Price Transparencybeta Hospital negotiated rates

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

MT. GRAHAM REGIONAL MEDICAL CENTER

Safford, AZ · CCN 031319 · Rates published

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You selected 27447 (CPT)

TOTAL KNEE ARTHROPLASTY

This hospital’s price: $4,423 across 6 payers · range $4,023-$10,148

Source: https://www.mtgraham.org/wp-content/uploads/2026/03/237094247_mt-graham-regional-medical-center_standardcharges.csv · observed 2026-01-01

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.

2,197 distinct procedures filed
194 distinct payers
41,270 rate rows
2026-01-01 last MRF observed
Data quality

40,832 of 41,270 rate rows are consumer-grade (98.9%)

438 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 308
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 78
placeholder amount (≤ $0.02) — excluded from medians 52
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.mtgraham.org/wp-content/uploads/2026/03/237094247_mt-graham-regional-medical-center_standardcharges.csv
Found on page https://www.mtgraham.org/pricing-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-07-31
Content fingerprint 460dabf51f6269b9… · 5,779,228 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
Q4278
HCPCS 		Epieffect, Per Sq Cm 1 $244,999.76 $244,999.76 $244,999.76 nat. median
$344
outlier · 712.1×
912
MS_DRG 		Extensive O.r. Procedure Unrel 1 $185,193.67 $185,193.67 $185,193.67 nat. median
$44,600
outlier · 4.2×
Q4259
HCPCS 		Celera Per Sq Cm 3 $55,421.92 $142,337.20 $142,337.20 nat. median
$1,017
outlier · 140.0×
424
MS_DRG 		Other Hepatobiliary Or Pancrea 2 $86,702.07 $86,702.07 $86,702.07 nat. median
$22,169
outlier · 3.9×
354
MS_DRG 		Hernia Procedures Except Ingui 1 $82,706.32 $82,706.32 $82,706.32 nat. median
$17,345
outlier · 4.8×
418
MS_DRG 		Laparoscopic Cholecystectomy W 1 $71,312.26 $71,312.26 $71,312.26 nat. median
$17,341
outlier · 4.1×
308
MS_DRG 		Cardiac Arrhythmia & Conductio 1 $68,103.80 $68,103.80 $68,103.80 nat. median
$12,590
outlier · 5.4×
690
MS_DRG 		Kidney & Urinary Tract Infecti 1 $65,843.83 $65,843.83 $65,843.83 nat. median
$8,869
outlier · 7.4×
330
MS_DRG 		Major Small & Large Bowel Proc 2 $48,740.53 $176,947.76 $63,929.30 nat. median
$24,077
outlier · 2.7×
314
MS_DRG 		Other Circulatory System Diagn 1 $62,710.56 $62,710.56 $62,710.56 nat. median
$20,500
outlier · 3.1×
853
MS_DRG 		Infectious & Parasitic Disease 1 $62,690.57 $62,690.57 $62,690.57 nat. median
$47,707
1.3× median
48
MS_DRG 		Peripheral Nerve And Other Ner 1 $61,296.59 $61,296.59 $61,296.59 nat. median
$8,326
outlier · 7.4×
282
MS_DRG 		Acute Myocardial Infarction, D 1 $56,694.04 $56,694.04 $56,694.04 nat. median
$8,425
outlier · 6.7×
775
MS_DRG 		Vaginal Delivery Without Compl 1 $55,512.96 $55,512.96 $55,512.96 nat. median
$4,728
outlier · 11.7×
417
MS_DRG 		Laparoscopic Cholecystectomy W 1 $53,450.79 $53,450.79 $53,450.79 nat. median
$23,528
outlier · 2.3×
0481
RC 		2 $48,003.00 $57,764.00 $52,883.50 nat. median
$3,480
outlier · 15.2×
710
MS_DRG 		Penis Procedures Without Cc/mcc 1 $52,052.31 $52,052.31 $52,052.31 nat. median
$14,879
outlier · 3.5×
231
MS_DRG 		Coronary Bypass W/ptca W/mcc 1 $48,328.87 $48,328.87 $48,328.87 nat. median
$79,040
0.6× median
641
MS_DRG 		Miscellaneous Disorders Of Nut 1 $44,260.21 $44,260.21 $44,260.21 nat. median
$8,588
outlier · 5.2×
190
MS_DRG 		Chronic Obstructive Pulmonary 2 $32,671.94 $51,727.93 $42,199.94 nat. median
$11,661
outlier · 3.6×
337
MS_DRG 		Peritoneal Adhesiolysis Without Cc 1 $34,294.27 $49,115.73 $41,705.00 nat. median
$16,034
outlier · 2.6×
674
MS_DRG 		Other Kidney & Urinary Tract P 1 $29,183.58 $52,818.45 $41,001.01 nat. median
$23,243
1.8× median
818
MS_DRG 		Other Antepartum Diagnoses Without 1 $39,660.61 $39,660.61 $39,660.61 nat. median
$12,579
outlier · 3.2×
720
MS_DRG 		Septicemia Without Mechanical 1 $38,436.86 $38,436.86 $38,436.86 nat. median
$10,914
outlier · 3.5×
391
MS_DRG 		Esophagitis, Gastroent & Misce 1 $36,634.31 $36,634.31 $36,634.31 nat. median
$13,072
outlier · 2.8×
331
MS_DRG 		Major Small & Large Bowel Proc 2 $35,938.66 $37,027.16 $36,482.91 nat. median
$17,453
outlier · 2.1×
813
MS_DRG 		Coagulation Disorders 1 $36,210.56 $36,210.56 $36,210.56 nat. median
$15,573
outlier · 2.3×
249
MS_DRG 		Perc Cardiovasc Proc W Non-dru 1 $33,827.17 $33,827.17 $33,827.17 nat. median
$14,021
outlier · 2.4×
503
MS_DRG 		Foot Procedures W/mcc 1 $11,908.34 $52,984.40 $32,446.37 nat. median
$26,831
1.2× median
419
MS_DRG 		Laparoscopic Cholecystectomy W 1 $31,899.75 $31,899.75 $31,899.75 nat. median
$14,273
outlier · 2.2×
J0716
HCPCS 		Centruroides Immune F(ab) 5 $21,084.40 $31,626.60 $31,626.60 nat. median
$5,351
outlier · 5.9×
J0717
HCPCS 		Certolizumab Pegol Inj 1mg 2 $26,997.58 $35,996.78 $31,497.18 nat. median
$1,187
outlier · 26.5×
420
MS_DRG 		Hepatobiliary Diagnostic Proce 1 $28,042.28 $28,042.28 $28,042.28 nat. median
$32,655
0.9× median
425
MS_DRG 		Other Hepatobiliary Or Pancrea 1 $28,022.10 $28,022.10 $28,022.10 nat. median
$15,584
1.8× median
C1602
HCPCS 		Orth/matrx/bn Fill Drug-elut 3 $27,888.75 $27,888.75 $27,888.75 nat. median
$6,302
outlier · 4.4×
326
MS_DRG 		Stomach, Esophageal & Duodenal 1 $26,999.53 $26,999.53 $26,999.53 nat. median
$48,124
0.6× median
J0841
HCPCS 		Inj Crotalidae IM F(ab')2 Eq 2 $26,900.00 $26,900.00 $26,900.00 nat. median
$1,842
outlier · 14.6×
193
MS_DRG 		Simple Pneumonia & Pleurisy With 2 $26,444.50 $27,190.39 $26,817.44 nat. median
$13,455
2.0× median
439
MS_DRG 		Disorders Of Pancreas Except M 1 $26,500.29 $26,500.29 $26,500.29 nat. median
$9,456
outlier · 2.8×
788
MS_DRG 		Cesarean Section Without Steriliza 1 $18,606.40 $33,389.33 $25,997.87 nat. median
$10,065
outlier · 2.6×
33210
CPT 		Insert Electrd/pm Cath Sngl 1 $25,310.00 $25,310.00 $25,310.00 nat. median
$8,276
outlier · 3.1×
0150
RC 		2 $24,554.88 $24,554.88 $24,554.88 nat. median
$862
outlier · 28.5×
194
MS_DRG 		Simple Pneumonia & Pleurisy With 1 $24,234.18 $24,234.18 $24,234.18 nat. median
$9,038
outlier · 2.7×
481
MS_DRG 		Hip & Femur Procedures Except 1 $24,181.11 $24,181.11 $24,181.11 nat. median
$21,418
1.1× median
440
MS_DRG 		Disorders Of Pancreas Except M 2 $21,318.57 $26,259.05 $23,788.81 nat. median
$7,284
outlier · 3.3×
189
MS_DRG 		Pulmonary Edema & Respiratory 1 $23,380.15 $23,380.15 $23,380.15 nat. median
$12,892
1.8× median
798
MS_DRG 		Vaginal Delivery With Steriliz 1 $22,651.44 $22,651.44 $22,651.44 nat. median
$9,531
outlier · 2.4×
Q5119
HCPCS 		Inj Ruxience, 10 Mg 2 $14,436.00 $28,872.00 $21,654.00 nat. median
$751
outlier · 28.8×
J9144
HCPCS 		Daratumumab, Hyaluronidase 1 $21,168.74 $21,168.74 $21,168.74 nat. median
$202
outlier · 104.7×
540
MS_DRG 		Osteomyelitis W/cc 2 $17,094.37 $24,984.54 $21,039.46 nat. median
$13,334
1.6× median

Other procedures at this hospital

Browse this hospital's 2,197 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
Q4278 HCPCS Epieffect, Per Sq Cm 1 1 $349,999.65 — $244,999.76 $244,999.76 $244,999.76 2026-01-01
912 MS_DRG Extensive O.r. Procedure Unrel 1 1 $185,193.67 — $185,193.67 $185,193.67 $185,193.67 2026-01-01
Q4259 HCPCS Celera Per Sq Cm 3 3 $186,426.08 — $55,421.92 $142,337.20 $142,337.20 2026-01-01
424 MS_DRG Other Hepatobiliary Or Pancrea 2 2 $86,702.07 — $86,702.07 $86,702.07 $86,702.07 2026-01-01
354 MS_DRG Hernia Procedures Except Ingui 1 1 $82,706.32 — $82,706.32 $82,706.32 $82,706.32 2026-01-01
418 MS_DRG Laparoscopic Cholecystectomy W 1 1 $71,312.26 — $71,312.26 $71,312.26 $71,312.26 2026-01-01
308 MS_DRG Cardiac Arrhythmia & Conductio 1 1 $68,103.80 — $68,103.80 $68,103.80 $68,103.80 2026-01-01
690 MS_DRG Kidney & Urinary Tract Infecti 1 1 $65,843.83 — $65,843.83 $65,843.83 $65,843.83 2026-01-01
330 MS_DRG Major Small & Large Bowel Proc 3 2 $63,929.30 — $48,740.53 $176,947.76 $63,929.30 2026-01-01
314 MS_DRG Other Circulatory System Diagn 1 1 $62,710.56 — $62,710.56 $62,710.56 $62,710.56 2026-01-01
853 MS_DRG Infectious & Parasitic Disease 1 1 $62,690.57 — $62,690.57 $62,690.57 $62,690.57 2026-01-01
48 MS_DRG Peripheral Nerve And Other Ner 1 1 $61,296.59 — $61,296.59 $61,296.59 $61,296.59 2026-01-01
282 MS_DRG Acute Myocardial Infarction, D 1 1 $56,694.04 — $56,694.04 $56,694.04 $56,694.04 2026-01-01
775 MS_DRG Vaginal Delivery Without Compl 1 1 $62,801.09 — $55,512.96 $55,512.96 $55,512.96 2026-01-01
417 MS_DRG Laparoscopic Cholecystectomy W 1 1 $53,450.79 — $53,450.79 $53,450.79 $53,450.79 2026-01-01
0481 RC — 2 2 $52,883.50 — $48,003.00 $57,764.00 $52,883.50 2026-01-01
710 MS_DRG Penis Procedures Without Cc/mcc 1 1 $52,052.31 — $52,052.31 $52,052.31 $52,052.31 2026-01-01
231 MS_DRG Coronary Bypass W/ptca W/mcc 1 1 $48,328.87 — $48,328.87 $48,328.87 $48,328.87 2026-01-01
641 MS_DRG Miscellaneous Disorders Of Nut 1 1 $44,260.21 — $44,260.21 $44,260.21 $44,260.21 2026-01-01
190 MS_DRG Chronic Obstructive Pulmonary 2 2 $65,156.26 — $32,671.94 $51,727.93 $42,199.94 2026-01-01
337 MS_DRG Peritoneal Adhesiolysis Without Cc 2 1 $41,705.00 — $34,294.27 $49,115.73 $41,705.00 2026-01-01
674 MS_DRG Other Kidney & Urinary Tract P 2 1 $41,001.01 — $29,183.58 $52,818.45 $41,001.01 2026-01-01
818 MS_DRG Other Antepartum Diagnoses Without 1 1 $39,660.61 — $39,660.61 $39,660.61 $39,660.61 2026-01-01
720 MS_DRG Septicemia Without Mechanical 1 1 $57,153.69 — $38,436.86 $38,436.86 $38,436.86 2026-01-01
391 MS_DRG Esophagitis, Gastroent & Misce 1 1 $36,634.31 — $36,634.31 $36,634.31 $36,634.31 2026-01-01
331 MS_DRG Major Small & Large Bowel Proc 2 2 $36,482.91 — $35,938.66 $37,027.16 $36,482.91 2026-01-01
813 MS_DRG Coagulation Disorders 1 1 $36,210.56 — $36,210.56 $36,210.56 $36,210.56 2026-01-01
249 MS_DRG Perc Cardiovasc Proc W Non-dru 1 1 $33,827.17 — $33,827.17 $33,827.17 $33,827.17 2026-01-01
503 MS_DRG Foot Procedures W/mcc 2 1 $32,446.37 — $11,908.34 $52,984.40 $32,446.37 2026-01-01
419 MS_DRG Laparoscopic Cholecystectomy W 1 1 $31,899.75 — $31,899.75 $31,899.75 $31,899.75 2026-01-01
J0716 HCPCS Centruroides Immune F(ab) 10 5 $31,626.60 — $21,084.40 $31,626.60 $31,626.60 2026-01-01
J0717 HCPCS Certolizumab Pegol Inj 1mg 2 2 $35,996.78 — $26,997.58 $35,996.78 $31,497.18 2026-01-01
420 MS_DRG Hepatobiliary Diagnostic Proce 1 1 $28,042.28 — $28,042.28 $28,042.28 $28,042.28 2026-01-01
425 MS_DRG Other Hepatobiliary Or Pancrea 1 1 $29,609.11 — $28,022.10 $28,022.10 $28,022.10 2026-01-01
C1602 HCPCS Orth/matrx/bn Fill Drug-elut 3 3 $27,888.75 — $27,888.75 $27,888.75 $27,888.75 2026-01-01
326 MS_DRG Stomach, Esophageal & Duodenal 1 1 $31,721.45 — $26,999.53 $26,999.53 $26,999.53 2026-01-01
J0841 HCPCS Inj Crotalidae IM F(ab')2 Eq 2 2 $26,900.00 — $26,900.00 $26,900.00 $26,900.00 2026-01-01
193 MS_DRG Simple Pneumonia & Pleurisy With 2 2 $31,035.17 — $26,444.50 $27,190.39 $26,817.44 2026-01-01
439 MS_DRG Disorders Of Pancreas Except M 1 1 $26,500.29 — $26,500.29 $26,500.29 $26,500.29 2026-01-01
788 MS_DRG Cesarean Section Without Steriliza 2 1 $25,997.87 — $18,606.40 $33,389.33 $25,997.87 2026-01-01
33210 CPT Insert Electrd/pm Cath Sngl 1 1 $25,310.00 — $25,310.00 $25,310.00 $25,310.00 2026-01-01
0150 RC — 2 2 $24,554.88 — $24,554.88 $24,554.88 $24,554.88 2026-01-01
194 MS_DRG Simple Pneumonia & Pleurisy With 1 1 $24,719.00 — $24,234.18 $24,234.18 $24,234.18 2026-01-01
481 MS_DRG Hip & Femur Procedures Except 1 1 $39,328.21 — $24,181.11 $24,181.11 $24,181.11 2026-01-01
440 MS_DRG Disorders Of Pancreas Except M 2 2 $23,788.81 — $21,318.57 $26,259.05 $23,788.81 2026-01-01
189 MS_DRG Pulmonary Edema & Respiratory 1 1 $23,380.15 — $23,380.15 $23,380.15 $23,380.15 2026-01-01
798 MS_DRG Vaginal Delivery With Steriliz 1 1 $22,651.44 — $22,651.44 $22,651.44 $22,651.44 2026-01-01
Q5119 HCPCS Inj Ruxience, 10 Mg 2 2 $21,654.00 — $14,436.00 $28,872.00 $21,654.00 2026-01-01
J9144 HCPCS Daratumumab, Hyaluronidase 1 1 $21,168.74 — $21,168.74 $21,168.74 $21,168.74 2026-01-01
540 MS_DRG Osteomyelitis W/cc 2 2 $26,931.56 — $17,094.37 $24,984.54 $21,039.46 2026-01-01
871 MS_DRG Septicemia Or Severe Sepsis With 4 2 $25,100.62 — $5,218.68 $41,717.76 $20,840.15 2026-01-01
J2327 HCPCS Inj Risankizumab-rzaa 1 Mg 1 1 $20,795.40 — $20,795.40 $20,795.40 $20,795.40 2026-01-01
0490 RC — 2 2 $20,728.72 — $1,994.80 $39,407.45 $20,701.12 2026-01-01
J2323 HCPCS Natalizumab Injection 2 2 $20,540.52 — $20,540.52 $20,540.52 $20,540.52 2026-01-01
482 MS_DRG Hip & Femur Procedures Except 1 1 $20,365.94 — $20,365.94 $20,365.94 $20,365.94 2026-01-01
C1889 HCPCS Implant/insert Device, Noc 10 7 $20,671.88 — $976.39 $21,731.25 $20,142.19 2026-01-01
786 MS_DRG Cesarean Section Without Steriliza 2 1 $20,102.70 — $18,186.56 $22,018.84 $20,102.70 2026-01-01
J1162 HCPCS Digoxin Immune Fab (ovine) 1 1 $19,996.00 — $19,996.00 $19,996.00 $19,996.00 2026-01-01
139 MS_DRG Salivary Gland Procedures 1 1 $19,985.83 — $19,985.83 $19,985.83 $19,985.83 2026-01-01
807 MS_DRG Vaginal Delivery Without Steri 4 2 $20,902.26 — $11,112.92 $25,557.42 $19,534.42 2026-01-01
C1776 HCPCS Joint Device (implantable) 37 22 $26,575.05 — $2,694.45 $58,128.75 $19,252.73 2026-01-01
J9358 HCPCS Inj Fam-trastu Deru-nxki 1mg 1 1 $18,668.82 — $18,668.82 $18,668.82 $18,668.82 2026-01-01
J0896 HCPCS Inj Luspatercept-aamt 0.25mg 2 2 $20,603.15 — $16,502.56 $20,283.71 $18,393.14 2026-01-01
783 MS_DRG Cesarean Section w/Sterilizati 2 1 $17,825.67 — $16,245.20 $19,406.14 $17,825.67 2026-01-01
179 MS_DRG Respiratory Infections & Infla 1 1 $17,817.84 — $17,817.84 $17,817.84 $17,817.84 2026-01-01
787 MS_DRG Cesarean Section Without Steriliza 3 2 $17,722.05 — $13,927.31 $19,085.97 $17,722.05 2026-01-01
93460 CPT R&l Hrt Art/ventricle Angio 7 6 $27,217.00 — $8,165.10 $27,217.00 $17,691.05 2026-01-01
C1761 HCPCS Cath, Trans Intra Litho/coro 1 1 $17,625.00 — $17,625.00 $17,625.00 $17,625.00 2026-01-01
784 MS_DRG Cesarean Section w/Sterilizati 3 2 $17,518.66 — $17,518.66 $17,790.57 $17,518.66 2026-01-01
Q5115 HCPCS Inj Truxima 10 Mg 1 1 $16,961.00 — $16,961.00 $16,961.00 $16,961.00 2026-01-01
33967 CPT Insert I-aort Percut Device 1 1 $24,557.00 — $15,962.00 $15,962.00 $15,962.00 2026-01-01
J0775 HCPCS Collagenase, Clost Hist Inj 1 1 $14,770.28 — $14,770.28 $14,770.28 $14,770.28 2026-01-01
797 MS_DRG Vaginal Delivery With Steriliz 1 1 $13,981.66 — $13,981.66 $13,981.66 $13,981.66 2026-01-01
394 MS_DRG Other Digestive System Diagnos 1 1 $13,862.18 — $13,862.18 $13,862.18 $13,862.18 2026-01-01
J2353 HCPCS Octreotide Injection, Depot 3 3 $13,850.12 — $9,981.81 $13,850.12 $13,850.12 2026-01-01
785 MS_DRG Cesarean Section w/Sterilizati 2 1 $13,828.42 — $11,056.64 $16,600.20 $13,828.42 2026-01-01
92920 CPT Prq Cardiac Angioplast 1 Art 1 1 $21,113.00 — $13,723.45 $13,723.45 $13,723.45 2026-01-01
J9306 HCPCS Injection, Pertuzumab, 1 Mg 1 1 $13,690.98 — $13,690.98 $13,690.98 $13,690.98 2026-01-01
J0741 HCPCS Inj, Cabote Rilpivir 2mg 3mg 1 1 $13,603.52 — $13,603.52 $13,603.52 $13,603.52 2026-01-01
Q5103 HCPCS Injection, Inflectra 4 2 $13,597.92 — $13,597.92 $17,483.04 $13,597.92 2026-01-01
J9145 HCPCS Injection, Daratumumab 10 Mg 3 1 $16,315.24 — $2,224.72 $15,573.08 $13,441.46 2026-01-01
J1602 HCPCS Golimumab For IV Use 1mg 2 2 $12,145.14 — $8,096.76 $16,193.52 $12,145.14 2026-01-01
805 MS_DRG Vaginal Delivery Without Steri 1 1 $12,077.04 — $12,077.04 $12,077.04 $12,077.04 2026-01-01
J0881 HCPCS Darbepoetin Alfa, Non-esrd 1 1 $11,610.10 — $11,610.10 $11,610.10 $11,610.10 2026-01-01
177 MS_DRG Respiratory Infections & Infla 2 2 $12,669.14 — $5,614.57 $16,989.67 $11,302.12 2026-01-01
33208 CPT Insrt Heart Pm Atrial & Vent 4 3 $11,183.00 — $11,183.00 $37,279.00 $11,183.00 2026-01-01
896 MS_DRG Alcohol/Drug Abuse Or Dependen 1 1 $11,073.07 — $11,073.07 $11,073.07 $11,073.07 2026-01-01
560 MS_DRG Aftercare, Musculoskeletal Sys 2 2 $17,302.42 — $4,059.52 $17,753.29 $10,906.41 2026-01-01
842 MS_DRG Lymphoma & Non-acute Leukemia 2 1 $10,865.50 — $10,865.50 $10,865.50 $10,865.50 2026-01-01
J3101 HCPCS Tenecteplase Injection 6 3 $10,972.88 — $288.00 $13,716.10 $10,835.72 2026-01-01
J0491 HCPCS Inj Anifrolumab-fnia 1mg 1 1 $10,931.28 — $10,720.01 $10,720.01 $10,720.01 2026-01-01
305 MS_DRG Hypertension Without Mcc 1 1 $16,289.51 — $10,509.33 $10,509.33 $10,509.33 2026-01-01
C1739 HCPCS Tissue Marker, Detectable 1 1 $9,971.78 — $9,971.78 $9,971.78 $9,971.78 2026-01-01
815 MS_DRG Reticuloendothelial And Immuni 1 1 $9,877.43 — $9,877.43 $9,877.43 $9,877.43 2026-01-01
43289 CPT Unlisted Laps Px Esoph 3 1 $9,802.46 — $1,838.75 $9,802.46 $9,802.46 2026-01-01
392 MS_DRG Esophagitis, Gastroent & Misce 1 1 $9,641.18 — $9,641.18 $9,641.18 $9,641.18 2026-01-01
806 MS_DRG Vaginal Delivery Without Steri 3 2 $9,579.85 — $7,476.59 $19,646.84 $9,579.85 2026-01-01
J9312 HCPCS Inj., Rituximab, 10 Mg 2 2 $9,445.20 — $9,445.20 $9,445.20 $9,445.20 2026-01-01
872 MS_DRG Septicemia Or Severe Sepsis With 3 2 $9,395.61 — $4,177.58 $12,049.74 $9,395.61 2026-01-01
769 MS_DRG Postpartum & Post Abortion Dia 1 1 $9,229.14 — $9,229.14 $9,229.14 $9,229.14 2026-01-01
0200 RC — 16 8 $9,126.00 — $3,042.00 $35,868.26 $9,126.00 2026-01-01
768 MS_DRG Vaginal Delivery With O.r. Pro 3 2 $9,077.90 — $7,182.62 $17,177.01 $9,077.90 2026-01-01
J9301 HCPCS Obinutuzumab Inj 1 1 $13,537.58 — $9,025.29 $9,025.29 $9,025.29 2026-01-01
J0129 HCPCS Abatacept Injection 9 5 $8,924.88 — $6,154.68 $9,450.00 $8,924.88 2026-01-01
65 MS_DRG Intracranial Hemorrhage Or Cer 2 2 $8,892.50 — $4,601.96 $13,183.04 $8,892.50 2026-01-01
J2356 HCPCS Inj Tezepelumab-ekko, 1mg 2 2 $8,762.92 — $8,762.92 $8,762.92 $8,762.92 2026-01-01
J1569 HCPCS Gammagard Liquid Injection 2 2 $8,755.50 — $7,009.40 $10,501.60 $8,755.50 2026-01-01
45399 CPT Unlisted Procedure Colon 1 1 $8,634.60 — $8,634.60 $8,634.60 $8,634.60 2026-01-01
92921 CPT Prq Cardiac Angio Addl Art 2 1 $8,618.77 — $3,978.00 $13,259.54 $8,618.77 2026-01-01
Q5111 HCPCS Injection, Udenyca 0.5 Mg 2 1 $8,375.00 — $8,375.00 $8,375.00 $8,375.00 2026-01-01
90375 CPT Rabies Ig Im/sc 14 10 $8,958.98 — $461.54 $13,398.46 $8,215.96 2026-01-01
841 MS_DRG Lymphoma & Non-acute Leukemia 2 1 $7,972.99 — $6,816.81 $9,129.16 $7,972.99 2026-01-01
28116 CPT Revision Of Foot 1 1 $7,942.00 — $7,942.00 $7,942.00 $7,942.00 2026-01-01
92928 CPT Prq Card Stent W/angio 1 Vsl 18 8 $7,931.00 — $7,021.00 $46,808.00 $7,931.00 2026-01-01
C1763 HCPCS Conn Tiss, Non-human 2 2 $7,895.89 — $6,952.50 $8,839.28 $7,895.89 2026-01-01
28110 CPT Part Removal Of Metatarsal 1 1 $7,818.00 — $7,818.00 $7,818.00 $7,818.00 2026-01-01
J1745 HCPCS Infliximab Not Biosimil 10mg 14 6 $7,800.00 — $1,586.68 $19,085.12 $7,800.00 2026-01-01
93454 CPT Coronary Artery Angio S&i 2 2 $10,634.40 — $5,068.80 $10,530.00 $7,799.40 2026-01-01
0120 RC — 34 16 $9,650.00 — $990.10 $28,100.00 $7,550.00 2026-01-01
G0390 HCPCS Trauma Respons W/hosp Criti 10 9 $7,478.00 — $3,066.00 $22,543.88 $7,478.00 2026-01-01
93458 CPT L Hrt Artery/ventricle Angio 22 10 $7,367.00 — $7,367.00 $49,114.00 $7,367.00 2026-01-01
27487 CPT Revise/replace Knee Joint 2 1 $8,210.71 — $6,124.42 $8,448.29 $7,286.36 2026-01-01
J1459 HCPCS Inj Ivig Privigen 500 Mg 4 3 $11,393.40 — $4,749.90 $15,087.40 $7,219.75 2026-01-01
J1306 HCPCS Injection, Inclisiran, 1 Mg 2 2 $7,200.46 — $7,062.47 $7,200.46 $7,131.47 2026-01-01
918 MS_DRG Poisoning & Toxic Effects Of D 2 1 $7,065.50 — $3,298.86 $10,832.15 $7,065.50 2026-01-01
602 MS_DRG Cellulitis W/mcc 1 1 $6,935.04 — $6,935.04 $6,935.04 $6,935.04 2026-01-01
57200 CPT Repair Of Vagina 1 1 $6,820.95 — $6,820.95 $6,820.95 $6,820.95 2026-01-01
49418 CPT Insert Tun Ip Cath Perc 3 3 $6,688.86 — $6,688.86 $6,688.86 $6,688.86 2026-01-01
J9035 HCPCS Bevacizumab Injection 3 2 $6,411.13 — $164.39 $6,425.52 $6,411.13 2026-01-01
92978 CPT Endoluminl Ivus Oct C 1st 16 9 $9,803.00 — $2,940.90 $11,273.45 $6,371.95 2026-01-01
27599 CPT Unlisted Px Femur/knee 3 2 $6,317.00 — $404.00 $6,317.00 $6,317.00 2026-01-01
27664 CPT Repair Of Leg Tendon Each 1 1 $6,257.50 — $6,257.50 $6,257.50 $6,257.50 2026-01-01
J9202 HCPCS Goserelin Acetate Implant 1 1 $6,209.60 — $6,209.60 $6,209.60 $6,209.60 2026-01-01
C1781 HCPCS Mesh (implantable) 22 15 $8,690.63 — $429.11 $11,626.13 $6,161.61 2026-01-01
43282 CPT Lap Paraesoph Her Rpr W/mesh 7 5 $6,619.50 — $2,095.00 $8,826.00 $6,039.56 2026-01-01
L8699 HCPCS Prosthetic Implant Nos 1 1 $5,981.25 — $5,981.25 $5,981.25 $5,981.25 2026-01-01
27828 CPT Treat Lower Leg Fracture 2 1 $5,899.00 — $2,283.00 $9,515.00 $5,899.00 2026-01-01
C1771 HCPCS Rep Dev, Urinary, W/sling 5 5 $5,883.75 — $198.97 $7,045.65 $5,883.75 2026-01-01
0404 RC — 1 1 $5,988.00 — $5,869.00 $5,869.00 $5,869.00 2026-01-01
28299 CPT Cor Hlx Vlgs Double Osteot 1 1 $5,863.50 — $5,863.50 $5,863.50 $5,863.50 2026-01-01
92929 CPT Prq Card Stent W/angio Addl 6 5 $5,738.00 — $5,738.00 $21,994.58 $5,738.00 2026-01-01
58554 CPT Laparo-vag Hyst W/t/o Compl 6 5 $6,515.00 — $2,301.25 $9,413.00 $5,711.12 2026-01-01
36566 CPT Insert Tunneled Cv Cath 1 1 $8,790.52 — $5,698.26 $5,698.26 $5,698.26 2026-01-01
J2357 HCPCS Omalizumab Injection 3 3 $5,714.48 — $5,652.16 $5,941.04 $5,652.16 2026-01-01
60240 CPT Removal Of Thyroid 4 2 $5,638.68 — $1,715.86 $9,561.50 $5,638.68 2026-01-01
J0257 HCPCS Glassia Injection 3 1 $5,625.00 — $5,625.00 $5,625.00 $5,625.00 2026-01-01
28496 CPT Treat Big Toe Fracture 2 1 $5,534.55 — $1,303.00 $9,766.09 $5,534.55 2026-01-01
27132 CPT Total Hip Arthroplasty 4 2 $5,916.95 — $5,275.46 $5,695.99 $5,485.73 2026-01-01
1967 OTHER Neuraxl Lbr Anes Vag Dlvr 30 16 $6,587.50 — $1,887.50 $17,387.50 $5,450.00 2026-01-01
Q0249 HCPCS Tocilizumab For Covid-19 1 1 $5,361.64 — $5,361.64 $5,361.64 $5,361.64 2026-01-01
Q4101 HCPCS Apligraf 3 2 $5,506.20 — $1,014.30 $9,562.50 $5,361.30 2026-01-01
J3262 HCPCS Tocilizumab Injection 2 2 $5,336.64 — $5,336.64 $5,336.64 $5,336.64 2026-01-01
22905 CPT Rad Resect Abd Tumor 5 Cm/> 1 1 $5,212.00 — $5,212.00 $5,212.00 $5,212.00 2026-01-01
28725 CPT Arthrodesis Subtalar 3 3 $5,212.00 — $5,212.00 $5,863.50 $5,212.00 2026-01-01
J3111 HCPCS Inj. Romosozumab-aqqg 1 Mg 7 4 $5,282.84 — $3,763.69 $10,565.68 $5,157.66 2026-01-01
C1713 HCPCS Anchor/screw Bn/bn,tis/bn 43 26 $6,041.35 — $622.94 $24,596.30 $5,148.01 2026-01-01
43281 CPT Lap Paraesophag Hern Repair 2 2 $7,355.00 — $5,124.22 $5,124.22 $5,124.22 2026-01-01
97810 CPT Acup 1/> Wo Estim 1st 15 Min 1 1 $4,967.33 — $4,967.33 $4,967.33 $4,967.33 2026-01-01
28041 CPT Exc Foot/toe Tum Dep 1.5cm/> 1 1 $4,954.50 — $4,954.50 $4,954.50 $4,954.50 2026-01-01
J0490 HCPCS Belimumab Injection 3 1 $8,512.80 — $3,148.83 $9,446.49 $4,891.20 2026-01-01
27870 CPT Fusion Of Ankle Joint Open 1 1 $4,886.25 — $4,886.25 $4,886.25 $4,886.25 2026-01-01
28297 CPT Cor Hlx Vlgs Jt Arthrd 8 6 $4,886.25 — $2,280.25 $8,677.50 $4,886.25 2026-01-01
44238 CPT Unlisted Laps Px Intestine 6 6 $4,881.51 — $4,560.50 $4,881.51 $4,881.51 2026-01-01
Q4159 HCPCS Affinity1 Square Cm 2 2 $4,781.25 — $4,781.25 $4,781.25 $4,781.25 2026-01-01
58270 CPT Vag Hyst W/enterocele Repair 1 1 $4,706.50 — $4,706.50 $4,706.50 $4,706.50 2026-01-01
59510 CPT Cesarean Delivery 11 10 $4,674.00 — $2,871.99 $4,674.00 $4,674.00 2026-01-01
27506 CPT Treatment Of Thigh Fracture 5 3 $5,148.50 — $3,199.25 $6,619.50 $4,627.73 2026-01-01
23474 CPT Revis Reconst Shoulder Joint 9 5 $5,148.50 — $3,676.48 $5,148.50 $4,565.14 2026-01-01
28730 CPT Fusion Of Foot Bones 1 1 $4,560.50 — $4,560.50 $4,560.50 $4,560.50 2026-01-01
28615 CPT Repair Foot Dislocation 1 1 $4,560.50 — $4,560.50 $4,560.50 $4,560.50 2026-01-01
78452 CPT Ht Muscle Image Spect Mult 20 8 $4,496.00 — $174.20 $9,908.00 $4,496.00 2026-01-01
27447 CPT Total Knee Arthroplasty 83 21 $4,423.49 — $4,023.49 $10,148.50 $4,423.49 2026-01-01
49659 CPT Unlstd Laps Px Hrnap Hrnrphy 1 1 $4,413.00 — $4,413.00 $4,413.00 $4,413.00 2026-01-01
27244 CPT Treat Thigh Fracture 2 1 $4,396.66 — $4,232.46 $4,560.85 $4,396.66 2026-01-01
27691 CPT Revise Lower Leg Tendon 1 1 $4,338.75 — $4,338.75 $4,338.75 $4,338.75 2026-01-01
15940 CPT Exc Ischial Pr Ulc Prim Sutr 1 1 $4,220.00 — $4,220.00 $4,220.00 $4,220.00 2026-01-01
59400 CPT Obstetrical Care 16 12 $4,220.00 — $2,532.00 $4,220.00 $4,220.00 2026-01-01
Q5129 HCPCS Inj, Vegzelma, 10 Mg 1 1 $4,214.40 — $4,214.40 $4,214.40 $4,214.40 2026-01-01
27236 CPT Treat Thigh Fracture 9 6 $4,208.34 — $3,407.17 $4,208.34 $4,208.34 2026-01-01
Q5108 HCPCS Injection, Fulphila 2 2 $4,200.00 — $4,200.00 $4,200.00 $4,200.00 2026-01-01
78816 CPT PET Image W/ct Full Body 18 9 $5,988.00 — $2,395.00 $5,988.00 $4,191.50 2026-01-01
35206 CPT Repair Blood Vessel Dir Uxtr 2 1 $4,171.75 — $3,131.50 $5,212.00 $4,171.75 2026-01-01
27514 CPT Treatment Of Thigh Fracture 7 3 $4,164.08 — $1,681.98 $7,355.00 $4,164.08 2026-01-01
0360 RC — 38 27 $4,486.75 — $1,226.33 $22,301.89 $4,161.00 2026-01-01
24586 CPT Treat Elbow Fracture 1 1 $4,110.30 — $4,110.30 $4,110.30 $4,110.30 2026-01-01
25999 CPT Unlisted Px Forearm/wrist 1 1 $4,106.00 — $4,106.00 $4,106.00 $4,106.00 2026-01-01
23473 CPT Revis Reconst Shoulder Joint 4 2 $4,633.49 — $3,382.98 $5,886.74 $4,083.23 2026-01-01
58553 CPT Laparo-vag Hyst Complex 2 1 $4,053.75 — $2,244.00 $5,863.50 $4,053.75 2026-01-01
24363 CPT Replace Elbow Joint 2 2 $4,000.00 — $4,000.00 $4,000.00 $4,000.00 2026-01-01
75716 CPT Artery X-rays Arms/legs 2 2 $3,986.00 — $3,986.00 $3,986.00 $3,986.00 2026-01-01
794 MS_DRG Neonate w/Other Significant Pr 3 2 $3,974.57 — $2,693.61 $13,459.25 $3,974.57 2026-01-01
24582 CPT Treat Humerus Fracture 2 1 $3,956.00 — $1,303.00 $6,609.00 $3,956.00 2026-01-01
J0256 HCPCS Alpha 1 Proteinase Inhibitor 2 2 $3,940.00 — $3,940.00 $3,940.00 $3,940.00 2026-01-01
27823 CPT Treatment Of Ankle Fracture 1 1 $3,909.00 — $3,909.00 $3,909.00 $3,909.00 2026-01-01
28291 CPT Corrj Halux Rigdus W/implt 1 1 $3,909.00 — $3,909.00 $3,909.00 $3,909.00 2026-01-01
49616 CPT Rpr Aa Hrn Rcr 3-10 Ncr/strn 2 2 $3,909.00 — $3,909.00 $3,909.00 $3,909.00 2026-01-01
95811 CPT Polysom 6/>yrs Cpap 4/> Parm 22 16 $3,895.00 — $2,657.95 $3,895.00 $3,895.00 2026-01-01
0350 RC — 28 19 $4,163.00 — $2,196.00 $7,785.00 $3,892.50 2026-01-01
23470 CPT Reconstruct Shoulder Joint 2 1 $4,058.53 — $3,704.07 $4,058.53 $3,881.30 2026-01-01
29827 CPT Sho Arthrs Srg Rt8tr Cuf Rpr 43 14 $3,865.75 — $1,737.33 $4,912.65 $3,865.75 2026-01-01
0683 RC — 32 22 $3,832.50 — $3,066.00 $25,048.75 $3,832.50 2026-01-01
27756 CPT Treatment Of Tibia Fracture 2 1 $3,782.65 — $1,959.30 $5,606.00 $3,782.65 2026-01-01
J0897 HCPCS Denosumab Injection 35 18 $3,775.86 — $2,662.62 $6,924.48 $3,775.86 2026-01-01
C8902 HCPCS MRA Without Fol W/cont, Abd 1 1 $3,720.00 — $3,720.00 $3,720.00 $3,720.00 2026-01-01
626 MS_DRG Thyroid, Parathyroid, & Thyrog 1 1 $4,494.71 — $3,679.66 $3,679.66 $3,679.66 2026-01-01
58570 CPT Tlh Uterus 250 G Or Less 1 1 $3,677.50 — $3,677.50 $3,677.50 $3,677.50 2026-01-01
23410 CPT Repair Rotator Cuff Acute 4 2 $4,473.32 — $2,802.13 $4,473.31 $3,637.72 2026-01-01
72158 CPT MRI Lumbar Spine Without & With Contrast 30 12 $4,274.00 — $1,710.00 $4,274.00 $3,633.00 2026-01-01
Q5114 HCPCS Inj Ogivri 10 Mg 1 1 $5,300.10 — $3,615.56 $3,615.56 $3,615.56 2026-01-01
25448 CPT Arthrp Ntrcrpl/crp/mtcrp Ssp 5 4 $4,253.00 — $2,642.80 $4,253.00 $3,612.41 2026-01-01
58552 CPT Laparo-vag Hyst Incl T/o 18 11 $4,560.50 — $1,976.00 $8,677.50 $3,594.00 2026-01-01
95810 CPT Polysom 6/> Yrs 4/> Param 24 17 $3,587.00 — $3,587.00 $3,587.00 $3,587.00 2026-01-01
60545 CPT Explore Adrenal Gland 6 1 $3,547.38 — $3,257.50 $3,547.48 $3,547.38 2026-01-01
25609 CPT Optx Dst Rd Xart Fx/ep Sep3+ 13 6 $3,520.00 — $1,760.00 $7,166.50 $3,520.00 2026-01-01
58563 CPT Hysteroscopy Ablation 29 13 $3,518.30 — $977.25 $3,603.25 $3,518.30 2026-01-01
24515 CPT Treat Humerus Fracture 2 1 $3,491.98 — $3,361.58 $3,622.39 $3,491.98 2026-01-01
0615 RC — 1 1 $3,942.00 — $3,486.50 $3,486.50 $3,486.50 2026-01-01
0611 RC — 2 2 $3,733.00 — $3,181.00 $3,733.00 $3,457.00 2026-01-01
75630 CPT X-ray Aorta Leg Arteries 2 2 $3,453.87 — $3,453.87 $3,453.87 $3,453.87 2026-01-01
44050 CPT Reduce Bowel Obstruction 2 2 $3,450.67 — $1,752.84 $5,148.50 $3,450.67 2026-01-01
C9359 HCPCS Implnt,bon Void Filler-putty 7 7 $3,438.75 — $3,438.75 $3,438.75 $3,438.75 2026-01-01
27235 CPT Treat Thigh Fracture 3 3 $3,425.00 — $3,015.50 $3,425.00 $3,425.00 2026-01-01
28238 CPT Revision Of Foot Tendon 4 4 $3,420.38 — $1,628.75 $5,212.00 $3,420.38 2026-01-01
791 MS_DRG Prematurity w/Major Problems 1 1 $3,417.88 — $3,417.88 $3,417.88 $3,417.88 2026-01-01
792 MS_DRG Prematurity Without Major Problems 2 1 $3,415.57 — $3,402.57 $3,428.57 $3,415.57 2026-01-01
44207 CPT L Colectomy/coloproctostomy 2 1 $3,414.52 — $3,414.52 $3,414.52 $3,414.52 2026-01-01
70552 CPT MRI Brain Stem With Contrast 1 1 $3,411.00 — $3,411.00 $3,411.00 $3,411.00 2026-01-01
G0257 HCPCS Unsched Dialysis Esrd Pt Hos 3 2 $3,409.25 — $3,409.25 $3,409.25 $3,409.25 2026-01-01
90935 CPT Hemodialysis One Evaluation 2 2 $3,388.25 — $3,388.25 $3,388.25 $3,388.25 2026-01-01
0801 RC — 1 1 $3,388.25 — $3,388.25 $3,388.25 $3,388.25 2026-01-01
P9037 HCPCS Plate Pheres Leukoredu Irrad 6 5 $3,368.00 — $1,684.00 $3,368.00 $3,368.00 2026-01-01
0614 RC — 4 3 $3,490.00 — $3,086.00 $3,894.00 $3,364.75 2026-01-01
640 MS_DRG Miscellaneous Disorders Of Nut 1 1 $5,179.29 — $3,330.93 $3,330.93 $3,330.93 2026-01-01
73723 CPT MRI Joint Lwr Extr W/O&with Contrast 18 7 $3,894.00 — $1,558.00 $3,894.00 $3,310.50 2026-01-01
27766 CPT Optx Medial Ankle Fx 1 1 $3,309.75 — $3,309.75 $3,309.75 $3,309.75 2026-01-01
73220 CPT MRI Uppr Extremity W/O&with Contrast 6 3 $3,302.46 — $1,550.00 $3,874.00 $3,302.46 2026-01-01
27822 CPT Treatment Of Ankle Fracture 4 3 $3,746.12 — $2,070.00 $5,212.00 $3,281.00 2026-01-01
J7307 HCPCS Etonogestrel Implant System 8 6 $3,277.44 — $3,277.44 $3,277.44 $3,277.44 2026-01-01
25310 CPT Transplant Forearm Tendon 3 2 $3,257.50 — $2,113.96 $3,257.50 $3,257.50 2026-01-01
54161 CPT Circum 28 Days Or Older 1 1 $3,257.50 — $3,257.50 $3,257.50 $3,257.50 2026-01-01
11771 CPT Remove Pilonidal Cyst Exten 1 1 $3,257.50 — $3,257.50 $3,257.50 $3,257.50 2026-01-01
58291 CPT Vag Hyst Incl T/o Complex 3 2 $3,257.50 — $2,510.00 $5,212.00 $3,257.50 2026-01-01
27331 CPT Explore/treat Knee Joint 1 1 $3,257.50 — $3,257.50 $3,257.50 $3,257.50 2026-01-01
0278 RC — 23 17 $3,235.54 — $125.00 $50,302.50 $3,235.54 2026-01-01
0335T OTHER Insj Sinus Tarsi Implant 1 1 $3,235.50 — $3,235.50 $3,235.50 $3,235.50 2026-01-01
67700 CPT Blepharotomy DRG Absc Eyelid 1 1 $3,235.50 — $3,235.50 $3,235.50 $3,235.50 2026-01-01
Q5136 HCPCS Inj. Denosumab-bbdz, 1 Mg 1 1 $3,233.26 — $3,233.26 $3,233.26 $3,233.26 2026-01-01
0612 RC — 7 7 $3,220.00 — $3,211.00 $12,817.00 $3,220.00 2026-01-01
0122 RC — 17 11 $3,200.00 — $1,600.00 $4,800.00 $3,200.00 2026-01-01
R0350 HCPCS R0350 1 1 $4,163.00 — $3,179.50 $3,179.50 $3,179.50 2026-01-01
72127 CPT CT Neck Spine Without & With Contrast 1 1 $3,178.00 — $3,178.00 $3,178.00 $3,178.00 2026-01-01
795 MS_DRG Normal Newborn 3 2 $4,529.57 — $3,102.59 $5,327.21 $3,173.57 2026-01-01
729 MS_DRG Other Male Reproductive System 1 1 $3,162.32 — $3,162.32 $3,162.32 $3,162.32 2026-01-01
27130 CPT Total Hip Arthroplasty 47 14 $3,160.00 — $425.72 $11,619.50 $3,160.00 2026-01-01
29880 CPT Knee Arthroscopy/surgery 21 9 $3,135.00 — $1,954.50 $4,954.50 $3,135.00 2026-01-01
60281 CPT Remove Thyroid Duct Lesion 1 1 $5,148.50 — $3,121.47 $3,121.47 $3,121.47 2026-01-01
49520 CPT Rerepair Ing Hernia Reduce 2 2 $4,990.25 — $1,303.00 $4,930.31 $3,116.66 2026-01-01
0610 RC — 8 7 $3,114.50 — $3,077.00 $4,237.00 $3,114.50 2026-01-01
44145 CPT Partial Removal Of Colon 1 1 $3,110.43 — $3,110.43 $3,110.43 $3,110.43 2026-01-01
74175 CPT CTA Abdomen W/contrast 6 2 $3,100.00 — $1,240.00 $3,100.00 $3,100.00 2026-01-01
25608 CPT Optx Dst Rd Xart Fx/epi Sep2 8 4 $3,583.25 — $2,000.00 $4,954.50 $3,066.05 2026-01-01
0684 RC — 28 23 $3,066.00 — $2,912.50 $20,039.00 $3,066.00 2026-01-01
0483 RC — 11 8 $3,647.00 — $2,454.00 $3,647.00 $3,050.50 2026-01-01
58579 CPT Unlisted Hystsc Px Uterus 1 1 $3,000.00 — $3,000.00 $3,000.00 $3,000.00 2026-01-01
70553 CPT MRI Brain Stem Without & With Contrast 68 23 $4,285.00 — $1,701.70 $4,285.00 $2,999.50 2026-01-01
J1439 HCPCS Inj Ferric Carboxymaltos 1mg 3 2 $2,995.18 — $2,909.40 $2,995.18 $2,995.18 2026-01-01
72157 CPT MRI Chest Spine Without & With Contrast 15 9 $4,278.00 — $1,711.00 $4,278.00 $2,994.50 2026-01-01
72156 CPT MRI Neck Spine Without & With Contrast 24 13 $4,265.00 — $1,706.00 $4,265.00 $2,985.50 2026-01-01
74183 CPT MRI Abd Without Cntr Flwd Cntr 42 19 $4,258.00 — $1,703.00 $4,258.00 $2,980.50 2026-01-01
27814 CPT Treatment Of Ankle Fracture 15 8 $3,207.29 — $1,954.50 $5,606.00 $2,976.37 2026-01-01
25337 CPT Reconstruct Ulna/radioulnar 3 1 $2,969.88 — $2,969.88 $3,909.00 $2,969.88 2026-01-01
27570 CPT Fixation Of Knee Joint 4 3 $2,963.05 — $2,518.00 $3,408.10 $2,963.05 2026-01-01
19307 CPT Mast Mod Rad 5 3 $3,677.50 — $2,236.22 $5,884.00 $2,956.86 2026-01-01
58571 CPT Tlh W/t/o 250 G Or Less 7 4 $2,955.55 — $2,364.44 $5,212.00 $2,955.55 2026-01-01
29891 CPT Ankle Arthroscopy/surgery 1 1 $2,942.00 — $2,942.00 $2,942.00 $2,942.00 2026-01-01
12057 CPT Intmd Rpr Face/mm >30.0 Cm 1 1 $2,942.00 — $2,942.00 $2,942.00 $2,942.00 2026-01-01
28750 CPT Fusion Of Big Toe Joint 4 3 $2,931.75 — $2,171.66 $3,909.00 $2,931.75 2026-01-01
72197 CPT MRI Pelvis Without & With Contrast 34 16 $4,176.00 — $1,670.00 $4,176.00 $2,923.00 2026-01-01
44204 CPT Laparo Partial Colectomy 13 9 $2,887.93 — $2,887.93 $11,032.50 $2,887.93 2026-01-01
1760 OTHER Anesth Elbow Replacement 2 2 $2,887.50 — $2,887.50 $2,887.50 $2,887.50 2026-01-01
70543 CPT MRI Orbt/fac/nck Without &with Contrast 12 6 $4,108.00 — $1,643.00 $4,108.00 $2,875.50 2026-01-01
45400 CPT Laparoscopic Proc 1 1 $2,871.74 — $2,871.74 $2,871.74 $2,871.74 2026-01-01
47564 CPT Laparo Cholecystectomy/explr 10 6 $2,997.06 — $747.08 $5,884.00 $2,866.83 2026-01-01
27536 CPT Treat Knee Fracture 2 1 $2,866.39 — $520.79 $5,212.00 $2,866.39 2026-01-01
789 MS_DRG Neonates, Died Or Transferred 2 1 $2,824.17 — $2,818.77 $2,829.57 $2,824.17 2026-01-01
58260 CPT Vaginal Hysterectomy 18 11 $3,467.50 — $1,736.67 $7,942.00 $2,822.84 2026-01-01
C1753 HCPCS Cath, Intravas Ultrasound 6 6 $2,812.50 — $2,812.50 $4,218.75 $2,812.50 2026-01-01
27245 CPT Treat Thigh Fracture 41 13 $2,800.00 — $2,500.00 $4,213.70 $2,800.00 2026-01-01
49553 CPT Rpr Fem Hernia Init Blocked 1 1 $4,413.00 — $2,798.04 $2,798.04 $2,798.04 2026-01-01
49596 CPT Rpr Aa Hrn 1st > 10 Ncr/strn 3 3 $3,257.50 — $2,305.96 $2,781.73 $2,781.73 2026-01-01
J2802 HCPCS Inj, Romiplostim 1 Microgram 5 4 $2,778.06 — $2,712.51 $2,778.06 $2,778.06 2026-01-01
32408 CPT Core Ndl Bx Lng/med Perq 11 6 $3,962.74 — $1,585.00 $3,962.74 $2,773.87 2026-01-01
73223 CPT MRI Joint Upr Extr W/O&with Contrast 3 2 $3,951.00 — $1,580.00 $3,951.00 $2,765.50 2026-01-01
70549 CPT Mr Angiograph Neck W/O&with Contrast 11 5 $3,942.00 — $1,577.00 $3,942.00 $2,759.50 2026-01-01
581 MS_DRG Other Skin, Subcutaneous Tissu 1 1 $2,899.37 — $2,755.16 $2,755.16 $2,755.16 2026-01-01
29888 CPT Knee Arthroscopy/surgery 17 6 $2,745.68 — $2,200.00 $7,166.50 $2,745.68 2026-01-01
19081 CPT Bx Breast 1st Lesion Strtctc 1 1 $3,908.00 — $2,735.50 $2,735.50 $2,735.50 2026-01-01
73218 CPT MRI Upper Extremity Without Contrast 20 8 $3,029.00 — $1,212.00 $3,029.00 $2,726.50 2026-01-01
33968 CPT Remove Aortic Assist Device 1 1 $4,188.00 — $2,722.20 $2,722.20 $2,722.20 2026-01-01
28308 CPT Incision Of Metatarsal 4 4 $2,704.50 — $2,280.25 $5,606.00 $2,704.50 2026-01-01
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