 |
| Ph body fluid CPT 83986 | $85.50 | $114.00 | $3.58 – $6.44 | 17 |
| Phencyclidine (pcp) CPT 83992 | $402.75 | $537.00 | not published | 0 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $203.37 | $271.15 | $66.59 – $282.87 | 2 |
| Phenobarbital therapeutic drug level CPT 80184 | $105.00 | $140.00 | $15.30 – $27.54 | 17 |
| Phentolaine mesylate inj HCPCS J2760 | $1,028.40 | $1,371.19 | $257.45 – $1,062.44 | 17 |
| Phenylep ketorolac opth soln HCPCS J1097 | not published | not published | $299.92 – $299.92 | 1 |
| Phenylephrine 10 mg/ml injection solution HCPCS J2371 | $58.80 | $78.39 | $0.09 – $0.09 | 1 |
| Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1165 | $7.71 | $10.28 | $1.58 – $5.67 | 2 |
| Phenytoin total therapeutic drug level CPT 80185 | $102.00 | $136.00 | $13.25 – $23.85 | 17 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | $3,068.25 | $4,091.00 | $3,062.12 – $5,511.82 | 16 |
| Phleb veins 1 extrm >20 stab CPT 37766 | $3,024.00 | $4,032.00 | $3,062.12 – $5,511.82 | 16 |
| Phlebotomy therapeutic CPT 99195 | $324.00 | $432.00 | $129.03 – $232.25 | 16 |
| Phosphorus CPT 84100 | $45.00 | $60.00 | $4.74 – $8.53 | 17 |
| Phosphorus 24 hour urine CPT 84105 | $97.50 | $130.00 | $5.78 – $10.40 | 17 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $158.14 | $210.85 | $6.91 – $26.10 | 2 |
| Pin caspar distraction 12mm HCPCS C1821 | $53,100.00 | $70,800.00 | not published | 0 |
| Pinworm exam CPT 87172 | $24.75 | $33.00 | $4.27 – $7.69 | 17 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $407.95 | $543.93 | $2.68 – $10.62 | 2 |
| Place cath intracranial art CPT 36228 | $6,437.25 | $8,583.00 | $1,423.61 – $2,562.49 | 16 |
| Place cath xtrnl carotid CPT 36227 | $5,439.00 | $7,252.00 | $257.74 – $463.94 | 16 |
| Place duod/jej tube perc CPT 49441 | $1,695.00 | $2,260.00 | $1,860.96 – $3,349.72 | 16 |
| Place gastrostomy tube perc CPT 49440 | $1,547.25 | $2,063.00 | $1,860.96 – $3,349.72 | 16 |
| Place ndl musc/tis for right CPT 20555 | $3,220.50 | $4,294.00 | $3,173.19 – $5,711.73 | 16 |
| Place slctv cath carotd art uni CPT 36224 | $8,814.75 | $11,753.00 | $5,396.44 – $9,713.59 | 16 |
| Place slctv cath carotid/inom art excrn uni CPT 36222 | $5,230.50 | $6,974.00 | $3,062.12 – $5,511.82 | 16 |
| Place slctv cath carotid/inom art intcrn uni CPT 36223 | $8,200.50 | $10,934.00 | $5,396.44 – $9,713.59 | 16 |
| Place slctv cath subclavian art CPT 36225 | $4,298.25 | $5,731.00 | $3,062.12 – $5,511.82 | 16 |
| Place slctv cath vertebral art uni CPT 36226 | $7,640.25 | $10,187.00 | $5,396.44 – $9,713.59 | 16 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $1,562.25 | $2,083.00 | $1,601.72 – $2,883.09 | 16 |
| Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left CPT 19282 | $1,417.50 | $1,890.00 | $153.44 – $276.20 | 16 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $1,795.50 | $2,394.00 | $686.75 – $1,236.14 | 16 |
| Placement nephrostomy catheter (both sides) CPT 50432 | $3,433.50 | $4,578.00 | $2,027.25 – $3,649.06 | 16 |
| Placement occlusive device venous/arterial access site post procedure HCPCS G0269 | $1,051.50 | $1,402.00 | not published | 0 |
| Placement stent(s) intravascular transcatheter artery initial CPT 37236 | $9,402.75 | $12,537.00 | $11,195.55 – $20,152.00 | 16 |
| Platelet aggregation each agent teg CPT 85576 | $171.00 | $228.00 | $24.91 – $44.84 | 17 |
| Platelet automated CPT 85049 | $25.50 | $34.00 | $4.48 – $8.06 | 17 |
| Platelet pheresis each unit HCPCS P9034 | $842.25 | $1,123.00 | $308.96 – $556.13 | 16 |
| Platelet pheresis irr ea HCPCS P9036 | $1,659.00 | $2,212.00 | $949.13 – $1,708.43 | 16 |
| Platelets each unit HCPCS P9019 | $1,555.50 | $2,074.00 | $53.17 – $95.71 | 16 |
| Platelets pheresis leukocytes reduced each unit HCPCS P9035 | $1,642.50 | $2,190.00 | $511.59 – $920.86 | 16 |
| Platelets pheresis leukocytes reduced irradiated each unit HCPCS P9037 | $1,648.50 | $2,198.00 | $680.61 – $1,225.10 | 16 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $2,487.00 | $3,316.00 | $607.43 – $1,093.37 | 16 |
| Plc pq device breast ea addl lesion MRI guide CPT 19288 | $4,300.50 | $5,734.00 | $421.19 – $758.13 | 16 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $1,640.25 | $2,187.00 | $264.34 – $475.82 | 16 |
| Plcmnt biliary drainage cath w/img ext CPT 47533 | $8,288.25 | $11,051.00 | $3,472.27 – $6,250.09 | 16 |
| Plcmnt stent transcath ctrl dialysis seg add-on CPT 36908 | $14,461.50 | $19,282.00 | $1,284.34 – $2,311.81 | 16 |
| Plcmnt ureteral stent pq w/img exstng trct CPT 50693 | $8,547.00 | $11,396.00 | $3,418.53 – $6,153.35 | 16 |
| Plcmnt ureteral stent pq w/img new w/cath CPT 50695 | $10,283.25 | $13,711.00 | $3,418.53 – $6,153.35 | 16 |
| Plcmt dlyd xtn pros 1st vsl CPT 34710 | $4,002.00 | $5,336.00 | $713.70 – $1,284.66 | 16 |
| Plcmt sft tiss loc pq w/img 1st lsn CPT 10035 | $776.25 | $1,035.00 | $686.75 – $1,236.14 | 16 |
| Plcmt sft tiss loc pq w/img ea addl lsn CPT 10036 | $385.50 | $514.00 | $268.07 – $482.52 | 16 |
| Plcmt xtn pros evasc rpr per vsl CPT 34709 | $4,002.00 | $5,336.00 | $286.95 – $516.50 | 16 |
| Plerixafor injection HCPCS J2562 | $36,856.95 | $49,142.59 | $32.74 – $290.77 | 17 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $368.25 | $491.00 | $361.89 – $651.40 | 16 |
| Plmt biliary drainage cath CPT 47534 | $8,671.50 | $11,562.00 | $3,472.27 – $6,250.09 | 16 |
| Plmt nephroureteral catheter CPT 50433 | $7,859.25 | $10,479.00 | $3,418.53 – $6,153.35 | 16 |
| Plmt ureteral stent prq CPT 50694 | $2,015.25 | $2,687.00 | $3,418.53 – $6,153.35 | 16 |
| Pm device progr eval dual CPT 93280 | $287.25 | $383.00 | $36.19 – $65.15 | 16 |
| Pm device progr eval multi CPT 93281 | $214.50 | $286.00 | $36.19 – $65.15 | 16 |
| Pm phone r-strip device eval CPT 93293 | $124.50 | $166.00 | $36.19 – $65.15 | 16 |
| Pmp22 gene dup/delet CPT 81324 | $1,054.50 | $1,406.00 | $758.36 – $1,365.05 | 17 |
| Poct blood gases ph pco2 po2 arterial calculated o2 CPT 82803 | $161.25 | $215.00 | $26.07 – $46.93 | 17 |
| Polatuzumab vedotin-piiq 140 mg intravenous solution HCPCS J9309 | $68,815.70 | $91,754.26 | $137.23 – $331.58 | 17 |
| Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap CPT 95811 | $5,448.75 | $7,265.00 | $832.81 – $1,499.05 | 16 |
| Porfimer sodium injection HCPCS J9600 | $75,528.84 | $100,705.11 | $54,284.04 – $205,453.44 | 2 |
| Postpartum Care Only CPT 59430 | $888.00 | $1,184.00 | $250.75 – $451.35 | 16 |
| Potassium 24 hour urine CPT 84133 | $76.50 | $102.00 | $4.73 – $8.51 | 17 |
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | $137.19 | $182.91 | $0.39 – $1.08 | 2 |
| Potassium serum/plasma/whole blood CPT 84132 | $73.50 | $98.00 | $4.76 – $8.57 | 17 |
| Pq biliary strict dil s&i CPT 74363 | $1,305.75 | $1,741.00 | not published | 0 |
| Pq dr cath chg w cont s&i CPT 75984 | $912.00 | $1,216.00 | $88.27 – $158.88 | 16 |
| Pq kyphplsty 1 bdy lumb w/img CPT 22514 | $9,571.50 | $12,762.00 | $7,037.08 – $12,666.74 | 16 |
| Pq thr inj ext pse CPT 36002 | $554.25 | $739.00 | $608.36 – $1,095.05 | 16 |
| Pq vrtbrplst 1 bdy inj crv-thr w/img ini CPT 22510 | $2,694.75 | $3,593.00 | $3,173.19 – $5,711.73 | 16 |
| Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl CPT 22512 | $2,154.00 | $2,872.00 | $689.08 – $1,240.35 | 16 |
| Pq vrtbrplst 1 bdy inj lmb-scr w/img ini CPT 22511 | $2,961.00 | $3,948.00 | $3,173.19 – $5,711.73 | 16 |
| Pr application of long arm splint CPT 29105 | $402.00 | $536.00 | $157.59 – $283.67 | 16 |
| Pr application splint static short arm CPT 29125 | $113.25 | $151.00 | $129.03 – $232.25 | 16 |
| Pr biopsy skin punch single lesion CPT 11104 | $307.50 | $410.00 | $394.24 – $709.63 | 16 |
| Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes CPT 99406 | $72.75 | $97.00 | $36.34 – $65.41 | 16 |
| Pr cystourethroscopy with insertion indwelling ureteral stent CPT 52332 | $2,577.00 | $3,436.00 | $3,418.53 – $6,153.35 | 16 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | $319.50 | $426.00 | $194.58 – $350.24 | 16 |
| Pr e&m preventive medicine initial comprehensive new patient 12-17 years CPT 99384 | $122.25 | $163.00 | $132.75 – $238.94 | 16 |
| Pr egd flexible transoral w/placement percutaneous gastrostomy tube CPT 43246 | $2,492.25 | $3,323.00 | $1,860.96 – $3,349.72 | 16 |
| Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm CPT 11404 | $2,569.50 | $3,426.00 | $1,601.72 – $2,883.09 | 16 |
| Pr excision nail/nail matrix partial/complete permanent removal CPT 11750 | $1,092.75 | $1,457.00 | $394.24 – $709.63 | 16 |
| Pr incision & drainage abscess complicated/multiple CPT 10061 | $382.50 | $510.00 | $394.24 – $709.63 | 16 |
| Pr incision & drainage abscess simple/single CPT 10060 | $314.25 | $419.00 | $194.58 – $350.24 | 16 |
| Pr incision & drainage abscess vulva/perineal CPT 56405 | $504.75 | $673.00 | $295.53 – $531.95 | 16 |
| Pr incision & removal foreign body subcutaneous tissues simple CPT 10120 | $1,857.75 | $2,477.00 | $394.24 – $709.63 | 16 |
| Pr moderate sedation same physician >= 5 years initial 15 minutes CPT 99152 | $578.25 | $771.00 | $47.78 – $86.01 | 16 |
| Pr planning advance care 1st 30 minutes CPT 99497 | $143.25 | $191.00 | $98.52 – $177.34 | 16 |
| Pr removal drug delivery implant CPT 11982 | $738.75 | $985.00 | $433.23 – $779.82 | 16 |
| Pr removal foreign body external auditory canal without anesthesia CPT 69200 | $134.25 | $179.00 | $129.03 – $232.25 | 16 |
| Pr removal intrauterine device CPT 58301 | $222.00 | $296.00 | $295.53 – $531.95 | 16 |
| Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm CPT 12032 | $807.00 | $1,076.00 | $394.24 – $709.63 | 16 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm CPT 12013 | $135.00 | $180.00 | $194.58 – $350.24 | 16 |
| Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm CPT 12011 | $127.50 | $170.00 | $194.58 – $350.24 | 16 |
| Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm CPT 12001 | $141.00 | $188.00 | $194.58 – $350.24 | 16 |
| Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm CPT 12002 | $141.75 | $189.00 | $194.58 – $350.24 | 16 |
| Pr tube thoracostomy w/connection to drainage open CPT 32551 | $2,682.00 | $3,576.00 | $1,526.62 – $2,747.91 | 16 |
| Pralatrexate injection HCPCS J9307 | $46,709.38 | $62,279.17 | $392.72 – $946.39 | 17 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | $297.18 | $396.23 | $223.68 – $936.36 | 2 |
| Prealbumin CPT 84134 | $114.00 | $152.00 | $14.59 – $26.26 | 17 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $3,856.50 | $5,141.99 | $0.66 – $3.78 | 2 |
| Prednisone 1 mg tablet HCPCS J7512 | $398.89 | $531.85 | $0.09 – $0.09 | 1 |
| Pregabalin - sendout CPT 80366 | $39.00 | $52.00 | not published | 0 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $703.50 | $938.00 | $101.39 – $182.50 | 17 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $610.50 | $814.00 | $101.39 – $182.50 | 17 |
| Pregnancy associated plasma protein-a CPT 84163 | $216.00 | $288.00 | $15.05 – $27.09 | 17 |
| Prep skin to 100cm2 other CPT 15004 | $1,401.75 | $1,869.00 | $394.24 – $709.63 | 16 |
| Prep skin to 100cm2 trk/ext CPT 15002 | $1,174.50 | $1,566.00 | $716.75 – $1,290.15 | 16 |
| Pressure max expiratory/inspiratory CPT 94799 | $116.25 | $155.00 | $124.79 – $224.62 | 16 |
| Pressure velocity wire add ves CPT 93572 | $1,649.25 | $2,199.00 | not published | 0 |
| Pretreat rbc absorption reference CPT 86978 | $128.25 | $171.00 | $57.21 – $102.98 | 16 |
| Pretreat rbc w enzyme reference CPT 86971 | $312.00 | $416.00 | $165.22 – $297.40 | 16 |
| Prgrmg dev eval impltbl sys CPT 93260 | $420.75 | $561.00 | $36.19 – $65.15 | 16 |
| Prgrmg dev eval pm/ldls pm CPT 93279 | $141.75 | $189.00 | $36.19 – $65.15 | 16 |
| Prgrmg dev eval scrms ip CPT 93285 | $186.75 | $249.00 | $36.19 – $65.15 | 16 |
| Prgrmg eval implantable dfb CPT 93282 | $170.25 | $227.00 | $36.19 – $65.15 | 16 |
| Prgrmg eval implantable dfb CPT 93283 | $287.25 | $383.00 | $36.19 – $65.15 | 16 |
| Prgrmg eval implantable dfb CPT 93284 | $363.75 | $485.00 | $36.19 – $65.15 | 16 |
| Prim art mech thrmbc non-intracranial CPT 37184 | $20,329.50 | $27,106.00 | $17,778.02 – $32,000.44 | 16 |
| Prim art mech thrmbc non-intracranial add-on CPT 37185 | $3,966.75 | $5,289.00 | $430.17 – $774.31 | 16 |
| Probe cryo 1150mm endo flex ster disp HCPCS C2618 | $5,175.00 | $6,900.00 | not published | 0 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | $1,611.15 | $2,148.19 | $214.81 – $472.95 | 17 |
| Procalcitonin CPT 84145 | $79.50 | $106.00 | $27.22 – $49.00 | 17 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $63.42 | $84.56 | $6.13 – $30.87 | 2 |
| Prochlorperazine maleate 5 mg tablet HCPCS Q0164 | not published | not published | $1.07 – $1.07 | 1 |
| Proctosigmoidoscopy control bleed 45317 CPT 45317 | $5,358.75 | $7,145.00 | $1,160.50 – $2,088.91 | 16 |
| Proctosigmoidoscopy removal CPT 45308 | $2,967.75 | $3,957.00 | $2,691.84 – $4,845.30 | 16 |
| Proctosigmoidoscopy w/fb remove 45307 CPT 45307 | $3,251.25 | $4,335.00 | $2,691.84 – $4,845.30 | 16 |
| Progenamatrix, per sq cm HCPCS Q4222 | not published | not published | $310.43 – $310.43 | 1 |
| Progesterone CPT 84144 | $75.00 | $100.00 | $20.86 – $37.55 | 17 |
| Prolactin CPT 84146 | $127.50 | $170.00 | $19.38 – $34.88 | 17 |
| Prolng off/op e/m ea 15 min 99417 CPT 99417 | $45.00 | $60.00 | $31.17 – $56.11 | 16 |
| Promethazine hcl injection HCPCS J2550 | $10.99 | $14.65 | $6.96 – $32.31 | 2 |
| Proph rta dtchmnt pc CPT 67145 | $534.75 | $713.00 | $533.39 – $960.10 | 16 |
| Propofol infusion 10 mg/ml HCPCS J2704 | $35.88 | $47.83 | $0.22 – $1.17 | 2 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $16.46 | $21.94 | $87.12 – $87.12 | 1 |
| Prostate biopsy, any mthd HCPCS G0416 | $525.00 | $700.00 | $347.62 – $625.72 | 16 |
| Prostatectomy (turp) CPT 52601 | $4,998.00 | $6,664.00 | $5,199.87 – $9,359.77 | 16 |
| Prosthesis voc advantage 20f 14mm HCPCS L8509 | $1,329.00 | $1,772.00 | $160.17 – $288.31 | 16 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | $112.23 | $149.63 | $3.97 – $14.94 | 2 |
| Protector nerve neurawrap 4cm HCPCS C9353 | $5,366.25 | $7,155.00 | not published | 0 |
| Protein c activity CPT 85303 | $90.00 | $120.00 | $13.84 – $24.91 | 17 |
| Protein c concentrate HCPCS J2724 | not published | not published | $3.65 – $3.65 | 1 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $60.75 | $81.00 | $10.74 – $19.33 | 17 |
| Protein s total CPT 85305 | $156.00 | $208.00 | $11.61 – $20.90 | 17 |
| Protein total 24 hour urine CPT 84156 | $51.75 | $69.00 | $3.67 – $6.61 | 17 |
| Protein total body fluid CPT 84157 | $81.75 | $109.00 | $4.00 – $7.20 | 17 |
| Protein total serum plasma whole blood CPT 84155 | $35.25 | $47.00 | $3.67 – $6.61 | 17 |
| Prothrombin complex kcentra HCPCS J7168 | $7,912.65 | $10,550.20 | $2.05 – $3.70 | 16 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $50.25 | $67.00 | $3.94 – $7.09 | 17 |
| Prq card revasc mi 1 vsl CPT 92941 | $21,910.50 | $29,214.00 | $583.47 – $1,050.25 | 16 |
| Prq card revasc mi 1 vsl drug-eluting HCPCS C9606 | $28,167.00 | $37,556.00 | not published | 0 |
| Prq revasc byp graft 1 art and/or branches CPT 92937 | $20,522.25 | $27,363.00 | $11,195.55 – $20,152.00 | 16 |
| Prq tcat plmt ntrac st 1 les CPT 92928 | $9,687.75 | $12,917.00 | $11,195.55 – $20,152.00 | 16 |
| Prq tcat plmt ntrac st 2+les CPT 92930 | $3,865.50 | $5,154.00 | $17,778.02 – $32,000.44 | 16 |
| Prq trl rvs ch occ ant&rtrgr CPT 92945 | $14,048.25 | $18,731.00 | $11,195.55 – $20,152.00 | 16 |
| Prq trlml c athrc st angiop1 CPT 92933 | $20,522.25 | $27,363.00 | $17,778.02 – $32,000.44 | 16 |
| Prq trluml c angiop 1art&/br CPT 92920 | $7,578.00 | $10,104.00 | $5,519.68 – $9,935.42 | 16 |
| Prq trluml c athrc 1 art&/br CPT 92924 | $12,754.50 | $17,006.00 | $11,195.55 – $20,152.00 | 16 |
| Prq trluml revsc ch occ ant CPT 92943 | $20,522.25 | $27,363.00 | $11,195.55 – $20,152.00 | 16 |
| Psy/npsy tst admin tech 2> ea l 30 min CPT 96139 | $102.00 | $136.00 | $32.32 – $58.18 | 16 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | $206.25 | $275.00 | $172.14 – $309.84 | 16 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | $266.25 | $355.00 | $172.14 – $309.84 | 16 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | $328.50 | $438.00 | $172.14 – $309.84 | 16 |
| Psycl/nrpsyc tech 1st CPT 96138 | $210.75 | $281.00 | $433.23 – $779.82 | 16 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | $114.75 | $153.00 | $14.18 – $25.52 | 16 |
| Pt application of modality >=1 area hot/cold packs CPT 97010 | $20.25 | $27.00 | $6.31 – $11.35 | 16 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $115.50 | $154.00 | $18.17 – $32.70 | 16 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $99.00 | $132.00 | $13.75 – $24.76 | 16 |
| Pt application of modality traction mechanical CPT 97012 | $119.25 | $159.00 | $13.84 – $24.92 | 16 |
| Pt evaluation high complexity patient/family CPT 97163 | $273.00 | $364.00 | $93.86 – $168.94 | 16 |
| Pt evaluation low complexity patient/family CPT 97161 | $276.00 | $368.00 | $93.86 – $168.94 | 16 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $276.00 | $368.00 | $93.86 – $168.94 | 16 |
| Pt re-evaluation patient/family CPT 97164 | $186.00 | $248.00 | $64.42 – $115.96 | 16 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $130.50 | $174.00 | $39.39 – $70.90 | 16 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $105.75 | $141.00 | $27.87 – $50.17 | 16 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $100.50 | $134.00 | $28.19 – $50.74 | 16 |
| Pt wheelchair management each 15 minutes CPT 97542 | $72.75 | $97.00 | $29.79 – $53.62 | 16 |
| Pul art balloon repr percut CPT 92997 | $10,756.50 | $14,342.00 | $11,195.55 – $20,152.00 | 16 |
| Pul art balloon repr percut CPT 92998 | $4,956.00 | $6,608.00 | $272.10 – $489.78 | 16 |
| Pulmonary vent imaging CPT 78579 | $398.25 | $531.00 | $387.70 – $697.86 | 17 |
| Pulse ox continuous overnight monitoring CPT 94762 | $119.25 | $159.00 | $124.79 – $224.62 | 16 |
| Pulse ox multiple CPT 94761 | $112.50 | $150.00 | $4.00 – $7.19 | 16 |
| Pulse ox single CPT 94760 | $50.25 | $67.00 | $3.69 – $6.64 | 16 |
| Punc of shunt for asp or inj CPT 61070 | $668.25 | $891.00 | $684.56 – $1,232.21 | 16 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $117.00 | $156.00 | $129.03 – $232.25 | 16 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $382.50 | $510.00 | $394.24 – $709.63 | 16 |
| Puncture spinal lumbar diagnostic CPT 62270 | $867.75 | $1,157.00 | $684.56 – $1,232.21 | 16 |
| Puraply 1 sq cm HCPCS Q4195 | $18,720.00 | $24,960.00 | $120.69 – $262.65 | 17 |
| Pvb thoracic 2nd+ inj site CPT 64462 | $543.75 | $725.00 | $74.72 – $134.50 | 16 |
| Pvb thoracic single inj site CPT 64461 | $668.25 | $891.00 | $684.56 – $1,232.21 | 16 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $29.11 | $38.81 | $31.13 – $133.47 | 2 |
| Pyruvate CPT 84210 | $97.50 | $130.00 | $14.48 – $26.06 | 17 |
| Pyruvate kinase CPT 84220 | $252.75 | $337.00 | $9.44 – $16.99 | 17 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $1,161.75 | $1,549.00 | $526.57 – $947.83 | 17 |
| Quant diff pulm perf w/imaging CPT 78597 | $805.50 | $1,074.00 | $387.70 – $697.86 | 17 |
| Quest t3 uptake CPT 84479 | $81.75 | $109.00 | $6.47 – $11.65 | 17 |
| Quinupristin/dalfopristin HCPCS J2770 | not published | not published | $1,202.32 – $1,202.32 | 1 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | $3,103.43 | $4,137.90 | $352.44 – $1,167.61 | 17 |
| Rabies ig ht&sol human im/sc CPT 90377 | $8,111.40 | $10,815.19 | $242.18 – $577.10 | 17 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $11,649.94 | $15,533.25 | $275.18 – $648.49 | 17 |
| Radiation therapy dose plan CPT 77300 | $340.50 | $454.00 | $130.35 – $234.63 | 17 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $1,333.50 | $1,778.00 | $526.57 – $1,694.37 | 17 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $1,455.00 | $1,940.00 | $526.57 – $1,694.37 | 17 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,187.25 | $1,583.00 | $526.57 – $947.83 | 17 |
| Radphm quant measure sgl area add-on CPT 78835 | $46.50 | $62.00 | $83.46 – $150.23 | 16 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | not published | not published | $181.21 – $181.21 | 1 |
| Ranibizumab injection HCPCS J2778 | not published | not published | $221.76 – $221.76 | 1 |
| Rapid Strep Test CPT 87880 | $150.00 | $200.00 | $16.53 – $29.75 | 17 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $20,465.52 | $27,287.36 | $382.19 – $916.35 | 17 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | $88,558.68 | $118,078.24 | $223.68 – $548.11 | 17 |
| Rbc count only automated CPT 85041 | $33.00 | $44.00 | $3.02 – $5.44 | 17 |
| Rbc deglycerolized each unit HCPCS P9039 | $1,011.00 | $1,348.00 | $313.00 – $563.40 | 16 |
| Rbc irradiated each unit HCPCS P9038 | $693.75 | $925.00 | $145.22 – $261.40 | 16 |
| Red blood cells each unit HCPCS P9021 | $1,056.75 | $1,409.00 | $150.57 – $271.03 | 16 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $602.25 | $803.00 | $184.91 – $332.84 | 16 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $693.75 | $925.00 | $265.41 – $477.74 | 16 |
| Red blood cells washed each unit HCPCS P9022 | $847.50 | $1,130.00 | $368.58 – $663.44 | 16 |
| Reduction of procidentia 45900 CPT 45900 | $889.50 | $1,186.00 | $901.87 – $1,623.37 | 16 |
| Refill maint impl spine pump CPT 95991 | $294.00 | $392.00 | $297.68 – $535.83 | 16 |
| Refill/maint pump/resvr syst CPT 96522 | $630.00 | $840.00 | $206.28 – $371.30 | 16 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $698.06 | $930.74 | $7.03 – $128.52 | 2 |
| Release of eye fluid CPT 67015 | $2,223.00 | $2,964.00 | $2,238.13 – $4,028.63 | 16 |
| Relocation skin pocket pm CPT 33222 | $1,749.00 | $2,332.00 | $2,000.97 – $3,601.74 | 16 |
| Rem endovas vena cava filter CPT 37193 | $4,993.50 | $6,658.00 | $3,062.12 – $5,511.82 | 16 |
| Rem interrog dev eval icpms CPT 93297 | $109.50 | $146.00 | $36.19 – $65.15 | 16 |
| Rem interrog dev eval scrms CPT 93298 | $109.50 | $146.00 | $36.19 – $65.15 | 16 |
| Rem interrog evl pm/ids CPT 93296 | $138.75 | $185.00 | $36.19 – $65.15 | 16 |
| Rem mntr physiol 1st dev supply ea 30 days CPT 99454 | $84.00 | $112.00 | $36.19 – $65.15 | 16 |
| Rem mntr physiol 1st set up pt educaj eqp CPT 99453 | $295.50 | $394.00 | $129.12 – $232.41 | 16 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $2,406.04 | $3,208.05 | $6.90 – $16.36 | 17 |
| Removal anal seton other marker 46030 CPT 46030 | $1,139.25 | $1,519.00 | $1,160.50 – $2,088.91 | 16 |
| Removal biliary drg cath CPT 47537 | $1,042.50 | $1,390.00 | $879.59 – $1,583.27 | 16 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | $1,311.00 | $1,748.00 | $608.36 – $1,095.05 | 16 |
| Removal central venous device tunneled w/port/pump central/peripheral insertion CPT 36590 | $2,118.00 | $2,824.00 | $1,526.62 – $2,747.91 | 16 |
| Removal cerclage w/anes CPT 59871 | $279.75 | $373.00 | $3,139.36 – $5,650.86 | 16 |
| Removal cerumen impacted (both sides) CPT 69210 | $161.25 | $215.00 | $57.21 – $102.98 | 16 |
| Removal clot in graft oth/thn 35875 CPT 35875 | $6,324.75 | $8,433.00 | $5,396.44 – $9,713.59 | 16 |
| Removal clot in graft xcp 35876 CPT 35876 | $6,324.75 | $8,433.00 | $5,396.44 – $9,713.59 | 16 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $343.50 | $458.00 | $194.58 – $350.24 | 16 |
| Removal duct glbldr calculi CPT 47544 | $2,007.75 | $2,677.00 | $734.12 – $1,321.42 | 16 |
| Removal embedded foreign body vestibule mouth smpl CPT 40804 | $1,051.50 | $1,402.00 | $879.59 – $1,583.27 | 16 |
| Removal foreign body foot cmplx CPT 28193 | $1,957.50 | $2,610.00 | $1,601.72 – $2,883.09 | 16 |
| Removal foreign body foot subcutaneous right CPT 28190 | $873.00 | $1,164.00 | $686.75 – $1,236.14 | 16 |
| Removal of anal tags CPT 46230 | $3,208.50 | $4,278.00 | $2,691.84 – $4,845.30 | 16 |
| Removal of shunt CPT 49429 | $4,862.25 | $6,483.00 | $3,062.12 – $5,511.82 | 16 |
| Removal of skin tags each add'l 10 CPT 11201 | $384.00 | $512.00 | $17.68 – $31.83 | 16 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | $153.75 | $205.00 | $194.58 – $350.24 | 16 |
| Removal sutr or stapl no anes CPT 15853 | $273.00 | $364.00 | $12.23 – $22.01 | 16 |
| Removal tunnled intprtnl cath CPT 49422 | $3,859.50 | $5,146.00 | $3,062.12 – $5,511.82 | 16 |
| Removal w/reinsrt nonbiogrdble CPT 11983 | $2,805.00 | $3,740.00 | $433.23 – $779.82 | 16 |
| Removal/replacement ppm generator dual lead system CPT 33228 | $8,001.75 | $10,669.00 | $10,136.35 – $18,245.42 | 16 |
| Remove anal fist subq CPT 46270 | $7,293.00 | $9,724.00 | $2,691.84 – $4,845.30 | 16 |
| Remove bladder stone CPT 52317 | $5,094.00 | $6,792.00 | $3,418.53 – $6,153.35 | 16 |
| Remove bladder stone CPT 52318 | $3,368.25 | $4,491.00 | $3,418.53 – $6,153.35 | 16 |
| Remove cva lumen obstruct CPT 75902 | $1,578.00 | $2,104.00 | $79.94 – $143.89 | 16 |
| Remove hip foreign body 27086 CPT 27086 | $348.00 | $464.00 | $2,816.99 – $5,070.59 | 16 |
| Remove hip/pelvis lesion 27047 CPT 27047 | $2,790.00 | $3,720.00 | $2,816.99 – $5,070.59 | 16 |
| Remove renal tube w/fluoro CPT 50389 | $1,281.75 | $1,709.00 | $676.24 – $1,217.23 | 16 |
| Remove shoulder foreign body subq 23330 CPT 23330 | $1,566.00 | $2,088.00 | $1,601.72 – $2,883.09 | 16 |
| Remove spine eltrd perq aray CPT 63661 | $1,866.00 | $2,488.00 | $1,893.75 – $3,408.76 | 16 |
| Remove ureter stent percut CPT 50384 | $2,451.00 | $3,268.00 | $2,027.25 – $3,649.06 | 16 |
| Remove vaginal foreign body 57415 CPT 57415 | $2,774.25 | $3,699.00 | $3,139.36 – $5,650.86 | 16 |
| Renal function panel CPT 80069 | $135.00 | $180.00 | $8.68 – $15.62 | 17 |
| Renal venogram bil s&i CPT 75833 | $2,628.75 | $3,505.00 | $3,062.12 – $5,511.82 | 17 |
| Repair blood vessel dir upper extr CPT 35206 | $3,068.25 | $4,091.00 | $3,062.12 – $5,511.82 | 16 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | $969.00 | $1,292.00 | $394.24 – $709.63 | 16 |
| Repair detached retina CPT 67110 | $2,250.75 | $3,001.00 | $2,238.13 – $4,028.63 | 16 |
| Repair detached retina pc CPT 67105 | $666.75 | $889.00 | $533.39 – $960.10 | 16 |
| Repair eyelid wound CPT 67930 | $2,745.75 | $3,661.00 | $2,305.69 – $4,150.23 | 16 |
| Repair eyelid wound CPT 67935 | $3,552.00 | $4,736.00 | $2,305.69 – $4,150.23 | 16 |
| Repair finger tendon CPT 26433 | $3,126.75 | $4,169.00 | $3,173.19 – $5,711.73 | 16 |
| Repair lip full thkns =<one-half vert height CPT 40652 | $1,080.75 | $1,441.00 | $523.04 – $941.47 | 16 |
| Repair lip full thkns >one-half vert height/cmplx CPT 40654 | $3,512.25 | $4,683.00 | $1,504.73 – $2,708.51 | 16 |
| Repair of toe dislocation CPT 28675 | $3,126.75 | $4,169.00 | $3,173.19 – $5,711.73 | 16 |
| Repair pm/icd lead dual CPT 33220 | $3,691.50 | $4,922.00 | $3,624.10 – $6,523.39 | 16 |
| Repair rpr lac tongue floor mouth > 2.6 cm/cmplx CPT 41252 | $217.50 | $290.00 | $229.70 – $413.45 | 16 |
| Repair rpr lip full thickness vermilion only CPT 40650 | $837.75 | $1,117.00 | $523.04 – $941.47 | 16 |
| Repair stomach opening CPT 43870 | $3,709.50 | $4,946.00 | $3,739.04 – $6,730.27 | 16 |
| Repair tendon/muscle forearm/wrist prime sngl ea CPT 25260 | $3,126.75 | $4,169.00 | $3,173.19 – $5,711.73 | 16 |
| Repair tongue lac <2.5cm past 1/3 tongue 41251 CPT 41251 | $217.50 | $290.00 | $229.70 – $413.45 | 16 |
| Repair upper arm/elbow tendon/muscle ea CPT 24341 | $6,911.25 | $9,215.00 | $7,037.08 – $12,666.74 | 16 |
| Replace aortic valve open femoral 33362 CPT 33362 | $18,614.25 | $24,819.00 | $1,161.00 – $2,089.80 | 16 |
| Replace aortic valve open iliac 33364 CPT 33364 | $18,614.25 | $24,819.00 | $1,247.68 – $2,245.83 | 16 |
| Replace aortic valve w/byp prq aprch 33367 CPT 33367 | $18,614.25 | $24,819.00 | $552.28 – $994.11 | 16 |
| Replace duod/jej tube perc CPT 49451 | $746.25 | $995.00 | $879.59 – $1,583.27 | 16 |
| Replace g-j tube perc CPT 49452 | $1,056.75 | $1,409.00 | $879.59 – $1,583.27 | 16 |
| Replace g/c tube perc CPT 49450 | $777.75 | $1,037.00 | $879.59 – $1,583.27 | 16 |
| Replace tunneled cv cath CPT 36578 | $4,001.25 | $5,335.00 | $3,062.12 – $5,511.82 | 16 |
| Reposg phrnc nrv stim trnsvn CPT 33281 | $3,353.25 | $4,471.00 | $3,390.52 – $6,102.94 | 16 |
| Reposition pm/icd lead CPT 33215 | $2,432.25 | $3,243.00 | $3,062.12 – $5,511.82 | 16 |
| Reptilase test CPT 85635 | $81.75 | $109.00 | $9.85 – $17.73 | 17 |
| Reslizumab 10 mg/ml intravenous solution HCPCS J2786 | $4,119.02 | $5,492.02 | $11.53 – $25.73 | 17 |
| Resp virus 6-11 targets CPT 87632 | $844.50 | $1,126.00 | $218.06 – $392.51 | 17 |
| Resuscitation cardiopulmonary CPT 92950 | $741.75 | $989.00 | $209.40 – $376.92 | 16 |
| Resuscitation delivery/birthing room CPT 99465 | $393.00 | $524.00 | $640.98 – $1,153.77 | 16 |
| Reticulated platelet assay CPT 85055 | $57.75 | $77.00 | $35.74 – $64.33 | 17 |
| Reticulocyte automated CPT 85045 | $28.50 | $38.00 | $3.99 – $7.18 | 17 |
| Rev-rem impl neurostim gen-rec CPT 63688 | $3,288.00 | $4,384.00 | $3,390.52 – $6,102.94 | 16 |
| Revasc evasc fpvt angio cplx 1st CPT 37265 | $6,573.75 | $8,765.00 | $5,519.68 – $9,935.42 | 16 |
| Revasc evasc fpvt angio sf 1st CPT 37263 | $6,573.75 | $8,765.00 | $5,519.68 – $9,935.42 | 16 |
| Revasc evasc fpvt athrec cplx 1st CPT 37273 | $9,198.00 | $12,264.00 | $17,778.02 – $32,000.44 | 16 |
| Revasc evasc fpvt athrec sf 1st CPT 37271 | $9,198.00 | $12,264.00 | $17,778.02 – $32,000.44 | 16 |
| Revasc evasc fpvt st athrec sf 1st CPT 37275 | $17,082.75 | $22,777.00 | $17,778.02 – $32,000.44 | 16 |
| Revasc evasc fpvt stent cplx 1st CPT 37269 | $16,699.50 | $22,266.00 | $11,195.55 – $20,152.00 | 16 |
| Revasc evasc fpvt stent sf 1st CPT 37267 | $16,699.50 | $22,266.00 | $11,195.55 – $20,152.00 | 16 |
| Revasc evasc imvt angio cplx 1st CPT 37298 | $9,255.00 | $12,340.00 | $11,195.55 – $20,152.00 | 16 |
| Revasc evasc imvt angio sf 1st CPT 37296 | $9,255.00 | $12,340.00 | $11,195.55 – $20,152.00 | 16 |
| Revasc evasc ivt angio cplx 1st CPT 37256 | $8,049.00 | $10,732.00 | $5,519.68 – $9,935.42 | 16 |
| Revasc evasc ivt stent cplx 1st CPT 37260 | $17,457.00 | $23,276.00 | $11,195.55 – $20,152.00 | 16 |
| Revasc evasc ivt stent sf 1st CPT 37258 | $17,457.00 | $23,276.00 | $11,195.55 – $20,152.00 | 16 |
| Revasc evasc tpvt angio cplx 1st CPT 37282 | $8,235.00 | $10,980.00 | $11,195.55 – $20,152.00 | 16 |
| Revasc evasc tpvt angio sf 1st CPT 37280 | $8,235.00 | $10,980.00 | $11,195.55 – $20,152.00 | 16 |
| Revasc evasc tpvt athrec cplx 1st CPT 37290 | $12,046.50 | $16,062.00 | $17,778.02 – $32,000.44 | 16 |
| Revasc evasc tpvt athrec sf 1st CPT 37288 | $12,046.50 | $16,062.00 | $17,778.02 – $32,000.44 | 16 |
| Revasc intra lithotrip-ather HCPCS C9766 | $16,941.00 | $22,588.00 | $17,778.02 – $32,000.44 | 16 |
| Revasc intra lithotrip-stent HCPCS C9765 | $16,941.00 | $22,588.00 | $17,778.02 – $32,000.44 | 16 |
| Revasc intravasc lithotripsy HCPCS C9764 | $10,628.25 | $14,171.00 | $11,195.55 – $20,152.00 | 16 |
| Revasc lith-sten-ath tib/per HCPCS C9775 | $16,941.00 | $22,588.00 | $17,778.02 – $32,000.44 | 16 |
| Revasc lithotr-ather tib/per HCPCS C9774 | $16,941.00 | $22,588.00 | $17,778.02 – $32,000.44 | 16 |
| Revasc lithotr-stent tib/per HCPCS C9773 | $16,941.00 | $22,588.00 | $17,778.02 – $32,000.44 | 16 |
| Revasc lithotrip tibi/perone HCPCS C9772 | $10,628.25 | $14,171.00 | $11,195.55 – $20,152.00 | 16 |
| Revasc lithotrip-stent-ather HCPCS C9767 | $16,941.00 | $22,588.00 | $17,778.02 – $32,000.44 | 16 |
| Revise abdomen-venous shunt CPT 49426 | $5,251.50 | $7,002.00 | $3,472.27 – $6,250.09 | 16 |
| Revision of cervix CPT 57720 | $2,175.00 | $2,900.00 | $3,139.36 – $5,650.86 | 16 |
| Revision of cervix CPT 59320 | $2,596.50 | $3,462.00 | $3,139.36 – $5,650.86 | 16 |
| Revision of penis CPT 54420 | $3,367.50 | $4,490.00 | $3,418.53 – $6,153.35 | 16 |
| Revision tips CPT 37183 | $6,434.25 | $8,579.00 | $5,519.68 – $9,935.42 | 16 |
| Rf abltj nrv nrvtg si jt CPT 64625 | $1,746.75 | $2,329.00 | $1,893.75 – $3,408.76 | 16 |
| Rheumatoid factor quantitative CPT 86431 | $100.50 | $134.00 | $5.67 – $10.21 | 17 |
| Rho d immune globulin 50 mcg HCPCS J2788 | not published | not published | $67.79 – $67.79 | 1 |
| Rho d immune globulin inj HCPCS J2790 | $240.75 | $321.00 | $200.61 – $730.44 | 2 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | not published | not published | $12.07 – $12.07 | 1 |
| Rho(d) immune globulin h, sd HCPCS J2792 | $5,242.06 | $6,989.41 | $34.26 – $74.89 | 17 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $300.54 | $400.72 | not published | 0 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $1,509.75 | $2,013.00 | $955.43 – $1,719.77 | 16 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $4,536.51 | $6,048.67 | $10.80 – $26.63 | 17 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | $27,790.74 | $37,054.31 | $36.28 – $89.96 | 17 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | not published | not published | $184.81 – $184.81 | 1 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $9,097.89 | $12,130.52 | $31.28 – $75.89 | 17 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | not published | not published | $72.80 – $72.80 | 1 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $8,464.14 | $11,285.51 | $13.69 – $64.50 | 17 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | $1,314.00 | $1,752.00 | $686.75 – $1,236.14 | 16 |
| Rmv&rplcmt phrnc nrv stim ld CPT 33288 | $13,161.00 | $17,548.00 | $10,806.19 – $19,451.13 | 16 |
| Rmv&rplcmt phrnc nrv stim pg CPT 33287 | $30,000.00 | $40,000.00 | $29,925.80 – $53,866.43 | 16 |
| Rmvl icd by tv extr CPT 33244 | $2,884.50 | $3,846.00 | $3,624.10 – $6,523.39 | 16 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | $31,260.00 | $41,680.00 | $30,440.92 – $54,793.66 | 16 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | $21,319.50 | $28,426.00 | $21,571.82 – $38,829.28 | 16 |
| Rmvl icd pulse gen only CPT 33241 | $2,562.75 | $3,417.00 | $3,624.10 – $6,523.39 | 16 |
| Rmvl ndwellg tun pleural cath CPT 32552 | $762.00 | $1,016.00 | $608.36 – $1,095.05 | 16 |
| Rmvl perm pm pulse gen CPT 33233 | $4,150.50 | $5,534.00 | $8,025.47 – $14,445.85 | 16 |
| Rmvl phrnc nrv stim pg only CPT 33280 | $3,353.25 | $4,471.00 | $3,390.52 – $6,102.94 | 16 |
| Rmvl phrnc nrv stim sys CPT 33278 | $3,353.25 | $4,471.00 | $3,390.52 – $6,102.94 | 16 |
| Rmvl phrnc nrv stim transvns CPT 33279 | $3,287.25 | $4,383.00 | $3,390.52 – $6,102.94 | 16 |
| Rmvl pq vad left hrt vein sep session CPT 33992 | $3,118.50 | $4,158.00 | $163.30 – $293.94 | 16 |
| Rmvl sq defib electrode CPT 33272 | $3,794.25 | $5,059.00 | $3,624.10 – $6,523.39 | 16 |
| Rmvl tv pm lead dual CPT 33235 | $2,460.75 | $3,281.00 | $3,624.10 – $6,523.39 | 16 |
| Rolapitant, oral, 1mg HCPCS J8670 | not published | not published | $3.77 – $3.77 | 1 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | $11,827.02 | $15,769.35 | $30.80 – $75.62 | 17 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $20,356.48 | $27,141.97 | $11.11 – $19.99 | 16 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $8,372.44 | $11,163.25 | $12.19 – $29.21 | 17 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $184.88 | $246.50 | $0.15 – $0.72 | 2 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $2,531.25 | $3,375.00 | $1,255.55 – $2,259.99 | 16 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | $1,865.25 | $2,487.00 | $1,526.62 – $2,747.91 | 16 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | $1,749.00 | $2,332.00 | $1,526.62 – $2,747.91 | 16 |
| Rpl tun cvc wo subq port CPT 36581 | $3,632.25 | $4,843.00 | $3,062.12 – $5,511.82 | 16 |
| Rpl tun-cvad w subq port CPT 36582 | $3,849.75 | $5,133.00 | $3,062.12 – $5,511.82 | 16 |
| Rubella antibody igg CPT 86762 | $83.25 | $111.00 | $14.39 – $25.90 | 17 |
| Rubeola antibody igg CPT 86765 | $166.50 | $222.00 | $12.88 – $23.18 | 17 |
| Russell viper venom diluted CPT 85613 | $81.00 | $108.00 | $9.58 – $17.24 | 17 |
| S bowel endoscope w/stent CPT 44379 | $6,608.25 | $8,811.00 | $5,887.56 – $10,597.60 | 16 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $9,478.55 | $12,638.06 | $36.80 – $88.23 | 17 |
| Salivary gland imaging CPT 78230 | $262.50 | $350.00 | $387.70 – $697.86 | 17 |
| Salmonella antibody CPT 86768 | $29.25 | $39.00 | $13.19 – $23.74 | 17 |
| Sargramostim injection HCPCS J2820 | $1,092.15 | $1,456.20 | $61.89 – $136.52 | 17 |
| Sarscov & inf vir a&b ag ia CPT 87428 | $134.25 | $179.00 | $70.29 – $126.52 | 16 |
| Sarscov coronavirus ag ia CPT 87426 | $59.25 | $79.00 | $35.33 – $63.59 | 16 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $905.25 | $1,207.00 | $231.40 – $416.51 | 16 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $868.50 | $1,158.00 | $101.39 – $182.50 | 16 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $734.25 | $979.00 | $231.40 – $416.51 | 16 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $855.75 | $1,141.00 | $101.39 – $182.50 | 16 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $127.50 | $170.00 | $101.39 – $182.50 | 16 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $810.75 | $1,081.00 | $101.39 – $182.50 | 16 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $908.25 | $1,211.00 | $231.40 – $416.51 | 16 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $612.00 | $816.00 | $101.39 – $182.50 | 16 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $855.75 | $1,141.00 | $101.39 – $182.50 | 16 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $1,077.00 | $1,436.00 | $1,601.72 – $2,883.09 | 16 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $7,863.75 | $10,485.00 | not published | 0 |
| Screen/visual acuity/bilat/quant 99173 CPT 99173 | $26.25 | $35.00 | $3.08 – $5.55 | 16 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $2,478.75 | $3,305.00 | $901.87 – $1,623.37 | 16 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $1,761.75 | $2,349.00 | $901.87 – $1,623.37 | 16 |
| Screening Mammogram CPT 77067 | $444.00 | $592.00 | $117.58 – $211.64 | 16 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $28,563.75 | $38,085.00 | not published | 0 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | $8,255.25 | $11,007.00 | $1,073.96 – $1,933.14 | 16 |
| Sedation moderate same physician performing a gastrointestinal endoscopic service >= 5 years initial 15 minutes intra-service time HCPCS G0500 | $667.50 | $890.00 | $61.07 – $109.93 | 16 |
| Sedimentation rate erythrocyte automated CPT 85652 | $39.00 | $52.00 | $2.70 – $4.86 | 17 |
| Select picture audiometry CPT 92583 | $56.25 | $75.00 | $57.21 – $102.98 | 16 |
| Self-mgmt educ/train 2-4 pt 30min CPT 98961 | $112.50 | $150.00 | $14.36 – $25.86 | 16 |
| Sertraline (zoloft) - sendout CPT 80332 | $88.50 | $118.00 | not published | 0 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $638.94 | $851.91 | not published | 0 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $206.25 | $275.00 | $194.58 – $350.24 | 16 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $7,076.25 | $9,435.00 | not published | 0 |
| Sheath laser cavaclear 14f HCPCS C1603 | $11,238.75 | $14,985.00 | not published | 0 |
| Shoe post-op mens m HCPCS L3260 | $29.76 | $39.67 | not published | 0 |
| Shoulder MRI (with and without contrast) CPT 73223 | $2,854.50 | $3,806.00 | $338.34 – $609.01 | 16 |
| Shoulder MRI (with contrast) CPT 73222 | $2,769.75 | $3,693.00 | $760.25 – $1,368.44 | 16 |
| Shoulder MRI (without contrast) CPT 73221 | $2,854.50 | $3,806.00 | $231.40 – $416.51 | 16 |
| Shoulder X-ray CPT 73030 | $276.00 | $368.00 | $84.40 – $151.91 | 17 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $4,050.00 | $5,400.00 | not published | 0 |
| Sialolithotomy 42330 CPT 42330 | $8,793.00 | $11,724.00 | $3,215.33 – $5,787.60 | 16 |
| Sickling rbc CPT 85660 | $102.75 | $137.00 | $5.51 – $9.92 | 17 |
| Sig w/tndsc balloon dilation CPT 45340 | $2,136.00 | $2,848.00 | $1,160.50 – $2,088.91 | 16 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | $1,976.25 | $2,635.00 | $901.87 – $1,623.37 | 16 |
| Sigmoidoscopy and biopsy CPT 45331 | $1,265.25 | $1,687.00 | $901.87 – $1,623.37 | 16 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | $882.75 | $1,177.00 | $901.87 – $1,623.37 | 16 |
| Sigmoidoscopy for bleeding CPT 45334 | $1,594.50 | $2,126.00 | $1,160.50 – $2,088.91 | 16 |
| Sigmoidoscopy w/ablation CPT 45346 | $2,029.50 | $2,706.00 | $1,160.50 – $2,088.91 | 16 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | $1,370.25 | $1,827.00 | $1,160.50 – $2,088.91 | 16 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | $5,678.25 | $7,571.00 | $5,887.56 – $10,597.60 | 16 |
| Sigmoidoscopy w/resection CPT 45349 | $2,712.75 | $3,617.00 | $2,691.84 – $4,845.30 | 16 |
| Sigmoidoscopy w/tumr remove CPT 45338 | $1,848.75 | $2,465.00 | $1,160.50 – $2,088.91 | 16 |
| Sigmoidoscopy w/ultrasound CPT 45341 | $1,746.00 | $2,328.00 | $901.87 – $1,623.37 | 16 |
| Sigmoidoscopy w/us guide bx CPT 45342 | $2,314.50 | $3,086.00 | $1,160.50 – $2,088.91 | 16 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | $1,365.75 | $1,821.00 | $901.87 – $1,623.37 | 16 |
| Simple cystometrogram 51725 CPT 51725 | $1,056.00 | $1,408.00 | $242.30 – $436.15 | 16 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $456.17 | $608.22 | $330.95 – $1,197.90 | 2 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,931.25 | $2,575.00 | $170.10 – $306.19 | 16 |
| Sinus CT scan (with contrast) CPT 70487 | $1,689.75 | $2,253.00 | $170.10 – $306.19 | 16 |
| Sinus CT scan (without contrast) CPT 70486 | $1,650.00 | $2,200.00 | $101.39 – $182.50 | 16 |
| Sinus/juglr venogram s&i CPT 75860 | $1,914.75 | $2,553.00 | $3,062.12 – $5,511.82 | 17 |
| Sipuleucel-t - su HCPCS Q2043 | $95,750.46 | $127,667.28 | $56,269.19 – $136,172.49 | 17 |
| Sirolimus, oral HCPCS J7520 | $12,667.27 | $16,889.69 | $2.31 – $24.03 | 2 |
| Skin Biopsy CPT 11102 | $303.75 | $405.00 | $394.24 – $709.63 | 16 |
| Skyla, 13.5 mg HCPCS J7301 | $3,739.59 | $4,986.11 | $10,402.74 – $10,402.74 | 1 |
| Sleep Study (Polysomnography) CPT 95810 | $6,070.50 | $8,094.00 | $832.81 – $1,499.05 | 16 |
| Sleep study attended CPT 95807 | $316.50 | $422.00 | $361.89 – $651.40 | 16 |
| Sleep study unattended CPT 95806 | $303.75 | $405.00 | $209.40 – $376.92 | 16 |
| Sleeve fing rolyan med HCPCS L3933 | $32.25 | $43.00 | $284.23 – $511.61 | 16 |
| Sling arm deluxe w/pad xs HCPCS A4565 | $30.35 | $40.46 | $10.98 – $19.76 | 16 |
| Sling suprapubic suburetheral HCPCS C1771 | $21,217.50 | $28,290.00 | not published | 0 |
| Small bowel endoscopy CPT 44360 | $1,497.75 | $1,997.00 | $1,860.96 – $3,349.72 | 16 |
| Small bowel endoscopy CPT 44364 | $2,108.25 | $2,811.00 | $1,860.96 – $3,349.72 | 16 |
| Small bowel endoscopy CPT 44366 | $2,289.75 | $3,053.00 | $1,860.96 – $3,349.72 | 16 |
| Small bowel endoscopy CPT 44369 | $1,830.75 | $2,441.00 | $1,860.96 – $3,349.72 | 16 |
| Small bowel endoscopy CPT 44376 | $1,757.25 | $2,343.00 | $1,860.96 – $3,349.72 | 16 |
| Small bowel endoscopy CPT 44378 | $2,350.50 | $3,134.00 | $1,860.96 – $3,349.72 | 16 |
| Small bowel endoscopy 44365 CPT 44365 | $2,040.75 | $2,721.00 | $1,860.96 – $3,349.72 | 16 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | $1,785.75 | $2,381.00 | $1,860.96 – $3,349.72 | 16 |
| Small bowel endoscopy br/wa CPT 44380 | $1,249.50 | $1,666.00 | $879.59 – $1,583.27 | 16 |
| Small bowel endoscopy br/wa CPT 44381 | $1,848.75 | $2,465.00 | $1,860.96 – $3,349.72 | 16 |
| Small bowel endoscopy/biopsy CPT 44361 | $2,400.00 | $3,200.00 | $1,860.96 – $3,349.72 | 16 |
| Small bowel endoscopy/biopsy CPT 44377 | $1,838.25 | $2,451.00 | $1,860.96 – $3,349.72 | 16 |
| Small bowel endoscopy/stent 44370 CPT 44370 | $5,506.50 | $7,342.00 | $5,887.56 – $10,597.60 | 16 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $83.25 | $111.00 | $5.39 – $9.70 | 17 |
| Smear gram stain CPT 87205 | $60.75 | $81.00 | $4.27 – $7.69 | 17 |
| Smear nasal eosinophil CPT 89190 | $37.50 | $50.00 | $5.79 – $10.42 | 17 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $42.75 | $57.00 | $5.99 – $10.78 | 17 |
| Smear wet mount CPT 87210 | $77.25 | $103.00 | $5.82 – $10.48 | 17 |
| Snrpn/ube3a gene CPT 81331 | $376.50 | $502.00 | $51.07 – $91.93 | 17 |
| So gsap cll fr dna/dna&rna CPT 81462 | $2,242.50 | $2,990.00 | $1,195.83 – $2,152.49 | 16 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | $1,137.00 | $1,516.00 | $1,046.35 – $1,883.43 | 16 |
| Sodium 24 hour urine CPT 84300 | $47.25 | $63.00 | $5.06 – $9.11 | 17 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $20.34 | $27.12 | $3.33 – $12.15 | 2 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $19.42 | $25.89 | $1.73 – $6.03 | 2 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $33.28 | $44.37 | $5.53 – $24.21 | 2 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $11.10 | $14.79 | $0.63 – $0.63 | 1 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $28.46 | $37.94 | $5.28 – $21.33 | 2 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $651.32 | $868.42 | $178.61 – $657.90 | 2 |
| Sodium serum/plasma/whole blood CPT 84295 | $44.25 | $59.00 | $4.81 – $8.66 | 17 |
| Somatosensory testing CPT 95927 | $1,130.25 | $1,507.00 | $209.40 – $376.92 | 16 |
| Somatropin injection HCPCS J2941 | $2,600.83 | $3,467.77 | $1,471.95 – $1,471.95 | 1 |
| Sotalol hydrochloride IV HCPCS C9482 | $13,396.05 | $17,861.39 | $186.39 – $186.39 | 1 |
| Specimen fat stain CPT 89125 | $39.75 | $53.00 | $5.88 – $10.58 | 17 |
| Speech evaluation complex CPT 70371 | $691.50 | $922.00 | $231.40 – $416.51 | 17 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $1,416.00 | $1,888.00 | $684.56 – $1,232.21 | 16 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $315.75 | $421.00 | $361.89 – $651.40 | 16 |
| Spirometry up to 2 yrs old CPT 94011 | $1,005.75 | $1,341.00 | $124.79 – $224.62 | 16 |
| Spleen imaging CPT 78185 | $390.75 | $521.00 | $387.70 – $697.86 | 17 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $48.75 | $65.00 | $592.42 – $1,066.36 | 16 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $93.00 | $124.00 | $74.01 – $133.22 | 16 |
| Splint finger frog med HCPCS L3927 | $73.50 | $98.00 | $46.60 – $83.88 | 16 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $35.25 | $47.00 | $130.42 – $234.76 | 16 |
| Split blood or products CPT 86985 | $471.75 | $629.00 | $165.22 – $297.40 | 16 |
| Sputum specimen collection CPT 89220 | $337.50 | $450.00 | $165.22 – $297.40 | 16 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $318.75 | $425.00 | $105.70 – $190.26 | 16 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $279.00 | $372.00 | $98.99 – $178.18 | 16 |
| St evaluate speech sound production CPT 92522 | $273.00 | $364.00 | $107.86 – $194.16 | 16 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $351.00 | $468.00 | $217.95 – $392.30 | 16 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $480.00 | $640.00 | $87.52 – $157.54 | 16 |
| St evaluation swallow function CPT 92610 | $383.25 | $511.00 | $81.27 – $146.28 | 16 |
| St treatment speech individual CPT 92507 | $288.00 | $384.00 | $73.34 – $132.01 | 16 |
| St treatment swallow dysfunction/oral CPT 92526 | $288.00 | $384.00 | $80.77 – $145.39 | 16 |
| Staph a dna amp probe CPT 87640 | $135.00 | $180.00 | $35.09 – $63.16 | 17 |
| Stem cells total count CPT 86367 | $102.75 | $137.00 | $77.78 – $140.00 | 17 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $47,137.50 | $62,850.00 | not published | 0 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $5,076.00 | $6,768.00 | not published | 0 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $38,815.81 | $51,754.41 | not published | 0 |
| Str markers specimen anal CPT 81265 | $1,270.50 | $1,694.00 | $233.07 – $419.53 | 17 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $145.50 | $194.00 | $157.59 – $283.67 | 16 |
| Strapping of hand or finger CPT 29280 | $272.25 | $363.00 | $57.21 – $102.98 | 16 |
| Strapping of knee CPT 29530 | $198.75 | $265.00 | $129.03 – $232.25 | 16 |
| Strapping of toes 29550 CPT 29550 | $131.25 | $175.00 | $57.21 – $102.98 | 16 |
| Streptomycin injection HCPCS J3000 | not published | not published | $76.31 – $76.31 | 1 |
| Streptozocin injection HCPCS J9320 | $1,286.99 | $1,715.98 | $901.02 – $3,331.62 | 2 |
| Stress test pulmonary CPT 94618 | $309.00 | $412.00 | $129.03 – $232.25 | 16 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $22.19 | $29.58 | $15.66 – $15.66 | 1 |
| Sulfonylurea screen qn-sendout CPT 80377 | $270.00 | $360.00 | not published | 0 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $167.98 | $223.97 | $1,469.61 – $1,469.61 | 1 |
| Support clav 29.6-40.5in med HCPCS L3650 | $105.75 | $141.00 | $88.92 – $160.06 | 16 |
| Supprelin la implant HCPCS J9226 | $185,546.55 | $247,395.39 | $41,173.43 – $110,893.99 | 17 |
| Surgical pathology level 1 gross examination only CPT 88300 | $96.75 | $129.00 | $28.05 – $50.49 | 16 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $168.75 | $225.00 | $36.22 – $65.20 | 16 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $182.25 | $243.00 | $50.54 – $90.97 | 16 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $184.50 | $246.00 | $50.54 – $90.97 | 16 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $472.50 | $630.00 | $347.62 – $625.72 | 16 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $996.75 | $1,329.00 | $781.35 – $1,406.43 | 16 |
| Susceptibility agar dilution per agent CPT 87181 | $134.25 | $179.00 | $4.75 – $8.55 | 17 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $22.50 | $30.00 | $4.75 – $8.55 | 17 |
| Susceptibility mic per plate CPT 87186 | $81.75 | $109.00 | $8.65 – $15.57 | 17 |
| Svc venogram s&i CPT 75827 | $2,241.75 | $2,989.00 | $863.01 – $2,747.91 | 17 |
| Synvisc or synvisc-one HCPCS J7325 | $1,696.83 | $2,262.43 | $6.96 – $22.13 | 17 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $70.50 | $94.00 | $4.40 – $7.92 | 17 |
| System cardiomems hosp electronics HCPCS C2624 | $53,437.50 | $71,250.00 | not published | 0 |
| System pacing micra av HCPCS C1786 | $33,750.00 | $45,000.00 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $11,441.25 | $15,255.00 | not published | 0 |
| System sealant biosentry tract HCPCS C2613 | $900.00 | $1,200.00 | not published | 0 |
| T cells total count CPT 86359 | $108.00 | $144.00 | $37.73 – $67.91 | 17 |
| T3 (triiodothyronine) free CPT 84481 | $46.50 | $62.00 | $16.94 – $30.49 | 17 |
| T3 (triiodothyronine) total CPT 84480 | $46.50 | $62.00 | $14.18 – $25.52 | 17 |
| T4 (thyroxine) free CPT 84439 | $78.00 | $104.00 | $9.02 – $16.24 | 17 |
| T4 (thyroxine) total CPT 84436 | $81.00 | $108.00 | $6.87 – $12.37 | 17 |
| Tacrol astagraf ex rel oral HCPCS J7508 | $2,970.47 | $3,960.62 | $1.41 – $4.95 | 2 |
| Tacrol envarsus ex rel oral HCPCS J7503 | $8,369.30 | $11,159.06 | $4.45 – $15.57 | 2 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $12,682.80 | $16,910.40 | $0.37 – $2.16 | 2 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $874.23 | $1,165.63 | $259.96 – $638.27 | 17 |
| Tacrolimus therapeutic drug level CPT 80197 | $128.25 | $171.00 | $13.73 – $24.71 | 17 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | $5,161.23 | $6,881.64 | $14.17 – $34.25 | 17 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | $25,827.38 | $34,436.50 | $73.94 – $179.00 | 17 |
| Target gsa panel hmtlmph neop CPT 81450 | $1,708.50 | $2,278.00 | $759.53 – $1,367.15 | 17 |
| Target gsa panel organ neop CPT 81445 | $1,182.75 | $1,577.00 | $597.91 – $1,076.24 | 17 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | $931.50 | $1,242.00 | $716.75 – $1,290.15 | 16 |
| Tavr perq femoral CPT 33361 | $14,986.50 | $19,982.00 | $1,065.65 – $1,918.17 | 16 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $357.75 | $477.00 | $100.00 – $180.00 | 17 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $959.55 | $1,279.39 | $0.25 – $0.71 | 17 |
| Tc-99m mebrofenin HCPCS A9537 | $1,248.75 | $1,664.99 | $1,021.14 – $1,021.14 | 1 |
| Tc-99m mertiatide HCPCS A9562 | $4,717.50 | $6,289.99 | $6,999.03 – $6,999.03 | 1 |
| Tc-99m pentetate dtpa HCPCS A9539 | $975.00 | $1,300.00 | $268.20 – $268.20 | 1 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $6,044.97 | $8,059.96 | $4,055.22 – $4,055.22 | 1 |
| Tc-99m sulfur colloid HCPCS A9541 | $3,734.48 | $4,979.30 | $3,191.58 – $3,191.58 | 1 |
| Tcd emboli detect w/inj CPT 93893 | $585.00 | $780.00 | $101.39 – $182.50 | 16 |
| Tcd emboli detect without inj CPT 93892 | $697.50 | $930.00 | $101.39 – $182.50 | 16 |
| Tee w or without fol w/cont, mon HCPCS C8927 | $900.00 | $1,200.00 | $760.25 – $1,368.44 | 16 |
| Tee w or without fol w/cont,cong HCPCS C8926 | $1,626.00 | $2,168.00 | $760.25 – $1,368.44 | 16 |
| Telavancin injection HCPCS J3095 | $2,428.05 | $3,237.39 | $7.03 – $18.16 | 17 |
| Telehealth original site facility fee HCPCS Q3014 | $151.50 | $202.00 | not published | 0 |
| Temozolomide HCPCS J8700 | $1,918.68 | $2,558.23 | $0.88 – $2.52 | 2 |
| Temozolomide 100 mg intravenous solution HCPCS J9328 | $3,438.61 | $4,584.81 | $10.40 – $25.29 | 17 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | not published | not published | $78.57 – $78.57 | 1 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $29,758.74 | $39,678.32 | $197.44 – $418.48 | 17 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $68.57 | $91.42 | $6.67 – $70.11 | 2 |
| Tert gene targeted seq alys CPT 81345 | $347.25 | $463.00 | $185.20 – $333.36 | 16 |
| Test for chlorohydrocarbons CPT 82441 | $225.00 | $300.00 | $6.01 – $10.82 | 17 |
| Test stress cardiovascular tracing only CPT 93017 | $715.50 | $954.00 | $209.40 – $376.92 | 16 |
| Testicular imaging w/vasc flow CPT 78761 | $544.50 | $726.00 | $387.70 – $697.86 | 17 |
| Testosterone undecanoate 1mg HCPCS J3145 | not published | not published | $4.84 – $4.84 | 1 |
| Tetanus immune globulin inj HCPCS J1670 | $1,939.05 | $2,585.40 | $558.12 – $1,404.52 | 17 |
| Theophylline therapeutic drug level CPT 80198 | $96.00 | $128.00 | $14.14 – $25.45 | 17 |
| Ther nma rdctj intus/obstrcj CPT 74283 | $208.50 | $278.00 | $170.10 – $356.07 | 17 |
| Therapy activation ipnss CPT 93150 | $90.00 | $120.00 | $92.20 – $165.96 | 16 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $50.25 | $67.00 | $35.12 – $63.21 | 16 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $48.00 | $64.00 | $30.31 – $54.56 | 16 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $23.67 | $31.56 | $4.33 – $22.14 | 2 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,287.00 | $1,716.00 | $608.36 – $1,095.05 | 16 |
| Thrombectmy crnry perq mechanical CPT 92973 | $3,142.50 | $4,190.00 | $80.65 – $145.16 | 16 |
| Thrombectomy/inf pq dialysis circuit CPT 36904 | $4,995.00 | $6,660.00 | $5,519.68 – $9,935.42 | 16 |
| Thrombectomy/inf pq dialysis circuit w/pta CPT 36905 | $8,133.75 | $10,845.00 | $11,195.55 – $20,152.00 | 16 |
| Thrombectomy/inf pq dialysis circuit w/stent plcmnt CPT 36906 | $12,329.25 | $16,439.00 | $17,778.02 – $32,000.44 | 16 |
| Thrombin time CPT 85670 | $88.50 | $118.00 | $5.77 – $10.39 | 17 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $58.50 | $78.00 | $6.47 – $11.65 | 17 |
| Thyroglobulin antibody CPT 86800 | $168.75 | $225.00 | $15.91 – $28.64 | 17 |
| Thyroid (TSH) Test CPT 84443 | $155.25 | $207.00 | $16.80 – $30.24 | 17 |
| Thyroid Ultrasound CPT 76536 | $736.50 | $982.00 | $101.39 – $182.50 | 17 |
| Thyroid mets imag whole body CPT 78018 | $1,128.00 | $1,504.00 | $526.57 – $947.83 | 17 |
| Thyroid uptake measurement CPT 78012 | $396.00 | $528.00 | $387.70 – $697.86 | 17 |
| Thyrotropin alfa 0.9 mg intramuscular solution HCPCS J3240 | $7,476.81 | $9,969.08 | $2,125.34 – $5,143.60 | 17 |
| Thyroxine binding globulin (tbg) CPT 84442 | $46.50 | $62.00 | $14.78 – $26.60 | 17 |
| Tib/per revasc stent & ather 37231 CPT 37231 | $17,629.50 | $23,506.00 | not published | 0 |
| Tigecycline injection HCPCS J3243 | $534.77 | $713.02 | $1.22 – $6.66 | 2 |
| Tilt table study CPT 93660 | $943.50 | $1,258.00 | $361.89 – $651.40 | 16 |
| Tirofiban 12.5 mg/50 ml HCPCS J3246 | not published | not published | $8.32 – $8.32 | 1 |
| Tisagenlecleucel car-pos t HCPCS Q2042 | $2,194,589.53 | $2,926,119.37 | $614,180.81 – $1,407,642.00 | 17 |
| Tisotumab vedotin-tftv 40 mg intravenous solution HCPCS J9273 | $27,364.47 | $36,485.95 | $196.12 – $459.15 | 17 |
| Tissue amnio epifix inj 100mg HCPCS Q4145 | not published | not published | $47.39 – $47.39 | 1 |
| Tissue culture placenta CPT 88235 | $6,844.50 | $9,126.00 | $150.30 – $270.54 | 17 |
| Tissue culture skin/biopsy CPT 88233 | $1,056.75 | $1,409.00 | $140.73 – $253.31 | 17 |
| Tissue culture tumor CPT 88239 | $773.25 | $1,031.00 | $147.52 – $265.54 | 17 |
| Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm HCPCS Q4122 | $2,516.07 | $3,354.75 | $120.69 – $217.24 | 16 |
| Tissue matrix xcm thk 20x30cm -cost per sq cm HCPCS Q4142 | $1,679.65 | $2,239.53 | $120.69 – $217.24 | 16 |
| Tissue surgimend prs meshed 20 cm x 10 cm - cost per 0.5cm HCPCS C9358 | $6,114.24 | $8,152.32 | not published | 0 |
| Tissue transglutaminase iga CPT 86364 | $33.00 | $44.00 | $11.53 – $20.75 | 16 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $286.24 | $381.65 | $5.99 – $23.94 | 2 |
| Tobramycin non-comp unit HCPCS J7682 | $124.14 | $165.51 | $35.17 – $196.11 | 2 |
| Tobramycin peak therapeutic drug level CPT 80200 | $88.50 | $118.00 | $16.13 – $29.03 | 17 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | not published | not published | $14.07 – $14.07 | 1 |
| Tomosynthesis breast screen bilateral CPT 77063 | $84.75 | $113.00 | $48.47 – $87.24 | 16 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | $517.65 | $690.20 | $3.26 – $7.02 | 2 |
| Total tau CPT 84394 | $504.00 | $672.00 | $128.92 – $232.06 | 16 |
| Toxoplasma antibody igg CPT 86777 | $51.75 | $69.00 | $14.39 – $25.90 | 17 |
| Toxoplasma antibody igm CPT 86778 | $93.00 | $124.00 | $14.41 – $25.94 | 17 |
| Tpmt gene com vrnts CPT 81335 | $782.25 | $1,043.00 | $174.81 – $314.66 | 17 |
| Trabectedin 1 mg intravenous solution HCPCS J9352 | $13,641.34 | $18,188.45 | $391.07 – $932.37 | 17 |
| Tracheobrnchsc thru est trachs incisn CPT 31615 | $1,497.75 | $1,997.00 | $523.04 – $941.47 | 16 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $101.25 | $135.00 | $53.67 – $96.60 | 16 |
| Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution HCPCS J3290 | $77.65 | $103.53 | not published | 0 |
| Transabdom amnioinfus w/us CPT 59070 | $338.25 | $451.00 | $295.53 – $531.95 | 16 |
| Transcath biopsy CPT 37200 | $8,130.75 | $10,841.00 | $5,396.44 – $9,713.59 | 16 |
| Transcath closure of asd CPT 93580 | $11,268.00 | $15,024.00 | $17,778.02 – $32,000.44 | 16 |
| Transcath mv repair init prosthesis CPT 33418 | $11,292.00 | $15,056.00 | $1,558.27 – $2,804.88 | 16 |
| Transcath occlusion cns CPT 61624 | $5,503.50 | $7,338.00 | $17,778.02 – $32,000.44 | 16 |
| Transcath occlusion non-cns CPT 61626 | $16,788.75 | $22,385.00 | $11,195.55 – $20,152.00 | 16 |
| Transcatheter bx s&i CPT 75970 | $3,087.75 | $4,117.00 | not published | 0 |
| Transferrin CPT 84466 | $98.25 | $131.00 | $12.76 – $22.97 | 17 |
| Transfusion blood/blood component(s) CPT 36430 | $684.75 | $913.00 | $427.85 – $770.13 | 16 |
| Transorl lwr esophgl myotomy CPT 43497 | $5,814.75 | $7,753.00 | $5,887.56 – $10,597.60 | 16 |
| Trastuzumab 150 mg intravenous solution HCPCS J9355 | $5,762.28 | $7,683.03 | $73.43 – $185.42 | 17 |
| Trastuzumab-anns 150 mg intravenous solution HCPCS Q5117 | $12,199.65 | $16,266.19 | $56.38 – $105.32 | 17 |
| Trastuzumab-qyyp 150 mg intravenous solution HCPCS Q5116 | not published | not published | $69.64 – $69.64 | 1 |
| Tray bonemarrw oncontrol 102mm HCPCS C1830 | $1,094.25 | $1,459.00 | not published | 0 |
| Treat ankle dislocation CPT 27842 | $1,560.00 | $2,080.00 | $1,559.43 – $2,806.97 | 16 |
| Treat elbow dislocation CPT 24605 | $1,513.50 | $2,018.00 | $1,559.43 – $2,806.97 | 16 |
| Treat elbow fracture CPT 24620 | $1,513.50 | $2,018.00 | $1,559.43 – $2,806.97 | 16 |
| Treat finger fracture each CPT 26742 | $1,513.50 | $2,018.00 | $1,559.43 – $2,806.97 | 16 |
| Treat foot dislocation CPT 28570 | $261.75 | $349.00 | $239.22 – $430.59 | 16 |
| Treat fracture of radius CPT 25505 | $1,514.25 | $2,019.00 | $1,559.43 – $2,806.97 | 16 |
| Treat fracture of radius CPT 25520 | $1,815.75 | $2,421.00 | $1,559.43 – $2,806.97 | 16 |
| Treat fracture of ulna CPT 25535 | $2,169.75 | $2,893.00 | $239.22 – $430.59 | 16 |
| Treat hip dislocation CPT 27252 | $1,513.50 | $2,018.00 | $1,559.43 – $2,806.97 | 16 |
| Treat humerus fracture CPT 24535 | $1,815.75 | $2,421.00 | $1,559.43 – $2,806.97 | 16 |
| Treat humerus fracture CPT 24565 | $1,815.75 | $2,421.00 | $1,559.43 – $2,806.97 | 16 |
| Treat knee dislocation CPT 27552 | $1,815.75 | $2,421.00 | $1,559.43 – $2,806.97 | 16 |
| Treat knee fracture 27530 CPT 27530 | $296.25 | $395.00 | $239.22 – $430.59 | 16 |
| Treat thigh fracture CPT 27230 | $261.75 | $349.00 | $239.22 – $430.59 | 16 |
| Treat thigh fx growth plate CPT 27517 | $1,815.75 | $2,421.00 | $1,559.43 – $2,806.97 | 16 |
| Treat ulnar fracture CPT 24675 | $2,730.00 | $3,640.00 | $1,559.43 – $2,806.97 | 16 |
| Treat vaginal bleeding CPT 57180 | $195.75 | $261.00 | $196.07 – $352.92 | 16 |
| Treat wrist bone fracture CPT 25635 | $1,513.50 | $2,018.00 | $1,559.43 – $2,806.97 | 16 |
| Treatment incomplete abortion completed surgically any trimester CPT 59812 | $1,886.25 | $2,515.00 | $3,139.36 – $5,650.86 | 16 |
| Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour CPT 94644 | $176.25 | $235.00 | $129.03 – $232.25 | 16 |
| Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour CPT 94645 | $141.00 | $188.00 | $15.28 – $27.50 | 16 |
| Treatment inhalation pressurized/nonpressurized acute airway obstruction CPT 94640 | $429.75 | $573.00 | $212.36 – $382.26 | 16 |
| Treatment missed abortion completed surgically 1st trimester CPT 59820 | $2,551.50 | $3,402.00 | $3,139.36 – $5,650.86 | 16 |
| Treatment of ankle fracture 27786 CPT 27786 | $284.25 | $379.00 | $239.22 – $430.59 | 16 |
| Treatment of foot infection CPT 28002 | $1,560.75 | $2,081.00 | $1,559.43 – $2,806.97 | 16 |
| Treatment of miscarriage CPT 59821 | $2,778.00 | $3,704.00 | $3,139.36 – $5,650.86 | 16 |
| Treatment of thigh fracture CPT 27501 | $732.75 | $977.00 | $239.22 – $430.59 | 16 |
| Treatment of thigh fracture CPT 27510 | $2,093.25 | $2,791.00 | $1,559.43 – $2,806.97 | 16 |
| Treatment of toe fracture 28510 CPT 28510 | $249.75 | $333.00 | $239.22 – $430.59 | 16 |
| Treatment x10sv retinopathy CPT 67228 | $561.75 | $749.00 | $533.39 – $960.10 | 16 |
| Treponema pallidum antibody CPT 86780 | $122.25 | $163.00 | $13.24 – $23.83 | 17 |
| Treprostinil injection HCPCS J3285 | $21,186.46 | $28,248.61 | $55.19 – $135.04 | 17 |
| Trg gene rearrangement anal CPT 81342 | $732.00 | $976.00 | $201.50 – $362.70 | 17 |
| Triamcinolone a inj prs-free HCPCS J3300 | $3,235.98 | $4,314.64 | $18.78 – $59.63 | 17 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $162.88 | $217.17 | $2.09 – $8.55 | 2 |
| Trichinella antibody CPT 86784 | $125.25 | $167.00 | $12.56 – $22.61 | 17 |
| Triglycerides CPT 84478 | $59.25 | $79.00 | $5.74 – $10.33 | 17 |
| Trilaciclib 300 mg intravenous solution HCPCS J1448 | not published | not published | $13.12 – $13.12 | 1 |
| Trim nail(s) HCPCS G0127 | $57.75 | $77.00 | $57.21 – $102.98 | 16 |
| Trim nondyst nails CPT 11719 | $295.50 | $394.00 | $57.21 – $102.98 | 16 |
| Trimethobenzamide hcl inj HCPCS J3250 | $191.20 | $254.93 | $129.98 – $430.56 | 2 |
| Triptorelin pamoate HCPCS J3315 | $16,454.18 | $21,938.90 | $469.38 – $1,197.26 | 17 |
| Trml dstrj ios bvn 1st 2 l/s CPT 64628 | $12,715.50 | $16,954.00 | $12,450.95 – $22,411.72 | 16 |
| Trml dstrj ios bvn ea addl CPT 64629 | $8,477.25 | $11,303.00 | $164.71 – $296.48 | 16 |
| Trnscath plc stent crv crtd w/prtct CPT 37215 | $7,863.00 | $10,484.00 | $877.04 – $1,578.68 | 16 |
| Trnscath plc stent crv crtd without prtct CPT 37216 | $6,395.25 | $8,527.00 | $841.82 – $1,515.27 | 16 |
| Trnscath plc vas stent w/s&i ea addl artery CPT 37237 | $5,642.25 | $7,523.00 | $1,125.53 – $2,025.95 | 16 |
| Trnscath plc vas stent w/s&i ea addl vein CPT 37239 | $5,934.75 | $7,913.00 | $1,525.60 – $2,746.07 | 16 |
| Trnscath plc vas stent w/s&i ini vein CPT 37238 | $8,450.25 | $11,267.00 | $11,195.55 – $20,152.00 | 16 |
| Trnscath retrv pq vasc fb w/guide CPT 37197 | $3,837.75 | $5,117.00 | $3,062.12 – $5,511.82 | 16 |
| Trnscath tx thromblytc art/ven sbsq day CPT 37213 | $3,692.25 | $4,923.00 | $3,062.12 – $5,511.82 | 16 |
| Trnscath tx thromblytc artery non-intracrn ini day CPT 37211 | $6,396.00 | $8,528.00 | $5,396.44 – $9,713.59 | 16 |
| Trnscath tx thromblytc cath rmv sbsq day CPT 37214 | $4,196.25 | $5,595.00 | $3,062.12 – $5,511.82 | 16 |
| Trnscath tx thromblytc vein ini day CPT 37212 | $2,462.25 | $3,283.00 | $3,062.12 – $5,511.82 | 16 |
| Troponin quantitative CPT 84484 | $147.00 | $196.00 | $12.47 – $22.45 | 17 |
| Tte w or without fol w/con,stres HCPCS C8928 | $1,369.50 | $1,826.00 | $760.25 – $1,368.44 | 16 |
| Tte w or without fol w/cont, com HCPCS C8921 | $1,142.25 | $1,523.00 | $760.25 – $1,368.44 | 16 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | $693.75 | $925.00 | $760.25 – $1,368.44 | 16 |
| Tx closed hip disl traumatic without anes CPT 27250 | $218.25 | $291.00 | $239.22 – $430.59 | 16 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | $3,767.25 | $5,023.00 | $3,173.19 – $5,711.73 | 16 |
| Tx closed tib shaft fx without manip CPT 27750 | $288.00 | $384.00 | $239.22 – $430.59 | 16 |
| Ugt1a1 gene analy common variants CPT 81350 | $438.75 | $585.00 | $234.00 – $421.20 | 17 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $548.25 | $731.00 | $101.39 – $182.50 | 17 |
| Ultrasound breast complete CPT 76641 | $439.50 | $586.00 | $101.39 – $182.50 | 17 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $216.75 | $289.00 | $84.40 – $151.91 | 17 |
| Ultrasound chest CPT 76604 | $362.25 | $483.00 | $101.39 – $182.50 | 17 |
| Ultrasound dx ophth b-scan CPT 76512 | $336.00 | $448.00 | $101.39 – $182.50 | 17 |
| Ultrasound elastography ea l target les CPT 76983 | $177.00 | $236.00 | $56.96 – $102.54 | 16 |
| Ultrasound encephalogram CPT 76506 | $397.50 | $530.00 | $101.39 – $182.50 | 17 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $885.75 | $1,181.00 | $101.39 – $182.50 | 17 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $728.25 | $971.00 | $101.39 – $182.50 | 17 |
| Ultrasound guidance for vascular access CPT 76937 | $668.25 | $891.00 | $37.87 – $68.16 | 16 |
| Ultrasound guide intraoperative CPT 76998 | $371.25 | $495.00 | not published | 0 |
| Ultrasound guide tissue ablation CPT 76940 | $1,032.75 | $1,377.00 | not published | 0 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $993.75 | $1,325.00 | $60.57 – $109.02 | 16 |
| Ultrasound hips infant dynamic CPT 76885 | $317.25 | $423.00 | $84.40 – $151.91 | 17 |
| Ultrasound infant hips ltd without stress CPT 76886 | $258.00 | $344.00 | $84.40 – $151.91 | 17 |
| Ultrasound joint complete left CPT 76881 | $763.50 | $1,018.00 | $101.39 – $182.50 | 17 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $752.25 | $1,003.00 | $101.39 – $182.50 | 17 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $687.00 | $916.00 | $83.79 – $150.83 | 16 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $455.25 | $607.00 | $57.68 – $103.82 | 16 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $970.50 | $1,294.00 | $161.25 – $416.51 | 17 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $597.75 | $797.00 | $101.39 – $182.50 | 17 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $527.25 | $703.00 | $101.39 – $182.50 | 17 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $703.50 | $938.00 | $101.39 – $182.50 | 17 |
| Ultrasound prostate/transrectal CPT 76872 | $745.50 | $994.00 | $101.39 – $182.50 | 17 |
| Ultrasound retroperitoneal limited CPT 76775 | $674.25 | $899.00 | $101.39 – $182.50 | 17 |
| Ultrasound scrotum and contents CPT 76870 | $736.50 | $982.00 | $101.39 – $182.50 | 17 |
| Ultrasound spinal canal and contents CPT 76800 | $292.50 | $390.00 | $101.39 – $182.50 | 17 |
| Ultrasound transabd ea addl gest CPT 76812 | $631.50 | $842.00 | $182.85 – $329.14 | 16 |
| Ultrasound transvaginal non obstetric CPT 76830 | $704.25 | $939.00 | $101.39 – $182.50 | 17 |
| Unit mobile power mpu HCPCS Q0479 | $18,857.25 | $25,143.00 | $17,581.09 – $31,645.96 | 16 |
| Unlisted CT procedure CPT 76497 | $1,578.75 | $2,105.00 | $84.40 – $151.91 | 16 |
| Unlisted chemotherapy px CPT 96549 | $44.25 | $59.00 | $45.41 – $81.74 | 16 |
| Unlisted dx gi procedure CPT 91299 | $2,463.00 | $3,284.00 | $124.79 – $224.62 | 16 |
| Unlisted misc path test CPT 89240 | $1,014.00 | $1,352.00 | $50.54 – $90.97 | 16 |
| Unlisted mr procedure CPT 76498 | $1,596.75 | $2,129.00 | $84.40 – $151.91 | 16 |
| Unlisted orl service/px CPT 92700 | $121.50 | $162.00 | $28.05 – $50.49 | 16 |
| Unlisted procedure colon CPT 45399 | $4,911.75 | $6,549.00 | $901.87 – $1,623.37 | 16 |
| Unlisted procedure larynx CPT 31599 | $4,133.25 | $5,511.00 | $229.70 – $413.45 | 16 |
| Unlisted procedure liver CPT 47399 | $2,802.00 | $3,736.00 | $686.75 – $1,236.14 | 16 |
| Unlisted procedure microbiology CPT 87999 | $277.50 | $370.00 | not published | 0 |
| Unlisted procedure rectum CPT 45999 | $882.75 | $1,177.00 | $901.87 – $1,623.37 | 16 |
| Unlisted px abdomen muscskel CPT 22999 | $1,520.25 | $2,027.00 | $239.22 – $430.59 | 16 |
| Unlisted px casting/strpg CPT 29799 | $316.50 | $422.00 | $157.59 – $283.67 | 16 |
| Unlisted px tongue flr mouth CPT 41599 | $1,627.50 | $2,170.00 | $229.70 – $413.45 | 16 |
| Unlisted ultrasound procedure CPT 76999 | $460.50 | $614.00 | $84.40 – $151.91 | 17 |
| Upgrade pm system CPT 33214 | $7,818.75 | $10,425.00 | $10,136.35 – $18,245.42 | 16 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $2,919.75 | $3,893.00 | $338.34 – $609.01 | 16 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $2,994.00 | $3,992.00 | $338.34 – $609.01 | 16 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $2,847.75 | $3,797.00 | $231.40 – $416.51 | 16 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $1,857.75 | $2,477.00 | $879.59 – $1,583.27 | 16 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $2,078.25 | $2,771.00 | $879.59 – $1,583.27 | 16 |
| Uppr gi scope w/submuc inj CPT 43236 | $1,764.00 | $2,352.00 | $879.59 – $1,583.27 | 16 |
| Urea nitrogen CPT 84520 | $38.25 | $51.00 | $3.95 – $7.11 | 17 |
| Urea nitrogen 24 hour urine CPT 84540 | $39.75 | $53.00 | $5.56 – $10.01 | 17 |
| Urea nitrogen clearance CPT 84545 | $57.00 | $76.00 | $7.20 – $12.96 | 17 |
| Ureteral reflux study CPT 78740 | $609.00 | $812.00 | $387.70 – $697.86 | 17 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $613.50 | $818.00 | $231.40 – $416.51 | 17 |
| Urethrocystography void s&i CPT 74455 | $634.50 | $846.00 | $231.40 – $416.51 | 17 |
| Uric acid blood CPT 84550 | $41.25 | $55.00 | $4.52 – $8.14 | 17 |
| Uric acid urine CPT 84560 | $35.25 | $47.00 | $5.08 – $9.14 | 17 |
| Urinalysis (with microscopy) CPT 81001 | $27.00 | $36.00 | $3.17 – $5.71 | 17 |
| Urinalysis (without microscopy) CPT 81003 | $49.50 | $66.00 | $2.25 – $4.05 | 17 |
| Urine Culture Test CPT 87086 | $65.25 | $87.00 | $8.07 – $14.53 | 17 |
| Urine pregnancy test CPT 81025 | $41.25 | $55.00 | $8.61 – $15.50 | 17 |
| Urography, antegrade CPT 74425 | $780.00 | $1,040.00 | $338.34 – $609.01 | 17 |
| Use 1st target lesion CPT 76982 | $151.50 | $202.00 | $101.39 – $182.50 | 16 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $8,225.22 | $10,966.96 | $11.62 – $32.35 | 17 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | $109,781.59 | $146,375.45 | $379.41 – $1,385.64 | 2 |
| Vaccine dtap < 7 years im CPT 90700 | $62.25 | $83.00 | $310.68 – $310.68 | 1 |
| Vaccine dtap-hep b-ipv im CPT 90723 | $233.91 | $311.87 | $1,024.29 – $1,024.29 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | $99.92 | $133.22 | $319.50 – $319.50 | 1 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $45.33 | $60.44 | $137.52 – $137.52 | 1 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $241.96 | $322.61 | $176.90 – $632.34 | 2 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | $354.74 | $472.98 | $1,163.97 – $1,163.97 | 1 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | $100.79 | $134.38 | $374.85 – $374.85 | 1 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | $54.75 | $73.00 | $75.15 – $182.89 | 17 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $162.07 | $216.09 | $75.15 – $171.28 | 17 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | $118.50 | $158.00 | $177.56 – $432.16 | 17 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $75.39 | $100.52 | $33.20 – $77.08 | 17 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $1,044.16 | $1,392.21 | $3,104.01 – $3,104.01 | 1 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $67.50 | $90.00 | $98.16 – $203.21 | 17 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $203.21 – $203.21 | 1 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $53.18 – $53.18 | 1 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $45.75 | $61.00 | $23.22 – $54.40 | 17 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $50.80 – $50.80 | 1 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $188.27 – $188.27 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $52.65 – $52.65 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $25.50 | $34.00 | $54.40 – $201.15 | 2 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $25.39 – $25.39 | 1 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | $50.25 | $67.00 | $178.66 – $660.60 | 2 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | $72.75 | $97.00 | $67.62 – $250.11 | 2 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | $63.00 | $84.00 | $49.50 – $89.67 | 17 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $26.58 – $26.58 | 1 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | $569.67 | $759.56 | $2,242.35 – $2,242.35 | 1 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | $545.45 | $727.26 | $1,636.11 – $1,636.11 | 1 |
| Vaccine mmr live subcutaneous CPT 90707 | $311.03 | $414.70 | $994.86 – $994.86 | 1 |
| Vaccine mmrv live subcutaneous CPT 90710 | $957.30 | $1,276.39 | $1,194.21 – $1,194.21 | 1 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $401.34 | $535.11 | $133.47 – $324.87 | 17 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | $793.01 | $1,057.34 | $257.99 – $627.92 | 17 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | $239.25 | $319.00 | $269.31 – $635.61 | 17 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | not published | not published | $761.60 – $761.60 | 1 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | $1,529.59 | $2,039.45 | $459.18 – $459.18 | 1 |
| Vaccine rabies im CPT 90675 | $1,514.28 | $2,019.04 | $315.22 – $759.48 | 17 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | $372.30 | $496.40 | $998.01 – $998.01 | 1 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | $291.89 | $389.18 | $1,035.00 – $1,035.00 | 1 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $145.19 | $193.58 | $88.50 – $273.06 | 2 |
| Vaccine tdap >=7 years im CPT 90715 | $131.22 | $174.95 | $96.63 – $344.79 | 2 |
| Vaccine varicella live subcutaneous CPT 90716 | $642.96 | $857.28 | $1,881.36 – $1,881.36 | 1 |
| Vaccine yellow fever live subcutaneous CPT 90717 | $632.19 | $842.91 | $1,436.49 – $1,436.49 | 1 |
| Vad battery clip set hmii 14-v li-ion HCPCS Q0497 | $2,592.00 | $3,456.00 | $686.78 – $1,236.20 | 16 |
| Vad univ batt charger hm 1440 HCPCS Q0495 | $16,971.75 | $22,629.00 | $6,127.93 – $11,030.27 | 16 |
| Vaginal bx CPT 58999 | $192.00 | $256.00 | $196.07 – $352.92 | 16 |
| Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr HCPCS J3379 | $22.29 | $29.71 | not published | 0 |
| Valproic acid total therapeutic drug level CPT 80164 | $117.00 | $156.00 | $13.54 – $24.37 | 17 |
| Valrubicin injection HCPCS J9357 | $6,841.31 | $9,121.74 | $1,270.52 – $3,351.08 | 17 |
| Valvuloplasty pulmonary CPT 92990 | $12,754.50 | $17,006.00 | $11,195.55 – $20,152.00 | 16 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | $366.03 | $488.03 | not published | 0 |
| Vancomycin 750 mg intravenous solution HCPCS J3374 | $303.13 | $404.17 | not published | 0 |
| Vancomycin peak therapeutic drug level CPT 80202 | $110.25 | $147.00 | $13.54 – $24.37 | 17 |
| Varicella zoster antibody igg CPT 86787 | $99.00 | $132.00 | $12.88 – $23.18 | 17 |
| Varicella-zoster immue globin im CPT 90396 | $8,070.06 | $10,760.07 | $2,363.25 – $4,253.85 | 16 |
| Vasc emb/occ w/prs cath HCPCS C9797 | $17,508.00 | $23,344.00 | $17,778.02 – $32,000.44 | 16 |
| Vasopressin 20 unit/ml intravenous solution HCPCS J2598 | $103.53 | $138.04 | $16.38 – $16.38 | 1 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | $34,608.27 | $46,144.36 | $20.98 – $53.69 | 17 |
| Veeg cont 2-12 hrs CPT 95713 | $2,361.75 | $3,149.00 | $361.89 – $651.40 | 16 |
| Veeg ea 12-26hr cont mntr CPT 95716 | $4,640.25 | $6,187.00 | $832.81 – $1,499.05 | 16 |
| Veeg intrmnt 2-12 hrs CPT 95712 | $1,329.00 | $1,772.00 | $361.89 – $651.40 | 16 |
| Veeg unmon 12-26 hrs CPT 95714 | $1,527.75 | $2,037.00 | $361.89 – $651.40 | 16 |
| Veeg unmon 2-12 hrs CPT 95711 | $728.25 | $971.00 | $209.40 – $376.92 | 16 |
| Vein x-ray adrenal gland CPT 75840 | $3,696.00 | $4,928.00 | $3,062.12 – $5,511.82 | 17 |
| Vein x-ray eye socket CPT 75880 | $1,141.50 | $1,522.00 | $608.36 – $1,095.05 | 17 |
| Vein x-ray kidney CPT 75831 | $1,925.25 | $2,567.00 | $3,062.12 – $5,511.82 | 17 |
| Vein x-ray liver CPT 75891 | $2,163.75 | $2,885.00 | $3,062.12 – $5,511.82 | 17 |
| Vein x-ray liver w/hemodynam CPT 75885 | $2,943.75 | $3,925.00 | $3,062.12 – $5,511.82 | 17 |
| Vein x-ray liver w/hemodynam CPT 75889 | $3,125.25 | $4,167.00 | $3,062.12 – $5,511.82 | 17 |
| Vein x-ray liver without hemodyn CPT 75887 | $3,975.00 | $5,300.00 | $1,384.84 – $5,511.82 | 17 |
| Vein x-ray skull CPT 75870 | $3,549.00 | $4,732.00 | $863.01 – $5,511.82 | 17 |
| Vein x-ray skull epidural CPT 75872 | $797.25 | $1,063.00 | $608.36 – $1,095.05 | 17 |
| Velaglucerase alfa 400 unit intravenous solution HCPCS J3385 | $5,564.78 | $7,419.70 | $388.16 – $925.36 | 17 |
| Ven thrombosis images bilat CPT 78458 | $498.00 | $664.00 | $387.70 – $697.86 | 17 |
| Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) CPT 36410 | $99.75 | $133.00 | $17.97 – $32.34 | 16 |
| Venogram ext bil s&i CPT 75822 | $1,189.50 | $1,586.00 | $1,384.84 – $2,747.91 | 17 |
| Venogram extremity supervision & interpretation unilateral CPT 75820 | $1,140.00 | $1,520.00 | $863.01 – $2,747.91 | 17 |
| Venous m-thrombectomy add-on CPT 37188 | $4,024.50 | $5,366.00 | $3,062.12 – $5,511.82 | 16 |
| Venous mech thrombectomy CPT 37187 | $17,892.75 | $23,857.00 | $11,195.55 – $20,152.00 | 16 |
| Venous sampling s&i CPT 75893 | $8,633.25 | $11,511.00 | $5,396.44 – $9,713.59 | 17 |
| Ventilator each subsequent day CPT 94003 | $532.50 | $710.00 | $599.13 – $1,078.44 | 16 |
| Ventilator initial day CPT 94002 | $864.00 | $1,152.00 | $599.13 – $1,078.44 | 16 |
| Ventricular puncture prev burr hole without inj 61020 CPT 61020 | $693.75 | $925.00 | $857.76 – $1,543.97 | 16 |
| Version cephalic external CPT 59412 | $83.25 | $111.00 | $3,139.36 – $5,650.86 | 16 |
| Verteporfin injection HCPCS J3396 | not published | not published | $28.11 – $28.11 | 1 |
| Very long chain fatty acids CPT 82726 | $342.75 | $457.00 | $19.75 – $35.55 | 17 |
| Vest large holster HCPCS Q0498 | $1,012.50 | $1,350.00 | $753.56 – $1,356.41 | 16 |
| Vinblastine 1 mg/ml intravenous solution HCPCS J9360 | $177.38 | $236.50 | $12.88 – $37.98 | 2 |
| Vincristine 1 mg/ml intravenous solution HCPCS J9370 | $111.30 | $148.40 | $19.13 – $69.57 | 2 |
| Vinorelbine 10 mg/ml intravenous solution (wrapper) HCPCS J9390 | $177.04 | $236.05 | $4.75 – $66.78 | 2 |
| Vital capacity test CPT 94150 | $119.25 | $159.00 | $124.79 – $224.62 | 16 |
| Vitamin D Test CPT 82306 | $174.75 | $233.00 | $29.60 – $53.28 | 17 |
| Vitamin b-12 CPT 82607 | $54.75 | $73.00 | $15.08 – $27.14 | 17 |
| Voiding pressure study/intra-abd 51797 CPT 51797 | $605.25 | $807.00 | $143.99 – $259.17 | 16 |
| Vol reduction of blood/prod CPT 86960 | $301.50 | $402.00 | $165.22 – $297.40 | 16 |
| Volume measurement urine timed CPT 81050 | $23.25 | $31.00 | $3.64 – $6.55 | 17 |
| Vonvendi inj 1 iu vwf:rco HCPCS J7179 | not published | not published | $4.48 – $4.48 | 1 |
| Voriconazole in ns IV syringe 5 mg/ml (pediatric) - cnr HCPCS J3465 | $221.85 | $295.80 | $1.87 – $10.44 | 2 |
| Warde 1003990 aldosterone CPT 82088 | $193.50 | $258.00 | $40.75 – $73.35 | 17 |
| Warde 1005020 citrate 24 hour urine CPT 82507 | $162.75 | $217.00 | $27.80 – $50.04 | 17 |
| Warde 1005055 5-hiaa 24 hour urine CPT 83497 | $98.25 | $131.00 | $12.90 – $23.22 | 17 |
| Warde 1006955 catecholamines fractionated 24 hour urine CPT 82384 | $87.00 | $116.00 | $25.25 – $45.45 | 17 |
| Warde 1007138 vanillymandelic acid 24 hour urine CPT 84585 | $104.25 | $139.00 | $15.50 – $27.90 | 17 |
| Warde 1015200 kappa light chain free CPT 83521 | $115.50 | $154.00 | $17.27 – $31.09 | 16 |
| Warde 3004000 immunoglobulin subclass 1 CPT 82787 | $159.00 | $212.00 | $8.02 – $14.44 | 17 |
| Warde 3008005 oligoclonal bands CPT 83916 | $78.00 | $104.00 | $27.39 – $49.30 | 17 |
| Warde 3016000 west nile virus antibody CPT 86788 | $150.00 | $200.00 | $16.85 – $30.33 | 17 |
| Warde 3016000 west nile virus antibody igg CPT 86789 | $150.00 | $200.00 | $14.39 – $25.90 | 17 |
| Warde 3016300 saccharomyces cerevisiae iga antibody CPT 86671 | $44.25 | $59.00 | $12.25 – $22.05 | 17 |
| Warde 3400652 ova & parasites direct smear concentration and id CPT 87177 | $36.00 | $48.00 | $8.90 – $16.02 | 17 |
| Warde 3400652 smear complex special stain ova/parasites CPT 87209 | $36.00 | $48.00 | $17.98 – $32.36 | 17 |
| Warde 3400683 amplification rna markers infectious disease bacterial vaginosis CPT 81513 | $400.50 | $534.00 | $142.63 – $256.73 | 16 |
| Warde 3400852 arsenic CPT 82175 | $170.25 | $227.00 | $18.97 – $34.15 | 17 |
| Warde 3708165 mercury urine CPT 83825 | $99.00 | $132.00 | $16.26 – $29.27 | 17 |
| Warde acetylcholine receptor blocking antibody CPT 86042 | $357.75 | $477.00 | $18.40 – $33.12 | 16 |
| Warde actin (smooth muscle) antibody each CPT 86015 | $135.00 | $180.00 | $12.05 – $21.69 | 16 |
| Warde adenosine deaminase pleural fluid CPT 84311 | $249.75 | $333.00 | $8.10 – $14.58 | 17 |
| Warde adrenocorticotropic hormone (acth) CPT 82024 | $129.75 | $173.00 | $38.62 – $69.52 | 17 |
| Warde aldolase CPT 82085 | $55.50 | $74.00 | $9.71 – $17.48 | 17 |
| Warde amino acids 6 or more quantitative each specimen CPT 82139 | $399.00 | $532.00 | $16.87 – $30.37 | 17 |
| Warde amiodarone therapeutic drug level CPT 80151 | $72.75 | $97.00 | $18.64 – $33.55 | 16 |
| Warde analysis gene hfe common variants CPT 81256 | $153.75 | $205.00 | $65.36 – $117.65 | 17 |
| Warde analysis translocation bcr/abl1 major breakpoint qualitative/quantitative CPT 81206 | $239.25 | $319.00 | $163.96 – $295.13 | 17 |
| Warde anti-mullerian hormone CPT 82166 | $198.75 | $265.00 | $38.62 – $69.52 | 16 |
| Warde antiepileptics nos definitive assay 1-3 clobazam w metabolites CPT 80339 | $92.25 | $123.00 | not published | 0 |
| Warde apolipoprotein b CPT 82172 | $115.50 | $154.00 | $21.09 – $37.96 | 17 |
| Warde bile acids CPT 82239 | $111.00 | $148.00 | $17.12 – $30.82 | 17 |
| Warde cadmium blood CPT 82300 | $50.25 | $67.00 | $23.64 – $42.55 | 17 |
| Warde calcitonin CPT 82308 | $77.25 | $103.00 | $26.79 – $48.22 | 17 |
| Warde calculus (stone) infrared CPT 82365 | $64.50 | $86.00 | $12.90 – $23.22 | 17 |
| Warde clozapine therapeutic drug level CPT 80159 | $64.50 | $86.00 | $20.15 – $36.27 | 17 |
| Warde cobalt heavy metal quantitative each nes CPT 83018 | $248.25 | $331.00 | $21.96 – $39.53 | 17 |
| Warde collagen cross links c-telopeptide CPT 82523 | $148.50 | $198.00 | $18.68 – $33.62 | 17 |
| Warde complement total hemolytic CPT 86162 | $171.75 | $229.00 | $20.32 – $36.58 | 17 |
| Warde copper CPT 82525 | $174.75 | $233.00 | $12.41 – $22.34 | 17 |
| Warde cryoglobulin CPT 82595 | $120.00 | $160.00 | $6.47 – $11.65 | 17 |
| Warde erythropoietin CPT 82668 | $99.75 | $133.00 | $18.79 – $33.82 | 17 |
| Warde fluorescent antibody screen endomysial iga CPT 86231 | $230.25 | $307.00 | $12.09 – $21.76 | 16 |
| Warde folic acid rbc CPT 82747 | $52.50 | $70.00 | $17.65 – $31.77 | 17 |
| Warde g6pd (glucose 6 phosphate dehydrogenase) quantitative CPT 82955 | $252.75 | $337.00 | $9.70 – $17.46 | 17 |
| Warde gastrin CPT 82941 | $99.75 | $133.00 | $17.63 – $31.73 | 17 |
| Warde growth hormone (hgh) CPT 83003 | $114.00 | $152.00 | $16.67 – $30.01 | 17 |
| Warde haloperidol therapeutic drug level CPT 80173 | $72.75 | $97.00 | $15.78 – $28.40 | 17 |
| Warde helminth antibody strongyloides igg CPT 86682 | $120.75 | $161.00 | $13.01 – $23.42 | 17 |
| Warde hemoglobin fractionation/quantitation electrophoresis CPT 83020 | $506.25 | $675.00 | $12.87 – $23.17 | 17 |
| Warde hepatitis a antibody CPT 86708 | $90.00 | $120.00 | $12.39 – $22.30 | 17 |
| Warde hepatitis be antibody CPT 86707 | $67.50 | $90.00 | $11.57 – $20.83 | 17 |
| Warde hepatitis delta agent antibody CPT 86692 | $177.00 | $236.00 | $17.16 – $30.89 | 17 |
| Warde immunofixation electrophoresis urine CPT 86335 | $345.00 | $460.00 | $29.35 – $52.83 | 17 |
| Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn CPT 87350 | $60.75 | $81.00 | $11.53 – $20.75 | 17 |
| Warde infectious agent nucleic acid genotype hepatitis c CPT 87902 | $900.75 | $1,201.00 | $257.45 – $463.41 | 17 |
| Warde islet cell antibody zinc transporter 8 CPT 86341 | $615.75 | $821.00 | $23.57 – $42.43 | 17 |
| Warde lipoprotein (a) CPT 83695 | $132.75 | $177.00 | $14.32 – $25.78 | 17 |
| Warde mitochondrial antibody each CPT 86381 | $123.00 | $164.00 | $25.45 – $45.81 | 16 |
| Warde neutralization rabies CPT 86382 | $105.00 | $140.00 | $16.91 – $30.44 | 17 |
| Warde oxcarbazepine therapeutic drug level CPT 80183 | $151.50 | $202.00 | $13.25 – $23.85 | 17 |
| Warde pancreatic elastase fecal quantitative CPT 82653 | $104.25 | $139.00 | $22.97 – $41.35 | 16 |
| Warde protein c antigen CPT 85302 | $122.25 | $163.00 | $12.01 – $21.62 | 17 |
| Warde sex hormone binding globulin CPT 84270 | $111.00 | $148.00 | $21.73 – $39.11 | 17 |
| Warde somatomedin CPT 84305 | $100.50 | $134.00 | $21.26 – $38.27 | 17 |
| Warde sugars single qualitative each specimen stool CPT 84376 | $39.75 | $53.00 | $5.50 – $9.90 | 17 |
| Warde t3 (triiodothyronine) reverse CPT 84482 | $46.50 | $62.00 | $15.76 – $28.37 | 17 |
| Warde thyroid stimulating immunoglobulins CPT 84445 | $279.00 | $372.00 | $50.86 – $91.55 | 17 |
| Warde topiramate therapeutic drug level CPT 80201 | $267.00 | $356.00 | $11.92 – $21.46 | 17 |
| Warde virus isolation tissue culture innoculation presumptive id herpes simplex CPT 87252 | $113.25 | $151.00 | $26.07 – $46.93 | 17 |
| Warde viscosity CPT 85810 | $112.50 | $150.00 | $11.67 – $21.01 | 17 |
| Warde vitamin a CPT 84590 | $69.00 | $92.00 | $11.61 – $20.90 | 17 |
| Warde vitamin b-1 (thiamine) CPT 84425 | $75.75 | $101.00 | $21.23 – $38.21 | 17 |
| Warde vitamin b6 (pyridoxine) CPT 84207 | $81.75 | $109.00 | $28.10 – $50.58 | 17 |
| Warde vitamin c (ascorbic acid) CPT 82180 | $26.25 | $35.00 | $9.89 – $17.80 | 17 |
| Warde vitamin d (1 25 dihydroxy) CPT 82652 | $153.00 | $204.00 | $38.50 – $69.30 | 17 |
| Warde vitamin e (alpha-tocopherol) CPT 84446 | $34.50 | $46.00 | $14.18 – $25.52 | 17 |
| Warde zinc CPT 84630 | $90.00 | $120.00 | $11.39 – $20.50 | 17 |
| Wbc automated CPT 85048 | $38.25 | $51.00 | $2.54 – $4.57 | 17 |
| Western blot test CPT 84181 | $542.25 | $723.00 | $17.03 – $30.65 | 17 |
| Wilate injection HCPCS J7183 | not published | not published | $3.09 – $3.09 | 1 |
| Wound therapy negative pressure per session <= 50 sq cm CPT 97607 | $471.75 | $629.00 | $394.24 – $709.63 | 16 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | $166.50 | $222.00 | $194.58 – $350.24 | 16 |
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | $509.25 | $679.00 | $394.24 – $709.63 | 16 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | $807.00 | $1,076.00 | $394.24 – $709.63 | 16 |
| Wrist X-ray CPT 73110 | $236.25 | $315.00 | $84.40 – $151.91 | 17 |
| X-ray abdomen 1 view CPT 74018 | $183.00 | $244.00 | $84.40 – $151.91 | 17 |
| X-ray abdomen 2 views CPT 74019 | $277.50 | $370.00 | $101.39 – $182.50 | 17 |
| X-ray abdomen >=3 views CPT 74021 | $305.25 | $407.00 | $101.39 – $182.50 | 17 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $440.25 | $587.00 | $101.39 – $182.50 | 17 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $283.50 | $378.00 | $84.40 – $151.91 | 17 |
| X-ray ankle 2 views (both sides) CPT 73600 | $213.75 | $285.00 | $84.40 – $151.91 | 17 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $576.75 | $769.00 | $338.34 – $642.95 | 17 |
| X-ray bone age studies CPT 77072 | $196.50 | $262.00 | $101.39 – $182.50 | 17 |
| X-ray bone length studies CPT 77073 | $283.50 | $378.00 | $101.39 – $182.50 | 17 |
| X-ray bone survey complete CPT 77075 | $267.75 | $357.00 | $101.39 – $182.50 | 17 |
| X-ray bone survey infant CPT 77076 | $240.75 | $321.00 | $101.39 – $182.50 | 17 |
| X-ray cervical spine 2-3 views CPT 72040 | $332.25 | $443.00 | $84.40 – $151.91 | 17 |
| X-ray cervical spine 4-5 views CPT 72050 | $468.00 | $624.00 | $101.39 – $182.50 | 17 |
| X-ray cervical spine >= 6 views CPT 72052 | $488.25 | $651.00 | $101.39 – $182.50 | 17 |
| X-ray clavicle complete (both sides) CPT 73000 | $267.75 | $357.00 | $84.40 – $151.91 | 17 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $690.75 | $921.00 | $170.10 – $356.07 | 17 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $1,115.25 | $1,487.00 | $170.10 – $356.07 | 17 |
| X-ray elbow 2 views (both sides) CPT 73070 | $259.50 | $346.00 | $84.40 – $151.91 | 17 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $283.50 | $378.00 | $84.40 – $151.91 | 17 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $561.00 | $748.00 | $170.10 – $356.07 | 17 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $330.00 | $440.00 | $101.39 – $182.50 | 17 |
| X-ray exam entire spi 6/> vw CPT 72084 | $333.75 | $445.00 | $101.39 – $182.50 | 17 |
| X-ray exam of arm infant CPT 73092 | $237.75 | $317.00 | $101.39 – $182.50 | 17 |
| X-ray exam of eye sockets CPT 70200 | $387.75 | $517.00 | $101.39 – $182.50 | 17 |
| X-ray exam of femur 1 CPT 73551 | $176.25 | $235.00 | $84.40 – $151.91 | 17 |
| X-ray exam of jaw joint CPT 70328 | $257.25 | $343.00 | $84.40 – $151.91 | 17 |
| X-ray exam of mastoids CPT 70120 | $258.00 | $344.00 | $101.39 – $182.50 | 17 |
| X-ray exam of sinuses CPT 70210 | $267.00 | $356.00 | $84.40 – $151.91 | 17 |
| X-ray exam thorac spine4/>vw CPT 72074 | $309.00 | $412.00 | $101.39 – $182.50 | 17 |
| X-ray facial bones complete > 3 views CPT 70150 | $457.50 | $610.00 | $101.39 – $182.50 | 17 |
| X-ray fallopian tube CPT 74742 | $682.50 | $910.00 | not published | 0 |
| X-ray femur >=2 views (both sides) CPT 73552 | $244.50 | $326.00 | $84.40 – $151.91 | 17 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $216.75 | $289.00 | $84.40 – $151.91 | 17 |
| X-ray foot 2 views (both sides) CPT 73620 | $222.75 | $297.00 | $84.40 – $151.91 | 17 |
| X-ray forearm 2 views (both sides) CPT 73090 | $259.50 | $346.00 | $84.40 – $151.91 | 17 |
| X-ray hand 2 views (both sides) CPT 73120 | $213.75 | $285.00 | $101.39 – $182.50 | 17 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $216.00 | $288.00 | $84.40 – $151.91 | 17 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $374.25 | $499.00 | $101.39 – $182.50 | 17 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $445.50 | $594.00 | $101.39 – $182.50 | 17 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $493.50 | $658.00 | $101.39 – $182.50 | 17 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $507.75 | $677.00 | $101.39 – $182.50 | 17 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $270.75 | $361.00 | $84.40 – $151.91 | 17 |
| X-ray humerus >= 2 views left CPT 73060 | $236.25 | $315.00 | $84.40 – $151.91 | 17 |
| X-ray joint survey 1 view CPT 77077 | $256.50 | $342.00 | $101.39 – $182.50 | 17 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $184.50 | $246.00 | $84.40 – $151.91 | 17 |
| X-ray knee 3 views (both sides) CPT 73562 | $210.75 | $281.00 | $84.40 – $151.91 | 17 |
| X-ray knee ap standing bilateral CPT 73565 | $192.00 | $256.00 | $84.40 – $151.91 | 17 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $385.50 | $514.00 | $101.39 – $182.50 | 17 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $183.75 | $245.00 | $84.40 – $151.91 | 17 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $418.50 | $558.00 | $101.39 – $182.50 | 17 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $420.75 | $561.00 | $101.39 – $182.50 | 17 |
| X-ray mandible complete > 4 views CPT 70110 | $288.75 | $385.00 | $101.39 – $182.50 | 17 |
| X-ray mandible ltd <4 views CPT 70100 | $191.25 | $255.00 | $84.40 – $151.91 | 17 |
| X-ray nasal bones complete > 3 views CPT 70160 | $283.50 | $378.00 | $84.40 – $151.91 | 17 |
| X-ray neck soft tissue CPT 70360 | $228.00 | $304.00 | $84.40 – $151.91 | 17 |
| X-ray nose to rectum for foreign body child CPT 76010 | $246.00 | $328.00 | $84.40 – $151.91 | 17 |
| X-ray of mammary ducts CPT 77054 | $438.00 | $584.00 | $231.40 – $416.51 | 16 |
| X-ray optic foramina CPT 70190 | $338.25 | $451.00 | $84.40 – $151.91 | 17 |
| X-ray pelvis 1-2 views CPT 72170 | $184.50 | $246.00 | $101.39 – $182.50 | 17 |
| X-ray pelvis complete > 3 views CPT 72190 | $351.75 | $469.00 | $101.39 – $182.50 | 17 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $774.75 | $1,033.00 | $338.34 – $642.95 | 17 |
| X-ray ribs 2 views left CPT 71100 | $287.25 | $383.00 | $84.40 – $151.91 | 17 |
| X-ray ribs 3 views bilateral CPT 71110 | $295.50 | $394.00 | $101.39 – $182.50 | 17 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $291.00 | $388.00 | $101.39 – $182.50 | 17 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $307.50 | $410.00 | $101.39 – $182.50 | 17 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $269.25 | $359.00 | $101.39 – $182.50 | 17 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $262.50 | $350.00 | $84.40 – $151.91 | 17 |
| X-ray scapula complete (both sides) CPT 73010 | $236.25 | $315.00 | $101.39 – $182.50 | 17 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $216.75 | $289.00 | $84.40 – $151.91 | 17 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $779.25 | $1,039.00 | $327.29 – $953.84 | 17 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $377.25 | $503.00 | $84.40 – $151.91 | 17 |
| X-ray skull < 4 views CPT 70250 | $262.50 | $350.00 | $101.39 – $182.50 | 17 |
| X-ray skull > 4 views complete CPT 70260 | $410.25 | $547.00 | $101.39 – $182.50 | 17 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $711.00 | $948.00 | $101.39 – $182.50 | 17 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $551.25 | $735.00 | $161.25 – $306.19 | 17 |
| X-ray small intestine follow-through study CPT 74248 | $422.25 | $563.00 | $74.71 – $134.48 | 16 |
| X-ray spine single view CPT 72020 | $254.25 | $339.00 | $84.40 – $151.91 | 17 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $288.75 | $385.00 | $84.40 – $151.91 | 17 |
| X-ray sternum > 2 views CPT 71120 | $283.50 | $378.00 | $84.40 – $151.91 | 17 |
| X-ray surgical specimen CPT 76098 | $195.00 | $260.00 | $529.91 – $953.84 | 17 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $241.50 | $322.00 | $161.25 – $306.19 | 17 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $349.50 | $466.00 | $84.40 – $151.91 | 17 |
| X-ray thoracic spine 2 views CPT 72070 | $306.75 | $409.00 | $101.39 – $182.50 | 17 |
| X-ray thoracic spine 3 views CPT 72072 | $307.50 | $410.00 | $101.39 – $182.50 | 17 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $298.50 | $398.00 | $84.40 – $151.91 | 17 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $291.00 | $388.00 | $84.40 – $151.91 | 17 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $326.25 | $435.00 | $101.39 – $182.50 | 17 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $228.00 | $304.00 | $84.40 – $151.91 | 17 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $186.75 | $249.00 | $84.40 – $151.91 | 17 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $589.50 | $786.00 | $170.10 – $356.07 | 17 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $488.25 | $651.00 | $170.10 – $356.07 | 17 |
| X-ray wrist 2 views (both sides) CPT 73100 | $213.75 | $285.00 | $84.40 – $151.91 | 17 |
| Xm archive tissue molec anal CPT 88363 | $40.50 | $54.00 | $28.05 – $50.49 | 16 |
| Xyntha inj HCPCS J7185 | not published | not published | $3.75 – $3.75 | 1 |
| Ziconotide injection HCPCS J2278 | $4,530.00 | $6,039.99 | $10.46 – $24.63 | 17 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $100.06 | $133.41 | $1.51 – $3.68 | 17 |
| Zika virus dna/rna amp probe CPT 87662 | $197.25 | $263.00 | $51.31 – $92.36 | 17 |
| Zika virus igm antibody CPT 86794 | $114.75 | $153.00 | $16.85 – $30.33 | 17 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $32.46 | $43.27 | $7.62 – $87.84 | 2 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $19.40 – $19.40 | 1 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $146.06 | $194.74 | $12.66 – $64.89 | 2 |
| _afb id by dna probe rflx ast CPT 87149 | $108.00 | $144.00 | $20.05 – $36.09 | 17 |
| _propoxygc/msur CPT 80367 | $173.25 | $231.00 | not published | 0 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.