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

GLENN MEDICAL CENTER

Willows, CA · CCN 051306 · Rates published

7,294 distinct procedures filed
28 distinct payers
193,156 rate rows
2025-10-04 last MRF observed · ⚠ 13 mo old
Data quality

187,074 of 193,156 rate rows are consumer-grade (96.9%)

6,082 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 5,285
per-diem day rate — not a per-procedure price 352
exceeds 10× this hospital's gross charge — excluded from medians 213
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 144
exceeds 3× this hospital's gross charge for a DRG stay — excluded 66
percent-of-charges filed in the dollar field — excluded from medians 22

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 13 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbGMCWILLOWSCA&type=CDMWithoutLabel&fileType=CSV
Found on page https://gmcmed.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-11-03
Content fingerprint dc3b40b41769d135… · 63,518,922 bytes · first seen 2026-11-02

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
05201301_1
CDM 		Quetiapine Fumarate 400 Mg Tab 22 $2,449,323.14 $7,756,189.93 $6,655,441.85 —
05203718_1
CDM 		Nystatin 10 Billion Unit Powd 22 $45,953.46 $145,519.29 $124,867.39 —
540
MS_DRG 		Osteomyelitis With Cc 22 $22,605.52 $100,899.00 $71,922.36 nat. median
$12,755
outlier · 5.6×
867
MS_DRG 		Other Infectious And Parasitic Diseases Diagnoses With Mcc 22 $18,863.77 $67,266.00 $60,707.72 nat. median
$20,236
outlier · 3.0×
560
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Cc 22 $45,277.56 $64,596.35 $59,192.37 nat. median
$11,475
outlier · 5.2×
559
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Mcc 22 $45,277.56 $60,539.40 $54,153.65 nat. median
$18,112
outlier · 3.0×
593
MS_DRG 		Skin Ulcers With Cc 22 $17,779.56 $70,629.30 $49,170.64 nat. median
$11,933
outlier · 4.1×
602
MS_DRG 		Cellulitis With Mcc 22 $15,655.13 $53,812.80 $48,188.43 nat. median
$14,007
outlier · 3.4×
371
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 22 $18,465.69 $46,284.02 $41,632.63 nat. median
$16,886
outlier · 2.5×
196
MS_DRG 		Interstitial Lung Disease With Mcc 22 $17,607.94 $46,584.20 $38,859.87 nat. median
$17,835
outlier · 2.2×
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 22 $17,643.53 $39,012.93 $34,688.39 nat. median
$15,375
outlier · 2.3×
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 22 $17,643.53 $38,672.33 $34,436.67 nat. median
$10,189
outlier · 3.4×
394
MS_DRG 		Other Digestive System Diagnoses With Cc 22 $15,092.52 $35,760.70 $30,248.06 nat. median
$9,671
outlier · 3.1×
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 22 $17,607.94 $32,822.60 $28,748.36 nat. median
$18,625
1.5× median
727
MS_DRG 		Inflammation Of The Male Reproductive System With Mcc 22 $10,061.68 $30,345.85 $25,138.06 nat. median
$14,459
1.7× median
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 22 $10,061.68 $27,787.05 $23,278.56 nat. median
$12,858
1.8× median
947
MS_DRG 		Signs And Symptoms With Mcc 22 $15,616.12 $25,716.87 $23,241.26 nat. median
$12,107
1.9× median
05203082_1
CDM 		Nf-diclo Gel Topical Application Gel 1% 22 $8,451.77 $26,763.92 $22,965.62 —
557
MS_DRG 		Tendonitis, Myositis And Bursitis With Mcc 22 $7,546.26 $33,150.63 $22,809.10 nat. median
$14,487
1.6× median
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 22 $12,577.10 $24,546.89 $21,396.10 nat. median
$8,511
outlier · 2.5×
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 22 $15,092.52 $23,176.29 $20,850.34 nat. median
$11,506
1.8× median
05203995_1
CDM 		Humira(cf) 20 Mg/0.2 Ml Syring 22 $6,360.17 $20,140.52 $17,282.21 —
300
MS_DRG 		Peripheral Vascular Disorders With Cc 22 $10,061.68 $19,284.86 $17,022.57 nat. median
$10,840
1.6× median
05203966_1
CDM 		Fluticasone Prop Micro Powder 22 $5,704.34 $18,063.73 $15,500.15 —
208
MS_DRG 		Respiratory System Diagnosis With Ventilator Support <=96 Hours 22 $5,030.84 $83,535.70 $15,366.15 nat. median
$25,366
0.6× median
393
MS_DRG 		Other Digestive System Diagnoses With Mcc 22 $10,061.68 $17,924.58 $15,340.70 nat. median
$15,607
1.0× median
640
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 22 $12,577.10 $16,816.50 $14,623.12 nat. median
$12,833
1.1× median
183
MS_DRG 		Major Chest Trauma With Mcc 20 $12,612.28 $20,036.01 $14,284.11 nat. median
$15,007
1.0× median
949
MS_DRG 		Aftercare With Cc/mcc 22 $12,191.44 $16,816.50 $14,066.08 nat. median
$11,791
1.2× median
92
MS_DRG 		Other Disorders Of Nervous System With Cc 22 $7,546.26 $24,930.99 $13,611.56 nat. median
$10,593
1.3× median
386
MS_DRG 		Inflammatory Bowel Disease With Cc 22 $5,030.84 $18,837.77 $13,485.78 nat. median
$10,168
1.3× median
637
MS_DRG 		Diabetes With Mcc 22 $10,061.68 $16,264.25 $13,343.18 nat. median
$13,945
1.0× median
291
MS_DRG 		Heart Failure And Shock With Mcc 22 $5,030.84 $18,542.71 $13,183.46 nat. median
$12,759
1.0× median
372
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Cc 22 $2,515.42 $18,465.69 $12,097.48 nat. median
$10,404
1.2× median
05204915_1
CDM 		Invega Sustenna 156 Mg/ml Syrg 22 $4,383.27 $13,880.36 $11,910.48 —
175
MS_DRG 		Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 22 $5,030.84 $19,244.85 $11,784.13 nat. median
$13,725
0.9× median
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 22 $5,030.84 $21,753.35 $11,548.38 nat. median
$10,397
1.1× median
00600011_1
CDM 		Operating Room Services - General Classification 22 $4,063.82 $12,868.75 $11,042.43 nat. median
$4,438
outlier · 2.5×
00600007_1
CDM 		Operating Room Services - General Classification 22 $4,063.82 $12,868.75 $11,042.43 nat. median
$924
outlier · 12.0×
378
MS_DRG 		Gastrointestinal Hemorrhage With Cc 22 $2,515.42 $19,382.88 $11,009.20 nat. median
$10,016
1.1× median
200
MS_DRG 		Pneumothorax With Cc 20 $9,573.21 $12,474.49 $10,705.51 nat. median
$11,050
1.0× median
05204076_1
CDM 		Invega Sustenna 234 Mg/1.5 Ml 22 $3,904.45 $12,364.08 $10,609.39 —
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 22 $3,722.04 $13,771.55 $10,361.69 nat. median
$3,824
outlier · 2.7×
377
MS_DRG 		Gastrointestinal Hemorrhage With Mcc 22 $2,515.42 $19,382.88 $10,181.80 nat. median
$17,281
0.6× median
920
MS_DRG 		Complications Of Treatment With Cc 20 $8,540.93 $17,913.58 $9,890.34 nat. median
$10,323
1.0× median
176
MS_DRG 		Pulmonary Embolism Without Mcc 22 $5,030.84 $19,244.85 $9,878.02 nat. median
$8,582
1.2× median
606
MS_DRG 		Minor Skin Disorders With Mcc 22 $5,030.84 $15,617.12 $9,840.37 nat. median
$14,895
0.7× median
433
MS_DRG 		Cirrhosis And Alcoholic Hepatitis With Cc 22 $2,515.42 $19,861.97 $9,640.56 nat. median
$10,753
0.9× median
296
MS_DRG 		Cardiac Arrest, Unexplained With Mcc 20 $8,081.60 $14,843.97 $9,253.13 nat. median
$15,575
0.6× median
729
MS_DRG 		Other Male Reproductive System Diagnoses With Cc/mcc 20 $7,018.40 $36,340.27 $9,208.27 nat. median
$10,890
0.8× median

Other procedures at this hospital

Browse this hospital's 7,294 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
05201301_1 CDM Quetiapine Fumarate 400 Mg Tab 24 22 $8,164,410.45 $4,898,646.27 40% off $2,449,323.14 $7,756,189.93 $6,655,441.85 2025-10-04
05203718_1 CDM Nystatin 10 Billion Unit Powd 24 22 $153,178.20 $91,906.92 40% off $45,953.46 $145,519.29 $124,867.39 2025-10-04
540 MS_DRG Osteomyelitis With Cc 24 22 $79,216.40 $47,529.84 40% off $22,605.52 $100,899.00 $71,922.36 2025-10-04
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 24 22 $70,759.54 $42,455.72 40% off $18,863.77 $67,266.00 $60,707.72 2025-10-04
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 24 22 $67,996.16 $40,797.70 40% off $45,277.56 $64,596.35 $59,192.37 2025-10-04
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 24 22 $60,819.35 $36,491.61 40% off $45,277.56 $60,539.40 $54,153.65 2025-10-04
593 MS_DRG Skin Ulcers With Cc 24 22 $53,661.81 $32,197.09 40% off $17,779.56 $70,629.30 $49,170.64 2025-10-04
602 MS_DRG Cellulitis With Mcc 24 22 $56,036.12 $33,621.67 40% off $15,655.13 $53,812.80 $48,188.43 2025-10-04
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 24 22 $48,720.03 $29,232.02 40% off $18,465.69 $46,284.02 $41,632.63 2025-10-04
196 MS_DRG Interstitial Lung Disease With Mcc 24 22 $49,036.00 $29,421.60 40% off $17,607.94 $46,584.20 $38,859.87 2025-10-04
177 MS_DRG Respiratory Infections And Inflammations With Mcc 24 22 $41,066.24 $24,639.74 40% off $17,643.53 $39,012.93 $34,688.39 2025-10-04
178 MS_DRG Respiratory Infections And Inflammations With Cc 24 22 $40,707.71 $24,424.63 40% off $17,643.53 $38,672.33 $34,436.67 2025-10-04
394 MS_DRG Other Digestive System Diagnoses With Cc 24 22 $37,642.84 $22,585.70 40% off $15,092.52 $35,760.70 $30,248.06 2025-10-04
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 24 22 $34,550.10 $20,730.06 40% off $17,607.94 $32,822.60 $28,748.36 2025-10-04
727 MS_DRG Inflammation Of The Male Reproductive System With Mcc 24 22 $31,943.00 $19,165.80 40% off $10,061.68 $30,345.85 $25,138.06 2025-10-04
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 24 22 $29,249.53 $17,549.72 40% off $10,061.68 $27,787.05 $23,278.56 2025-10-04
947 MS_DRG Signs And Symptoms With Mcc 24 22 $27,070.39 $16,242.23 40% off $15,616.12 $25,716.87 $23,241.26 2025-10-04
05203082_1 CDM Nf-diclo Gel Topical Application Gel 1% 24 22 $28,172.55 $16,903.53 40% off $8,451.77 $26,763.92 $22,965.62 2025-10-04
557 MS_DRG Tendonitis, Myositis And Bursitis With Mcc 24 22 $28,332.00 $16,999.20 40% off $7,546.26 $33,150.63 $22,809.10 2025-10-04
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 24 22 $25,838.83 $15,503.30 40% off $12,577.10 $24,546.89 $21,396.10 2025-10-04
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 24 22 $24,396.09 $14,637.65 40% off $15,092.52 $23,176.29 $20,850.34 2025-10-04
05203995_1 CDM Humira(cf) 20 Mg/0.2 Ml Syring 24 22 $21,200.55 $12,720.33 40% off $6,360.17 $20,140.52 $17,282.21 2025-10-04
300 MS_DRG Peripheral Vascular Disorders With Cc 24 22 $20,299.86 $12,179.91 40% off $10,061.68 $19,284.86 $17,022.57 2025-10-04
05203966_1 CDM Fluticasone Prop Micro Powder 24 22 $19,014.45 $11,408.67 40% off $5,704.34 $18,063.73 $15,500.15 2025-10-04
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 24 22 $15,470.00 $9,282.00 40% off $5,030.84 $83,535.70 $15,366.15 2025-10-04
393 MS_DRG Other Digestive System Diagnoses With Mcc 24 22 $17,868.70 $10,721.22 40% off $10,061.68 $17,924.58 $15,340.70 2025-10-04
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 24 22 $16,239.64 $9,743.79 40% off $12,577.10 $16,816.50 $14,623.12 2025-10-04
183 MS_DRG Major Chest Trauma With Mcc 20 20 $15,765.35 $9,459.21 40% off $12,612.28 $20,036.01 $14,284.11 2025-10-04
949 MS_DRG Aftercare With Cc/mcc 24 22 $15,664.01 $9,398.41 40% off $12,191.44 $16,816.50 $14,066.08 2025-10-04
92 MS_DRG Other Disorders Of Nervous System With Cc 24 22 $15,719.46 $9,431.68 40% off $7,546.26 $24,930.99 $13,611.56 2025-10-04
386 MS_DRG Inflammatory Bowel Disease With Cc 24 22 $16,631.38 $9,978.83 40% off $5,030.84 $18,837.77 $13,485.78 2025-10-04
637 MS_DRG Diabetes With Mcc 24 22 $15,122.10 $9,073.26 40% off $10,061.68 $16,264.25 $13,343.18 2025-10-04
291 MS_DRG Heart Failure And Shock With Mcc 24 22 $16,218.28 $9,730.97 40% off $5,030.84 $18,542.71 $13,183.46 2025-10-04
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 24 22 $15,405.50 $9,243.30 40% off $2,515.42 $18,465.69 $12,097.48 2025-10-04
05204915_1 CDM Invega Sustenna 156 Mg/ml Syrg 24 22 $14,610.91 $8,766.55 40% off $4,383.27 $13,880.36 $11,910.48 2025-10-04
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 24 22 $14,183.50 $8,510.10 40% off $5,030.84 $19,244.85 $11,784.13 2025-10-04
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 24 22 $13,698.83 $8,219.30 40% off $5,030.84 $21,753.35 $11,548.38 2025-10-04
00600011_1 CDM Operating Room Services - General Classification 24 22 $13,546.05 $8,127.63 40% off $4,063.82 $12,868.75 $11,042.43 2025-10-04
00600007_1 CDM Operating Room Services - General Classification 24 22 $13,546.05 $8,127.63 40% off $4,063.82 $12,868.75 $11,042.43 2025-10-04
378 MS_DRG Gastrointestinal Hemorrhage With Cc 24 22 $13,801.00 $8,280.60 40% off $2,515.42 $19,382.88 $11,009.20 2025-10-04
200 MS_DRG Pneumothorax With Cc 20 20 $11,966.51 $7,179.91 40% off $9,573.21 $12,474.49 $10,705.51 2025-10-04
05204076_1 CDM Invega Sustenna 234 Mg/1.5 Ml 24 22 $13,014.82 $7,808.89 40% off $3,904.45 $12,364.08 $10,609.39 2025-10-04
J3101 HCPCS Injection, Tenecteplase, 1 Mg 24 22 $12,406.80 $7,444.08 40% off $3,722.04 $13,771.55 $10,361.69 2025-10-04
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 24 22 $12,622.50 $7,573.50 40% off $2,515.42 $19,382.88 $10,181.80 2025-10-04
920 MS_DRG Complications Of Treatment With Cc 20 20 $10,676.16 $6,405.70 40% off $8,540.93 $17,913.58 $9,890.34 2025-10-04
176 MS_DRG Pulmonary Embolism Without Mcc 24 22 $11,468.56 $6,881.14 40% off $5,030.84 $19,244.85 $9,878.02 2025-10-04
606 MS_DRG Minor Skin Disorders With Mcc 24 22 $11,630.23 $6,978.14 40% off $5,030.84 $15,617.12 $9,840.37 2025-10-04
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 24 22 $11,823.16 $7,093.90 40% off $2,515.42 $19,861.97 $9,640.56 2025-10-04
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 20 20 $10,102.00 $6,061.20 40% off $8,081.60 $14,843.97 $9,253.13 2025-10-04
729 MS_DRG Other Male Reproductive System Diagnoses With Cc/mcc 20 20 $8,773.00 $5,263.80 40% off $7,018.40 $36,340.27 $9,208.27 2025-10-04
05204760_1 CDM Enbrel 25 Mg/0.5 Ml Syringe 24 22 $11,102.70 $6,661.62 40% off $3,330.81 $10,547.57 $9,050.67 2025-10-04
05204998_1 CDM Dalvance 500 Mg Vial 24 22 $10,674.00 $6,404.40 40% off $3,202.20 $10,140.30 $8,701.20 2025-10-04
292 MS_DRG Heart Failure And Shock With Cc 24 22 $9,793.48 $5,876.09 40% off $5,030.84 $18,542.71 $8,672.72 2025-10-04
05202504_1 CDM Vivitrol 380 Mg Vial-diluent 24 22 $10,257.45 $6,154.47 40% off $3,077.24 $9,744.58 $8,361.64 2025-10-04
05202519_1 CDM Vivitrol 380 Mg Vial-diluent 24 22 $10,257.45 $6,154.47 40% off $3,077.24 $9,744.58 $8,361.64 2025-10-04
05202539_1 CDM Vivitrol 380 Mg Vial-diluent 24 22 $10,257.45 $6,154.47 40% off $3,077.24 $9,744.58 $8,361.64 2025-10-04
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 20 20 $8,541.98 $5,125.19 40% off $6,833.58 $14,388.88 $7,916.06 2025-10-04
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 24 22 $9,123.20 $5,473.92 40% off $2,515.42 $23,183.64 $7,883.36 2025-10-04
00600005_1 CDM Operating Room Services - General Classification 24 22 $9,432.15 $5,659.29 40% off $2,829.65 $8,960.54 $7,688.88 2025-10-04
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 20 20 $7,741.00 $4,644.60 40% off $6,192.80 $20,041.01 $7,523.84 2025-10-04
185 MS_DRG Major Chest Trauma Without Cc/mcc 24 22 $8,064.50 $4,838.70 40% off $5,030.84 $20,036.01 $7,521.05 2025-10-04
05202549_1 CDM Vivitrol 380 Mg Vial-diluent 24 22 $8,919.75 $5,351.85 40% off $2,675.93 $8,473.76 $7,271.18 2025-10-04
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 24 22 $7,897.31 $4,738.38 40% off $5,030.84 $16,548.31 $7,258.34 2025-10-04
05202441_1 CDM Nf-enbrel Subcutaneous Solution 50mg/1ml 24 22 $8,877.75 $5,326.65 40% off $2,663.33 $8,433.86 $7,236.94 2025-10-04
49560 HCPCS Repair Initial Incisional Or Ventral Hernia; Reducible 24 22 $7,036.05 $4,221.63 40% off $7,036.05 $7,036.05 $7,036.05 2025-10-04
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc 24 22 $5,340.94 $3,204.57 40% off $4,272.75 $53,640.73 $7,009.08 2025-10-04
05203046_1 CDM Activase 50 Mg Vial 24 22 $8,517.60 $5,110.56 40% off $2,555.28 $8,091.72 $6,943.35 2025-10-04
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 20 20 $7,008.73 $4,205.24 40% off $5,606.99 $17,924.58 $6,801.09 2025-10-04
297 MS_DRG Cardiac Arrest, Unexplained With Cc 20 20 $7,144.39 $4,286.63 40% off $5,715.51 $14,843.97 $6,761.35 2025-10-04
302 MS_DRG Atherosclerosis With Mcc 20 20 $6,764.58 $4,058.75 40% off $5,411.67 $17,125.42 $6,555.43 2025-10-04
05200916_1 CDM Humira Pen 40 Mg/0.8 Ml 24 22 $8,026.20 $4,815.72 40% off $2,407.86 $7,624.89 $6,542.78 2025-10-04
388 MS_DRG Gastrointestinal Obstruction With Mcc 20 20 $6,796.00 $4,077.60 40% off $5,436.80 $15,983.20 $6,524.79 2025-10-04
688 MS_DRG Kidney And Urinary Tract Neoplasms Without Cc/mcc 20 20 $5,177.00 $3,106.20 40% off $4,141.60 $43,181.63 $6,520.70 2025-10-04
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 20 20 $6,613.00 $3,967.80 40% off $5,290.40 $18,751.75 $6,509.04 2025-10-04
00600003_1 CDM Operating Room Services - General Classification 24 22 $7,889.70 $4,733.82 40% off $2,366.91 $7,495.22 $6,431.51 2025-10-04
197 MS_DRG Interstitial Lung Disease With Cc 24 22 $7,168.54 $4,301.13 40% off $2,515.42 $20,342.07 $6,392.63 2025-10-04
100 MS_DRG Seizures With Mcc 20 20 $6,172.67 $3,703.60 40% off $4,938.13 $17,120.42 $6,056.49 2025-10-04
445 MS_DRG Disorders Of The Biliary Tract With Cc 24 22 $6,327.50 $3,796.50 40% off $2,515.42 $21,365.27 $5,844.78 2025-10-04
05200918_1 CDM Humatrope 12 Mg Cartridge 24 22 $7,047.60 $4,228.56 40% off $2,114.28 $6,695.22 $5,745.04 2025-10-04
789 MS_DRG Neonates, Died Or Transferred To Another Acute Care Facility 20 20 $6,309.31 $3,785.59 40% off $5,047.45 $8,218.64 $5,726.52 2025-10-04
05204996_4 CDM Nexplanon Subq Implant 68mg 24 22 $6,937.70 $4,162.62 40% off $2,081.31 $6,590.82 $5,655.46 2025-10-04
05204996_1 CDM Nexplanon Subq Implant 68mg 24 22 $6,937.70 $4,162.62 40% off $2,081.31 $6,590.82 $5,655.46 2025-10-04
389 MS_DRG Gastrointestinal Obstruction With Cc 20 20 $5,719.33 $3,431.60 40% off $4,575.47 $15,983.20 $5,617.70 2025-10-04
155 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Cc 20 20 $4,454.25 $2,672.55 40% off $3,563.40 $34,313.86 $5,468.40 2025-10-04
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 24 22 $5,061.13 $3,036.68 40% off $4,048.91 $16,548.31 $5,267.11 2025-10-04
202 MS_DRG Bronchitis And Asthma With Cc/mcc 24 22 $5,288.81 $3,173.28 40% off $4,231.05 $12,474.49 $5,257.22 2025-10-04
54 MS_DRG Nervous System Neoplasms With Mcc 20 20 $4,765.00 $2,859.00 40% off $3,812.00 $22,002.40 $5,114.63 2025-10-04
A0428 HCPCS Ambulance Service, Basic Life Support, Non-emergency Transport, (bls) 24 22 $6,066.90 $3,640.14 40% off $1,820.07 $6,734.26 $5,066.85 2025-10-04
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 24 22 $4,719.96 $2,831.97 40% off $3,775.97 $16,666.33 $5,032.50 2025-10-04
948 MS_DRG Signs And Symptoms Without Mcc 24 22 $4,768.05 $2,860.83 40% off $3,814.44 $15,616.12 $5,022.51 2025-10-04
J0840 HCPCS Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram 24 22 $6,137.25 $3,682.35 40% off $1,841.18 $5,830.39 $4,953.35 2025-10-04
00600024_1 CDM Gastro - Intestinal (gi) Services - General Classification 24 22 $6,001.80 $3,601.08 40% off $1,800.54 $5,701.71 $4,892.53 2025-10-04
00600010_1 CDM Operating Room Services - General Classification 24 22 $6,001.80 $3,601.08 40% off $1,800.54 $5,701.71 $4,892.53 2025-10-04
05000873_1 CDM Set Hta Genesys Procedure 24 22 $5,720.40 $3,432.24 40% off $1,716.12 $5,434.38 $4,663.14 2025-10-04
05204515_1 CDM Ozempic 0.25-0.5 Mg/dose Pen 24 22 $5,682.65 $3,409.59 40% off $1,704.80 $5,398.52 $4,632.37 2025-10-04
395 MS_DRG Other Digestive System Diagnoses Without Cc/mcc 24 22 $4,047.10 $2,428.26 40% off $3,237.68 $17,924.58 $4,612.52 2025-10-04
J1950 HCPCS Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg 24 22 $5,822.25 $3,493.35 40% off $1,746.68 $5,531.14 $4,550.73 2025-10-04
00600012_1 CDM Operating Room Services - General Classification 24 22 $5,487.30 $3,292.38 40% off $1,646.19 $5,212.94 $4,473.12 2025-10-04
A4264 HCPCS Permanent Implantable Contraceptive Intratubal Occlusion Device(s) And Delivery … 48 22 $5,876.85 $3,526.11 40% off $1,443.02 $6,523.30 $4,462.65 2025-10-04
122 MS_DRG Acute Major Eye Infections Without Cc/mcc 20 20 $5,229.77 $3,137.86 40% off $1,098.25 $4,968.28 $4,460.99 2025-10-04
181 MS_DRG Respiratory Neoplasms With Cc 20 20 $3,548.00 $2,128.80 40% off $2,838.40 $29,186.84 $4,448.53 2025-10-04
728 MS_DRG Inflammation Of The Male Reproductive System Without Mcc 24 22 $3,919.12 $2,351.47 40% off $3,135.30 $15,909.18 $4,438.70 2025-10-04
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 20 20 $3,972.00 $2,383.20 40% off $3,177.60 $20,041.01 $4,348.46 2025-10-04
45378 HCPCS Colonoscopy, Flexible; Diagnostic, Including Collection Of Specimen(s) By Brushi… 48 22 $6,001.80 $3,601.08 40% off $50.00 $5,701.71 $4,332.34 2025-10-04
43239 HCPCS Esophagogastroduodenoscopy, Flexible, Transoral; With Biopsy, Single Or Multiple 48 22 $6,001.80 $3,601.08 40% off $40.00 $5,701.71 $4,326.79 2025-10-04
74177 HCPCS Computed Tomography, Abdomen And Pelvis; With Contrast Material(s) 24 22 $5,707.80 $3,424.68 40% off $404.21 $5,422.41 $4,300.67 2025-10-04
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 20 20 $3,780.00 $2,268.00 40% off $3,024.00 $22,124.42 $4,290.87 2025-10-04
314 MS_DRG Other Circulatory System Diagnoses With Mcc 20 20 $4,047.00 $2,428.20 40% off $3,237.60 $16,870.37 $4,253.12 2025-10-04
90375 HCPCS Rabies Immune Globulin (rig), Human, For Intramuscular And/or Subcutaneous Use 68 22 $12,574.80 $7,544.88 40% off $280.04 $11,946.06 $4,233.93 2025-10-04
189 MS_DRG Pulmonary Edema And Respiratory Failure 24 22 $3,359.08 $2,015.45 40% off $2,687.27 $20,342.07 $4,230.21 2025-10-04
603 MS_DRG Cellulitis Without Mcc 24 22 $3,552.54 $2,131.53 40% off $2,842.04 $15,655.13 $4,170.74 2025-10-04
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 24 22 $3,412.86 $2,047.72 40% off $2,730.29 $17,643.53 $4,155.52 2025-10-04
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 20 20 $3,816.00 $2,289.60 40% off $3,052.80 $18,751.75 $4,152.57 2025-10-04
682 MS_DRG Renal Failure With Mcc 24 22 $4,215.33 $2,529.20 40% off $2,515.42 $16,288.26 $4,150.32 2025-10-04
187 MS_DRG Pleural Effusion With Cc 20 20 $3,633.50 $2,180.10 40% off $2,906.80 $20,342.07 $4,078.33 2025-10-04
05204521_1 CDM Lenalidomide 10 Mg Capsule 24 22 $4,986.45 $2,991.87 40% off $1,495.94 $4,737.13 $4,064.84 2025-10-04
05204260_1 CDM Lenalidomide 10 Mg Capsule 24 22 $4,986.45 $2,991.87 40% off $1,495.94 $4,737.13 $4,064.84 2025-10-04
05204262_1 CDM Lenalidomide 10 Mg Capsule 24 22 $4,986.45 $2,991.87 40% off $1,495.94 $4,737.13 $4,064.84 2025-10-04
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 24 22 $3,390.96 $2,034.58 40% off $2,712.77 $15,587.12 $4,054.47 2025-10-04
81229 HCPCS Cytogenomic (genome-wide) Analysis For Constitutional Chromosomal Abnormalities;… 24 22 $4,840.50 $2,904.30 40% off $1,452.15 $5,372.96 $4,042.61 2025-10-04
73723 HCPCS Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity; Without C… 72 22 $5,254.20 $3,152.52 40% off $822.18 $4,991.49 $3,998.46 2025-10-04
535 MS_DRG Fractures Of Hip And Pelvis With Mcc 20 20 $3,728.00 $2,236.80 40% off $2,982.40 $16,930.39 $3,987.36 2025-10-04
74183 HCPCS Magnetic Resonance (eg, Proton) Imaging, Abdomen; Without Contrast Material(s), … 24 22 $5,254.20 $3,152.52 40% off $661.42 $4,991.49 $3,984.33 2025-10-04
72197 HCPCS Magnetic Resonance (eg, Proton) Imaging, Pelvis; Without Contrast Material(s), F… 24 22 $5,254.20 $3,152.52 40% off $660.00 $4,991.49 $3,984.20 2025-10-04
70543 HCPCS Magnetic Resonance (eg, Proton) Imaging, Orbit, Face, And/or Neck; Without Contr… 24 22 $5,254.20 $3,152.52 40% off $597.22 $4,991.49 $3,978.68 2025-10-04
72156 HCPCS Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Without Cont… 24 22 $5,254.20 $3,152.52 40% off $592.86 $4,991.49 $3,978.30 2025-10-04
70553 HCPCS Magnetic Resonance (eg, Proton) Imaging, Brain (including Brain Stem); Without C… 48 22 $5,253.15 $3,151.89 40% off $594.39 $4,990.49 $3,977.65 2025-10-04
72158 HCPCS Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Without Cont… 24 22 $5,254.20 $3,152.52 40% off $583.81 $4,991.49 $3,977.51 2025-10-04
72157 HCPCS Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Without Cont… 24 22 $5,254.20 $3,152.52 40% off $554.74 $4,991.49 $3,974.95 2025-10-04
811 MS_DRG Red Blood Cell Disorders With Mcc 20 20 $3,284.00 $1,970.40 40% off $2,627.20 $23,589.72 $3,946.26 2025-10-04
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 20 20 $3,329.74 $1,997.84 40% off $2,663.79 $22,124.42 $3,911.53 2025-10-04
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 24 22 $3,720.54 $2,232.33 40% off $2,515.42 $18,751.75 $3,905.59 2025-10-04
604 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 20 20 $3,523.25 $2,113.95 40% off $2,818.60 $18,685.74 $3,902.63 2025-10-04
00600023_1 CDM Gastro - Intestinal (gi) Services - General Classification 24 22 $4,754.40 $2,852.64 40% off $1,426.32 $4,516.68 $3,875.68 2025-10-04
00600021_1 CDM Gastro - Intestinal (gi) Services - General Classification 24 22 $4,754.40 $2,852.64 40% off $1,426.32 $4,516.68 $3,875.68 2025-10-04
543 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 20 20 $2,297.00 $1,378.20 40% off $1,837.60 $38,017.60 $3,836.10 2025-10-04
74176 HCPCS Computed Tomography, Abdomen And Pelvis; Without Contrast Material 24 22 $5,073.60 $3,044.16 40% off $256.82 $4,819.92 $3,813.80 2025-10-04
444 MS_DRG Disorders Of The Biliary Tract With Mcc 20 20 $3,236.00 $1,941.60 40% off $2,588.80 $21,365.27 $3,794.59 2025-10-04
74178 HCPCS Computed Tomography, Abdomen And Pelvis; Without Contrast Material In One Or Bot… 46 22 $6,340.95 $3,804.57 40% off $457.92 $6,023.90 $3,780.09 2025-10-04
05000870_1 CDM Mesh 3.2 Large Circle 24 22 $4,633.65 $2,780.19 40% off $1,390.10 $4,401.97 $3,777.25 2025-10-04
73223 HCPCS Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Upper Extremity; Without C… 48 22 $4,933.95 $2,960.37 40% off $611.50 $4,687.25 $3,740.64 2025-10-04
315 MS_DRG Other Circulatory System Diagnoses With Cc 20 20 $3,438.13 $2,062.88 40% off $2,750.50 $16,870.37 $3,740.14 2025-10-04
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc 24 22 $3,470.42 $2,082.25 40% off $2,515.42 $18,465.69 $3,718.06 2025-10-04
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 20 20 $3,069.57 $1,841.74 40% off $2,455.66 $22,124.42 $3,692.33 2025-10-04
05204390_1 CDM Ibrance 100 Mg Tablet 24 22 $4,522.35 $2,713.41 40% off $1,356.71 $4,296.23 $3,686.52 2025-10-04
05203541_1 CDM Nf-resveratrol Route Not Applicable Powd 24 22 $4,515.00 $2,709.00 40% off $1,354.50 $4,289.25 $3,680.53 2025-10-04
184 MS_DRG Major Chest Trauma With Cc 20 20 $3,178.00 $1,906.80 40% off $2,542.40 $20,036.01 $3,679.27 2025-10-04
05203742_1 CDM Ibrance 100 Mg Tablet 24 22 $4,401.60 $2,640.96 40% off $1,320.48 $4,181.52 $3,588.08 2025-10-04
73720 HCPCS Magnetic Resonance (eg, Proton) Imaging, Lower Extremity Other Than Joint; Witho… 116 22 $5,254.20 $3,152.52 40% off $560.10 $4,991.49 $3,544.26 2025-10-04
73220 HCPCS Magnetic Resonance (eg, Proton) Imaging, Upper Extremity, Other Than Joint; With… 92 22 $4,933.95 $2,960.37 40% off $560.10 $4,687.25 $3,537.19 2025-10-04
53 MS_DRG Spinal Disorders And Injuries Without Cc/mcc 20 20 $612.50 $367.50 40% off $490.00 $59,648.93 $3,498.48 2025-10-04
50000764_1 CDM Nova Sure Wand 24 22 $4,284.00 $2,570.40 40% off $1,285.20 $4,069.80 $3,492.22 2025-10-04
390 MS_DRG Gastrointestinal Obstruction Without Cc/mcc 20 20 $3,162.00 $1,897.20 40% off $2,529.60 $15,983.20 $3,463.14 2025-10-04
05000121_1 CDM Ablation Wand J & J 24 22 $4,237.80 $2,542.68 40% off $1,271.34 $4,025.91 $3,454.56 2025-10-04
72191 HCPCS Computed Tomographic Angiography, Pelvis, With Contrast Material(s), Including N… 24 22 $4,572.75 $2,743.65 40% off $414.36 $4,344.11 $3,453.40 2025-10-04
00600022_1 CDM Gastro - Intestinal (gi) Services - General Classification 24 22 $4,206.30 $2,523.78 40% off $1,261.89 $3,995.99 $3,428.88 2025-10-04
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 24 22 $2,358.77 $1,415.26 40% off $1,887.01 $17,924.58 $3,427.17 2025-10-04
10_1 CDM Room & Board - Semi-private (two Beds) - General Classification 24 22 $4,056.00 $2,433.60 40% off $851.76 $3,853.20 $3,395.27 2025-10-04
11_1 CDM Room & Board - Private (one Bed) - General Classification 24 22 $4,056.00 $2,433.60 40% off $851.76 $3,853.20 $3,395.27 2025-10-04
C1888 HCPCS Catheter, Ablation, Non-cardiac, Endovascular (implantable) 24 22 $4,053.00 $2,431.80 40% off $1,215.90 $4,498.83 $3,384.91 2025-10-04
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 20 20 $2,055.50 $1,233.30 40% off $1,644.40 $32,994.60 $3,381.49 2025-10-04
551 MS_DRG Medical Back Problems With Mcc 20 20 $2,712.50 $1,627.50 40% off $2,170.00 $20,007.00 $3,285.63 2025-10-04
311 MS_DRG Angina Pectoris 20 20 $3,049.44 $1,829.67 40% off $2,439.56 $14,224.84 $3,280.40 2025-10-04
379 MS_DRG Gastrointestinal Hemorrhage Without Cc/mcc 20 20 $2,728.80 $1,637.28 40% off $2,183.04 $19,382.88 $3,268.16 2025-10-04
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 20 20 $2,946.20 $1,767.72 40% off $2,356.96 $15,528.11 $3,258.58 2025-10-04
74182 HCPCS Magnetic Resonance (eg, Proton) Imaging, Abdomen; With Contrast Material(s) 24 22 $4,278.75 $2,567.25 40% off $594.79 $4,064.81 $3,249.57 2025-10-04
72142 HCPCS Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Cervical; Wi… 24 22 $4,278.75 $2,567.25 40% off $497.21 $4,064.81 $3,240.99 2025-10-04
72149 HCPCS Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Lumbar; With… 24 22 $4,277.70 $2,566.62 40% off $485.48 $4,063.82 $3,239.18 2025-10-04
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 24 22 $2,507.63 $1,504.58 40% off $2,006.10 $23,183.64 $3,238.68 2025-10-04
05202559_1 CDM Nf-p-care Mg Mr Kit 24 22 $3,970.05 $2,382.03 40% off $1,191.02 $3,771.55 $3,236.30 2025-10-04
74170 HCPCS Computed Tomography, Abdomen; Without Contrast Material, Followed By Contrast Ma… 46 22 $4,827.90 $2,896.74 40% off $340.87 $4,586.51 $3,184.50 2025-10-04
687 MS_DRG Kidney And Urinary Tract Neoplasms With Cc 20 20 $1,213.00 $727.80 40% off $970.40 $43,181.63 $3,181.03 2025-10-04
694 MS_DRG Urinary Stones Without Mcc 20 20 $2,655.29 $1,593.17 40% off $2,124.23 $18,442.69 $3,159.21 2025-10-04
73206 HCPCS Computed Tomographic Angiography, Upper Extremity, With Contrast Material(s), In… 48 22 $4,165.35 $2,499.21 40% off $423.72 $3,957.08 $3,149.79 2025-10-04
87 MS_DRG Traumatic Stupor And Coma <1 Hour Without Cc/mcc 20 20 $2,418.67 $1,451.20 40% off $1,934.93 $22,216.44 $3,148.55 2025-10-04
293 MS_DRG Heart Failure And Shock Without Cc/mcc 24 22 $1,906.36 $1,143.82 40% off $1,525.09 $18,542.71 $3,135.30 2025-10-04
73719 HCPCS Magnetic Resonance (eg, Proton) Imaging, Lower Extremity Other Than Joint; With … 92 22 $4,072.95 $2,443.77 40% off $686.07 $3,869.30 $3,129.92 2025-10-04
52 MS_DRG Spinal Disorders And Injuries With Cc/mcc 20 20 $166.43 $99.86 40% off $133.14 $59,648.93 $3,122.66 2025-10-04
70549 HCPCS Magnetic Resonance Angiography, Neck; Without Contrast Material(s), Followed By … 24 22 $4,072.95 $2,443.77 40% off $790.73 $3,869.30 $3,113.02 2025-10-04
101 MS_DRG Seizures Without Mcc 24 22 $1,952.39 $1,171.43 40% off $1,561.91 $17,120.42 $3,108.35 2025-10-04
72196 HCPCS Magnetic Resonance (eg, Proton) Imaging, Pelvis; With Contrast Material(s) 24 22 $4,072.95 $2,443.77 40% off $536.92 $3,869.30 $3,090.70 2025-10-04
74175 HCPCS Computed Tomographic Angiography, Abdomen, With Contrast Material(s), Including … 24 22 $4,083.45 $2,450.07 40% off $440.60 $3,879.28 $3,090.08 2025-10-04
72195 HCPCS Magnetic Resonance (eg, Proton) Imaging, Pelvis; Without Contrast Material(s) 24 22 $4,072.95 $2,443.77 40% off $491.22 $3,869.30 $3,086.68 2025-10-04
70552 HCPCS Magnetic Resonance (eg, Proton) Imaging, Brain (including Brain Stem); With Cont… 24 22 $4,072.95 $2,443.77 40% off $489.84 $3,869.30 $3,086.56 2025-10-04
72147 HCPCS Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Thoracic; Wi… 24 22 $4,072.95 $2,443.77 40% off $442.89 $3,869.30 $3,082.43 2025-10-04
70540 HCPCS Magnetic Resonance (eg, Proton) Imaging, Orbit, Face, And/or Neck; Without Contr… 24 22 $4,072.95 $2,443.77 40% off $421.04 $3,869.30 $3,080.51 2025-10-04
72146 HCPCS Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Thoracic; Wi… 24 22 $4,072.95 $2,443.77 40% off $394.99 $3,869.30 $3,078.22 2025-10-04
72141 HCPCS Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Cervical; Wi… 24 22 $4,072.95 $2,443.77 40% off $391.86 $3,869.30 $3,077.95 2025-10-04
72148 HCPCS Magnetic Resonance (eg, Proton) Imaging, Spinal Canal And Contents, Lumbar; With… 24 22 $4,072.95 $2,443.77 40% off $390.06 $3,869.30 $3,077.79 2025-10-04
638 MS_DRG Diabetes With Cc 20 20 $2,673.27 $1,603.96 40% off $2,138.62 $16,264.25 $3,065.45 2025-10-04
303 MS_DRG Atherosclerosis Without Mcc 24 22 $1,875.68 $1,125.41 40% off $1,500.55 $17,125.42 $3,054.71 2025-10-04
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 20 20 $2,604.27 $1,562.56 40% off $2,083.41 $16,930.39 $3,040.61 2025-10-04
72 MS_DRG Other Cerebrovascular Disorders Without Cc/mcc 24 22 $2,388.74 $1,433.25 40% off $1,910.99 $20,426.08 $3,040.32 2025-10-04
760 MS_DRG Menstrual And Other Female Reproductive System Disorders With Cc/mcc 20 20 $2,734.50 $1,640.70 40% off $2,187.60 $14,332.87 $3,020.46 2025-10-04
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 20 20 $1,775.33 $1,065.20 40% off $1,420.27 $30,395.08 $3,015.47 2025-10-04
95808 HCPCS Polysomnography; Any Age, Sleep Staging With 1-3 Additional Parameters Of Sleep,… 24 22 $3,993.15 $2,395.89 40% off $335.43 $3,793.49 $3,013.36 2025-10-04
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 20 20 $2,720.00 $1,632.00 40% off $2,176.00 $14,152.83 $2,999.24 2025-10-04
05203905_1 CDM Nf-iclusig Oral Tablet 15mg 24 22 $3,651.90 $2,191.14 40% off $1,095.57 $3,469.31 $2,976.95 2025-10-04
05203920_1 CDM Nf-iclusig Oral Tablet 15mg 24 22 $3,651.90 $2,191.14 40% off $1,095.57 $3,469.31 $2,976.95 2025-10-04
73722 HCPCS Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Lower Extremity; With Cont… 48 22 $3,874.50 $2,324.70 40% off $654.95 $3,680.78 $2,952.79 2025-10-04
05202654_1 CDM Cabometyx 40 Mg Tablet 24 22 $3,615.15 $2,169.09 40% off $1,084.55 $3,434.39 $2,946.99 2025-10-04
73222 HCPCS Magnetic Resonance (eg, Proton) Imaging, Any Joint Of Upper Extremity; With Cont… 48 22 $3,874.50 $2,324.70 40% off $494.14 $3,680.78 $2,938.65 2025-10-04
70551 HCPCS Magnetic Resonance (eg, Proton) Imaging, Brain (including Brain Stem); Without C… 24 22 $3,873.45 $2,324.07 40% off $439.07 $3,679.78 $2,933.02 2025-10-04
74181 HCPCS Magnetic Resonance (eg, Proton) Imaging, Abdomen; Without Contrast Material(s) 46 22 $4,072.95 $2,443.77 40% off $434.02 $3,869.30 $2,932.51 2025-10-04
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 24 22 $2,595.77 $1,557.46 40% off $2,076.61 $14,152.83 $2,924.28 2025-10-04
73706 HCPCS Computed Tomographic Angiography, Lower Extremity, With Contrast Material(s), In… 24 22 $3,838.80 $2,303.28 40% off $456.21 $3,646.86 $2,908.64 2025-10-04
86711 HCPCS Antibody; Jc (john Cunningham) Virus 24 22 $3,839.85 $2,303.91 40% off $19.38 $3,647.86 $2,871.02 2025-10-04
72127 HCPCS Computed Tomography, Cervical Spine; Without Contrast Material, Followed By Cont… 24 22 $3,798.90 $2,279.34 40% off $352.06 $3,608.96 $2,869.67 2025-10-04
831 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Mcc 20 20 $2,814.79 $1,688.87 40% off $2,251.83 $9,897.98 $2,866.36 2025-10-04
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 24 22 $2,253.47 $1,352.08 40% off $1,802.78 $18,437.69 $2,862.50 2025-10-04
C8902 HCPCS Magnetic Resonance Angiography Without Contrast Followed By With Contrast, Abdom… 24 22 $3,397.80 $2,038.68 40% off $1,019.34 $3,771.56 $2,837.72 2025-10-04
C8900 HCPCS Magnetic Resonance Angiography With Contrast, Abdomen 24 22 $3,397.80 $2,038.68 40% off $1,019.34 $3,771.56 $2,837.72 2025-10-04
C8909 HCPCS Magnetic Resonance Angiography With Contrast, Chest (excluding Myocardium) 24 22 $3,397.80 $2,038.68 40% off $1,019.34 $3,771.56 $2,837.72 2025-10-04
C8901 HCPCS Magnetic Resonance Angiography Without Contrast, Abdomen 24 22 $3,397.80 $2,038.68 40% off $1,019.34 $3,771.56 $2,837.72 2025-10-04
983 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc 20 20 $233.20 $139.92 40% off $186.56 $52,088.42 $2,800.89 2025-10-04
102 MS_DRG Headaches With Mcc 20 20 $2,261.00 $1,356.60 40% off $1,808.80 $17,591.52 $2,784.47 2025-10-04
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 24 22 $1,523.04 $913.82 40% off $1,218.43 $16,548.31 $2,783.07 2025-10-04
58400 HCPCS Uterine Suspension, With Or Without Shortening Of Round Ligaments, With Or Witho… 24 22 $2,776.20 $1,665.72 40% off $2,776.20 $2,776.20 $2,776.20 2025-10-04
538 MS_DRG Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh Without Cc/mcc 20 20 $1,032.55 $619.53 40% off $826.04 $38,017.60 $2,770.81 2025-10-04
72130 HCPCS Computed Tomography, Thoracic Spine; Without Contrast Material, Followed By Cont… 24 22 $3,658.20 $2,194.92 40% off $352.55 $3,475.29 $2,764.57 2025-10-04
375 MS_DRG Digestive Malignancy With Cc 20 20 $1,982.00 $1,189.20 40% off $1,585.60 $21,667.33 $2,753.20 2025-10-04
312 MS_DRG Syncope And Collapse 20 20 $2,285.77 $1,371.46 40% off $1,828.62 $16,483.30 $2,749.93 2025-10-04
05204285_1 CDM Imbruvica 420 Mg Tablet 24 22 $3,364.20 $2,018.52 40% off $1,009.26 $3,195.99 $2,742.42 2025-10-04
05202168_1 CDM Injection, Etanercept, 25 Mg (code May Be Used For Medicare When Drug Administer… 24 22 $3,332.70 $1,999.62 40% off $999.81 $3,166.07 $2,716.74 2025-10-04
541 MS_DRG Osteomyelitis Without Cc/mcc 24 22 $1,771.26 $1,062.75 40% off $1,417.01 $22,605.52 $2,697.60 2025-10-04
684 MS_DRG Renal Failure Without Cc/mcc 24 22 $1,409.83 $845.90 40% off $1,127.86 $16,288.26 $2,692.76 2025-10-04
149 MS_DRG Dysequilibrium 20 20 $1,860.83 $1,116.50 40% off $1,488.66 $22,296.46 $2,682.57 2025-10-04
C8934 HCPCS Magnetic Resonance Angiography With Contrast, Upper Extremity 48 22 $3,188.85 $1,913.31 40% off $956.66 $3,539.62 $2,663.21 2025-10-04
C8912 HCPCS Magnetic Resonance Angiography With Contrast, Lower Extremity 48 22 $3,188.85 $1,913.31 40% off $956.66 $3,539.62 $2,663.21 2025-10-04
71275 HCPCS Computed Tomographic Angiography, Chest (noncoronary), With Contrast Material(s)… 24 22 $3,512.25 $2,107.35 40% off $388.59 $3,336.64 $2,658.68 2025-10-04
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 24 22 $1,360.51 $816.31 40% off $1,088.41 $15,861.17 $2,640.34 2025-10-04
683 MS_DRG Renal Failure With Cc 24 22 $2,063.59 $1,238.16 40% off $1,650.88 $16,288.26 $2,639.63 2025-10-04
69 MS_DRG Transient Ischemia Without Thrombolytic 20 20 $2,006.38 $1,203.83 40% off $1,605.10 $18,870.77 $2,633.91 2025-10-04
201 MS_DRG Pneumothorax Without Cc/mcc 20 20 $2,375.50 $1,425.30 40% off $1,900.40 $12,474.49 $2,625.09 2025-10-04
894 MS_DRG Alcohol, Drug Abuse Or Dependence, Left Ama 20 20 $2,496.33 $1,497.80 40% off $1,997.06 $10,393.08 $2,622.81 2025-10-04
75635 HCPCS Computed Tomographic Angiography, Abdominal Aorta And Bilateral Iliofemoral Lowe… 24 22 $3,416.70 $2,050.02 40% off $491.34 $3,245.87 $2,596.31 2025-10-04
71555 HCPCS Magnetic Resonance Angiography, Chest (excluding Myocardium), With Or Without Co… 24 22 $3,397.80 $2,038.68 40% off $519.01 $3,227.91 $2,584.62 2025-10-04
70547 HCPCS Magnetic Resonance Angiography, Neck; Without Contrast Material(s) 24 22 $3,397.80 $2,038.68 40% off $516.93 $3,227.91 $2,584.44 2025-10-04
70544 HCPCS Magnetic Resonance Angiography, Head; Without Contrast Material(s) 24 22 $3,397.80 $2,038.68 40% off $514.85 $3,227.91 $2,584.26 2025-10-04
446 MS_DRG Disorders Of The Biliary Tract Without Cc/mcc 20 20 $1,787.35 $1,072.41 40% off $1,429.88 $21,365.27 $2,574.11 2025-10-04
05000858_1 CDM Bicep Tendon Repair Kit 24 22 $3,141.60 $1,884.96 40% off $942.48 $2,984.52 $2,560.96 2025-10-04
05200971_1 CDM Revlimid 5 Mg Capsule 24 22 $3,137.40 $1,882.44 40% off $941.22 $2,980.53 $2,557.54 2025-10-04
73202 HCPCS Computed Tomography, Upper Extremity; Without Contrast Material, Followed By Con… 48 22 $3,376.80 $2,026.08 40% off $362.24 $3,207.96 $2,555.15 2025-10-04
72133 HCPCS Computed Tomography, Lumbar Spine; Without Contrast Material, Followed By Contra… 24 22 $3,376.80 $2,026.08 40% off $352.37 $3,207.96 $2,554.28 2025-10-04
72194 HCPCS Computed Tomography, Pelvis; Without Contrast Material, Followed By Contrast Mat… 24 22 $3,376.80 $2,026.08 40% off $339.01 $3,207.96 $2,553.10 2025-10-04
70482 HCPCS Computed Tomography, Orbit, Sella, Or Posterior Fossa Or Outer, Middle, Or Inner… 24 22 $3,376.80 $2,026.08 40% off $330.14 $3,207.96 $2,552.32 2025-10-04
74160 HCPCS Computed Tomography, Abdomen; With Contrast Material(s) 24 22 $3,376.80 $2,026.08 40% off $299.45 $3,207.96 $2,549.63 2025-10-04
72129 HCPCS Computed Tomography, Thoracic Spine; With Contrast Material 24 22 $3,376.80 $2,026.08 40% off $297.75 $3,207.96 $2,549.48 2025-10-04
72126 HCPCS Computed Tomography, Cervical Spine; With Contrast Material 24 22 $3,376.80 $2,026.08 40% off $297.58 $3,207.96 $2,549.46 2025-10-04
72132 HCPCS Computed Tomography, Lumbar Spine; With Contrast Material 24 22 $3,376.80 $2,026.08 40% off $296.65 $3,207.96 $2,549.38 2025-10-04
73701 HCPCS Computed Tomography, Lower Extremity; With Contrast Material(s) 48 22 $3,376.80 $2,026.08 40% off $293.26 $3,207.96 $2,549.08 2025-10-04
70498 HCPCS Computed Tomographic Angiography, Neck, With Contrast Material(s), Including Non… 24 22 $3,349.50 $2,009.70 40% off $522.23 $3,182.03 $2,548.82 2025-10-04
73201 HCPCS Computed Tomography, Upper Extremity; With Contrast Material(s) 48 22 $3,376.80 $2,026.08 40% off $289.05 $3,207.96 $2,548.71 2025-10-04
72128 HCPCS Computed Tomography, Thoracic Spine; Without Contrast Material 24 22 $3,376.80 $2,026.08 40% off $233.48 $3,207.96 $2,543.83 2025-10-04
72131 HCPCS Computed Tomography, Lumbar Spine; Without Contrast Material 48 22 $3,376.80 $2,026.08 40% off $232.06 $3,207.96 $2,543.70 2025-10-04
74150 HCPCS Computed Tomography, Abdomen; Without Contrast Material 24 22 $3,376.80 $2,026.08 40% off $208.42 $3,207.96 $2,541.62 2025-10-04
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 24 22 $923.26 $553.96 40% off $738.61 $33,150.63 $2,541.61 2025-10-04
72192 HCPCS Computed Tomography, Pelvis; Without Contrast Material 24 22 $3,376.80 $2,026.08 40% off $204.64 $3,207.96 $2,541.29 2025-10-04
544 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 20 20 $753.00 $451.80 40% off $602.40 $38,017.60 $2,535.28 2025-10-04
552 MS_DRG Medical Back Problems Without Mcc 24 22 $959.96 $575.98 40% off $767.97 $20,007.00 $2,531.86 2025-10-04
05204882_1 CDM Trulicity 1.5 Mg/0.5 Ml Pen 24 22 $3,078.60 $1,847.16 40% off $923.58 $2,924.67 $2,509.61 2025-10-04
05202766_1 CDM Ozempic 0.25-0.5 Mg/dose Pen 24 22 $3,071.25 $1,842.75 40% off $921.38 $2,917.69 $2,503.62 2025-10-04
730 MS_DRG Other Male Reproductive System Diagnoses Without Cc/mcc 20 20 $803.84 $482.31 40% off $643.07 $36,340.27 $2,494.25 2025-10-04
836 MS_DRG Acute Leukemia Without Cc/mcc 20 20 $176.00 $105.60 40% off $140.80 $46,752.35 $2,485.90 2025-10-04
188 MS_DRG Pleural Effusion Without Cc/mcc 20 20 $1,735.80 $1,041.48 40% off $1,388.64 $20,342.07 $2,479.51 2025-10-04
90 MS_DRG Concussion Without Cc/mcc 20 20 $1,756.38 $1,053.83 40% off $1,405.10 $19,974.99 $2,478.50 2025-10-04
313 MS_DRG Chest Pain 20 20 $2,095.94 $1,257.56 40% off $1,676.75 $13,969.79 $2,464.32 2025-10-04
93 MS_DRG Other Disorders Of Nervous System Without Cc/mcc 24 22 $1,287.82 $772.69 40% off $1,030.25 $24,930.99 $2,455.08 2025-10-04
95810 HCPCS Polysomnography; Age 6 Years Or Older, Sleep Staging With 4 Or More Additional P… 90 22 $3,993.15 $2,395.89 40% off $289.80 $3,793.49 $2,441.48 2025-10-04
198 MS_DRG Interstitial Lung Disease Without Cc/mcc 20 20 $1,686.00 $1,011.60 40% off $1,348.80 $20,342.07 $2,437.56 2025-10-04
99291 HCPCS Critical Care, Evaluation And Management Of The Critically Ill Or Critically Inj… 48 22 $3,369.45 $2,021.67 40% off $121.60 $3,200.98 $2,436.68 2025-10-04
05204544_1 CDM Trulicity 0.75 Mg/0.5 Ml Pen 24 22 $2,931.60 $1,758.96 40% off $879.48 $2,785.02 $2,389.77 2025-10-04
05203901_1 CDM Trulicity 0.75 Mg/0.5 Ml Pen 24 22 $2,931.60 $1,758.96 40% off $879.48 $2,785.02 $2,389.77 2025-10-04
565 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 20 20 $1,834.00 $1,100.40 40% off $1,467.20 $16,750.35 $2,382.66 2025-10-04
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 24 22 $1,325.28 $795.17 40% off $1,060.23 $22,017.40 $2,359.98 2025-10-04
951 MS_DRG Other Factors Influencing Health Status 24 22 $964.24 $578.54 40% off $771.39 $15,616.12 $2,351.91 2025-10-04
73702 HCPCS Computed Tomography, Lower Extremity; Without Contrast Material, Followed By Con… 70 22 $3,376.80 $2,026.08 40% off $356.22 $3,207.96 $2,334.41 2025-10-04
885 MS_DRG Psychoses 24 22 $1,799.38 $1,079.63 40% off $1,439.51 $12,732.55 $2,305.97 2025-10-04
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 20 20 $1,882.42 $1,129.45 40% off $1,505.93 $14,388.88 $2,305.38 2025-10-04
73219 HCPCS Magnetic Resonance (eg, Proton) Imaging, Upper Extremity, Other Than Joint; With… 92 22 $3,874.50 $2,324.70 40% off $527.23 $3,680.78 $2,299.41 2025-10-04
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 20 20 $2,231.60 $1,338.96 40% off $1,785.28 $8,218.64 $2,291.06 2025-10-04
05204929_1 CDM Trulicity 0.75 Mg/0.5 Ml Pen 24 22 $2,791.95 $1,675.17 40% off $837.59 $2,652.35 $2,275.94 2025-10-04
05204346_1 CDM Trulicity 0.75 Mg/0.5 Ml Pen 24 22 $2,791.95 $1,675.17 40% off $837.59 $2,652.35 $2,275.94 2025-10-04
05204875_1 CDM Oasis Tri-layer Matrix Sheet 24 22 $2,756.25 $1,653.75 40% off $826.88 $2,618.44 $2,246.83 2025-10-04
00600008_1 CDM Operating Room Services - General Classification 24 22 $2,743.65 $1,646.19 40% off $823.10 $2,606.47 $2,236.56 2025-10-04
384 MS_DRG Uncomplicated Peptic Ulcer Without Mcc 20 20 $1,410.00 $846.00 40% off $1,128.00 $20,938.19 $2,234.83 2025-10-04
50000167_4 CDM Sved Pro 24 22 $2,732.10 $1,639.26 40% off $819.63 $2,595.50 $2,227.15 2025-10-04
50000167_2 CDM Sved Pro 24 22 $2,732.10 $1,639.26 40% off $819.63 $2,595.50 $2,227.15 2025-10-04
50000167_3 CDM Sved Pro 24 22 $2,732.10 $1,639.26 40% off $819.63 $2,595.50 $2,227.15 2025-10-04
50000167_5 CDM Sved Pro 24 22 $2,732.10 $1,639.26 40% off $819.63 $2,595.50 $2,227.15 2025-10-04
50000167_1 CDM Sved Pro 24 22 $2,732.10 $1,639.26 40% off $819.63 $2,595.50 $2,227.15 2025-10-04
05203037_1 CDM Trulicity 1.5 Mg/0.5 Ml Pen 24 22 $2,716.35 $1,629.81 40% off $814.91 $2,580.53 $2,214.31 2025-10-04
305 MS_DRG Hypertension Without Mcc 24 22 $723.44 $434.06 40% off $578.75 $16,317.26 $2,212.07 2025-10-04
71270 HCPCS Computed Tomography, Thorax, Diagnostic; Without Contrast Material, Followed By … 24 22 $2,896.95 $1,738.17 40% off $357.58 $2,752.10 $2,196.17 2025-10-04
91 MS_DRG Other Disorders Of Nervous System With Mcc 20 20 $1,122.50 $673.50 40% off $898.00 $24,930.99 $2,192.26 2025-10-04
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 20 20 $1,632.83 $979.70 40% off $1,306.27 $16,288.26 $2,190.07 2025-10-04
60 MS_DRG Multiple Sclerosis And Cerebellar Ataxia Without Cc/mcc 20 20 $585.25 $351.15 40% off $468.20 $33,320.66 $2,159.11 2025-10-04
204 MS_DRG Respiratory Signs And Symptoms 24 22 $1,297.99 $778.79 40% off $1,038.39 $17,470.49 $2,151.36 2025-10-04
05201715_1 CDM Nf-arixtra Subcutaneous Soln 10mg/0.8ml 24 22 $2,617.65 $1,570.59 40% off $785.30 $2,486.77 $2,133.85 2025-10-04
71260 HCPCS Computed Tomography, Thorax, Diagnostic; With Contrast Material(s) 24 22 $2,795.10 $1,677.06 40% off $297.64 $2,655.35 $2,114.80 2025-10-04
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