|
556
|
MS_DRG
|
Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc
|
12
|
9
|
$361,569.19
|
$14,213,284.86
|
$12,491.39
|
$948,036.19
|
$230,500.36
|
2026-02-25
|
|
547
|
MS_DRG
|
Connective Tissue Disorders Without Cc/mcc
|
12
|
9
|
$221,117.33
|
$8,692,122.24
|
$12,575.61
|
$483,513.00
|
$140,962.30
|
2026-02-25
|
|
310
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc
|
12
|
9
|
$220,141.47
|
$8,653,761.19
|
$8,513.58
|
$483,513.00
|
$140,340.19
|
2026-02-25
|
|
93
|
MS_DRG
|
Other Disorders Of Nervous System Without Cc/mcc
|
12
|
9
|
$219,237.21
|
$8,618,214.53
|
$11,975.56
|
$483,513.00
|
$139,763.71
|
2026-02-25
|
|
71
|
MS_DRG
|
Other Cerebrovascular Disorders With Cc
|
12
|
9
|
$218,831.69
|
$8,602,273.73
|
$15,430.01
|
$600,500.69
|
$139,505.20
|
2026-02-25
|
|
60
|
MS_DRG
|
Multiple Sclerosis And Cerebellar Ataxia Without Cc/mcc
|
12
|
9
|
$218,564.85
|
$8,591,784.25
|
$13,832.87
|
$483,513.00
|
$139,335.09
|
2026-02-25
|
|
438
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy With Mcc
|
12
|
9
|
$191,239.85
|
$7,517,638.50
|
$24,516.58
|
$510,848.85
|
$121,915.40
|
2026-02-25
|
|
57
|
MS_DRG
|
Degenerative Nervous System Disorders Without Mcc
|
12
|
9
|
$135,243.79
|
$5,316,433.57
|
$19,484.53
|
$352,453.79
|
$86,217.92
|
2026-02-25
|
|
98
|
MS_DRG
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc
|
12
|
9
|
$132,239.05
|
$5,198,317.06
|
$20,020.00
|
$112,403.19
|
$84,302.40
|
2026-02-25
|
|
92
|
MS_DRG
|
Other Disorders Of Nervous System With Cc
|
12
|
9
|
$128,808.04
|
$5,063,444.05
|
$15,384.90
|
$275,170.00
|
$82,115.12
|
2026-02-25
|
|
52
|
MS_DRG
|
Spinal Disorders And Injuries With Cc/mcc
|
12
|
9
|
$121,120.56
|
$4,761,249.21
|
$25,435.32
|
$161,171.00
|
$77,214.36
|
2026-02-25
|
|
546
|
MS_DRG
|
Connective Tissue Disorders With Cc
|
12
|
9
|
$115,880.27
|
$4,555,253.22
|
$17,345.98
|
$106,137.00
|
$73,873.67
|
2026-02-25
|
|
192
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease Without Cc/mcc
|
12
|
9
|
$104,077.64
|
$4,091,292.21
|
$9,655.04
|
$246,815.64
|
$66,349.50
|
2026-02-25
|
|
552
|
MS_DRG
|
Medical Back Problems Without Mcc
|
12
|
9
|
$98,453.31
|
$3,870,199.46
|
$14,456.99
|
$231,882.31
|
$62,763.98
|
2026-02-25
|
|
561
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc
|
12
|
9
|
$78,768.00
|
$3,096,369.98
|
$12,089.85
|
$212,197.00
|
$50,214.60
|
2026-02-25
|
|
682
|
MS_DRG
|
Renal Failure With Mcc
|
12
|
9
|
$59,184.39
|
$2,326,538.45
|
$12,428.72
|
$136,759.39
|
$37,730.05
|
2026-02-25
|
|
301
|
MS_DRG
|
Peripheral Vascular Disorders Without Cc/mcc
|
12
|
9
|
$59,125.75
|
$2,324,233.22
|
$10,823.57
|
$66,827.00
|
$37,692.67
|
2026-02-25
|
|
689
|
MS_DRG
|
Kidney And Urinary Tract Infections With Mcc
|
12
|
9
|
$57,580.83
|
$2,263,502.54
|
$8,580.00
|
$48,943.71
|
$36,707.78
|
2026-02-25
|
|
177
|
MS_DRG
|
Respiratory Infections And Inflammations With Mcc
|
12
|
9
|
$57,370.24
|
$2,255,224.29
|
$7,150.00
|
$48,764.71
|
$36,573.53
|
2026-02-25
|
|
56
|
MS_DRG
|
Degenerative Nervous System Disorders With Mcc
|
12
|
9
|
$57,110.38
|
$2,245,009.04
|
$11,993.18
|
$117,930.00
|
$36,407.87
|
2026-02-25
|
|
560
|
MS_DRG
|
Aftercare, Musculoskeletal System And Connective Tissue With Cc
|
12
|
9
|
$56,065.51
|
$2,203,935.30
|
$11,773.76
|
$115,022.51
|
$35,741.76
|
2026-02-25
|
|
291
|
MS_DRG
|
Heart Failure And Shock With Mcc
|
12
|
9
|
$55,546.05
|
$2,183,515.08
|
$7,150.00
|
$47,214.14
|
$35,410.61
|
2026-02-25
|
|
884
|
MS_DRG
|
Organic Disturbances And Intellectual Disability
|
12
|
9
|
$54,342.36
|
$2,136,198.17
|
$11,411.90
|
$117,930.00
|
$34,643.25
|
2026-02-25
|
|
540
|
MS_DRG
|
Osteomyelitis With Cc
|
12
|
9
|
$52,184.48
|
$2,051,371.91
|
$10,958.74
|
$51,103.00
|
$33,267.61
|
2026-02-25
|
|
871
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc
|
12
|
9
|
$51,195.71
|
$2,012,503.36
|
$7,150.00
|
$43,516.35
|
$32,637.26
|
2026-02-25
|
|
193
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Mcc
|
12
|
9
|
$50,140.52
|
$1,971,023.95
|
$5,720.00
|
$42,619.44
|
$31,964.58
|
2026-02-25
|
|
640
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…
|
12
|
9
|
$50,088.38
|
$1,968,974.22
|
$5,720.00
|
$42,575.12
|
$31,931.34
|
2026-02-25
|
|
308
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders With Mcc
|
12
|
9
|
$48,042.71
|
$1,888,558.90
|
$5,720.00
|
$40,836.30
|
$30,627.23
|
2026-02-25
|
|
645
|
MS_DRG
|
Endocrine Disorders Without Cc/mcc
|
12
|
9
|
$45,345.32
|
$1,782,524.53
|
$5,720.00
|
$38,543.52
|
$28,907.64
|
2026-02-25
|
|
699
|
MS_DRG
|
Other Kidney And Urinary Tract Diagnoses With Cc
|
12
|
9
|
$42,378.27
|
$1,665,889.79
|
$5,720.00
|
$36,021.53
|
$27,016.15
|
2026-02-25
|
|
65
|
MS_DRG
|
Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours
|
12
|
9
|
$42,130.56
|
$1,656,152.31
|
$5,720.00
|
$35,810.98
|
$26,858.23
|
2026-02-25
|
|
208
|
MS_DRG
|
Respiratory System Diagnosis With Ventilator Support <=96 Hours
|
13
|
10
|
$41,671.42
|
$1,638,103.63
|
$2,211.00
|
$41,337.70
|
$26,565.53
|
2026-02-25
|
|
541
|
MS_DRG
|
Osteomyelitis Without Cc/mcc
|
12
|
9
|
$39,726.10
|
$1,561,632.99
|
$8,342.48
|
$33,767.19
|
$25,325.39
|
2026-02-25
|
|
945
|
MS_DRG
|
Rehabilitation With Cc/mcc
|
12
|
9
|
$39,658.03
|
$1,558,957.16
|
$8,328.19
|
$79,997.03
|
$25,281.99
|
2026-02-25
|
|
199
|
MS_DRG
|
Pneumothorax With Mcc
|
12
|
9
|
$37,993.97
|
$1,493,542.96
|
$7,978.73
|
$32,294.87
|
$24,221.15
|
2026-02-25
|
|
948
|
MS_DRG
|
Signs And Symptoms Without Mcc
|
12
|
9
|
$37,509.78
|
$1,474,509.57
|
$7,877.05
|
$43,241.00
|
$23,912.49
|
2026-02-25
|
|
190
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Mcc
|
12
|
9
|
$36,865.18
|
$1,449,170.41
|
$7,150.00
|
$31,335.41
|
$23,501.56
|
2026-02-25
|
|
300
|
MS_DRG
|
Peripheral Vascular Disorders With Cc
|
12
|
9
|
$36,798.26
|
$1,446,539.71
|
$5,720.00
|
$31,278.52
|
$23,458.89
|
2026-02-25
|
|
690
|
MS_DRG
|
Kidney And Urinary Tract Infections Without Mcc
|
12
|
9
|
$35,661.91
|
$1,401,869.75
|
$7,150.00
|
$30,312.62
|
$22,734.47
|
2026-02-25
|
|
189
|
MS_DRG
|
Pulmonary Edema And Respiratory Failure
|
12
|
9
|
$35,391.76
|
$1,391,250.09
|
$4,290.00
|
$30,083.00
|
$22,562.25
|
2026-02-25
|
|
292
|
MS_DRG
|
Heart Failure And Shock With Cc
|
12
|
9
|
$33,108.09
|
$1,301,479.13
|
$6,952.70
|
$28,141.88
|
$21,106.41
|
2026-02-25
|
|
293
|
MS_DRG
|
Heart Failure And Shock Without Cc/mcc
|
12
|
9
|
$33,040.79
|
$1,298,833.44
|
$6,938.57
|
$78,494.46
|
$21,063.50
|
2026-02-25
|
|
684
|
MS_DRG
|
Renal Failure Without Cc/mcc
|
12
|
9
|
$32,571.19
|
$1,280,373.28
|
$6,839.95
|
$31,448.00
|
$20,764.13
|
2026-02-25
|
|
543
|
MS_DRG
|
Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…
|
12
|
9
|
$31,859.38
|
$1,252,392.23
|
$4,290.00
|
$27,080.47
|
$20,310.35
|
2026-02-25
|
|
194
|
MS_DRG
|
Simple Pneumonia And Pleurisy With Cc
|
12
|
9
|
$30,771.14
|
$1,209,613.54
|
$4,290.00
|
$26,155.47
|
$19,616.60
|
2026-02-25
|
|
918
|
MS_DRG
|
Poisoning And Toxic Effects Of Drugs Without Mcc
|
12
|
9
|
$29,098.65
|
$1,143,868.04
|
$4,290.00
|
$24,733.85
|
$18,550.39
|
2026-02-25
|
|
641
|
MS_DRG
|
Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…
|
12
|
9
|
$29,006.51
|
$1,140,245.83
|
$4,290.00
|
$24,655.53
|
$18,491.65
|
2026-02-25
|
|
872
|
MS_DRG
|
Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc
|
12
|
9
|
$28,798.74
|
$1,132,078.47
|
$4,290.00
|
$24,478.93
|
$18,359.20
|
2026-02-25
|
|
378
|
MS_DRG
|
Gastrointestinal Hemorrhage With Cc
|
12
|
9
|
$28,222.60
|
$1,109,430.41
|
$2,860.00
|
$23,989.21
|
$17,991.91
|
2026-02-25
|
|
558
|
MS_DRG
|
Tendonitis, Myositis And Bursitis Without Mcc
|
12
|
9
|
$27,745.56
|
$1,090,677.96
|
$4,290.00
|
$23,583.73
|
$17,687.79
|
2026-02-25
|
|
869
|
MS_DRG
|
Other Infectious And Parasitic Diseases Diagnoses Without Cc/mcc
|
12
|
9
|
$27,641.52
|
$1,086,588.15
|
$4,290.00
|
$23,495.29
|
$17,621.47
|
2026-02-25
|
|
280
|
MS_DRG
|
Acute Myocardial Infarction, Discharged Alive With Mcc
|
12
|
9
|
$27,594.46
|
$1,084,738.22
|
$5,794.84
|
$24,124.06
|
$17,591.47
|
2026-02-25
|
|
202
|
MS_DRG
|
Bronchitis And Asthma With Cc/mcc
|
12
|
9
|
$27,529.61
|
$1,082,188.77
|
$2,860.00
|
$23,400.16
|
$17,550.12
|
2026-02-25
|
|
440
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy Without Cc/mcc
|
12
|
9
|
$27,483.88
|
$1,080,391.32
|
$4,290.00
|
$23,361.30
|
$17,520.97
|
2026-02-25
|
|
603
|
MS_DRG
|
Cellulitis Without Mcc
|
12
|
9
|
$26,749.09
|
$1,051,506.69
|
$5,617.31
|
$22,736.73
|
$17,052.54
|
2026-02-25
|
|
683
|
MS_DRG
|
Renal Failure With Cc
|
12
|
9
|
$26,241.97
|
$1,031,571.84
|
$4,290.00
|
$22,305.67
|
$16,729.26
|
2026-02-25
|
|
371
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections With Mcc
|
12
|
9
|
$25,960.96
|
$1,020,525.34
|
$2,860.00
|
$25,960.96
|
$16,550.11
|
2026-02-25
|
|
439
|
MS_DRG
|
Disorders Of Pancreas Except Malignancy With Cc
|
12
|
9
|
$25,371.90
|
$997,369.47
|
$2,860.00
|
$21,566.12
|
$16,174.59
|
2026-02-25
|
|
391
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc
|
12
|
9
|
$24,797.90
|
$974,805.35
|
$2,860.00
|
$21,078.21
|
$15,808.66
|
2026-02-25
|
|
441
|
MS_DRG
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc
|
12
|
9
|
$24,713.90
|
$971,503.41
|
$5,189.92
|
$24,713.90
|
$15,755.11
|
2026-02-25
|
|
602
|
MS_DRG
|
Cellulitis With Mcc
|
12
|
9
|
$24,607.66
|
$967,327.11
|
$2,860.00
|
$21,374.93
|
$15,687.38
|
2026-02-25
|
|
74
|
MS_DRG
|
Cranial And Peripheral Nerve Disorders Without Mcc
|
12
|
9
|
$24,051.74
|
$945,473.70
|
$4,290.00
|
$20,443.97
|
$15,332.98
|
2026-02-25
|
|
Q4342
|
HCPCS
|
Theramend, Per Square Centimeter
|
38
|
9
|
$88,320.00
|
$15,897.60
82% off
|
$441.60
|
$75,072.00
|
$15,114.41
|
2026-02-25
|
|
178
|
MS_DRG
|
Respiratory Infections And Inflammations With Cc
|
12
|
9
|
$23,510.31
|
$924,190.29
|
$4,290.00
|
$19,983.76
|
$14,987.82
|
2026-02-25
|
|
536
|
MS_DRG
|
Fractures Of Hip And Pelvis Without Mcc
|
12
|
9
|
$23,413.71
|
$920,392.74
|
$2,860.00
|
$19,901.65
|
$14,926.24
|
2026-02-25
|
|
191
|
MS_DRG
|
Chronic Obstructive Pulmonary Disease With Cc
|
12
|
9
|
$22,753.64
|
$894,445.48
|
$4,778.26
|
$19,655.00
|
$14,505.44
|
2026-02-25
|
|
432
|
MS_DRG
|
Cirrhosis And Alcoholic Hepatitis With Mcc
|
12
|
9
|
$22,561.60
|
$886,896.30
|
$4,737.93
|
$27,517.00
|
$14,383.02
|
2026-02-25
|
|
387
|
MS_DRG
|
Inflammatory Bowel Disease Without Cc/mcc
|
12
|
9
|
$22,311.17
|
$877,052.07
|
$4,290.00
|
$18,964.49
|
$14,223.37
|
2026-02-25
|
|
638
|
MS_DRG
|
Diabetes With Cc
|
12
|
9
|
$21,804.49
|
$857,134.34
|
$4,290.00
|
$18,533.81
|
$13,900.36
|
2026-02-25
|
|
309
|
MS_DRG
|
Cardiac Arrhythmia And Conduction Disorders With Cc
|
12
|
9
|
$21,334.60
|
$838,662.93
|
$2,860.00
|
$18,134.41
|
$13,600.81
|
2026-02-25
|
|
433
|
MS_DRG
|
Cirrhosis And Alcoholic Hepatitis With Cc
|
12
|
9
|
$20,428.83
|
$803,057.31
|
$4,290.05
|
$23,586.00
|
$13,023.38
|
2026-02-25
|
|
195
|
MS_DRG
|
Simple Pneumonia And Pleurisy Without Cc/mcc
|
12
|
9
|
$19,790.55
|
$777,966.60
|
$1,430.00
|
$16,821.97
|
$12,616.48
|
2026-02-25
|
|
373
|
MS_DRG
|
Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc
|
12
|
9
|
$19,644.79
|
$772,236.69
|
$2,860.00
|
$16,698.07
|
$12,523.55
|
2026-02-25
|
|
639
|
MS_DRG
|
Diabetes Without Cc/mcc
|
12
|
9
|
$19,625.90
|
$771,494.21
|
$2,860.00
|
$16,682.02
|
$12,511.51
|
2026-02-25
|
|
897
|
MS_DRG
|
Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc
|
12
|
9
|
$19,527.48
|
$767,625.24
|
$2,860.00
|
$16,598.36
|
$12,448.77
|
2026-02-25
|
|
392
|
MS_DRG
|
Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc
|
12
|
9
|
$17,296.19
|
$679,913.34
|
$3,632.20
|
$14,701.76
|
$11,026.32
|
2026-02-25
|
|
923
|
MS_DRG
|
Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc
|
12
|
9
|
$17,110.75
|
$672,623.58
|
$3,593.26
|
$15,305.19
|
$10,908.10
|
2026-02-25
|
|
Q4161
|
HCPCS
|
Bio-connekt Wound Matrix, Per Square Centimeter
|
35
|
10
|
$36,000.00
|
$6,480.00
82% off
|
$945.00
|
$36,000.00
|
$10,404.12
|
2026-02-25
|
|
305
|
MS_DRG
|
Hypertension Without Mcc
|
12
|
9
|
$14,804.78
|
$581,975.71
|
$1,430.00
|
$12,584.06
|
$9,438.04
|
2026-02-25
|
|
595
|
MS_DRG
|
Major Skin Disorders With Mcc
|
12
|
9
|
$13,639.28
|
$536,160.10
|
$2,860.00
|
$13,639.28
|
$8,695.04
|
2026-02-25
|
|
176
|
MS_DRG
|
Pulmonary Embolism Without Mcc
|
12
|
9
|
$11,781.07
|
$463,113.76
|
$1,430.00
|
$11,781.07
|
$7,510.43
|
2026-02-25
|
|
637
|
MS_DRG
|
Diabetes With Mcc
|
12
|
9
|
$11,250.63
|
$442,262.27
|
$2,362.63
|
$11,250.63
|
$7,172.28
|
2026-02-25
|
|
435
|
MS_DRG
|
Malignancy Of Hepatobiliary System Or Pancreas With Mcc
|
12
|
9
|
$10,788.25
|
$424,086.11
|
$1,430.00
|
$10,788.25
|
$6,877.51
|
2026-02-25
|
|
312
|
MS_DRG
|
Syncope And Collapse
|
12
|
9
|
$10,718.64
|
$421,349.74
|
$1,430.00
|
$10,718.64
|
$6,833.13
|
2026-02-25
|
|
153
|
MS_DRG
|
Otitis Media And Uri Without Mcc
|
12
|
9
|
$10,708.60
|
$420,955.07
|
$2,248.81
|
$11,793.00
|
$6,826.73
|
2026-02-25
|
|
935
|
MS_DRG
|
Non-extensive Burns
|
12
|
9
|
$10,500.01
|
$412,755.39
|
$2,205.00
|
$10,500.01
|
$6,693.76
|
2026-02-25
|
|
812
|
MS_DRG
|
Red Blood Cell Disorders Without Mcc
|
12
|
9
|
$10,353.24
|
$406,985.86
|
$1,430.00
|
$10,353.24
|
$6,600.19
|
2026-02-25
|
|
728
|
MS_DRG
|
Inflammation Of The Male Reproductive System Without Mcc
|
12
|
9
|
$9,868.09
|
$387,914.62
|
$1,430.00
|
$9,868.09
|
$6,290.91
|
2026-02-25
|
|
313
|
MS_DRG
|
Chest Pain
|
12
|
9
|
$9,028.20
|
$354,898.54
|
$1,430.00
|
$9,028.20
|
$5,755.48
|
2026-02-25
|
|
04827293
|
CDM
|
Humira(cf) Pedi Crohn 80mg/0.8
|
12
|
9
|
$28,647.38
|
$5,156.53
82% off
|
$945.00
|
$24,350.27
|
$5,311.52
|
2026-02-25
|
|
IO
|
CDM
|
Room & Board - Private (one Bed) - General Classification
|
11
|
8
|
$8,046.53
|
$3,931.00
51% off
|
$1,430.00
|
$6,839.55
|
$5,129.66
|
2026-02-25
|
|
44143
|
HCPCS
|
Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin
|
12
|
9
|
$7,161.00
|
$1,500.66
79% off
|
$70.00
|
$5,012.70
|
$5,012.70
|
2026-02-25
|
|
203
|
MS_DRG
|
Bronchitis And Asthma Without Cc/mcc
|
12
|
9
|
$7,849.40
|
$308,559.91
|
$1,430.00
|
$7,849.40
|
$5,003.99
|
2026-02-25
|
|
01800053
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$15,060.20
|
$2,710.84
82% off
|
$945.00
|
$12,801.17
|
$4,773.74
|
2026-02-25
|
|
44204
|
HCPCS
|
Partial Removal Of Large Bowel Using An Endoscope
|
12
|
9
|
$6,672.00
|
$1,389.08
79% off
|
$218.17
|
$4,670.40
|
$4,670.40
|
2026-02-25
|
|
389
|
MS_DRG
|
Gastrointestinal Obstruction With Cc
|
12
|
9
|
$7,313.68
|
$287,500.76
|
$1,430.00
|
$7,313.68
|
$4,662.47
|
2026-02-25
|
|
894
|
MS_DRG
|
Alcohol, Drug Abuse Or Dependence, Left Ama
|
12
|
9
|
$7,279.18
|
$286,144.57
|
$1,430.00
|
$7,279.18
|
$4,640.48
|
2026-02-25
|
|
45402
|
HCPCS
|
Repair Of Rectal Prolapse With Partial Removal Of Lower Large Bowel Using An End…
|
12
|
9
|
$6,611.00
|
$1,378.55
79% off
|
$228.59
|
$4,627.70
|
$4,627.70
|
2026-02-25
|
|
43631
|
HCPCS
|
Removal Of Lower Part Of Stomach With Reattachment Of Remaining Stomach To First…
|
12
|
9
|
$6,314.00
|
$1,324.55
79% off
|
$936.33
|
$4,419.80
|
$4,419.80
|
2026-02-25
|
|
01601654
|
CDM
|
Excision, Open, Intr-abd Tumor, Cyst, En
|
1
|
1
|
$6,297.36
|
—
|
$4,408.15
|
$4,408.15
|
$4,408.15
|
2026-02-25
|
|
J3101
|
HCPCS
|
Injection, Tenecteplase, 1 Mg
|
12
|
9
|
$10,523.94
|
$1,894.31
82% off
|
$129.59
|
$10,523.94
|
$4,396.09
|
2026-02-25
|
|
IC
|
CDM
|
Intensive Care Unit - General Classification
|
12
|
9
|
$6,866.72
|
$3,931.00
43% off
|
$1,430.00
|
$5,836.71
|
$4,377.53
|
2026-02-25
|
|
44202
|
HCPCS
|
Partial Removal And Reconnection Of Small Bowel Using An Endoscope
|
12
|
9
|
$6,033.00
|
$1,263.09
79% off
|
$40.00
|
$4,223.10
|
$4,223.10
|
2026-02-25
|
|
44140
|
HCPCS
|
Partial Removal Of Large Bowel With Connection
|
12
|
9
|
$5,844.00
|
$1,225.72
79% off
|
$40.00
|
$4,090.80
|
$4,090.80
|
2026-02-25
|
|
59612
|
HCPCS
|
Vaginal Delivery After Previous Cesarean Delivery
|
25
|
10
|
$9,392.17
|
$1,690.59
82% off
|
$544.28
|
$7,983.34
|
$3,999.03
|
2026-02-25
|
|
182
|
MS_DRG
|
Respiratory Neoplasms Without Cc/mcc
|
12
|
9
|
$6,137.53
|
$241,266.30
|
$1,288.88
|
$11,793.00
|
$3,912.68
|
2026-02-25
|
|
J9217
|
HCPCS
|
Leuprolide Acetate (for Depot Suspension), 7.5 Mg
|
11
|
8
|
$8,422.33
|
$152.44
98% off
|
$334.77
|
$7,158.98
|
$3,870.81
|
2026-02-25
|
|
44120
|
HCPCS
|
Partial Removal Of Small Bowel With Reconnection
|
12
|
9
|
$5,310.00
|
$1,110.22
79% off
|
$698.81
|
$3,717.00
|
$3,717.00
|
2026-02-25
|
|
04821271
|
CDM
|
Nf-avonex IM Kit 30mcg/0.5ml
|
12
|
9
|
$19,454.14
|
$3,501.75
82% off
|
$945.00
|
$16,536.02
|
$3,710.37
|
2026-02-25
|
|
01800046
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$11,295.10
|
$2,033.12
82% off
|
$903.61
|
$9,600.84
|
$3,648.60
|
2026-02-25
|
|
19307
|
HCPCS
|
Removal Of Breast And Underarm Lymph Nodes
|
12
|
9
|
$5,200.00
|
$1,115.97
79% off
|
$70.00
|
$3,640.00
|
$3,640.00
|
2026-02-25
|
|
43770
|
HCPCS
|
Insertion Of Adjustable Stomach Reduction Device Using An Endoscope
|
12
|
9
|
$4,934.00
|
$1,049.85
79% off
|
$130.00
|
$3,453.80
|
$3,453.80
|
2026-02-25
|
|
47605
|
HCPCS
|
Removal Of Gallbladder With X-ray Study Of Bile Ducts
|
12
|
9
|
$4,927.00
|
$1,041.24
79% off
|
$618.02
|
$3,448.90
|
$3,448.90
|
2026-02-25
|
|
44005
|
HCPCS
|
Release Of Intestinal Scar Tissue
|
12
|
9
|
$4,751.00
|
$998.21
79% off
|
$70.00
|
$3,325.70
|
$3,325.70
|
2026-02-25
|
|
47600
|
HCPCS
|
Removal Of Gallbladder
|
12
|
9
|
$4,691.00
|
$992.79
79% off
|
$115.41
|
$3,283.70
|
$3,283.70
|
2026-02-25
|
|
43280
|
HCPCS
|
Strengthening Of Muscle Between Esophagus And Stomach By Wrapping Part Of Stomac…
|
12
|
9
|
$4,686.00
|
$988.99
79% off
|
$65.00
|
$3,280.20
|
$3,280.20
|
2026-02-25
|
|
04827832
|
CDM
|
Humira(cf) Pen 40 Mg/0.4 Ml
|
12
|
9
|
$16,614.00
|
$2,990.52
82% off
|
$945.00
|
$14,121.90
|
$3,198.89
|
2026-02-25
|
|
58150
|
HCPCS
|
Removal Of Uterus And Cervix Through Abdomen
|
12
|
9
|
$4,511.00
|
$923.93
80% off
|
$65.00
|
$3,157.70
|
$3,157.70
|
2026-02-25
|
|
TE
|
CDM
|
Room & Board - Semi-private (two Beds) - General Classification
|
11
|
8
|
$4,777.57
|
$3,931.00
|
$1,003.29
|
$4,060.93
|
$3,045.70
|
2026-02-25
|
|
58552
|
HCPCS
|
Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, 250.…
|
12
|
9
|
$4,342.00
|
$870.14
80% off
|
$125.00
|
$3,039.40
|
$3,039.40
|
2026-02-25
|
|
57280
|
HCPCS
|
Attachment Of Vagina To Rear Pelvic Bone
|
12
|
9
|
$4,273.00
|
$853.30
80% off
|
$65.00
|
$2,991.10
|
$2,991.10
|
2026-02-25
|
|
58180
|
HCPCS
|
Removal Of Uterus Through Abdomen
|
12
|
9
|
$4,250.00
|
$859.04
80% off
|
$70.00
|
$2,975.00
|
$2,975.00
|
2026-02-25
|
|
74170
|
HCPCS
|
CT Scan Of Abdomen Before And After Contrast
|
13
|
10
|
$7,308.82
|
$1,315.59
82% off
|
$340.87
|
$7,308.82
|
$2,965.82
|
2026-02-25
|
|
43774
|
HCPCS
|
Removal Of Stomach Reduction Device And Port Using An Endoscope
|
12
|
9
|
$4,205.00
|
$888.89
79% off
|
$160.00
|
$2,943.50
|
$2,943.50
|
2026-02-25
|
|
02408782
|
CDM
|
Pro-osteon
|
12
|
9
|
$14,777.84
|
$2,660.01
82% off
|
$945.00
|
$12,561.16
|
$2,885.50
|
2026-02-25
|
|
J1162
|
HCPCS
|
Injection, Digoxin Immune Fab (ovine), Per Vial
|
12
|
9
|
$6,623.51
|
$1,192.23
82% off
|
$529.88
|
$5,699.92
|
$2,874.92
|
2026-02-25
|
|
58571
|
HCPCS
|
Removal Of Uterus, Tubes, And/or Ovaries Through Abdomen Using An Endoscope, 250…
|
12
|
9
|
$4,034.00
|
$822.29
80% off
|
$160.00
|
$2,823.80
|
$2,823.80
|
2026-02-25
|
|
44180
|
HCPCS
|
Release Of Small Bowel Scar Tissue Using An Endoscope
|
12
|
9
|
$4,021.00
|
$847.45
79% off
|
$130.00
|
$2,814.70
|
$2,814.70
|
2026-02-25
|
|
58740
|
HCPCS
|
Removal Of Scar Tissue Of Ovaries Or Fallopian Tubes
|
12
|
9
|
$4,004.00
|
$819.34
80% off
|
$709.38
|
$2,802.80
|
$2,802.80
|
2026-02-25
|
|
58545
|
HCPCS
|
Removal Of Growth Of Uterus Using An Endoscope, 250.0 G Or Less
|
12
|
9
|
$3,981.00
|
$800.02
80% off
|
$155.00
|
$2,786.70
|
$2,786.70
|
2026-02-25
|
|
04821541
|
CDM
|
Lupron Depot 22.5 Mg 3mo Kit
|
12
|
9
|
$14,332.40
|
$2,579.83
82% off
|
$945.00
|
$12,182.54
|
$2,771.09
|
2026-02-25
|
|
72194
|
HCPCS
|
CT Scan Of Pelvis Before And After Contrast
|
13
|
10
|
$6,773.18
|
$1,219.17
82% off
|
$339.01
|
$6,773.18
|
$2,756.91
|
2026-02-25
|
|
71270
|
HCPCS
|
CT Scan Of Chest Before And After Contrast
|
13
|
10
|
$6,773.18
|
$1,219.17
82% off
|
$357.58
|
$6,773.18
|
$2,756.91
|
2026-02-25
|
|
58550
|
HCPCS
|
Removal Of Uterus Through Vagina Using An Endoscope, 250.0 G Or Less
|
12
|
9
|
$3,908.00
|
$781.63
80% off
|
$130.00
|
$2,735.60
|
$2,735.60
|
2026-02-25
|
|
74178
|
HCPCS
|
CT Scan Of Abdomen And Pelvis Before And After Contrast
|
13
|
10
|
$6,689.54
|
$1,204.12
82% off
|
$457.92
|
$6,689.54
|
$2,724.30
|
2026-02-25
|
|
44960
|
HCPCS
|
Removal Of Ruptured Infected Appendix
|
12
|
9
|
$3,830.00
|
$807.98
79% off
|
$65.00
|
$2,681.00
|
$2,681.00
|
2026-02-25
|
|
J2997
|
HCPCS
|
Injection, Alteplase Recombinant, 1 Mg
|
32
|
9
|
$12,967.18
|
$2,334.09
82% off
|
$9.59
|
$11,022.10
|
$2,664.45
|
2026-02-25
|
|
44620
|
HCPCS
|
Closure Of Surgically Created Large Or Small Bowel Opening
|
12
|
9
|
$3,784.00
|
$795.50
79% off
|
$84.51
|
$2,648.80
|
$2,648.80
|
2026-02-25
|
|
04826539
|
CDM
|
Humira Pen Ps-uv-adol Hs 40 Mg
|
12
|
9
|
$13,286.19
|
$2,391.51
82% off
|
$945.00
|
$11,293.26
|
$2,574.93
|
2026-02-25
|
|
49900
|
HCPCS
|
Suture Of Postsurgical Opening In Abdominal Wall
|
12
|
9
|
$3,666.00
|
$796.54
78% off
|
$334.70
|
$2,566.20
|
$2,566.20
|
2026-02-25
|
|
01800038
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$7,530.11
|
$1,355.42
82% off
|
$602.41
|
$6,400.59
|
$2,523.50
|
2026-02-25
|
|
05400517
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$7,530.11
|
$1,355.42
82% off
|
$602.41
|
$6,400.59
|
$2,523.50
|
2026-02-25
|
|
05400814
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$7,530.11
|
$1,355.42
82% off
|
$602.41
|
$6,400.59
|
$2,523.50
|
2026-02-25
|
|
05400756
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$7,530.11
|
$1,355.42
82% off
|
$602.41
|
$6,400.59
|
$2,523.50
|
2026-02-25
|
|
74160
|
HCPCS
|
CT Scan Of Abdomen With Contrast
|
13
|
10
|
$6,148.10
|
$1,106.66
82% off
|
$299.45
|
$6,148.10
|
$2,513.14
|
2026-02-25
|
|
58570
|
HCPCS
|
Removal Of Uterus Through Abdomen Using An Endoscope, 250.0 G Or Less
|
12
|
9
|
$3,589.00
|
$723.09
80% off
|
$136.30
|
$2,512.30
|
$2,512.30
|
2026-02-25
|
|
71260
|
HCPCS
|
CT Scan Of Chest With Contrast
|
13
|
10
|
$6,060.23
|
$1,090.84
82% off
|
$297.64
|
$6,060.23
|
$2,490.76
|
2026-02-25
|
|
72193
|
HCPCS
|
CT Scan Of Pelvis With Contrast
|
13
|
10
|
$6,060.23
|
$1,090.84
82% off
|
$293.26
|
$6,060.23
|
$2,478.86
|
2026-02-25
|
|
74177
|
HCPCS
|
CT Scan Of Abdomen And Pelvis With Contrast
|
13
|
10
|
$5,972.81
|
$1,075.11
82% off
|
$404.21
|
$5,972.81
|
$2,456.49
|
2026-02-25
|
|
57260
|
HCPCS
|
Plastic Repair Of Vagina And Tissue Separating Vagina, Rectum, And Bladder
|
12
|
9
|
$3,449.00
|
$684.85
80% off
|
$121.61
|
$2,414.30
|
$2,414.30
|
2026-02-25
|
|
58925
|
HCPCS
|
Removal Of Cysts Of Ovaries
|
12
|
9
|
$3,411.00
|
$694.72
80% off
|
$68.00
|
$2,387.70
|
$2,387.70
|
2026-02-25
|
|
27502
|
HCPCS
|
Closed Treatment Of Broken Thigh Bone At Midportion With Manipulation
|
12
|
9
|
$3,392.00
|
$755.28
78% off
|
$71.48
|
$2,374.40
|
$2,374.40
|
2026-02-25
|
|
27252
|
HCPCS
|
Closed Treatment Of Dislocated Hip Under Anesthesia
|
12
|
9
|
$3,362.00
|
$721.39
79% off
|
$36.00
|
$2,353.40
|
$2,353.40
|
2026-02-25
|
|
57287
|
HCPCS
|
Removal Or Revision Of Incontinence Sling
|
12
|
9
|
$3,326.00
|
$667.43
80% off
|
$596.89
|
$2,328.20
|
$2,328.20
|
2026-02-25
|
|
25605
|
HCPCS
|
Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit…
|
25
|
10
|
$5,345.83
|
$962.25
82% off
|
$15.00
|
$4,543.96
|
$2,293.65
|
2026-02-25
|
|
19371
|
HCPCS
|
Removal Of Capsule Around Breast Implant
|
12
|
9
|
$3,222.00
|
$656.69
80% off
|
$84.51
|
$2,255.40
|
$2,255.40
|
2026-02-25
|
|
J0840
|
HCPCS
|
Injection, Crotalidae Polyvalent Immune Fab (ovine), Up To 1 Gram
|
12
|
9
|
$4,947.50
|
$890.55
82% off
|
$395.80
|
$4,345.18
|
$2,221.28
|
2026-02-25
|
|
15760
|
HCPCS
|
Graft With Closure Of Wound
|
12
|
9
|
$3,165.00
|
$623.57
80% off
|
$60.00
|
$2,215.50
|
$2,215.50
|
2026-02-25
|
|
47563
|
HCPCS
|
Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope
|
12
|
9
|
$3,162.00
|
$673.51
79% off
|
$536.48
|
$2,213.40
|
$2,213.40
|
2026-02-25
|
|
58662
|
HCPCS
|
Destruction Or Removal Of Ovary Or Growth Of Pelvis Using An Endoscope
|
12
|
9
|
$3,156.00
|
$640.83
80% off
|
$305.66
|
$2,209.20
|
$2,209.20
|
2026-02-25
|
|
60210
|
HCPCS
|
Partial Removal Of Thyroid Lobe On Side Of Neck
|
12
|
9
|
$3,149.00
|
$644.20
80% off
|
$565.52
|
$2,204.30
|
$2,204.30
|
2026-02-25
|
|
23073
|
HCPCS
|
Removal Of Growth Of Muscle Of Shoulder, 5.0 Cm Or More
|
12
|
9
|
$3,131.00
|
$659.56
79% off
|
$36.00
|
$2,191.70
|
$2,191.70
|
2026-02-25
|
|
43870
|
HCPCS
|
Closure Of Surgically Created Opening From Stomach To Skin
|
12
|
9
|
$3,116.00
|
$665.45
79% off
|
$25.00
|
$2,181.20
|
$2,181.20
|
2026-02-25
|
|
15120
|
HCPCS
|
Partial Thickness Self Skin Graft To Face, Scalp, Eyelids, Mouth, Neck, Ears, Ar…
|
12
|
9
|
$3,107.00
|
$621.97
80% off
|
$92.70
|
$2,174.90
|
$2,174.90
|
2026-02-25
|
|
51840
|
HCPCS
|
Simple Suture Of Bladder Neck To Vaginal Wall And Pubic Bone With Urethra Suspen…
|
12
|
9
|
$3,101.00
|
$626.99
80% off
|
$60.00
|
$2,170.70
|
$2,170.70
|
2026-02-25
|
|
43830
|
HCPCS
|
Insertion Of Stomach Feeding Tube
|
12
|
9
|
$3,101.00
|
$670.13
78% off
|
$483.99
|
$2,170.70
|
$2,170.70
|
2026-02-25
|
|
59409
|
HCPCS
|
Vaginal Delivery
|
25
|
10
|
$4,681.46
|
$842.66
82% off
|
$35.00
|
$4,074.00
|
$2,124.67
|
2026-02-25
|
|
70488
|
HCPCS
|
CT Scan Of Face Before And After Contrast
|
13
|
10
|
$5,142.19
|
$925.59
82% off
|
$265.31
|
$5,142.19
|
$2,120.83
|
2026-02-25
|
|
70470
|
HCPCS
|
CT Scan Of Head Or Brain Before And After Contrast
|
13
|
10
|
$5,142.19
|
$925.59
82% off
|
$247.72
|
$5,142.19
|
$2,120.83
|
2026-02-25
|
|
19330
|
HCPCS
|
Removal Of Ruptured Breast Implant And Implant Material
|
12
|
9
|
$2,920.00
|
$599.34
79% off
|
$85.63
|
$2,044.00
|
$2,044.00
|
2026-02-25
|
|
47562
|
HCPCS
|
Removal Of Gallbladder Using An Endoscope
|
12
|
9
|
$2,911.00
|
$622.92
79% off
|
$466.12
|
$2,037.70
|
$2,037.70
|
2026-02-25
|
|
04826661
|
CDM
|
Enema Bottle 120 Ml
|
1
|
1
|
$2,902.00
|
—
|
$2,031.40
|
$2,031.40
|
$2,031.40
|
2026-02-25
|
|
J0897
|
HCPCS
|
Injection, Denosumab, 1 Mg
|
12
|
9
|
$4,423.20
|
$796.18
82% off
|
$29.70
|
$3,759.72
|
$2,016.80
|
2026-02-25
|
|
58661
|
HCPCS
|
Removal Of Ovaries And/or Tubes Using An Endoscope
|
12
|
9
|
$2,881.00
|
$579.34
80% off
|
$97.79
|
$2,016.70
|
$2,016.70
|
2026-02-25
|
|
70482
|
HCPCS
|
CT Scan Of Cranial Cavity Before And After Contrast
|
13
|
10
|
$4,804.96
|
$864.89
82% off
|
$330.14
|
$4,804.96
|
$1,989.31
|
2026-02-25
|
|
49553
|
HCPCS
|
Repair Of Trapped Femoral Groin Hernia
|
12
|
9
|
$2,798.00
|
$601.49
79% off
|
$79.30
|
$1,958.60
|
$1,958.60
|
2026-02-25
|
|
49520
|
HCPCS
|
Repair Of Groin Hernia That Is Not Trapped
|
12
|
9
|
$2,796.00
|
$599.93
79% off
|
$84.51
|
$1,957.20
|
$1,957.20
|
2026-02-25
|
|
27048
|
HCPCS
|
Removal Of Growth Of Soft Tissue Of Pelvis And Hip, Less Than 5.0 Cm
|
12
|
9
|
$2,766.00
|
$588.30
79% off
|
$75.00
|
$1,936.20
|
$1,936.20
|
2026-02-25
|
|
IS
|
CDM
|
Room & Board - Private (one Bed) - General Classification
|
11
|
8
|
$3,017.45
|
$3,931.00
|
$633.66
|
$3,931.00
|
$1,923.62
|
2026-02-25
|
|
57250
|
HCPCS
|
Repair Of Herniated Rectum Into Vaginal Wall
|
12
|
9
|
$2,740.00
|
$545.68
80% off
|
$70.94
|
$1,918.00
|
$1,918.00
|
2026-02-25
|
|
C1771
|
HCPCS
|
Repair Device, Urinary, Incontinence, With Sling Graft
|
13
|
10
|
$4,608.34
|
$829.50
82% off
|
$829.50
|
$4,608.34
|
$1,906.72
|
2026-02-25
|
|
99291
|
HCPCS
|
Critical Care, First 30-74 Minutes
|
25
|
10
|
$4,377.22
|
$787.90
82% off
|
$121.60
|
$3,720.64
|
$1,868.44
|
2026-02-25
|
|
44970
|
HCPCS
|
Removal Of Appendix Using An Endoscope
|
12
|
9
|
$2,660.00
|
$571.27
79% off
|
$130.00
|
$1,862.00
|
$1,862.00
|
2026-02-25
|
|
70487
|
HCPCS
|
CT Scan Of Face With Contrast
|
13
|
10
|
$4,471.59
|
$804.89
82% off
|
$230.16
|
$4,471.59
|
$1,859.30
|
2026-02-25
|
|
46262
|
HCPCS
|
Removal Of Multiple Hemorrhoid Groups With Removal Of Abnormal Drainage Tract Fr…
|
12
|
9
|
$2,637.00
|
$590.95
78% off
|
$65.00
|
$1,845.90
|
$1,845.90
|
2026-02-25
|
|
93886
|
HCPCS
|
Complete Ultrasound Of Within The Brain Blood Flow
|
13
|
10
|
$4,234.59
|
$762.23
82% off
|
$280.97
|
$3,599.40
|
$1,829.88
|
2026-02-25
|
|
11772
|
HCPCS
|
Complicated Removal Of Cyst Of Tailbone
|
12
|
9
|
$2,612.00
|
$582.46
78% off
|
$50.00
|
$1,828.40
|
$1,828.40
|
2026-02-25
|
|
49507
|
HCPCS
|
Repair Of Trapped Groin Hernia (5 Years Or Older)
|
12
|
9
|
$2,605.00
|
$562.17
78% off
|
$414.74
|
$1,823.50
|
$1,823.50
|
2026-02-25
|
|
70492
|
HCPCS
|
CT Scan Of Soft Tissue Of Neck Before And After Contrast
|
13
|
10
|
$4,312.72
|
$776.29
82% off
|
$330.14
|
$4,312.72
|
$1,797.34
|
2026-02-25
|
|
49550
|
HCPCS
|
Repair Of Femoral Groin Hernia
|
12
|
9
|
$2,563.00
|
$552.11
78% off
|
$35.00
|
$1,794.10
|
$1,794.10
|
2026-02-25
|
|
70481
|
HCPCS
|
CT Scan Of Cranial Cavity With Contrast
|
13
|
10
|
$4,298.96
|
$773.81
82% off
|
$330.14
|
$4,298.96
|
$1,791.97
|
2026-02-25
|
|
70460
|
HCPCS
|
CT Scan Head Or Brain With Contrast
|
13
|
10
|
$4,298.96
|
$773.81
82% off
|
$216.71
|
$4,298.96
|
$1,791.97
|
2026-02-25
|
|
49525
|
HCPCS
|
Repair Of Sliding Groin Hernia
|
12
|
9
|
$2,543.00
|
$548.19
78% off
|
$35.00
|
$1,780.10
|
$1,780.10
|
2026-02-25
|
|
49651
|
HCPCS
|
Repair Of Recurrent Groin Hernia Using An Endoscope
|
12
|
9
|
$2,517.00
|
$546.94
78% off
|
$130.00
|
$1,761.90
|
$1,761.90
|
2026-02-25
|
|
58940
|
HCPCS
|
Removal Of Ovaries
|
12
|
9
|
$2,485.00
|
$517.09
79% off
|
$38.00
|
$1,739.50
|
$1,739.50
|
2026-02-25
|
|
49593
|
HCPCS
|
Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length
|
8
|
5
|
$2,471.00
|
$507.29
79% off
|
$92.70
|
$1,729.70
|
$1,729.70
|
2026-02-25
|
|
74150
|
HCPCS
|
CT Scan Of Abdomen Without Contrast
|
13
|
10
|
$4,117.11
|
$741.08
82% off
|
$208.42
|
$4,117.11
|
$1,721.05
|
2026-02-25
|
|
02407172
|
CDM
|
Dhc-25 Staple Gun
|
12
|
9
|
$8,343.51
|
$1,501.83
82% off
|
$667.48
|
$7,091.98
|
$1,679.06
|
2026-02-25
|
|
04828021
|
CDM
|
Ajovy 225 Mg/1.5 Ml Syringe
|
1
|
1
|
$2,346.00
|
—
|
$1,642.20
|
$1,642.20
|
$1,642.20
|
2026-02-25
|
|
49505
|
HCPCS
|
Repair Of Groin Hernia (5 Years Or Older)
|
12
|
9
|
$2,323.00
|
$503.49
78% off
|
$35.00
|
$1,626.10
|
$1,626.10
|
2026-02-25
|
|
04823643
|
CDM
|
Humira 40 Mg/0.8 Ml Syringe
|
12
|
9
|
$8,222.97
|
$1,480.13
82% off
|
$657.84
|
$6,989.52
|
$1,625.58
|
2026-02-25
|
|
73701
|
HCPCS
|
CT Scan Of Leg With Contrast Material
|
13
|
10
|
$3,869.60
|
$696.53
82% off
|
$293.26
|
$3,869.60
|
$1,624.52
|
2026-02-25
|
|
74176
|
HCPCS
|
CT Scan Of Abdomen And Pelvis Without Contrast
|
13
|
10
|
$3,822.60
|
$688.07
82% off
|
$256.82
|
$3,822.60
|
$1,613.69
|
2026-02-25
|
|
70491
|
HCPCS
|
CT Scan Of Soft Tissue Of Neck With Contrast
|
13
|
10
|
$3,823.85
|
$688.29
82% off
|
$305.43
|
$3,823.85
|
$1,606.67
|
2026-02-25
|
|
MS
|
CDM
|
Room & Board - Semi-private (two Beds) - General Classification
|
11
|
8
|
$2,514.55
|
$3,931.00
|
$528.06
|
$3,931.00
|
$1,603.03
|
2026-02-25
|
|
27562
|
HCPCS
|
Closed Treatment Of Dislocated Kneecap Under Anesthesia
|
12
|
9
|
$2,286.00
|
$486.69
79% off
|
$41.00
|
$1,600.20
|
$1,600.20
|
2026-02-25
|
|
72192
|
HCPCS
|
CT Scan Of Pelvis Without Contrast
|
13
|
10
|
$3,800.04
|
$684.01
82% off
|
$204.64
|
$3,800.04
|
$1,597.39
|
2026-02-25
|
|
27842
|
HCPCS
|
Closed Treatment Of Dislocated Ankle Under Anesthesia
|
12
|
9
|
$2,273.00
|
$500.62
78% off
|
$10.00
|
$1,591.10
|
$1,591.10
|
2026-02-25
|
|
27752
|
HCPCS
|
Closed Treatment Of Middle Part Of Broken Shin Bone With Manipulation
|
12
|
9
|
$2,269.00
|
$511.23
77% off
|
$35.00
|
$1,588.30
|
$1,588.30
|
2026-02-25
|
|
57295
|
HCPCS
|
Revision Of Prosthetic Vaginal Graft
|
12
|
9
|
$2,246.00
|
$451.87
80% off
|
$30.00
|
$1,572.20
|
$1,572.20
|
2026-02-25
|
|
70498
|
HCPCS
|
CT Scan Of Blood Vessels Of Neck With Contrast
|
13
|
10
|
$3,711.40
|
$668.05
82% off
|
$296.91
|
$3,711.40
|
$1,562.82
|
2026-02-25
|
|
46280
|
HCPCS
|
Repair Of Abnormal Drainage Tract Around Anal Sphincter
|
12
|
9
|
$2,192.00
|
$494.09
77% off
|
$378.97
|
$1,534.40
|
$1,534.40
|
2026-02-25
|
|
04824463
|
CDM
|
Gamunex-c Ivpb : 24g /240 Ml
|
12
|
9
|
$7,697.19
|
$1,385.49
82% off
|
$615.78
|
$6,542.61
|
$1,526.99
|
2026-02-25
|
|
04823989
|
CDM
|
Gamunex-c Ivpb : 70g /700 Ml
|
12
|
9
|
$7,697.19
|
$1,385.49
82% off
|
$615.78
|
$6,542.61
|
$1,526.99
|
2026-02-25
|
|
46260
|
HCPCS
|
Removal Of Multiple Hemorrhoid Groups
|
12
|
9
|
$2,180.00
|
$487.01
78% off
|
$382.35
|
$1,526.00
|
$1,526.00
|
2026-02-25
|
|
46258
|
HCPCS
|
Removal Of Single External And Internal Hemorrhoid Group With Removal Of Abnorma…
|
12
|
9
|
$2,171.00
|
$483.91
78% off
|
$332.84
|
$1,519.70
|
$1,519.70
|
2026-02-25
|
|
25565
|
HCPCS
|
Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation
|
12
|
9
|
$2,166.00
|
$522.66
76% off
|
$265.82
|
$1,516.20
|
$1,516.20
|
2026-02-25
|
|
04828051
|
CDM
|
Wegovy 2.4 Mg/0.75 Ml Pen
|
1
|
1
|
$2,158.00
|
—
|
$1,510.60
|
$1,510.60
|
$1,510.60
|
2026-02-25
|
|
04827925
|
CDM
|
Trulicity 1.5 Mg/0.5 Ml Pen
|
1
|
1
|
$2,127.00
|
—
|
$1,488.90
|
$1,488.90
|
$1,488.90
|
2026-02-25
|
|
04827280
|
CDM
|
Trulicity 1.5 Mg/0.5 Ml Pen
|
1
|
1
|
$2,127.00
|
—
|
$1,488.90
|
$1,488.90
|
$1,488.90
|
2026-02-25
|
|
04823396
|
CDM
|
Humira Pen 40 Mg/0.8 Ml
|
12
|
9
|
$7,482.23
|
$1,346.80
82% off
|
$598.58
|
$6,359.90
|
$1,486.69
|
2026-02-25
|
|
24505
|
HCPCS
|
Closed Treatment Of Broken Middle Part Of Upper Arm Bone With Manipulation
|
12
|
9
|
$2,118.00
|
$486.21
77% off
|
$10.00
|
$1,482.60
|
$1,482.60
|
2026-02-25
|
|
71275
|
HCPCS
|
CT Scan Of Blood Vessels Of Chest With Contrast
|
13
|
10
|
$3,484.44
|
$627.20
82% off
|
$278.76
|
$3,484.44
|
$1,481.14
|
2026-02-25
|
|
21931
|
HCPCS
|
Removal Of Growth Under Skin Of Back Or Lower Sides, 3.0 Cm Or More
|
12
|
9
|
$2,107.00
|
$452.87
79% off
|
$77.07
|
$1,474.90
|
$1,474.90
|
2026-02-25
|
|
70486
|
HCPCS
|
CT Scan Of Face Without Contrast
|
13
|
10
|
$3,450.27
|
$621.05
82% off
|
$208.72
|
$3,450.27
|
$1,460.98
|
2026-02-25
|
|
04826508
|
CDM
|
Forteo 560 Mcg/2.24 Ml Pen Inj
|
12
|
9
|
$7,332.71
|
$1,319.89
82% off
|
$586.62
|
$6,232.80
|
$1,458.65
|
2026-02-25
|
|
74175
|
HCPCS
|
CT Scan Of Blood Vessels Of Abdomen With Contrast
|
13
|
10
|
$3,385.50
|
$609.39
82% off
|
$270.84
|
$3,385.50
|
$1,435.72
|
2026-02-25
|
|
27762
|
HCPCS
|
Closed Treatment Of Inside Portion Of Shin Bone At Ankle With Manipulation
|
9
|
8
|
$2,044.00
|
$504.37
75% off
|
$369.45
|
$1,430.80
|
$1,430.80
|
2026-02-25
|
|
72128
|
HCPCS
|
CT Scan Of Middle Spine Without Contrast
|
13
|
10
|
$3,336.20
|
$600.52
82% off
|
$233.48
|
$3,336.20
|
$1,423.88
|
2026-02-25
|
|
72131
|
HCPCS
|
CT Scan Of Lower Spine Without Contrast
|
13
|
10
|
$3,336.20
|
$600.52
82% off
|
$232.06
|
$3,336.20
|
$1,423.88
|
2026-02-25
|
|
02406596
|
CDM
|
Hickman Subcutaneous Port
|
12
|
9
|
$6,973.78
|
$1,255.28
82% off
|
$557.90
|
$5,927.71
|
$1,422.24
|
2026-02-25
|
|
11771
|
HCPCS
|
Extensive Removal Of Cyst Of Tailbone
|
12
|
9
|
$2,024.00
|
$445.78
78% off
|
$55.00
|
$1,416.80
|
$1,416.80
|
2026-02-25
|
|
72130
|
HCPCS
|
CT Scan Of Middle Spine Before And After Contrast
|
13
|
10
|
$3,336.20
|
$600.52
82% off
|
$266.90
|
$3,336.20
|
$1,416.49
|
2026-02-25
|
|
70480
|
HCPCS
|
CT Scan Of Cranial Cavity Without Contrast
|
13
|
10
|
$3,336.20
|
$600.52
82% off
|
$266.90
|
$3,336.20
|
$1,416.49
|
2026-02-25
|
|
93922
|
HCPCS
|
Ultrasound Study Of Arm And Leg Arteries
|
13
|
10
|
$3,024.57
|
$544.42
82% off
|
$74.73
|
$2,570.88
|
$1,410.41
|
2026-02-25
|
|
25635
|
HCPCS
|
Closed Treatment Of Other Broken Wrist Bone With Manipulation
|
12
|
9
|
$2,009.00
|
$436.65
78% off
|
$32.00
|
$1,406.30
|
$1,406.30
|
2026-02-25
|
|
SW
|
CDM
|
Room & Board - Private (one Bed) - General Classification
|
11
|
8
|
$2,200.00
|
$3,931.00
|
$462.00
|
$3,931.00
|
$1,402.50
|
2026-02-25
|
|
27810
|
HCPCS
|
Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation
|
12
|
9
|
$2,000.00
|
$476.46
76% off
|
$250.19
|
$1,400.00
|
$1,400.00
|
2026-02-25
|
|
05400715
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$3,765.01
|
$677.70
82% off
|
$301.20
|
$3,200.26
|
$1,398.36
|
2026-02-25
|
|
01800020
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$3,765.01
|
$677.70
82% off
|
$301.20
|
$3,200.26
|
$1,398.36
|
2026-02-25
|
|
05400731
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$3,765.01
|
$677.70
82% off
|
$301.20
|
$3,200.26
|
$1,398.36
|
2026-02-25
|
|
05400806
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$3,765.01
|
$677.70
82% off
|
$301.20
|
$3,200.26
|
$1,398.36
|
2026-02-25
|
|
22903
|
HCPCS
|
Removal Of Growth Of Soft Tissue Of Abdominal Wall, 3.0 Cm Or More
|
12
|
9
|
$1,974.00
|
$428.64
78% off
|
$38.00
|
$1,381.80
|
$1,381.80
|
2026-02-25
|
|
46040
|
HCPCS
|
Drainage Of Deep Abscess In Rectum
|
12
|
9
|
$1,946.00
|
$443.63
77% off
|
$50.00
|
$1,362.20
|
$1,362.20
|
2026-02-25
|
|
27265
|
HCPCS
|
Closed Treatment Of Dislocated Hip Prosthesis
|
12
|
9
|
$1,943.00
|
$507.54
74% off
|
$328.44
|
$1,360.10
|
$1,360.10
|
2026-02-25
|
|
49650
|
HCPCS
|
Repair Of Groin Hernia Using An Endoscope
|
12
|
9
|
$1,933.00
|
$422.45
78% off
|
$52.87
|
$1,353.10
|
$1,353.10
|
2026-02-25
|
|
04827717
|
CDM
|
Opsumit 10 Mg Tablet
|
1
|
1
|
$1,932.00
|
—
|
$1,352.40
|
$1,352.40
|
$1,352.40
|
2026-02-25
|
|
01405304
|
CDM
|
Laceration Repair Complex
|
1
|
1
|
$1,917.34
|
—
|
$1,342.14
|
$1,342.14
|
$1,342.14
|
2026-02-25
|
|
24655
|
HCPCS
|
Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow With Manipulation
|
9
|
8
|
$1,915.00
|
$455.99
76% off
|
$329.69
|
$1,340.50
|
$1,340.50
|
2026-02-25
|
|
46257
|
HCPCS
|
Removal Of Single External And Internal Hemorrhoid Group And Chronic Tear In Anu…
|
12
|
9
|
$1,907.00
|
$428.13
78% off
|
$65.00
|
$1,334.90
|
$1,334.90
|
2026-02-25
|
|
23655
|
HCPCS
|
Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia
|
12
|
9
|
$1,905.00
|
$430.53
77% off
|
$26.00
|
$1,333.50
|
$1,333.50
|
2026-02-25
|
|
02407081
|
CDM
|
Peritoneo-venous Shunt
|
12
|
9
|
$6,482.02
|
$1,166.76
82% off
|
$518.56
|
$5,509.72
|
$1,330.03
|
2026-02-25
|
|
19120
|
HCPCS
|
Removal Of Growth And Tissue Of Breast, Duct, Or Nipple
|
12
|
9
|
$1,873.00
|
$408.55
78% off
|
$40.00
|
$1,311.10
|
$1,311.10
|
2026-02-25
|
|
27550
|
HCPCS
|
Closed Treatment Of Dislocated Knee
|
12
|
9
|
$1,864.70
|
$536.64
71% off
|
$257.37
|
$1,305.29
|
$1,305.29
|
2026-02-25
|
|
94002
|
HCPCS
|
Initial Hospital Inpatient Or Observation Ventilation Assistance And Management
|
13
|
10
|
$3,022.01
|
$543.96
82% off
|
$64.26
|
$2,568.71
|
$1,296.71
|
2026-02-25
|
|
04823531
|
CDM
|
Nf-avonex 30mcg Intramuscular Kit
|
12
|
9
|
$6,463.66
|
$1,163.46
82% off
|
$517.09
|
$5,494.11
|
$1,295.71
|
2026-02-25
|
|
71250
|
HCPCS
|
CT Scan Of Chest Without Contrast
|
13
|
10
|
$3,800.04
|
$684.01
82% off
|
$233.36
|
$3,800.04
|
$1,294.05
|
2026-02-25
|
|
46270
|
HCPCS
|
Repair Of Abnormal Anal Drainage Tract
|
12
|
9
|
$1,842.00
|
$418.89
77% off
|
$150.41
|
$1,289.40
|
$1,289.40
|
2026-02-25
|
|
J9214
|
HCPCS
|
Injection, Interferon, Alfa-2b, Recombinant, 1 Million Units
|
11
|
8
|
$2,371.78
|
$152.44
94% off
|
$35.85
|
$2,371.78
|
$1,274.97
|
2026-02-25
|
|
27840
|
HCPCS
|
Closed Treatment Of Dislocated Ankle
|
12
|
9
|
$1,810.00
|
$466.87
74% off
|
$170.32
|
$1,267.00
|
$1,267.00
|
2026-02-25
|
|
43246
|
HCPCS
|
Insertion Of Stomach Tube Using A Flexible Endoscope
|
13
|
10
|
$2,823.74
|
$508.27
82% off
|
$225.90
|
$2,400.18
|
$1,258.58
|
2026-02-25
|
|
43450
|
HCPCS
|
Dilation Of Esophagus
|
13
|
10
|
$2,823.74
|
$508.27
82% off
|
$46.54
|
$2,400.18
|
$1,258.58
|
2026-02-25
|
|
02407289
|
CDM
|
Novasure System
|
12
|
9
|
$6,098.63
|
$1,097.75
82% off
|
$487.89
|
$5,183.84
|
$1,258.15
|
2026-02-25
|
|
J7307
|
HCPCS
|
Etonogestrel (contraceptive) Implant System, Including Implant And Supplies
|
11
|
8
|
$2,250.40
|
$152.44
93% off
|
$405.07
|
$2,250.40
|
$1,215.35
|
2026-02-25
|
|
73202
|
HCPCS
|
CT Scan Of Arm Before And After Contrast
|
13
|
10
|
$2,796.00
|
$503.28
82% off
|
$223.68
|
$2,796.00
|
$1,205.82
|
2026-02-25
|
|
93880
|
HCPCS
|
Ultrasound Of Both Sides Of Head And Neck Blood Flow
|
13
|
10
|
$3,024.57
|
$544.42
82% off
|
$224.68
|
$2,570.88
|
$1,203.79
|
2026-02-25
|
|
73702
|
HCPCS
|
CT Scan Of Leg Before And After Contrast
|
13
|
10
|
$2,786.02
|
$501.48
82% off
|
$222.88
|
$2,786.02
|
$1,201.92
|
2026-02-25
|
|
Q4186
|
HCPCS
|
Epifix, Per Square Centimeter
|
34
|
10
|
$3,330.00
|
$599.40
82% off
|
$142.23
|
$2,830.50
|
$1,200.85
|
2026-02-25
|
|
73700
|
HCPCS
|
CT Scan Of Leg Without Contrast
|
13
|
10
|
$2,751.41
|
$495.25
82% off
|
$220.11
|
$2,751.41
|
$1,188.42
|
2026-02-25
|
|
04824882
|
CDM
|
Nf-enbrel Subcutaneous Solution 50mg/1ml
|
12
|
9
|
$5,819.92
|
$1,047.59
82% off
|
$465.59
|
$4,946.93
|
$1,175.01
|
2026-02-25
|
|
27788
|
HCPCS
|
Closed Treatment Of Broken Outside Lower Leg Bone At Ankle With Manipulation
|
13
|
10
|
$2,632.95
|
$473.93
82% off
|
$210.64
|
$2,238.01
|
$1,173.54
|
2026-02-25
|
|
28193
|
HCPCS
|
Complicated Removal Of Foreign Body In Foot
|
12
|
9
|
$1,669.00
|
$350.35
79% off
|
$70.00
|
$1,168.30
|
$1,168.30
|
2026-02-25
|
|
04824129
|
CDM
|
Harvoni 90-400 Mg Tablet
|
12
|
9
|
$5,778.00
|
$1,040.04
82% off
|
$462.24
|
$4,911.30
|
$1,167.14
|
2026-02-25
|
|
04824130
|
CDM
|
Harvoni 90-400 Mg Tablet
|
12
|
9
|
$5,778.00
|
$1,040.04
82% off
|
$462.24
|
$4,911.30
|
$1,167.14
|
2026-02-25
|
|
04825620
|
CDM
|
Harvoni 90-400 Mg Tablet
|
12
|
9
|
$5,778.00
|
$1,040.04
82% off
|
$462.24
|
$4,911.30
|
$1,167.14
|
2026-02-25
|
|
43886
|
HCPCS
|
Revision Of Port For Saline Injection Into Stomach Banding Device
|
12
|
9
|
$1,665.00
|
$377.23
77% off
|
$45.79
|
$1,165.50
|
$1,165.50
|
2026-02-25
|
|
58671
|
HCPCS
|
Blockage Of Uterine Tubes By Device Using An Endoscope
|
12
|
9
|
$1,657.00
|
$333.57
80% off
|
$130.00
|
$1,159.90
|
$1,159.90
|
2026-02-25
|
|
72125
|
HCPCS
|
CT Scan Of Upper Spine Without Contrast
|
13
|
10
|
$3,336.20
|
$600.52
82% off
|
$238.84
|
$3,336.20
|
$1,151.85
|
2026-02-25
|
|
01000724
|
CDM
|
Reduction/manipulation
|
12
|
9
|
$3,181.54
|
$572.68
82% off
|
$254.52
|
$2,704.31
|
$1,151.70
|
2026-02-25
|
|
20103
|
HCPCS
|
Exploration Of Wound Of Arm Or Leg
|
25
|
10
|
$2,579.61
|
$464.33
82% off
|
$49.00
|
$2,192.67
|
$1,140.45
|
2026-02-25
|
|
99285
|
HCPCS
|
Emergency Department Visit With High Level Of Medical Decision Making
|
25
|
10
|
$3,288.72
|
$591.97
82% off
|
$108.08
|
$2,795.41
|
$1,140.42
|
2026-02-25
|
|
SF
|
CDM
|
Room & Board - Semi-private (two Beds) - General Classification
|
11
|
8
|
$1,776.95
|
$3,931.00
|
$373.16
|
$3,931.00
|
$1,132.81
|
2026-02-25
|
|
SN
|
CDM
|
Room & Board - Private (one Bed) - General Classification
|
11
|
8
|
$1,776.95
|
$3,931.00
|
$373.16
|
$3,931.00
|
$1,132.81
|
2026-02-25
|
|
24600
|
HCPCS
|
Repair Of Dislocated Elbow
|
9
|
8
|
$1,611.00
|
$413.21
74% off
|
$271.59
|
$1,127.70
|
$1,127.70
|
2026-02-25
|
|
27560
|
HCPCS
|
Closed Treatment Of Dislocated Kneecap
|
12
|
9
|
$1,608.00
|
$411.55
74% off
|
$40.21
|
$1,125.60
|
$1,125.60
|
2026-02-25
|
|
46255
|
HCPCS
|
Removal Of Single External And Internal Hemorrhoid Group
|
12
|
9
|
$1,607.00
|
$357.13
78% off
|
$30.00
|
$1,124.90
|
$1,124.90
|
2026-02-25
|
|
02409558
|
CDM
|
Bipolar Device Ns2007
|
12
|
9
|
$5,342.49
|
$961.65
82% off
|
$427.40
|
$4,541.12
|
$1,116.37
|
2026-02-25
|
|
01800012
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$2,823.74
|
$508.27
82% off
|
$225.90
|
$2,400.18
|
$1,116.21
|
2026-02-25
|
|
05400707
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$2,823.74
|
$508.27
82% off
|
$225.90
|
$2,400.18
|
$1,116.21
|
2026-02-25
|
|
05400137
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$2,823.74
|
$508.27
82% off
|
$225.90
|
$2,400.18
|
$1,116.21
|
2026-02-25
|
|
05400780
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$2,823.74
|
$508.27
82% off
|
$225.90
|
$2,400.18
|
$1,116.21
|
2026-02-25
|
|
05400152
|
CDM
|
Operating Room Services - General Classification
|
12
|
9
|
$2,823.74
|
$508.27
82% off
|
$225.90
|
$2,400.18
|
$1,116.21
|
2026-02-25
|
|
00752
|
HCPCS
|
Anesthesia For Procedure To Repair Upper Abdominal Incisional Hernia And/or Woun…
|
5
|
4
|
$1,587.44
|
—
|
$41.00
|
$1,587.44
|
$1,111.21
|
2026-02-25
|
|
70490
|
HCPCS
|
CT Scan Of Soft Tissue Of Neck Without Contrast
|
13
|
10
|
$2,534.39
|
$456.19
82% off
|
$202.75
|
$2,534.39
|
$1,103.79
|
2026-02-25
|
|
46200
|
HCPCS
|
Removal Of Chronic Tear Of Anus
|
12
|
9
|
$1,571.00
|
$362.32
77% off
|
$25.00
|
$1,099.70
|
$1,099.70
|
2026-02-25
|
|
04823950
|
CDM
|
Gamunex-c 40 Gram/400 Ml Vial
|
12
|
9
|
$5,409.65
|
$973.74
82% off
|
$432.77
|
$4,598.20
|
$1,098.08
|
2026-02-25
|
|
93923
|
HCPCS
|
Complete Ultrasound Study Of Arm And Leg Arteries
|
13
|
10
|
$2,268.21
|
$408.28
82% off
|
$139.65
|
$1,927.98
|
$1,096.26
|
2026-02-25
|
|
26115
|
HCPCS
|
Removal (less Than 1.5 Centimeters) Tissue Beneath The Skin Growth Of Hand Or Fi…
|
12
|
9
|
$1,553.00
|
$330.04
79% off
|
$60.00
|
$1,087.10
|
$1,087.10
|
2026-02-25
|
|
25111
|
HCPCS
|
Removal Of First Cyst Of Wrist
|
12
|
9
|
$1,536.00
|
$332.21
78% off
|
$40.00
|
$1,075.20
|
$1,075.20
|
2026-02-25
|
|
01405296
|
CDM
|
Laceration Repair Interme
|
1
|
1
|
$1,533.82
|
—
|
$1,073.67
|
$1,073.67
|
$1,073.67
|
2026-02-25
|