Hospital

SOUTH ARKANSAS REGIONAL HOSPITAL LLC

El Dorado, AR · CCN 040088 · Rates published

11,167 distinct procedures filed

22 distinct payers

197,913 rate rows

2026-01-08 last MRF observed

Data quality

197,677 of 197,913 rate rows are consumer-grade (99.9%)

236 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
per-diem day rate — not a per-procedure price	196
percent-of-charges filed in the dollar field — excluded from medians	29
exceeds 10× this hospital's gross charge — excluded from medians	10
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	1

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

Source MRF file	https://machine-readable-files.com/south-arkansas-regional-hospital/923616260_South-Arkansas-Regional-Hospital-LLC_standardcharges.csv
Found on page	https://sarhcare.org/cms-hpt.txt
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-10-21
Content fingerprint	6216376f24f7c38f… · 50,070,525 bytes · first seen 2026-05-11

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
1061547 CDM	S-rem-rep Cvd Mult	16	$30,000.00	$99,999.99	$82,499.99	nat. median $68,000 1.2× median
1061546 CDM	S-rem-rep Cvd Dual	16	$30,000.00	$99,999.99	$82,499.99	nat. median $64,999 1.3× median
1061520 CDM	S-fem Pop Stnt Athr	16	$29,999.97	$99,999.90	$82,499.92	nat. median $40,431 outlier · 2.0×
1061524 CDM	S-tib Per Rev Stn At	16	$29,999.97	$99,999.90	$82,499.92	nat. median $31,548 outlier · 2.6×
1061454 CDM	P-insert Icd Gen	16	$29,999.78	$99,999.25	$82,499.38	nat. median $68,000 1.2× median
1061467 CDM	S-ins-rep Pace-defib	16	$29,999.70	$99,999.00	$82,499.17	nat. median $67,613 1.2× median
C1882 HCPCS	Aicd Ohr Thn Sgl/du1	14	$24,032.42	$93,863.65	$69,234.13	nat. median $27,303 outlier · 2.5×
C1721 HCPCS	Aicd Dual Chamber L1	14	$8,215.59	$99,999.95	$61,878.22	nat. median $22,298 outlier · 2.8×
C1722 HCPCS	Aicd Single Chamber1	14	$20,283.42	$69,123.34	$56,384.18	nat. median $20,868 outlier · 2.7×
1061519 CDM	S-fem Pop Revas Stnt	16	$19,476.26	$64,920.87	$53,559.72	nat. median $28,720 1.9× median
1260244 CDM	Bilat Lithotripsy	16	$18,631.32	$62,104.40	$51,236.13	nat. median $51,236 1.0× median
1061545 CDM	S-rem-rep Cvd Single	16	$18,067.39	$60,224.64	$49,685.32	nat. median $54,698 0.9× median
1410017 CDM	Oth Ster Supp Lvl 17	16	$17,135.38	$57,117.94	$47,122.30	nat. median $59,000 0.8× median
2850078 CDM	Ir-tc Plc Stn Art Ea	16	$17,128.88	$57,096.27	$47,104.43	nat. median $6,507 outlier · 7.2×
8061069 CDM	Ir-tc Plc Stn Art Ea	16	$17,128.88	$57,096.27	$47,104.43	nat. median $42,822 1.1× median
1061523 CDM	S-tib Per Revas Stnt	16	$15,972.47	$53,241.56	$43,924.29	nat. median $26,843 1.6× median
1061522 CDM	S-tib Per Revas Athr	16	$15,972.47	$53,241.56	$43,924.29	nat. median $27,834 1.6× median
1061518 CDM	S-fem Pop Revas Athr	16	$15,972.47	$53,241.56	$43,924.29	nat. median $27,035 1.6× median
1061267 CDM	P-ins Dual Pac Sys	16	$15,454.92	$51,516.41	$42,501.04	nat. median $34,703 1.2× median
1061598 CDM	Ir-tc Plc Stn Art In	16	$15,150.15	$50,500.49	$41,662.90	nat. median $26,984 1.5× median
1061456 CDM	Trans Sten Cca W Eps	16	$14,662.86	$48,876.19	$40,322.85	nat. median $3,976 outlier · 10.1×
C9608 HCPCS	Ic-pr De Cr Rv Ch Ea	17	$1,599.00	$49,716.56	$39,773.25	nat. median $11,848 outlier · 3.4×
C9607 HCPCS	Ic-prq De Cor Rev Ch	17	$1,599.00	$49,716.56	$39,773.25	nat. median $20,008 2.0× median
92933 CPT	Ic-prq Crd St-at-ang	17	$1,599.00	$49,716.56	$39,773.25	nat. median $18,561 outlier · 2.1×
C9602 HCPCS	Ic-prq De Cr Stnt Ar	17	$1,599.00	$49,716.56	$39,773.25	nat. median $20,095 2.0× median
C9606 HCPCS	Ic-prq De Cr Rev Ami	17	$1,599.00	$49,716.56	$39,773.25	nat. median $17,854 outlier · 2.2×
C9603 HCPCS	Ic-pr De Cr Stn Ar B	17	$1,599.00	$49,716.56	$39,773.25	nat. median $12,723 outlier · 3.1×
2850079 CDM	Ir-tc Plc Stnt Vn Ea	16	$14,248.63	$47,495.44	$39,183.74	nat. median $27,453 1.4× median
1061514 CDM	S-iliac Revas W Stnt	16	$13,843.65	$46,145.51	$38,070.04	nat. median $26,577 1.4× median
2850120 CDM	P-ins Lv Lead New	16	$13,751.27	$45,837.57	$37,815.99	nat. median $2,408 outlier · 15.7×
8061024 CDM	P-ins Lv Lead New	16	$13,751.27	$45,837.57	$37,815.99	nat. median $35,524 1.1× median
2850050 CDM	S-tib-per Rev Ath Ad	16	$13,654.40	$45,514.67	$37,549.60	nat. median $23,820 1.6× median
8061066 CDM	S-tib-per Rev Ath Ad	16	$13,654.40	$45,514.67	$37,549.60	nat. median $36,412 1.0× median
92996 CPT	Ic-atherect Coro Add	17	$1,599.00	$46,236.23	$36,988.98	nat. median $8,097 outlier · 4.6×
1061280 CDM	P-ins Lv Lead Exist	16	$13,370.39	$44,567.98	$36,768.58	nat. median $23,812 1.5× median
1061801 CDM	Ir-tlum Bal Ang 1sta	16	$13,281.38	$44,271.26	$36,523.79	nat. median $28,776 1.3× median
2852102 CDM	S-stent Plmt Dial	16	$12,838.16	$42,793.88	$35,304.95	nat. median $30,495 1.2× median
1061265 CDM	P-ins Gen-lead Atr	16	$12,743.18	$42,477.28	$35,043.76	nat. median $18,421 1.9× median
1061533 CDM	Ic-trl Peri Ath Ilia	16	$12,711.01	$42,370.02	$34,955.27	nat. median $29,624 1.2× median
1061599 CDM	Ir-tc Plc Stnt Vn In	16	$12,602.60	$42,008.65	$34,657.13	nat. median $34,280 1.0× median
1260864 CDM	Lithotripsy	16	$12,420.88	$41,402.92	$34,157.41	nat. median $34,157 1.0× median
1110864 CDM	Lithotripsy	16	$12,420.88	$41,402.92	$34,157.41	nat. median $22,051 1.5× median
1061306 CDM	Ic-xtrcran Vert Stnt	16	$12,197.27	$40,657.55	$33,542.48	nat. median $32,526 1.0× median
1061667 CDM	Cc-rpr A-biili Ndgft	16	$11,860.71	$39,535.70	$32,616.96	nat. median $52,703 0.6× median
92925 CPT	Ic-atherect Coro Add	17	$1,599.00	$46,236.23	$32,355.05	nat. median $9,823 outlier · 3.3×
92934 CPT	Ic-prq St-at-ang Ea	17	$1,599.00	$49,716.56	$32,355.05	nat. median $9,683 outlier · 3.3×
1061281 CDM	P-ins Lv Lead New	16	$11,229.06	$37,430.19	$30,879.90	nat. median $23,872 1.3× median
37183 CPT	S-revision Tips	16	$11,149.93	$37,166.44	$30,662.31	nat. median $7,190 outlier · 4.3×
1061453 CDM	S-revision Tips	16	$11,149.93	$37,166.44	$30,662.31	nat. median $30,662 1.0× median
93461 CPT	Cc-r-l Hrt Art-angio	17	$1,599.00	$35,999.78	$28,799.82	nat. median $6,204 outlier · 4.6×

Other procedures at this hospital

Browse this hospital's 11,167 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

1061547	CDM	S-rem-rep Cvd Mult	16	16	$99,999.99	$99,999.99	$30,000.00	$99,999.99	$82,499.99	2026-01-08
1061546	CDM	S-rem-rep Cvd Dual	16	16	$99,999.99	$99,999.99	$30,000.00	$99,999.99	$82,499.99	2026-01-08
1061520	CDM	S-fem Pop Stnt Athr	16	16	$99,999.90	$99,999.90	$29,999.97	$99,999.90	$82,499.92	2026-01-08
1061524	CDM	S-tib Per Rev Stn At	16	16	$99,999.90	$99,999.90	$29,999.97	$99,999.90	$82,499.92	2026-01-08
1061454	CDM	P-insert Icd Gen	16	16	$99,999.25	$99,999.25	$29,999.78	$99,999.25	$82,499.38	2026-01-08
1061467	CDM	S-ins-rep Pace-defib	16	16	$99,999.00	$99,999.00	$29,999.70	$99,999.00	$82,499.17	2026-01-08
C1882	HCPCS	Aicd Ohr Thn Sgl/du1	42	14	$82,795.76	$82,795.76	$24,032.42	$93,863.65	$69,234.13	2026-01-08
C1721	HCPCS	Aicd Dual Chamber L1	56	14	$77,347.78	$77,347.78	$8,215.59	$99,999.95	$61,878.22	2026-01-08
C1722	HCPCS	Aicd Single Chamber1	28	14	$68,367.36	$68,367.36	$20,283.42	$69,123.34	$56,384.18	2026-01-08
1061519	CDM	S-fem Pop Revas Stnt	16	16	$64,920.87	$64,920.87	$19,476.26	$64,920.87	$53,559.72	2026-01-08
1260244	CDM	Bilat Lithotripsy	16	16	$62,104.40	$62,104.40	$18,631.32	$62,104.40	$51,236.13	2026-01-08
1061545	CDM	S-rem-rep Cvd Single	16	16	$60,224.64	$60,224.64	$18,067.39	$60,224.64	$49,685.32	2026-01-08
1410017	CDM	Oth Ster Supp Lvl 17	16	16	$57,117.94	$57,117.94	$17,135.38	$57,117.94	$47,122.30	2026-01-08
2850078	CDM	Ir-tc Plc Stn Art Ea	16	16	$57,096.27	$57,096.27	$17,128.88	$57,096.27	$47,104.43	2026-01-08
8061069	CDM	Ir-tc Plc Stn Art Ea	16	16	$57,096.27	$57,096.27	$17,128.88	$57,096.27	$47,104.43	2026-01-08
1061523	CDM	S-tib Per Revas Stnt	16	16	$53,241.56	$53,241.56	$15,972.47	$53,241.56	$43,924.29	2026-01-08
1061522	CDM	S-tib Per Revas Athr	16	16	$53,241.56	$53,241.56	$15,972.47	$53,241.56	$43,924.29	2026-01-08
1061518	CDM	S-fem Pop Revas Athr	16	16	$53,241.56	$53,241.56	$15,972.47	$53,241.56	$43,924.29	2026-01-08
1061267	CDM	P-ins Dual Pac Sys	16	16	$51,516.41	$51,516.41	$15,454.92	$51,516.41	$42,501.04	2026-01-08
1061598	CDM	Ir-tc Plc Stn Art In	16	16	$50,500.49	$50,500.49	$15,150.15	$50,500.49	$41,662.90	2026-01-08
1061456	CDM	Trans Sten Cca W Eps	16	16	$48,876.19	$48,876.19	$14,662.86	$48,876.19	$40,322.85	2026-01-08
C9608	HCPCS	Ic-pr De Cr Rv Ch Ea	17	17	$49,716.56	$49,716.56	$1,599.00	$49,716.56	$39,773.25	2026-01-08
C9607	HCPCS	Ic-prq De Cor Rev Ch	17	17	$49,716.56	$49,716.56	$1,599.00	$49,716.56	$39,773.25	2026-01-08
92933	CPT	Ic-prq Crd St-at-ang	17	17	$49,716.56	$49,716.56	$1,599.00	$49,716.56	$39,773.25	2026-01-08
C9602	HCPCS	Ic-prq De Cr Stnt Ar	17	17	$49,716.56	$49,716.56	$1,599.00	$49,716.56	$39,773.25	2026-01-08
C9606	HCPCS	Ic-prq De Cr Rev Ami	17	17	$49,716.56	$49,716.56	$1,599.00	$49,716.56	$39,773.25	2026-01-08
C9603	HCPCS	Ic-pr De Cr Stn Ar B	17	17	$49,716.56	$49,716.56	$1,599.00	$49,716.56	$39,773.25	2026-01-08
2850079	CDM	Ir-tc Plc Stnt Vn Ea	16	16	$47,495.44	$47,495.44	$14,248.63	$47,495.44	$39,183.74	2026-01-08
1061514	CDM	S-iliac Revas W Stnt	16	16	$46,145.51	$46,145.51	$13,843.65	$46,145.51	$38,070.04	2026-01-08
2850120	CDM	P-ins Lv Lead New	16	16	$45,837.57	$45,837.57	$13,751.27	$45,837.57	$37,815.99	2026-01-08
8061024	CDM	P-ins Lv Lead New	16	16	$45,837.57	$45,837.57	$13,751.27	$45,837.57	$37,815.99	2026-01-08
2850050	CDM	S-tib-per Rev Ath Ad	16	16	$45,514.67	$45,514.67	$13,654.40	$45,514.67	$37,549.60	2026-01-08
8061066	CDM	S-tib-per Rev Ath Ad	16	16	$45,514.67	$45,514.67	$13,654.40	$45,514.67	$37,549.60	2026-01-08
92996	CPT	Ic-atherect Coro Add	17	17	$46,236.23	$46,236.23	$1,599.00	$46,236.23	$36,988.98	2026-01-08
1061280	CDM	P-ins Lv Lead Exist	16	16	$44,567.98	$44,567.98	$13,370.39	$44,567.98	$36,768.58	2026-01-08
1061801	CDM	Ir-tlum Bal Ang 1sta	16	16	$44,271.26	$44,271.26	$13,281.38	$44,271.26	$36,523.79	2026-01-08
2852102	CDM	S-stent Plmt Dial	16	16	$42,793.88	$42,793.88	$12,838.16	$42,793.88	$35,304.95	2026-01-08
1061265	CDM	P-ins Gen-lead Atr	16	16	$42,477.28	$42,477.28	$12,743.18	$42,477.28	$35,043.76	2026-01-08
1061533	CDM	Ic-trl Peri Ath Ilia	16	16	$42,370.02	$42,370.02	$12,711.01	$42,370.02	$34,955.27	2026-01-08
1061599	CDM	Ir-tc Plc Stnt Vn In	16	16	$42,008.65	$42,008.65	$12,602.60	$42,008.65	$34,657.13	2026-01-08
1260864	CDM	Lithotripsy	16	16	$41,402.92	$41,402.92	$12,420.88	$41,402.92	$34,157.41	2026-01-08
1110864	CDM	Lithotripsy	16	16	$41,402.92	$41,402.92	$12,420.88	$41,402.92	$34,157.41	2026-01-08
1061306	CDM	Ic-xtrcran Vert Stnt	16	16	$40,657.55	$40,657.55	$12,197.27	$40,657.55	$33,542.48	2026-01-08
1061667	CDM	Cc-rpr A-biili Ndgft	16	16	$39,535.70	$39,535.70	$11,860.71	$39,535.70	$32,616.96	2026-01-08
92925	CPT	Ic-atherect Coro Add	33	17	$35,950.06	$35,950.06	$1,599.00	$46,236.23	$32,355.05	2026-01-08
92934	CPT	Ic-prq St-at-ang Ea	33	17	$35,950.06	$35,950.06	$1,599.00	$49,716.56	$32,355.05	2026-01-08
1061281	CDM	P-ins Lv Lead New	16	16	$37,430.19	$37,430.19	$11,229.06	$37,430.19	$30,879.90	2026-01-08
37183	CPT	S-revision Tips	16	16	$37,166.44	$37,166.44	$11,149.93	$37,166.44	$30,662.31	2026-01-08
1061453	CDM	S-revision Tips	16	16	$37,166.44	$37,166.44	$11,149.93	$37,166.44	$30,662.31	2026-01-08
93461	CPT	Cc-r-l Hrt Art-angio	17	17	$35,999.78	$35,999.78	$1,599.00	$35,999.78	$28,799.82	2026-01-08
92937	CPT	Ic-prq Rv Byp Grf In	17	17	$35,950.06	$35,950.06	$1,599.00	$35,950.06	$28,760.05	2026-01-08
92929	CPT	Ic-prq Stnt W-ang Ea	17	17	$35,950.06	$35,950.06	$1,599.00	$35,950.06	$28,760.05	2026-01-08
C9604	HCPCS	Ic-prq De Cr Rev Cab	17	17	$35,950.06	$35,950.06	$1,599.00	$35,950.06	$28,760.05	2026-01-08
C9605	HCPCS	Ic-pr De Cr Rv Cab B	17	17	$35,950.06	$35,950.06	$1,599.00	$35,950.06	$28,760.05	2026-01-08
92943	CPT	Ic-prq Revsc Chr 1vs	17	17	$35,950.06	$35,950.06	$1,599.00	$35,950.06	$28,760.05	2026-01-08
92941	CPT	Ic-prq Card Rev 1 Vs	17	17	$35,950.06	$35,950.06	$1,599.00	$35,950.06	$28,760.05	2026-01-08
C9601	HCPCS	Ic-prq De Cor Stnt B	17	17	$35,950.06	$35,950.06	$1,599.00	$35,950.06	$28,760.05	2026-01-08
92924	CPT	Ic-atherct Coro Ini	17	17	$35,950.06	$35,950.06	$1,599.00	$35,950.06	$28,760.05	2026-01-08
92995	CPT	Ic-atherct Coro Ini	17	17	$35,950.06	$35,950.06	$1,599.00	$35,950.06	$28,760.05	2026-01-08
C9600	HCPCS	Ic-prq De Cor Stnt	17	17	$35,950.06	$35,950.06	$1,599.00	$35,950.06	$28,760.05	2026-01-08
92928	CPT	Ic-prq Crd Stn W-ang	17	17	$35,950.06	$35,950.06	$1,599.00	$35,950.06	$28,760.05	2026-01-08
92938	CPT	Ic-prq Rv Byp Grf Ad	17	17	$35,950.06	$35,950.06	$1,599.00	$35,950.06	$28,760.05	2026-01-08
92944	CPT	Ic-prq Revsc Chr Add	17	17	$35,950.06	$35,950.06	$1,599.00	$35,950.06	$28,760.05	2026-01-08
93459	CPT	Cc-l Hrt Art-grf Ang	17	17	$35,071.73	$35,071.73	$1,599.00	$35,071.73	$28,057.38	2026-01-08
1061539	CDM	S-ins Pulse Gen Mult	16	16	$33,121.63	$33,121.63	$9,936.49	$33,121.63	$27,325.35	2026-01-08
1061668	CDM	Cc-rpr A-biiliac Rpt	16	16	$32,887.52	$32,887.52	$9,866.26	$32,887.52	$27,132.21	2026-01-08
1061270	CDM	P-ins-rpl Gen Sngl	16	16	$30,950.21	$30,950.21	$9,285.06	$30,950.21	$25,533.92	2026-01-08
1061802	CDM	Ir-tlum Bal Ang 1stv	16	16	$30,610.22	$30,610.22	$9,183.07	$30,610.22	$25,253.43	2026-01-08
1061535	CDM	S-ins Cath Renart 2b	16	16	$30,584.51	$30,584.51	$9,175.35	$30,584.51	$25,232.22	2026-01-08
1061288	CDM	P-implnt Loop Rec	16	16	$30,416.24	$30,416.24	$9,124.87	$30,416.24	$25,093.40	2026-01-08
33285	CPT	P-implnt Loop Rec	16	16	$30,416.24	$30,416.24	$9,124.87	$30,416.24	$25,093.40	2026-01-08
33282	CPT	P-implnt Loop Rec	16	16	$30,416.24	$30,416.24	$9,124.87	$30,416.24	$25,093.40	2026-01-08
J2505	HCPCS	Pgfilgrastim 6mg Ij	16	16	$29,909.08	$29,909.08	$8,972.72	$29,909.08	$24,674.99	2026-01-08
7211850	CDM	Pgfilgrastim 6mg Ij	16	16	$29,909.08	$29,909.08	$8,972.72	$29,909.08	$24,674.99	2026-01-08
2852202	CDM	S-trlum Bal Ang Adlv	16	16	$29,697.50	$29,697.50	$8,909.25	$29,697.50	$24,500.44	2026-01-08
8061072	CDM	S-trlum Bal Ang Adlv	16	16	$29,697.50	$29,697.50	$8,909.25	$29,697.50	$24,500.44	2026-01-08
93460	CPT	Cc-r-l Hrt Art-vent	17	17	$30,521.56	$30,521.56	$1,599.00	$30,521.56	$24,417.25	2026-01-08
2852201	CDM	S-trlum Bal Ang Adla	16	16	$29,217.46	$29,217.46	$8,765.24	$29,217.46	$24,104.40	2026-01-08
8061071	CDM	S-trlum Bal Ang Adla	16	16	$29,217.46	$29,217.46	$8,765.24	$29,217.46	$24,104.40	2026-01-08
1061339	CDM	S-transcath Stent Ad	16	16	$28,978.11	$28,978.11	$8,693.43	$28,978.11	$23,906.94	2026-01-08
1691245	CDM	Ir-vasc Emb Occ Veno	16	16	$28,914.85	$28,914.85	$8,674.46	$28,914.85	$23,854.75	2026-01-08
1691248	CDM	Ir-vasc Emb Occ Bled	16	16	$28,914.85	$28,914.85	$8,674.46	$28,914.85	$23,854.75	2026-01-08
1061595	CDM	Ir-vasc Emb-occ Arty	16	16	$28,914.85	$28,914.85	$8,674.46	$28,914.85	$23,854.75	2026-01-08
1691247	CDM	Ir-vasc Emb Occ Orgn	16	16	$28,914.85	$28,914.85	$8,674.46	$28,914.85	$23,854.75	2026-01-08
1691246	CDM	Ir-vasc Emb Occ Arty	16	16	$28,914.85	$28,914.85	$8,674.46	$28,914.85	$23,854.75	2026-01-08
2812103	CDM	S-dial Embolj	16	16	$28,914.45	$28,914.45	$8,674.34	$28,914.45	$23,854.42	2026-01-08
1410016	CDM	Oth Ster Supp Lvl 16	16	16	$28,558.97	$28,558.97	$8,567.69	$28,558.97	$23,561.15	2026-01-08
93457	CPT	Cc-r Hrt Art-grf Ang	17	17	$29,102.01	$29,102.01	$1,599.00	$29,102.01	$23,281.61	2026-01-08
C2621	HCPCS	Pmkr Othr Th Sngl L1	28	14	$29,472.64	$29,472.64	$7,384.01	$34,331.90	$23,174.04	2026-01-08
1061498	CDM	S-endo Aaa Rep 2 Dl	16	16	$28,039.62	$28,039.62	$8,411.89	$28,039.62	$23,132.69	2026-01-08
1061499	CDM	S-endo Aaa Rep 1-p	16	16	$28,039.62	$28,039.62	$8,411.89	$28,039.62	$23,132.69	2026-01-08
1061420	CDM	S-transcath Init	16	16	$27,306.72	$27,306.72	$8,192.02	$27,306.72	$22,528.04	2026-01-08
1061338	CDM	S-transcath Emboliz	16	16	$27,251.66	$27,251.66	$8,175.50	$27,251.66	$22,482.62	2026-01-08
1061517	CDM	S-fem Pop Revas Tla	16	16	$27,210.59	$27,210.59	$8,163.18	$27,210.59	$22,448.74	2026-01-08
1061272	CDM	P-upgrd Sng To Dual	16	16	$27,048.89	$27,048.89	$8,114.67	$27,048.89	$22,315.33	2026-01-08
93458	CPT	Cc-l Hrt Artery-vent	17	17	$27,792.87	$27,792.87	$1,599.00	$27,792.87	$22,234.30	2026-01-08
2811436	CDM	S-non-cns Embl/occl	16	16	$26,454.49	$26,454.49	$7,936.35	$26,454.49	$21,824.96	2026-01-08
1061437	CDM	S-transcath Stent In	16	16	$25,689.53	$25,689.53	$7,706.86	$25,689.53	$21,193.86	2026-01-08
1061705	CDM	Ir-thrmbc Tran Bal	16	16	$25,194.67	$25,194.67	$7,558.40	$25,194.67	$20,785.61	2026-01-08
36226	CPT	Ir-ang Vert Ips Bi	32	16	$25,899.78	$25,899.78	$6,588.15	$29,839.06	$20,325.89	2026-01-08
1061274	CDM	P-ins Lead Sngl	16	16	$24,071.83	$24,071.83	$7,221.55	$24,071.83	$19,859.26	2026-01-08
C1785	HCPCS	Pmkr Dual Rate-rs L1	42	14	$25,572.54	$25,572.54	$4,119.86	$34,331.90	$19,818.72	2026-01-08
2811529	CDM	S-transcath Stent In	16	16	$23,760.20	$23,760.20	$7,128.06	$23,760.20	$19,602.17	2026-01-08
2811465	CDM	S-transcath Stent Ad	16	16	$23,760.20	$23,760.20	$7,128.06	$23,760.20	$19,602.17	2026-01-08
1061527	CDM	S-ins Cath Renart 1b	16	16	$23,435.37	$23,435.37	$7,030.61	$23,435.37	$19,334.18	2026-01-08
1061268	CDM	P-ins Tmp Pac Ld Sgl	16	16	$23,285.96	$23,285.96	$6,985.79	$23,285.96	$19,210.92	2026-01-08
1061529	CDM	Ic-trl Peri Ath Renl	16	16	$22,923.83	$22,923.83	$6,877.15	$22,923.83	$18,912.16	2026-01-08
1180134	CDM	Perfusion Level 4	16	16	$22,875.30	$22,875.30	$6,862.59	$22,875.30	$18,872.12	2026-01-08
1180012	CDM	Open Hrt Lv 2 1st 15	16	16	$22,851.73	$22,851.73	$6,855.52	$22,851.73	$18,852.68	2026-01-08
2811466	CDM	S-transcath Emboliz	16	16	$22,791.51	$22,791.51	$6,837.45	$22,791.51	$18,802.99	2026-01-08
8061064	CDM	S-iliac Revas Stnt A	16	16	$22,733.76	$22,733.76	$6,820.13	$22,733.76	$18,755.35	2026-01-08
2850048	CDM	S-iliac Revas Stnt A	16	16	$22,733.76	$22,733.76	$6,820.13	$22,733.76	$18,755.35	2026-01-08
2850049	CDM	S-tib-per Revas Add	16	16	$22,733.76	$22,733.76	$6,820.13	$22,733.76	$18,755.35	2026-01-08
8061065	CDM	S-tib-per Revas Add	16	16	$22,733.76	$22,733.76	$6,820.13	$22,733.76	$18,755.35	2026-01-08
93799	CPT	Cc-inj L Vent-atrial	209	17	$27,792.87	$27,792.87	$446.60	$49,716.56	$18,549.68	2026-01-08
1061513	CDM	S-iliac Revasc	16	16	$22,316.65	$22,316.65	$6,695.00	$22,316.65	$18,411.24	2026-01-08
1061521	CDM	S-tib Per Revas W Tl	16	16	$22,316.65	$22,316.65	$6,695.00	$22,316.65	$18,411.24	2026-01-08
2850071	CDM	S-sec Art M Thro Add	16	16	$21,909.35	$21,909.35	$6,572.81	$21,909.35	$18,075.22	2026-01-08
2850070	CDM	S-pri Art M Thro Add	16	16	$21,909.35	$21,909.35	$6,572.81	$21,909.35	$18,075.22	2026-01-08
8061061	CDM	S-pri Art M Thro Add	16	16	$21,909.35	$21,909.35	$6,572.81	$21,909.35	$18,075.22	2026-01-08
8061062	CDM	S-sec Art M Thro Add	16	16	$21,909.35	$21,909.35	$6,572.81	$21,909.35	$18,075.22	2026-01-08
2811295	CDM	S-perc Vertebal Thor	16	16	$21,732.22	$21,732.22	$6,519.67	$21,732.22	$17,929.08	2026-01-08
2811647	CDM	S-perc Vertibrl Lumb	16	16	$21,732.22	$21,732.22	$6,519.67	$21,732.22	$17,929.08	2026-01-08
2811292	CDM	S-perc Verte Aug Add	16	16	$21,732.22	$21,732.22	$6,519.67	$21,732.22	$17,929.08	2026-01-08
92920	CPT	Ic-ptca, Single	17	17	$22,316.65	$22,316.65	$1,599.00	$22,316.65	$17,853.32	2026-01-08
92982	CPT	Ic-ptca, Single	17	17	$22,316.65	$22,316.65	$1,599.00	$22,316.65	$17,853.32	2026-01-08
92921	CPT	Ic-ptca, Addl	17	17	$22,316.65	$22,316.65	$1,599.00	$22,316.65	$17,853.32	2026-01-08
92984	CPT	Ic-ptca, Addl	17	17	$22,316.65	$22,316.65	$1,599.00	$22,316.65	$17,853.32	2026-01-08
1691257	CDM	Ir-perc Vrt Aug Thor	16	16	$21,405.25	$21,405.25	$6,421.58	$21,405.25	$17,659.33	2026-01-08
1691258	CDM	Ir-perc Vrt Aug Lumb	16	16	$21,405.25	$21,405.25	$6,421.58	$21,405.25	$17,659.33	2026-01-08
93456	CPT	Cc-r Hrt Coronry Art	17	17	$21,823.15	$21,823.15	$1,599.00	$21,823.15	$17,458.52	2026-01-08
93524	CPT	Cc-r-l Cath Lv Punc	17	17	$21,532.98	$21,532.98	$1,599.00	$21,532.98	$17,226.38	2026-01-08
93453	CPT	Cc-r-l Cath Lv Punc	17	17	$21,532.98	$21,532.98	$1,599.00	$21,532.98	$17,226.38	2026-01-08
1180133	CDM	Perfusion Level 3	16	16	$20,800.76	$20,800.76	$6,240.23	$20,800.76	$17,160.63	2026-01-08
92972	CPT	Pcu Trluml Cor Litho	17	17	$21,185.00	$21,185.00	$1,599.00	$21,185.00	$16,948.00	2026-01-08
1180011	CDM	Open Hrt Lv 1 1st 15	16	16	$20,312.62	$20,312.62	$6,093.79	$20,312.62	$16,757.92	2026-01-08
C1776	HCPCS	Joint Device Implt 1	168	14	$23,359.96	$23,359.96	$3.00	$56,250.00	$16,698.96	2026-01-08
72292	CPT	CT-guide Vertebropla	17	17	$20,789.27	$20,789.27	$3,437.00	$20,789.27	$16,631.42	2026-01-08
1631557	CDM	CT-guide Vertebropla	17	17	$20,789.27	$20,789.27	$3,437.00	$20,789.27	$16,631.42	2026-01-08
92980	CPT	Ic-ins Bms Stnt,init	17	17	$20,486.23	$20,486.23	$1,599.00	$20,486.23	$16,388.98	2026-01-08
1061245	CDM	Ic-ins Bms Stnt Add	17	17	$20,486.23	$20,486.23	$1,599.00	$20,486.23	$16,388.98	2026-01-08
1061244	CDM	Ic-ins Bms Stnt,init	17	17	$20,486.23	$20,486.23	$1,599.00	$20,486.23	$16,388.98	2026-01-08
92981	CPT	Ic-ins Bms Stnt Add	17	17	$20,486.23	$20,486.23	$1,599.00	$20,486.23	$16,388.98	2026-01-08
72291	CPT	Ir-vertebroplasty	16	16	$19,813.43	$19,813.43	$5,944.03	$19,813.43	$16,346.08	2026-01-08
1691091	CDM	Ir-vertebroplasty	16	16	$19,813.43	$19,813.43	$5,944.03	$19,813.43	$16,346.08	2026-01-08
1061308	CDM	S-pta Renal-visceral	16	16	$19,793.78	$19,793.78	$5,938.13	$19,793.78	$16,329.86	2026-01-08
1061312	CDM	S-pta Brachcephal	16	16	$19,793.78	$19,793.78	$5,938.13	$19,793.78	$16,329.86	2026-01-08
1061309	CDM	S-pta Aorta	16	16	$19,793.78	$19,793.78	$5,938.13	$19,793.78	$16,329.86	2026-01-08
1061313	CDM	S-pta Venous	16	16	$19,793.78	$19,793.78	$5,938.13	$19,793.78	$16,329.86	2026-01-08
1061316	CDM	S-atherect Iliac	16	16	$19,283.25	$19,283.25	$5,784.98	$19,283.25	$15,908.68	2026-01-08
1061266	CDM	P-ins Gen-lead Ven	16	16	$19,003.43	$19,003.43	$5,701.03	$19,003.43	$15,677.83	2026-01-08
1180132	CDM	Perfusion Level 2	16	16	$18,909.92	$18,909.92	$5,672.98	$18,909.92	$15,600.69	2026-01-08
1061384	CDM	Ir-angioplsty Periph	16	16	$18,664.93	$18,664.93	$5,599.48	$18,664.93	$15,398.57	2026-01-08
A9600	HCPCS	Sr89 Chlor / Mci	17	17	$19,246.12	$19,246.12	$1,822.00	$19,246.12	$15,396.90	2026-01-08
1410015	CDM	Oth Ster Supp Lvl 15	16	16	$18,310.53	$18,310.53	$5,493.16	$18,310.53	$15,106.19	2026-01-08
93452	CPT	Cc-lhc Vent Punc	17	17	$18,804.29	$18,804.29	$1,599.00	$18,804.29	$15,043.43	2026-01-08
93514	CPT	Cc-lhc Vent Punc	17	17	$18,804.29	$18,804.29	$1,599.00	$18,804.29	$15,043.43	2026-01-08
1061573	CDM	S-trnscth Throm Art	16	16	$18,187.21	$18,187.21	$5,456.16	$18,187.21	$15,004.45	2026-01-08
1061574	CDM	S-trnscth Throm Ven	16	16	$18,187.21	$18,187.21	$5,456.16	$18,187.21	$15,004.45	2026-01-08
C1783	HCPCS	Ocular Imp Aqu Dran1	28	14	$48,850.12	$48,850.12	$131.40	$97,262.25	$14,808.34	2026-01-08
C1895	HCPCS	Lead Aicd End Dul L1	28	14	$18,292.00	$18,292.00	$5,150.05	$19,417.18	$14,591.80	2026-01-08
1061448	CDM	S-prim Art Mech Thro	16	16	$17,669.56	$17,669.56	$5,300.87	$17,669.56	$14,577.39	2026-01-08
1061541	CDM	S-rem-rep Pm Gen Dul	16	16	$17,554.43	$17,554.43	$5,266.33	$17,554.43	$14,482.41	2026-01-08
1691259	CDM	Ir-perc Sacrplty Uni	16	16	$17,347.14	$17,347.14	$5,204.14	$17,347.14	$14,311.39	2026-01-08
1691260	CDM	Ir-perc Sacrpslty Bi	16	16	$17,347.14	$17,347.14	$5,204.14	$17,347.14	$14,311.39	2026-01-08
1061526	CDM	S-ins Cath Renart 1u	16	16	$17,191.23	$17,191.23	$5,157.37	$17,191.23	$14,182.76	2026-01-08
1061528	CDM	S-ins Cath Renart 2u	16	16	$17,191.23	$17,191.23	$5,157.37	$17,191.23	$14,182.76	2026-01-08
1110851	CDM	Perfusion Level 1	16	16	$17,190.65	$17,190.65	$5,157.20	$17,190.65	$14,182.28	2026-01-08
1180131	CDM	Perfusion Level 1	16	16	$17,190.65	$17,190.65	$5,157.20	$17,190.65	$14,182.28	2026-01-08
2811499	CDM	S-pta Renal-visceral	16	16	$16,966.01	$16,966.01	$5,089.80	$16,966.01	$13,996.96	2026-01-08
2811500	CDM	S-pta Aorta	16	16	$16,966.01	$16,966.01	$5,089.80	$16,966.01	$13,996.96	2026-01-08
2811503	CDM	S-pta Brachcephal	16	16	$16,966.01	$16,966.01	$5,089.80	$16,966.01	$13,996.96	2026-01-08
2811504	CDM	S-pta Venous	16	16	$16,966.01	$16,966.01	$5,089.80	$16,966.01	$13,996.96	2026-01-08
1061540	CDM	S-rem-rep Pm Gen Sng	16	16	$16,906.73	$16,906.73	$5,072.02	$16,906.73	$13,948.05	2026-01-08
1061542	CDM	S-rem-rep Pm Gen Mlt	16	16	$16,906.73	$16,906.73	$5,072.02	$16,906.73	$13,948.05	2026-01-08
75962	CPT	Ir-angioplsty Periph	32	16	$17,331.68	$17,331.68	$4,799.53	$18,664.93	$13,798.69	2026-01-08
C1777	HCPCS	Lead Aicd Endo Sn L1	28	14	$16,735.30	$16,735.30	$4,891.13	$17,166.82	$13,795.83	2026-01-08
C1786	HCPCS	Pmkr Singl Rate-rsl1	42	14	$17,001.39	$17,001.39	$4,119.86	$29,082.38	$13,732.85	2026-01-08
1061451	CDM	S-venous Mech Thromb	16	16	$16,553.93	$16,553.93	$4,966.18	$16,553.93	$13,656.99	2026-01-08
C1764	HCPCS	Event Recrdr Cardiac	14	14	$16,408.98	$16,408.98	$4,922.69	$16,408.98	$13,537.40	2026-01-08
36222	CPT	Ir-ang Crt Ext Cc Bi	32	16	$17,192.91	$17,192.91	$4,348.95	$19,889.31	$13,484.69	2026-01-08
C1874	HCPCS	Stnt Coat/cov W/del1	70	14	$17,092.64	$17,092.64	$683.71	$56,500.82	$13,246.80	2026-01-08
1691049	CDM	Ir-angioplsty Periph	16	16	$15,998.43	$15,998.43	$4,799.53	$15,998.43	$13,198.70	2026-01-08
2852101	CDM	S-balo Angiop Dial	16	16	$15,939.82	$15,939.82	$4,781.95	$15,939.82	$13,150.35	2026-01-08
93455	CPT	Cc-s-i Vnt Atr Angio	17	17	$16,267.44	$16,267.44	$1,599.00	$16,267.44	$13,013.95	2026-01-08
1061702	CDM	Ir-cat Dial Tran Bal	16	16	$15,647.35	$15,647.35	$4,694.21	$15,647.35	$12,909.06	2026-01-08
36223	CPT	Ir-ang Cartd Ips Bi	32	16	$16,212.40	$16,212.40	$3,760.64	$19,889.31	$12,535.48	2026-01-08
1061271	CDM	P-ins-rpl Gen Dual	16	16	$14,601.74	$14,601.74	$4,380.52	$14,601.74	$12,046.43	2026-01-08
2811577	CDM	S-ablat Pulmon Tumor	16	16	$14,559.47	$14,559.47	$4,367.84	$14,559.47	$12,011.56	2026-01-08
2811309	CDM	S-per Pf Abl Ren Tum	16	16	$14,559.47	$14,559.47	$4,367.84	$14,559.47	$12,011.56	2026-01-08
36299	CPT	Ir-ang Cartd Ips Uni	64	16	$16,212.40	$16,212.40	$2,811.00	$25,667.20	$11,908.70	2026-01-08
C1767	HCPCS	Genratr Neurostm 1	28	14	$23,785.71	$23,785.71	$3,375.00	$36,321.41	$11,250.00	2026-01-08
2811135	CDM	S-stone Remvl Lt 2cm	16	16	$13,580.60	$13,580.60	$4,074.18	$13,580.60	$11,203.99	2026-01-08
2811659	CDM	S-stone Remvl Gt 2cm	16	16	$13,232.28	$13,232.28	$3,969.68	$13,232.28	$10,916.63	2026-01-08
1061359	CDM	Ir-angio Renal Bilat	16	16	$13,057.71	$13,057.71	$3,917.31	$13,057.71	$10,772.61	2026-01-08
C1896	HCPCS	Lead Aicd No-sing L1	14	14	$12,891.38	$12,891.38	$3,867.41	$12,891.38	$10,635.39	2026-01-08
93454	CPT	Cc-angio Coron Only	17	17	$13,090.19	$13,090.19	$1,599.00	$13,090.19	$10,472.15	2026-01-08
J1595	HCPCS	Glatiramer Acet 20mg	16	16	$12,541.79	$12,541.79	$3,762.54	$12,541.79	$10,346.98	2026-01-08
93451	CPT	Cc-rhc	17	17	$12,834.57	$12,834.57	$1,599.00	$12,834.57	$10,267.66	2026-01-08
36225	CPT	Ir-ang Subcl Ips Bi	32	16	$13,406.37	$13,406.37	$3,051.66	$16,640.55	$10,172.19	2026-01-08
C1768	HCPCS	Gore Tag	112	14	$13,674.12	$13,674.12	$664.67	$74,386.94	$10,144.10	2026-01-08
1061311	CDM	S-pta Fem-pop	16	16	$12,293.09	$12,293.09	$3,687.93	$12,293.09	$10,141.80	2026-01-08
C1724	HCPCS	Cath Trns Arthr Rot1	42	14	$13,555.09	$13,555.09	$1,025.56	$15,541.37	$10,134.10	2026-01-08
1061450	CDM	S-sec Art M-thro Add	16	16	$12,256.33	$12,256.33	$3,676.90	$12,256.33	$10,111.47	2026-01-08
2811563	CDM	S-bx Ndl Salv Glnd	16	16	$12,184.19	$12,184.19	$3,655.26	$12,184.19	$10,051.95	2026-01-08
1061449	CDM	S-pri Art M-thro Add	16	16	$12,016.01	$12,016.01	$3,604.80	$12,016.01	$9,913.21	2026-01-08
1110806	CDM	Or Lev 6 Ini 15 Min	16	16	$11,925.38	$11,925.38	$3,577.61	$11,925.38	$9,838.43	2026-01-08
2811173	CDM	S-rep Arterial Block	16	16	$11,896.54	$11,896.54	$3,568.96	$11,896.54	$9,814.65	2026-01-08
C1714	HCPCS	Cath Trns Arthr Dir1	42	14	$13,204.49	$13,204.49	$853.10	$14,705.20	$9,730.88	2026-01-08
1410014	CDM	Oth Ster Supp Lvl 14	16	16	$11,732.44	$11,732.44	$3,519.73	$11,732.44	$9,679.26	2026-01-08
1061386	CDM	Ir-angioplsty Renal	16	16	$11,654.44	$11,654.44	$3,496.33	$11,654.44	$9,614.91	2026-01-08
282813	CDM	Delivery Level 3	17	17	$11,976.51	$11,976.51	$629.00	$11,976.51	$9,581.21	2026-01-08
75724	CPT	Ir-angio Renal Bilat	32	16	$11,989.16	$11,989.16	$3,276.18	$13,057.71	$9,537.90	2026-01-08
7410796	CDM	Introducer Kyphx 1st	16	16	$11,400.94	$11,400.94	$3,420.28	$11,400.94	$9,405.77	2026-01-08
1061283	CDM	P-remov Pace Gen	16	16	$11,389.51	$11,389.51	$3,416.85	$11,389.51	$9,396.35	2026-01-08
36224	CPT	Ir-ang Int Car Ip Bi	32	16	$17,518.60	$17,518.60	$2,811.00	$25,667.20	$9,369.99	2026-01-08
C1762	HCPCS	Conn Tissue Human 1	140	14	$11,839.47	$11,839.47	$3.00	$39,811.56	$9,298.34	2026-01-08
1691120	CDM	Ir-venous M Throm Ad	16	16	$11,079.65	$11,079.65	$3,323.90	$11,079.65	$9,140.71	2026-01-08
1691111	CDM	Ir-prim Art Mech Thr	16	16	$11,079.65	$11,079.65	$3,323.90	$11,079.65	$9,140.71	2026-01-08
1691119	CDM	Ir-venous Mech Throm	16	16	$11,079.65	$11,079.65	$3,323.90	$11,079.65	$9,140.71	2026-01-08
92973	CPT	Ic-cor Thrombectomy	33	17	$10,743.14	$10,743.14	$1,599.00	$12,914.90	$9,131.67	2026-01-08
75966	CPT	Ir-angioplsty Renal	48	16	$10,780.71	$10,780.71	$3,206.62	$11,654.44	$9,085.42	2026-01-08
1691024	CDM	Ir-angio Renal Bilat	16	16	$10,920.61	$10,920.61	$3,276.18	$10,920.61	$9,009.51	2026-01-08
C1813	HCPCS	Prsths Penile Infl 1	56	14	$18,174.42	$18,174.42	$1,584.14	$28,028.70	$9,000.00	2026-01-08
1061213	CDM	Cc-r-l Cng Anom Rtr	17	17	$11,240.77	$11,240.77	$1,599.00	$11,240.77	$8,992.62	2026-01-08
93531	CPT	Cc-r-l Cng Anom Rtr	17	17	$11,240.77	$11,240.77	$1,599.00	$11,240.77	$8,992.62	2026-01-08
C1900	HCPCS	Lead Lt Vent Cor Lv1	42	14	$12,639.15	$12,639.15	$2,246.01	$12,800.00	$8,903.70	2026-01-08
2850098	CDM	Ir-angioplsty Renal	16	16	$10,780.71	$10,780.71	$3,234.21	$10,780.71	$8,894.08	2026-01-08
2811850	CDM	S-perc Thor Lumb Ea	16	16	$10,702.63	$10,702.63	$3,210.79	$10,702.63	$8,829.67	2026-01-08
8691016	CDM	S-perc Thor Lumb Ea	16	16	$10,702.63	$10,702.63	$3,210.79	$10,702.63	$8,829.67	2026-01-08
1691051	CDM	Ir-angioplsty Renal	16	16	$10,688.73	$10,688.73	$3,206.62	$10,688.73	$8,818.20	2026-01-08
2811498	CDM	S-pta Tibioperoneal	16	16	$10,618.59	$10,618.59	$3,185.58	$10,618.59	$8,760.33	2026-01-08
2811502	CDM	S-pta Fem-pop	16	16	$10,618.59	$10,618.59	$3,185.58	$10,618.59	$8,760.33	2026-01-08
1061310	CDM	S-pta Iliac	16	16	$10,618.59	$10,618.59	$3,185.58	$10,618.59	$8,760.33	2026-01-08
2811501	CDM	S-pta Iliac	16	16	$10,618.59	$10,618.59	$3,185.58	$10,618.59	$8,760.33	2026-01-08
1061307	CDM	S-pta Tibioperoneal	16	16	$10,618.59	$10,618.59	$3,185.58	$10,618.59	$8,760.33	2026-01-08
1110805	CDM	Or Lev 5 Ini 15 Min	16	16	$10,600.22	$10,600.22	$3,180.07	$10,600.22	$8,745.19	2026-01-08
1061465	CDM	S-ins Cvad Port Gt 5	16	16	$10,587.19	$10,587.19	$3,176.16	$10,587.19	$8,734.43	2026-01-08
75736	CPT	Ir-angio Pelvic Sel	32	16	$10,544.80	$10,544.80	$3,147.20	$10,598.95	$8,698.10	2026-01-08
2811741	CDM	S-iliac Revas Stnt A	16	16	$10,505.26	$10,505.26	$3,151.58	$10,505.26	$8,666.84	2026-01-08
7410869	CDM	Stage 1 Cement Mold2	16	16	$10,421.28	$10,421.28	$3,126.38	$10,421.28	$8,597.56	2026-01-08
74178	CPT	CT-abd Pelvis Wwo	17	17	$10,710.32	$10,710.32	$3,213.10	$10,710.32	$8,568.26	2026-01-08
2811595	CDM	S-trans Needle Place	16	16	$10,261.76	$10,261.76	$3,078.53	$10,261.76	$8,465.95	2026-01-08
C1899	HCPCS	Lead Pmkr/aicd Cmbl1	14	14	$10,237.26	$10,237.26	$3,071.18	$10,237.26	$8,445.74	2026-01-08
282812	CDM	Delivery Level 2	17	17	$10,537.85	$10,537.85	$629.00	$10,537.85	$8,430.28	2026-01-08
J0840	HCPCS	Crotalid Poly IM 1gm	16	16	$10,130.30	$10,130.30	$3,039.09	$10,130.30	$8,357.50	2026-01-08
C9274	HCPCS	Crotalid Poly IM 1gm	16	16	$10,130.30	$10,130.30	$3,039.09	$10,130.30	$8,357.50	2026-01-08
J0800	HCPCS	Corticotropn 40u Inj	16	16	$10,049.40	$10,049.40	$3,014.82	$10,049.40	$8,290.76	2026-01-08
7212136	CDM	Corticotropn 40u Inj	16	16	$10,049.40	$10,049.40	$3,014.82	$10,049.40	$8,290.76	2026-01-08
75630	CPT	Ir-aabf Serial	32	16	$10,371.22	$10,371.22	$2,841.62	$11,270.39	$8,252.02	2026-01-08
1061278	CDM	P-revse Pocket Pace	16	16	$9,947.99	$9,947.99	$2,984.40	$9,947.99	$8,207.09	2026-01-08
1061563	CDM	Ic-retrieval Cathete	16	16	$9,882.95	$9,882.95	$2,964.89	$9,882.95	$8,153.43	2026-01-08
1691289	CDM	Ir-exchg Nphstmy Cth	16	16	$9,762.38	$9,762.38	$2,928.71	$9,762.38	$8,053.96	2026-01-08
C1763	HCPCS	Tissue Non-human 1	154	14	$12,112.61	$12,112.61	$3.00	$33,706.68	$7,977.48	2026-01-08
75625	CPT	Ir-abd Aorta Serial	48	16	$9,472.06	$9,472.06	$2,788.59	$11,270.39	$7,976.12	2026-01-08
75716	CPT	Ir-angio Extrem Bi	48	16	$9,472.06	$9,472.06	$2,788.59	$11,270.39	$7,976.12	2026-01-08
75710	CPT	Ir-angio Extrem Uni	48	16	$9,472.06	$9,472.06	$2,788.59	$11,270.39	$7,976.12	2026-01-08
1061284	CDM	P-remov Lead, Sng	16	16	$9,588.81	$9,588.81	$2,876.64	$9,588.81	$7,910.77	2026-01-08
1061279	CDM	P-revse Pocket Icd	16	16	$9,474.28	$9,474.28	$2,842.28	$9,474.28	$7,816.28	2026-01-08
C1761	HCPCS	Cath Trans Int Litho	14	14	$9,400.00	$9,400.00	$2,820.00	$9,400.00	$7,755.00	2026-01-08
1061285	CDM	P-remov Lead, Dual	16	16	$9,399.63	$9,399.63	$2,819.89	$9,399.63	$7,754.69	2026-01-08
1061576	CDM	S-trncth Cess Cth Rm	16	16	$9,357.92	$9,357.92	$2,807.38	$9,357.92	$7,720.28	2026-01-08
1693844	CDM	S-ins Pleural Cath	16	16	$9,288.84	$9,288.84	$2,786.65	$9,288.84	$7,663.29	2026-01-08
1110804	CDM	Or Lev 4 Ini 15 Min	16	16	$9,275.33	$9,275.33	$2,782.60	$9,275.33	$7,652.15	2026-01-08
1691242	CDM	Ir-cath Fluid Colxn	16	16	$9,265.52	$9,265.52	$2,779.66	$9,265.52	$7,644.06	2026-01-08
72157	CPT	Mr-thor Spine Wwo	17	17	$9,423.65	$9,423.65	$2,170.00	$9,423.65	$7,538.92	2026-01-08
1061536	CDM	S-ins Endo Vena Cava	16	16	$9,089.96	$9,089.96	$2,726.99	$9,089.96	$7,499.22	2026-01-08
8061068	CDM	S-tib-per Revasc Stn	16	16	$9,014.41	$9,014.41	$2,704.32	$9,014.41	$7,436.89	2026-01-08
2850052	CDM	S-tib-per Revasc Stn	16	16	$9,014.41	$9,014.41	$2,704.32	$9,014.41	$7,436.89	2026-01-08
2850047	CDM	S-iliac Revas Add-on	16	16	$9,014.41	$9,014.41	$2,704.32	$9,014.41	$7,436.89	2026-01-08
8061067	CDM	S-revs Opn-prq Tib-p	16	16	$9,014.41	$9,014.41	$2,704.32	$9,014.41	$7,436.89	2026-01-08
8061063	CDM	S-iliac Revas Add-on	16	16	$9,014.41	$9,014.41	$2,704.32	$9,014.41	$7,436.89	2026-01-08
2850051	CDM	S-revs Opn-prq Tib-p	16	16	$9,014.41	$9,014.41	$2,704.32	$9,014.41	$7,436.89	2026-01-08
1061352	CDM	Ir-ang Car-cereb Bi	16	16	$9,012.94	$9,012.94	$2,703.88	$9,012.94	$7,435.68	2026-01-08
75671	CPT	Ir-ang Car-cereb Bi	16	16	$9,012.94	$9,012.94	$2,703.88	$9,012.94	$7,435.68	2026-01-08
282811	CDM	Delivery Level 1	17	17	$9,287.67	$9,287.67	$629.00	$9,287.67	$7,430.14	2026-01-08
J2993	HCPCS	Reteplase 18.1mg Ij	16	16	$9,003.43	$9,003.43	$2,701.03	$9,003.43	$7,427.83	2026-01-08
2811411	CDM	S-av Fistula Thrombe	16	16	$8,922.21	$8,922.21	$2,676.66	$8,922.21	$7,360.83	2026-01-08
7410674	CDM	Clamp Isolator Trans	16	16	$8,918.98	$8,918.98	$2,675.69	$8,918.98	$7,358.16	2026-01-08
75894	CPT	Ir-embolization Ther	32	16	$9,236.34	$9,236.34	$2,557.75	$9,946.85	$7,353.55	2026-01-08
2811113	CDM	S-ins T Cvad 2c Wsqp	16	16	$8,855.82	$8,855.82	$2,656.75	$8,855.82	$7,306.06	2026-01-08
2811114	CDM	S-ins Tu Cvad W Pump	16	16	$8,855.82	$8,855.82	$2,656.75	$8,855.82	$7,306.06	2026-01-08
2811110	CDM	S-rpl Com Tcvad Pump	16	16	$8,855.82	$8,855.82	$2,656.75	$8,855.82	$7,306.06	2026-01-08
36566	CPT	S-ins T Cvad 2c Wsqp	16	16	$8,855.82	$8,855.82	$2,656.75	$8,855.82	$7,306.06	2026-01-08
36563	CPT	S-ins Tu Cvad W Pump	16	16	$8,855.82	$8,855.82	$2,656.75	$8,855.82	$7,306.06	2026-01-08
75743	CPT	Ir-ang Pulmonary Bi	16	16	$8,818.28	$8,818.28	$2,645.48	$8,818.28	$7,275.08	2026-01-08
75741	CPT	Ir-ang Pulmonary Uni	16	16	$8,818.28	$8,818.28	$2,645.48	$8,818.28	$7,275.08	2026-01-08
37197	CPT	Ic-retrieval Cathete	32	16	$9,056.65	$9,056.65	$2,469.10	$9,882.95	$7,201.55	2026-01-08
1691255	CDM	Ir-perc Cervithr Inj	16	16	$8,726.50	$8,726.50	$2,617.95	$8,726.50	$7,199.36	2026-01-08
1691256	CDM	Ir-perc Lumbscrl Inj	16	16	$8,726.50	$8,726.50	$2,617.95	$8,726.50	$7,199.36	2026-01-08
2811451	CDM	S-bi End Prc W Stnt	16	16	$8,714.65	$8,714.65	$2,614.40	$8,714.65	$7,189.59	2026-01-08
2811450	CDM	S-stone Remvl T-tube	16	16	$8,714.65	$8,714.65	$2,614.40	$8,714.65	$7,189.59	2026-01-08
75726	CPT	Ir-angio Visceral Se	32	16	$10,316.32	$10,316.32	$2,146.02	$13,479.24	$7,153.40	2026-01-08
72156	CPT	Mr-cerv Spine Wwo	17	17	$8,941.38	$8,941.38	$2,170.00	$8,941.38	$7,153.10	2026-01-08
2811159	CDM	S-insrt Cannla Perm	16	16	$8,634.45	$8,634.45	$2,590.34	$8,634.45	$7,123.42	2026-01-08
2811405	CDM	S-rpl Com Tcvad Port	16	16	$8,628.65	$8,628.65	$2,588.60	$8,628.65	$7,118.64	2026-01-08
2811473	CDM	S-ins Central Port	16	16	$8,628.65	$8,628.65	$2,588.60	$8,628.65	$7,118.64	2026-01-08
36565	CPT	S-ins T Cvad 2c Wosq	16	16	$8,628.65	$8,628.65	$2,588.60	$8,628.65	$7,118.64	2026-01-08
2811399	CDM	S-ins T Cvad 2c Wosq	16	16	$8,628.65	$8,628.65	$2,588.60	$8,628.65	$7,118.64	2026-01-08
77295	CPT	Rt-rad Tx Simu 3d	17	17	$8,775.36	$8,775.36	$221.00	$8,775.36	$7,020.29	2026-01-08

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