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

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Hospital

CASA COLINA HOSPITAL

Pomona, CA · CCN 050782 · Rates published

3,715 distinct procedures filed
95 distinct payers
201,486 rate rows
2026-05-08 last MRF observed
Data quality

198,557 of 201,486 rate rows are consumer-grade (98.5%)

2,929 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
per-diem day rate — not a per-procedure price 1,667
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 925
exceeds 10× this hospital's gross charge — excluded from medians 231
percent-of-charges filed in the dollar field — excluded from medians 54
exceeds 3× this hospital's gross charge for a DRG stay — excluded 31
placeholder amount (≤ $0.02) — excluded from medians 21
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbCCHPOMONACA&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/CasaColina.aspx
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint 3caefd7060df1cdf… · 96,239,724 bytes · first seen 2026-05-14

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
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 39 $59,106.19 $264,483.38 $65,673.50 nat. median
$66,526
1.0× median
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 37 $2,200.00 $120,532.62 $46,924.85 nat. median
$48,170
1.0× median
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 39 $39,306.92 $105,921.82 $43,674.33 nat. median
$44,810
1.0× median
C1823
HCPCS 		Generator, Neurostimulator (implantable), Non-rechargeable, With Transvenous Sen… 25 $1,500.00 $203,250.00 $40,650.00 nat. median
$26,775
1.5× median
278C177818
CDM 		Proclaim 5 Penta Sys 29 $1,500.00 $78,750.00 $37,500.00 nat. median
$37,500
1.0× median
472
MS_DRG 		Cervical Spinal Fusion With Cc 41 $25,193.54 $97,661.49 $33,591.37 nat. median
$29,858
1.1× median
264
MS_DRG 		Other Circulatory System O.r. Procedures 40 $28,567.11 $76,944.97 $33,493.96 nat. median
$33,061
1.0× median
L8687
HCPCS 		Implantable Neurostimulator Pulse Generator, Dual Array, Rechargeable, Includes… 25 $1,500.00 $69,676.20 $31,671.00 nat. median
$14,605
outlier · 2.2×
483
MS_DRG 		Major Joint Or Limb Reattachment Procedures Of Upper Extremities 41 $23,703.88 $68,417.90 $31,605.15 nat. median
$26,699
1.2× median
C1767
HCPCS 		Generator, Neurostimulator (implantable), Non-rechargeable 25 $1,500.00 $145,125.00 $28,650.00 nat. median
$22,481
1.3× median
629
MS_DRG 		Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 41 $18,631.99 $57,265.30 $24,842.63 nat. median
$22,198
1.1× median
278C183163
CDM 		Coroent Xlf 10x18x50 10 29 $1,500.00 $51,861.60 $24,696.00 nat. median
$24,696
1.0× median
522
MS_DRG 		Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 41 $18,109.49 $64,558.74 $24,145.97 nat. median
$21,760
1.1× median
481
MS_DRG 		Hip And Femur Procedures Except Major Joint With Cc 41 $17,911.10 $69,917.50 $23,881.45 nat. median
$21,529
1.1× median
330
MS_DRG 		Major Small And Large Bowel Procedures With Cc 40 $20,499.63 $60,934.20 $22,777.36 nat. median
$24,346
0.9× median
516
MS_DRG 		Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 41 $17,770.85 $79,055.55 $22,680.56 nat. median
$21,082
1.1× median
674
MS_DRG 		Other Kidney And Urinary Tract Procedures With Cc 20 $22,220.56 $66,990.43 $22,220.56 nat. median
$23,466
0.9× median
C1820
HCPCS 		Generator, Neurostimulator (implantable), With Rechargeable Battery And Charging… 25 $1,119.00 $147,000.00 $21,820.50 nat. median
$22,013
1.0× median
C1889
HCPCS 		Implantable/insertable Device, Not Otherwise Classified 25 $1,500.00 $99,765.00 $19,953.00 nat. median
$2,392
outlier · 8.3×
314
MS_DRG 		Other Circulatory System Diagnoses With Mcc 37 $2,200.00 $47,381.20 $19,812.84 nat. median
$20,752
1.0× median
278C1776GP
CDM 		ZimBio Delta Fem Cer 36/-3.5 S 29 $1,500.00 $40,773.60 $19,416.00 nat. median
$19,416
1.0× median
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 40 $13,897.02 $26,177.71 $19,107.82 nat. median
$20,254
0.9× median
519
MS_DRG 		Back And Neck Procedures Except Spinal Fusion With Cc 39 $12,929.40 $50,439.11 $19,005.20 nat. median
$20,494
0.9× median
854
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Cc 37 $2,200.00 $73,828.79 $18,985.25 nat. median
$20,421
0.9× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 21 $1,408.70 $57,096.49 $18,456.96 nat. median
$19,634
0.9× median
470
MS_DRG 		Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without… 41 $16,494.97 $72,743.62 $18,327.73 nat. median
$20,055
0.9× median
617
MS_DRG 		Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 40 $10,667.12 $24,346.18 $17,770.94 nat. median
$19,472
0.9× median
377
MS_DRG 		Gastrointestinal Hemorrhage With Mcc 20 $13,320.00 $76,719.71 $17,369.02 nat. median
$18,249
1.0× median
623
MS_DRG 		Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 37 $2,200.00 $43,287.67 $17,045.01 nat. median
$18,744
0.9× median
42
MS_DRG 		Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc 40 $10,203.85 $22,489.92 $16,416.00 nat. median
$18,118
0.9× median
331
MS_DRG 		Major Small And Large Bowel Procedures Without Cc/mcc 40 $14,391.30 $58,626.48 $15,990.33 nat. median
$17,703
0.9× median
988
MS_DRG 		Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 40 $13,273.72 $24,423.64 $15,616.91 nat. median
$17,322
0.9× median
280
MS_DRG 		Acute Myocardial Infarction, Discharged Alive With Mcc 39 $13,717.45 $21,570.24 $15,241.60 nat. median
$16,529
0.9× median
393
MS_DRG 		Other Digestive System Diagnoses With Mcc 37 $2,200.00 $43,710.43 $15,195.99 nat. median
$16,482
0.9× median
909
MS_DRG 		Other O.r. Procedures For Injuries Without Cc/mcc 41 $11,225.54 $97,463.40 $14,967.38 nat. median
$13,888
1.1× median
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 20 $14,848.23 $60,552.61 $14,848.23 nat. median
$16,234
0.9× median
186
MS_DRG 		Pleural Effusion With Mcc 20 $14,808.32 $45,466.10 $14,808.32 nat. median
$15,980
0.9× median
517
MS_DRG 		Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/mc… 40 $13,141.07 $36,767.11 $14,601.19 nat. median
$16,146
0.9× median
E0783
HCPCS 		Infusion Pump System, Implantable, Programmable (includes All Components, E.g.,… 50 $9,333.96 $128,400.00 $14,584.31 nat. median
$11,439
1.3× median
813
MS_DRG 		Coagulation Disorders 40 $9,821.29 $19,855.23 $14,492.87 nat. median
$15,711
0.9× median
520
MS_DRG 		Back And Neck Procedures Except Spinal Fusion Without Cc/mcc 39 $12,775.07 $37,479.34 $14,194.51 nat. median
$15,716
0.9× median
2781776068
CDM 		Psn Rev Fem Cmt Ccr Pls Sz 3 R 29 $1,500.00 $29,691.90 $14,139.00 nat. median
$14,139
1.0× median
682
MS_DRG 		Renal Failure With Mcc 20 $6,000.00 $33,707.45 $14,071.94 nat. median
$15,223
0.9× median
C1827
HCPCS 		Generator, Neurostimulator (implantable), Non-rechargeable, With Implantable Sti… 25 $1,500.00 $68,750.00 $13,750.00 nat. median
$28,413
outlier · 0.5×
278C177822
CDM 		Ins 37603 Activa Sc No Paryln 29 $1,500.00 $28,854.00 $13,740.00 nat. median
$13,740
1.0× median
278C177811
CDM 		Ins 37603 Activa Sc Dbs Eman 29 $1,500.00 $28,854.00 $13,740.00 nat. median
$13,740
1.0× median
602
MS_DRG 		Cellulitis With Mcc 37 $2,200.00 $18,501.43 $13,504.70 nat. median
$14,837
0.9× median
811
MS_DRG 		Red Blood Cell Disorders With Mcc 39 $12,008.86 $87,950.50 $13,343.17 nat. median
$14,380
0.9× median
2781776069
CDM 		Psn Rev Fem Cem Ccr Pls Sz 9 L 29 $1,500.00 $27,745.20 $13,212.00 nat. median
$13,212
1.0× median
L8679
HCPCS 		Implantable Neurostimulator, Pulse Generator, Any Type 50 $8,423.95 $63,030.00 $13,162.43 nat. median
$10,682
1.2× median

Other procedures at this hospital

Browse this hospital's 3,715 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
             
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 39 39 $287,481.93 — $59,106.19 $264,483.38 $65,673.50 2026-02-25
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 37 37 $131,013.71 — $2,200.00 $120,532.62 $46,924.85 2026-02-25
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 39 39 $115,132.41 — $39,306.92 $105,921.82 $43,674.33 2026-02-25
C1823 HCPCS Generator, Neurostimulator (implantable), Non-rechargeable, With Transvenous Sen… 25 25 $81,300.00 — $1,500.00 $203,250.00 $40,650.00 2026-02-25
278C177818 CDM Proclaim 5 Penta Sys 29 29 $75,000.00 — $1,500.00 $78,750.00 $37,500.00 2026-02-25
472 MS_DRG Cervical Spinal Fusion With Cc 41 41 $106,153.79 — $25,193.54 $97,661.49 $33,591.37 2026-02-25
264 MS_DRG Other Circulatory System O.r. Procedures 40 40 $83,635.84 — $28,567.11 $76,944.97 $33,493.96 2026-02-25
L8687 HCPCS Implantable Neurostimulator Pulse Generator, Dual Array, Rechargeable, Includes … 25 25 $63,342.00 — $1,500.00 $69,676.20 $31,671.00 2026-02-25
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 41 41 $74,367.28 — $23,703.88 $68,417.90 $31,605.15 2026-02-25
C1767 HCPCS Generator, Neurostimulator (implantable), Non-rechargeable 76 25 $57,300.00 — $1,500.00 $145,125.00 $28,650.00 2026-02-25
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 41 41 $62,244.90 — $18,631.99 $57,265.30 $24,842.63 2026-02-25
278C183163 CDM Coroent Xlf 10x18x50 10 29 29 $49,392.00 — $1,500.00 $51,861.60 $24,696.00 2026-02-25
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 41 41 $70,172.54 — $18,109.49 $64,558.74 $24,145.97 2026-02-25
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 41 41 $75,997.29 — $17,911.10 $69,917.50 $23,881.45 2026-02-25
330 MS_DRG Major Small And Large Bowel Procedures With Cc 40 40 $66,232.83 — $20,499.63 $60,934.20 $22,777.36 2026-02-25
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 41 41 $85,929.95 — $17,770.85 $79,055.55 $22,680.56 2026-02-25
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 20 20 $72,815.69 — $22,220.56 $66,990.43 $22,220.56 2026-02-25
C1820 HCPCS Generator, Neurostimulator (implantable), With Rechargeable Battery And Charging… 67 25 $58,500.00 — $1,119.00 $147,000.00 $21,820.50 2026-02-25
C1889 HCPCS Implantable/insertable Device, Not Otherwise Classified 25 25 $39,906.00 — $1,500.00 $99,765.00 $19,953.00 2026-02-25
314 MS_DRG Other Circulatory System Diagnoses With Mcc 37 37 $51,501.31 — $2,200.00 $47,381.20 $19,812.84 2026-02-25
278C1776GP CDM ZimBio Delta Fem Cer 36/-3.5 S 29 29 $38,832.00 — $1,500.00 $40,773.60 $19,416.00 2026-02-25
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 40 40 $27,794.04 $3,433,161.51 $13,897.02 $26,177.71 $19,107.82 2026-02-25
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 39 39 $54,825.12 — $12,929.40 $50,439.11 $19,005.20 2026-02-25
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 37 37 $80,248.68 — $2,200.00 $73,828.79 $18,985.25 2026-02-25
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 21 21 $62,061.40 — $1,408.70 $57,096.49 $18,456.96 2026-02-25
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 41 41 $79,069.16 — $16,494.97 $72,743.62 $18,327.73 2026-02-25
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 40 40 $21,334.24 $2,635,237.33 $10,667.12 $24,346.18 $17,770.94 2026-02-25
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 20 20 $83,390.99 — $13,320.00 $76,719.71 $17,369.02 2026-02-25
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 37 37 $47,051.81 — $2,200.00 $43,287.67 $17,045.01 2026-02-25
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc 40 40 $20,407.70 $2,520,789.72 $10,203.85 $22,489.92 $16,416.00 2026-02-25
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/mcc 40 40 $63,724.44 — $14,391.30 $58,626.48 $15,990.33 2026-02-25
988 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 40 40 $26,547.43 $3,279,178.37 $13,273.72 $24,423.64 $15,616.91 2026-02-25
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 39 39 $23,445.91 $2,896,073.97 $13,717.45 $21,570.24 $15,241.60 2026-02-25
393 MS_DRG Other Digestive System Diagnoses With Mcc 37 37 $47,511.33 — $2,200.00 $43,710.43 $15,195.99 2026-02-25
909 MS_DRG Other O.r. Procedures For Injuries Without Cc/mcc 41 41 $105,938.48 — $11,225.54 $97,463.40 $14,967.38 2026-02-25
177 MS_DRG Respiratory Infections And Inflammations With Mcc 20 20 $65,818.05 — $14,848.23 $60,552.61 $14,848.23 2026-02-25
186 MS_DRG Pleural Effusion With Mcc 20 20 $49,419.67 — $14,808.32 $45,466.10 $14,808.32 2026-02-25
517 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/mc… 40 40 $39,964.25 $4,936,443.49 $13,141.07 $36,767.11 $14,601.19 2026-02-25
E0783 HCPCS Infusion Pump System, Implantable, Programmable (includes All Components, E.g., … 65 50 $37,347.00 $15,167.69 59% off $9,333.96 $128,400.00 $14,584.31 2026-02-25
813 MS_DRG Coagulation Disorders 40 40 $19,642.58 $2,426,280.95 $9,821.29 $19,855.23 $14,492.87 2026-02-25
520 MS_DRG Back And Neck Procedures Except Spinal Fusion Without Cc/mcc 39 39 $40,738.41 — $12,775.07 $37,479.34 $14,194.51 2026-02-25
2781776068 CDM Psn Rev Fem Cmt Ccr Pls Sz 3 R 29 29 $28,278.00 — $1,500.00 $29,691.90 $14,139.00 2026-02-25
682 MS_DRG Renal Failure With Mcc 20 20 $36,638.54 $4,525,646.97 $6,000.00 $33,707.45 $14,071.94 2026-02-25
C1827 HCPCS Generator, Neurostimulator (implantable), Non-rechargeable, With Implantable Sti… 25 25 $27,500.00 — $1,500.00 $68,750.00 $13,750.00 2026-02-25
278C177822 CDM Ins 37603 Activa Sc No Paryln 29 29 $27,480.00 — $1,500.00 $28,854.00 $13,740.00 2026-02-25
278C177811 CDM Ins 37603 Activa Sc Dbs Eman 29 29 $27,480.00 — $1,500.00 $28,854.00 $13,740.00 2026-02-25
602 MS_DRG Cellulitis With Mcc 37 37 $15,794.31 $1,950,936.86 $2,200.00 $18,501.43 $13,504.70 2026-02-25
811 MS_DRG Red Blood Cell Disorders With Mcc 39 39 $95,598.37 — $12,008.86 $87,950.50 $13,343.17 2026-02-25
2781776069 CDM Psn Rev Fem Cem Ccr Pls Sz 9 L 29 29 $26,424.00 — $1,500.00 $27,745.20 $13,212.00 2026-02-25
L8679 HCPCS Implantable Neurostimulator, Pulse Generator, Any Type 65 50 $27,480.00 $13,688.92 50% off $8,423.95 $63,030.00 $13,162.43 2026-02-25
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 20 20 $66,691.27 — $13,051.47 $61,355.97 $13,051.47 2026-02-25
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 37 37 $21,898.44 $2,704,928.47 $2,200.00 $20,146.57 $12,690.40 2026-02-25
278C1831AJ CDM Roic Lord Coated Cage H6 12x14 29 29 $25,200.00 — $1,500.00 $26,460.00 $12,600.00 2026-02-25
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 21 21 $29,113.83 $3,596,183.71 $2,200.00 $26,784.72 $12,488.97 2026-02-25
540 MS_DRG Osteomyelitis With Cc 40 40 $34,920.06 $4,313,378.19 $11,085.30 $32,126.46 $12,316.99 2026-02-25
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 20 20 $74,196.56 — $12,310.34 $68,260.84 $12,310.34 2026-02-25
291 MS_DRG Heart Failure And Shock With Mcc 21 21 $44,442.79 — $2,200.00 $40,887.36 $12,198.22 2026-02-25
59 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Cc 20 20 $62,964.00 — $11,790.60 $57,926.88 $11,790.60 2026-02-25
189 MS_DRG Pulmonary Edema And Respiratory Failure 21 21 $52,106.50 — $2,200.00 $47,937.98 $11,738.34 2026-02-25
2781776048 CDM Wag Sl Rev 135 Nk Ang 21x225mm 29 29 $22,932.00 — $1,500.00 $24,078.60 $11,466.00 2026-02-25
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 20 20 $54,196.21 — $11,439.99 $49,860.51 $11,439.99 2026-02-25
593 MS_DRG Skin Ulcers With Cc 38 38 $18,223.67 $2,251,015.05 $2,200.00 $16,765.78 $11,271.81 2026-02-25
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 21 21 $33,175.01 $4,097,827.42 $2,200.00 $30,521.01 $11,024.76 2026-02-25
2781776049 CDM Radial Hd 19 Hd 5.5 Stm 9 +3 S 29 29 $21,468.00 — $1,500.00 $22,541.40 $10,734.00 2026-02-25
33285 HCPCS Insertion Of Heart Rhythm Monitor Under Skin 50 50 $24,460.00 $13,836.55 43% off $1,208.95 $20,791.00 $10,643.50 2026-02-25
278C177807 CDM Cyber Perennial Flex Vns Lead 29 29 $21,099.00 — $1,500.00 $22,153.95 $10,549.50 2026-02-25
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 20 20 $36,505.36 $4,509,197.05 $5,914.29 $33,584.93 $10,524.98 2026-02-25
C9761 HCPCS Cystourethroscopy, With Ureteroscopy And/or Pyeloscopy, With Lithotripsy, And Ur… 56 47 $13,635.00 $15,828.15 $1,500.00 $15,219.38 $9,908.33 2026-02-25
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 37 37 $22,904.62 $2,829,213.23 $2,200.00 $21,072.25 $9,723.04 2026-02-25
278C183164 CDM Coroent Xlf 12x18x55 10 29 29 $19,392.00 — $1,500.00 $20,361.60 $9,696.00 2026-02-25
278C183198 CDM Jts Xp 10x27x8mm 5-10a-¦expca 29 29 $19,200.00 — $1,500.00 $20,160.00 $9,600.00 2026-02-25
2781776131 CDM Psn Rev Tm Tib Cntrl Cone Fix 29 29 $19,008.00 — $1,500.00 $19,958.40 $9,504.00 2026-02-25
2781776132 CDM Psn Rev Tm Tib Cntrl Cone Sm 29 29 $19,008.00 — $1,500.00 $19,958.40 $9,504.00 2026-02-25
2781776133 CDM Psn Rev Tm Tib Cntrl Cone M 29 29 $19,008.00 — $1,500.00 $19,958.40 $9,504.00 2026-02-25
378 MS_DRG Gastrointestinal Hemorrhage With Cc 20 20 $26,319.08 $3,250,972.24 $1,080.00 $24,213.55 $9,318.27 2026-02-25
278C1831AD CDM Stalif Mid Cage 42x13x12 29 29 $18,450.00 — $1,500.00 $19,372.50 $9,225.00 2026-02-25
2781776241 CDM Psn Tm Fm/tm Tb/ve/tm Pt 29 29 $18,300.00 — $1,500.00 $19,215.00 $9,150.00 2026-02-25
552 MS_DRG Medical Back Problems Without Mcc 21 21 $60,226.03 — $2,200.00 $55,407.95 $9,133.94 2026-02-25
2781776051 CDM Tria Cr Fem Comp - Cem 802 29 29 $18,130.20 — $1,500.00 $19,036.71 $9,065.10 2026-02-25
2781776050 CDM Tria Cr Fem Comp - Cem 801 29 29 $18,130.20 — $1,500.00 $19,036.71 $9,065.10 2026-02-25
278C173466 CDM 8- Hole Plate Synthes 29 29 $17,697.00 — $1,500.00 $18,581.85 $8,848.50 2026-02-25
812 MS_DRG Red Blood Cell Disorders Without Mcc 38 38 $11,931.91 $1,473,847.42 $2,200.00 $11,952.45 $8,724.42 2026-02-25
638 MS_DRG Diabetes With Cc 21 21 $33,333.36 $4,117,386.61 $2,200.00 $30,666.69 $8,515.38 2026-02-25
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 40 40 $13,003.66 $1,606,231.59 $6,501.83 $11,963.37 $8,388.06 2026-02-25
683 MS_DRG Renal Failure With Cc 21 21 $27,095.70 $3,346,901.48 $2,200.00 $24,928.04 $8,321.55 2026-02-25
603 MS_DRG Cellulitis Without Mcc 21 21 $23,034.26 $2,845,226.52 $2,200.00 $21,191.52 $8,274.99 2026-02-25
278C1831AP CDM Cohere Xl, 8x18x55mm 10a-¦ 29 29 $16,464.00 — $1,500.00 $17,287.20 $8,232.00 2026-02-25
C1831 HCPCS Interbody Cage, Anterior, Lateral Or Posterior, Personalized (implantable) 851 25 $12,600.00 — $496.80 $132,168.75 $8,100.00 2026-02-25
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 20 20 $40,268.14 $4,973,981.45 $7,992.79 $37,046.69 $7,992.79 2026-02-25
278C1776CZ CDM Zim NexGen Pat All Poly 38mm 29 29 $15,876.00 — $1,500.00 $16,669.80 $7,938.00 2026-02-25
554 MS_DRG Bone Diseases And Arthropathies Without Mcc 20 20 $38,842.62 $4,797,898.07 $7,887.32 $35,735.21 $7,887.32 2026-02-25
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 21 21 $22,591.44 $2,790,528.06 $2,200.00 $20,784.12 $7,691.59 2026-02-25
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 39 39 $32,091.67 $3,964,011.22 $6,906.18 $29,524.34 $7,673.53 2026-02-25
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 37 37 $11,253.20 $1,390,012.39 $2,200.00 $10,490.61 $7,657.38 2026-02-25
2781776273 CDM Osc357816 Attune Fb With Dom 29 29 $15,300.00 — $1,500.00 $16,065.00 $7,650.00 2026-02-25
31614 HCPCS Revision Of Permanent Opening Of Windpipe For Breathing With Flap Rotation 50 50 $17,746.98 $9,898.06 44% off $316.46 $15,084.93 $7,613.89 2026-02-25
948 MS_DRG Signs And Symptoms Without Mcc 20 20 $49,305.14 — $7,606.07 $45,360.73 $7,606.07 2026-02-25
93 MS_DRG Other Disorders Of Nervous System Without Cc/mcc 20 20 $78,007.47 — $7,566.16 $71,766.87 $7,566.16 2026-02-25
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 21 21 $33,646.81 $4,156,103.82 $2,200.00 $30,955.06 $7,407.49 2026-02-25
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 21 21 $13,997.18 $1,728,952.66 $300.00 $12,877.41 $7,394.18 2026-02-25
2781776240 CDM Psn Cm Fm/cm Tb/ve/ve Psn Pt 29 29 $14,400.00 — $1,500.00 $15,120.00 $7,200.00 2026-02-25
37191 HCPCS Insertion Of Vena Cava Filter With Review By Radiologist 50 50 $15,419.28 $9,303.92 40% off $196.27 $13,106.39 $7,156.86 2026-02-25
2781776239 CDM Psn Cm Fm/cm Tb/ve/xlpe Pt 29 29 $13,950.00 — $1,500.00 $14,647.50 $6,975.00 2026-02-25
278C177819 CDM Lead Istm Ssmri 4.32mm Eman US 29 29 $13,662.00 — $1,500.00 $14,345.10 $6,831.00 2026-02-25
L8692 HCPCS Auditory Osseointegrated Device, External Sound Processor, Used Without Osseoint… 38 23 $12,474.00 — $1,500.00 $14,784.00 $6,720.00 2026-02-25
2781776004 CDM Comp Primary Stem 12mm Mini 29 29 $13,257.00 — $1,500.00 $13,919.85 $6,628.50 2026-02-25
2502131100 CDM Activase 50 Mg Vial 28 28 $13,200.54 — $1,500.00 $11,220.46 $6,600.27 2026-02-25
2781776238 CDM Psn Cem Fm/cm Tb/std Sf/std Pt 29 29 $13,200.00 — $1,500.00 $13,860.00 $6,600.00 2026-02-25
2781776236 CDM Fem/cem Tib/flx Prlng Surf/std 29 29 $13,200.00 — $1,500.00 $13,860.00 $6,600.00 2026-02-25
278C173450 CDM 3.5va Prox Tib Plsmall 4/87/lt 29 29 $13,182.00 — $1,500.00 $13,841.10 $6,591.00 2026-02-25
278C173557 CDM Omega3 Surgiclose Micro 29 29 $12,900.00 — $1,500.00 $13,545.00 $6,450.00 2026-02-25
278C173563 CDM Surgiclose Micro 93sq Cm 29 29 $12,900.00 — $1,500.00 $13,545.00 $6,450.00 2026-02-25
57288 HCPCS Creation Of Sling Around Urethra In Female To Control Leakage 50 50 $13,905.33 $8,364.19 40% off $775.25 $11,819.53 $6,433.99 2026-02-25
278C173475 CDM Tibial Nail-advanced10 285 St 29 29 $12,840.00 — $1,500.00 $13,482.00 $6,420.00 2026-02-25
3607950800{2} CDM Operating Room Services - General Classification 28 28 $12,675.00 — $1,500.00 $10,773.75 $6,337.50 2026-02-25
3607950800 CDM Operating Room Services - General Classification 28 28 $12,675.00 — $1,500.00 $10,773.75 $6,337.50 2026-02-25
278C1831AM CDM Roi-c Lord Coat IM 14x17 H5 29 29 $12,600.00 — $1,500.00 $13,230.00 $6,300.00 2026-02-25
278C1831AO CDM Roic Ana Coat Cage H6 14x15.5 29 29 $12,600.00 — $1,500.00 $13,230.00 $6,300.00 2026-02-25
278C1831AN CDM Roic Lord Coat Cage H6 14x15.5 29 29 $12,600.00 — $1,500.00 $13,230.00 $6,300.00 2026-02-25
278C1831AL CDM Roi-c Lord Coat IM 14x17 H8 29 29 $12,600.00 — $1,500.00 $13,230.00 $6,300.00 2026-02-25
278C1831AH CDM Roi-c Lord Coat IM 12x15.5 H7 29 29 $12,600.00 — $1,500.00 $13,230.00 $6,300.00 2026-02-25
278C1831AK CDM Roi-c Lord Coat IM 12x14 H5 29 29 $12,600.00 — $1,500.00 $13,230.00 $6,300.00 2026-02-25
278C1831AF CDM Zim Peek Optima D14 W15.5 -h7 29 29 $12,600.00 — $1,500.00 $13,230.00 $6,300.00 2026-02-25
278C1831AG CDM Roi-c Lord Coat IM 12x15.5 H8 29 29 $12,600.00 — $1,500.00 $13,230.00 $6,300.00 2026-02-25
278C1831AI CDM Roi-c Lord Coat IM 12x14 H7 29 29 $12,600.00 — $1,500.00 $13,230.00 $6,300.00 2026-02-25
278C1831AE CDM Zim Peek Optima D14 W17 - H7 29 29 $12,600.00 — $1,500.00 $13,230.00 $6,300.00 2026-02-25
2781776257 CDM G7 Osseoti Multihole 58mm G 29 29 $12,402.00 — $1,500.00 $13,022.10 $6,201.00 2026-02-25
2781776287 CDM G7 Osseoti Multihole 52mm E 29 29 $12,402.00 — $1,500.00 $13,022.10 $6,201.00 2026-02-25
2781776251 CDM G7 Osseoti Multihole 54mm F 29 29 $12,402.00 — $1,500.00 $13,022.10 $6,201.00 2026-02-25
2781776258 CDM G7 Osseoti Multihole 62mm H 29 29 $12,402.00 — $1,500.00 $13,022.10 $6,201.00 2026-02-25
C1602 HCPCS Orthopedic/device/drug Matrix/absorbable Bone Void Filler, Antimicrobial-eluting… 25 25 $12,366.00 — $1,500.00 $30,915.00 $6,183.00 2026-02-25
2781776012 CDM Srom Stm St 36+ 6lnk 11x16x150 29 29 $12,103.20 — $1,500.00 $12,708.36 $6,051.60 2026-02-25
379 MS_DRG Gastrointestinal Hemorrhage Without Cc/mcc 20 20 $40,311.44 $4,979,328.92 $5,989.84 $37,086.52 $5,989.84 2026-02-25
2781776014 CDM G7 Freedom Const E1 Lnr 36mm D 29 29 $11,952.00 — $1,500.00 $12,549.60 $5,976.00 2026-02-25
2780000100 CDM Certas Plus Programmable Valve 29 29 $11,924.25 — $1,500.00 $12,520.46 $5,962.13 2026-02-25
C1778 HCPCS Lead, Neurostimulator (implantable) 511 25 $9,000.00 — $48.00 $195,000.00 $5,812.50 2026-02-25
2781776184 CDM X3 Tria Insert Ps #4 12mm 29 29 $11,568.00 — $1,500.00 $12,146.40 $5,784.00 2026-02-25
J0630 HCPCS Injection, Calcitonin Salmon, Up To 400 Units 23 23 $11,275.56 — $1,500.00 $12,403.12 $5,637.78 2026-02-25
278C173467 CDM Cellular Bone Matrix 29 29 $11,182.20 — $1,500.00 $11,741.31 $5,591.10 2026-02-25
278C1776LS CDM Pers Fem Cem Cr 12 Rt 29 29 $11,115.00 — $1,500.00 $11,670.75 $5,557.50 2026-02-25
2781776066 CDM Psn Fem Cem Cr Stand Lt Sz 12 29 29 $11,115.00 — $1,500.00 $11,670.75 $5,557.50 2026-02-25
278C1713VB CDM 10/130 Deg Ti Cann Tfna 235/lt 29 29 $11,109.00 — $1,500.00 $11,664.45 $5,554.50 2026-02-25
49652 HCPCS Laparoscopy, Surgical, Repair, Ventral, Umbilical, Spigelian Or Epigastric Herni… 23 23 $10,785.00 — $1,500.00 $26,962.50 $5,392.50 2026-02-25
49654 HCPCS Laparoscopy, Surgical, Repair, Incisional Hernia (includes Mesh Insertion, When … 23 23 $10,785.00 — $1,500.00 $26,962.50 $5,392.50 2026-02-25
49653 HCPCS Laparoscopy, Surgical, Repair, Ventral, Umbilical, Spigelian Or Epigastric Herni… 23 23 $10,785.00 — $1,500.00 $26,962.50 $5,392.50 2026-02-25
2502745703 CDM Octagam 10% Vial 28 28 $10,776.00 — $1,500.00 $9,159.60 $5,388.00 2026-02-25
278C173464 CDM Xlif Ams Plate 12mm Dual-sided 29 29 $10,500.00 — $1,500.00 $11,025.00 $5,250.00 2026-02-25
3607950600 CDM Operating Room Services - General Classification 28 28 $10,450.00 — $1,500.00 $8,882.50 $5,225.00 2026-02-25
3607950600{2} CDM Operating Room Services - General Classification 28 28 $10,450.00 — $1,500.00 $8,882.50 $5,225.00 2026-02-25
278C173531 CDM Sm Occip Plate Virage 29 29 $10,431.00 — $1,500.00 $10,952.55 $5,215.50 2026-02-25
390 MS_DRG Gastrointestinal Obstruction Without Cc/mcc 40 40 $18,599.61 $2,297,451.73 $4,652.01 $17,111.64 $5,168.90 2026-02-25
J1162 HCPCS Injection, Digoxin Immune Fab (ovine), Per Vial 50 50 $13,266.00 $6,718.70 49% off $1,500.00 $14,592.60 $5,168.23 2026-02-25
2000000001 CDM Intensive Care Unit - General Classification 18 18 $8,348.00 — $2,087.00 $7,680.16 $5,086.44 2026-02-25
278C1713VA CDM 10/130 Def Ti Cann Tfna 170 St 29 29 $10,098.00 — $1,500.00 $10,602.90 $5,049.00 2026-02-25
278C1713VC CDM 11/130 Deg Ti Cann Tfna 235/lt 29 29 $10,098.00 — $1,500.00 $10,602.90 $5,049.00 2026-02-25
200 OTHER ICU General 9 7 — — $3,075.00 $5,843.60 $4,982.00 2026-05-08
278C1713UZ CDM 10 Ti Cann Tib Nail-ex Prox Bn 29 29 $9,951.00 — $1,500.00 $10,448.55 $4,975.50 2026-02-25
278C173462 CDM Anterior Tt Plate Right 29 29 $9,747.81 — $1,500.00 $10,235.20 $4,873.91 2026-02-25
2000000000 CDM Intensive Care Unit - General Classification 18 18 $7,950.00 — $1,987.50 $7,314.00 $4,843.94 2026-02-25
278C173456 CDM 10.0mmx40mm Ifuse-torq 29 29 $9,678.00 — $1,500.00 $10,161.90 $4,839.00 2026-02-25
278C183199 CDM Spin El 12x27x12mm Cage 5d Pc 29 29 $9,600.00 — $1,500.00 $10,080.00 $4,800.00 2026-02-25
278C1831AQ CDM Spin El 12x27x11mm Cage 5d Pc 29 29 $9,600.00 — $1,500.00 $10,080.00 $4,800.00 2026-02-25
278C1831AC CDM Spin El 12x27x8mm Cage 5d Pc 29 29 $9,600.00 — $1,500.00 $10,080.00 $4,800.00 2026-02-25
278C1831AB CDM Spin El 12x27x9mm Cage 5d Pc 29 29 $9,600.00 — $1,500.00 $10,080.00 $4,800.00 2026-02-25
278C1831AA CDM Spin El 12x27x10mm Cage 5d Pc 29 29 $9,600.00 — $1,500.00 $10,080.00 $4,800.00 2026-02-25
C1876 HCPCS Stent, Non-coated/non-covered, With Delivery System 25 25 $9,523.35 — $1,500.00 $23,808.38 $4,761.68 2026-02-25
2781776130 CDM Psn Rev Tib Fixed Keel Cem F L 29 29 $9,468.00 — $1,500.00 $9,941.40 $4,734.00 2026-02-25
2781776129 CDM Psn Rev Tib Fx Keel Cmt Sz E R 29 29 $9,468.00 — $1,500.00 $9,941.40 $4,734.00 2026-02-25
J0139 HCPCS Injection, Adalimumab, 1 Mg 27 27 $9,313.36 — $1,500.00 $10,244.70 $4,656.68 2026-02-25
278C1776CN CDM Mck Fem-lm-rl-sz 5 29 29 $9,283.95 — $1,500.00 $9,748.15 $4,641.98 2026-02-25
2781776088 CDM Psn Rev Cck Ve 10mm L Ef 7-9+ 29 29 $9,270.00 — $1,500.00 $9,733.50 $4,635.00 2026-02-25
2781776114 CDM Psn Rev Cck Asf Ve 12mm R3-5ef 29 29 $9,270.00 — $1,500.00 $9,733.50 $4,635.00 2026-02-25
2781776089 CDM Psn Rev Cck Ve 12mm L Ef 7-9+ 29 29 $9,270.00 — $1,500.00 $9,733.50 $4,635.00 2026-02-25
278C173472 CDM 2.7/3.5 Va-lcp Olecranon Pl2h 29 29 $9,069.00 — $1,500.00 $9,522.45 $4,534.50 2026-02-25
278C173434 CDM Xlif Ams Plate 10mm Single Sid 29 29 $9,000.00 — $1,500.00 $9,450.00 $4,500.00 2026-02-25
2781776242 CDM Pr Prm St/cer 29 29 $8,985.00 — $1,500.00 $9,434.25 $4,492.50 2026-02-25
2781776243 CDM Pr Std St/cer 29 29 $8,985.00 — $1,500.00 $9,434.25 $4,492.50 2026-02-25
47490 HCPCS Insertion Of Tube Into Gallbladder Using Imaging Guidance With Review By Radiolo… 50 50 $1,134.00 $5,986.49 $444.53 $5,756.24 $4,441.87 2026-02-25
278C1776IY CDM DepSyn Tfna Can Ti 10/130 235l 29 29 $8,808.00 — $1,500.00 $9,248.40 $4,404.00 2026-02-25
278C183168 CDM Jts Silversto P Intbdy 22x11 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183191 CDM Silstone 22x10x12mm 7a-¦ Plif 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183194 CDM Silstone 22x10x7mm 7a-¦ Plif 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183190 CDM Silstone 26x10x9mm 7a-¦ Plif 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183192 CDM Silstone 22x10x11mm 7a-¦ Plif 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183186 CDM Silstone 30x10x10mm 7a-¦ Tplif 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183188 CDM Silstone 30x10x13mm 7a-¦ Tplif 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183187 CDM Silstone 30x10x11mm 7a-¦ Tplif 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183189 CDM Silstone 26x10x11mm 7a-¦ Plif 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183176 CDM 10x32x10mm Cage 5 Deg 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183185 CDM Silstone 30x10x9mm 7a-¦ Tplif 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183193 CDM Silstone 22x10x8mm 7a-¦ Plif 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183166 CDM Jts Silversto Intbdy 22x10x11 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183175 CDM 10x27x12mm Cage 5 Deg 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183165 CDM Jts Intbdy Cage 10x22x10 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183184 CDM Silstone 30x10x8mm 7a-¦ Tplif 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183177 CDM 10x32x12mm Cage 5 Deg 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183167 CDM Jts Silversto Intbdy 22x10x8 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
278C183183 CDM Silstone 26x10x15mm 7a-¦ Plif 29 29 $8,700.00 — $1,500.00 $9,135.00 $4,350.00 2026-02-25
3700000044 CDM Anes 1stáhr Mac W Spinal&Rgnl 28 28 $8,600.00 — $1,500.00 $7,310.00 $4,300.00 2026-02-25
3700000002 CDM Anes 1st Hr Gnrl W Spinal 28 28 $8,500.00 — $1,500.00 $7,225.00 $4,250.00 2026-02-25
3700000002{2} CDM Anes 1st Hr Gnrl W Spinal 28 28 $8,500.00 — $1,500.00 $7,225.00 $4,250.00 2026-02-25
3700000000{2} CDM Anes 1st Hr Gnrl 28 28 $8,500.00 — $1,500.00 $7,225.00 $4,250.00 2026-02-25
3700000000 CDM Anes 1st Hr Gnrl 28 28 $8,500.00 — $1,500.00 $7,225.00 $4,250.00 2026-02-25
C1787 HCPCS Patient Programmer, Neurostimulator 25 25 $8,427.00 — $1,500.00 $21,067.50 $4,213.50 2026-02-25
28124 HCPCS Partial Removal Of Toe Bone 50 50 $8,929.98 $5,470.84 39% off $299.59 $7,590.48 $4,208.34 2026-02-25
3607950400{2} CDM Operating Room Services - General Classification 28 28 $8,250.00 — $1,500.00 $7,012.50 $4,125.00 2026-02-25
3607950400 CDM Operating Room Services - General Classification 28 28 $8,250.00 — $1,500.00 $7,012.50 $4,125.00 2026-02-25
278C173484 CDM Echelon Reloads 45mm Gold 29 29 $8,141.16 — $1,500.00 $8,548.22 $4,070.58 2026-02-25
37193 HCPCS Removal Of Vena Cava Filter With Review By Radiologist 50 50 $8,936.91 $5,279.37 41% off $303.15 $7,596.37 $4,061.05 2026-02-25
36558 HCPCS Insertion Of Tunneled Central Venous Tube For Infusion (5 Years Or Older) 50 50 $8,936.91 $5,279.37 41% off $135.63 $7,596.37 $4,061.05 2026-02-25
36556 HCPCS Insertion Of Non-tunneled Central Venous Tube For Infusion (5 Years Or Older) 57 50 $8,936.91 $5,279.37 41% off $74.21 $9,383.76 $4,061.05 2026-02-25
V5130 HCPCS Binaural, In The Ear 23 23 $8,000.00 — $1,500.00 $20,000.00 $4,000.00 2026-02-25
V5140 HCPCS Binaural, Behind The Ear 23 23 $8,000.00 — $1,500.00 $20,000.00 $4,000.00 2026-02-25
V5221 HCPCS Hearing Aid, Contralateral Routing System, Binaural, Bte/bte 23 23 $8,000.00 — $1,500.00 $20,000.00 $4,000.00 2026-02-25
278C173436 CDM Acu-loc2 Vdr Prox Plt Std R 29 29 $7,938.00 — $1,500.00 $8,334.90 $3,969.00 2026-02-25
2781776113 CDM Psn Asf Cps 16mm Ve R Cd 3-5 29 29 $7,908.75 — $1,500.00 $8,304.19 $3,954.38 2026-02-25
49585 HCPCS Repair Umbilical Hernia, Age 5 Years Or Older; Reducible 23 23 $7,840.00 — $1,500.00 $19,600.00 $3,920.00 2026-02-25
75825 HCPCS Review By Radiologist Of Major Lower Body Vein Image 49 49 $523.60 $5,279.37 $173.32 $5,076.31 $3,858.00 2026-02-25
3700000001 CDM Anes 1st Hr Gnrl W Rgnl 28 28 $7,500.00 — $1,500.00 $6,375.00 $3,750.00 2026-02-25
3700000001{2} CDM Anes 1st Hr Gnrl W Rgnl 28 28 $7,500.00 — $1,500.00 $6,375.00 $3,750.00 2026-02-25
3700000027 CDM Anes 1st Hr Gnrl W Epidural 28 28 $7,500.00 — $1,500.00 $6,375.00 $3,750.00 2026-02-25
3700000028 CDM Anes 1st Hr Gnrl & Fem 28 28 $7,500.00 — $1,500.00 $6,375.00 $3,750.00 2026-02-25
20240 HCPCS Biopsy Of Surface Bone 50 50 $7,749.75 $4,856.74 37% off $126.58 $6,587.29 $3,735.95 2026-02-25
10180 HCPCS Complex Drainage Of Wound Infection After Surgery 50 50 $7,749.75 $4,856.74 37% off $168.76 $6,587.29 $3,735.95 2026-02-25
278C173477 CDM 3.5mm Lcp Metaphyseal Plate 6 29 29 $7,464.00 — $1,500.00 $7,837.20 $3,732.00 2026-02-25
2781713039 CDM Phan Cs Ls Ret Sl/sl 120mm Rak 29 29 $7,362.00 — $1,500.00 $7,730.10 $3,681.00 2026-02-25
C1729 HCPCS Catheter, Drainage 126 25 $4,696.56 — $330.40 $44,533.20 $3,500.00 2026-02-25
3700000015 CDM Anes 1st Hr Gnrl W Fem Block 28 28 $7,000.00 — $1,500.00 $5,950.00 $3,500.00 2026-02-25
V2790 HCPCS Amniotic Membrane For Surgical Reconstruction, Per Procedure 25 25 $6,200.00 — $1,500.00 $15,500.00 $3,500.00 2026-02-25
C1052 HCPCS Hemostatic Agent, Gastrointestinal, Topical 25 25 $4,875.00 — $1,500.00 $12,187.50 $3,500.00 2026-02-25
278C173446 CDM Duragen Plus 4 X 5 (sub) 29 29 $6,913.89 — $1,500.00 $7,259.58 $3,456.95 2026-02-25
278C173491 CDM Strand Plus Large 29 29 $6,900.00 — $1,500.00 $7,245.00 $3,450.00 2026-02-25
278C1776FU CDM ZimAM Stem UnCem Ha 5 12/14 29 29 $6,750.00 — $1,500.00 $7,087.50 $3,375.00 2026-02-25
2505879600 CDM Praxbind 5g Dose(2x 2.5g/50ml) 28 28 $6,675.66 — $1,500.00 $5,674.31 $3,337.83 2026-02-25
2781776189 CDM Tria Trit Baseplate Sz 5 29 29 $6,675.00 — $1,500.00 $7,008.75 $3,337.50 2026-02-25
2781776190 CDM Tria Trit Baseplate Sz 8 29 29 $6,675.00 — $1,500.00 $7,008.75 $3,337.50 2026-02-25
2781776291 CDM Tria Trit Baseplate Sz 7 29 29 $6,675.00 — $1,500.00 $7,008.75 $3,337.50 2026-02-25
2781776188 CDM Tria Trit Baseplate Sz 4 29 29 $6,675.00 — $1,500.00 $7,008.75 $3,337.50 2026-02-25
2781776231 CDM Trident Ii Trit Clustrhole 52e 29 29 $6,675.00 — $1,500.00 $7,008.75 $3,337.50 2026-02-25
2781776188{2} CDM Tria Trit Baseplate Sz 4 29 29 $6,675.00 — $1,500.00 $7,008.75 $3,337.50 2026-02-25
2781776277 CDM Stry Tria Pat Asymetric A32x10 29 29 $6,675.00 — $1,500.00 $7,008.75 $3,337.50 2026-02-25
2781776283 CDM X3 Tria Insert Cs #6 14mm 29 29 $6,629.70 — $1,500.00 $6,961.19 $3,314.85 2026-02-25
2781776173 CDM X3 Tria Insert Cs #7 10mm 29 29 $6,629.16 — $1,500.00 $6,960.62 $3,314.58 2026-02-25
2781776043 CDM Biolox Da Opt Fem Hd 28mm +0mm 29 29 $6,606.00 — $1,500.00 $6,936.30 $3,303.00 2026-02-25
2781776226 CDM Sz 8 Accolade Ii 127 Deg 29 29 $6,600.00 — $1,500.00 $6,930.00 $3,300.00 2026-02-25
2781776197 CDM Tri Lm/rl Tib Aug Sz2 5mm 29 29 $6,600.00 — $1,500.00 $6,930.00 $3,300.00 2026-02-25
2781776228 CDM Insignia Collared High 4 29 29 $6,600.00 — $1,500.00 $6,930.00 $3,300.00 2026-02-25
2781776218 CDM Delta V-40 Ceramic Head 28/-4 29 29 $6,600.00 — $1,500.00 $6,930.00 $3,300.00 2026-02-25
2781776203 CDM Trident 0-¦ X3 Insert 40mm G 29 29 $6,600.00 — $1,500.00 $6,930.00 $3,300.00 2026-02-25
2781776198 CDM Tri Rm/ll Tib Aug Sz2 5mm 29 29 $6,600.00 — $1,500.00 $6,930.00 $3,300.00 2026-02-25
2781776199 CDM Tri Lm/rl Tib Aug Sz3 5mm 29 29 $6,600.00 — $1,500.00 $6,930.00 $3,300.00 2026-02-25
2781776229 CDM Insignia Collared High 6 29 29 $6,600.00 — $1,500.00 $6,930.00 $3,300.00 2026-02-25
2781776235 CDM Trident 0 Deg Insert 36mm 29 29 $6,600.00 — $1,500.00 $6,930.00 $3,300.00 2026-02-25
2781776225 CDM Sz 6 Accolade Ii 127 Deg 29 29 $6,600.00 — $1,500.00 $6,930.00 $3,300.00 2026-02-25
206 OTHER Telemetry ICU 7 7 — — $2,350.00 $4,329.00 $3,290.00 2026-05-08
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 9 9 $4,841.94 $598,083.69 $2,420.97 $4,454.58 $3,245.07 2026-02-25
3700000041 CDM Anes 1stáhr Mac W Spinal 28 28 $6,400.00 — $1,500.00 $5,440.00 $3,200.00 2026-02-25
636Q414803 CDM Neox-« Cord 1k 6.0x3.0cm 29 29 $6,300.00 — $1,500.00 $6,615.00 $3,150.00 2026-02-25
278C173452 CDM Syndesmosis Tighrope Tray . 29 29 $6,300.00 — $1,500.00 $6,615.00 $3,150.00 2026-02-25
1110000001 CDM Room & Board - Private (one Bed) - Medical/surgical/gyn 18 18 $5,145.00 — $1,286.25 $4,733.40 $3,134.85 2026-02-25
1110000001{2} CDM Room & Board - Private (one Bed) - Medical/surgical/gyn 18 18 $5,145.00 — $1,286.25 $4,733.40 $3,134.85 2026-02-25
3700000047 CDM Anes 1stáhr Spinal&Regional 28 28 $6,200.00 — $1,500.00 $5,270.00 $3,100.00 2026-02-25
3607950200 CDM Operating Room Services - General Classification 28 28 $6,050.00 — $1,500.00 $5,142.50 $3,025.00 2026-02-25
3607950200{2} CDM Operating Room Services - General Classification 28 28 $6,050.00 — $1,500.00 $5,142.50 $3,025.00 2026-02-25
2781713008 CDM Phan Cs Acf Dist Rt 120mm Rack 29 29 $6,001.20 — $1,500.00 $6,301.26 $3,000.60 2026-02-25
2781713000 CDM Phan Cs Acf Dist Lt 120mm Rack 29 29 $6,001.20 — $1,500.00 $6,301.26 $3,000.60 2026-02-25
2781776276 CDM Stry Tria Pat Symmetric 33x9 29 29 $6,000.00 — $1,500.00 $6,300.00 $3,000.00 2026-02-25
2781776264 CDM Avenir Lateral Stem Cem 5 29 29 $6,000.00 — $1,500.00 $6,300.00 $3,000.00 2026-02-25
C1776 HCPCS Joint Device (implantable) 7,225 25 $4,077.00 — $1.20 $158,355.00 $3,000.00 2026-02-25
2781776285 CDM Stry Tria Pat Symmetric 39x11 29 29 $6,000.00 — $1,500.00 $6,300.00 $3,000.00 2026-02-25
2781776278 CDM Stry Tria Pat Asymetric A29x9 29 29 $6,000.00 — $1,500.00 $6,300.00 $3,000.00 2026-02-25
278C173500 CDM Helistat 3 X 4 Inch X 5.0mm 29 29 $5,977.95 — $1,494.49 $6,276.85 $2,988.98 2026-02-25
2781776142 CDM Psn Rev Tapered Stem Ext 14x75 29 29 $5,976.00 — $1,494.00 $6,274.80 $2,988.00 2026-02-25
278C1776DG CDM Zim Pers Rev Stem Ext 14/+75 29 29 $5,976.00 — $1,494.00 $6,274.80 $2,988.00 2026-02-25
49560 HCPCS Repair Initial Incisional Or Ventral Hernia; Reducible 23 23 $5,975.00 — $1,500.00 $14,937.50 $2,987.50 2026-02-25
278C173518 CDM 12mmev Wedge Allopure Bicortic 29 29 $5,928.00 — $1,482.00 $6,224.40 $2,964.00 2026-02-25
278C173441 CDM Grafton Dbf Inject 9cc 29 29 $5,880.00 — $1,470.00 $6,174.00 $2,940.00 2026-02-25
2781776011 CDM Srom Sleeve Prx Ztt 16b-sml 29 29 $5,878.80 — $1,469.70 $6,172.74 $2,939.40 2026-02-25
278C173495 CDM Staple Nitinol 18x16fuseforce 29 29 $5,797.14 — $1,449.29 $6,087.00 $2,898.57 2026-02-25
278C173517 CDM Shift Fix Mdco Plate 29 29 $5,793.96 — $1,448.49 $6,083.66 $2,896.98 2026-02-25
3700000045 CDM Anes 1st Sub.5hr MAC&Spnl&Rgnl 28 28 $5,765.00 — $1,441.25 $4,900.25 $2,882.50 2026-02-25
278C173509 CDM 6 Hole Clavical Plate 29 29 $5,745.00 — $1,436.25 $6,032.25 $2,872.50 2026-02-25
2060000000 CDM Intensive Care Unit - Intermediate ICU 18 18 $4,700.00 — $1,175.00 $4,324.00 $2,863.71 2026-02-25
C1755 HCPCS Catheter, Intraspinal 25 25 $3,483.00 — $1,299.16 $8,707.50 $2,786.40 2026-02-25
111 OTHER Outpatient Obs Bed Rate 10 8 — — $1,942.50 $3,950.00 $2,762.75 2026-05-08
C1771 HCPCS Repair Device, Urinary, Incontinence, With Sling Graft 50 25 $4,242.00 — $1,106.69 $13,792.50 $2,758.50 2026-02-25
3700000003{2} CDM Anes 1st Hr Rgnl 28 28 $5,500.00 — $1,375.00 $4,675.00 $2,750.00 2026-02-25
3700000003 CDM Anes 1st Hr Rgnl 28 28 $5,500.00 — $1,375.00 $4,675.00 $2,750.00 2026-02-25
3700000025 CDM Anes 1st Hr Spinal&Epidural 28 28 $5,500.00 — $1,375.00 $4,675.00 $2,750.00 2026-02-25
278C178121 CDM Ventrio St Large Oval 5.4x7" 29 29 $5,460.30 — $1,365.08 $5,733.32 $2,730.15 2026-02-25
2781776146 CDM Tria Cr Fem Comp - Cem 101 29 29 $5,400.00 — $1,350.00 $5,670.00 $2,700.00 2026-02-25
278C173541 CDM 10cc Attrax Putty 12.5x50x8mm 29 29 $5,400.00 — $1,350.00 $5,670.00 $2,700.00 2026-02-25
2781776147 CDM Tria Cr Fem Comp - Cem 201 29 29 $5,400.00 — $1,350.00 $5,670.00 $2,700.00 2026-02-25
2781776293 CDM Tria Cr Fem Comp - Cem 602 29 29 $5,400.00 — $1,350.00 $5,670.00 $2,700.00 2026-02-25
2781776292 CDM Tria Cr Fem Comp - Cem 601 29 29 $5,400.00 — $1,350.00 $5,670.00 $2,700.00 2026-02-25
2781776047 CDM St Ao Fit. Modular Shaft 450mm 29 29 $5,400.00 — $1,350.00 $5,670.00 $2,700.00 2026-02-25
2781776281 CDM Tria Cr Fem Comp - Cem 401 29 29 $5,400.00 — $1,350.00 $5,670.00 $2,700.00 2026-02-25
2781776282 CDM Tria Cr Fem Comp - Cem 301 29 29 $5,400.00 — $1,350.00 $5,670.00 $2,700.00 2026-02-25
2781776270 CDM Tria Cr Fem Comp - Cem 501 29 29 $5,400.00 — $1,350.00 $5,670.00 $2,700.00 2026-02-25
2781776253 CDM Tria Cr Fem Comp - Cem 302 29 29 $5,400.00 — $1,350.00 $5,670.00 $2,700.00 2026-02-25
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