Hospital

DEKALB REGIONAL MEDICAL CENTER

Fort Payne, AL · CCN 010012 · Rates published

3,965 distinct procedures filed

7 distinct payers

27,762 rate rows

2025-03-12 last MRF observed · ⚠ 15 mo old

Data quality

20,959 of 27,762 rate rows are consumer-grade (75.5%)

6,803 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	6,147
template filing: same amount across many unrelated codes — excluded	495
exceeds 10× this hospital's gross charge — excluded from medians	161

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 15 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://dekalbregional.org/wp-content/uploads/934333907_Dekalb-Regional-Medical-Center_standardcharges.csv
Found on page	https://dekalbregional.org/patients-visitors/financial-information/price-transparency/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	3c26a2a82ffeba52… · 4,017,921 bytes · first seen 2026-05-08

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
1414954 CDM	Stnt Coat/cov W/del4	4	$23,999.76	$99,999.00	$77,749.23	nat. median $77,749 1.0× median
1414020 CDM	Anchor/scrw Level 20	4	$23,999.76	$99,999.00	$77,749.23	nat. median $77,749 1.0× median
1414707 CDM	Joint Device Implt 8	4	$23,999.76	$99,999.00	$77,749.23	nat. median $77,749 1.0× median
1414709 CDM	Joint Device Implt10	4	$23,999.76	$99,999.00	$77,749.23	nat. median $77,749 1.0× median
1414708 CDM	Joint Device Implt 9	4	$23,999.76	$99,999.00	$77,749.23	nat. median $249 outlier · 312.5×
1417056 CDM	Tissue Non-human 8	5	$35.10	$99,999.00	$69,999.30	nat. median $69,999 1.0× median
1413004 CDM	Aicd Ohr Thn Sgl/du1	5	$344.69	$99,999.00	$69,999.30	nat. median $69,999 1.0× median
1414017 CDM	Anchor/scrw Level 17	5	$117.57	$99,999.00	$69,999.30	nat. median $69,999 1.0× median
1413177 CDM	Lead Aicd End Dul L1	5	$344.69	$99,999.00	$69,999.30	nat. median $69,999 1.0× median
1061550 CDM	S-per Ins Lh Vad Art	5	$288.33	$99,999.00	$69,999.30	nat. median $40,000 1.8× median
1414705 CDM	Joint Device Implt 6	5	$64.29	$99,999.00	$69,999.30	nat. median $69,999 1.0× median
1414018 CDM	Anchor/scrw Level 18	5	$210.62	$99,999.00	$69,999.30	nat. median $69,999 1.0× median
1413006 CDM	Aicd Single Chamber2	5	$339.19	$99,999.00	$69,999.30	nat. median $69,999 1.0× median
1410077 CDM	Lead Aicd End Dul L7	5	$344.69	$99,999.00	$69,999.30	nat. median $69,999 1.0× median
1413214 CDM	Pmkr Dul Non Rat Lv1	5	$421.24	$99,999.00	$69,999.30	nat. median $103 outlier · 682.9×
1413003 CDM	Aicd Dual Chamber L1	5	$240.65	$99,999.00	$69,999.30	nat. median $69,999 1.0× median
1413213 CDM	Pmkr Dual Rate-rs L1	5	$344.69	$99,999.00	$69,999.30	nat. median $226 outlier · 310.0×
1413005 CDM	Aicd Single Chamber1	5	$255.87	$99,999.00	$69,999.30	nat. median $69,999 1.0× median
1414706 CDM	Joint Device Implt 7	5	$27.49	$99,999.00	$69,999.30	nat. median $69,999 1.0× median
1414019 CDM	Anchor/scrw Level 19	5	$255.87	$99,999.00	$69,999.30	nat. median $69,999 1.0× median
1414481 CDM	Conn Tissue Human 7	5	$117.57	$99,039.98	$69,327.99	nat. median $69,328 1.0× median
1413217 CDM	Pmkr Sngl Non Rte-re	5	$224.16	$99,039.98	$69,327.99	nat. median $69,328 1.0× median
1413216 CDM	Pmkr Singl Rate-rsl1	5	$195.51	$99,039.98	$69,327.99	nat. median $1,673 outlier · 41.4×
1414878 CDM	Prsths Penile Infl 4	5	$364.99	$97,574.16	$68,301.91	nat. median $68,302 1.0× median
1413178 CDM	Lead Aicd Endo Sn L1	5	$195.51	$95,230.79	$66,661.55	nat. median $66,662 1.0× median
1061280 CDM	P-ins Lv Lead Exist	5	$23.72	$99,999.00	$65,742.33	nat. median $10,110 outlier · 6.5×
1417055 CDM	Tissue Non-human 7	5	$98.97	$89,135.28	$62,394.70	nat. median $62,395 1.0× median
1414704 CDM	Joint Device Implt 5	5	$117.57	$89,135.28	$62,394.70	nat. median $62,395 1.0× median
1414016 CDM	Anchor/scrw Level 16	5	$247.52	$89,135.28	$62,394.70	nat. median $62,395 1.0× median
1414480 CDM	Conn Tissue Human 6	5	$195.81	$85,173.97	$59,621.78	nat. median $59,622 1.0× median
1061599 CDM	Ir-tc Plc Stnt Vn In	5	$18.14	$76,891.61	$53,824.13	nat. median $29,406 1.8× median
1414953 CDM	Stnt Coat/cov W/del3	5	$93.04	$71,425.17	$49,997.62	nat. median $49,998 1.0× median
1417054 CDM	Tissue Non-human 6	5	$131.54	$71,310.73	$49,917.51	nat. median $49,918 1.0× median
1414015 CDM	Anchor/scrw Level 15	5	$10.06	$69,328.68	$48,530.08	nat. median $48,530 1.0× median
1061601 CDM	Cc-ins Defib W Elect	5	$309.90	$99,999.00	$46,999.53	nat. median $33,585 1.4× median
1061546 CDM	S-rem-rep Cvd Dual	5	$591.26	$99,999.00	$46,999.53	nat. median $64,999 0.7× median
1061547 CDM	S-rem-rep Cvd Mult	5	$1,846.10	$99,999.00	$46,999.53	nat. median $69,999 0.7× median
1061545 CDM	S-rem-rep Cvd Single	5	$210.30	$99,999.00	$46,999.53	nat. median $50,353 0.9× median
1061467 CDM	S-ins-rep Pace-defib	5	$73.03	$99,999.00	$46,999.53	nat. median $69,198 0.7× median
1061272 CDM	P-upgrd Sng To Dual	5	$14.89	$66,942.69	$46,859.88	nat. median $12,104 outlier · 3.9×
1061267 CDM	P-ins Dual Pac Sys	5	$9.77	$66,942.69	$46,859.88	nat. median $15,758 outlier · 3.0×
1413124 CDM	Event Recrdr Cardiac	5	$94.74	$66,661.28	$46,662.90	nat. median $46,663 1.0× median
1061524 CDM	S-tib Per Rev Stn At	5	$1,210.05	$66,567.08	$46,596.96	nat. median $10,110 outlier · 4.6×
1414703 CDM	Joint Device Implt 4	5	$61.75	$64,379.14	$45,065.40	nat. median $45,065 1.0× median
1061542 CDM	S-rem-rep Pm Gen Mlt	5	$968.13	$63,717.85	$44,602.50	nat. median $11,835 outlier · 3.8×
1061541 CDM	S-rem-rep Pm Gen Dul	5	$726.68	$63,717.85	$44,602.50	nat. median $11,880 outlier · 3.8×
1414479 CDM	Conn Tissue Human 5	5	$29.60	$63,386.69	$44,370.68	nat. median $44,371 1.0× median
1061520 CDM	S-fem Pop Stnt Athr	5	$482.91	$62,268.39	$43,587.87	nat. median $14,638 outlier · 3.0×
1413180 CDM	Lead Lt Vent Cor Lv1	5	$186.94	$82,467.48	$41,928.62	nat. median $41,929 1.0× median
1061540 CDM	S-rem-rep Pm Gen Sng	5	$3,339.75	$59,695.26	$41,786.68	nat. median $11,710 outlier · 3.6×

Other procedures at this hospital

Browse this hospital's 3,965 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

1061239	CDM	Ic-cor Thrombectomy	5	5	$12,483.82	$12,483.82	$373.04	$24,505.10	$8,738.67	2025-03-12
1061246	CDM	Ic-ptca, Single	5	5	$14,613.11	$14,613.11	$1,089.26	$14,613.11	$10,229.18	2025-03-12
1061247	CDM	Ic-ptca, Addl	5	5	$14,613.11	$14,613.11	$519.25	$14,613.11	$10,229.18	2025-03-12
1061265	CDM	P-ins Gen-lead Atr	5	5	$58,194.41	$58,194.41	$1,218.63	$58,194.41	$40,736.09	2025-03-12
1061266	CDM	P-ins Gen-lead Ven	5	5	$58,194.41	$58,194.41	$3,339.75	$58,194.41	$40,736.09	2025-03-12
1061267	CDM	P-ins Dual Pac Sys	5	5	$66,942.69	$66,942.69	$9.77	$66,942.69	$46,859.88	2025-03-12
1061268	CDM	P-ins Tmp Pac Ld Sgl	5	5	$34,627.07	$34,627.07	$8,310.50	$34,627.07	$24,238.95	2025-03-12
1061270	CDM	P-ins-rpl Gen Sngl	5	5	$48,285.58	$48,285.58	$11,588.54	$48,285.58	$33,799.91	2025-03-12
1061271	CDM	P-ins-rpl Gen Dual	5	5	$52,309.81	$52,309.81	$12,554.35	$52,309.81	$36,616.87	2025-03-12
1061272	CDM	P-upgrd Sng To Dual	5	5	$66,942.69	$66,942.69	$14.89	$66,942.69	$46,859.88	2025-03-12
1061273	CDM	P-repos Ra-rv Lead	5	5	$11,711.43	$11,711.43	$2,810.74	$11,711.43	$9,268.78	2025-03-12
1061274	CDM	P-ins Lead Sngl	5	5	$33,387.87	$33,387.87	$8,013.09	$33,387.87	$23,371.51	2025-03-12
1061275	CDM	P-ins Lead Dual	5	5	$33,387.87	$33,387.87	$8,013.09	$33,387.87	$23,371.51	2025-03-12
1061278	CDM	P-revse Pocket Pace	5	5	$7,462.49	$7,462.49	$1,791.00	$7,462.49	$5,372.13	2025-03-12
1061280	CDM	P-ins Lv Lead Exist	7	5	$99,999.00	$99,999.00	$23.72	$99,999.00	$65,742.33	2025-03-12
1061283	CDM	P-remov Pace Gen	5	5	$11,711.43	$11,711.43	$2,810.74	$11,711.43	$10,013.27	2025-03-12
1061284	CDM	P-remov Lead, Sng	5	5	$11,396.82	$11,396.82	$2,735.24	$11,396.82	$7,977.77	2025-03-12
1061285	CDM	P-remov Lead, Dual	5	5	$33,905.40	$33,905.40	$8,137.30	$33,905.40	$23,733.78	2025-03-12
1061286	CDM	P-remov Icd Gen	5	5	$11,408.07	$11,408.07	$2,737.94	$11,408.07	$9,268.78	2025-03-12
1061287	CDM	P-remov Icd Lead	5	5	$11,369.53	$11,369.53	$2,728.69	$11,369.53	$6,829.90	2025-03-12
1061288	CDM	P-implnt Loop Rec	5	5	$33,596.56	$33,596.56	$9,203.00	$33,596.56	$23,517.59	2025-03-12
1061360	CDM	Ir-angio Visceral Se	5	5	$6,249.06	$6,249.06	$448.51	$10,394.32	$6,249.06	2025-03-12
1061448	CDM	S-prim Art Mech Thro	5	5	$19,141.85	$19,141.85	$4,594.04	$19,141.85	$13,399.30	2025-03-12
1061452	CDM	S-venous M Thromb Ad	5	5	$19,141.85	$19,141.85	$4,594.04	$19,141.85	$13,399.30	2025-03-12
1061467	CDM	S-ins-rep Pace-defib	6	5	$99,999.00	$99,999.00	$73.03	$99,999.00	$46,999.53	2025-03-12
1061502	CDM	Cc-lhc Vent Punc	7	7	$13,397.71	$13,397.71	$3,215.45	$13,397.71	$8,168.50	2025-03-12
1061503	CDM	Cc-r-l Cath Lv Punc	5	5	$13,397.71	$13,397.71	$567.04	$13,397.71	$8,684.26	2025-03-12
1061504	CDM	Cc-angio Coron Only	7	7	$13,644.78	$13,644.78	$3,274.75	$13,644.78	$8,168.50	2025-03-12
1061505	CDM	Cc-s-i Vnt Atr Angio	7	7	$15,527.02	$15,527.02	$3,726.48	$15,527.02	$8,168.50	2025-03-12
1061506	CDM	Cc-r Hrt Coronry Art	5	5	$25,725.54	$25,725.54	$6,174.13	$25,725.54	$13,275.60	2025-03-12
1061507	CDM	Cc-r Hrt Art-grf Ang	5	5	$27,607.81	$27,607.81	$6,625.87	$27,607.81	$19,325.47	2025-03-12
1061508	CDM	Cc-l Hrt Artery-vent	5	5	$14,978.48	$14,978.48	$3,594.84	$23,604.68	$10,484.94	2025-03-12
1061509	CDM	Cc-l Hrt Art-grf Ang	7	7	$16,837.70	$16,837.70	$4,041.05	$16,837.70	$8,168.50	2025-03-12
1061510	CDM	Cc-r-l Hrt Art-vent	7	7	$14,963.83	$14,963.83	$852.00	$14,963.83	$7,634.26	2025-03-12
1061511	CDM	Cc-r-l Hrt Art-angio	7	7	$16,837.70	$16,837.70	$2,141.09	$16,837.70	$6,905.52	2025-03-12
1061513	CDM	S-iliac Revasc	5	5	$43,108.88	$43,108.88	$10,346.13	$43,108.88	$30,299.70	2025-03-12
1061514	CDM	S-iliac Revas W Stnt	5	5	$47,897.13	$47,897.13	$11,495.31	$47,897.13	$33,527.99	2025-03-12
1061517	CDM	S-fem Pop Revas Tla	5	5	$43,108.88	$43,108.88	$10,346.13	$43,108.88	$30,299.70	2025-03-12
1061518	CDM	S-fem Pop Revas Athr	5	5	$47,897.13	$47,897.13	$11,495.31	$47,897.13	$33,527.99	2025-03-12
1061519	CDM	S-fem Pop Revas Stnt	5	5	$57,478.50	$57,478.50	$357.49	$57,478.50	$40,234.95	2025-03-12
1061520	CDM	S-fem Pop Stnt Athr	5	5	$62,268.39	$62,268.39	$482.91	$62,268.39	$43,587.87	2025-03-12
1061521	CDM	S-tib Per Revas W Tl	5	5	$43,108.88	$43,108.88	$10,346.13	$43,108.88	$30,299.70	2025-03-12
1061522	CDM	S-tib Per Revas Athr	5	5	$47,897.13	$47,897.13	$11,495.31	$47,897.13	$33,527.99	2025-03-12
1061523	CDM	S-tib Per Revas Stnt	5	5	$57,478.50	$57,478.50	$825.16	$57,478.50	$40,234.95	2025-03-12
1061524	CDM	S-tib Per Rev Stn At	5	5	$66,567.08	$66,567.08	$1,210.05	$66,567.08	$46,596.96	2025-03-12
1061526	CDM	S-ins Cath Renart 1u	5	5	$15,711.56	$15,711.56	$3,770.77	$15,711.56	$10,998.09	2025-03-12
1061527	CDM	S-ins Cath Renart 1b	5	5	$15,711.56	$15,711.56	$3,770.77	$15,711.56	$10,998.09	2025-03-12
1061529	CDM	Ic-trl Peri Ath Renl	5	5	$30,590.02	$30,590.02	$7,341.60	$30,590.02	$19,272.50	2025-03-12
1061532	CDM	Ic-trl Peri Ath Brch	5	5	$30,590.02	$30,590.02	$7,341.60	$30,590.02	$21,413.01	2025-03-12
1061533	CDM	Ic-trl Peri Ath Ilia	5	5	$43,108.88	$43,108.88	$10,346.13	$43,108.88	$30,299.70	2025-03-12
1061537	CDM	S-redo Endo Vena Cav	5	5	$13,849.27	$13,849.27	$271.70	$17,161.76	$9,694.49	2025-03-12
1061538	CDM	S-rem Endo Vena Cava	5	5	$13,849.27	$13,849.27	$263.78	$13,849.27	$9,694.49	2025-03-12
1061540	CDM	S-rem-rep Pm Gen Sng	5	5	$59,695.26	$59,695.26	$3,339.75	$59,695.26	$41,786.68	2025-03-12
1061541	CDM	S-rem-rep Pm Gen Dul	5	5	$63,717.85	$63,717.85	$726.68	$63,717.85	$44,602.50	2025-03-12
1061542	CDM	S-rem-rep Pm Gen Mlt	5	5	$63,717.85	$63,717.85	$968.13	$63,717.85	$44,602.50	2025-03-12
1061545	CDM	S-rem-rep Cvd Single	6	5	$99,999.00	$99,999.00	$210.30	$99,999.00	$46,999.53	2025-03-12
1061546	CDM	S-rem-rep Cvd Dual	6	5	$99,999.00	$99,999.00	$591.26	$99,999.00	$46,999.53	2025-03-12
1061547	CDM	S-rem-rep Cvd Mult	6	5	$99,999.00	$99,999.00	$1,846.10	$99,999.00	$46,999.53	2025-03-12
1061550	CDM	S-per Ins Lh Vad Art	5	5	$99,999.00	$99,999.00	$288.33	$99,999.00	$69,999.30	2025-03-12
1061554	CDM	Ic-prq Crd Stn W-ang	5	5	$28,660.94	$28,660.94	$2,036.41	$28,660.94	$12,494.21	2025-03-12
1061555	CDM	Ic-prq Stnt W-ang Ea	5	5	$28,660.94	$28,660.94	$81.84	$28,660.94	$20,062.66	2025-03-12
1061558	CDM	Ic-prq Rv Byp Grf In	5	5	$28,660.94	$28,660.94	$60.90	$28,660.94	$20,062.66	2025-03-12
1061559	CDM	Ic-prq Rv Byp Grf Ad	5	5	$28,660.94	$28,660.94	$621.07	$28,660.94	$20,062.66	2025-03-12
1061560	CDM	Ic-prq Card Rev 1 Vs	5	5	$28,660.94	$28,660.94	$309.95	$28,660.94	$20,062.66	2025-03-12
1061561	CDM	Ic-prq Revsc Chr 1vs	5	5	$28,660.94	$28,660.94	$260.42	$28,660.94	$20,062.66	2025-03-12
1061562	CDM	Ic-prq Revsc Chr Add	5	5	$28,660.94	$28,660.94	$373.04	$28,660.94	$20,062.66	2025-03-12
1061563	CDM	Ic-retrieval Cathete	5	5	$14,271.49	$14,271.49	$271.70	$14,271.49	$9,990.04	2025-03-12
1061564	CDM	Ic-prq De Cor Stnt	5	5	$26,958.74	$26,958.74	$474.99	$26,958.74	$6,470.10	2025-03-12
1061565	CDM	Ic-prq De Cor Stnt B	5	5	$26,958.74	$26,958.74	$523.38	$26,958.74	$18,871.12	2025-03-12
1061568	CDM	Ic-prq De Cr Rev Cab	5	5	$26,958.74	$26,958.74	$2,185.63	$26,958.74	$18,871.12	2025-03-12
1061569	CDM	Ic-pr De Cr Rv Cab B	5	5	$26,958.74	$26,958.74	$2,323.33	$26,958.74	$18,871.12	2025-03-12
1061570	CDM	Ic-prq De Cr Rev Ami	5	5	$26,958.74	$26,958.74	$3,171.90	$26,958.74	$18,871.12	2025-03-12
1061571	CDM	Ic-prq De Cor Rev Ch	5	5	$26,958.74	$26,958.74	$2,185.63	$26,958.74	$18,871.12	2025-03-12
1061572	CDM	Ic-pr De Cr Rv Ch Ea	5	5	$26,958.74	$26,958.74	$2,323.33	$26,958.74	$18,871.12	2025-03-12
1061573	CDM	S-trnscth Throm Art	5	5	$7,934.43	$7,934.43	$1,904.26	$7,934.43	$6,380.43	2025-03-12
1061574	CDM	S-trnscth Throm Ven	5	5	$7,934.43	$7,934.43	$1,904.26	$7,934.43	$6,783.94	2025-03-12
1061580	CDM	Ir-ang Ext Crt Ns	4	4	$22,863.57	$22,863.57	$3,737.79	$22,863.57	$10,745.88	2025-03-12
1061581	CDM	Ir-ang Crt Ext Cc Un	4	4	$22,863.57	$22,863.57	$5,487.26	$22,863.57	$17,776.42	2025-03-12
1061582	CDM	Ir-ang Crt Ext Cc Bi	4	4	$22,863.57	$22,863.57	$5,487.26	$22,863.57	$17,776.42	2025-03-12
1061583	CDM	Ir-ang Cartd Ips Uni	4	4	$35,598.16	$35,598.16	$8,543.56	$35,598.16	$22,233.53	2025-03-12
1061584	CDM	Ir-ang Cartd Ips Bi	4	4	$53,396.44	$53,396.44	$12,815.15	$53,396.44	$33,906.97	2025-03-12
1061585	CDM	Ir-ang Int Car Ip Un	4	4	$33,904.59	$33,904.59	$8,137.10	$45,653.96	$28,818.90	2025-03-12
1061586	CDM	Ir-ang Int Car Ip Bi	4	4	$61,664.54	$61,664.54	$14,799.49	$61,664.54	$36,076.80	2025-03-12
1061587	CDM	Ir-ang Subcl Ips Uni	5	5	$15,241.86	$15,241.86	$157.33	$52,723.18	$10,669.30	2025-03-12
1061588	CDM	Ir-ang Subcl Ips Bi	5	5	$22,863.57	$22,863.57	$271.94	$22,863.57	$13,031.79	2025-03-12
1061589	CDM	Ir-ang Vert Ips Uni	5	5	$15,671.77	$15,671.77	$271.94	$19,548.35	$10,970.24	2025-03-12
1061590	CDM	Ir-ang Vert Ips Bi	5	5	$23,503.84	$23,503.84	$458.46	$23,503.84	$13,399.36	2025-03-12
1061598	CDM	Ir-tc Plc Stn Art In	5	5	$45,035.09	$45,035.09	$10,808.42	$45,035.09	$31,524.56	2025-03-12
1061599	CDM	Ir-tc Plc Stnt Vn In	5	5	$76,891.61	$76,891.61	$18.14	$76,891.61	$53,824.13	2025-03-12
1061601	CDM	Cc-ins Defib W Elect	6	5	$99,999.00	$99,999.00	$309.90	$99,999.00	$46,999.53	2025-03-12
1061702	CDM	Ir-cat Dial Tran Bal	5	5	$20,787.71	$20,787.71	$4,989.05	$20,787.71	$14,551.40	2025-03-12
1061705	CDM	Ir-thrmbc Tran Bal	5	5	$20,787.71	$20,787.71	$4,989.05	$20,787.71	$14,551.40	2025-03-12
1061738	CDM	Cc-revasc Ivl	5	5	$13,929.72	$13,929.72	$7,333.00	$13,929.72	$10,179.76	2025-03-12
1061739	CDM	Cc-rvsc Ivl Stent	5	5	$22,540.93	$22,540.93	$9,203.00	$22,540.93	$15,778.65	2025-03-12
1061740	CDM	Cc-rvsc Ivl Ather	5	5	$22,540.93	$22,540.93	$9,203.00	$22,540.93	$15,778.65	2025-03-12
1061741	CDM	Cc-rv Ivl Stnt Athr	5	5	$22,540.93	$22,540.93	$9,203.00	$22,540.93	$15,778.65	2025-03-12
1061760	CDM	Cc-rv Ivl Angio	5	5	$13,929.74	$13,929.74	$9,203.00	$13,929.74	$10,273.34	2025-03-12
1061761	CDM	Cc-rv Ivl Stnt Angio	5	5	$22,540.93	$22,540.93	$9,203.00	$22,540.93	$15,778.65	2025-03-12
1061762	CDM	Cc-rv Ivl Athr Angio	5	5	$22,540.93	$22,540.93	$9,203.00	$22,540.93	$15,778.65	2025-03-12
1061763	CDM	Cc-rv Ivl Snt Ath An	5	5	$22,540.93	$22,540.93	$9,203.00	$22,540.93	$15,778.65	2025-03-12
1061801	CDM	Ir-tlum Bal Ang 1sta	5	5	$21,602.59	$21,602.59	$5,184.62	$21,602.59	$15,121.81	2025-03-12
1061802	CDM	Ir-tlum Bal Ang 1stv	5	5	$14,371.23	$14,371.23	$3,449.10	$14,371.23	$10,438.02	2025-03-12
1110834	CDM	Cosmetic Level 4	5	5	$6,283.19	$6,283.19	$1,507.97	$6,829.90	$5,307.21	2025-03-12
1212114	CDM	Crotalid Poly IM 1gm	5	5	$30,972.20	$30,972.20	$25.10	$30,972.20	$7,433.33	2025-03-12
1331031	CDM	S-h Plat Hla-m L-r E	5	5	$7,881.82	$7,881.82	$184.00	$7,881.82	$5,209.28	2025-03-12
1410013	CDM	Oth Ster Supp Lvl 13	5	5	$11,752.75	$11,752.75	$2,820.66	$11,752.75	$6,027.97	2025-03-12
1410014	CDM	Oth Ster Supp Lvl 14	5	5	$16,451.07	$16,451.07	$487.64	$16,451.07	$10,048.60	2025-03-12
1410015	CDM	Oth Ster Supp Lvl 15	5	5	$37,601.83	$37,601.83	$597.09	$37,601.83	$14,065.66	2025-03-12
1410016	CDM	Oth Ster Supp Lvl 16	5	5	$56,403.43	$56,403.43	$1,798.71	$56,403.43	$32,149.56	2025-03-12
1410043	CDM	Lead Lt Vent Cor Lv3	5	5	$14,195.59	$14,195.59	$79.56	$14,195.59	$9,936.91	2025-03-12
1410053	CDM	Lead Pmkr Non-trn L3	5	5	$13,787.80	$13,787.80	$61.32	$13,787.80	$8,145.10	2025-03-12
1410064	CDM	Lead Aicd Endo Sn L4	5	5	$29,544.90	$29,544.90	$86.28	$29,544.90	$17,985.57	2025-03-12
1410065	CDM	Lead Aicd Endo Sn L5	5	5	$43,332.71	$43,332.71	$172.97	$43,332.71	$25,260.89	2025-03-12
1410074	CDM	Lead Aicd End Dul L4	5	5	$29,544.90	$29,544.90	$150.14	$29,544.90	$20,681.43	2025-03-12
1410075	CDM	Lead Aicd End Dul L5	5	5	$49,039.32	$49,039.32	$172.97	$49,039.32	$34,327.52	2025-03-12
1410077	CDM	Lead Aicd End Dul L7	5	5	$99,999.00	$99,999.00	$344.69	$99,999.00	$69,999.30	2025-03-12
1410093	CDM	Pmkr Othr Th Sngl L3	5	5	$21,035.76	$21,035.76	$86.28	$21,035.76	$14,725.03	2025-03-12
1413003	CDM	Aicd Dual Chamber L1	5	5	$99,999.00	$99,999.00	$240.65	$99,999.00	$69,999.30	2025-03-12
1413004	CDM	Aicd Ohr Thn Sgl/du1	5	5	$99,999.00	$99,999.00	$344.69	$99,999.00	$69,999.30	2025-03-12
1413005	CDM	Aicd Single Chamber1	5	5	$99,999.00	$99,999.00	$255.87	$99,999.00	$69,999.30	2025-03-12
1413006	CDM	Aicd Single Chamber2	5	5	$99,999.00	$99,999.00	$339.19	$99,999.00	$69,999.30	2025-03-12
1413039	CDM	Cath Bal Dil Nonvas2	5	5	$7,965.92	$7,965.92	$1,911.82	$7,965.92	$5,576.14	2025-03-12
1413124	CDM	Event Recrdr Cardiac	5	5	$66,661.28	$66,661.28	$94.74	$66,661.28	$46,662.90	2025-03-12
1413177	CDM	Lead Aicd End Dul L1	5	5	$99,999.00	$99,999.00	$344.69	$99,999.00	$69,999.30	2025-03-12
1413178	CDM	Lead Aicd Endo Sn L1	5	5	$95,230.79	$95,230.79	$195.51	$95,230.79	$66,661.55	2025-03-12
1413180	CDM	Lead Lt Vent Cor Lv1	5	5	$82,467.48	$82,467.48	$186.94	$82,467.48	$41,928.62	2025-03-12
1413183	CDM	Lead Pmkr Non-trn L1	5	5	$9,526.43	$9,526.43	$46.81	$9,526.43	$5,075.57	2025-03-12
1413185	CDM	Lead Pmkr Trnsv Vdd1	5	5	$19,048.69	$19,048.69	$83.75	$19,048.69	$12,137.23	2025-03-12
1413213	CDM	Pmkr Dual Rate-rs L1	5	5	$99,999.00	$99,999.00	$344.69	$99,999.00	$69,999.30	2025-03-12
1413214	CDM	Pmkr Dul Non Rat Lv1	5	5	$99,999.00	$99,999.00	$421.24	$99,999.00	$69,999.30	2025-03-12
1413216	CDM	Pmkr Singl Rate-rsl1	5	5	$99,039.98	$99,039.98	$195.51	$99,039.98	$69,327.99	2025-03-12
1413217	CDM	Pmkr Sngl Non Rte-re	5	5	$99,039.98	$99,039.98	$224.16	$99,039.98	$69,327.99	2025-03-12
1414008	CDM	Anchor/scrw Level 8	5	5	$7,428.51	$7,428.51	$1,782.84	$7,428.51	$5,199.96	2025-03-12
1414010	CDM	Anchor/scrw Level 10	5	5	$8,252.06	$8,252.06	$1,980.49	$8,252.06	$5,776.44	2025-03-12
1414011	CDM	Anchor/scrw Level 11	5	5	$18,325.65	$18,325.65	$4,398.16	$18,325.65	$12,827.96	2025-03-12
1414012	CDM	Anchor/scrw Level 12	5	5	$24,760.35	$24,760.35	$5,942.48	$24,760.35	$17,332.25	2025-03-12
1414013	CDM	Anchor/scrw Level 13	5	5	$34,662.24	$34,662.24	$8,318.94	$34,662.24	$27,007.99	2025-03-12
1414014	CDM	Anchor/scrw Level 14	5	5	$38,872.02	$38,872.02	$9,329.28	$38,872.02	$30,299.70	2025-03-12
1414015	CDM	Anchor/scrw Level 15	5	5	$69,328.68	$69,328.68	$10.06	$69,328.68	$48,530.08	2025-03-12
1414016	CDM	Anchor/scrw Level 16	5	5	$89,135.28	$89,135.28	$247.52	$89,135.28	$62,394.70	2025-03-12
1414017	CDM	Anchor/scrw Level 17	5	5	$99,999.00	$99,999.00	$117.57	$99,999.00	$69,999.30	2025-03-12
1414018	CDM	Anchor/scrw Level 18	5	5	$99,999.00	$99,999.00	$210.62	$99,999.00	$69,999.30	2025-03-12
1414019	CDM	Anchor/scrw Level 19	5	5	$99,999.00	$99,999.00	$255.87	$99,999.00	$69,999.30	2025-03-12
1414020	CDM	Anchor/scrw Level 20	4	4	$99,999.00	$99,999.00	$23,999.76	$99,999.00	$77,749.23	2025-03-12
1414151	CDM	Cath Abltn Nocrd Ed2	5	5	$10,562.12	$10,562.12	$2,534.91	$10,562.12	$7,393.48	2025-03-12
1414176	CDM	Cath Hemodial Lt 2	5	5	$8,462.81	$8,462.81	$2,031.07	$8,462.81	$5,923.97	2025-03-12
1414200	CDM	Cath Intravas Ultra1	5	5	$26,452.08	$26,452.08	$6,348.50	$26,452.08	$19,206.17	2025-03-12
1414251	CDM	Cath Thrmb/embol 3	5	5	$8,533.99	$8,533.99	$2,048.16	$8,533.99	$5,973.79	2025-03-12
1414252	CDM	Cath Thrmb/embol 4	5	5	$24,955.77	$24,955.77	$5,989.38	$24,955.77	$17,469.04	2025-03-12
1414285	CDM	Cath Trns Arthr Rot1	5	5	$12,478.56	$12,478.56	$2,994.85	$12,478.56	$8,734.99	2025-03-12
1414286	CDM	Cath Trns Arthr Rot2	5	5	$37,437.11	$37,437.11	$8,984.91	$37,437.11	$30,299.70	2025-03-12
1414300	CDM	Cath Trnslum Ang La1	5	5	$19,048.69	$19,048.69	$4,571.69	$19,048.69	$14,404.20	2025-03-12
1414301	CDM	Cath Trnslum Ang La2	5	5	$57,141.83	$57,141.83	$23.26	$57,141.83	$39,999.28	2025-03-12
1414328	CDM	Cath-angio Level 4	5	5	$9,906.09	$9,906.09	$2,377.46	$9,906.09	$6,934.26	2025-03-12
1414329	CDM	Cath-angio Level 5	5	5	$7,968.69	$7,968.69	$1,912.49	$7,968.69	$5,578.08	2025-03-12
1414354	CDM	Cath-drainag Level 5	5	5	$9,410.58	$9,410.58	$2,258.54	$9,410.58	$6,587.41	2025-03-12
1414355	CDM	Cath-drainag Level 6	5	5	$12,379.48	$12,379.48	$2,971.08	$12,379.48	$8,665.64	2025-03-12
1414358	CDM	Cath-drainag Level 9	5	5	$13,808.44	$13,808.44	$3,314.03	$13,808.44	$9,665.91	2025-03-12
1414377	CDM	Catheter Guiding 3	5	5	$11,428.93	$11,428.93	$2,742.94	$11,428.93	$8,000.25	2025-03-12
1414408	CDM	Cath-infus Perif 9	5	5	$8,418.15	$8,418.15	$2,020.36	$8,418.15	$5,892.71	2025-03-12
1414409	CDM	Cath-infus Perif 10	5	5	$7,392.24	$7,392.24	$1,774.14	$7,392.24	$5,174.57	2025-03-12
1414410	CDM	Cath-infus Perif 11	5	5	$10,471.39	$10,471.39	$2,513.13	$10,471.39	$7,329.97	2025-03-12
1414411	CDM	Cath-infus Perif 12	5	5	$18,477.79	$18,477.79	$4,434.67	$18,477.79	$12,934.45	2025-03-12
1414451	CDM	Closure Devic Vasc 2	5	5	$9,240.31	$9,240.31	$2,217.67	$9,240.31	$6,468.22	2025-03-12
1414475	CDM	Conn Tissue Human 1	5	5	$7,928.21	$7,928.21	$1,902.77	$7,928.21	$5,549.75	2025-03-12
1414476	CDM	Conn Tissue Human 2	5	5	$8,533.99	$8,533.99	$2,048.16	$8,533.99	$5,973.79	2025-03-12
1414477	CDM	Conn Tissue Human 3	5	5	$31,696.14	$31,696.14	$7,607.07	$31,696.14	$26,067.91	2025-03-12
1414478	CDM	Conn Tissue Human 4	5	5	$47,538.63	$47,538.63	$11,409.27	$47,538.63	$33,277.04	2025-03-12
1414479	CDM	Conn Tissue Human 5	5	5	$63,386.69	$63,386.69	$29.60	$63,386.69	$44,370.68	2025-03-12
1414480	CDM	Conn Tissue Human 6	5	5	$85,173.97	$85,173.97	$195.81	$85,173.97	$59,621.78	2025-03-12
1414481	CDM	Conn Tissue Human 7	5	5	$99,039.98	$99,039.98	$117.57	$99,039.98	$69,327.99	2025-03-12
1414507	CDM	Drill Bit/blade Lvl8	5	5	$7,392.24	$7,392.24	$1,774.14	$24,987.65	$5,174.57	2025-03-12
1414600	CDM	Graft Vascular 1	5	5	$9,924.25	$9,924.25	$2,381.82	$9,924.25	$6,946.98	2025-03-12
1414601	CDM	Graft Vascular 2	5	5	$14,857.05	$14,857.05	$3,565.69	$14,857.05	$10,399.94	2025-03-12
1414602	CDM	Graft Vascular 3	5	5	$24,760.35	$24,760.35	$5,942.48	$24,760.35	$17,332.25	2025-03-12
1414603	CDM	Graft Vascular 4	5	5	$39,618.79	$39,618.79	$9,508.51	$39,618.79	$30,299.70	2025-03-12
1414630	CDM	Guidewire Level 6	5	5	$8,917.84	$8,917.84	$2,140.28	$8,917.84	$6,242.49	2025-03-12
1414631	CDM	Guidewire Level 7	5	5	$10,895.72	$10,895.72	$2,614.97	$10,895.72	$7,627.00	2025-03-12
1414632	CDM	Guidewire Level 8	5	5	$12,876.39	$12,876.39	$3,090.33	$12,876.39	$9,013.47	2025-03-12
1414633	CDM	Guidewire Level 9	5	5	$14,857.05	$14,857.05	$3,565.69	$14,857.05	$10,399.94	2025-03-12
1414634	CDM	Guidewire Level 10	5	5	$16,839.09	$16,839.09	$4,041.38	$16,839.09	$11,787.36	2025-03-12
1414635	CDM	Guidewire Level 11	5	5	$18,818.36	$18,818.36	$4,516.41	$18,818.36	$13,204.77	2025-03-12
1414636	CDM	Guidewire Level 12	5	5	$9,807.87	$9,807.87	$2,353.89	$9,807.87	$6,865.51	2025-03-12
1414638	CDM	Guidewire Level 14	5	5	$27,718.07	$27,718.07	$6,652.34	$27,718.07	$19,506.88	2025-03-12
1414639	CDM	Guidewire Level 15	5	5	$30,488.78	$30,488.78	$7,317.31	$30,488.78	$25,403.15	2025-03-12
1414701	CDM	Joint Device Implt 2	5	5	$17,068.01	$17,068.01	$4,096.32	$17,068.01	$11,947.61	2025-03-12
1414702	CDM	Joint Device Implt 3	5	5	$44,569.74	$44,569.74	$10,696.74	$44,569.74	$31,198.82	2025-03-12
1414703	CDM	Joint Device Implt 4	5	5	$64,379.14	$64,379.14	$61.75	$64,379.14	$45,065.40	2025-03-12
1414704	CDM	Joint Device Implt 5	5	5	$89,135.28	$89,135.28	$117.57	$89,135.28	$62,394.70	2025-03-12
1414705	CDM	Joint Device Implt 6	5	5	$99,999.00	$99,999.00	$64.29	$99,999.00	$69,999.30	2025-03-12
1414706	CDM	Joint Device Implt 7	5	5	$99,999.00	$99,999.00	$27.49	$99,999.00	$69,999.30	2025-03-12
1414707	CDM	Joint Device Implt 8	4	4	$99,999.00	$99,999.00	$23,999.76	$99,999.00	$77,749.23	2025-03-12
1414708	CDM	Joint Device Implt 9	4	4	$99,999.00	$99,999.00	$23,999.76	$99,999.00	$77,749.23	2025-03-12
1414709	CDM	Joint Device Implt10	4	4	$99,999.00	$99,999.00	$23,999.76	$99,999.00	$77,749.23	2025-03-12
1414752	CDM	Mesh Implantable 3	5	5	$9,906.09	$9,906.09	$2,377.46	$9,906.09	$6,934.26	2025-03-12
1414753	CDM	Mesh Implantable 4	5	5	$13,866.00	$13,866.00	$3,327.84	$13,866.00	$9,706.20	2025-03-12
1414754	CDM	Mesh Implantable 5	5	5	$17,827.35	$17,827.35	$4,278.56	$17,827.35	$12,479.15	2025-03-12
1414755	CDM	Mesh Implantable 6	5	5	$22,779.68	$22,779.68	$5,467.12	$22,779.68	$16,489.26	2025-03-12
1414756	CDM	Mesh Implantable 7	5	5	$28,724.46	$28,724.46	$6,893.87	$28,724.46	$21,607.15	2025-03-12
1414757	CDM	Mesh Implantable 8	5	5	$35,657.47	$35,657.47	$8,557.79	$35,657.47	$29,564.97	2025-03-12
1414758	CDM	Mesh Implantable 9	5	5	$44,569.74	$44,569.74	$10,696.74	$44,569.74	$31,198.82	2025-03-12
1414759	CDM	Mesh Implantable 10	5	5	$54,467.45	$54,467.45	$13,072.19	$54,467.45	$38,127.22	2025-03-12
1414776	CDM	Morcellator 2	5	5	$11,191.65	$11,191.65	$2,686.00	$11,191.65	$7,834.16	2025-03-12
1414827	CDM	Port 3	5	5	$9,906.09	$9,906.09	$2,377.46	$9,906.09	$6,934.26	2025-03-12
1414851	CDM	Probe Cryoablation 2	5	5	$21,153.57	$21,153.57	$5,076.86	$21,153.57	$14,807.50	2025-03-12
1414852	CDM	Probe Cryoablation 3	5	5	$36,954.18	$36,954.18	$8,869.00	$36,954.18	$30,009.11	2025-03-12
1414878	CDM	Prsths Penile Infl 4	5	5	$97,574.16	$97,574.16	$364.99	$97,574.16	$68,301.91	2025-03-12
1414901	CDM	Rep Dev Urinry W/sl2	5	5	$19,048.69	$19,048.69	$4,571.69	$19,048.69	$13,504.63	2025-03-12
1414926	CDM	Sheath Non-lasr 3	5	5	$8,533.99	$8,533.99	$2,048.16	$8,533.99	$5,973.79	2025-03-12
1414930	CDM	Sheath Non-lasr 7	5	5	$54,419.99	$54,419.99	$13,060.80	$54,419.99	$38,093.99	2025-03-12
1414951	CDM	Stnt Coat/cov W/del1	5	5	$14,284.74	$14,284.74	$3,428.34	$14,284.74	$9,999.32	2025-03-12
1414952	CDM	Stnt Coat/cov W/del2	5	5	$33,329.24	$33,329.24	$7,999.02	$33,329.24	$27,007.99	2025-03-12
1414953	CDM	Stnt Coat/cov W/del3	5	5	$71,425.17	$71,425.17	$93.04	$71,425.17	$49,997.62	2025-03-12
1414954	CDM	Stnt Coat/cov W/del4	4	4	$99,999.00	$99,999.00	$23,999.76	$99,999.00	$77,749.23	2025-03-12
1414960	CDM	Stnt Coat/cov Without 1	5	5	$19,048.69	$19,048.69	$4,571.69	$19,048.69	$13,504.63	2025-03-12
1414961	CDM	Stnt Coat/cov Without 2	5	5	$57,141.83	$57,141.83	$13,714.04	$57,141.83	$39,999.28	2025-03-12
1414971	CDM	Stnt No Cocv W/del 2	5	5	$17,068.01	$17,068.01	$4,096.32	$17,068.01	$11,947.61	2025-03-12
1414972	CDM	Stnt No Cocv W/del 3	5	5	$47,614.01	$47,614.01	$11,427.36	$47,614.01	$33,329.81	2025-03-12
1414979	CDM	Stnt No-coa/cov W/o2	5	5	$29,711.29	$29,711.29	$7,130.71	$29,711.29	$21,641.83	2025-03-12
1417020	CDM	Surgical Access Port	5	5	$7,852.83	$7,852.83	$1,884.68	$7,852.83	$5,496.98	2025-03-12
1417050	CDM	Tissue Non-human 2	5	5	$9,906.09	$9,906.09	$2,377.46	$9,906.09	$6,934.26	2025-03-12
1417051	CDM	Tissue Non-human 3	5	5	$27,733.42	$27,733.42	$6,656.02	$27,733.42	$20,198.37	2025-03-12
1417052	CDM	Tissue Non-human 4	5	5	$43,580.11	$43,580.11	$10,459.23	$43,580.11	$30,506.08	2025-03-12
1417053	CDM	Tissue Non-human 5	5	5	$57,441.94	$57,441.94	$37.64	$57,441.94	$40,209.36	2025-03-12
1417054	CDM	Tissue Non-human 6	5	5	$71,310.73	$71,310.73	$131.54	$71,310.73	$49,917.51	2025-03-12
1417055	CDM	Tissue Non-human 7	5	5	$89,135.28	$89,135.28	$98.97	$89,135.28	$62,394.70	2025-03-12
1417056	CDM	Tissue Non-human 8	5	5	$99,999.00	$99,999.00	$35.10	$99,999.00	$69,999.30	2025-03-12
1417076	CDM	Vena Cava Filter 2	5	5	$17,068.01	$17,068.01	$4,096.32	$17,068.01	$11,947.61	2025-03-12
1417089	CDM	Stapler/reload 5	5	5	$9,526.43	$9,526.43	$2,286.34	$30,299.70	$6,668.50	2025-03-12
1417090	CDM	Stapler/reload 6	5	5	$11,885.35	$11,885.35	$2,852.48	$30,299.70	$8,319.75	2025-03-12
1417124	CDM	Adhesion Barrier2	5	5	$24,073.60	$24,073.60	$5,777.66	$24,073.60	$16,851.52	2025-03-12
1418041	CDM	Cath Translum Coro 1	5	5	$28,660.78	$28,660.78	$6,878.59	$28,660.78	$21,006.59	2025-03-12
1630008	CDM	CT-abd Pelvis W	5	5	$8,509.08	$8,509.08	$282.58	$8,509.08	$5,356.60	2025-03-12
1630009	CDM	CT-abd Pelvis Wwo	5	5	$10,122.28	$10,122.28	$292.25	$10,122.28	$7,085.60	2025-03-12
1631507	CDM	CTA-upper Ext Bi	5	5	$9,900.77	$9,900.77	$25.78	$9,900.77	$6,930.54	2025-03-12
1641001	CDM	Mr-upper Ext W	5	5	$7,667.77	$7,667.77	$610.96	$11,373.77	$5,367.44	2025-03-12
1641002	CDM	Mr-upper Ext Wwo	5	5	$10,468.32	$10,468.32	$610.96	$16,294.02	$7,327.82	2025-03-12
1641004	CDM	Mr-upper Joint W	5	5	$7,667.77	$7,667.77	$1,089.31	$7,667.77	$5,367.44	2025-03-12
1641005	CDM	Mr-upper Joint Wwo	5	5	$10,468.32	$10,468.32	$610.96	$10,468.32	$6,555.94	2025-03-12
1641008	CDM	MRA-neck W	5	5	$7,667.77	$7,667.77	$610.96	$7,667.77	$5,367.44	2025-03-12
1641009	CDM	MRA-neck Wwo	5	5	$10,468.32	$10,468.32	$5.59	$10,468.32	$6,555.94	2025-03-12
1641011	CDM	Mr-chest W	5	5	$7,667.77	$7,667.77	$1,089.31	$7,667.77	$5,367.44	2025-03-12
1641012	CDM	Mr-chest Wwo	5	5	$10,889.04	$10,889.04	$610.96	$10,889.04	$6,555.94	2025-03-12
1641014	CDM	Mr-lower Extr Wo	4	4	$7,498.86	$7,498.86	$372.86	$8,950.41	$6,374.03	2025-03-12
1641015	CDM	Mr-lower Extr W	5	5	$7,976.38	$7,976.38	$4.61	$11,373.77	$5,583.47	2025-03-12
1641016	CDM	Mr-lower Extr Wwo	5	5	$10,468.32	$10,468.32	$6.98	$10,468.32	$6,819.80	2025-03-12
1641018	CDM	Mr-lw Joint W	5	5	$7,667.77	$7,667.77	$22.91	$10,936.32	$5,367.44	2025-03-12
1641019	CDM	Mr-lw Joint Wwo	5	5	$11,533.89	$11,533.89	$80.36	$11,533.89	$6,555.94	2025-03-12
1641020	CDM	Mr-abdomen Wo	5	5	$7,951.80	$7,951.80	$85.87	$9,861.48	$5,566.26	2025-03-12
1641021	CDM	Mr-abdomen W	5	5	$8,455.41	$8,455.41	$184.40	$8,455.41	$5,918.79	2025-03-12
1641022	CDM	Mr-abdomen Wwo	5	5	$11,533.89	$11,533.89	$187.52	$11,533.89	$7,229.38	2025-03-12
1641023	CDM	Mr-card Morp Wo	5	5	$7,951.80	$7,951.80	$260.10	$9,861.48	$5,566.26	2025-03-12
1641031	CDM	MRA-abdomen W	5	5	$8,455.41	$8,455.41	$143.79	$8,950.41	$5,918.79	2025-03-12
1641032	CDM	MRA-abdomen Wo	5	5	$7,951.80	$7,951.80	$372.86	$7,951.80	$5,566.26	2025-03-12
1641033	CDM	MRA-abdomen Wwo	5	5	$11,533.89	$11,533.89	$38.91	$11,533.89	$6,798.79	2025-03-12
1641043	CDM	MRA-lw Extr W	5	5	$8,455.41	$8,455.41	$16.75	$8,950.41	$5,918.79	2025-03-12
1641045	CDM	MRA-lw Extr Wwo	5	5	$10,468.32	$10,468.32	$27.92	$10,468.32	$6,167.36	2025-03-12
1641047	CDM	Mr-orbt Face Neck W	5	5	$7,667.77	$7,667.77	$610.96	$7,667.77	$5,367.44	2025-03-12
1641048	CDM	Mr-orbt Fac Nck Wwo	5	5	$11,533.89	$11,533.89	$610.96	$11,533.89	$6,555.94	2025-03-12
1641050	CDM	MRA-head W	5	5	$7,667.77	$7,667.77	$356.36	$7,667.77	$5,367.44	2025-03-12
1641051	CDM	MRA-head Wwo	5	5	$10,468.32	$10,468.32	$532.21	$10,468.32	$6,555.94	2025-03-12
1641053	CDM	Mr-brain W	5	5	$7,667.77	$7,667.77	$610.96	$7,667.77	$5,367.44	2025-03-12
1641054	CDM	Mr-brain Wwo	5	5	$10,468.32	$10,468.32	$610.96	$10,468.32	$7,052.81	2025-03-12
1641056	CDM	Mr-cerv Spine W	5	5	$7,667.77	$7,667.77	$610.96	$7,667.77	$5,367.44	2025-03-12
1641057	CDM	Mr-thor Spine Wo	5	5	$7,213.29	$7,213.29	$372.86	$7,213.29	$5,049.30	2025-03-12
1641058	CDM	Mr-thor Spine W	5	5	$7,667.77	$7,667.77	$610.96	$7,667.77	$5,367.44	2025-03-12
1641060	CDM	Mr-lumb Spine W	5	5	$7,667.77	$7,667.77	$610.96	$7,667.77	$5,367.44	2025-03-12
1641061	CDM	Mr-cerv Spine Wwo	5	5	$10,468.32	$10,468.32	$610.96	$10,468.32	$6,555.94	2025-03-12
1641062	CDM	Mr-thor Spine Wwo	5	5	$10,468.32	$10,468.32	$610.96	$10,468.32	$7,327.82	2025-03-12
1641063	CDM	Mr-lumb Spine Wwo	5	5	$10,468.32	$10,468.32	$610.96	$10,468.32	$7,327.82	2025-03-12
1641065	CDM	Mr-pelvis Wo	5	5	$7,213.29	$7,213.29	$372.86	$9,310.13	$5,049.30	2025-03-12
1641066	CDM	Mr-pelvis W	5	5	$7,667.77	$7,667.77	$610.96	$7,667.77	$5,367.44	2025-03-12
1641067	CDM	Mr-pelvis Wwo	5	5	$10,468.32	$10,468.32	$610.96	$10,468.32	$6,555.94	2025-03-12
1641074	CDM	Mr-upper Ext Bi Wo	5	5	$13,302.66	$13,302.66	$372.86	$13,302.66	$6,167.36	2025-03-12
1641075	CDM	Mr-upper Ext Bi W	5	5	$19,057.33	$19,057.33	$610.96	$19,057.33	$6,555.94	2025-03-12
1641076	CDM	Mr-upper Ext Bi Wwo	5	5	$23,276.61	$23,276.61	$610.96	$23,276.61	$8,950.41	2025-03-12
1641078	CDM	Mr-lower Extr Bi Wo	4	4	$13,302.66	$13,302.66	$372.86	$13,302.66	$7,861.69	2025-03-12
1641083	CDM	Mr-lw Joint Wo Bi	5	5	$12,791.02	$12,791.02	$10.07	$12,791.02	$6,167.36	2025-03-12
1691002	CDM	Ir-endovn Chem Abl 1	5	5	$34,448.91	$34,448.91	$8,267.74	$34,448.91	$24,114.24	2025-03-12
1913238	CDM	Insertion Flow Cath	5	5	$6,220.09	$6,220.09	$859.00	$11,455.04	$6,220.09	2025-03-12
2070226	CDM	Proc Wnd Care Complx	5	5	$11,022.29	$11,022.29	$309.90	$11,022.29	$7,715.60	2025-03-12
2811668	CDM	S-asp-inj Ganglion	5	5	$34,944.81	$34,944.81	$8,386.75	$34,944.81	$24,461.37	2025-03-12
2850047	CDM	S-iliac Revas Add-on	5	5	$21,556.04	$21,556.04	$5,173.45	$21,556.04	$15,089.23	2025-03-12
2850048	CDM	S-iliac Revas Stnt A	5	5	$47,897.13	$47,897.13	$11,495.31	$47,897.13	$33,527.99	2025-03-12
2850049	CDM	S-tib-per Revas Add	5	5	$21,556.04	$21,556.04	$5,173.45	$21,556.04	$15,089.23	2025-03-12
2850050	CDM	S-tib-per Rev Ath Ad	5	5	$38,439.39	$38,439.39	$9,225.45	$38,439.39	$26,907.57	2025-03-12
2850051	CDM	S-revs Opn-prq Tib-p	5	5	$35,922.48	$35,922.48	$8,621.40	$35,922.48	$25,145.74	2025-03-12
2850052	CDM	S-tib-per Revasc Stn	5	5	$40,715.53	$40,715.53	$9,771.73	$40,715.53	$28,500.87	2025-03-12
2850070	CDM	S-pri Art M Thro Add	5	5	$19,141.85	$19,141.85	$4,594.04	$19,141.85	$13,399.30	2025-03-12
2850071	CDM	S-sec Art M Thro Add	5	5	$19,141.85	$19,141.85	$4,594.04	$19,141.85	$13,399.30	2025-03-12
2850078	CDM	Ir-tc Plc Stn Art Ea	5	5	$45,035.09	$45,035.09	$10,808.42	$45,035.09	$31,524.56	2025-03-12
2850079	CDM	Ir-tc Plc Stnt Vn Ea	5	5	$37,185.75	$37,185.75	$8,924.58	$37,185.75	$26,030.03	2025-03-12
2850083	CDM	Ir-aabf Serial	5	5	$12,157.10	$12,157.10	$271.70	$12,157.10	$8,509.97	2025-03-12
2850085	CDM	Ir-angio Extrem Uni	5	5	$12,157.10	$12,157.10	$263.78	$12,157.10	$8,509.97	2025-03-12
2850086	CDM	Ir-angio Extrem Bi	5	5	$12,157.10	$12,157.10	$271.70	$12,157.10	$8,509.97	2025-03-12
2850090	CDM	Ir-ang Pulmonary Uni	5	5	$12,157.10	$12,157.10	$461.97	$12,157.10	$5,342.95	2025-03-12
2850091	CDM	Ir-ang Pulmonary Bi	5	5	$12,157.10	$12,157.10	$448.51	$12,157.10	$8,509.97	2025-03-12
2852101	CDM	S-balo Angiop Dial	5	5	$41,575.39	$41,575.39	$9,978.09	$41,575.39	$30,299.70	2025-03-12
2852201	CDM	S-trlum Bal Ang Adla	5	5	$21,602.59	$21,602.59	$5,184.62	$21,602.59	$15,121.81	2025-03-12
2852202	CDM	S-trlum Bal Ang Adlv	5	5	$13,287.01	$13,287.01	$3,188.88	$13,287.01	$10,013.27	2025-03-12

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