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

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Hospital

North Alabama Specialty Hospital

Huntsville, AL · CCN 012014 · Rates published

12,704 distinct procedures filed
1 distinct payers
139,744 rate rows
2025-07-02 last MRF observed · ⚠ 15 mo old
Data quality

12,704 of 139,744 rate rows are consumer-grade (9.1%)

127,040 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 63,520
per-diem day rate — not a per-procedure price 63,520

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 15 months old.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://www.nashospital.com/siteuploads/staging-north-alabama-hospital/1188_pdf_1_1188_pdf_1_47-2148706_north-alabama-specialty-hospital_standardcharges.csv
Found on page https://www.nashospital.com/
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-09-21
Content fingerprint 78eaa62e90430585… · 16,490,518 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
33249
CDM 		Aicd-auto Implant Cardio-defib 1 $48,400.00 $48,400.00 $48,400.00 nat. median
$11,243
outlier · 4.3×
28725
CDM 		Subtalar Arthodesis 1 $33,245.52 $33,245.52 $33,245.52 nat. median
$50
outlier · 671.6×
33208
CDM 		Insert Pacemaker Dual Chamber 1 $26,400.00 $26,400.00 $26,400.00 nat. median
$18,483
1.4× median
37184
CDM 		Percut Translu Thrombectomy 1 $26,162.40 $26,162.40 $26,162.40 —
37244
CDM 		Vasc Embol Art/ven Hemorrhage 1 $25,520.00 $25,520.00 $25,520.00 —
92928
CDM 		Perc Transcath Intracoron Angi 1 $25,520.00 $25,520.00 $25,520.00 —
27590
CDM 		Aka-above Knee Amputation 1 $24,200.00 $24,200.00 $24,200.00 —
93460
CDM 		Heart Cath W Rt And Lft Placem 1 $20,416.00 $20,416.00 $20,416.00 —
PH008838
CDM 		Alteplase Inj 100 Mg Vial 1 $19,217.48 $19,217.48 $19,217.48 —
21620
CDM 		Partial Removal Sternum 1 $16,539.60 $16,539.60 $16,539.60 nat. median
$263
outlier · 62.9×
28415
CDM 		Open Trt CALCANEAl Fx, Int Fix 1 $16,500.00 $16,500.00 $16,500.00 —
36085015
CDM 		Chole Tube Placement Ir (Gall) 1 $15,937.68 $15,937.68 $15,937.68 —
37183
CDM 		Tips Rev Trans Intrahep Shunt 1 $15,840.00 $15,840.00 $15,840.00 nat. median
$8,258
1.9× median
21627
CDM 		Sternal Debridement 1 $15,840.00 $15,840.00 $15,840.00 —
37230
CDM 		Revasculr, Translum Stent-angi 1 $13,200.00 $13,200.00 $13,200.00 —
44227
CDM 		Bypass Transver Colon To Cutan 1 $12,760.00 $12,760.00 $12,760.00 —
43635
CDM 		Hemigastrect.subtot Gast 1 $12,760.00 $12,760.00 $12,760.00 —
43405
CDM 		Ligation Or Stap Gastroesophag 1 $12,760.00 $12,760.00 $12,760.00 —
28122
CDM 		Par Exc. Bone; Tarsal Or Metat 1 $12,545.28 $12,545.28 $12,545.28 nat. median
$1,450
outlier · 8.7×
37225
CDM 		Revasc With Atherectomy. Angiopl 1 $12,320.00 $12,320.00 $12,320.00 —
47556
CDM 		Biliary Endo, Percutan T-tube 1 $12,130.80 $12,130.80 $12,130.80 nat. median
$18,628
0.7× median
60200
CDM 		Exc Of Cyst Or Adema Of Thyroi 1 $11,880.00 $11,880.00 $11,880.00 —
45347
CDM 		Sigmoidoscopy, W Stent Insert 1 $11,880.00 $11,880.00 $11,880.00 —
43266
CDM 		Egd W Stent Placement 1 $11,869.44 $11,869.44 $11,869.44 —
37224
CDM 		Angio, Fem Popliteal Artery Un 1 $11,809.60 $11,809.60 $11,809.60 —
52601
CDM 		Turp 1 $11,651.20 $11,651.20 $11,651.20 nat. median
$384
outlier · 30.3×
27130
CDM 		Hip Replacement 1 $11,440.00 $11,440.00 $11,440.00 nat. median
$515
outlier · 22.2×
37226
CDM 		Stent Plcmt, W Angioplas Femor 1 $11,000.00 $11,000.00 $11,000.00 —
PHAR0250
CDM 		Ritauxin 1 $10,995.60 $10,995.60 $10,995.60 —
37220
CDM 		Revascularization Lowe Extrem 1 $10,560.00 $10,560.00 $10,560.00 —
15830
CDM 		Exc, Excess Skin-sub Tissue Ab 1 $10,560.00 $10,560.00 $10,560.00 —
37221
CDM 		Revascul, With Stent/angioplas 1 $10,560.00 $10,560.00 $10,560.00 —
36058018
CDM 		Chole Tube Placement Ir (Gall) 1 $10,560.00 $10,560.00 $10,560.00 —
37205
CDM 		Transcath Placement Of Stent 1 $10,560.00 $10,560.00 $10,560.00 —
35476
CDM 		Trans Balloon Angioplasty 1 $10,181.60 $10,181.60 $10,181.60 nat. median
$274
outlier · 37.2×
33228
CDM 		Replace Pacemaker Generator 1 $9,724.88 $9,724.88 $9,724.88 nat. median
$19
outlier · 521.7×
66180
CDM 		Glau Shunt With Peri Patch Gra 1 $9,609.60 $9,609.60 $9,609.60 —
43274
CDM 		Endo Retro Cholangiopan Stent 1 $9,539.20 $9,539.20 $9,539.20 —
52353
CDM 		Cystoureth,w Lithotripsy 1 $9,197.76 $9,197.76 $9,197.76 nat. median
$450
outlier · 20.4×
27880
CDM 		Bka- Below Knee Amputation 1 $9,108.00 $9,108.00 $9,108.00 —
27122
CDM 		Resection Fem Head Girdlestone 1 $8,800.00 $8,800.00 $8,800.00 nat. median
$515
outlier · 17.1×
43653
CDM 		Gastrostomy Without Tube 1 $8,624.00 $8,624.00 $8,624.00 nat. median
$67
outlier · 128.7×
49418
CDM 		Insert Tun Peri Cath Wo Port 1 $8,207.76 $8,207.76 $8,207.76 nat. median
$1,212
outlier · 6.8×
44180
CDM 		Lap. Enterolysis Lysis Adh Int 1 $7,920.00 $7,920.00 $7,920.00 —
44345
CDM 		Revision Of Colostomy 1 $7,920.00 $7,920.00 $7,920.00 —
54120
CDM 		Partial Amputation Of Penis 1 $7,849.60 $7,849.60 $7,849.60 —
PH009581
CDM 		Digoxin Immune Fab 1 $7,840.51 $7,840.51 $7,840.51 —
47500
CDM 		Cholangiogram 1 $7,685.46 $7,685.46 $7,685.46 —
27704
CDM 		Removal Of Ankle Implant 1 $7,637.52 $7,637.52 $7,637.52 —
27687
CDM 		Gastrocnemius Recession 1 $7,480.00 $7,480.00 $7,480.00 —

Other procedures at this hospital

Browse this hospital's 12,704 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
33249 CDM Aicd-auto Implant Cardio-defib 1 1 $55,000.00 $55,000.00 $48,400.00 $48,400.00 $48,400.00 2025-07-02
28725 CDM Subtalar Arthodesis 1 1 $37,779.00 $37,779.00 $33,245.52 $33,245.52 $33,245.52 2025-07-02
33208 CDM Insert Pacemaker Dual Chamber 1 1 $30,000.00 $30,000.00 $26,400.00 $26,400.00 $26,400.00 2025-07-02
37184 CDM Percut Translu Thrombectomy 1 1 $29,730.00 $29,730.00 $26,162.40 $26,162.40 $26,162.40 2025-07-02
37244 CDM Vasc Embol Art/ven Hemorrhage 1 1 $29,000.00 $29,000.00 $25,520.00 $25,520.00 $25,520.00 2025-07-02
92928 CDM Perc Transcath Intracoron Angi 1 1 $29,000.00 $29,000.00 $25,520.00 $25,520.00 $25,520.00 2025-07-02
27590 CDM Aka-above Knee Amputation 1 1 $27,500.00 $27,500.00 $24,200.00 $24,200.00 $24,200.00 2025-07-02
93460 CDM Heart Cath W Rt And Lft Placem 1 1 $23,200.00 $23,200.00 $20,416.00 $20,416.00 $20,416.00 2025-07-02
PH008838 CDM Alteplase Inj 100 Mg Vial 1 1 $21,838.05 $21,838.05 $19,217.48 $19,217.48 $19,217.48 2025-07-02
21620 CDM Partial Removal Sternum 1 1 $18,795.00 $18,795.00 $16,539.60 $16,539.60 $16,539.60 2025-07-02
28415 CDM Open Trt CALCANEAl Fx, Int Fix 1 1 $18,750.00 $18,750.00 $16,500.00 $16,500.00 $16,500.00 2025-07-02
36085015 CDM Chole Tube Placement Ir (Gall) 1 1 $18,111.00 $18,111.00 $15,937.68 $15,937.68 $15,937.68 2025-07-02
37183 CDM Tips Rev Trans Intrahep Shunt 1 1 $18,000.00 $18,000.00 $15,840.00 $15,840.00 $15,840.00 2025-07-02
21627 CDM Sternal Debridement 1 1 $18,000.00 $18,000.00 $15,840.00 $15,840.00 $15,840.00 2025-07-02
37230 CDM Revasculr, Translum Stent-angi 1 1 $15,000.00 $15,000.00 $13,200.00 $13,200.00 $13,200.00 2025-07-02
43635 CDM Hemigastrect.subtot Gast 1 1 $14,500.00 $14,500.00 $12,760.00 $12,760.00 $12,760.00 2025-07-02
43405 CDM Ligation Or Stap Gastroesophag 1 1 $14,500.00 $14,500.00 $12,760.00 $12,760.00 $12,760.00 2025-07-02
44227 CDM Bypass Transver Colon To Cutan 1 1 $14,500.00 $14,500.00 $12,760.00 $12,760.00 $12,760.00 2025-07-02
28122 CDM Par Exc. Bone; Tarsal Or Metat 1 1 $14,256.00 $14,256.00 $12,545.28 $12,545.28 $12,545.28 2025-07-02
37225 CDM Revasc With Atherectomy. Angiopl 1 1 $14,000.00 $14,000.00 $12,320.00 $12,320.00 $12,320.00 2025-07-02
47556 CDM Biliary Endo, Percutan T-tube 1 1 $13,785.00 $13,785.00 $12,130.80 $12,130.80 $12,130.80 2025-07-02
60200 CDM Exc Of Cyst Or Adema Of Thyroi 1 1 $13,500.00 $13,500.00 $11,880.00 $11,880.00 $11,880.00 2025-07-02
45347 CDM Sigmoidoscopy, W Stent Insert 1 1 $13,500.00 $13,500.00 $11,880.00 $11,880.00 $11,880.00 2025-07-02
43266 CDM Egd W Stent Placement 1 1 $13,488.00 $13,488.00 $11,869.44 $11,869.44 $11,869.44 2025-07-02
37224 CDM Angio, Fem Popliteal Artery Un 1 1 $13,420.00 $13,420.00 $11,809.60 $11,809.60 $11,809.60 2025-07-02
52601 CDM Turp 1 1 $13,240.00 $13,240.00 $11,651.20 $11,651.20 $11,651.20 2025-07-02
27130 CDM Hip Replacement 1 1 $13,000.00 $13,000.00 $11,440.00 $11,440.00 $11,440.00 2025-07-02
37226 CDM Stent Plcmt, W Angioplas Femor 1 1 $12,500.00 $12,500.00 $11,000.00 $11,000.00 $11,000.00 2025-07-02
PHAR0250 CDM Ritauxin 1 1 $12,495.00 $12,495.00 $10,995.60 $10,995.60 $10,995.60 2025-07-02
15830 CDM Exc, Excess Skin-sub Tissue Ab 1 1 $12,000.00 $12,000.00 $10,560.00 $10,560.00 $10,560.00 2025-07-02
37221 CDM Revascul, With Stent/angioplas 1 1 $12,000.00 $12,000.00 $10,560.00 $10,560.00 $10,560.00 2025-07-02
36058018 CDM Chole Tube Placement Ir (Gall) 1 1 $12,000.00 $12,000.00 $10,560.00 $10,560.00 $10,560.00 2025-07-02
37205 CDM Transcath Placement Of Stent 1 1 $12,000.00 $12,000.00 $10,560.00 $10,560.00 $10,560.00 2025-07-02
37220 CDM Revascularization Lowe Extrem 1 1 $12,000.00 $12,000.00 $10,560.00 $10,560.00 $10,560.00 2025-07-02
35476 CDM Trans Balloon Angioplasty 1 1 $11,570.00 $11,570.00 $10,181.60 $10,181.60 $10,181.60 2025-07-02
33228 CDM Replace Pacemaker Generator 1 1 $11,051.00 $11,051.00 $9,724.88 $9,724.88 $9,724.88 2025-07-02
66180 CDM Glau Shunt With Peri Patch Gra 1 1 $10,920.00 $10,920.00 $9,609.60 $9,609.60 $9,609.60 2025-07-02
43274 CDM Endo Retro Cholangiopan Stent 1 1 $10,840.00 $10,840.00 $9,539.20 $9,539.20 $9,539.20 2025-07-02
52353 CDM Cystoureth,w Lithotripsy 1 1 $10,452.00 $10,452.00 $9,197.76 $9,197.76 $9,197.76 2025-07-02
27880 CDM Bka- Below Knee Amputation 1 1 $10,350.00 $10,350.00 $9,108.00 $9,108.00 $9,108.00 2025-07-02
27122 CDM Resection Fem Head Girdlestone 1 1 $10,000.00 $10,000.00 $8,800.00 $8,800.00 $8,800.00 2025-07-02
43653 CDM Gastrostomy Without Tube 1 1 $9,800.00 $9,800.00 $8,624.00 $8,624.00 $8,624.00 2025-07-02
49418 CDM Insert Tun Peri Cath Wo Port 1 1 $9,327.00 $9,327.00 $8,207.76 $8,207.76 $8,207.76 2025-07-02
44180 CDM Lap. Enterolysis Lysis Adh Int 1 1 $9,000.00 $9,000.00 $7,920.00 $7,920.00 $7,920.00 2025-07-02
44345 CDM Revision Of Colostomy 1 1 $9,000.00 $9,000.00 $7,920.00 $7,920.00 $7,920.00 2025-07-02
54120 CDM Partial Amputation Of Penis 1 1 $8,920.00 $8,920.00 $7,849.60 $7,849.60 $7,849.60 2025-07-02
PH009581 CDM Digoxin Immune Fab 1 1 $8,909.67 $8,909.67 $7,840.51 $7,840.51 $7,840.51 2025-07-02
47500 CDM Cholangiogram 1 1 $8,733.48 $8,733.48 $7,685.46 $7,685.46 $7,685.46 2025-07-02
27704 CDM Removal Of Ankle Implant 1 1 $8,679.00 $8,679.00 $7,637.52 $7,637.52 $7,637.52 2025-07-02
27687 CDM Gastrocnemius Recession 1 1 $8,500.00 $8,500.00 $7,480.00 $7,480.00 $7,480.00 2025-07-02
35860 CDM Expl Postop Hemor Extremity 1 1 $8,500.00 $8,500.00 $7,480.00 $7,480.00 $7,480.00 2025-07-02
36831 CDM Thrombectomy Open 1 1 $8,300.00 $8,300.00 $7,304.00 $7,304.00 $7,304.00 2025-07-02
PH001868 CDM Aa 2.75%/callyts/d10 Sol 100 1 1 $8,096.16 $8,096.16 $7,124.62 $7,124.62 $7,124.62 2025-07-02
36821 CDM Insert Of Cn For Dialysis Any 1 1 $8,000.00 $8,000.00 $7,040.00 $7,040.00 $7,040.00 2025-07-02
47562 CDM Lap Cholecystectomy 1 1 $7,825.00 $7,825.00 $6,886.00 $6,886.00 $6,886.00 2025-07-02
49320 CDM Laparoscopy, Abd Perineur 1 1 $7,700.00 $7,700.00 $6,776.00 $6,776.00 $6,776.00 2025-07-02
27886 CDM Re-amputation - Leg Bk 1 1 $7,678.00 $7,678.00 $6,756.64 $6,756.64 $6,756.64 2025-07-02
36561 CDM Insert Venous Access Dev W/por 1 1 $7,560.00 $7,560.00 $6,652.80 $6,652.80 $6,652.80 2025-07-02
62365 CDM Removal Of Pump, Infusion 1 1 $7,500.00 $7,500.00 $6,600.00 $6,600.00 $6,600.00 2025-07-02
35475 CDM Balloon Angioplasty 1 1 $7,500.00 $7,500.00 $6,600.00 $6,600.00 $6,600.00 2025-07-02
PH011740 CDM Immune Globulin Premix 1 Gm/10 1 1 $7,436.25 $7,436.25 $6,543.90 $6,543.90 $6,543.90 2025-07-02
15273IH CDM Ap Sk Sub Tr/le/ue Up To 100sc 1 1 $7,210.00 $7,210.00 $6,344.80 $6,344.80 $6,344.80 2025-07-02
15273 CDM Ap Sk Sub Tr/le/ue Up To 100sc 1 1 $7,210.00 $7,210.00 $6,344.80 $6,344.80 $6,344.80 2025-07-02
15277 CDM Ap Sk Sub Fa/sc/ne 1st 100sqcm 1 1 $7,210.00 $7,210.00 $6,344.80 $6,344.80 $6,344.80 2025-07-02
15277IH CDM Ap Sk Sub Fa/sc/ne 1st 100sqcm 1 1 $7,210.00 $7,210.00 $6,344.80 $6,344.80 $6,344.80 2025-07-02
27598 CDM Amputation At The Knee 1 1 $7,200.00 $7,200.00 $6,336.00 $6,336.00 $6,336.00 2025-07-02
20240 CDM Biopsy, Bone Open, Superficial 1 1 $7,140.00 $7,140.00 $6,283.20 $6,283.20 $6,283.20 2025-07-02
28118 CDM Ostectomy, Calcaneus 1 1 $7,127.00 $7,127.00 $6,271.76 $6,271.76 $6,271.76 2025-07-02
38222 CDM Bone Marrow Biopsy & Aspiratio 1 1 $7,110.00 $7,110.00 $6,256.80 $6,256.80 $6,256.80 2025-07-02
11006 CDM Debride Genitalia 1 1 $7,000.00 $7,000.00 $6,160.00 $6,160.00 $6,160.00 2025-07-02
36861 CDM Ext Can/fistula Declot W Ballo 1 1 $7,000.00 $7,000.00 $6,160.00 $6,160.00 $6,160.00 2025-07-02
20680 CDM Removal Of Hardware Hip 1 1 $7,000.00 $7,000.00 $6,160.00 $6,160.00 $6,160.00 2025-07-02
19370 CDM Open Peripr Capsulect Breast 1 1 $7,000.00 $7,000.00 $6,160.00 $6,160.00 $6,160.00 2025-07-02
27596 CDM Re- Amputation Knee 1 1 $7,000.00 $7,000.00 $6,160.00 $6,160.00 $6,160.00 2025-07-02
10140IH CDM I&d Hematoma Seroma Fluid Coll 1 1 $6,900.00 $6,900.00 $6,072.00 $6,072.00 $6,072.00 2025-07-02
10140 CDM I&d Hematoma Seroma Fluid Coll 1 1 $6,900.00 $6,900.00 $6,072.00 $6,072.00 $6,072.00 2025-07-02
36565 CDM Insert Venous Acc Dev 2sites N 1 1 $6,750.00 $6,750.00 $5,940.00 $5,940.00 $5,940.00 2025-07-02
38525 CDM Biop / Exc Lymph Node Deep Axi 1 1 $6,700.00 $6,700.00 $5,896.00 $5,896.00 $5,896.00 2025-07-02
31820 CDM Surg Closure Trach/fis Wo Plas 1 1 $6,600.00 $6,600.00 $5,808.00 $5,808.00 $5,808.00 2025-07-02
35840 CDM Explor Postop Hemorrhage 1 1 $6,500.00 $6,500.00 $5,720.00 $5,720.00 $5,720.00 2025-07-02
27310 CDM Arthrotomy Knee 1 1 $6,500.00 $6,500.00 $5,720.00 $5,720.00 $5,720.00 2025-07-02
35556 CDM Bypass Graft, Fem-pop 1 1 $6,500.00 $6,500.00 $5,720.00 $5,720.00 $5,720.00 2025-07-02
27610 CDM Arthrotomy Ankle 1 1 $6,500.00 $6,500.00 $5,720.00 $5,720.00 $5,720.00 2025-07-02
20692 CDM Insert External Fixation Syste 1 1 $6,425.00 $6,425.00 $5,654.00 $5,654.00 $5,654.00 2025-07-02
PH001408 CDM Hydrocortisone 2.5% Crm 1 Hy 1 1 $6,045.96 $6,045.96 $5,320.44 $5,320.44 $5,320.44 2025-07-02
47532 CDM Perc Transher Cholangiogram 1 1 $6,000.00 $6,000.00 $5,280.00 $5,280.00 $5,280.00 2025-07-02
92980 CDM Stent/trans Cath Placement 1 1 $6,000.00 $6,000.00 $5,280.00 $5,280.00 $5,280.00 2025-07-02
33227 CDM Rem/rep Pacemaker Generator 1 1 $6,000.00 $6,000.00 $5,280.00 $5,280.00 $5,280.00 2025-07-02
36475 CDM Ablation Of Incom Vein, Extrem 1 1 $6,000.00 $6,000.00 $5,280.00 $5,280.00 $5,280.00 2025-07-02
50395 CDM Placement Nephrostomy Tube 1 1 $6,000.00 $6,000.00 $5,280.00 $5,280.00 $5,280.00 2025-07-02
37765 CDM Stab Phlebectomy Of Var Vein E 1 1 $6,000.00 $6,000.00 $5,280.00 $5,280.00 $5,280.00 2025-07-02
44204 CDM Lap Colectomy, Partial 1 1 $6,000.00 $6,000.00 $5,280.00 $5,280.00 $5,280.00 2025-07-02
14040 CDM Adj Tissue Transfer 10 Cm /les 1 1 $5,750.00 $5,750.00 $5,060.00 $5,060.00 $5,060.00 2025-07-02
74178 CDM CT Abdomen/Pelvis 1 1 $5,562.00 $5,562.00 $4,894.56 $4,894.56 $4,894.56 2025-07-02
31603 CDM Tracheostomy Emergent 1 1 $5,500.00 $5,500.00 $4,840.00 $4,840.00 $4,840.00 2025-07-02
27331 CDM Arthrotomy, Exc, Exp Removal 1 1 $5,500.00 $5,500.00 $4,840.00 $4,840.00 $4,840.00 2025-07-02
36558 CDM Insert Venous Cath N/port Pump 1 1 $5,400.00 $5,400.00 $4,752.00 $4,752.00 $4,752.00 2025-07-02
36571 CDM Insert Of Vascular Access Dev 1 1 $5,400.00 $5,400.00 $4,752.00 $4,752.00 $4,752.00 2025-07-02
36478 CDM Endovenous Ablation Therapy 1 1 $5,373.00 $5,373.00 $4,728.24 $4,728.24 $4,728.24 2025-07-02
11451 CDM Exc Of Skin/subcu Tis Complex 1 1 $5,300.00 $5,300.00 $4,664.00 $4,664.00 $4,664.00 2025-07-02
11450 CDM Exc Skin /subc Tiss Simple Axi 1 1 $5,300.00 $5,300.00 $4,664.00 $4,664.00 $4,664.00 2025-07-02
28140 CDM Metatarsectomy 1 1 $5,200.00 $5,200.00 $4,576.00 $4,576.00 $4,576.00 2025-07-02
28805 CDM Amputation, Foot, Transmetatar 1 1 $5,175.00 $5,175.00 $4,554.00 $4,554.00 $4,554.00 2025-07-02
28120 CDM Partial Exc Bone, Talus Or Cal 1 1 $5,160.00 $5,160.00 $4,540.80 $4,540.80 $4,540.80 2025-07-02
13160 CDM Secondary Closure Wound/dehis 1 1 $5,160.00 $5,160.00 $4,540.80 $4,540.80 $4,540.80 2025-07-02
52317 CDM Litholapaxy, Simple Or Small 1 1 $5,100.00 $5,100.00 $4,488.00 $4,488.00 $4,488.00 2025-07-02
44208 CDM Lap Loop Colostomy 1 1 $5,000.00 $5,000.00 $4,400.00 $4,400.00 $4,400.00 2025-07-02
50040 CDM Nephrostomy,w Drainage 1 1 $5,000.00 $5,000.00 $4,400.00 $4,400.00 $4,400.00 2025-07-02
43239 CDM Upper Gi Endoscopy W/biopsy 1 1 $5,000.00 $5,000.00 $4,400.00 $4,400.00 $4,400.00 2025-07-02
31600 CDM Tracheostomy Planned 1 1 $5,000.00 $5,000.00 $4,400.00 $4,400.00 $4,400.00 2025-07-02
36901 CDM Fistulagram 1 1 $5,000.00 $5,000.00 $4,400.00 $4,400.00 $4,400.00 2025-07-02
44360 CDM Small Bowel Endoscopy 1 1 $4,977.00 $4,977.00 $4,379.76 $4,379.76 $4,379.76 2025-07-02
PH006274 CDM Acyclovir Sodium 50 Mg 1 1 $4,902.00 $4,902.00 $4,313.76 $4,313.76 $4,313.76 2025-07-02
58120 CDM D&c Diag/ther. 1 1 $4,900.00 $4,900.00 $4,312.00 $4,312.00 $4,312.00 2025-07-02
95811 CDM Polysomnography W/cpap Titrati 1 1 $4,860.00 $4,860.00 $4,276.80 $4,276.80 $4,276.80 2025-07-02
36581 CDM Replace Venous Cath No Port Pu 1 1 $4,860.00 $4,860.00 $4,276.80 $4,276.80 $4,276.80 2025-07-02
PH013524 CDM Prolia Sol 60mg/ml 1 1 $4,837.89 $4,837.89 $4,257.34 $4,257.34 $4,257.34 2025-07-02
15922 CDM Exc Coccy Pres Ulcer Wi/ Flap 1 1 $4,800.00 $4,800.00 $4,224.00 $4,224.00 $4,224.00 2025-07-02
19020 CDM Mastotomy W/exp Or Drain Abces 1 1 $4,773.00 $4,773.00 $4,200.24 $4,200.24 $4,200.24 2025-07-02
15946 CDM Exc., Ischial Pr Ulcer. Ostect 1 1 $4,762.00 $4,762.00 $4,190.56 $4,190.56 $4,190.56 2025-07-02
75860 CDM Venography,sinus/jugular Cath 1 1 $4,758.00 $4,758.00 $4,187.04 $4,187.04 $4,187.04 2025-07-02
52281 CDM Cystourethroscopy 1 1 $4,729.00 $4,729.00 $4,161.52 $4,161.52 $4,161.52 2025-07-02
43255 CDM Upper Endo Control Bleeding 1 1 $4,700.00 $4,700.00 $4,136.00 $4,136.00 $4,136.00 2025-07-02
PH001739 CDM Nitroglycerin Patch Pat 1 Ni 1 1 $4,699.17 $4,699.17 $4,135.27 $4,135.27 $4,135.27 2025-07-02
PH012618 CDM Miacalcin Inj 200/ml 1 1 $4,666.47 $4,666.47 $4,106.49 $4,106.49 $4,106.49 2025-07-02
43760 CDM Peg Replacement 1 1 $4,600.00 $4,600.00 $4,048.00 $4,048.00 $4,048.00 2025-07-02
29871 CDM Arthrosopy, Knee Lav Drainage 1 1 $4,500.00 $4,500.00 $3,960.00 $3,960.00 $3,960.00 2025-07-02
49904 CDM Omental Flap Abd 1 1 $4,500.00 $4,500.00 $3,960.00 $3,960.00 $3,960.00 2025-07-02
28825 CDM Amputation Toe Interphalangeal 1 1 $4,500.00 $4,500.00 $3,960.00 $3,960.00 $3,960.00 2025-07-02
49419 CDM Insert Tun Peri Cath W Port 1 1 $4,500.00 $4,500.00 $3,960.00 $3,960.00 $3,960.00 2025-07-02
95810 CDM Polysomnography, 4/+ Add Param 1 1 $4,455.00 $4,455.00 $3,920.40 $3,920.40 $3,920.40 2025-07-02
206940 CDM Removal Of External Fixation S 1 1 $4,452.00 $4,452.00 $3,917.76 $3,917.76 $3,917.76 2025-07-02
20694 CDM Removal Of External Fixation 1 1 $4,452.00 $4,452.00 $3,917.76 $3,917.76 $3,917.76 2025-07-02
20693 CDM Revision Of External Fixation 1 1 $4,452.00 $4,452.00 $3,917.76 $3,917.76 $3,917.76 2025-07-02
75635 CDM CTA Abd Aorta W/runoff 1 1 $4,400.00 $4,400.00 $3,872.00 $3,872.00 $3,872.00 2025-07-02
36555 CDM Insert Tunnel Cv Cath 1 1 $4,400.00 $4,400.00 $3,872.00 $3,872.00 $3,872.00 2025-07-02
28003IH CDM I&d Below Fascia Toes Multiple 1 1 $4,365.00 $4,365.00 $3,841.20 $3,841.20 $3,841.20 2025-07-02
28003 CDM I&d Below Fascia Toes, Multipl 1 1 $4,365.00 $4,365.00 $3,841.20 $3,841.20 $3,841.20 2025-07-02
15002IH CDM Prep/graft Debrid Skin 1st 100 1 1 $4,359.99 $4,359.99 $3,836.79 $3,836.79 $3,836.79 2025-07-02
15002 CDM Prep/graft Debrid Skin 1st 100 1 1 $4,359.99 $4,359.99 $3,836.79 $3,836.79 $3,836.79 2025-07-02
49405 CDM Image Guide Fluid Drain-cath 1 1 $4,311.00 $4,311.00 $3,793.68 $3,793.68 $3,793.68 2025-07-02
49424 CDM Contrast Inj Asses Abscess/cys 1 1 $4,300.00 $4,300.00 $3,784.00 $3,784.00 $3,784.00 2025-07-02
15003IH CDM Pre/graft Debrid Skin Add 100 1 1 $4,300.00 $4,300.00 $3,784.00 $3,784.00 $3,784.00 2025-07-02
15240IH CDM Fu Th Autogr Fh/ch/ne 20sqcm 1 1 $4,243.84 $4,243.84 $3,734.58 $3,734.58 $3,734.58 2025-07-02
15240 CDM Fu Th Autogr Fh,ch,ne 20sqcm 1 1 $4,243.84 $4,243.84 $3,734.58 $3,734.58 $3,734.58 2025-07-02
15220IH CDM Fu Th Autogr Sc/ue/le 20sqcm 1 1 $4,243.84 $4,243.84 $3,734.58 $3,734.58 $3,734.58 2025-07-02
15220 CDM Fu Th Autogr Sc/ue/le 20sqcm 1 1 $4,243.84 $4,243.84 $3,734.58 $3,734.58 $3,734.58 2025-07-02
15200IH CDM Fu Th Autogr Tr 20sqcm Or Less 1 1 $4,243.84 $4,243.84 $3,734.58 $3,734.58 $3,734.58 2025-07-02
15200 CDM Fu Th Autogr Tr 20sqcm Or Less 1 1 $4,243.84 $4,243.84 $3,734.58 $3,734.58 $3,734.58 2025-07-02
15120IH CDM St Autogr Fa/sc/ne/h/f 100sqcm 1 1 $4,243.84 $4,243.84 $3,734.58 $3,734.58 $3,734.58 2025-07-02
15120 CDM St Autogr Fa/sc/ne/h/f 100sqcm 1 1 $4,243.84 $4,243.84 $3,734.58 $3,734.58 $3,734.58 2025-07-02
15100IH CDM Sp Th Autogr Tr/ue/le 100 Sqcm 1 1 $4,243.84 $4,243.84 $3,734.58 $3,734.58 $3,734.58 2025-07-02
15100 CDM Sp Th Autogr Tr/ue/le 100 Sqcm 1 1 $4,243.84 $4,243.84 $3,734.58 $3,734.58 $3,734.58 2025-07-02
20225IH CDM Biopsy Deep Bone Troc Needle 1 1 $4,242.00 $4,242.00 $3,732.96 $3,732.96 $3,732.96 2025-07-02
20225 CDM Biopsy Deep Bone Troc Needle 1 1 $4,242.00 $4,242.00 $3,732.96 $3,732.96 $3,732.96 2025-07-02
15003 CDM Prep/graft Debrid Skin Add 100 1 1 $4,233.00 $4,233.00 $3,725.04 $3,725.04 $3,725.04 2025-07-02
49407 CDM Image Guid Drain Transvag/rect 1 1 $4,130.00 $4,130.00 $3,634.40 $3,634.40 $3,634.40 2025-07-02
62269 CDM Needle Biopsy Spinal Cord 1 1 $4,126.00 $4,126.00 $3,630.88 $3,630.88 $3,630.88 2025-07-02
15275IH CDM Ap Sk Sub Fa/sc/ne Up To 100sq 1 1 $4,120.00 $4,120.00 $3,625.60 $3,625.60 $3,625.60 2025-07-02
15275 CDM Ap Sk Sub Fa/sc/ne Up To 100sq 1 1 $4,120.00 $4,120.00 $3,625.60 $3,625.60 $3,625.60 2025-07-02
78315 CDM Bone Imaging 3 Phase 1 1 $4,120.00 $4,120.00 $3,625.60 $3,625.60 $3,625.60 2025-07-02
15271 CDM Ap Sk Sub/tr/le/ue 20sc To 100 1 1 $4,120.00 $4,120.00 $3,625.60 $3,625.60 $3,625.60 2025-07-02
78813 CDM PET Scan 1 1 $4,120.00 $4,120.00 $3,625.60 $3,625.60 $3,625.60 2025-07-02
15271IH CDM Ap Sk Sub Tr/le/ue 20sc To 100 1 1 $4,120.00 $4,120.00 $3,625.60 $3,625.60 $3,625.60 2025-07-02
95805 CDM Multiple Sleep Latency Test 1 1 $4,050.00 $4,050.00 $3,564.00 $3,564.00 $3,564.00 2025-07-02
37233 CDM Angioplas-tib/per W/ather Addi 1 1 $4,000.00 $4,000.00 $3,520.00 $3,520.00 $3,520.00 2025-07-02
37229 CDM Angioplasty Tib/per W Atherect 1 1 $4,000.00 $4,000.00 $3,520.00 $3,520.00 $3,520.00 2025-07-02
35800 CDM Explor For Hemorrhage Neck 1 1 $4,000.00 $4,000.00 $3,520.00 $3,520.00 $3,520.00 2025-07-02
37232 CDM Angioplas, Tib/per Ar Ea Add V 1 1 $4,000.00 $4,000.00 $3,520.00 $3,520.00 $3,520.00 2025-07-02
37191 CDM Insert Intra Vencav Filter-gf 1 1 $4,000.00 $4,000.00 $3,520.00 $3,520.00 $3,520.00 2025-07-02
35820 CDM Explor For Hemmorr-chest 1 1 $4,000.00 $4,000.00 $3,520.00 $3,520.00 $3,520.00 2025-07-02
37228 CDM Angioplasty, Tib/per Art In Ve 1 1 $4,000.00 $4,000.00 $3,520.00 $3,520.00 $3,520.00 2025-07-02
75825 CDM Venography, Vena Cava 1 1 $4,000.00 $4,000.00 $3,520.00 $3,520.00 $3,520.00 2025-07-02
43247 CDM Upper Gi-endosc Rem For. Body 1 1 $4,000.00 $4,000.00 $3,520.00 $3,520.00 $3,520.00 2025-07-02
43248 CDM Upper Gi Endos W Guidewire 1 1 $4,000.00 $4,000.00 $3,520.00 $3,520.00 $3,520.00 2025-07-02
45380 CDM Colonoscopy W/biopsy 1 1 $4,000.00 $4,000.00 $3,520.00 $3,520.00 $3,520.00 2025-07-02
44202 CDM Lap Enterectomy Resect Intesti 1 1 $4,000.00 $4,000.00 $3,520.00 $3,520.00 $3,520.00 2025-07-02
47011 CDM Hepatotomy, Percut Drain Abces 1 1 $3,900.00 $3,900.00 $3,432.00 $3,432.00 $3,432.00 2025-07-02
49021 CDM Drainage Of Periton Abcess Per 1 1 $3,900.00 $3,900.00 $3,432.00 $3,432.00 $3,432.00 2025-07-02
PH003874 CDM Tracleer 62.5 Mg Tablet 1 1 $3,833.16 $3,833.16 $3,373.18 $3,373.18 $3,373.18 2025-07-02
46255 CDM Hemorrhoidectomy, Int/ext Sing 1 1 $3,800.00 $3,800.00 $3,344.00 $3,344.00 $3,344.00 2025-07-02
43820 CDM Gastrojejunostomy 1 1 $3,800.00 $3,800.00 $3,344.00 $3,344.00 $3,344.00 2025-07-02
PH012727 CDM Darbepoetin Alfa Vl 300mcg A 1 1 $3,776.34 $3,776.34 $3,323.18 $3,323.18 $3,323.18 2025-07-02
27603 CDM I&d , Leg Or Ankle 1 1 $3,773.00 $3,773.00 $3,320.24 $3,320.24 $3,320.24 2025-07-02
PH001823 CDM Hydrocortisone Ont 1 Hydro 1 1 $3,763.44 $3,763.44 $3,311.83 $3,311.83 $3,311.83 2025-07-02
PH007955 CDM Vancomycin Cap 250mg Vanco 1 1 $3,644.82 $3,644.82 $3,207.44 $3,207.44 $3,207.44 2025-07-02
32551 CDM Insert Chest Tube A/o Drainage 1 1 $3,600.00 $3,600.00 $3,168.00 $3,168.00 $3,168.00 2025-07-02
75724 CDM Angio, Renal, Bil, Sel W/Aorto 1 1 $3,600.00 $3,600.00 $3,168.00 $3,168.00 $3,168.00 2025-07-02
26160 CDM Exc Of Lesion Of Tendon Or Joi 1 1 $3,600.00 $3,600.00 $3,168.00 $3,168.00 $3,168.00 2025-07-02
27884 CDM Amputation, Scar Rev Sec Closu 1 1 $3,600.00 $3,600.00 $3,168.00 $3,168.00 $3,168.00 2025-07-02
15999 CDM Excision Pressure Ulcer 1 1 $3,600.00 $3,600.00 $3,168.00 $3,168.00 $3,168.00 2025-07-02
PH005700 CDM Enalapril Maleate 10 Mg 1 1 $3,542.19 $3,542.19 $3,117.13 $3,117.13 $3,117.13 2025-07-02
75733 CDM Angio, Adrenal, Bil, Sel 1 1 $3,540.00 $3,540.00 $3,115.20 $3,115.20 $3,115.20 2025-07-02
7001 CDM Noxafil 4 Oz 1 1 $3,510.00 $3,510.00 $3,088.80 $3,088.80 $3,088.80 2025-07-02
54415 CDM Rem Penile Prosth Inf/non Infl 1 1 $3,500.00 $3,500.00 $3,080.00 $3,080.00 $3,080.00 2025-07-02
36245 CDM Sel Cath Plc Arterial 1 1 $3,500.00 $3,500.00 $3,080.00 $3,080.00 $3,080.00 2025-07-02
44120 CDM Enterectomy, Resec Sm Intestin 1 1 $3,500.00 $3,500.00 $3,080.00 $3,080.00 $3,080.00 2025-07-02
69436 CDM Tympanostomy With Tube Insert 1 1 $3,500.00 $3,500.00 $3,080.00 $3,080.00 $3,080.00 2025-07-02
52332 CDM Cystourethroscopy W Stent Plac 1 1 $3,500.00 $3,500.00 $3,080.00 $3,080.00 $3,080.00 2025-07-02
19301 CDM Lumpectomy,partial Mastectomy 1 1 $3,500.00 $3,500.00 $3,080.00 $3,080.00 $3,080.00 2025-07-02
27266 CDM Closed Treat Of Post Hip Arthr 1 1 $3,500.00 $3,500.00 $3,080.00 $3,080.00 $3,080.00 2025-07-02
11960 CDM Inser Tissue-expander 1 1 $3,475.00 $3,475.00 $3,058.00 $3,058.00 $3,058.00 2025-07-02
28820 CDM Amputation Of Toe 1 1 $3,450.00 $3,450.00 $3,036.00 $3,036.00 $3,036.00 2025-07-02
28810 CDM Amputation, Metatarsal, W Toe 1 1 $3,450.00 $3,450.00 $3,036.00 $3,036.00 $3,036.00 2025-07-02
26952 CDM Amputation Of Finger 1 1 $3,450.00 $3,450.00 $3,036.00 $3,036.00 $3,036.00 2025-07-02
25931 CDM Reamputation Of Index Finger 1 1 $3,450.00 $3,450.00 $3,036.00 $3,036.00 $3,036.00 2025-07-02
75716 CDM Angio, Extremity, Bil 1 1 $3,400.00 $3,400.00 $2,992.00 $2,992.00 $2,992.00 2025-07-02
46615 CDM Endo Polypectomy 1 1 $3,300.00 $3,300.00 $2,904.00 $2,904.00 $2,904.00 2025-07-02
31624 CDM Bronchoscopy W Lavage 1 1 $3,115.00 $3,115.00 $2,741.20 $2,741.20 $2,741.20 2025-07-02
PH012365 CDM Mycophenolate Mofet. Sus 250 1 1 $3,092.85 $3,092.85 $2,721.71 $2,721.71 $2,721.71 2025-07-02
PH007036 CDM carBAMazepine 1 1 $3,072.78 $3,072.78 $2,704.05 $2,704.05 $2,704.05 2025-07-02
49440 CDM Placement Of Gastro Tube 1 1 $3,052.00 $3,052.00 $2,685.76 $2,685.76 $2,685.76 2025-07-02
35036000 CDM Lower Extremity W/Contrast 1 1 $3,004.00 $3,004.00 $2,643.52 $2,643.52 $2,643.52 2025-07-02
PH006964 CDM rOPINIRole Hcl 1 1 $3,003.15 $3,003.15 $2,642.77 $2,642.77 $2,642.77 2025-07-02
51102 CDM Asp Of Bladder, Suprapub Cath 1 1 $3,000.00 $3,000.00 $2,640.00 $2,640.00 $2,640.00 2025-07-02
31525 CDM Laryngoscopy Direct 1 1 $3,000.00 $3,000.00 $2,640.00 $2,640.00 $2,640.00 2025-07-02
63267 CDM Laminectomy Excision Or Eval 1 1 $3,000.00 $3,000.00 $2,640.00 $2,640.00 $2,640.00 2025-07-02
37211 CDM Transcath Ther, Arter Infusion 1 1 $3,000.00 $3,000.00 $2,640.00 $2,640.00 $2,640.00 2025-07-02
54161 CDM Circumcision, Older Than 28 1 1 $3,000.00 $3,000.00 $2,640.00 $2,640.00 $2,640.00 2025-07-02
15937 CDM Exc. Sacral Pres Ulcer Ostecto 1 1 $3,000.00 $3,000.00 $2,640.00 $2,640.00 $2,640.00 2025-07-02
36905 CDM Perc Translum Thrombectomy 1 1 $3,000.00 $3,000.00 $2,640.00 $2,640.00 $2,640.00 2025-07-02
11971 CDM Remo Of Tissue Expander 1 1 $2,975.00 $2,975.00 $2,618.00 $2,618.00 $2,618.00 2025-07-02
45332 CDM Sigmoidoscopy, Rem Foreign Bod 1 1 $2,940.00 $2,940.00 $2,587.20 $2,587.20 $2,587.20 2025-07-02
20999 CDM Sacral Debridement 1 1 $2,875.00 $2,875.00 $2,530.00 $2,530.00 $2,530.00 2025-07-02
11752 CDM Amput.finger Tip -nail Removal 1 1 $2,875.00 $2,875.00 $2,530.00 $2,530.00 $2,530.00 2025-07-02
PH001032 CDM Valproic Acid Syr 250mg Depa 1 1 $2,857.65 $2,857.65 $2,514.73 $2,514.73 $2,514.73 2025-07-02
28001 CDM I&d Bursa Foot 1 1 $2,826.00 $2,826.00 $2,486.88 $2,486.88 $2,486.88 2025-07-02
28001IH CDM I&d Bursa Foot 1 1 $2,826.00 $2,826.00 $2,486.88 $2,486.88 $2,486.88 2025-07-02
PH004039 CDM Hydralazine 20 Mg/ml Vial 1 1 $2,790.48 $2,790.48 $2,455.62 $2,455.62 $2,455.62 2025-07-02
72157 CDM MRI T SPINEW/&without Contrast 1 1 $2,781.00 $2,781.00 $2,447.28 $2,447.28 $2,447.28 2025-07-02
72156 CDM MRI Spinal Canl W/&without Contras 1 1 $2,781.00 $2,781.00 $2,447.28 $2,447.28 $2,447.28 2025-07-02
ICUA CDM ICU - Advanced 1 1 $2,755.00 $2,755.00 $2,424.40 $2,424.40 $2,424.40 2025-07-02
70553 CDM MRI Brain W/&without Contrast 1 1 $2,752.65 $2,752.65 $2,422.33 $2,422.33 $2,422.33 2025-07-02
72158 CDM MRI L Spine W/&without Contrast 1 1 $2,752.65 $2,752.65 $2,422.33 $2,422.33 $2,422.33 2025-07-02
PH008101 CDM Privigen(10%)10g/100 Ml Premix 1 1 $2,718.72 $2,718.72 $2,392.47 $2,392.47 $2,392.47 2025-07-02
19101 CDM Biopsy Breast Open Incisional 1 1 $2,700.00 $2,700.00 $2,376.00 $2,376.00 $2,376.00 2025-07-02
50392 CDM Intro Intracath Renal Pelv Dra 1 1 $2,700.00 $2,700.00 $2,376.00 $2,376.00 $2,376.00 2025-07-02
43800 CDM Pyloroplasty 1 1 $2,700.00 $2,700.00 $2,376.00 $2,376.00 $2,376.00 2025-07-02
75722 CDM Angio, Renal, Uni, W/Aortog 1 1 $2,700.00 $2,700.00 $2,376.00 $2,376.00 $2,376.00 2025-07-02
PH005240 CDM Clindamycin Phosphate 1 % 1 1 $2,663.46 $2,663.46 $2,343.84 $2,343.84 $2,343.84 2025-07-02
PH001838 CDM Tobramycin/dexametha Sus 2 T 1 1 $2,564.28 $2,564.28 $2,256.57 $2,256.57 $2,256.57 2025-07-02
32035202 CDM CT Chest/abd/pelvis 1 1 $2,545.00 $2,545.00 $2,239.60 $2,239.60 $2,239.60 2025-07-02
32099082 CDM CTA Chest/Abd/Pelvis 1 1 $2,545.00 $2,545.00 $2,239.60 $2,239.60 $2,239.60 2025-07-02
32099013 CDM CTA Chest 1 1 $2,545.00 $2,545.00 $2,239.60 $2,239.60 $2,239.60 2025-07-02
PH007525 CDM Cubicin 600mg/100ml Ns 1 1 $2,535.30 $2,535.30 $2,231.06 $2,231.06 $2,231.06 2025-07-02
PH007521 CDM Cubicin 750mg 1 1 $2,521.38 $2,521.38 $2,218.81 $2,218.81 $2,218.81 2025-07-02
58823 CDM Pelvic Abcess Drainage Intrava 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
47000 CDM Biopsy Of Liver 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
75710 CDM Angio, Extremity, Uni 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
36147 CDM Dialysis Fistulagram 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
47537 CDM Removal Drain Cath, Percutan 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
27065 CDM Excision Of Bone Cyst 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
49000 CDM Exploratory Laparotomy 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
44050 CDM Reduct Internal Hernia Lap 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
42800 CDM Biopsy Oropharynx 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
49460 CDM Rem Of Obstruct Material Gastr 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
75791 CDM Shunt, Arteriovenous 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
45381 CDM Colonoscopy W/submucos Inj 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
49450 CDM Replace G Tube Percutan 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
45385 CDM Colonoscopy W Les/pol Removal 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
75731 CDM Angio, Adrenal, Uni, Sel 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
49441 CDM Insertion Of J-tube 1 1 $2,500.00 $2,500.00 $2,200.00 $2,200.00 $2,200.00 2025-07-02
20670 CDM Rem Of Implant,wire,pin,rod 1 1 $2,447.00 $2,447.00 $2,153.36 $2,153.36 $2,153.36 2025-07-02
PH011359 CDM Darbepoetin Alfa Vl 400mcg A 1 1 $2,438.40 $2,438.40 $2,145.79 $2,145.79 $2,145.79 2025-07-02
3700005 CDM Anesthesia Each Addl Hour 1 1 $2,430.00 $2,430.00 $2,138.40 $2,138.40 $2,138.40 2025-07-02
3700004 CDM Anesthesia 1 Hour 1 1 $2,430.00 $2,430.00 $2,138.40 $2,138.40 $2,138.40 2025-07-02
PRCOL01 CDM Colonoscopy 1 1 $2,415.00 $2,415.00 $2,125.20 $2,125.20 $2,125.20 2025-07-02
75625 CDM Aortogram Abdominal 1 1 $2,400.00 $2,400.00 $2,112.00 $2,112.00 $2,112.00 2025-07-02
75626 CDM Angio, Visceral, Sel W/without Aor 1 1 $2,400.00 $2,400.00 $2,112.00 $2,112.00 $2,112.00 2025-07-02
75605 CDM Aortography, Thoracic, Serialo 1 1 $2,400.00 $2,400.00 $2,112.00 $2,112.00 $2,112.00 2025-07-02
75630 CDM Aortography, Abd+bil Iliofem L 1 1 $2,400.00 $2,400.00 $2,112.00 $2,112.00 $2,112.00 2025-07-02
75685 CDM Angio Vert, Cervi, Intracra 1 1 $2,400.00 $2,400.00 $2,112.00 $2,112.00 $2,112.00 2025-07-02
55700 CDM Biopsy, Prostate 1 1 $2,400.00 $2,400.00 $2,112.00 $2,112.00 $2,112.00 2025-07-02
32601 CDM Vats Video Assisted Thoracosco 1 1 $2,400.00 $2,400.00 $2,112.00 $2,112.00 $2,112.00 2025-07-02
43246 CDM Peg Tube Placement 1 1 $2,369.00 $2,369.00 $2,084.72 $2,084.72 $2,084.72 2025-07-02
PH000756 CDM Methocarbamol Sdv 500mg Roba 1 1 $2,367.09 $2,367.09 $2,083.04 $2,083.04 $2,083.04 2025-07-02
28002IH CDM I&d Below Fascia Foot 1 1 $2,350.00 $2,350.00 $2,068.00 $2,068.00 $2,068.00 2025-07-02
28002 CDM I&d Below Fascia, Foot Single 1 1 $2,350.00 $2,350.00 $2,068.00 $2,068.00 $2,068.00 2025-07-02
PH007071 CDM Immune Globul 10 Gm 1 1 $2,333.31 $2,333.31 $2,053.31 $2,053.31 $2,053.31 2025-07-02
PH011593 CDM Collagenase Oin 1 Santy 1 1 $2,316.42 $2,316.42 $2,038.45 $2,038.45 $2,038.45 2025-07-02
36005001 CDM Insert Tunneled Cv Cath 1 1 $2,303.00 $2,303.00 $2,026.64 $2,026.64 $2,026.64 2025-07-02
PH008807 CDM Econazole Nitrate 1% Crea 1 1 $2,285.70 $2,285.70 $2,011.42 $2,011.42 $2,011.42 2025-07-02
PH001443 CDM Primidone Tab 50mg Primi 1 1 $2,283.69 $2,283.69 $2,009.65 $2,009.65 $2,009.65 2025-07-02
35000010 CDM CT Guided Ndl Place 1 1 $2,267.20 $2,267.20 $1,995.14 $1,995.14 $1,995.14 2025-07-02
PH010459 CDM Argatroban Inj 1.00 Argat 1 1 $2,255.82 $2,255.82 $1,985.12 $1,985.12 $1,985.12 2025-07-02
PHAR1331 CDM Lupron Depot 7.5mg Kit 1 1 $2,250.00 $2,250.00 $1,980.00 $1,980.00 $1,980.00 2025-07-02
PH006682 CDM Vasostrict 20 Unit 1 1 $2,211.18 $2,211.18 $1,945.84 $1,945.84 $1,945.84 2025-07-02
49406 CDM Image Guide Drain Preitoneal 1 1 $2,200.00 $2,200.00 $1,936.00 $1,936.00 $1,936.00 2025-07-02
43241 CDM Egd With Transendo Tube/cath Pla 1 1 $2,190.00 $2,190.00 $1,927.20 $1,927.20 $1,927.20 2025-07-02
PH007843 CDM Ferric Carboxymaltose Inj 750 1 1 $2,183.64 $2,183.64 $1,921.60 $1,921.60 $1,921.60 2025-07-02
43245 CDM Egd 1 1 $2,150.00 $2,150.00 $1,892.00 $1,892.00 $1,892.00 2025-07-02
ICUI CDM ICU/Intermediate Care Room 1 1 $2,135.00 $2,135.00 $1,878.80 $1,878.80 $1,878.80 2025-07-02
ICUP CDM ICU - Private 1 1 $2,135.00 $2,135.00 $1,878.80 $1,878.80 $1,878.80 2025-07-02
PH004003 CDM Zovirax 5% Ointment 1 1 $2,122.38 $2,122.38 $1,867.69 $1,867.69 $1,867.69 2025-07-02
74230 CDM Modified Barium Swallow (mbs) 1 1 $2,110.47 $2,110.47 $1,857.21 $1,857.21 $1,857.21 2025-07-02
MSC6009 CDM Flexi Seal 1 1 $2,106.00 $2,106.00 $1,853.28 $1,853.28 $1,853.28 2025-07-02
36569 CDM Insert Of Picc Without Port Pump O 1 1 $2,085.75 $2,085.75 $1,835.46 $1,835.46 $1,835.46 2025-07-02
15274IH CDM Ap Sk Sub Tr/le/ue Add 100sqcm 1 1 $2,060.00 $2,060.00 $1,812.80 $1,812.80 $1,812.80 2025-07-02
15274 CDM Ap Sk Sub Tr/le/ue Add 100sqcm 1 1 $2,060.00 $2,060.00 $1,812.80 $1,812.80 $1,812.80 2025-07-02
15241IH CDM Fu Th Autogr Fh/ch/ne Add 20sc 1 1 $2,060.00 $2,060.00 $1,812.80 $1,812.80 $1,812.80 2025-07-02
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