Hospital

YUKON KUSKOKWIM DELTA REG HOSPITAL

Bethel, AK · CCN 020018 · Rates published

4,939 distinct procedures filed

13 distinct payers

19,765 rate rows

2026-04-13 last MRF observed

Data quality

19,735 of 19,765 rate rows are consumer-grade (99.8%)

30 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	15
exceeds 3× this hospital's gross charge for a DRG stay — excluded	13
exceeds 10× this hospital's gross charge — excluded from medians	2

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

Source MRF file	https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbYKDRHBETHELAK&type=CDMWithoutLabel&fileType=CSV
Discovered via	Discovered by HANK
Last fetch	—
Content fingerprint	40a01e424946a3df… · 7,663,754 bytes · first seen 2026-05-13

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
949 MS_DRG	Aftercare With Cc/mcc	8	$15,325.10	$216,615.33	$189,538.41	nat. median $12,475 outlier · 15.2×
689 MS_DRG	Kidney And Urinary Tract Infections With Mcc	8	$14,946.38	$193,079.92	$168,944.92	nat. median $12,152 outlier · 13.9×
540 MS_DRG	Osteomyelitis With Cc	8	$9,174.74	$96,945.16	$84,827.01	nat. median $13,478 outlier · 6.3×
696 MS_DRG	Kidney And Urinary Tract Signs And Symptoms Without Mcc	8	$7,728.28	$77,666.48	$67,958.17	nat. median $7,850 outlier · 8.7×
922 MS_DRG	Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc	8	$22,534.86	$75,068.41	$65,684.86	nat. median $17,446 outlier · 3.8×
811 MS_DRG	Red Blood Cell Disorders With Mcc	8	$18,089.46	$73,195.43	$64,046.01	nat. median $14,380 outlier · 4.5×
917 MS_DRG	Poisoning And Toxic Effects Of Drugs With Mcc	8	$16,136.75	$69,337.72	$60,670.50	nat. median $15,271 outlier · 4.0×
884 MS_DRG	Organic Disturbances And Intellectual Disability	8	$18,980.97	$54,826.47	$47,973.16	nat. median $14,856 outlier · 3.2×
57 MS_DRG	Degenerative Nervous System Disorders Without Mcc	8	$14,423.98	$54,261.34	$47,478.68	nat. median $13,201 outlier · 3.6×
552 MS_DRG	Medical Back Problems Without Mcc	8	$11,684.27	$53,145.02	$46,501.89	nat. median $10,424 outlier · 4.5×
883 MS_DRG	Disorders Of Personality And Impulse Control	8	$5,793.21	$51,418.90	$44,991.54	nat. median $17,090 outlier · 2.6×
593 MS_DRG	Skin Ulcers With Cc	8	$14,450.61	$49,257.23	$43,100.08	nat. median $12,573 outlier · 3.4×
853 MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	8	$22,060.84	$63,616.48	$42,302.74	nat. median $48,170 0.9× median
964 MS_DRG	Other Multiple Significant Trauma With Cc	8	$19,742.16	$48,293.47	$42,256.79	nat. median $15,735 outlier · 2.7×
699 MS_DRG	Other Kidney And Urinary Tract Diagnoses With Cc	8	$7,183.87	$48,144.58	$42,126.51	nat. median $10,936 outlier · 3.9×
52 MS_DRG	Spinal Disorders And Injuries With Cc/mcc	8	$13,448.07	$40,646.30	$35,565.51	nat. median $19,132 1.9× median
551 MS_DRG	Medical Back Problems With Mcc	8	$7,525.89	$40,492.10	$35,430.59	nat. median $16,881 outlier · 2.1×
122 MS_DRG	Acute Major Eye Infections Without Cc/mcc	8	$6,006.37	$38,803.74	$33,953.28	nat. median $8,314 outlier · 4.1×
376 MS_DRG	Digestive Malignancy Without Cc/mcc	8	$5,507.87	$38,249.87	$33,468.62	nat. median $10,083 outlier · 3.3×
442 MS_DRG	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc	8	$12,434.49	$37,384.32	$32,711.28	nat. median $10,562 outlier · 3.1×
309 MS_DRG	Cardiac Arrhythmia And Conduction Disorders With Cc	8	$9,476.90	$37,159.95	$32,514.96	nat. median $8,437 outlier · 3.9×
154 MS_DRG	Other Ear, Nose, Mouth And Throat Diagnoses With Mcc	8	$14,734.63	$35,649.81	$31,193.58	nat. median $16,089 1.9× median
177 MS_DRG	Respiratory Infections And Inflammations With Mcc	8	$12,132.87	$34,686.77	$30,350.92	nat. median $16,235 1.9× median
281 MS_DRG	Acute Myocardial Infarction, Discharged Alive With Cc	8	$11,839.37	$34,596.14	$30,271.62	nat. median $10,382 outlier · 2.9×
371 MS_DRG	Major Gastrointestinal Disorders And Peritoneal Infections With Mcc	8	$8,858.67	$30,191.96	$26,417.97	nat. median $17,809 1.5× median
872 MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc	8	$11,858.95	$29,488.76	$25,802.67	nat. median $11,105 outlier · 2.3×
375 MS_DRG	Digestive Malignancy With Cc	8	$3,201.23	$28,457.68	$24,900.47	nat. median $12,916 1.9× median
918 MS_DRG	Poisoning And Toxic Effects Of Drugs Without Mcc	8	$6,461.11	$28,293.01	$24,756.39	nat. median $8,831 outlier · 2.8×
191 MS_DRG	Chronic Obstructive Pulmonary Disease With Cc	8	$10,859.09	$28,255.08	$24,723.19	nat. median $9,408 outlier · 2.6×
178 MS_DRG	Respiratory Infections And Inflammations With Cc	8	$7,041.51	$28,249.40	$24,718.22	nat. median $10,875 outlier · 2.3×
844 MS_DRG	Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…	8	$15,681.91	$28,157.65	$24,637.94	nat. median $12,712 1.9× median
196 MS_DRG	Interstitial Lung Disease With Mcc	8	$13,313.21	$27,644.45	$24,594.97	nat. median $18,723 1.3× median
291 MS_DRG	Heart Failure And Shock With Mcc	8	$11,766.87	$27,211.50	$23,810.06	nat. median $13,522 1.8× median
65 MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours	8	$8,667.46	$26,766.51	$23,420.69	nat. median $11,174 outlier · 2.1×
812 MS_DRG	Red Blood Cell Disorders Without Mcc	8	$7,376.37	$26,188.77	$22,915.17	nat. median $9,870 outlier · 2.3×
923 MS_DRG	Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc	8	$6,213.51	$26,181.89	$22,909.16	nat. median $10,772 outlier · 2.1×
896 MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc	8	$11,661.44	$25,809.16	$22,853.86	nat. median $16,145 1.4× median
190 MS_DRG	Chronic Obstructive Pulmonary Disease With Mcc	8	$11,982.73	$25,523.55	$22,333.10	nat. median $11,700 1.9× median
602 MS_DRG	Cellulitis With Mcc	8	$8,644.25	$25,134.22	$21,992.44	nat. median $14,838 1.5× median
146 MS_DRG	Ear, Nose, Mouth And Throat Malignancy With Mcc	8	$10,072.68	$27,275.25	$21,639.48	nat. median $21,758 1.0× median
315 MS_DRG	Other Circulatory System Diagnoses With Cc	8	$12,408.73	$24,270.15	$21,236.39	nat. median $10,515 outlier · 2.0×
433 MS_DRG	Cirrhosis And Alcoholic Hepatitis With Cc	8	$9,520.68	$24,233.79	$21,204.57	nat. median $11,437 1.9× median
394 MS_DRG	Other Digestive System Diagnoses With Cc	8	$7,319.24	$24,197.49	$21,172.81	nat. median $10,260 outlier · 2.1×
125 MS_DRG	Other Disorders Of The Eye Without Mcc	8	$7,310.39	$24,187.66	$21,164.20	nat. median $8,777 outlier · 2.4×
871 MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	8	$10,389.61	$25,022.27	$21,144.71	nat. median $19,635 1.1× median
684 MS_DRG	Renal Failure Without Cc/mcc	8	$7,732.75	$24,146.41	$21,128.10	nat. median $7,094 outlier · 3.0×
389 MS_DRG	Gastrointestinal Obstruction With Cc	8	$10,173.79	$24,059.43	$21,052.01	nat. median $8,897 outlier · 2.4×
640 MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…	8	$7,716.56	$23,835.70	$20,856.24	nat. median $13,400 1.6× median
596 MS_DRG	Major Skin Disorders Without Mcc	8	$5,497.52	$23,779.85	$20,807.37	nat. median $11,374 1.8× median
372 MS_DRG	Major Gastrointestinal Disorders And Peritoneal Infections With Cc	8	$8,583.47	$23,594.06	$20,644.81	nat. median $11,088 1.9× median

Other procedures at this hospital

Browse this hospital's 4,939 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

949	MS_DRG	Aftercare With Cc/mcc	8	8	$216,615.33	$216,615.33	$15,325.10	$216,615.33	$189,538.41	2026-04-13
689	MS_DRG	Kidney And Urinary Tract Infections With Mcc	8	8	$193,079.92	$193,079.92	$14,946.38	$193,079.92	$168,944.92	2026-04-13
540	MS_DRG	Osteomyelitis With Cc	8	8	$96,945.16	$96,945.16	$9,174.74	$96,945.16	$84,827.01	2026-04-13
696	MS_DRG	Kidney And Urinary Tract Signs And Symptoms Without Mcc	8	8	$77,666.48	$77,666.48	$7,728.28	$77,666.48	$67,958.17	2026-04-13
922	MS_DRG	Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc	8	8	$75,068.41	$75,068.41	$22,534.86	$75,068.41	$65,684.86	2026-04-13
811	MS_DRG	Red Blood Cell Disorders With Mcc	8	8	$73,195.43	$73,195.43	$18,089.46	$73,195.43	$64,046.01	2026-04-13
917	MS_DRG	Poisoning And Toxic Effects Of Drugs With Mcc	8	8	$69,337.72	$69,337.72	$16,136.75	$69,337.72	$60,670.50	2026-04-13
884	MS_DRG	Organic Disturbances And Intellectual Disability	8	8	$54,826.47	$54,826.47	$18,980.97	$54,826.47	$47,973.16	2026-04-13
57	MS_DRG	Degenerative Nervous System Disorders Without Mcc	8	8	$54,261.34	$54,261.34	$14,423.98	$54,261.34	$47,478.68	2026-04-13
552	MS_DRG	Medical Back Problems Without Mcc	8	8	$53,145.02	$53,145.02	$11,684.27	$53,145.02	$46,501.89	2026-04-13
883	MS_DRG	Disorders Of Personality And Impulse Control	8	8	$51,418.90	$51,418.90	$5,793.21	$51,418.90	$44,991.54	2026-04-13
593	MS_DRG	Skin Ulcers With Cc	8	8	$49,257.23	$49,257.23	$14,450.61	$49,257.23	$43,100.08	2026-04-13
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	8	8	$47,003.04	$47,003.04	$22,060.84	$63,616.48	$42,302.74	2026-04-13
964	MS_DRG	Other Multiple Significant Trauma With Cc	8	8	$48,293.47	$48,293.47	$19,742.16	$48,293.47	$42,256.79	2026-04-13
699	MS_DRG	Other Kidney And Urinary Tract Diagnoses With Cc	8	8	$48,144.58	$48,144.58	$7,183.87	$48,144.58	$42,126.51	2026-04-13
52	MS_DRG	Spinal Disorders And Injuries With Cc/mcc	8	8	$40,646.30	$40,646.30	$13,448.07	$40,646.30	$35,565.51	2026-04-13
551	MS_DRG	Medical Back Problems With Mcc	8	8	$40,492.10	$40,492.10	$7,525.89	$40,492.10	$35,430.59	2026-04-13
122	MS_DRG	Acute Major Eye Infections Without Cc/mcc	8	8	$38,803.74	$38,803.74	$6,006.37	$38,803.74	$33,953.28	2026-04-13
376	MS_DRG	Digestive Malignancy Without Cc/mcc	8	8	$38,249.87	$38,249.87	$5,507.87	$38,249.87	$33,468.62	2026-04-13
442	MS_DRG	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc	8	8	$37,384.32	$37,384.32	$12,434.49	$37,384.32	$32,711.28	2026-04-13
309	MS_DRG	Cardiac Arrhythmia And Conduction Disorders With Cc	8	8	$37,159.95	$37,159.95	$9,476.90	$37,159.95	$32,514.96	2026-04-13
154	MS_DRG	Other Ear, Nose, Mouth And Throat Diagnoses With Mcc	8	8	$35,649.81	$35,649.81	$14,734.63	$35,649.81	$31,193.58	2026-04-13
177	MS_DRG	Respiratory Infections And Inflammations With Mcc	8	8	$34,686.77	$34,686.77	$12,132.87	$34,686.77	$30,350.92	2026-04-13
281	MS_DRG	Acute Myocardial Infarction, Discharged Alive With Cc	8	8	$34,596.14	$34,596.14	$11,839.37	$34,596.14	$30,271.62	2026-04-13
371	MS_DRG	Major Gastrointestinal Disorders And Peritoneal Infections With Mcc	8	8	$30,191.96	$30,191.96	$8,858.67	$30,191.96	$26,417.97	2026-04-13
872	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc	8	8	$29,488.76	$29,488.76	$11,858.95	$29,488.76	$25,802.67	2026-04-13
375	MS_DRG	Digestive Malignancy With Cc	8	8	$28,457.68	$28,457.68	$3,201.23	$28,457.68	$24,900.47	2026-04-13
918	MS_DRG	Poisoning And Toxic Effects Of Drugs Without Mcc	8	8	$28,293.01	$28,293.01	$6,461.11	$28,293.01	$24,756.39	2026-04-13
191	MS_DRG	Chronic Obstructive Pulmonary Disease With Cc	8	8	$28,255.08	$28,255.08	$10,859.09	$28,255.08	$24,723.19	2026-04-13
178	MS_DRG	Respiratory Infections And Inflammations With Cc	8	8	$28,249.40	$28,249.40	$7,041.51	$28,249.40	$24,718.22	2026-04-13
844	MS_DRG	Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…	8	8	$28,157.65	$28,157.65	$15,681.91	$28,157.65	$24,637.94	2026-04-13
196	MS_DRG	Interstitial Lung Disease With Mcc	8	8	$27,644.45	$27,644.45	$13,313.21	$27,644.45	$24,594.97	2026-04-13
291	MS_DRG	Heart Failure And Shock With Mcc	8	8	$27,211.50	$27,211.50	$11,766.87	$27,211.50	$23,810.06	2026-04-13
65	MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours	8	8	$26,766.51	$26,766.51	$8,667.46	$26,766.51	$23,420.69	2026-04-13
812	MS_DRG	Red Blood Cell Disorders Without Mcc	8	8	$26,188.77	$26,188.77	$7,376.37	$26,188.77	$22,915.17	2026-04-13
923	MS_DRG	Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc	8	8	$26,181.89	$26,181.89	$6,213.51	$26,181.89	$22,909.16	2026-04-13
896	MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc	8	8	$25,809.16	$25,809.16	$11,661.44	$25,809.16	$22,853.86	2026-04-13
190	MS_DRG	Chronic Obstructive Pulmonary Disease With Mcc	8	8	$25,523.55	$25,523.55	$11,982.73	$25,523.55	$22,333.10	2026-04-13
602	MS_DRG	Cellulitis With Mcc	8	8	$25,134.22	$25,134.22	$8,644.25	$25,134.22	$21,992.44	2026-04-13
146	MS_DRG	Ear, Nose, Mouth And Throat Malignancy With Mcc	8	8	$24,043.87	$24,043.87	$10,072.68	$27,275.25	$21,639.48	2026-04-13
315	MS_DRG	Other Circulatory System Diagnoses With Cc	8	8	$24,270.15	$24,270.15	$12,408.73	$24,270.15	$21,236.39	2026-04-13
433	MS_DRG	Cirrhosis And Alcoholic Hepatitis With Cc	8	8	$24,233.79	$24,233.79	$9,520.68	$24,233.79	$21,204.57	2026-04-13
394	MS_DRG	Other Digestive System Diagnoses With Cc	8	8	$24,197.49	$24,197.49	$7,319.24	$24,197.49	$21,172.81	2026-04-13
125	MS_DRG	Other Disorders Of The Eye Without Mcc	8	8	$24,187.66	$24,187.66	$7,310.39	$24,187.66	$21,164.20	2026-04-13
871	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	8	8	$23,494.12	$23,494.12	$10,389.61	$25,022.27	$21,144.71	2026-04-13
684	MS_DRG	Renal Failure Without Cc/mcc	8	8	$24,146.41	$24,146.41	$7,732.75	$24,146.41	$21,128.10	2026-04-13
389	MS_DRG	Gastrointestinal Obstruction With Cc	8	8	$24,059.43	$24,059.43	$10,173.79	$24,059.43	$21,052.01	2026-04-13
640	MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…	8	8	$23,835.70	$23,835.70	$7,716.56	$23,835.70	$20,856.24	2026-04-13
596	MS_DRG	Major Skin Disorders Without Mcc	8	8	$23,779.85	$23,779.85	$5,497.52	$23,779.85	$20,807.37	2026-04-13
372	MS_DRG	Major Gastrointestinal Disorders And Peritoneal Infections With Cc	8	8	$23,594.06	$23,594.06	$8,583.47	$23,594.06	$20,644.81	2026-04-13
373	MS_DRG	Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc	8	8	$23,429.02	$23,429.02	$5,181.76	$23,429.02	$20,500.39	2026-04-13
184	MS_DRG	Major Chest Trauma With Cc	8	8	$23,301.02	$23,301.02	$12,295.81	$23,301.02	$20,388.39	2026-04-13
544	MS_DRG	Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…	8	8	$23,250.00	$23,250.00	$6,466.50	$23,250.00	$20,343.75	2026-04-13
563	MS_DRG	Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…	8	8	$23,206.67	$23,206.67	$8,355.31	$23,206.67	$20,305.84	2026-04-13
832	MS_DRG	Other Antepartum Diagnoses Without O.r. Procedures With Cc	8	8	$23,037.38	$23,037.38	$4,829.29	$23,037.38	$20,157.71	2026-04-13
683	MS_DRG	Renal Failure With Cc	8	8	$22,959.24	$22,959.24	$9,819.44	$22,959.24	$20,089.33	2026-04-13
867	MS_DRG	Other Infectious And Parasitic Diseases Diagnoses With Mcc	8	8	$22,136.12	$22,136.12	$5,464.01	$26,963.51	$19,922.51	2026-04-13
199	MS_DRG	Pneumothorax With Mcc	8	8	$21,878.92	$21,878.92	$13,907.63	$22,724.22	$19,691.03	2026-04-13
698	MS_DRG	Other Kidney And Urinary Tract Diagnoses With Mcc	8	8	$21,801.65	$21,801.65	$5,162.99	$21,801.65	$19,621.49	2026-04-13
536	MS_DRG	Fractures Of Hip And Pelvis Without Mcc	8	8	$22,051.56	$22,051.56	$6,351.80	$22,051.56	$19,295.11	2026-04-13
550	MS_DRG	Septic Arthritis Without Cc/mcc	8	8	$21,921.99	$21,921.99	$5,271.29	$21,921.99	$19,181.74	2026-04-13
205	MS_DRG	Other Respiratory System Diagnoses With Mcc	8	8	$21,172.38	$21,172.38	$7,488.34	$23,585.99	$19,055.14	2026-04-13
690	MS_DRG	Kidney And Urinary Tract Infections Without Mcc	8	8	$21,679.84	$21,679.84	$8,373.46	$21,679.84	$18,969.86	2026-04-13
561	MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc	8	8	$21,367.08	$21,367.08	$10,355.42	$21,367.08	$18,696.19	2026-04-13
600	MS_DRG	Non-malignant Breast Disorders With Cc/mcc	8	8	$21,185.99	$21,185.99	$4,608.89	$21,185.99	$18,537.74	2026-04-13
885	MS_DRG	Psychoses	8	8	$21,010.08	$21,010.08	$3,156.19	$21,010.08	$18,450.96	2026-04-13
558	MS_DRG	Tendonitis, Myositis And Bursitis Without Mcc	8	8	$20,788.63	$20,788.63	$6,661.02	$20,788.63	$18,190.06	2026-04-13
897	MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc	8	8	$20,473.33	$20,473.33	$4,401.26	$20,473.33	$17,914.17	2026-04-13
179	MS_DRG	Respiratory Infections And Inflammations Without Cc/mcc	8	8	$20,080.06	$20,080.06	$2,580.81	$20,080.06	$17,570.06	2026-04-13
914	MS_DRG	Traumatic Injury Without Mcc	8	8	$19,774.87	$19,774.87	$3,461.94	$19,774.87	$17,303.01	2026-04-13
200	MS_DRG	Pneumothorax With Cc	8	8	$19,506.78	$19,506.78	$7,435.15	$19,506.78	$17,068.43	2026-04-13
440	MS_DRG	Disorders Of Pancreas Except Malignancy Without Cc/mcc	8	8	$19,502.84	$19,502.84	$7,142.44	$19,502.84	$17,064.99	2026-04-13
868	MS_DRG	Other Infectious And Parasitic Diseases Diagnoses With Cc	8	8	$19,482.53	$19,482.53	$5,967.48	$19,482.53	$17,047.22	2026-04-13
603	MS_DRG	Cellulitis Without Mcc	8	8	$19,293.59	$19,293.59	$5,881.25	$19,293.59	$16,881.89	2026-04-13
158	MS_DRG	Dental And Oral Diseases With Cc	8	8	$19,109.71	$19,109.71	$4,909.01	$19,109.71	$16,721.00	2026-04-13
887	MS_DRG	Other Mental Disorder Diagnoses	8	8	$18,659.07	$18,659.07	$2,334.66	$18,659.07	$16,326.68	2026-04-13
940	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc	8	8	$17,764.35	$17,764.35	$2,975.27	$30,102.73	$15,987.92	2026-04-13
192	MS_DRG	Chronic Obstructive Pulmonary Disease Without Cc/mcc	8	8	$18,252.45	$18,252.45	$5,824.30	$18,252.45	$15,970.89	2026-04-13
594	MS_DRG	Skin Ulcers Without Cc/mcc	8	8	$18,125.35	$18,125.35	$4,746.02	$18,125.35	$15,859.68	2026-04-13
138	MS_DRG	Mouth Procedures Without Cc/mcc	8	8	$17,983.57	$17,983.57	$7,510.11	$17,983.57	$15,735.62	2026-04-13
378	MS_DRG	Gastrointestinal Hemorrhage With Cc	8	8	$17,871.24	$17,871.24	$7,409.01	$17,871.24	$15,637.33	2026-04-13
121	MS_DRG	Acute Major Eye Infections With Cc/mcc	8	8	$17,724.42	$17,724.42	$4,385.18	$17,724.42	$15,508.87	2026-04-13
604	MS_DRG	Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc	8	8	$17,021.59	$17,021.59	$6,644.33	$18,962.83	$15,319.43	2026-04-13
769	MS_DRG	Postpartum And Post Abortion Diagnoses With O.r. Procedures	8	8	$16,995.86	$16,995.86	$6,621.18	$21,767.12	$15,296.28	2026-04-13
87	MS_DRG	Traumatic Stupor And Coma <1 Hour Without Cc/mcc	8	8	$17,444.78	$17,444.78	$4,133.50	$17,444.78	$15,264.18	2026-04-13
159	MS_DRG	Dental And Oral Diseases Without Cc/mcc	8	8	$17,159.40	$17,159.40	$3,876.66	$17,159.40	$15,014.47	2026-04-13
886	MS_DRG	Behavioral And Developmental Disorders	8	8	$16,461.83	$16,461.83	$1,803.00	$26,732.94	$14,815.65	2026-04-13
4366415_1	CDM	Entyvio 300 Mg Vial	3	3	$16,301.65	$16,301.65	$13,041.32	$14,671.49	$14,671.49	2026-04-13
880	MS_DRG	Acute Adjustment Reaction And Psychosocial Dysfunction	8	8	$16,666.82	$16,666.82	$2,733.73	$16,666.82	$14,583.46	2026-04-13
193	MS_DRG	Simple Pneumonia And Pleurisy With Mcc	8	8	$16,097.01	$16,097.01	$4,944.70	$16,931.42	$14,487.31	2026-04-13
638	MS_DRG	Diabetes With Cc	8	8	$16,167.77	$16,167.77	$5,875.89	$16,167.77	$14,146.80	2026-04-13
439	MS_DRG	Disorders Of Pancreas Except Malignancy With Cc	8	8	$16,159.67	$16,159.67	$4,904.70	$16,159.67	$14,139.71	2026-04-13
4480583_1	CDM	Tnkase 50 Mg Kit	3	3	$15,671.55	$15,671.55	$12,537.24	$14,104.40	$14,104.40	2026-04-13
293	MS_DRG	Heart Failure And Shock Without Cc/mcc	8	8	$16,015.07	$16,015.07	$7,290.92	$16,015.07	$14,013.18	2026-04-13
194	MS_DRG	Simple Pneumonia And Pleurisy With Cc	8	8	$15,545.32	$15,545.32	$4,841.64	$15,545.32	$13,602.16	2026-04-13
881	MS_DRG	Depressive Neuroses	8	8	$15,526.35	$15,526.35	$1,683.99	$15,526.35	$13,585.56	2026-04-13
310	MS_DRG	Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc	8	8	$15,196.92	$15,196.92	$6,447.98	$15,196.92	$13,297.31	2026-04-13
66	MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc	8	8	$15,071.30	$15,071.30	$7,780.77	$15,071.30	$13,187.39	2026-04-13
796	MS_DRG	Vaginal Delivery With Sterilization And/or D&c With Mcc	8	8	$14,509.47	$14,509.47	$5,829.27	$15,032.69	$13,058.52	2026-04-13
920	MS_DRG	Complications Of Treatment With Cc	8	8	$14,658.30	$14,658.30	$4,517.37	$14,658.30	$13,051.79	2026-04-13
797	MS_DRG	Vaginal Delivery With Sterilization And/or D&c With Cc	8	8	$14,529.46	$14,529.46	$6,136.43	$14,529.46	$12,981.57	2026-04-13
392	MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc	8	8	$14,451.91	$14,451.91	$4,476.20	$14,451.91	$12,645.42	2026-04-13
292	MS_DRG	Heart Failure And Shock With Cc	8	8	$14,280.75	$14,280.75	$4,659.53	$14,280.75	$12,495.66	2026-04-13
727	MS_DRG	Inflammation Of The Male Reproductive System With Mcc	8	8	$13,883.38	$13,883.38	$3,819.94	$19,101.95	$12,495.04	2026-04-13
816	MS_DRG	Reticuloendothelial And Immunity Disorders Without Cc/mcc	8	8	$14,105.72	$14,105.72	$2,863.37	$14,105.72	$12,342.51	2026-04-13
152	MS_DRG	Otitis Media And Uri With Mcc	8	8	$13,512.00	$13,512.00	$6,377.40	$15,228.49	$12,160.80	2026-04-13
379	MS_DRG	Gastrointestinal Hemorrhage Without Cc/mcc	8	8	$13,880.32	$13,880.32	$3,817.19	$13,880.32	$12,145.28	2026-04-13
186	MS_DRG	Pleural Effusion With Mcc	8	8	$13,397.45	$13,397.45	$3,382.61	$20,075.79	$12,057.71	2026-04-13
787	MS_DRG	Cesarean Section Without Sterilization With Cc	8	8	$13,397.07	$13,397.07	$4,828.11	$14,386.04	$12,057.36	2026-04-13
815	MS_DRG	Reticuloendothelial And Immunity Disorders With Cc	8	8	$13,298.15	$13,298.15	$1,847.39	$13,298.15	$11,968.34	2026-04-13
639	MS_DRG	Diabetes Without Cc/mcc	8	8	$13,620.00	$13,620.00	$6,474.60	$13,620.00	$11,917.50	2026-04-13
776	MS_DRG	Postpartum And Post Abortion Diagnoses Without O.r. Procedures	8	8	$13,565.67	$13,565.67	$4,360.20	$13,565.67	$11,869.96	2026-04-13
882	MS_DRG	Neuroses Except Depressive	8	8	$13,122.62	$13,122.62	$2,171.36	$13,832.13	$11,810.36	2026-04-13
746	MS_DRG	Vagina, Cervix And Vulva Procedures With Cc/mcc	8	8	$12,906.22	$12,906.22	$2,940.50	$22,376.42	$11,615.60	2026-04-13
304	MS_DRG	Hypertension With Mcc	8	8	$12,863.04	$12,863.04	$2,901.64	$15,328.96	$11,576.74	2026-04-13
J2997	HCPCS	Injection, Alteplase Recombinant, 1 Mg	3	3	$12,832.65	$12,832.65	$10,266.12	$11,549.39	$11,549.39	2026-04-13
202	MS_DRG	Bronchitis And Asthma With Cc/mcc	8	8	$12,754.25	$12,754.25	$2,601.98	$12,754.25	$11,478.82	2026-04-13
788	MS_DRG	Cesarean Section Without Sterilization Without Cc/mcc	8	8	$12,464.07	$12,464.07	$3,988.41	$12,464.07	$11,217.66	2026-04-13
641	MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…	8	8	$12,668.20	$12,668.20	$2,833.38	$12,668.20	$11,084.67	2026-04-13
607	MS_DRG	Minor Skin Disorders Without Mcc	8	8	$12,291.82	$12,291.82	$2,965.88	$12,291.82	$11,062.64	2026-04-13
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	7	7	$12,191.60	$12,191.60	$2,297.34	$12,191.60	$10,972.44	2026-04-13
554	MS_DRG	Bone Diseases And Arthropathies Without Mcc	8	8	$12,277.04	$12,277.04	$3,820.08	$12,277.04	$10,871.12	2026-04-13
768	MS_DRG	Vaginal Delivery With O.r. Procedures Except Sterilization And/or D&c	8	8	$11,619.52	$11,619.52	$4,288.61	$13,803.79	$10,457.57	2026-04-13
185	MS_DRG	Major Chest Trauma Without Cc/mcc	8	8	$11,904.00	$11,904.00	$2,038.50	$11,904.00	$10,422.44	2026-04-13
831	MS_DRG	Other Antepartum Diagnoses Without O.r. Procedures With Mcc	8	8	$11,475.05	$11,475.05	$3,459.75	$15,489.98	$10,327.54	2026-04-13
758	MS_DRG	Infections, Female Reproductive System With Cc	8	8	$11,395.60	$11,395.60	$1,580.94	$12,610.97	$10,256.04	2026-04-13
195	MS_DRG	Simple Pneumonia And Pleurisy Without Cc/mcc	8	8	$11,627.64	$11,627.64	$3,741.67	$11,627.64	$10,174.18	2026-04-13
805	MS_DRG	Vaginal Delivery Without Sterilization Or D&c With Mcc	8	8	$11,262.50	$11,262.50	$4,200.65	$13,901.69	$10,136.25	2026-04-13
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	7	7	$10,970.00	$10,970.00	$1,197.90	$10,970.00	$9,873.00	2026-04-13
149	MS_DRG	Dysequilibrium	8	8	$11,133.50	$11,133.50	$1,345.05	$11,133.50	$9,850.93	2026-04-13
204	MS_DRG	Respiratory Signs And Symptoms	8	8	$10,943.77	$10,943.77	$4,065.99	$10,943.77	$9,849.39	2026-04-13
390	MS_DRG	Gastrointestinal Obstruction Without Cc/mcc	8	8	$11,046.26	$11,046.26	$3,435.30	$11,046.26	$9,665.47	2026-04-13
786	MS_DRG	Cesarean Section Without Sterilization With Mcc	8	8	$10,713.75	$10,713.75	$4,822.87	$21,248.00	$9,642.37	2026-04-13
153	MS_DRG	Otitis Media And Uri Without Mcc	8	8	$10,721.68	$10,721.68	$2,902.22	$10,721.68	$9,579.32	2026-04-13
728	MS_DRG	Inflammation Of The Male Reproductive System Without Mcc	8	8	$10,518.75	$10,518.75	$3,683.48	$10,518.75	$9,466.88	2026-04-13
290	MS_DRG	Acute And Subacute Endocarditis Without Cc/mcc	8	8	$10,408.96	$10,408.96	$3,584.66	$11,975.91	$9,368.06	2026-04-13
785	MS_DRG	Cesarean Section With Sterilization Without Cc/mcc	8	8	$9,995.07	$9,995.07	$3,212.16	$12,337.88	$8,995.56	2026-04-13
201	MS_DRG	Pneumothorax Without Cc/mcc	8	8	$9,734.04	$9,734.04	$2,977.24	$9,734.04	$8,760.64	2026-04-13
807	MS_DRG	Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc	8	8	$9,662.69	$9,662.69	$3,491.36	$9,662.69	$8,690.56	2026-04-13
605	MS_DRG	Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc	8	8	$9,530.03	$9,530.03	$3,516.55	$11,799.44	$8,577.02	2026-04-13
913	MS_DRG	Traumatic Injury With Mcc	8	8	$9,521.00	$9,521.00	$2,785.50	$21,056.07	$8,568.90	2026-04-13
203	MS_DRG	Bronchitis And Asthma Without Cc/mcc	8	8	$9,466.16	$9,466.16	$2,639.76	$9,466.16	$8,519.55	2026-04-13
806	MS_DRG	Vaginal Delivery Without Sterilization Or D&c With Cc	8	8	$9,407.51	$9,407.51	$3,559.63	$9,712.64	$8,466.76	2026-04-13
101	MS_DRG	Seizures Without Mcc	8	8	$9,403.63	$9,403.63	$4,125.72	$11,626.82	$8,463.27	2026-04-13
864	MS_DRG	Fever And Inflammatory Conditions	8	8	$9,029.34	$9,029.34	$1,981.54	$11,434.89	$8,126.40	2026-04-13
391	MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc	8	8	$8,993.86	$8,993.86	$2,311.07	$16,337.58	$8,094.47	2026-04-13
156	MS_DRG	Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/mcc	8	8	$8,947.07	$8,947.07	$2,268.96	$8,947.07	$8,052.36	2026-04-13
779	MS_DRG	Abortion Without D&c	8	8	$8,926.60	$8,926.60	$3,696.39	$9,185.78	$8,033.94	2026-04-13
798	MS_DRG	Vaginal Delivery With Sterilization And/or D&c Without Cc/mcc	8	8	$8,922.15	$8,922.15	$3,692.38	$12,328.86	$8,029.93	2026-04-13
381	MS_DRG	Complicated Peptic Ulcer With Cc	8	8	$8,906.25	$8,906.25	$2,232.23	$13,957.08	$8,015.63	2026-04-13
100	MS_DRG	Seizures With Mcc	8	8	$8,894.30	$8,894.30	$2,221.47	$24,948.85	$8,004.87	2026-04-13
393	MS_DRG	Other Digestive System Diagnoses With Mcc	8	8	$8,235.10	$8,235.10	$1,628.19	$20,601.35	$7,411.59	2026-04-13
833	MS_DRG	Other Antepartum Diagnoses Without O.r. Procedures Without Cc/mcc	8	8	$8,291.69	$8,291.69	$2,643.02	$8,291.69	$7,255.23	2026-04-13
998	MS_DRG	Principal Diagnosis Invalid As Discharge Diagnosis	7	7	$7,903.45	$7,903.45	$2,775.55	$7,903.45	$7,113.10	2026-04-13
982	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	7	7	$7,752.10	$7,752.10	$1,193.49	$7,752.10	$6,976.89	2026-04-13
601	MS_DRG	Non-malignant Breast Disorders Without Cc/mcc	8	8	$7,729.60	$7,729.60	$1,173.24	$7,793.30	$6,956.64	2026-04-13
950	MS_DRG	Aftercare Without Cc/mcc	8	8	$7,625.60	$7,625.60	$1,079.64	$8,085.71	$6,863.04	2026-04-13
86	MS_DRG	Traumatic Stupor And Coma <1 Hour With Cc	8	8	$7,573.60	$7,573.60	$1,032.84	$16,780.70	$6,816.24	2026-04-13
189	MS_DRG	Pulmonary Edema And Respiratory Failure	8	8	$7,538.80	$7,538.80	$3,893.22	$15,913.78	$6,784.92	2026-04-13
682	MS_DRG	Renal Failure With Mcc	8	8	$7,517.40	$7,517.40	$982.26	$19,077.47	$6,765.66	2026-04-13
313	MS_DRG	Chest Pain	8	8	$7,461.65	$7,461.65	$3,823.79	$9,274.67	$6,715.49	2026-04-13
4328420_1	CDM	Invega Sustenna 234 Mg/1.5 Ml	3	3	$6,739.30	$6,739.30	$5,391.44	$6,065.37	$6,065.37	2026-04-13
791	MS_DRG	Prematurity With Major Problems	7	7	$6,717.93	$6,717.93	$5,323.21	$6,717.93	$6,046.14	2026-04-13
206	MS_DRG	Other Respiratory System Diagnoses Without Mcc	8	8	$6,707.10	$6,707.10	$3,144.69	$12,122.76	$6,036.39	2026-04-13
793	MS_DRG	Full Term Neonate With Major Problems	7	7	$6,663.60	$6,663.60	$4,712.04	$6,663.60	$5,997.24	2026-04-13
792	MS_DRG	Prematurity Without Major Problems	7	7	$6,523.01	$6,523.01	$5,218.40	$6,523.01	$5,870.70	2026-04-13
155	MS_DRG	Other Ear, Nose, Mouth And Throat Diagnoses With Cc	8	8	$6,202.44	$6,202.44	$1,244.65	$11,805.88	$5,582.20	2026-04-13
951	MS_DRG	Other Factors Influencing Health Status	8	8	$6,193.84	$6,193.84	$1,236.90	$7,162.10	$5,574.45	2026-04-13
4596413_1	CDM	Nplate 500 Mcg Vial	3	3	$5,872.14	$5,872.14	$4,697.71	$5,284.93	$5,284.93	2026-04-13
560	MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue With Cc	8	8	$5,602.80	$5,602.80	$2,150.82	$14,505.83	$5,042.52	2026-04-13
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	7	7	$5,594.83	$5,594.83	$4,475.86	$5,594.83	$5,035.35	2026-04-13
432	MS_DRG	Cirrhosis And Alcoholic Hepatitis With Mcc	7	7	$5,420.10	$5,420.10	$1,986.39	$5,420.10	$4,878.09	2026-04-13
556	MS_DRG	Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc	8	8	$5,101.80	$5,101.80	$1,699.92	$10,699.36	$4,591.62	2026-04-13
85	MS_DRG	Traumatic Stupor And Coma <1 Hour With Mcc	7	7	$5,093.45	$5,093.45	$1,692.41	$5,093.45	$4,584.11	2026-04-13
395	MS_DRG	Other Digestive System Diagnoses Without Cc/mcc	8	8	$5,030.27	$5,030.27	$1,635.54	$8,360.08	$4,527.24	2026-04-13
94002	HCPCS	Initial Hospital Inpatient Or Observation Ventilation Assistance And Management	4	4	$5,141.60	$5,141.60	$117.24	$4,627.44	$4,370.36	2026-04-13
549	MS_DRG	Septic Arthritis With Cc	7	7	$4,597.70	$4,597.70	$1,246.23	$4,597.70	$4,137.93	2026-04-13
794	MS_DRG	Neonate With Other Significant Problems	7	7	$4,499.22	$4,499.22	$3,599.38	$4,499.22	$4,049.30	2026-04-13
80	MS_DRG	Nontraumatic Stupor And Coma With Mcc	7	7	$4,396.20	$4,396.20	$1,064.88	$4,396.20	$3,956.58	2026-04-13
916	MS_DRG	Allergic Reactions Without Mcc	8	8	$4,177.10	$4,177.10	$867.69	$8,582.93	$3,759.39	2026-04-13
74177	HCPCS	CT Scan Of Abdomen And Pelvis With Contrast	8	4	$4,410.90	$4,410.90	$113.11	$4,175.28	$3,737.85	2026-04-13
92	MS_DRG	Other Disorders Of Nervous System With Cc	7	7	$4,153.13	$4,153.13	$846.12	$4,153.13	$3,737.82	2026-04-13
69	MS_DRG	Transient Ischemia Without Thrombolytic	8	8	$4,102.82	$4,102.82	$800.84	$10,289.73	$3,692.54	2026-04-13
795	MS_DRG	Normal Newborn	8	8	$4,124.28	$4,124.28	$2,573.72	$4,124.28	$3,663.92	2026-04-13
297	MS_DRG	Cardiac Arrest, Unexplained With Cc	8	8	$3,973.90	$3,973.90	$684.81	$8,031.60	$3,576.51	2026-04-13
99	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis Without Cc/mcc	7	7	$3,960.00	$3,960.00	$672.30	$3,960.00	$3,564.00	2026-04-13
93	MS_DRG	Other Disorders Of Nervous System Without Cc/mcc	8	8	$3,918.90	$3,918.90	$635.31	$10,257.52	$3,527.01	2026-04-13
198	MS_DRG	Interstitial Lung Disease Without Cc/mcc	8	8	$3,913.90	$3,913.90	$630.81	$9,225.72	$3,522.51	2026-04-13
74176	HCPCS	CT Scan Of Abdomen And Pelvis Without Contrast	12	8	$4,015.50	$4,015.50	$108.17	$4,015.50	$3,352.82	2026-04-13
74175	HCPCS	CT Scan Of Blood Vessels Of Abdomen With Contrast	8	4	$3,908.05	$3,908.05	$112.40	$3,700.62	$3,311.65	2026-04-13
4596412_1	CDM	Nplate 250 Mcg Vial	3	3	$3,670.80	$3,670.80	$2,936.64	$3,303.72	$3,303.72	2026-04-13
4120336_1	CDM	Sublocade 300 Mg/1.5 Ml Syring	3	3	$3,478.05	$3,478.05	$2,782.44	$3,130.25	$3,130.25	2026-04-13
4120335_1	CDM	Sublocade 100 Mg/0.5 Ml Syring	3	3	$3,478.05	$3,478.05	$2,782.44	$3,130.25	$3,130.25	2026-04-13
70498	HCPCS	CT Scan Of Blood Vessels Of Neck With Contrast	12	8	$3,727.00	$3,727.00	$108.67	$3,727.00	$3,074.77	2026-04-13
70496	HCPCS	CT Scan Of Blood Vessels Of Head With Contrast	11	4	$3,842.20	$3,842.20	$108.67	$3,457.98	$3,073.76	2026-04-13
1368139_1	CDM	Room/bed: Swing Bed	3	3	$3,213.21	$3,213.21	$2,570.57	$2,891.89	$2,891.89	2026-04-13
74170	HCPCS	CT Scan Of Abdomen Before And After Contrast	8	4	$3,202.55	$3,202.55	$87.00	$3,032.55	$2,713.82	2026-04-13
75574	HCPCS	CT Scan Of Blood Vessels And Grafts Of Heart With Contrast	4	4	$3,064.30	$3,064.30	$149.68	$2,757.87	$2,604.65	2026-04-13
73202	HCPCS	CT Scan Of Arm Before And After Contrast	12	4	$3,036.70	$3,036.70	$75.49	$2,733.03	$2,581.20	2026-04-13
3928334_1	CDM	Prolia 60 Mg/ml Syringe	3	3	$2,843.10	$2,843.10	$2,274.48	$2,558.79	$2,558.79	2026-04-13
J2315	HCPCS	Injection, Naltrexone, Depot Form, 1 Mg	3	3	$2,772.00	$2,772.00	$2,217.60	$2,494.80	$2,494.80	2026-04-13
1333553_1	CDM	BiPAP/CPAP Mode	3	3	$2,734.10	$2,734.10	$2,187.28	$2,460.69	$2,460.69	2026-04-13
785844_1	CDM	Aerosol Treatment Route	3	3	$2,734.10	$2,734.10	$2,187.28	$2,460.69	$2,460.69	2026-04-13
74160	HCPCS	CT Scan Of Abdomen With Contrast	12	8	$2,805.70	$2,805.70	$79.07	$2,805.70	$2,332.14	2026-04-13
94644	HCPCS	Inhalation Treatment For Acute Airway Obstruction, First Hour	4	4	$2,734.10	$2,734.10	$66.18	$2,460.69	$2,323.99	2026-04-13
94660	HCPCS	Therapy Procedure Using A Positive Pressure Ventilator	4	4	$2,734.10	$2,734.10	$44.23	$2,460.69	$2,323.99	2026-04-13
94003	HCPCS	Follow-up Inpatient Or Observation Ventilation Assistance And Management	4	4	$2,640.10	$2,640.10	$80.81	$2,376.09	$2,244.09	2026-04-13
72128	HCPCS	CT Scan Of Middle Spine Without Contrast	4	4	$2,482.90	$2,482.90	$62.65	$2,234.61	$2,110.47	2026-04-13
70492	HCPCS	CT Scan Of Soft Tissue Of Neck Before And After Contrast	8	4	$3,000.45	$3,000.45	$100.20	$3,326.49	$2,074.32	2026-04-13
73701	HCPCS	CT Scan Of Leg With Contrast Material	12	4	$2,498.90	$2,498.90	$72.13	$2,249.01	$2,012.64	2026-04-13
70486	HCPCS	CT Scan Of Face Without Contrast	20	4	$2,401.10	$2,401.10	$53.53	$2,160.99	$1,920.88	2026-04-13
73201	HCPCS	CT Scan Of Arm With Contrast	12	4	$2,214.90	$2,214.90	$72.13	$1,993.41	$1,882.66	2026-04-13
74150	HCPCS	CT Scan Of Abdomen Without Contrast	8	4	$2,221.00	$2,221.00	$73.99	$2,097.81	$1,882.36	2026-04-13
789	MS_DRG	Neonates, Died Or Transferred To Another Acute Care Facility	7	7	$1,945.20	$1,945.20	$1,556.16	$1,945.20	$1,750.68	2026-04-13
81420	HCPCS	Test For Detecting Genes Associated With Fetal Disease, Aneuploidy Genomic Seque…	4	4	$1,897.63	$1,897.63	$759.05	$1,707.87	$1,612.98	2026-04-13
73200	HCPCS	CT Scan Of Arm Without Contrast	15	4	$1,961.30	$1,961.30	$62.65	$1,776.96	$1,579.52	2026-04-13
J1950	HCPCS	Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg	6	3	$1,922.56	$1,922.56	$550.62	$2,841.17	$1,572.47	2026-04-13
72082	HCPCS	X-ray Of Entire Middle And Lower Spine, 2-3 Views	4	4	$1,768.70	$1,768.70	$20.02	$1,591.83	$1,503.39	2026-04-13
71270	HCPCS	CT Scan Of Chest Before And After Contrast	8	4	$2,448.20	$2,448.20	$77.71	$2,903.49	$1,503.27	2026-04-13
P9035	HCPCS	Platelets, Pheresis, Leukocytes Reduced, Each Unit	3	3	$1,657.40	$1,657.40	$1,325.92	$1,491.66	$1,491.66	2026-04-13
93970	HCPCS	Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers	8	4	$1,738.10	$1,738.10	$43.00	$1,645.83	$1,472.86	2026-04-13
74178	HCPCS	CT Scan Of Abdomen And Pelvis Before And After Contrast	11	4	$1,786.30	$1,786.30	$125.31	$5,058.27	$1,448.37	2026-04-13
72194	HCPCS	CT Scan Of Pelvis Before And After Contrast	8	4	$1,687.40	$1,687.40	$75.85	$1,567.80	$1,431.56	2026-04-13
70470	HCPCS	CT Scan Of Head Or Brain Before And After Contrast	8	4	$2,438.20	$2,438.20	$79.07	$2,987.55	$1,401.21	2026-04-13
70482	HCPCS	CT Scan Of Cranial Cavity Before And After Contrast	8	4	$2,436.40	$2,436.40	$78.71	$2,992.05	$1,393.47	2026-04-13
93930	HCPCS	Ultrasound Of Arm Arteries Or Artery Grafts	8	4	$1,638.40	$1,638.40	$49.62	$1,474.56	$1,392.64	2026-04-13
1368126_1	CDM	Room/bed: Nursery	3	3	$1,545.00	$1,545.00	$1,236.00	$1,390.50	$1,390.50	2026-04-13
73702	HCPCS	CT Scan Of Leg Before And After Contrast	12	4	$1,621.20	$1,621.20	$75.49	$1,459.08	$1,305.75	2026-04-13
74248	HCPCS	Follow-through X-ray Of Small Intestines	4	4	$1,526.90	$1,526.90	$43.34	$1,374.21	$1,297.87	2026-04-13
73706	HCPCS	CT Scan Of Blood Vessels Of Lower Leg With Contrast	23	8	$1,406.20	$1,406.20	$117.31	$3,617.28	$1,265.58	2026-04-13
93880	HCPCS	Ultrasound Of Both Sides Of Head And Neck Blood Flow	8	4	$1,472.40	$1,472.40	$49.97	$1,383.93	$1,248.28	2026-04-13
93925	HCPCS	Ultrasound Of Leg Arteries Or Artery Grafts	8	4	$1,472.40	$1,472.40	$49.26	$1,394.28	$1,247.70	2026-04-13
72193	HCPCS	CT Scan Of Pelvis With Contrast	8	4	$2,041.70	$2,041.70	$72.13	$2,475.18	$1,199.88	2026-04-13
71260	HCPCS	CT Scan Of Chest With Contrast	8	4	$2,079.05	$2,079.05	$72.49	$2,556.81	$1,185.48	2026-04-13
81220	HCPCS	Gene Analysis (cystic Fibrosis Transmembrane Conductance Regular) Common Variant…	4	4	$1,391.50	$1,391.50	$556.60	$1,252.35	$1,182.78	2026-04-13
99284	HCPCS	Emergency Department Visit With Moderate Level Of Medical Decision Making	4	4	$1,452.80	$1,452.80	$159.73	$2,257.74	$1,182.09	2026-04-13
72125	HCPCS	CT Scan Of Upper Spine Without Contrast	8	4	$1,895.75	$1,895.75	$62.65	$2,246.13	$1,166.22	2026-04-13
72131	HCPCS	CT Scan Of Lower Spine Without Contrast	8	4	$1,882.45	$1,882.45	$62.65	$2,230.92	$1,157.49	2026-04-13
70481	HCPCS	CT Scan Of Cranial Cavity With Contrast	8	4	$1,848.95	$1,848.95	$70.27	$2,209.14	$1,118.97	2026-04-13
70487	HCPCS	CT Scan Of Face With Contrast	8	4	$1,894.95	$1,894.95	$70.27	$2,302.47	$1,108.44	2026-04-13
70491	HCPCS	CT Scan Of Soft Tissue Of Neck With Contrast	8	4	$2,009.05	$2,009.05	$86.00	$2,509.83	$1,106.46	2026-04-13
70460	HCPCS	CT Scan Head Or Brain With Contrast	8	4	$1,955.45	$1,955.45	$70.27	$2,421.00	$1,098.81	2026-04-13
73700	HCPCS	CT Scan Of Leg Without Contrast	28	8	$1,247.10	$1,247.10	$62.65	$1,247.10	$1,091.22	2026-04-13
74280	HCPCS	Double Contrast X-ray Of Large Intestine	8	4	$1,277.85	$1,277.85	$78.21	$1,210.05	$1,082.84	2026-04-13
74270	HCPCS	Single Contrast X-ray Of Large Intestine	8	4	$1,277.85	$1,277.85	$64.51	$1,210.05	$1,082.84	2026-04-13
81528	HCPCS	Gene Analysis (colorectal Cancer)	4	4	$1,272.18	$1,272.18	$508.87	$1,144.96	$1,081.35	2026-04-13
76942	HCPCS	Ultrasonic Guidance For Needle Placement	8	4	$1,244.00	$1,244.00	$42.37	$1,178.01	$1,054.15	2026-04-13
72192	HCPCS	CT Scan Of Pelvis Without Contrast	8	4	$1,769.05	$1,769.05	$67.37	$2,153.88	$1,030.41	2026-04-13
1585335_1	CDM	Room/bed: Sub Acute I, Snf	3	3	$1,116.11	$1,116.11	$892.89	$1,004.50	$1,004.50	2026-04-13
1585336_1	CDM	Room/bed: Sub Acute Ii, Icf	3	3	$1,116.11	$1,116.11	$892.89	$1,004.50	$1,004.50	2026-04-13
1391958_1	CDM	0191 Subacute/level I	3	3	$1,100.00	$1,100.00	$880.00	$990.00	$990.00	2026-04-13
70480	HCPCS	CT Scan Of Cranial Cavity Without Contrast	8	4	$1,675.40	$1,675.40	$79.92	$2,026.71	$989.01	2026-04-13
70490	HCPCS	CT Scan Of Soft Tissue Of Neck Without Contrast	8	4	$1,706.40	$1,706.40	$79.92	$2,095.02	$976.50	2026-04-13
1368125_1	CDM	Room/bed: Standard Ward	3	3	$1,067.00	$1,067.00	$853.60	$960.30	$960.30	2026-04-13
1368128_1	CDM	Room/bed: ICU	3	3	$1,067.00	$1,067.00	$853.60	$960.30	$960.30	2026-04-13
70450	HCPCS	CT Scan Head Or Brain Without Contrast	8	4	$1,734.70	$1,734.70	$53.18	$2,178.72	$943.74	2026-04-13
76380	HCPCS	Limited Or Follow-up CT Scan	8	4	$1,091.90	$1,091.90	$60.41	$1,000.53	$927.12	2026-04-13
74240	HCPCS	Single Contrast X-ray Of Upper Digestive Tract	11	4	$1,150.30	$1,150.30	$50.84	$1,035.27	$920.24	2026-04-13
74249	HCPCS	Radiological Examination, Gastrointestinal Tract, Upper, Air Contrast, With Spec…	3	3	$987.60	$987.60	$790.08	$888.84	$888.84	2026-04-13
87483	HCPCS	Test For Detecting Nucleic Acid Of Organism Causing Infection Of Central Nervous…	4	4	$1,041.95	$1,041.95	$416.78	$937.76	$885.66	2026-04-13
87633	HCPCS	Detection Test By Nucleic Acid For Multiple Types Of Respiratory Virus, Multiple…	4	4	$1,041.95	$1,041.95	$416.78	$937.76	$885.66	2026-04-13
87507	HCPCS	Detection Test By Nucleic Acid For Digestive Tract Pathogen, Multiple Types Or S…	4	4	$1,041.95	$1,041.95	$416.78	$937.76	$885.66	2026-04-13
76700	HCPCS	Complete Ultrasound Scan Of Abdomen	8	4	$1,031.80	$1,031.80	$50.63	$977.04	$874.34	2026-04-13
74245	HCPCS	Radiologic Examination, Gastrointestinal Tract, Upper; With Small Intestine, Inc…	6	3	$1,046.15	$1,046.15	$452.32	$1,374.21	$865.19	2026-04-13
4526412_1	CDM	Dupixent 300 Mg/2 Ml Syringe	3	3	$961.02	$961.02	$768.82	$864.92	$864.92	2026-04-13
3812334_1	CDM	Aripiprazole 10 Mg Tablet	3	3	$960.00	$960.00	$768.00	$864.00	$864.00	2026-04-13
J9170	HCPCS	00075-8001-80 - Docetaxel 40 mg/mL Soln	3	3	$929.03	$929.03	$743.22	$836.13	$836.13	2026-04-13
2193333_1	CDM	00052-4330-01 - Etonogestrel 68 Mg Imp	3	3	$925.82	$925.82	$740.66	$833.24	$833.24	2026-04-13
74250	HCPCS	Single Contrast X-ray Of Small Intestine	11	4	$923.40	$923.40	$50.46	$1,374.21	$831.06	2026-04-13
93926	HCPCS	Ultrasound Of One Leg Arteries Or Artery Grafts	12	4	$990.50	$990.50	$30.09	$891.45	$830.50	2026-04-13
93971	HCPCS	Ultrasound Study Of One Arm Or Leg Veins With Compression And Maneuvers	18	4	$907.40	$907.40	$27.58	$1,097.37	$816.66	2026-04-13
3810334_1	CDM	Epclusa 400 Mg-100 Mg Tablet	3	3	$905.15	$905.15	$724.12	$814.64	$814.64	2026-04-13
76870	HCPCS	Ultrasound Scan Of Scrotum	8	4	$950.45	$950.45	$39.98	$900.00	$805.40	2026-04-13
76856	HCPCS	Complete Ultrasound Scan Of Pelvis	8	4	$947.00	$947.00	$43.55	$852.30	$804.95	2026-04-13
76819	HCPCS	Ultrasound Scan Of Fetus	8	4	$947.00	$947.00	$49.34	$852.30	$804.95	2026-04-13
76811	HCPCS	Ultrasound Scan Of Pregnant Uterus With Detailed Fetal Anatomic Examination, Sin…	8	4	$939.50	$939.50	$121.91	$845.55	$798.58	2026-04-13
70488	HCPCS	CT Scan Of Face Before And After Contrast	8	4	$1,949.00	$1,949.00	$79.07	$2,709.90	$798.30	2026-04-13
J1451	HCPCS	Injection, Fomepizole, 15 Mg	11	8	$874.67	$874.67	$6.54	$874.67	$787.20	2026-04-13
74241	HCPCS	Radiologic Examination, Gastrointestinal Tract, Upper; With Or Without Delayed I…	3	3	$872.10	$872.10	$697.68	$784.89	$784.89	2026-04-13
76376	HCPCS	3d Radiographic Procedure	8	4	$918.10	$918.10	$12.69	$826.29	$780.38	2026-04-13
4312498_1	CDM	Hydroxyprogest 250 Mg/ml Vial	3	3	$865.39	$865.39	$692.31	$778.85	$778.85	2026-04-13
82731	HCPCS	Fetal Fibronectin (protein) Analysis	4	4	$911.00	$911.00	$64.41	$819.90	$774.35	2026-04-13
74246	HCPCS	Double Contrast X-ray Of Upper Digestive Tract	20	4	$923.95	$923.95	$56.39	$1,035.27	$774.27	2026-04-13
71275	HCPCS	CT Scan Of Blood Vessels Of Chest With Contrast	8	4	$1,961.20	$1,961.20	$112.76	$2,757.87	$772.29	2026-04-13
4312497_1	CDM	69238-1797-01 - HYDROXYprogesterone 250 mg/mL Soln	3	3	$853.19	$853.19	$682.55	$767.87	$767.87	2026-04-13
4110333_1	CDM	Hyperrab 300 Unit/ml Vial	3	3	$852.14	$852.14	$681.71	$766.93	$766.93	2026-04-13
90378	HCPCS	Respiratory Syncytial Virus Antibody For Injection Into Tissue Or Muscle	3	3	$849.20	$849.20	$679.36	$764.28	$764.28	2026-04-13
J9201	HCPCS	Injection, Gemcitabine Hydrochloride, Not Otherwise Specified, 200 Mg	3	3	$847.32	$847.32	$677.86	$762.59	$762.59	2026-04-13
1040534_1	CDM	50419-0421-01 - Levonorgestrel 52 Mg Devi	3	3	$843.66	$843.66	$674.93	$759.29	$759.29	2026-04-13
93931	HCPCS	Ultrasound Of One Arm Arteries Or Artery Grafts	12	4	$929.00	$929.00	$30.45	$836.10	$748.25	2026-04-13
J9217	HCPCS	Leuprolide Acetate (for Depot Suspension), 7.5 Mg	3	3	$828.01	$828.01	$662.41	$745.21	$745.21	2026-04-13
4048372_1	CDM	Makena 1,250 Mg/5 Ml Vial	3	3	$828.00	$828.00	$662.40	$745.20	$745.20	2026-04-13
3986334_1	CDM	64011-0247-02 - HYDROXYprogesterone 250 mg/mL Soln	3	3	$828.00	$828.00	$662.40	$745.20	$745.20	2026-04-13
41115	HCPCS	Removal Of Tissue Connecting Tongue And Floor Of Mouth	4	4	$863.50	$863.50	$163.07	$777.15	$733.97	2026-04-13
4402737_1	CDM	Hyperrab 300 Unit/ml Vial	3	3	$804.53	$804.53	$643.62	$724.08	$724.08	2026-04-13
74022	HCPCS	X-ray Series Of Abdomen With Single X-ray Of Chest	8	4	$833.95	$833.95	$20.17	$774.00	$707.56	2026-04-13
76770	HCPCS	Complete Ultrasound Scan Behind Abdominal Cavity	8	4	$831.95	$831.95	$46.06	$787.77	$704.99	2026-04-13
76805	HCPCS	Ultrasound Scan Of Pregnant Uterus (14 Weeks Or More), Single Or First Fetus	8	4	$829.25	$829.25	$63.39	$753.03	$704.49	2026-04-13
1040695_1	CDM	00085-1341-02 - Mometasone 220 Mcg/inh Aero	3	3	$780.04	$780.04	$624.03	$702.04	$702.04	2026-04-13
3691335_1	CDM	Inj Hydroxocobalamin IV 25mg	3	3	$779.35	$779.35	$623.48	$701.42	$701.42	2026-04-13

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