Hospital

HEALTHBRIDGE CHILDREN'S HOSPITAL - ORANGE

Orange, CA · CCN 053308 · Rates published

2,568 distinct procedures filed

23 distinct payers

37,595 rate rows

2025-12-24 last MRF observed

Data quality

37,218 of 37,595 rate rows are consumer-grade (99.0%)

377 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
placeholder amount (≤ $0.02) — excluded from medians	264
per-diem day rate — not a per-procedure price	113

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

Source MRF file	https://healthbridgekids.pt.panaceainc.com/MRFDownload/healthbridgekids/healthbridgekids
Found on page	https://healthbridgekids.com/locations/orange-county-ca-region-pediatric-hospital/#price-transparency
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	f530411828d630cb… · 11,954,752 bytes · first seen 2026-05-08

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
5831 APR_DRG		14	$171,306.53	$696,747.25	$300,760.12	nat. median $144,745 outlier · 2.1×
1611 APR_DRG		14	$153,918.40	$466,019.66	$201,791.44	nat. median $76,806 outlier · 2.6×
5881 APR_DRG		14	$119,885.29	$519,684.04	$185,172.75	nat. median $124,573 1.5× median
0021 APR_DRG		14	$96,610.62	$451,470.64	$155,087.73	nat. median $128,074 1.2× median
5931 APR_DRG		14	$1,931.73	$341,634.44	$126,044.58	nat. median $29,713 outlier · 4.2×
5911 APR_DRG		14	$1,092.23	$338,227.13	$106,959.76	nat. median $40,526 outlier · 2.6×
0061 APR_DRG		14	$69,693.91	$225,769.25	$102,136.84	nat. median $59,647 1.7× median
0111 APR_DRG		14	$38,440.81	$350,698.15	$101,912.42	nat. median $85,731 1.2× median
6021 APR_DRG		14	$12,763.97	$246,517.91	$101,893.49	nat. median $29,952 outlier · 3.4×
0041 APR_DRG		14	$52,545.99	$295,245.48	$101,127.49	nat. median $78,058 1.3× median
0071 APR_DRG		14	$59,477.23	$292,283.13	$95,003.71	nat. median $75,827 1.3× median
0011 APR_DRG		14	$68,511.60	$283,358.85	$92,130.34	nat. median $68,418 1.3× median
6301 APR_DRG		14	$23,865.20	$353,227.86	$85,565.21	nat. median $25,176 outlier · 3.4×
6071 APR_DRG		14	$23,647.51	$191,631.56	$76,485.33	nat. median $32,357 outlier · 2.4×
0051 APR_DRG		14	$45,926.29	$202,718.53	$75,023.07	nat. median $60,936 1.2× median
1621 APR_DRG		14	$47,716.65	$181,719.34	$69,509.54	nat. median $34,207 outlier · 2.0×
3031 APR_DRG		14	$43,965.78	$184,580.96	$68,761.36	nat. median $35,173 2.0× median
6091 APR_DRG		14	$41,024.38	$328,473.60	$68,063.08	nat. median $32,820 outlier · 2.1×
0091 APR_DRG		14	$43,173.82	$300,808.91	$67,324.44	nat. median $47,988 1.4× median
1781 APR_DRG		14	$52,485.94	$147,727.83	$64,684.41	nat. median $36,523 1.8× median
J9029 HCPCS	Instill Adstiladrin, Tx Dose	8	$63,505.40	$152,412.96	$63,505.40	nat. median $69,774 0.9× median
4401 APR_DRG		14	$48,217.10	$171,288.70	$61,162.49	nat. median $38,311 1.6× median
1651 APR_DRG		14	$41,838.87	$142,411.80	$58,406.26	nat. median $31,198 1.9× median
1631 APR_DRG		14	$41,309.64	$153,748.86	$57,781.95	nat. median $29,216 2.0× median
6031 APR_DRG		14	$1,652.73	$256,275.94	$55,924.50	nat. median $15,754 outlier · 3.5×
6081 APR_DRG		14	$8,137.31	$104,656.10	$53,971.81	nat. median $16,430 outlier · 3.3×
6311 APR_DRG		14	$4,565.35	$332,272.78	$52,345.19	nat. median $10,076 outlier · 5.2×
1601 APR_DRG		14	$31,259.35	$212,492.31	$51,883.99	nat. median $25,452 outlier · 2.0×
1791 APR_DRG		14	$36,761.80	$126,557.85	$50,475.38	nat. median $24,855 outlier · 2.0×
1831 APR_DRG		14	$42,514.47	$132,070.94	$50,409.07	nat. median $29,252 1.7× median
5891 APR_DRG		14	$1,091.78	$85,867.83	$50,028.73	nat. median $93,370 0.5× median
1661 APR_DRG		14	$36,955.73	$125,360.21	$48,712.55	nat. median $25,846 1.9× median
0081 APR_DRG		14	$25,220.17	$141,875.38	$48,584.93	nat. median $31,348 1.5× median
6121 APR_DRG		14	$24,801.05	$139,702.11	$48,311.57	nat. median $23,756 outlier · 2.0×
3041 APR_DRG		14	$30,294.74	$134,067.74	$47,325.37	nat. median $23,525 outlier · 2.0×
1671 APR_DRG		14	$31,629.69	$142,146.88	$45,302.29	nat. median $22,505 outlier · 2.0×
J9226 HCPCS	Supprelin La Implant	8	$44,578.75	$106,989.00	$44,578.75	nat. median $60,368 0.7× median
8411 APR_DRG		14	$18,051.23	$334,704.09	$44,277.93	nat. median $34,381 1.3× median
1301 APR_DRG		14	$32,765.71	$103,509.83	$43,988.30	nat. median $26,213 1.7× median
9101 APR_DRG		14	$28,630.74	$126,369.56	$41,347.79	nat. median $24,895 1.7× median
6111 APR_DRG		14	$12,080.86	$145,341.19	$41,311.21	nat. median $13,793 outlier · 3.0×
1691 APR_DRG		14	$31,170.52	$112,365.73	$40,294.98	nat. median $20,102 outlier · 2.0×
6131 APR_DRG		14	$17,160.43	$118,411.46	$40,256.51	nat. median $17,066 outlier · 2.4×
8631 APR_DRG		14	$9,389.69	$152,646.75	$37,076.46	nat. median $8,191 outlier · 4.5×
0211 APR_DRG		14	$21,240.34	$109,998.90	$36,913.18	nat. median $24,348 1.5× median
0911 APR_DRG		14	$16,459.80	$122,259.93	$36,891.29	nat. median $18,295 outlier · 2.0×
6141 APR_DRG		14	$9,558.59	$99,167.91	$35,621.56	nat. median $10,881 outlier · 3.3×
0201 APR_DRG		14	$22,609.07	$103,323.21	$35,089.67	nat. median $24,012 1.5× median
0301 APR_DRG		14	$20,041.77	$84,296.73	$34,690.10	nat. median $19,929 1.7× median
0891 APR_DRG		14	$16,473.56	$103,726.08	$34,555.13	nat. median $19,825 1.7× median

Other procedures at this hospital

Browse this hospital's 2,568 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

5831	APR_DRG	—	56	14	—	—	$171,306.53	$696,747.25	$300,760.12	2025-12-24
1611	APR_DRG	—	56	14	—	—	$153,918.40	$466,019.66	$201,791.44	2025-12-24
5881	APR_DRG	—	56	14	—	—	$119,885.29	$519,684.04	$185,172.75	2025-12-24
0021	APR_DRG	—	56	14	—	—	$96,610.62	$451,470.64	$155,087.73	2025-12-24
5931	APR_DRG	—	56	14	—	—	$1,931.73	$341,634.44	$126,044.58	2025-12-24
5911	APR_DRG	—	56	14	—	—	$1,092.23	$338,227.13	$106,959.76	2025-12-24
0061	APR_DRG	—	56	14	—	—	$69,693.91	$225,769.25	$102,136.84	2025-12-24
0111	APR_DRG	—	56	14	—	—	$38,440.81	$350,698.15	$101,912.42	2025-12-24
6021	APR_DRG	—	56	14	—	—	$12,763.97	$246,517.91	$101,893.49	2025-12-24
0041	APR_DRG	—	56	14	—	—	$52,545.99	$295,245.48	$101,127.49	2025-12-24
0071	APR_DRG	—	56	14	—	—	$59,477.23	$292,283.13	$95,003.71	2025-12-24
0011	APR_DRG	—	56	14	—	—	$68,511.60	$283,358.85	$92,130.34	2025-12-24
6301	APR_DRG	—	56	14	—	—	$23,865.20	$353,227.86	$85,565.21	2025-12-24
6071	APR_DRG	—	56	14	—	—	$23,647.51	$191,631.56	$76,485.33	2025-12-24
0051	APR_DRG	—	56	14	—	—	$45,926.29	$202,718.53	$75,023.07	2025-12-24
1621	APR_DRG	—	56	14	—	—	$47,716.65	$181,719.34	$69,509.54	2025-12-24
3031	APR_DRG	—	56	14	—	—	$43,965.78	$184,580.96	$68,761.36	2025-12-24
6091	APR_DRG	—	56	14	—	—	$41,024.38	$328,473.60	$68,063.08	2025-12-24
0091	APR_DRG	—	56	14	—	—	$43,173.82	$300,808.91	$67,324.44	2025-12-24
1781	APR_DRG	—	56	14	—	—	$52,485.94	$147,727.83	$64,684.41	2025-12-24
J9029	HCPCS	Instill Adstiladrin, Tx Dose	8	8	—	—	$63,505.40	$152,412.96	$63,505.40	2025-12-24
4401	APR_DRG	—	56	14	—	—	$48,217.10	$171,288.70	$61,162.49	2025-12-24
1651	APR_DRG	—	56	14	—	—	$41,838.87	$142,411.80	$58,406.26	2025-12-24
1631	APR_DRG	—	56	14	—	—	$41,309.64	$153,748.86	$57,781.95	2025-12-24
6031	APR_DRG	—	56	14	—	—	$1,652.73	$256,275.94	$55,924.50	2025-12-24
6081	APR_DRG	—	56	14	—	—	$8,137.31	$104,656.10	$53,971.81	2025-12-24
6311	APR_DRG	—	56	14	—	—	$4,565.35	$332,272.78	$52,345.19	2025-12-24
1601	APR_DRG	—	56	14	—	—	$31,259.35	$212,492.31	$51,883.99	2025-12-24
1791	APR_DRG	—	56	14	—	—	$36,761.80	$126,557.85	$50,475.38	2025-12-24
1831	APR_DRG	—	56	14	—	—	$42,514.47	$132,070.94	$50,409.07	2025-12-24
5891	APR_DRG	—	56	14	—	—	$1,091.78	$85,867.83	$50,028.73	2025-12-24
1661	APR_DRG	—	56	14	—	—	$36,955.73	$125,360.21	$48,712.55	2025-12-24
0081	APR_DRG	—	56	14	—	—	$25,220.17	$141,875.38	$48,584.93	2025-12-24
6121	APR_DRG	—	56	14	—	—	$24,801.05	$139,702.11	$48,311.57	2025-12-24
3041	APR_DRG	—	56	14	—	—	$30,294.74	$134,067.74	$47,325.37	2025-12-24
1671	APR_DRG	—	56	14	—	—	$31,629.69	$142,146.88	$45,302.29	2025-12-24
J9226	HCPCS	Supprelin La Implant	8	8	—	—	$44,578.75	$106,989.00	$44,578.75	2025-12-24
8411	APR_DRG	—	56	14	—	—	$18,051.23	$334,704.09	$44,277.93	2025-12-24
1301	APR_DRG	—	56	14	—	—	$32,765.71	$103,509.83	$43,988.30	2025-12-24
9101	APR_DRG	—	56	14	—	—	$28,630.74	$126,369.56	$41,347.79	2025-12-24
6111	APR_DRG	—	56	14	—	—	$12,080.86	$145,341.19	$41,311.21	2025-12-24
1691	APR_DRG	—	56	14	—	—	$31,170.52	$112,365.73	$40,294.98	2025-12-24
6131	APR_DRG	—	56	14	—	—	$17,160.43	$118,411.46	$40,256.51	2025-12-24
8631	APR_DRG	—	56	14	—	—	$9,389.69	$152,646.75	$37,076.46	2025-12-24
0211	APR_DRG	—	56	14	—	—	$21,240.34	$109,998.90	$36,913.18	2025-12-24
0911	APR_DRG	—	56	14	—	—	$16,459.80	$122,259.93	$36,891.29	2025-12-24
6141	APR_DRG	—	56	14	—	—	$9,558.59	$99,167.91	$35,621.56	2025-12-24
0201	APR_DRG	—	56	14	—	—	$22,609.07	$103,323.21	$35,089.67	2025-12-24
0301	APR_DRG	—	56	14	—	—	$20,041.77	$84,296.73	$34,690.10	2025-12-24
0891	APR_DRG	—	56	14	—	—	$16,473.56	$103,726.08	$34,555.13	2025-12-24
0231	APR_DRG	—	56	14	—	—	$17,319.32	$109,403.36	$34,483.51	2025-12-24
3251	APR_DRG	—	56	14	—	—	$22,360.10	$83,558.88	$33,123.38	2025-12-24
1701	APR_DRG	—	56	14	—	—	$24,461.99	$83,790.96	$32,912.40	2025-12-24
1201	APR_DRG	—	56	14	—	—	$20,322.02	$110,977.54	$32,733.65	2025-12-24
9121	APR_DRG	—	56	14	—	—	$22,084.85	$112,751.06	$32,667.65	2025-12-24
1811	APR_DRG	—	56	14	—	—	$16,828.88	$94,812.75	$32,096.36	2025-12-24
2601	APR_DRG	—	56	14	—	—	$19,351.15	$105,157.99	$31,649.55	2025-12-24
6801	APR_DRG	—	56	14	—	—	$16,918.96	$123,680.90	$31,621.56	2025-12-24
4411	APR_DRG	—	56	14	—	—	$15,396.34	$101,751.18	$31,558.07	2025-12-24
4011	APR_DRG	—	56	14	—	—	$14,225.29	$93,512.20	$31,536.01	2025-12-24
8421	APR_DRG	—	56	14	—	—	$12,901.60	$182,693.65	$31,164.90	2025-12-24
1751	APR_DRG	—	56	14	—	—	$21,984.76	$80,767.31	$30,796.44	2025-12-24
3211	APR_DRG	—	56	14	—	—	$19,303.60	$88,583.71	$30,253.29	2025-12-24
9111	APR_DRG	—	56	14	—	—	$16,409.75	$112,615.33	$30,174.47	2025-12-24
2201	APR_DRG	—	56	14	—	—	$15,525.21	$105,952.76	$29,831.50	2025-12-24
9501	APR_DRG	—	56	14	—	—	$16,150.77	$103,338.54	$29,619.92	2025-12-24
1761	APR_DRG	—	56	14	—	—	$17,971.15	$93,825.30	$29,430.21	2025-12-24
0271	APR_DRG	—	56	14	—	—	$18,577.95	$97,521.13	$29,138.07	2025-12-24
3121	APR_DRG	—	56	14	—	—	$12,590.07	$103,406.41	$28,993.26	2025-12-24
1741	APR_DRG	—	56	14	—	—	$21,496.82	$72,578.69	$28,889.72	2025-12-24
0291	APR_DRG	—	56	14	—	—	$21,755.81	$75,950.48	$27,478.45	2025-12-24
6231	APR_DRG	—	56	14	—	—	$9,611.14	$74,879.83	$27,356.31	2025-12-24
3221	APR_DRG	—	56	14	—	—	$19,598.87	$70,115.54	$27,142.06	2025-12-24
2611	APR_DRG	—	56	14	—	—	$15,946.83	$95,673.21	$26,771.72	2025-12-24
2311	APR_DRG	—	56	14	—	—	$16,491.07	$79,326.64	$26,732.47	2025-12-24
2301	APR_DRG	—	56	14	—	—	$14,359.16	$89,150.79	$26,567.17	2025-12-24
3631	APR_DRG	—	56	14	—	—	$11,205.07	$67,877.90	$26,467.54	2025-12-24
6501	APR_DRG	—	56	14	—	—	$15,161.13	$78,560.33	$26,460.35	2025-12-24
3231	APR_DRG	—	56	14	—	—	$18,170.08	$67,170.70	$26,394.51	2025-12-24
1821	APR_DRG	—	56	14	—	—	$19,887.88	$81,102.30	$26,379.97	2025-12-24
3091	APR_DRG	—	56	14	—	—	$15,268.72	$76,500.04	$26,327.58	2025-12-24
1211	APR_DRG	—	56	14	—	—	$14,599.37	$88,950.48	$26,266.74	2025-12-24
6221	APR_DRG	—	56	14	—	—	$15,520.20	$78,239.85	$26,136.00	2025-12-24
6901	APR_DRG	—	56	14	—	—	$9,349.65	$105,177.69	$25,899.68	2025-12-24
3611	APR_DRG	—	56	14	—	—	$14,808.31	$102,048.94	$25,491.04	2025-12-24
3131	APR_DRG	—	56	14	—	—	$14,628.15	$75,895.74	$25,337.78	2025-12-24
7921	APR_DRG	—	56	14	—	—	$14,962.20	$90,006.86	$25,268.18	2025-12-24
0921	APR_DRG	—	56	14	—	—	$14,030.11	$87,966.28	$25,221.42	2025-12-24
1711	APR_DRG	—	56	14	—	—	$17,448.18	$70,306.03	$25,212.97	2025-12-24
1771	APR_DRG	—	56	14	—	—	$12,859.06	$61,981.66	$24,247.58	2025-12-24
5101	APR_DRG	—	56	14	—	—	$14,385.43	$92,034.31	$24,143.89	2025-12-24
8501	APR_DRG	—	56	14	—	—	$14,550.08	$67,448.14	$24,098.66	2025-12-24
5111	APR_DRG	—	56	14	—	—	$14,882.13	$88,242.15	$24,090.56	2025-12-24
6211	APR_DRG	—	56	14	—	—	$3,967.31	$113,520.08	$24,012.84	2025-12-24
6811	APR_DRG	—	56	14	—	—	$12,645.12	$105,985.61	$23,603.57	2025-12-24
0261	APR_DRG	—	56	14	—	—	$13,644.76	$79,797.38	$23,591.37	2025-12-24
3621	APR_DRG	—	56	14	—	—	$13,774.88	$67,792.51	$23,579.95	2025-12-24
4421	APR_DRG	—	56	14	—	—	$15,172.39	$77,960.41	$23,527.40	2025-12-24
6251	APR_DRG	—	56	14	—	—	$11,056.19	$75,208.63	$23,314.24	2025-12-24
2291	APR_DRG	—	56	14	—	—	$12,288.54	$75,626.44	$23,132.51	2025-12-24
2241	APR_DRG	—	56	14	—	—	$14,854.60	$74,109.14	$23,111.87	2025-12-24
3151	APR_DRG	—	56	14	—	—	$10,710.88	$71,324.13	$23,100.92	2025-12-24
7101	APR_DRG	—	56	14	—	—	$10,858.51	$81,713.16	$22,917.95	2025-12-24
3081	APR_DRG	—	56	14	—	—	$15,326.28	$60,322.05	$22,902.31	2025-12-24
3241	APR_DRG	—	56	14	—	—	$15,998.13	$66,640.85	$22,853.67	2025-12-24
4801	APR_DRG	—	56	14	—	—	$14,235.30	$75,168.84	$22,753.74	2025-12-24
3261	APR_DRG	—	56	14	—	—	$15,921.81	$57,464.79	$22,550.90	2025-12-24
0491	APR_DRG	—	56	14	—	—	$9,474.76	$64,427.30	$22,387.63	2025-12-24
0221	APR_DRG	—	56	14	—	—	$14,691.96	$77,408.66	$22,385.75	2025-12-24
5121	APR_DRG	—	56	14	—	—	$13,771.13	$81,675.94	$22,349.15	2025-12-24
9511	APR_DRG	—	56	14	—	—	$12,179.70	$75,600.16	$22,115.19	2025-12-24
6511	APR_DRG	—	56	14	—	—	$11,474.06	$81,450.43	$22,093.14	2025-12-24
8511	APR_DRG	—	56	14	—	—	$14,091.67	$91,906.39	$22,082.98	2025-12-24
4051	APR_DRG	—	56	14	—	—	$13,872.47	$82,131.35	$21,845.26	2025-12-24
4041	APR_DRG	—	56	14	—	—	$10,289.25	$81,829.20	$21,611.78	2025-12-24
3201	APR_DRG	—	56	14	—	—	$11,552.88	$70,514.03	$21,593.47	2025-12-24
3101	APR_DRG	—	56	14	—	—	$12,294.80	$73,220.21	$21,498.24	2025-12-24
4471	APR_DRG	—	56	14	—	—	$13,734.85	$78,282.26	$21,394.54	2025-12-24
7111	APR_DRG	—	56	14	—	—	$11,416.51	$74,514.19	$21,266.46	2025-12-24
0241	APR_DRG	—	56	14	—	—	$11,427.77	$76,530.69	$21,234.72	2025-12-24
2641	APR_DRG	—	56	14	—	—	$14,370.42	$83,013.70	$21,102.88	2025-12-24
2231	APR_DRG	—	56	14	—	—	$12,974.16	$69,719.25	$21,030.47	2025-12-24
1801	APR_DRG	—	56	14	—	—	$12,881.58	$67,216.69	$20,895.50	2025-12-24
3051	APR_DRG	—	56	14	—	—	$11,355.21	$70,984.76	$20,765.22	2025-12-24
1311	APR_DRG	—	56	14	—	—	$12,087.11	$50,215.65	$20,655.91	2025-12-24
4441	APR_DRG	—	56	14	—	—	$9,785.04	$64,786.38	$19,963.72	2025-12-24
2271	APR_DRG	—	56	14	—	—	$12,382.38	$69,964.46	$19,922.44	2025-12-24
4431	APR_DRG	—	56	14	—	—	$12,871.57	$62,864.03	$19,897.42	2025-12-24
7931	APR_DRG	—	56	14	—	—	$10,984.87	$70,980.38	$19,567.90	2025-12-24
2321	APR_DRG	—	56	14	—	—	$12,362.36	$86,019.84	$19,426.53	2025-12-24
4031	APR_DRG	—	56	14	—	—	$12,341.09	$80,007.56	$19,374.60	2025-12-24
2331	APR_DRG	—	56	14	—	—	$11,338.94	$55,645.34	$19,248.08	2025-12-24
9521	APR_DRG	—	56	14	—	—	$9,957.70	$70,419.88	$19,103.42	2025-12-24
5141	APR_DRG	—	56	14	—	—	$8,709.08	$78,242.85	$19,085.28	2025-12-24
2221	APR_DRG	—	56	14	—	—	$8,037.22	$70,612.55	$18,988.17	2025-12-24
5181	APR_DRG	—	56	14	—	—	$9,011.85	$71,624.09	$18,861.01	2025-12-24
3171	APR_DRG	—	56	14	—	—	$10,494.43	$64,499.55	$18,676.01	2025-12-24
2631	APR_DRG	—	56	14	—	—	$11,751.81	$61,486.85	$18,665.37	2025-12-24
6921	APR_DRG	—	56	14	—	—	$6,716.03	$60,011.14	$18,590.15	2025-12-24
4831	APR_DRG	—	56	14	—	—	$9,843.85	$60,291.40	$18,493.50	2025-12-24
0981	APR_DRG	—	56	14	—	—	$9,148.22	$70,448.34	$18,383.08	2025-12-24
4841	APR_DRG	—	56	14	—	—	$12,538.77	$71,652.55	$18,377.77	2025-12-24
7401	APR_DRG	—	56	14	—	—	$7,739.95	$54,069.86	$18,254.66	2025-12-24
5191	APR_DRG	—	56	14	—	—	$10,000.24	$72,037.90	$18,193.07	2025-12-24
5131	APR_DRG	—	56	14	—	—	$10,565.75	$60,357.08	$17,938.78	2025-12-24
0401	APR_DRG	—	56	14	—	—	$9,504.79	$48,928.05	$17,805.85	2025-12-24
1921	APR_DRG	—	56	14	—	—	$10,725.89	$57,092.58	$17,708.42	2025-12-24
0501	APR_DRG	—	56	14	—	—	$7,345.35	$67,759.68	$17,565.48	2025-12-24
0731	APR_DRG	—	56	14	—	—	$10,010.25	$61,843.73	$17,385.47	2025-12-24
4451	APR_DRG	—	56	14	—	—	$10,633.31	$61,224.11	$17,303.37	2025-12-24
J7310	HCPCS	Ganciclovir Long Act Implant	8	8	—	—	$16,960.00	$40,704.00	$16,960.00	2025-12-24
3161	APR_DRG	—	56	14	—	—	$8,990.58	$59,669.59	$16,722.06	2025-12-24
6911	APR_DRG	—	56	14	—	—	$9,252.06	$60,766.51	$16,699.85	2025-12-24
6361	APR_DRG	—	56	14	—	—	$5,476.17	$57,363.58	$16,618.38	2025-12-24
3141	APR_DRG	—	56	14	—	—	$11,957.00	$53,357.35	$16,456.82	2025-12-24
2281	APR_DRG	—	56	14	—	—	$9,853.86	$56,127.03	$16,408.50	2025-12-24
0431	APR_DRG	—	56	14	—	—	$8,928.02	$60,324.24	$16,322.95	2025-12-24
L7180	HCPCS	Electronic Elbow Sequential	8	8	—	—	$16,310.00	$39,144.00	$16,310.00	2025-12-24
7941	APR_DRG	—	56	14	—	—	$9,168.24	$58,524.49	$16,089.30	2025-12-24
3641	APR_DRG	—	56	14	—	—	$8,229.90	$54,756.41	$15,907.58	2025-12-24
2341	APR_DRG	—	56	14	—	—	$9,105.68	$50,940.18	$15,683.16	2025-12-24
4461	APR_DRG	—	56	14	—	—	$9,061.89	$53,127.45	$15,551.79	2025-12-24
1931	APR_DRG	—	56	14	—	—	$8,463.86	$41,987.44	$15,150.02	2025-12-24
L5856	HCPCS	Elec Knee-shin Swing/stance	8	8	—	—	$15,119.69	$36,287.26	$15,119.69	2025-12-24
1911	APR_DRG	—	56	14	—	—	$10,049.03	$44,063.05	$14,927.17	2025-12-24
4821	APR_DRG	—	56	14	—	—	$7,797.01	$51,688.98	$14,820.67	2025-12-24
2261	APR_DRG	—	56	14	—	—	$8,452.60	$50,736.55	$14,684.29	2025-12-24
0581	APR_DRG	—	56	14	—	—	$8,448.84	$35,835.03	$14,473.17	2025-12-24
0441	APR_DRG	—	56	14	—	—	$8,048.48	$29,308.23	$14,301.13	2025-12-24
9301	APR_DRG	—	56	14	—	—	$8,412.56	$54,476.16	$14,081.41	2025-12-24
6331	APR_DRG	—	56	14	—	—	$1,940.49	$106,827.05	$13,920.01	2025-12-24
0951	APR_DRG	—	56	14	—	—	$9,060.64	$42,254.55	$13,611.14	2025-12-24
0451	APR_DRG	—	56	14	—	—	$8,441.34	$37,818.69	$13,586.59	2025-12-24
5171	APR_DRG	—	56	14	—	—	$7,648.12	$47,141.45	$13,532.95	2025-12-24
6951	APR_DRG	—	56	14	—	—	$6,509.60	$90,466.65	$13,420.19	2025-12-24
0551	APR_DRG	—	56	14	—	—	$6,744.81	$45,805.88	$13,311.19	2025-12-24
3431	APR_DRG	—	56	14	—	—	$8,157.33	$41,803.53	$13,299.15	2025-12-24
6341	APR_DRG	—	56	14	—	—	$5,910.31	$69,292.55	$13,175.59	2025-12-24
8601	APR_DRG	—	56	14	—	—	$8,531.67	$20,023.00	$13,026.83	2025-12-24
6611	APR_DRG	—	56	14	—	—	$7,704.42	$44,428.69	$12,795.40	2025-12-24
3461	APR_DRG	—	56	14	—	—	$6,698.52	$49,418.49	$12,458.70	2025-12-24
8901	APR_DRG	—	56	14	—	—	$8,288.70	$47,909.95	$12,457.76	2025-12-24
L5973	HCPCS	Ank-foot Sys Dors-plant Flex	8	8	—	—	$12,453.00	$29,887.20	$12,453.00	2025-12-24
0591	APR_DRG	—	56	14	—	—	$5,778.94	$33,196.73	$12,373.78	2025-12-24
0971	APR_DRG	—	56	14	—	—	$5,897.80	$45,571.60	$12,326.24	2025-12-24
3441	APR_DRG	—	56	14	—	—	$7,195.21	$36,108.71	$12,296.05	2025-12-24
1361	APR_DRG	—	56	14	—	—	$6,709.78	$35,070.78	$12,245.85	2025-12-24
2841	APR_DRG	—	56	14	—	—	$7,022.56	$38,177.76	$12,126.06	2025-12-24
K0863	HCPCS	Pwc Gp3 Vhd Mult Pow Opt S/b	8	8	—	—	$12,064.92	$28,955.81	$12,064.92	2025-12-24
K0860	HCPCS	Pwc Gp3 Vhd Sing Pow Opt S/b	8	8	—	—	$12,064.92	$28,955.81	$12,064.92	2025-12-24
0571	APR_DRG	—	56	14	—	—	$5,861.52	$35,581.05	$12,006.73	2025-12-24
1101	APR_DRG	—	56	14	—	—	$7,829.54	$39,106.10	$11,985.77	2025-12-24
K0864	HCPCS	Pwc Gp3 Xhd Mult Pow Opt S/b	8	8	—	—	$11,964.50	$28,714.80	$11,964.50	2025-12-24
0561	APR_DRG	—	56	14	—	—	$6,478.32	$36,642.94	$11,959.66	2025-12-24
0421	APR_DRG	—	56	14	—	—	$7,167.69	$39,417.00	$11,917.74	2025-12-24
2401	APR_DRG	—	56	14	—	—	$7,666.89	$35,147.54	$11,879.90	2025-12-24
6961	APR_DRG	—	56	14	—	—	$6,786.10	$45,681.08	$11,834.69	2025-12-24
1351	APR_DRG	—	56	14	—	—	$7,644.37	$39,858.59	$11,802.49	2025-12-24
1901	APR_DRG	—	56	14	—	—	$8,493.88	$32,837.65	$11,722.88	2025-12-24
L5858	HCPCS	Stance Phase Only	8	8	—	—	$11,705.58	$28,093.39	$11,705.58	2025-12-24
8931	APR_DRG	—	56	14	—	—	$8,193.61	$30,845.23	$11,697.54	2025-12-24
2811	APR_DRG	—	56	14	—	—	$6,594.67	$30,597.83	$11,621.53	2025-12-24
K0854	HCPCS	Pwc Gp 3 Xhd Seat/back	8	8	—	—	$11,566.32	$27,759.17	$11,566.32	2025-12-24
0511	APR_DRG	—	56	14	—	—	$5,287.25	$42,473.50	$11,544.76	2025-12-24
6391	APR_DRG	—	56	14	—	—	$3,425.58	$49,990.45	$11,485.94	2025-12-24
6941	APR_DRG	—	56	14	—	—	$6,590.92	$39,003.19	$11,438.88	2025-12-24
5481	APR_DRG	—	56	14	—	—	$3,747.28	$37,607.06	$11,436.55	2025-12-24
K0840	HCPCS	Pwc Gp2 Xhd Sing Pow Opt S/b	8	8	—	—	$11,397.96	$27,355.10	$11,397.96	2025-12-24
7211	APR_DRG	—	56	14	—	—	$6,075.46	$38,786.44	$11,303.28	2025-12-24
2411	APR_DRG	—	56	14	—	—	$6,622.20	$40,636.54	$11,149.08	2025-12-24
0411	APR_DRG	—	56	14	—	—	$8,283.69	$29,163.71	$11,094.50	2025-12-24
4611	APR_DRG	—	56	14	—	—	$6,335.69	$31,543.68	$10,988.94	2025-12-24
7201	APR_DRG	—	56	14	—	—	$6,225.59	$38,177.76	$10,935.92	2025-12-24
K0855	HCPCS	Pwc Gp 3 Xhd Cap Chair	8	8	—	—	$10,926.12	$26,222.69	$10,926.12	2025-12-24
5471	APR_DRG	—	56	14	—	—	$5,505.29	$28,250.03	$10,899.57	2025-12-24
3491	APR_DRG	—	56	14	—	—	$5,708.88	$34,116.30	$10,884.62	2025-12-24
6601	APR_DRG	—	56	14	—	—	$6,669.74	$44,036.78	$10,873.68	2025-12-24
1341	APR_DRG	—	56	14	—	—	$6,219.34	$34,985.20	$10,838.80	2025-12-24
3471	APR_DRG	—	56	14	—	—	$6,483.32	$36,156.88	$10,770.61	2025-12-24
8921	APR_DRG	—	56	14	—	—	$7,799.51	$32,754.45	$10,763.11	2025-12-24
0461	APR_DRG	—	56	14	—	—	$7,161.43	$36,855.33	$10,754.67	2025-12-24
2461	APR_DRG	—	56	14	—	—	$6,482.07	$29,450.54	$10,753.42	2025-12-24
7241	APR_DRG	—	56	14	—	—	$6,228.10	$42,893.88	$10,738.24	2025-12-24
5301	APR_DRG	—	56	14	—	—	$5,924.07	$32,500.46	$10,713.22	2025-12-24
2531	APR_DRG	—	56	14	—	—	$6,204.32	$34,265.18	$10,692.26	2025-12-24
1331	APR_DRG	—	56	14	—	—	$4,094.93	$34,744.24	$10,678.03	2025-12-24
1421	APR_DRG	—	56	14	—	—	$6,663.49	$35,219.41	$10,597.65	2025-12-24
1431	APR_DRG	—	56	14	—	—	$5,517.46	$32,951.63	$10,522.27	2025-12-24
7591	APR_DRG	—	56	14	—	—	$6,720.04	$39,230.28	$10,491.80	2025-12-24
4621	APR_DRG	—	56	14	—	—	$4,674.20	$41,923.94	$10,457.52	2025-12-24
4231	APR_DRG	—	56	14	—	—	$5,762.68	$47,870.54	$10,444.39	2025-12-24
2421	APR_DRG	—	56	14	—	—	$5,916.57	$39,307.53	$10,428.74	2025-12-24
3811	APR_DRG	—	56	14	—	—	$4,052.39	$45,913.15	$10,424.99	2025-12-24
2451	APR_DRG	—	56	14	—	—	$6,079.21	$33,325.90	$10,392.31	2025-12-24
2821	APR_DRG	—	56	14	—	—	$5,741.41	$43,894.46	$10,378.70	2025-12-24
3841	APR_DRG	—	56	14	—	—	$6,100.48	$32,421.65	$10,318.49	2025-12-24
8431	APR_DRG	—	56	14	—	—	$5,296.01	$37,967.58	$10,305.04	2025-12-24
3821	APR_DRG	—	56	14	—	—	$5,987.88	$28,865.95	$10,285.97	2025-12-24
5001	APR_DRG	—	56	14	—	—	$5,842.75	$36,143.75	$10,249.83	2025-12-24
0471	APR_DRG	—	56	14	—	—	$7,112.64	$30,527.76	$10,237.95	2025-12-24
2481	APR_DRG	—	56	14	—	—	$5,755.17	$34,766.56	$10,233.58	2025-12-24
2441	APR_DRG	—	56	14	—	—	$5,653.83	$34,359.33	$10,224.81	2025-12-24
8941	APR_DRG	—	56	14	—	—	$6,143.02	$28,975.43	$10,154.60	2025-12-24
4241	APR_DRG	—	56	14	—	—	$5,342.30	$34,663.66	$10,142.71	2025-12-24
1371	APR_DRG	—	56	14	—	—	$6,602.18	$33,861.44	$10,095.32	2025-12-24
6621	APR_DRG	—	56	14	—	—	$5,487.43	$39,487.06	$10,091.58	2025-12-24
2521	APR_DRG	—	56	14	—	—	$6,133.01	$35,574.49	$10,081.09	2025-12-24
3801	APR_DRG	—	56	14	—	—	$5,761.43	$33,030.33	$10,062.80	2025-12-24
2801	APR_DRG	—	56	14	—	—	$5,617.55	$40,448.24	$10,059.51	2025-12-24
0481	APR_DRG	—	56	14	—	—	$6,657.23	$35,219.79	$10,013.37	2025-12-24
2541	APR_DRG	—	56	14	—	—	$5,393.59	$32,750.06	$9,983.66	2025-12-24
2431	APR_DRG	—	56	14	—	—	$5,750.17	$34,199.50	$9,927.05	2025-12-24
8131	APR_DRG	—	56	14	—	—	$6,037.92	$33,041.26	$9,889.20	2025-12-24
8441	APR_DRG	—	56	14	—	—	$3,941.04	$44,003.94	$9,868.87	2025-12-24
6631	APR_DRG	—	56	14	—	—	$5,195.92	$31,007.25	$9,851.36	2025-12-24
3421	APR_DRG	—	56	14	—	—	$5,562.50	$31,629.06	$9,819.76	2025-12-24
0821	APR_DRG	—	56	14	—	—	$5,924.07	$33,943.33	$9,810.22	2025-12-24
5311	APR_DRG	—	56	14	—	—	$5,339.80	$32,277.14	$9,775.19	2025-12-24
1941	APR_DRG	—	56	14	—	—	$5,570.00	$32,036.30	$9,729.37	2025-12-24
4651	APR_DRG	—	56	14	—	—	$5,547.48	$32,524.55	$9,690.11	2025-12-24
8101	APR_DRG	—	56	14	—	—	$4,969.46	$37,869.05	$9,643.35	2025-12-24
1151	APR_DRG	—	56	14	—	—	$4,971.97	$33,192.34	$9,638.98	2025-12-24
4271	APR_DRG	—	56	14	—	—	$4,935.68	$38,396.71	$9,638.82	2025-12-24
2061	APR_DRG	—	56	14	—	—	$6,858.66	$36,174.40	$9,624.74	2025-12-24
2071	APR_DRG	—	56	14	—	—	$5,765.18	$31,804.21	$9,592.53	2025-12-24
1441	APR_DRG	—	56	14	—	—	$5,351.06	$31,758.05	$9,579.39	2025-12-24
0521	APR_DRG	—	56	14	—	—	$6,204.32	$35,338.03	$9,477.90	2025-12-24
2831	APR_DRG	—	56	14	—	—	$5,377.33	$33,001.85	$9,460.69	2025-12-24
2001	APR_DRG	—	56	14	—	—	$4,921.92	$31,598.41	$9,428.31	2025-12-24
2791	APR_DRG	—	56	14	—	—	$5,341.05	$37,777.09	$9,345.11	2025-12-24
4691	APR_DRG	—	56	14	—	—	$5,032.02	$36,091.20	$9,319.00	2025-12-24
3511	APR_DRG	—	56	14	—	—	$5,269.73	$33,420.05	$9,215.93	2025-12-24
4681	APR_DRG	—	56	14	—	—	$5,032.02	$32,782.91	$9,199.52	2025-12-24
0541	APR_DRG	—	56	14	—	—	$6,100.48	$26,341.49	$9,153.85	2025-12-24
4261	APR_DRG	—	56	14	—	—	$5,060.80	$31,322.54	$9,146.34	2025-12-24
4211	APR_DRG	—	56	14	—	—	$4,376.43	$34,208.25	$9,120.07	2025-12-24
1971	APR_DRG	—	56	14	—	—	$5,157.13	$29,774.58	$9,116.62	2025-12-24
1391	APR_DRG	—	56	14	—	—	$4,961.96	$29,996.96	$9,059.24	2025-12-24
2471	APR_DRG	—	56	14	—	—	$5,122.10	$31,657.53	$9,050.32	2025-12-24
5011	APR_DRG	—	56	14	—	—	$4,975.72	$34,298.03	$9,038.28	2025-12-24
8611	APR_DRG	—	56	14	—	—	$4,091.17	$24,416.95	$9,034.06	2025-12-24
2051	APR_DRG	—	56	14	—	—	$5,245.96	$36,237.89	$8,986.51	2025-12-24
2041	APR_DRG	—	56	14	—	—	$5,979.12	$26,207.94	$8,924.43	2025-12-24
3831	APR_DRG	—	56	14	—	—	$4,751.77	$32,730.36	$8,921.45	2025-12-24
1401	APR_DRG	—	56	14	—	—	$5,770.18	$29,132.19	$8,822.93	2025-12-24
1991	APR_DRG	—	56	14	—	—	$5,483.68	$28,368.94	$8,812.29	2025-12-24
4661	APR_DRG	—	56	14	—	—	$4,704.23	$26,906.38	$8,805.88	2025-12-24
0531	APR_DRG	—	56	14	—	—	$5,172.15	$36,187.54	$8,795.24	2025-12-24
E1008	HCPCS	Pwr Seat Combo Pwr Shear	8	8	—	—	$8,742.05	$20,980.92	$8,742.05	2025-12-24
E1007	HCPCS	Pwr Seat Combo W/shear	8	8	—	—	$8,741.27	$20,979.05	$8,741.27	2025-12-24
K0853	HCPCS	Pwc Gp 3 Vhd Cap Chair	8	8	—	—	$8,730.72	$20,953.73	$8,730.72	2025-12-24
3851	APR_DRG	—	56	14	—	—	$4,705.48	$30,521.19	$8,725.03	2025-12-24
2011	APR_DRG	—	56	14	—	—	$4,826.84	$30,271.59	$8,643.39	2025-12-24
8151	APR_DRG	—	56	14	—	—	$4,193.77	$37,418.01	$8,642.76	2025-12-24
1961	APR_DRG	—	56	14	—	—	$4,352.66	$30,928.43	$8,614.93	2025-12-24
3401	APR_DRG	—	56	14	—	—	$5,120.85	$25,750.34	$8,612.90	2025-12-24
3411	APR_DRG	—	56	14	—	—	$5,554.99	$28,224.44	$8,589.28	2025-12-24
5391	APR_DRG	—	56	14	—	—	$5,563.64	$27,283.90	$8,575.02	2025-12-24
K0852	HCPCS	Pwc Gp 3 Vhd Seat/back	8	8	—	—	$8,499.12	$20,397.89	$8,499.12	2025-12-24
2511	APR_DRG	—	56	14	—	—	$5,124.60	$23,663.78	$8,455.72	2025-12-24

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