Hospital

BENSON HOSPITAL

Benson, AZ · CCN 031301 · Rates published

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You selected 93306 (CPT)

FAC US ECHOCARDIO COMP

This hospital’s price: $240 across 7 payers · range $240-$2,427

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/8123/866007695_benson-hospital-corporation_standardcharges.csv · observed 2025-03-27

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

15,663 distinct procedures filed

7 distinct payers

55,524 rate rows

2025-03-27 last MRF observed · ⚠ 19 mo old

Data quality

54,781 of 55,524 rate rows are consumer-grade (98.7%)

743 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
percent-of-charges filed in the dollar field — excluded from medians	504
template filing: same amount across many unrelated codes — excluded	132
exceeds 10× this hospital's gross charge — excluded from medians	78
placeholder amount (≤ $0.02) — excluded from medians	16
per-diem day rate — not a per-procedure price	12
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	1

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 19 months old.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://sthpiprd.blob.core.windows.net/machine-readable-files/8123/866007695_benson-hospital-corporation_standardcharges.csv
Found on page	https://search.hospitalpriceindex.com/hpi2/machineReadable/BensonHospital/8123
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-09-21
Content fingerprint	89477c365cd7910a… · 18,654,918 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
J3399 HCPCS	Inj Onase Abepar-xioi Treat	1	$3,674,413.46	$3,674,413.46	$3,674,413.46	nat. median $2,466,282 1.5× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	1	$3,304,378.35	$3,304,378.35	$3,304,378.35	nat. median $738,272 outlier · 4.5×
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	1	$3,304,378.35	$3,304,378.35	$3,304,378.35	nat. median $608,101 outlier · 5.4×
Q2056 HCPCS	Ciltacabtagene Car-pos T	1	$3,304,378.35	$3,304,378.35	$3,304,378.35	nat. median $646,415 outlier · 5.1×
Q0480 HCPCS	Driver Pneumatic Vad, Rep	1	$762,075.89	$762,075.89	$762,075.89	nat. median $111,503 outlier · 6.8×
Q2043 HCPCS	Sipuleucel-t Auto Cd54+	1	$446,641.03	$446,641.03	$446,641.03	nat. median $65,720 outlier · 6.8×
A9543 HCPCS	Y90 Ibritumomab, Rx	1	$424,988.70	$424,988.70	$424,988.70	nat. median $63,643 outlier · 6.7×
J9226 HCPCS	Supprelin La Implant	1	$376,697.99	$376,697.99	$376,697.99	nat. median $55,159 outlier · 6.8×
L7181 HCPCS	Electronic Elbo Simultaneous	1	$339,033.80	$339,033.80	$339,033.80	nat. median $50,453 outlier · 6.7×
E0194 HCPCS	Air Fluidized Bed	1	$326,526.09	$326,526.09	$326,526.09	nat. median $4,438 outlier · 73.6×
L7180 HCPCS	Electronic Elbow Sequential	1	$312,289.95	$312,289.95	$312,289.95	nat. median $46,980 outlier · 6.6×
L8702 HCPCS	Ewhf S/d Uprt Micro Sensor	1	$307,743.00	$307,743.00	$307,743.00	nat. median $70,178 outlier · 4.4×
L8701 HCPCS	Ewh S/d Uprt Micro Sensor	1	$307,743.00	$307,743.00	$307,743.00	nat. median $35,670 outlier · 8.6×
J9029 HCPCS	Instill Adstiladrin, Tx Dose	1	$295,272.68	$295,272.68	$295,272.68	nat. median $68,423 outlier · 4.3×
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	1	$235,497.74	$235,497.74	$235,497.74	nat. median $249,124 0.9× median
K0606 HCPCS	Aed Garment W Elec Analysis	1	$227,580.50	$227,580.50	$227,580.50	nat. median $3,697 outlier · 61.6×
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	1	$210,269.88	$210,269.88	$210,269.88	nat. median $190,557 1.1× median
L6880 HCPCS	Elec Hand Ind Art Digits	1	$206,809.98	$206,809.98	$206,809.98	nat. median $30,016 outlier · 6.9×
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	1	$205,788.17	$205,788.17	$205,788.17	nat. median $198,433 1.0× median
L5856 HCPCS	Elec Knee-shin Swing/stance	1	$203,124.22	$203,124.22	$203,124.22	nat. median $30,017 outlier · 6.8×
J9600 HCPCS	Porfimer Sodium Injection	1	$196,548.41	$196,548.41	$196,548.41	nat. median $30,131 outlier · 6.5×
J9266 HCPCS	Pegaspargase Injection	1	$175,044.82	$175,044.82	$175,044.82	nat. median $33,238 outlier · 5.3×
L8614 HCPCS	Cochlear Device	1	$170,018.97	$170,018.97	$170,018.97	nat. median $22,385 outlier · 7.6×
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	1	$165,819.58	$165,819.58	$165,819.58	nat. median $103,967 1.6× median
L5859 HCPCS	Knee-shin Pro Flex/ext Cont	1	$160,870.67	$160,870.67	$160,870.67	nat. median $18,321 outlier · 8.8×
L6975 HCPCS	Interscap-thor Myoelectronic	1	$160,149.71	$160,149.71	$160,149.71	nat. median $22,861 outlier · 7.0×
Q0483 HCPCS	Monitor Elec Vad, Rep	1	$158,647.63	$158,647.63	$158,647.63	nat. median $23,335 outlier · 6.8×
L5858 HCPCS	Stance Phase Only	1	$157,257.51	$157,257.51	$157,257.51	nat. median $23,235 outlier · 6.8×
215 MS_DRG	Other Heart Assist System Implant	1	$157,036.81	$157,036.81	$157,036.81	nat. median $93,917 1.7× median
L8687 HCPCS	Implt Nrostm Pls Gen Dua Rec	1	$151,201.54	$151,201.54	$151,201.54	nat. median $14,605 outlier · 10.4×
A9604 HCPCS	Sm 153 Lexidronam	1	$142,164.17	$142,164.17	$142,164.17	nat. median $12,749 outlier · 11.2×
Q0489 HCPCS	Pwr Pck Base Combo Vad, Rep	1	$137,538.96	$137,538.96	$137,538.96	nat. median $20,275 outlier · 6.8×
Q0488 HCPCS	Pwr Pack Base Elec Vad, Rep	1	$137,538.96	$137,538.96	$137,538.96	nat. median $147 outlier · 935.1×
L6970 HCPCS	Interscapular-thor Switch CT	1	$135,437.84	$135,437.84	$135,437.84	nat. median $21,078 outlier · 6.4×
C1823 HCPCS	Gen, Neuro, Trans Sen/stim	1	$128,047.05	$128,047.05	$128,047.05	nat. median $31,620 outlier · 4.0×
C1820 HCPCS	Generator Neuro Rechg Bat Sy	1	$128,047.05	$128,047.05	$128,047.05	nat. median $22,969 outlier · 5.6×
C1822 HCPCS	Gen, Neuro, Hf, Rechg Bat	1	$128,047.05	$128,047.05	$128,047.05	nat. median $31,540 outlier · 4.1×
L6965 HCPCS	Shldr Disartic Myoelectronic	1	$127,882.91	$127,882.91	$127,882.91	nat. median $20,067 outlier · 6.4×
L5969 HCPCS	Ak/ft Power Asst Incl Motors	1	$127,861.12	$127,861.12	$127,861.12	nat. median $19,444 outlier · 6.6×
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And…	1	$127,073.60	$127,073.60	$127,073.60	nat. median $126,722 1.0× median
20 MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	1	$124,119.25	$124,119.25	$124,119.25	nat. median $74,460 1.7× median
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	1	$119,287.18	$119,287.18	$119,287.18	nat. median $94,964 1.3× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	1	$117,966.02	$117,966.02	$117,966.02	nat. median $110,192 1.1× median
K0891 HCPCS	Pwc Gp5 Ped Mult Pow Opt S/b	1	$116,392.86	$116,392.86	$116,392.86	nat. median $2,801 outlier · 41.5×
L8685 HCPCS	Implt Nrostm Pls Gen Sng Rec	1	$116,184.00	$116,184.00	$116,184.00	nat. median $11,915 outlier · 9.8×
7 MS_DRG	Lung Transplant	1	$115,250.72	$115,250.72	$115,250.72	nat. median $117,894 1.0× median
19 MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	1	$113,820.08	$113,820.08	$113,820.08	nat. median $66,660 1.7× median
275 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	1	$111,261.71	$111,261.71	$111,261.71	nat. median $66,649 1.7× median
Q0481 HCPCS	Microprcsr Cu Elec Vad, Rep	1	$111,046.46	$111,046.46	$111,046.46	nat. median $15,211 outlier · 7.3×
E0764 HCPCS	Functional Neuromuscularstim	1	$111,039.35	$111,039.35	$111,039.35	nat. median $1,656 outlier · 67.1×

Other procedures at this hospital

Browse this hospital's 15,663 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

J3399	HCPCS	Inj Onase Abepar-xioi Treat	1	1	—	—	$3,674,413.46	$3,674,413.46	$3,674,413.46	2025-03-27
Q2042	HCPCS	Tisagenlecleucel Car-pos T	1	1	—	—	$3,304,378.35	$3,304,378.35	$3,304,378.35	2025-03-27
Q2056	HCPCS	Ciltacabtagene Car-pos T	1	1	—	—	$3,304,378.35	$3,304,378.35	$3,304,378.35	2025-03-27
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	1	1	—	—	$3,304,378.35	$3,304,378.35	$3,304,378.35	2025-03-27
Q0480	HCPCS	Driver Pneumatic Vad, Rep	1	1	—	—	$762,075.89	$762,075.89	$762,075.89	2025-03-27
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	1	1	—	—	$446,641.03	$446,641.03	$446,641.03	2025-03-27
A9543	HCPCS	Y90 Ibritumomab, Rx	1	1	—	—	$424,988.70	$424,988.70	$424,988.70	2025-03-27
J9226	HCPCS	Supprelin La Implant	1	1	—	—	$376,697.99	$376,697.99	$376,697.99	2025-03-27
L7181	HCPCS	Electronic Elbo Simultaneous	1	1	—	—	$339,033.80	$339,033.80	$339,033.80	2025-03-27
E0194	HCPCS	Air Fluidized Bed	1	1	—	—	$326,526.09	$326,526.09	$326,526.09	2025-03-27
L7180	HCPCS	Electronic Elbow Sequential	1	1	—	—	$312,289.95	$312,289.95	$312,289.95	2025-03-27
L8701	HCPCS	Ewh S/d Uprt Micro Sensor	1	1	—	—	$307,743.00	$307,743.00	$307,743.00	2025-03-27
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	1	1	—	—	$307,743.00	$307,743.00	$307,743.00	2025-03-27
J9029	HCPCS	Instill Adstiladrin, Tx Dose	1	1	—	—	$295,272.68	$295,272.68	$295,272.68	2025-03-27
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	1	1	—	—	$235,497.74	$235,497.74	$235,497.74	2025-03-27
K0606	HCPCS	Aed Garment W Elec Analysis	1	1	—	—	$227,580.50	$227,580.50	$227,580.50	2025-03-27
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	1	1	—	—	$210,269.88	$210,269.88	$210,269.88	2025-03-27
L6880	HCPCS	Elec Hand Ind Art Digits	1	1	—	—	$206,809.98	$206,809.98	$206,809.98	2025-03-27
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	1	1	—	—	$205,788.17	$205,788.17	$205,788.17	2025-03-27
L5856	HCPCS	Elec Knee-shin Swing/stance	1	1	—	—	$203,124.22	$203,124.22	$203,124.22	2025-03-27
J9600	HCPCS	Porfimer Sodium Injection	1	1	—	—	$196,548.41	$196,548.41	$196,548.41	2025-03-27
J9266	HCPCS	Pegaspargase Injection	1	1	—	—	$175,044.82	$175,044.82	$175,044.82	2025-03-27
L8614	HCPCS	Cochlear Device	1	1	—	—	$170,018.97	$170,018.97	$170,018.97	2025-03-27
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	1	1	—	—	$165,819.58	$165,819.58	$165,819.58	2025-03-27
L5859	HCPCS	Knee-shin Pro Flex/ext Cont	1	1	—	—	$160,870.67	$160,870.67	$160,870.67	2025-03-27
L6975	HCPCS	Interscap-thor Myoelectronic	1	1	—	—	$160,149.71	$160,149.71	$160,149.71	2025-03-27
Q0483	HCPCS	Monitor Elec Vad, Rep	1	1	—	—	$158,647.63	$158,647.63	$158,647.63	2025-03-27
L5858	HCPCS	Stance Phase Only	1	1	—	—	$157,257.51	$157,257.51	$157,257.51	2025-03-27
215	MS_DRG	Other Heart Assist System Implant	1	1	—	—	$157,036.81	$157,036.81	$157,036.81	2025-03-27
L8687	HCPCS	Implt Nrostm Pls Gen Dua Rec	1	1	—	—	$151,201.54	$151,201.54	$151,201.54	2025-03-27
A9604	HCPCS	Sm 153 Lexidronam	1	1	—	—	$142,164.17	$142,164.17	$142,164.17	2025-03-27
Q0489	HCPCS	Pwr Pck Base Combo Vad, Rep	1	1	—	—	$137,538.96	$137,538.96	$137,538.96	2025-03-27
Q0488	HCPCS	Pwr Pack Base Elec Vad, Rep	1	1	—	—	$137,538.96	$137,538.96	$137,538.96	2025-03-27
L6970	HCPCS	Interscapular-thor Switch CT	1	1	—	—	$135,437.84	$135,437.84	$135,437.84	2025-03-27
C1820	HCPCS	Generator Neuro Rechg Bat Sy	1	1	—	—	$128,047.05	$128,047.05	$128,047.05	2025-03-27
C1823	HCPCS	Gen, Neuro, Trans Sen/stim	1	1	—	—	$128,047.05	$128,047.05	$128,047.05	2025-03-27
C1822	HCPCS	Gen, Neuro, Hf, Rechg Bat	1	1	—	—	$128,047.05	$128,047.05	$128,047.05	2025-03-27
L6965	HCPCS	Shldr Disartic Myoelectronic	1	1	—	—	$127,882.91	$127,882.91	$127,882.91	2025-03-27
L5969	HCPCS	Ak/ft Power Asst Incl Motors	1	1	—	—	$127,861.12	$127,861.12	$127,861.12	2025-03-27
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …	1	1	—	—	$127,073.60	$127,073.60	$127,073.60	2025-03-27
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	1	1	—	—	$124,119.25	$124,119.25	$124,119.25	2025-03-27
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	1	1	—	—	$119,287.18	$119,287.18	$119,287.18	2025-03-27
14	MS_DRG	Allogeneic Bone Marrow Transplant	1	1	—	—	$117,966.02	$117,966.02	$117,966.02	2025-03-27
K0891	HCPCS	Pwc Gp5 Ped Mult Pow Opt S/b	1	1	—	—	$116,392.86	$116,392.86	$116,392.86	2025-03-27
L8685	HCPCS	Implt Nrostm Pls Gen Sng Rec	1	1	—	—	$116,184.00	$116,184.00	$116,184.00	2025-03-27
7	MS_DRG	Lung Transplant	1	1	—	—	$115,250.72	$115,250.72	$115,250.72	2025-03-27
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	1	1	—	—	$113,820.08	$113,820.08	$113,820.08	2025-03-27
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	1	1	—	—	$111,261.71	$111,261.71	$111,261.71	2025-03-27
Q0481	HCPCS	Microprcsr Cu Elec Vad, Rep	1	1	—	—	$111,046.46	$111,046.46	$111,046.46	2025-03-27
E0764	HCPCS	Functional Neuromuscularstim	1	1	—	—	$111,039.35	$111,039.35	$111,039.35	2025-03-27
L6960	HCPCS	Shldr Disartic Switch Contro	1	1	—	—	$110,141.64	$110,141.64	$110,141.64	2025-03-27
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	1	1	—	—	$107,929.62	$107,929.62	$107,929.62	2025-03-27
E0483	HCPCS	Hi Freq Chest Wall Oscil Sys	1	1	—	—	$106,669.68	$106,669.68	$106,669.68	2025-03-27
E0636	HCPCS	Pt Support & Positioning Sys	1	1	—	—	$105,809.66	$105,809.66	$105,809.66	2025-03-27
K0864	HCPCS	Pwc Gp3 Xhd Mult Pow Opt S/b	1	1	—	—	$103,468.91	$103,468.91	$103,468.91	2025-03-27
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	1	1	—	—	$103,019.08	$103,019.08	$103,019.08	2025-03-27
L6955	HCPCS	Above Elbow Myoelectronic CT	1	1	—	—	$102,943.41	$102,943.41	$102,943.41	2025-03-27
C1767	HCPCS	Generator, Neuro Non-recharg	1	1	—	—	$99,379.80	$99,379.80	$99,379.80	2025-03-27
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	1	1	—	—	$97,267.31	$97,267.31	$97,267.31	2025-03-27
L8688	HCPCS	Implt Nrostm Pls Gen Dua Non	1	1	—	—	$96,478.81	$96,478.81	$96,478.81	2025-03-27
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	1	1	—	—	$95,979.01	$95,979.01	$95,979.01	2025-03-27
Q4244	HCPCS	Outpatient Services	1	1	—	—	$91,862.65	$91,862.65	$91,862.65	2025-03-27
0613T	CPT	Perq Tcat Intratrl Septl Sht	1	1	—	—	$91,544.09	$91,544.09	$91,544.09	2025-03-27
93591	CPT	Perq Transcath Cls Aortic	1	1	—	—	$91,544.09	$91,544.09	$91,544.09	2025-03-27
93590	CPT	Perq Transcath Cls Mitral	1	1	—	—	$91,544.09	$91,544.09	$91,544.09	2025-03-27
93583	CPT	Perq Transcath Septal Reduxn	1	1	—	—	$91,544.09	$91,544.09	$91,544.09	2025-03-27
93581	CPT	Transcath Closure Of Vsd	1	1	—	—	$91,544.09	$91,544.09	$91,544.09	2025-03-27
93580	CPT	Transcath Closure Of Asd	1	1	—	—	$91,544.09	$91,544.09	$91,544.09	2025-03-27
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	1	—	—	$91,340.36	$91,340.36	$91,340.36	2025-03-27
C2616	HCPCS	Brachytx, Non-str,yttrium-90	1	1	—	—	$90,894.29	$90,894.29	$90,894.29	2025-03-27
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	1	1	—	—	$90,320.30	$90,320.30	$90,320.30	2025-03-27
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	1	1	—	—	$89,546.59	$89,546.59	$89,546.59	2025-03-27
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	1	—	—	$89,351.33	$89,351.33	$89,351.33	2025-03-27
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	1	1	—	—	$88,999.15	$88,999.15	$88,999.15	2025-03-27
231	MS_DRG	Coronary Bypass With Ptca With Mcc	1	1	—	—	$88,679.81	$88,679.81	$88,679.81	2025-03-27
L6945	HCPCS	Elbow Disart Myoelectronic C	1	1	—	—	$87,977.88	$87,977.88	$87,977.88	2025-03-27
K0890	HCPCS	Pwc Gp5 Ped Sing Pow Opt S/b	1	1	—	—	$87,889.05	$87,889.05	$87,889.05	2025-03-27
K0860	HCPCS	Pwc Gp3 Vhd Sing Pow Opt S/b	1	1	—	—	$86,948.15	$86,948.15	$86,948.15	2025-03-27
K0863	HCPCS	Pwc Gp3 Vhd Mult Pow Opt S/b	1	1	—	—	$86,948.15	$86,948.15	$86,948.15	2025-03-27
L6950	HCPCS	Above Elbow Switch Control	1	1	—	—	$85,955.49	$85,955.49	$85,955.49	2025-03-27
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	1	1	—	—	$84,884.22	$84,884.22	$84,884.22	2025-03-27
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	1	—	—	$84,521.09	$84,521.09	$84,521.09	2025-03-27
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	1	1	—	—	$84,380.58	$84,380.58	$84,380.58	2025-03-27
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	1	1	—	—	$83,942.62	$83,942.62	$83,942.62	2025-03-27
K0854	HCPCS	Pwc Gp 3 Xhd Seat/back	1	1	—	—	$83,353.65	$83,353.65	$83,353.65	2025-03-27
K0013	HCPCS	Custom Power Whlchr Base	1	1	—	—	$82,275.01	$82,275.01	$82,275.01	2025-03-27
E0783	HCPCS	Programmable Infusion Pump	1	1	—	—	$82,143.68	$82,143.68	$82,143.68	2025-03-27
K0840	HCPCS	Pwc Gp2 Xhd Sing Pow Opt S/b	1	1	—	—	$82,141.23	$82,141.23	$82,141.23	2025-03-27
6	MS_DRG	Liver Transplant Without Mcc	1	1	—	—	$81,564.91	$81,564.91	$81,564.91	2025-03-27
955	MS_DRG	Craniotomy For Multiple Significant Trauma	1	1	—	—	$81,006.52	$81,006.52	$81,006.52	2025-03-27
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	1	1	—	—	$80,844.11	$80,844.11	$80,844.11	2025-03-27
K0880	HCPCS	Pwc Gp4 Vhd Sing Pow Opt S/b	1	1	—	—	$80,832.10	$80,832.10	$80,832.10	2025-03-27
E0786	HCPCS	Implantable Pump Replacement	1	1	—	—	$80,126.18	$80,126.18	$80,126.18	2025-03-27
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	1	1	—	—	$79,849.60	$79,849.60	$79,849.60	2025-03-27
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	1	1	—	—	$79,840.47	$79,840.47	$79,840.47	2025-03-27
L7191	HCPCS	Elbow Child Myoelectronic CT	1	1	—	—	$79,667.81	$79,667.81	$79,667.81	2025-03-27
K0855	HCPCS	Pwc Gp 3 Xhd Cap Chair	1	1	—	—	$78,740.13	$78,740.13	$78,740.13	2025-03-27
L8679	HCPCS	Imp Neurosti Pls Gn Any Type	1	1	—	—	$77,209.32	$77,209.32	$77,209.32	2025-03-27
81416	CPT	Exome Sequence Analysis	1	1	—	—	$76,608.07	$76,608.07	$76,608.07	2025-03-27
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	1	1	—	—	$76,360.58	$76,360.58	$76,360.58	2025-03-27
L7186	HCPCS	Electron Elbow Child Switch	1	1	—	—	$76,241.44	$76,241.44	$76,241.44	2025-03-27
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	1	1	—	—	$76,064.96	$76,064.96	$76,064.96	2025-03-27
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	1	1	—	—	$75,951.83	$75,951.83	$75,951.83	2025-03-27
L6940	HCPCS	Elbow Disarticulation Switch	1	1	—	—	$75,703.41	$75,703.41	$75,703.41	2025-03-27
E1008	HCPCS	Pwr Seat Combo Pwr Shear	1	1	—	—	$75,600.88	$75,600.88	$75,600.88	2025-03-27
E1007	HCPCS	Pwr Seat Combo W/shear	1	1	—	—	$75,594.07	$75,594.07	$75,594.07	2025-03-27
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	1	1	—	—	$75,258.40	$75,258.40	$75,258.40	2025-03-27
L8686	HCPCS	Implt Nrostm Pls Gen Sng Non	1	1	—	—	$74,134.88	$74,134.88	$74,134.88	2025-03-27
10	MS_DRG	Pancreas Transplant	1	1	—	—	$73,973.74	$73,973.74	$73,973.74	2025-03-27
L6925	HCPCS	Wrist Disart Myoelectronic C	1	1	—	—	$73,340.67	$73,340.67	$73,340.67	2025-03-27
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	1	—	—	$73,234.70	$73,234.70	$73,234.70	2025-03-27
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	1	1	—	—	$73,234.70	$73,234.70	$73,234.70	2025-03-27
E0193	HCPCS	Powered Air Flotation Bed	1	1	—	—	$73,041.08	$73,041.08	$73,041.08	2025-03-27
L8619	HCPCS	Coch Imp Ext Proc/contr Rplc	1	1	—	—	$72,988.19	$72,988.19	$72,988.19	2025-03-27
C1882	HCPCS	Aicd, Other Than Sing/dual	1	1	—	—	$72,623.70	$72,623.70	$72,623.70	2025-03-27
C1721	HCPCS	Aicd, Dual Chamber	1	1	—	—	$72,623.70	$72,623.70	$72,623.70	2025-03-27
C1722	HCPCS	Aicd, Single Chamber	1	1	—	—	$72,623.70	$72,623.70	$72,623.70	2025-03-27
C1899	HCPCS	Lead, pmkr/AICD Combination	1	1	—	—	$72,623.70	$72,623.70	$72,623.70	2025-03-27
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	1	1	—	—	$72,148.94	$72,148.94	$72,148.94	2025-03-27
L5857	HCPCS	Elec Knee-shin Swing Only	1	1	—	—	$72,076.27	$72,076.27	$72,076.27	2025-03-27
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	1	1	—	—	$71,802.23	$71,802.23	$71,802.23	2025-03-27
C1813	HCPCS	Prosthesis, Penile, Inflatab	1	1	—	—	$71,742.59	$71,742.59	$71,742.59	2025-03-27
L6026	HCPCS	Part Hand Myo Exclu Term Dev	1	1	—	—	$70,519.82	$70,519.82	$70,519.82	2025-03-27
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	1	1	—	—	$70,282.17	$70,282.17	$70,282.17	2025-03-27
C1895	HCPCS	Lead, Aicd, Endo Dual Coil	1	1	—	—	$69,995.63	$69,995.63	$69,995.63	2025-03-27
L6935	HCPCS	Below Elbow Myoelectronic CT	1	1	—	—	$69,467.09	$69,467.09	$69,467.09	2025-03-27
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	1	1	—	—	$68,315.04	$68,315.04	$68,315.04	2025-03-27
E2510	HCPCS	Sgd W Multi Methods Msg/accs	1	1	—	—	$67,909.49	$67,909.49	$67,909.49	2025-03-27
L7190	HCPCS	Elbow Adolescent Myoelectron	1	1	—	—	$67,589.65	$67,589.65	$67,589.65	2025-03-27
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	1	1	—	—	$67,183.66	$67,183.66	$67,183.66	2025-03-27
C1891	HCPCS	Infusion Pump,non-prog, Perm	1	1	—	—	$66,829.09	$66,829.09	$66,829.09	2025-03-27
C1772	HCPCS	Infusion Pump, Programmable	1	1	—	—	$66,829.09	$66,829.09	$66,829.09	2025-03-27
E0304	HCPCS	Hosp Bed Xtra Hvy Dty X Wide	1	1	—	—	$66,647.91	$66,647.91	$66,647.91	2025-03-27
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	1	1	—	—	$66,172.72	$66,172.72	$66,172.72	2025-03-27
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	1	1	—	—	$65,919.08	$65,919.08	$65,919.08	2025-03-27
K0014	HCPCS	Other Power Whlchr Base	1	1	—	—	$65,820.01	$65,820.01	$65,820.01	2025-03-27
K0856	HCPCS	Pwc Gp3 Std Sing Pow Opt S/b	1	1	—	—	$65,711.14	$65,711.14	$65,711.14	2025-03-27
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	1	1	—	—	$65,576.01	$65,576.01	$65,576.01	2025-03-27
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	1	1	—	—	$65,150.83	$65,150.83	$65,150.83	2025-03-27
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	1	1	—	—	$65,103.39	$65,103.39	$65,103.39	2025-03-27
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	1	1	—	—	$64,784.05	$64,784.05	$64,784.05	2025-03-27
J9216	HCPCS	Interferon Gamma 1-b Inj	1	1	—	—	$64,699.32	$64,699.32	$64,699.32	2025-03-27
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	1	1	—	—	$64,389.89	$64,389.89	$64,389.89	2025-03-27
L6920	HCPCS	Wrist Disarticul Switch Ctrl	1	1	—	—	$64,261.57	$64,261.57	$64,261.57	2025-03-27
C1825	HCPCS	Gen, Neuro, Carot Sinus Baro	1	1	—	—	$64,023.53	$64,023.53	$64,023.53	2025-03-27
C1827	HCPCS	Gen, Neuro, Imp Led, Ex Cntr	1	1	—	—	$64,023.53	$64,023.53	$64,023.53	2025-03-27
C1824	HCPCS	Generator, Ccm, Implant	1	1	—	—	$64,023.53	$64,023.53	$64,023.53	2025-03-27
C1826	HCPCS	Gen, Neuro, Clo Loop, Rechg	1	1	—	—	$64,023.53	$64,023.53	$64,023.53	2025-03-27
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	1	1	—	—	$63,086.99	$63,086.99	$63,086.99	2025-03-27
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	1	1	—	—	$63,015.82	$63,015.82	$63,015.82	2025-03-27
K0853	HCPCS	Pwc Gp 3 Vhd Cap Chair	1	1	—	—	$62,918.88	$62,918.88	$62,918.88	2025-03-27
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	1	1	—	—	$62,773.12	$62,773.12	$62,773.12	2025-03-27
E0302	HCPCS	Ex Hd Hosp Bed > 600 Lbs	1	1	—	—	$61,870.82	$61,870.82	$61,870.82	2025-03-27
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	1	1	—	—	$61,722.04	$61,722.04	$61,722.04	2025-03-27
E1035	HCPCS	Patient Transfer System <300	1	1	—	—	$61,525.28	$61,525.28	$61,525.28	2025-03-27
28	MS_DRG	Spinal Procedures With Mcc	1	1	—	—	$61,492.11	$61,492.11	$61,492.11	2025-03-27
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	1	1	—	—	$61,430.07	$61,430.07	$61,430.07	2025-03-27
E0472	HCPCS	Rad W Backup Invasive Intrfc	1	1	—	—	$61,363.96	$61,363.96	$61,363.96	2025-03-27
K0852	HCPCS	Pwc Gp 3 Vhd Seat/back	1	1	—	—	$61,250.07	$61,250.07	$61,250.07	2025-03-27
L5987	HCPCS	Shank Ft W Vert Load Pylon	1	1	—	—	$60,869.37	$60,869.37	$60,869.37	2025-03-27
K0858	HCPCS	Pwc Gp3 Hd Sing Pow Opt S/b	1	1	—	—	$60,860.95	$60,860.95	$60,860.95	2025-03-27
K0862	HCPCS	Pwc Gp3 Hd Mult Pow Opt S/b	1	1	—	—	$60,860.95	$60,860.95	$60,860.95	2025-03-27
850	MS_DRG	Acute Leukemia With Other Procedures	1	1	—	—	$60,583.36	$60,583.36	$60,583.36	2025-03-27
C1817	HCPCS	Septal Defect Imp Sys	1	1	—	—	$60,068.37	$60,068.37	$60,068.37	2025-03-27
L6930	HCPCS	Below Elbow Switch Control	1	1	—	—	$59,811.35	$59,811.35	$59,811.35	2025-03-27
K0828	HCPCS	Pwc Gp 2 Xtra Hd Seat/back	1	1	—	—	$59,741.80	$59,741.80	$59,741.80	2025-03-27
L5250	HCPCS	Hip Canad Sing Axi Cons Fric	1	1	—	—	$59,628.10	$59,628.10	$59,628.10	2025-03-27
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	1	1	—	—	$59,134.47	$59,134.47	$59,134.47	2025-03-27
L5270	HCPCS	Tilt Table Locking Hip Sing	1	1	—	—	$59,105.76	$59,105.76	$59,105.76	2025-03-27
K0849	HCPCS	Pwc Gp 3 Std Cap Chair	1	1	—	—	$58,857.92	$58,857.92	$58,857.92	2025-03-27
L5280	HCPCS	Hemipelvect Canad Sing Axis	1	1	—	—	$58,514.67	$58,514.67	$58,514.67	2025-03-27
K0884	HCPCS	Pwc Gp4 Std Mult Pow Opt S/b	1	1	—	—	$58,393.28	$58,393.28	$58,393.28	2025-03-27
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	1	1	—	—	$58,121.70	$58,121.70	$58,121.70	2025-03-27
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	1	1	—	—	$58,081.56	$58,081.56	$58,081.56	2025-03-27
L5341	HCPCS	Hemipelvectomy Canadian Sach	1	1	—	—	$58,081.30	$58,081.30	$58,081.30	2025-03-27
K0859	HCPCS	Pwc Gp3 Hd Sing Pow Opt Cap	1	1	—	—	$58,042.38	$58,042.38	$58,042.38	2025-03-27
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	1	1	—	—	$57,975.72	$57,975.72	$57,975.72	2025-03-27
K0885	HCPCS	Pwc Gp4 Std Mult Pow Opt Cap	1	1	—	—	$57,707.19	$57,707.19	$57,707.19	2025-03-27
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	1	1	—	—	$57,597.99	$57,597.99	$57,597.99	2025-03-27
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	1	1	—	—	$57,373.54	$57,373.54	$57,373.54	2025-03-27
E1006	HCPCS	Pwr Seat Combo Without Shear	1	1	—	—	$55,828.60	$55,828.60	$55,828.60	2025-03-27
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	1	1	—	—	$55,570.63	$55,570.63	$55,570.63	2025-03-27
834	MS_DRG	Acute Leukemia With Mcc	1	1	—	—	$55,406.40	$55,406.40	$55,406.40	2025-03-27
L8609	HCPCS	Artificial Cornea	1	1	—	—	$55,130.09	$55,130.09	$55,130.09	2025-03-27
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	1	1	—	—	$54,911.88	$54,911.88	$54,911.88	2025-03-27
K0829	HCPCS	Pwc Gp 2 Xtra Hd Cap Chair	1	1	—	—	$54,859.18	$54,859.18	$54,859.18	2025-03-27
0215U	CPT	Rare Ds Xom DNA Alys Ea Comp	1	1	—	—	$54,720.05	$54,720.05	$54,720.05	2025-03-27
459	MS_DRG	Inpatient Ms-DRG	1	1	—	—	$54,694.73	$54,694.73	$54,694.73	2025-03-27
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	1	1	—	—	$54,694.73	$54,694.73	$54,694.73	2025-03-27
A9582	HCPCS	Iodine I-123 Iobenguane	1	1	—	—	$54,669.83	$54,669.83	$54,669.83	2025-03-27
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	1	1	—	—	$54,494.00	$54,494.00	$54,494.00	2025-03-27
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	1	1	—	—	$54,342.54	$54,342.54	$54,342.54	2025-03-27
K0839	HCPCS	Pwc Gp2 Vhd Sing Pow Opt S/b	1	1	—	—	$54,216.26	$54,216.26	$54,216.26	2025-03-27
K0826	HCPCS	Pwc Gp 2 Vhd Seat/back	1	1	—	—	$54,216.26	$54,216.26	$54,216.26	2025-03-27
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	1	1	—	—	$53,950.21	$53,950.21	$53,950.21	2025-03-27
26	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Cc	1	1	—	—	$53,787.80	$53,787.80	$53,787.80	2025-03-27
K0886	HCPCS	Pwc Gp4 Hd Mult Pow S/b	1	1	—	—	$53,297.23	$53,297.23	$53,297.23	2025-03-27
K0850	HCPCS	Pwc Gp 3 Hd Seat/back	1	1	—	—	$53,010.73	$53,010.73	$53,010.73	2025-03-27
L8682	HCPCS	Implt Neurostim Radiofq Rec	1	1	—	—	$52,967.76	$52,967.76	$52,967.76	2025-03-27
653	MS_DRG	Major Bladder Procedures With Mcc	1	1	—	—	$52,924.67	$52,924.67	$52,924.67	2025-03-27
A9572	HCPCS	Indium In-111 Pentetreotide	1	1	—	—	$52,557.07	$52,557.07	$52,557.07	2025-03-27
K0879	HCPCS	Pwc Gp4 Hd Sing Pow Opt S/b	1	1	—	—	$51,653.64	$51,653.64	$51,653.64	2025-03-27
L7185	HCPCS	Electron Elbow Adolescent Sw	1	1	—	—	$51,600.74	$51,600.74	$51,600.74	2025-03-27
L5600	HCPCS	Hip Disart Sach Laminat Mold	1	1	—	—	$51,099.88	$51,099.88	$51,099.88	2025-03-27
462	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	1	1	—	—	$50,990.39	$50,990.39	$50,990.39	2025-03-27
K0851	HCPCS	Pwc Gp 3 Hd Cap Chair	1	1	—	—	$50,968.84	$50,968.84	$50,968.84	2025-03-27
L7170	HCPCS	Electronic Elbow Hosmer Swit	1	1	—	—	$50,538.59	$50,538.59	$50,538.59	2025-03-27
65770	CPT	Keratoprosthesis	1	1	—	—	$50,454.36	$50,454.36	$50,454.36	2025-03-27
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	1	1	—	—	$50,342.58	$50,342.58	$50,342.58	2025-03-27
L6570	HCPCS	Scap Thorac Prosth Tiss Shap	1	1	—	—	$50,300.10	$50,300.10	$50,300.10	2025-03-27
L5331	HCPCS	Hip Disart Canadian Sach Ft	1	1	—	—	$50,195.36	$50,195.36	$50,195.36	2025-03-27
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	1	1	—	—	$50,189.30	$50,189.30	$50,189.30	2025-03-27
K0857	HCPCS	Pwc Gp3 Std Sing Pow Opt Cap	1	1	—	—	$50,036.98	$50,036.98	$50,036.98	2025-03-27
L5702	HCPCS	Replace Socket Hip	1	1	—	—	$49,929.78	$49,929.78	$49,929.78	2025-03-27
L7008	HCPCS	Pediatric Electric Hand	1	1	—	—	$49,860.29	$49,860.29	$49,860.29	2025-03-27
L8627	HCPCS	Cid Ext Speech Process Repl	1	1	—	—	$49,597.41	$49,597.41	$49,597.41	2025-03-27
E0373	HCPCS	Nonpowered Pressure Mattress	1	1	—	—	$49,588.99	$49,588.99	$49,588.99	2025-03-27
K0011	HCPCS	Stnd Wt Pwr Whlchr W Control	1	1	—	—	$49,322.96	$49,322.96	$49,322.96	2025-03-27
0543T	CPT	Ta Mv Rpr W/artif Chord Tend	1	1	—	—	$49,269.45	$49,269.45	$49,269.45	2025-03-27
0544T	CPT	Tcat Mv Annulus Rcnstj	1	1	—	—	$49,269.45	$49,269.45	$49,269.45	2025-03-27
93654	CPT	Compre Ep Eval Tx Vt	1	1	—	—	$49,244.98	$49,244.98	$49,244.98	2025-03-27
K0861	HCPCS	Pwc Gp3 Std Mult Pow Opt S/b	1	1	—	—	$49,132.60	$49,132.60	$49,132.60	2025-03-27
J0600	HCPCS	Edetate Calcium Disodium Inj	1	1	—	—	$49,094.93	$49,094.93	$49,094.93	2025-03-27
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	1	1	—	—	$48,530.56	$48,530.56	$48,530.56	2025-03-27
0094U	CPT	Genome Rapid Sequence Alys	1	1	—	—	$48,404.77	$48,404.77	$48,404.77	2025-03-27
93653	CPT	Compre Ep Eval Tx Svt	1	1	—	—	$48,267.86	$48,267.86	$48,267.86	2025-03-27
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	1	1	—	—	$48,046.98	$48,046.98	$48,046.98	2025-03-27
E0616	HCPCS	Cardiac Event Recorder	1	1	—	—	$48,008.09	$48,008.09	$48,008.09	2025-03-27
C1786	HCPCS	Pmkr, Single, Rate-resp	1	1	—	—	$48,008.09	$48,008.09	$48,008.09	2025-03-27
C1785	HCPCS	Pmkr, Dual, Rate-resp	1	1	—	—	$48,008.09	$48,008.09	$48,008.09	2025-03-27
C1764	HCPCS	Event Recorder, Cardiac	1	1	—	—	$48,008.09	$48,008.09	$48,008.09	2025-03-27
K0871	HCPCS	Pwc Gp 4 Vhd Seat/back	1	1	—	—	$47,903.27	$47,903.27	$47,903.27	2025-03-27
E0652	HCPCS	Pneum Compres W/cal Pressure	1	1	—	—	$47,869.73	$47,869.73	$47,869.73	2025-03-27
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	1	1	—	—	$47,764.14	$47,764.14	$47,764.14	2025-03-27
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	1	1	—	—	$47,286.04	$47,286.04	$47,286.04	2025-03-27
93656	CPT	Compre Ep Eval Abltj Atr Fib	1	1	—	—	$46,878.05	$46,878.05	$46,878.05	2025-03-27
L8683	HCPCS	Radiofq Trsmtr For Implt Neu	1	1	—	—	$46,623.89	$46,623.89	$46,623.89	2025-03-27
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	1	1	—	—	$46,530.58	$46,530.58	$46,530.58	2025-03-27
163	MS_DRG	Major Chest Procedures With Mcc	1	1	—	—	$46,353.57	$46,353.57	$46,353.57	2025-03-27
A9597	HCPCS	Pet, Dx, For Tumor Id, Noc	1	1	—	—	$46,285.90	$46,285.90	$46,285.90	2025-03-27
L5595	HCPCS	Hip Disartic Sach Thermopls	1	1	—	—	$46,273.52	$46,273.52	$46,273.52	2025-03-27
K0827	HCPCS	Pwc Gp Vhd Cap Chair	1	1	—	—	$46,101.51	$46,101.51	$46,101.51	2025-03-27
K0848	HCPCS	Pwc Gp 3 Std Seat/back	1	1	—	—	$45,699.42	$45,699.42	$45,699.42	2025-03-27
93592	CPT	Perq Transcath Closure Each	1	1	—	—	$45,676.49	$45,676.49	$45,676.49	2025-03-27
E1005	HCPCS	Pwr Seat Recline Pwr	1	1	—	—	$45,577.86	$45,577.86	$45,577.86	2025-03-27
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	1	1	—	—	$45,552.48	$45,552.48	$45,552.48	2025-03-27
E1841	HCPCS	Sps/pass Shoulder Device	1	1	—	—	$45,451.72	$45,451.72	$45,451.72	2025-03-27
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	1	1	—	—	$45,302.48	$45,302.48	$45,302.48	2025-03-27
K0843	HCPCS	Pwc Gp2 Hd Mult Pow Opt S/b	1	1	—	—	$44,965.54	$44,965.54	$44,965.54	2025-03-27
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	1	1	—	—	$44,838.99	$44,838.99	$44,838.99	2025-03-27
31	MS_DRG	Ventricular Shunt Procedures With Mcc	1	1	—	—	$44,815.26	$44,815.26	$44,815.26	2025-03-27
L6350	HCPCS	Thoracic Intern Lock Elbow	1	1	—	—	$44,674.96	$44,674.96	$44,674.96	2025-03-27
G2070	HCPCS	Outpatient Services	1	1	—	—	$44,543.86	$44,543.86	$44,543.86	2025-03-27
E0694	HCPCS	Uvl Md Cabinet Sys 6 Ft	1	1	—	—	$44,421.93	$44,421.93	$44,421.93	2025-03-27
J0716	HCPCS	Centruroides Immune F(ab)	1	1	—	—	$44,287.15	$44,287.15	$44,287.15	2025-03-27
L5160	HCPCS	Mold Socket Bent Knee Shin S	1	1	—	—	$43,895.68	$43,895.68	$43,895.68	2025-03-27
J2350	HCPCS	Ocrevus 300 Mg/10 Ml Vial	17	7	$58,504.70	$28,082.26 52% off	$499.88	$52,654.23	$43,878.53	2025-03-27
L6550	HCPCS	Shldr Disar Prosth Tiss Shap	1	1	—	—	$43,822.75	$43,822.75	$43,822.75	2025-03-27
L5230	HCPCS	Fem Focal Defic Constant Fri	1	1	—	—	$43,718.55	$43,718.55	$43,718.55	2025-03-27
K0878	HCPCS	Pwc Gp4 Std Sing Pow Opt Cap	1	1	—	—	$43,548.47	$43,548.47	$43,548.47	2025-03-27
K0868	HCPCS	Pwc Gp 4 Std Seat/back	1	1	—	—	$43,548.47	$43,548.47	$43,548.47	2025-03-27
K0869	HCPCS	Pwc Gp 4 Std Cap Chair	1	1	—	—	$43,548.47	$43,548.47	$43,548.47	2025-03-27
K0870	HCPCS	Pwc Gp 4 Hd Seat/back	1	1	—	—	$43,548.47	$43,548.47	$43,548.47	2025-03-27
E0372	HCPCS	Powered Air Mattress Overlay	1	1	—	—	$43,286.79	$43,286.79	$43,286.79	2025-03-27
E0782	HCPCS	Non-programble Infusion Pump	1	1	—	—	$43,078.07	$43,078.07	$43,078.07	2025-03-27
321	MS_DRG	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	1	1	—	—	$42,999.59	$42,999.59	$42,999.59	2025-03-27
E2328	HCPCS	Head/extremity Control Inter	1	1	—	—	$42,853.34	$42,853.34	$42,853.34	2025-03-27
L6300	HCPCS	Shlder Disart Int Lock Elbow	1	1	—	—	$42,815.79	$42,815.79	$42,815.79	2025-03-27
K0010	HCPCS	Stnd Wt Frame Power Whlchr	1	1	—	—	$42,741.71	$42,741.71	$42,741.71	2025-03-27
E0986	HCPCS	Man W/c Push-rim Powr System	1	1	—	—	$42,620.40	$42,620.40	$42,620.40	2025-03-27
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	1	1	—	—	$42,614.55	$42,614.55	$42,614.55	2025-03-27
G2072	HCPCS	Outpatient Services	1	1	—	—	$42,396.56	$42,396.56	$42,396.56	2025-03-27
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	1	1	—	—	$42,185.73	$42,185.73	$42,185.73	2025-03-27
E1004	HCPCS	Pwr Seat Recline Mech	1	1	—	—	$42,107.29	$42,107.29	$42,107.29	2025-03-27
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	1	1	—	—	$42,085.36	$42,085.36	$42,085.36	2025-03-27
K0824	HCPCS	Pwc Gp 2 Hd Seat/back	1	1	—	—	$41,879.41	$41,879.41	$41,879.41	2025-03-27
K0837	HCPCS	Pwc Gp 2 Hd Sing Pow Opt S/b	1	1	—	—	$41,879.41	$41,879.41	$41,879.41	2025-03-27
959	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	1	1	—	—	$41,576.24	$41,576.24	$41,576.24	2025-03-27
29	MS_DRG	Spinal Procedures With Cc Or Spinal Neurostimulators	1	1	—	—	$41,183.91	$41,183.91	$41,183.91	2025-03-27
970	MS_DRG	HIV With Extensive O.r. Procedures Without Mcc	1	1	—	—	$41,136.47	$41,136.47	$41,136.47	2025-03-27
652	MS_DRG	Kidney Transplant	1	1	—	—	$40,762.38	$40,762.38	$40,762.38	2025-03-27
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	1	1	—	—	$40,729.54	$40,729.54	$40,729.54	2025-03-27
242	MS_DRG	Permanent Cardiac Pacemaker Implant With Mcc	1	1	—	—	$40,581.73	$40,581.73	$40,581.73	2025-03-27
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	1	1	—	—	$40,563.48	$40,563.48	$40,563.48	2025-03-27
411	MS_DRG	Cholecystectomy With C.d.e. With Mcc	1	1	—	—	$40,559.83	$40,559.83	$40,559.83	2025-03-27
245	MS_DRG	Aicd Generator Procedures	1	1	—	—	$40,499.61	$40,499.61	$40,499.61	2025-03-27
265	MS_DRG	Aicd Lead Procedures	1	1	—	—	$40,499.61	$40,499.61	$40,499.61	2025-03-27
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	1	1	—	—	$40,413.85	$40,413.85	$40,413.85	2025-03-27
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	1	1	—	—	$40,388.30	$40,388.30	$40,388.30	2025-03-27
854	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Cc	1	1	—	—	$40,377.35	$40,377.35	$40,377.35	2025-03-27
L5150	HCPCS	Mold Sckt Ext Knee Shin Sach	1	1	—	—	$40,357.15	$40,357.15	$40,357.15	2025-03-27
E0482	HCPCS	Cough Stimulating Device	1	1	—	—	$40,045.48	$40,045.48	$40,045.48	2025-03-27
L5105	HCPCS	Plast Socket Jts/thgh Lacer	1	1	—	—	$39,923.53	$39,923.53	$39,923.53	2025-03-27
332	MS_DRG	Rectal Resection With Mcc	1	1	—	—	$39,888.30	$39,888.30	$39,888.30	2025-03-27
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	1	1	—	—	$39,625.53	$39,625.53	$39,625.53	2025-03-27
27	MS_DRG	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	1	1	—	—	$39,612.76	$39,612.76	$39,612.76	2025-03-27
J9225	HCPCS	Vantas Implant	1	1	—	—	$39,442.17	$39,442.17	$39,442.17	2025-03-27
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	1	1	—	—	$39,196.70	$39,196.70	$39,196.70	2025-03-27
460	MS_DRG	Inpatient Ms-DRG	1	1	—	—	$39,178.46	$39,178.46	$39,178.46	2025-03-27
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	1	1	—	—	$39,178.46	$39,178.46	$39,178.46	2025-03-27

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