Hospital

HCA HEALTHONE ROSE

Denver, CO · CCN 060032 · Rates published

Your selected procedure

You selected 93306 (CPT)

ECHO2D COMP W CF DOP

This hospital’s price: $5,052 across 13 payers · range $1,409-$8,342

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/84-1321373_HCA-HEALTHONE-ROSE_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D · observed 2026-03-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

27,093 distinct procedures filed

32 distinct payers

463,976 rate rows

2026-07-17 last MRF observed

Data quality

445,185 of 463,976 rate rows are consumer-grade (96.0%)

18,791 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	18,569
per-diem day rate — not a per-procedure price	147
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	31
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	28
template filing: same amount across many unrelated codes — excluded	8
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	6
placeholder amount (≤ $0.02) — excluded from medians	2

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

Source MRF file	https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/84-1321373_HCA-HEALTHONE-ROSE_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page	https://www.healthonecares.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered via	Discovered by HANK
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-11
Content fingerprint	75d0ba0a998907c5… · 526,979,021 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
589193 CDM	Kit Lo Prfl Comp Shth 7f	17	$72,735.80	$430,672.50	$228,256.42	nat. median $71,700 outlier · 3.2×
863779 CDM	Set Vntrc 17.4x13.8in	17	$72,735.80	$430,672.50	$228,256.42	nat. median $65,490 outlier · 3.5×
866933 CDM	Set Pump 21fr 5.0	17	$72,735.80	$430,672.50	$228,256.42	nat. median $43,868 outlier · 5.2×
494787 CDM	Graft Bn Dist Fem Rt	16	$48,633.92	$287,964.00	$207,974.00	nat. median $1,667 outlier · 124.7×
778799 CDM	Graft Evas 45x45mm 10cm	16	$44,776.31	$265,122.90	$191,477.65	nat. median $29,232 outlier · 6.6×
955647 CDM	Rmv Icd W Rplc Mult Ld	15	$45,241.89	$267,879.60	$190,492.16	nat. median $80,815 outlier · 2.4×
C1822 HCPCS	Pulse Gen Imp	16	$44,319.25	$262,416.60	$189,523.10	nat. median $31,540 outlier · 6.0×
93654 CPT	Ep Repos Ele Vt 3d Map	12	$39,611.96	$234,544.50	$174,605.35	nat. median $27,029 outlier · 6.5×
883402 CDM	Ins/repl Subq Imp Icd Sy	15	$40,819.30	$241,693.20	$171,870.72	nat. median $830 outlier · 207.1×
C2616 HCPCS	Brachytx Ns Yttrium 90	13	$39,654.06	$234,793.80	$169,573.30	nat. median $26,836 outlier · 6.3×
783359 CDM	Stnt Thorac 28x28mm 10cm	16	$39,119.48	$231,628.50	$167,287.25	nat. median $33,000 outlier · 5.1×
955644 CDM	Ins Icd Gen W Mult Lead	15	$39,340.64	$232,938.00	$165,644.80	nat. median $75,470 outlier · 2.2×
943426 CDM	Inst/rp Gen Sg/dl Icd	15	$39,340.64	$232,938.00	$165,644.80	nat. median $8,311 outlier · 19.9×
J9999 HCPCS	Carmustine Wafers 8/box	17	$38,836.15	$229,950.90	$163,520.64	nat. median $2,702 outlier · 60.5×
C1735 HCPCS	Catheter Renal 6fr	16	$46,550.91	$275,630.40	$153,893.64	nat. median $18,894 outlier · 8.1×
C1882 HCPCS	Crt-d Amplia Dtmb1qq	16	$18,387.90	$230,896.80	$149,412.48	nat. median $27,370 outlier · 5.5×
93656 CPT	Com Ep Repo Cth Tx Afib	12	$33,788.23	$200,061.90	$148,934.97	nat. median $27,253 outlier · 5.5×
C9293 HCPCS	Glucarpidase 1000 U Inj	17	$34,901.78	$206,655.30	$146,954.88	nat. median $30,181 outlier · 4.9×
835878 CDM	Stent Eprsth 34mm 10cm	16	$33,118.22	$196,094.70	$141,623.95	nat. median $199 outlier · 711.7×
819686 CDM	Stent Eprsth 31mm 10cm	16	$33,118.22	$196,094.70	$141,623.95	nat. median $111 outlier · 1280.2×
959471 CDM	Perc Clsr Lt Atrl W/imp	15	$31,781.53	$188,180.10	$133,816.96	nat. median $76,029 1.8× median
779092 CDM	Perc Oclsn Lt Artrl Apnd	15	$31,248.16	$185,022.00	$131,571.20	nat. median $1,797 outlier · 73.2×
C1820 HCPCS	Device Neurostimulator	16	$22,162.06	$254,676.60	$131,277.60	nat. median $22,969 outlier · 5.7×
J7330 HCPCS	Autolog Chondro Implant	17	$41,323.94	$244,681.20	$129,681.04	nat. median $75,037 1.7× median
563715 CDM	Implant Crnfcl Small	16	$30,004.19	$177,656.40	$128,307.40	nat. median $128,307 1.0× median
872010 CDM	Graft Evas 26x14.5m 14cm	16	$29,952.66	$177,351.30	$128,087.05	nat. median $61,144 outlier · 2.1×
568954 CDM	Graft Bn Elbw Algrf Frzn	16	$29,776.50	$176,308.20	$127,333.70	nat. median $25 outlier · 5040.9×
955643 CDM	Ins Icd Gen W Dual Lead	15	$29,253.46	$173,211.30	$123,172.48	nat. median $43,151 outlier · 2.9×
C1767 HCPCS	Generator Nrstm 5 Ipg	16	$7,550.48	$512,099.10	$122,768.00	nat. median $23,881 outlier · 5.1×
779721 CDM	Kit Prfsn Bypass Tube	17	$37,822.62	$223,949.70	$118,693.34	nat. median $39,160 outlier · 3.0×
955645 CDM	Rmv Icd W Rplc Sgl Ld	15	$27,994.30	$165,755.70	$117,870.72	nat. median $25,193 outlier · 4.7×
967441 CDM	Graft Bn Fem Medial Left	16	$26,962.37	$159,645.60	$115,299.60	nat. median $46,563 outlier · 2.5×
562607 CDM	Graft Endo Aaa 36x14mm	16	$26,314.54	$155,809.80	$112,529.30	nat. median $24,270 outlier · 4.6×
999395 CDM	Nrstm Impl 60mm Fsn Spn	16	$25,489.64	$150,925.50	$109,001.75	nat. median $75,463 1.4× median
786191 CDM	Pacemaker Card U228	16	$25,406.34	$150,432.30	$108,645.55	nat. median $106,974 1.0× median
872798 CDM	Guide Dev 6140 Episense	17	$34,113.21	$201,986.10	$107,052.63	nat. median $273 outlier · 391.7×
975598 CDM	Graft Bn Hemi Condrl Rt	16	$24,721.28	$146,376.00	$105,716.00	nat. median $2,085 outlier · 50.7×
E0749 HCPCS	Stim Bn Ostgn Spf Spnl	14	$23,521.70	$139,273.20	$104,454.90	nat. median $2,843 outlier · 36.7×
867110 CDM	Graft Evas 14.5mm 12cm	16	$24,014.18	$142,189.20	$102,692.20	nat. median $38,911 outlier · 2.6×
872011 CDM	Graft Evas 14.5mm 14cm	16	$24,014.18	$142,189.20	$102,692.20	nat. median $10,450 outlier · 9.8×
C1722 HCPCS	Defib Card .99cm 5.37x7.	16	$19,773.83	$251,278.20	$100,423.40	nat. median $20,902 outlier · 4.8×
895204 CDM	Graft Evas 10cm 10mm	16	$23,453.90	$138,871.80	$100,296.30	nat. median $19,521 outlier · 5.1×
866765 CDM	Graft Evas 31x14.5m 15cm	16	$23,314.37	$138,045.60	$99,699.60	nat. median $43,974 outlier · 2.3×
891885 CDM	Occluder Cv 35x18mm	16	$23,314.37	$138,045.60	$99,699.60	nat. median $18,796 outlier · 5.3×
851481 CDM	Graft Evas 35x14.5m 16cm	16	$23,314.37	$138,045.60	$99,699.60	nat. median $1,122 outlier · 88.9×
891884 CDM	Occluder Cv 18x18mm	16	$23,314.37	$138,045.60	$99,699.60	nat. median $2,886 outlier · 34.6×
872023 CDM	Graft Evas 14.5mm 18cm	16	$23,314.37	$138,045.60	$99,699.60	nat. median $25,738 outlier · 3.9×
872022 CDM	Graft Evas 28.5x12m 18cm	16	$23,314.37	$138,045.60	$99,699.60	nat. median $97 outlier · 1031.8×
866168 CDM	Graft Evas 31x14.5m 17cm	16	$23,314.37	$138,045.60	$99,699.60	nat. median $22,239 outlier · 4.5×
C1721 HCPCS	Defib Card 2ch Df4/is-1	16	$15,766.50	$156,071.70	$98,135.10	nat. median $22,368 outlier · 4.4×

Other procedures at this hospital

Browse this hospital's 27,093 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

866933	CDM	Set Pump 21fr 5.0	35	17	$478,525.00	$478,525.00	$72,735.80	$430,672.50	$228,256.42	2026-03-01
863779	CDM	Set Vntrc 17.4x13.8in	35	17	$478,525.00	$478,525.00	$72,735.80	$430,672.50	$228,256.42	2026-03-01
589193	CDM	Kit Lo Prfl Comp Shth 7f	35	17	$478,525.00	$478,525.00	$72,735.80	$430,672.50	$228,256.42	2026-03-01
494787	CDM	Graft Bn Dist Fem Rt	23	16	$319,960.00	$319,960.00	$48,633.92	$287,964.00	$207,974.00	2026-03-01
778799	CDM	Graft Evas 45x45mm 10cm	23	16	$294,581.00	$294,581.00	$44,776.31	$265,122.90	$191,477.65	2026-03-01
955647	CDM	Rmv Icd W Rplc Mult Ld	29	15	$297,644.00	$297,644.00	$45,241.89	$267,879.60	$190,492.16	2026-03-01
C1822	HCPCS	Pulse Gen Imp	23	16	$291,574.00	$291,574.00	$44,319.25	$262,416.60	$189,523.10	2026-03-01
93654	CPT	Ep Repos Ele Vt 3d Map	18	12	$260,605.00	$260,605.00	$39,611.96	$234,544.50	$174,605.35	2026-07-17
883402	CDM	Ins/repl Subq Imp Icd Sy	29	15	$268,548.00	$268,548.00	$40,819.30	$241,693.20	$171,870.72	2026-03-01
C2616	HCPCS	Brachytx Ns Yttrium 90	19	13	$260,882.00	$260,882.00	$39,654.06	$234,793.80	$169,573.30	2026-07-17
783359	CDM	Stnt Thorac 28x28mm 10cm	23	16	$257,365.00	$257,365.00	$39,119.48	$231,628.50	$167,287.25	2026-03-01
943426	CDM	Inst/rp Gen Sg/dl Icd	29	15	$258,820.00	$258,820.00	$39,340.64	$232,938.00	$165,644.80	2026-03-01
955644	CDM	Ins Icd Gen W Mult Lead	29	15	$258,820.00	$258,820.00	$39,340.64	$232,938.00	$165,644.80	2026-03-01
J9999	HCPCS	Carmustine Wafers 8/box	31	17	$255,501.00	$255,501.00	$38,836.15	$229,950.90	$163,520.64	2026-03-01
C1735	HCPCS	Catheter Renal 6fr	32	16	$306,256.00	$306,256.00	$46,550.91	$275,630.40	$153,893.64	2026-03-01
C1882	HCPCS	Crt-d Amplia Dtmb1qq	253	16	$233,457.00	$233,457.00	$18,387.90	$230,896.80	$149,412.48	2026-03-01
93656	CPT	Com Ep Repo Cth Tx Afib	18	12	$222,291.00	$222,291.00	$33,788.23	$200,061.90	$148,934.97	2026-07-17
C9293	HCPCS	Glucarpidase 1000 U Inj	31	17	$229,617.00	$229,617.00	$34,901.78	$206,655.30	$146,954.88	2026-03-01
835878	CDM	Stent Eprsth 34mm 10cm	23	16	$217,883.00	$217,883.00	$33,118.22	$196,094.70	$141,623.95	2026-03-01
819686	CDM	Stent Eprsth 31mm 10cm	23	16	$217,883.00	$217,883.00	$33,118.22	$196,094.70	$141,623.95	2026-03-01
959471	CDM	Perc Clsr Lt Atrl W/imp	29	15	$209,089.00	$209,089.00	$31,781.53	$188,180.10	$133,816.96	2026-03-01
779092	CDM	Perc Oclsn Lt Artrl Apnd	29	15	$205,580.00	$205,580.00	$31,248.16	$185,022.00	$131,571.20	2026-03-01
C1820	HCPCS	Device Neurostimulator	161	16	$234,794.00	$234,794.00	$22,162.06	$254,676.60	$131,277.60	2026-03-01
J7330	HCPCS	Autolog Chondro Implant	35	17	$271,868.00	$271,868.00	$41,323.94	$244,681.20	$129,681.04	2026-07-17
563715	CDM	Implant Crnfcl Small	23	16	$197,396.00	$197,396.00	$30,004.19	$177,656.40	$128,307.40	2026-03-01
872010	CDM	Graft Evas 26x14.5m 14cm	23	16	$197,057.00	$197,057.00	$29,952.66	$177,351.30	$128,087.05	2026-03-01
568954	CDM	Graft Bn Elbw Algrf Frzn	23	16	$195,898.00	$195,898.00	$29,776.50	$176,308.20	$127,333.70	2026-03-01
955643	CDM	Ins Icd Gen W Dual Lead	29	15	$192,457.00	$192,457.00	$29,253.46	$173,211.30	$123,172.48	2026-03-01
C1767	HCPCS	Generator Nrstm 5 Ipg	230	16	$190,290.50	$190,290.50	$7,550.48	$512,099.10	$122,768.00	2026-03-01
779721	CDM	Kit Prfsn Bypass Tube	35	17	$248,833.00	$248,833.00	$37,822.62	$223,949.70	$118,693.34	2026-03-01
955645	CDM	Rmv Icd W Rplc Sgl Ld	29	15	$184,173.00	$184,173.00	$27,994.30	$165,755.70	$117,870.72	2026-03-01
967441	CDM	Graft Bn Fem Medial Left	23	16	$177,384.00	$177,384.00	$26,962.37	$159,645.60	$115,299.60	2026-03-01
562607	CDM	Graft Endo Aaa 36x14mm	23	16	$173,122.00	$173,122.00	$26,314.54	$155,809.80	$112,529.30	2026-03-01
999395	CDM	Nrstm Impl 60mm Fsn Spn	23	16	$167,695.00	$167,695.00	$25,489.64	$150,925.50	$109,001.75	2026-03-01
786191	CDM	Pacemaker Card U228	23	16	$167,147.00	$167,147.00	$25,406.34	$150,432.30	$108,645.55	2026-03-01
872798	CDM	Guide Dev 6140 Episense	35	17	$224,429.00	$224,429.00	$34,113.21	$201,986.10	$107,052.63	2026-03-01
975598	CDM	Graft Bn Hemi Condrl Rt	23	16	$162,640.00	$162,640.00	$24,721.28	$146,376.00	$105,716.00	2026-03-01
E0749	HCPCS	Stim Bn Ostgn Spf Spnl	20	14	$154,748.00	$154,748.00	$23,521.70	$139,273.20	$104,454.90	2026-07-17
867110	CDM	Graft Evas 14.5mm 12cm	23	16	$157,988.00	$157,988.00	$24,014.18	$142,189.20	$102,692.20	2026-03-01
872011	CDM	Graft Evas 14.5mm 14cm	23	16	$157,988.00	$157,988.00	$24,014.18	$142,189.20	$102,692.20	2026-03-01
C1722	HCPCS	Defib Card .99cm 5.37x7.	230	16	$151,248.50	$151,248.50	$19,773.83	$251,278.20	$100,423.40	2026-03-01
895204	CDM	Graft Evas 10cm 10mm	23	16	$154,302.00	$154,302.00	$23,453.90	$138,871.80	$100,296.30	2026-03-01
891884	CDM	Occluder Cv 18x18mm	23	16	$153,384.00	$153,384.00	$23,314.37	$138,045.60	$99,699.60	2026-03-01
851481	CDM	Graft Evas 35x14.5m 16cm	23	16	$153,384.00	$153,384.00	$23,314.37	$138,045.60	$99,699.60	2026-03-01
891885	CDM	Occluder Cv 35x18mm	23	16	$153,384.00	$153,384.00	$23,314.37	$138,045.60	$99,699.60	2026-03-01
866765	CDM	Graft Evas 31x14.5m 15cm	23	16	$153,384.00	$153,384.00	$23,314.37	$138,045.60	$99,699.60	2026-03-01
872022	CDM	Graft Evas 28.5x12m 18cm	23	16	$153,384.00	$153,384.00	$23,314.37	$138,045.60	$99,699.60	2026-03-01
872023	CDM	Graft Evas 14.5mm 18cm	23	16	$153,384.00	$153,384.00	$23,314.37	$138,045.60	$99,699.60	2026-03-01
866168	CDM	Graft Evas 31x14.5m 17cm	23	16	$153,384.00	$153,384.00	$23,314.37	$138,045.60	$99,699.60	2026-03-01
C1721	HCPCS	Defib Card 2ch Df4/is-1	207	16	$149,558.00	$149,558.00	$15,766.50	$156,071.70	$98,135.10	2026-03-01
862138	CDM	Graft Evas 23x14.5m14cm	23	16	$150,544.00	$150,544.00	$22,882.69	$135,489.60	$97,853.60	2026-03-01
872013	CDM	Graft Evas 35x14.5m 18cm	23	16	$150,544.00	$150,544.00	$22,882.69	$135,489.60	$97,853.60	2026-03-01
872021	CDM	Graft Evas 26x14.5m 18cm	23	16	$150,544.00	$150,544.00	$22,882.69	$135,489.60	$97,853.60	2026-03-01
872014	CDM	Graft Evas 23x14.5m 16cm	23	16	$150,544.00	$150,544.00	$22,882.69	$135,489.60	$97,853.60	2026-03-01
872005	CDM	Graft Evas 23x14.5m 12cm	23	16	$150,544.00	$150,544.00	$22,882.69	$135,489.60	$97,853.60	2026-03-01
879797	CDM	Graft Evas 10cm 14.5mm	23	16	$150,544.00	$150,544.00	$22,882.69	$135,489.60	$97,853.60	2026-03-01
872018	CDM	Graft Evas 14.5mm 16cm	23	16	$146,157.00	$146,157.00	$22,215.86	$131,541.30	$95,002.05	2026-03-01
872008	CDM	Graft Evas 26x12mm 14cm	23	16	$146,157.00	$146,157.00	$22,215.86	$131,541.30	$95,002.05	2026-03-01
606075	CDM	Pack Cath Gd Vasc 100cm	35	17	$191,391.00	$191,391.00	$29,091.43	$172,251.90	$91,293.51	2026-03-01
606089	CDM	Pack Cath Vasc 80cm	35	17	$191,391.00	$191,391.00	$29,091.43	$172,251.90	$91,293.51	2026-03-01
606072	CDM	Pack Cath Gd Vasc 100cm	35	17	$191,391.00	$191,391.00	$29,091.43	$172,251.90	$91,293.51	2026-03-01
606065	CDM	Pack Cath Gd Vasc 115cm	35	17	$191,391.00	$191,391.00	$29,091.43	$172,251.90	$91,293.51	2026-03-01
606074	CDM	Pack Cath Gd Vasc 100cm	35	17	$191,391.00	$191,391.00	$29,091.43	$172,251.90	$91,293.51	2026-03-01
606070	CDM	Pack Cath Gd Vasc 80cm	35	17	$191,391.00	$191,391.00	$29,091.43	$172,251.90	$91,293.51	2026-03-01
606063	CDM	Pack Cath Gd Vasc 100cm	35	17	$191,391.00	$191,391.00	$29,091.43	$172,251.90	$91,293.51	2026-03-01
606060	CDM	Pack Cath Gd Vasc 100cm	35	17	$191,391.00	$191,391.00	$29,091.43	$172,251.90	$91,293.51	2026-03-01
606071	CDM	Pack Cath Gd Vasc 80cm	35	17	$191,391.00	$191,391.00	$29,091.43	$172,251.90	$91,293.51	2026-03-01
606067	CDM	Pack Cath Gd Vasc 115cm	35	17	$191,391.00	$191,391.00	$29,091.43	$172,251.90	$91,293.51	2026-03-01
955642	CDM	Rmv Ppm W Rplc Mult Ld	29	15	$142,051.00	$142,051.00	$21,591.75	$127,845.90	$90,912.64	2026-03-01
551227	CDM	Cage Spn Sz A 25mm	23	16	$136,170.00	$136,170.00	$20,697.84	$122,553.00	$88,510.50	2026-03-01
775018	CDM	Cage Spnl Cntrpc 13mm	23	16	$136,170.00	$136,170.00	$20,697.84	$122,553.00	$88,510.50	2026-03-01
551229	CDM	Cage Spn Sz E 13mm	23	16	$136,170.00	$136,170.00	$20,697.84	$122,553.00	$88,510.50	2026-03-01
949704	CDM	Ins Temp Pacer Dual	29	15	$137,792.00	$137,792.00	$20,944.38	$124,012.80	$88,186.88	2026-03-01
93655	CPT	Ep Intracard Dx Tx	22	15	$131,259.00	$131,259.00	$19,951.37	$118,133.10	$87,943.53	2026-07-17
575080	CDM	Endplate Spnl 43-65x20mm	23	16	$130,951.00	$130,951.00	$19,904.55	$117,855.90	$85,118.15	2026-03-01
865425	CDM	Graft Algrf Disc 20mm	23	16	$129,200.00	$129,200.00	$19,638.40	$116,280.00	$83,980.00	2026-03-01
975513	CDM	Gft Bfur 36-18x155 24fr	23	16	$127,418.00	$127,418.00	$19,367.54	$114,676.20	$82,821.70	2026-03-01
957980	CDM	Prc D-e Cor Revsc Ami Ld	29	16	$129,073.00	$129,073.00	$19,619.10	$116,165.70	$82,606.72	2026-03-01
957986	CDM	Prc D-e Cor Revsc Chrnlc	29	16	$129,073.00	$129,073.00	$19,619.10	$116,165.70	$82,606.72	2026-03-01
957982	CDM	Prc D-e Cor Revsc Ami Rc	29	16	$129,073.00	$129,073.00	$19,619.10	$116,165.70	$82,606.72	2026-03-01
957989	CDM	Prc D-e Cor Revsc Chrnrc	29	16	$129,073.00	$129,073.00	$19,619.10	$116,165.70	$82,606.72	2026-03-01
583745	CDM	Cath Vasc Acc 6fr	35	17	$171,312.00	$171,312.00	$26,039.42	$154,180.80	$81,715.82	2026-03-01
883569	CDM	Tiss Abl Lmtd Without Bypass	29	15	$126,499.00	$126,499.00	$19,227.85	$113,849.10	$80,959.36	2026-03-01
791942	CDM	Valve Aortic 29mm	23	16	$124,296.00	$124,296.00	$18,892.99	$111,866.40	$80,792.40	2026-03-01
793098	CDM	Valve Aortic 25mm	23	16	$124,296.00	$124,296.00	$18,892.99	$111,866.40	$80,792.40	2026-03-01
791943	CDM	Valve Aortic 19mm	23	16	$124,296.00	$124,296.00	$18,892.99	$111,866.40	$80,792.40	2026-03-01
953034	CDM	Revasc Fem/pop Stnt/ath	29	15	$124,682.00	$124,682.00	$18,951.66	$112,213.80	$79,796.48	2026-03-01
952975	CDM	Trns Peri Ath Brch Trnk	29	15	$122,718.00	$122,718.00	$18,653.14	$110,446.20	$78,539.52	2026-03-01
953037	CDM	Revasc Tib W Stntplc Ini	29	15	$122,718.00	$122,718.00	$18,653.14	$110,446.20	$78,539.52	2026-03-01
953004	CDM	Revasc Tib Stnt/ath Init	29	15	$122,718.00	$122,718.00	$18,653.14	$110,446.20	$78,539.52	2026-03-01
953009	CDM	Trns Peri Ath Iliac Art	29	15	$122,718.00	$122,718.00	$18,653.14	$110,446.20	$78,539.52	2026-03-01
953002	CDM	Revasc Tib W Ath Init	29	15	$122,718.00	$122,718.00	$18,653.14	$110,446.20	$78,539.52	2026-03-01
953038	CDM	Revasc Tib Stnt/ath Init	29	15	$122,718.00	$122,718.00	$18,653.14	$110,446.20	$78,539.52	2026-03-01
554282	CDM	Cage Spn Interbdy 12mm	23	16	$120,465.00	$120,465.00	$18,310.68	$108,418.50	$78,302.25	2026-03-01
773834	CDM	Cage Spnl 40x13mm	23	16	$120,465.00	$120,465.00	$18,310.68	$108,418.50	$78,302.25	2026-03-01
771793	CDM	Cage Spnl 36x24x10mm 12d	23	16	$120,465.00	$120,465.00	$18,310.68	$108,418.50	$78,302.25	2026-03-01
570741	CDM	Graft Drms Ptch 16x20cm	23	16	$118,713.00	$118,713.00	$18,044.38	$106,841.70	$77,163.45	2026-03-01
567634	CDM	Spacer Tissue Shldr Med	23	16	$118,535.00	$118,535.00	$18,017.32	$106,681.50	$77,047.75	2026-03-01
794827	CDM	Valve Aortic 27mm	23	16	$116,911.00	$116,911.00	$17,770.47	$105,219.90	$75,992.15	2026-03-01
792605	CDM	Valve Aortic 21mm	23	16	$116,911.00	$116,911.00	$17,770.47	$105,219.90	$75,992.15	2026-03-01
953042	CDM	Revasc Tib Stnt/ath Add	29	15	$118,442.00	$118,442.00	$18,003.18	$106,597.80	$75,802.88	2026-03-01
820466	CDM	Cage Spnl 27-38mm 20mm	23	16	$116,519.00	$116,519.00	$17,710.89	$104,867.10	$75,737.35	2026-03-01
824217	CDM	Graft Nrv 2-3mm 70mm	23	16	$113,247.00	$113,247.00	$17,213.54	$101,922.30	$73,610.55	2026-03-01
835665	CDM	Graft Bn Rt Hum Hd Algrf	23	16	$113,104.00	$113,104.00	$17,191.81	$101,793.60	$73,517.60	2026-03-01
836325	CDM	Spacer Vert Ti 6d Sm H24	23	16	$110,970.00	$110,970.00	$16,867.44	$99,873.00	$72,130.50	2026-03-01
834677	CDM	Spcr Spn 12x16-25 Sm Ti	23	16	$110,970.00	$110,970.00	$16,867.44	$99,873.00	$72,130.50	2026-03-01
818842	CDM	Cage Spnl 16-25mm 12mm S	23	16	$110,970.00	$110,970.00	$16,867.44	$99,873.00	$72,130.50	2026-03-01
C1813	HCPCS	Ams Penile Prosthesis Re	184	16	$113,714.00	$113,714.00	$1,360.10	$150,410.70	$71,893.12	2026-03-01
957975	CDM	Prc D-el Cor Stnt Ath Rc	29	16	$112,238.00	$112,238.00	$17,060.18	$101,014.20	$71,832.32	2026-03-01
957976	CDM	Prc D-el Cor Stnt Ath Ri	29	16	$112,238.00	$112,238.00	$17,060.18	$101,014.20	$71,832.32	2026-03-01
957892	CDM	Prc D-el Cor Stnt Ath Sl	29	16	$112,238.00	$112,238.00	$17,060.18	$101,014.20	$71,832.32	2026-03-01
949743	CDM	Per Cl Con Vt Sp Df W/im	29	16	$112,238.00	$112,238.00	$17,060.18	$101,014.20	$71,832.32	2026-03-01
893115	CDM	Per Clos Para Leak Aor	29	16	$112,238.00	$112,238.00	$17,060.18	$101,014.20	$71,832.32	2026-03-01
776941	CDM	Allograft Dermis 16x20cm	23	16	$109,919.00	$109,919.00	$16,707.69	$98,927.10	$71,447.35	2026-03-01
998953	CDM	Cage Spnl 30x10x25mm 6d	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
998955	CDM	Cage Spnl 37x14x27mm 6d	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
773897	CDM	Cage Spnl 40x14mm	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
562478	CDM	Cage Spnl 36x10mm	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
772920	CDM	Cage Spnl 40x13mm	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
777462	CDM	Cage Spnl Endo 36x14mm	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
558462	CDM	Cage Spnl 40x12mm	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
847814	CDM	Cage Spnl 30x14mm Mag+ 1	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
846653	CDM	Cage Spnl 37x12x27mm 12d	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
846892	CDM	Cage Spnl 41x16x27mm 12d	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
846462	CDM	Cage Spnl 37x14x27mm 6d	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
846461	CDM	Cage Spnl 30x12x25mm 6d	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
772718	CDM	Cage Spnl 36x12mm	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
839360	CDM	Cage Spnl 37x12x27mm 12d	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
842507	CDM	Cage Spnl 37x12x27mm 6d	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
851330	CDM	Cage Spnl 30x12x25mm 12d	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
836160	CDM	Cage Spnl 41x16x27mm 6d	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
835336	CDM	Cage Spnl 37x14x27mm 12d	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
831890	CDM	Cage Spnl 41x12x27mm 12d	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
774293	CDM	Cage Spnl 16deg 14mm	23	16	$109,121.00	$109,121.00	$16,586.39	$98,208.90	$70,928.65	2026-03-01
957977	CDM	Ptca Stn W Ath Sgl Lm	29	16	$110,469.00	$110,469.00	$16,791.29	$99,422.10	$70,700.16	2026-03-01
958398	CDM	Ptca Stn W Ath Sgl Ld	29	16	$110,469.00	$110,469.00	$16,791.29	$99,422.10	$70,700.16	2026-03-01
958399	CDM	Ptca Stn W Ath Sgl Rc	29	16	$110,469.00	$110,469.00	$16,791.29	$99,422.10	$70,700.16	2026-03-01
892447	CDM	Perc Mch Thrm Per W Stnt	29	15	$109,256.00	$109,256.00	$16,606.91	$98,330.40	$69,923.84	2026-03-01
647599	CDM	Cath Thrmb 150cm	35	17	$146,238.00	$146,238.00	$22,228.18	$131,614.20	$69,755.53	2026-03-01
C1817	HCPCS	Occluder Cv 10fr 32mm	207	16	$114,190.00	$114,190.00	$1,698.14	$125,684.10	$69,057.00	2026-03-01
998019	CDM	Spacer Spnl 26mmx9mm	23	16	$105,644.00	$105,644.00	$16,057.89	$95,079.60	$68,668.60	2026-03-01
988266	CDM	Cage Peek Ti Synfis -lr	23	16	$105,422.00	$105,422.00	$16,024.14	$94,879.80	$68,524.30	2026-03-01
973628	CDM	Spacer 30/38 17x12 Deg	23	16	$105,422.00	$105,422.00	$16,024.14	$94,879.80	$68,524.30	2026-03-01
844450	CDM	Spacer Spn 24x30x11mm	23	16	$105,422.00	$105,422.00	$16,024.14	$94,879.80	$68,524.30	2026-03-01
647801	CDM	Graft St Tis 12x22cm	23	16	$105,121.00	$105,121.00	$15,978.39	$94,608.90	$68,328.65	2026-03-01
996613	CDM	Graft Bn Lt Dist Tib Lg	23	16	$104,120.00	$104,120.00	$15,826.24	$93,708.00	$67,678.00	2026-03-01
801638	CDM	Cage Spnl Cg/infs Ti 20	23	16	$103,676.00	$103,676.00	$15,758.75	$93,308.40	$67,389.40	2026-03-01
988013	CDM	Cage Spnl Cg/infs Ti 23	23	16	$103,676.00	$103,676.00	$15,758.75	$93,308.40	$67,389.40	2026-03-01
C1821	HCPCS	Implnt Spn 10mm	23	16	$103,572.00	$103,572.00	$15,742.94	$93,214.80	$67,321.80	2026-03-01
778419	CDM	Graft St Tis Bioclns Rl	23	16	$103,362.00	$103,362.00	$15,711.02	$93,025.80	$67,185.30	2026-03-01
932546	CDM	Carotid Stent W Emb	29	15	$104,810.00	$104,810.00	$15,931.12	$94,329.00	$67,078.40	2026-03-01
932846	CDM	Carotid Stent W Emb	29	15	$104,810.00	$104,810.00	$15,931.12	$94,329.00	$67,078.40	2026-03-01
878299	CDM	Cage Spn Aero 13mm 26deg	23	16	$102,648.00	$102,648.00	$15,602.50	$92,383.20	$66,721.20	2026-03-01
879010	CDM	Cage Spnl 38x13mm	23	16	$102,648.00	$102,648.00	$15,602.50	$92,383.20	$66,721.20	2026-03-01
826676	CDM	Cage Spn 38x32x16mm 12d	23	16	$101,723.00	$101,723.00	$15,461.90	$91,550.70	$66,119.95	2026-03-01
826869	CDM	Cage Spinal 16x42x30 12d	23	16	$101,723.00	$101,723.00	$15,461.90	$91,550.70	$66,119.95	2026-03-01
974314	CDM	Spacer Synfx 26x32x12 8d	23	16	$101,723.00	$101,723.00	$15,461.90	$91,550.70	$66,119.95	2026-03-01
999659	CDM	Cage Spn Brigde 14x42x30	23	16	$101,723.00	$101,723.00	$15,461.90	$91,550.70	$66,119.95	2026-03-01
810827	CDM	Cage Spn 38x32x14mm 12d	23	16	$101,723.00	$101,723.00	$15,461.90	$91,550.70	$66,119.95	2026-03-01
963139	CDM	Spacer Spn Peek 12d 32x	23	16	$101,723.00	$101,723.00	$15,461.90	$91,550.70	$66,119.95	2026-03-01
851495	CDM	Spcr Spn 36x28x13mm	23	16	$101,538.00	$101,538.00	$15,433.78	$91,384.20	$65,999.70	2026-03-01
860955	CDM	Spacer Spn 30x24x13mm	23	16	$101,538.00	$101,538.00	$15,433.78	$91,384.20	$65,999.70	2026-03-01
872841	CDM	Spacer Spnl 30x40x15mm	23	16	$101,538.00	$101,538.00	$15,433.78	$91,384.20	$65,999.70	2026-03-01
897769	CDM	Coag Dvc Kit Cdp-4330-1	35	17	$137,828.00	$137,828.00	$20,949.86	$124,045.20	$65,743.96	2026-03-01
594161	CDM	Spacer Spn 0d 14x16x30mm	23	16	$100,706.00	$100,706.00	$15,307.31	$90,635.40	$65,458.90	2026-03-01
953033	CDM	Revasc Fem/pop W Stntplc	29	15	$101,566.00	$101,566.00	$15,438.03	$91,409.40	$65,002.24	2026-03-01
952999	CDM	Revasc Fem/pop W Stntplc	29	15	$101,566.00	$101,566.00	$15,438.03	$91,409.40	$65,002.24	2026-03-01
C2621	HCPCS	Crt-p 4.45x6.17x0.75cm	115	16	$98,232.00	$98,232.00	$12,850.38	$92,066.40	$64,952.96	2026-03-01
775311	CDM	Allograft Dermis 16x20cm	23	16	$99,926.00	$99,926.00	$15,188.75	$89,933.40	$64,951.90	2026-03-01
851165	CDM	Cage Spnl 30x40x14mm	23	16	$98,865.00	$98,865.00	$15,027.48	$88,978.50	$64,262.25	2026-03-01
997675	CDM	Grft Bn Tlus Fsh Frzn	23	16	$98,800.00	$98,800.00	$15,017.60	$88,920.00	$64,220.00	2026-03-01
831648	CDM	Grft Bn Allgrft Dist Tib	23	16	$98,800.00	$98,800.00	$15,017.60	$88,920.00	$64,220.00	2026-03-01
942355	CDM	Spacer 26/32 13.5x8 Deg	23	16	$98,764.00	$98,764.00	$15,012.13	$88,887.60	$64,196.60	2026-03-01
970251	CDM	Spacer 30/38 13.5x8 Deg	23	16	$98,764.00	$98,764.00	$15,012.13	$88,887.60	$64,196.60	2026-03-01
575046	CDM	Spacer Tissue Shldr Sm	23	16	$98,215.00	$98,215.00	$14,928.68	$88,393.50	$63,839.75	2026-03-01
986045	CDM	Valve Aortic 19mm	23	16	$97,975.00	$97,975.00	$14,892.20	$88,177.50	$63,683.75	2026-03-01
973071	CDM	Valve Aortic 29mm	23	16	$97,975.00	$97,975.00	$14,892.20	$88,177.50	$63,683.75	2026-03-01
886039	CDM	Device Suture Lariat 12f	35	17	$133,030.00	$133,030.00	$20,220.56	$119,727.00	$63,455.31	2026-03-01
860436	CDM	Valve Aor 34mm	23	16	$97,390.00	$97,390.00	$14,803.28	$87,651.00	$63,303.50	2026-03-01
830972	CDM	Valve Aor 32mm 21mm	23	16	$97,390.00	$97,390.00	$14,803.28	$87,651.00	$63,303.50	2026-03-01
830973	CDM	Valve Aortic 34mm	23	16	$97,390.00	$97,390.00	$14,803.28	$87,651.00	$63,303.50	2026-03-01
830974	CDM	Valve Heart Frstl 29mm	23	16	$97,390.00	$97,390.00	$14,803.28	$87,651.00	$63,303.50	2026-03-01
93621	CPT	Ep W/la Rec W/arrhythmia	22	15	$94,349.00	$94,349.00	$14,341.05	$84,914.10	$63,213.83	2026-07-17
93620	CPT	Ep W/arrhythmia	18	12	$94,349.00	$94,349.00	$14,341.05	$84,914.10	$63,213.83	2026-07-17
875276	CDM	Spacer Spnl 28x36x11mm C	23	16	$97,099.00	$97,099.00	$14,759.05	$87,389.10	$63,114.35	2026-03-01
863041	CDM	Spacer Spn 36x28x19mm	23	16	$97,099.00	$97,099.00	$14,759.05	$87,389.10	$63,114.35	2026-03-01
851496	CDM	Spcr Spn 36x28x15mm	23	16	$97,099.00	$97,099.00	$14,759.05	$87,389.10	$63,114.35	2026-03-01
890964	CDM	Spcr 14 X 12 X 20 Mm 5 D	23	16	$97,099.00	$97,099.00	$14,759.05	$87,389.10	$63,114.35	2026-03-01
789471	CDM	Cage Spn Endsklt 32x12mm	23	16	$97,099.00	$97,099.00	$14,759.05	$87,389.10	$63,114.35	2026-03-01
789355	CDM	Cage 13mm Lrg Endoskelet	23	16	$97,099.00	$97,099.00	$14,759.05	$87,389.10	$63,114.35	2026-03-01
790362	CDM	Cage Spn Bs 34x24x8mm15d	23	16	$97,099.00	$97,099.00	$14,759.05	$87,389.10	$63,114.35	2026-03-01
788851	CDM	Cage Spn 12d 36x24x13mm	23	16	$97,099.00	$97,099.00	$14,759.05	$87,389.10	$63,114.35	2026-03-01
790108	CDM	Cage Spnl 12d 36mm 15mm	23	16	$97,099.00	$97,099.00	$14,759.05	$87,389.10	$63,114.35	2026-03-01
790279	CDM	Cage Spnl 32x10mm	23	16	$97,099.00	$97,099.00	$14,759.05	$87,389.10	$63,114.35	2026-03-01
789356	CDM	Cage Endoskltn Tas 7d 14	23	16	$97,099.00	$97,099.00	$14,759.05	$87,389.10	$63,114.35	2026-03-01
790281	CDM	Cage Spnl 36x17mm Endosk	23	16	$97,099.00	$97,099.00	$14,759.05	$87,389.10	$63,114.35	2026-03-01
566174	CDM	Cage Spnl Long 7mm	23	16	$96,174.00	$96,174.00	$14,618.45	$86,556.60	$62,513.10	2026-03-01
552022	CDM	Cage Spnl Fusion 7mm	23	16	$96,174.00	$96,174.00	$14,618.45	$86,556.60	$62,513.10	2026-03-01
568489	CDM	Cage Spn Short 9mm	23	16	$96,174.00	$96,174.00	$14,618.45	$86,556.60	$62,513.10	2026-03-01
569065	CDM	Cage Spnl Long 9mm	23	16	$96,174.00	$96,174.00	$14,618.45	$86,556.60	$62,513.10	2026-03-01
568547	CDM	Spacer Spn Shrt 7mm	23	16	$96,174.00	$96,174.00	$14,618.45	$86,556.60	$62,513.10	2026-03-01
568268	CDM	Spacer Spnl Lng 11mm	23	16	$96,174.00	$96,174.00	$14,618.45	$86,556.60	$62,513.10	2026-03-01
861975	CDM	Cage Spn X-cor2 18x24-33	23	16	$95,666.00	$95,666.00	$14,541.23	$86,099.40	$62,182.90	2026-03-01
556229	CDM	Graft Bn Dist Tib Lt	23	16	$94,895.00	$94,895.00	$14,424.04	$85,405.50	$61,681.75	2026-03-01
988061	CDM	Cage Spn 35x10x12mm 5d	23	16	$94,843.00	$94,843.00	$14,416.14	$85,358.70	$61,647.95	2026-03-01
779245	CDM	Disc Cerv 6x15x16mm	23	16	$93,791.00	$93,791.00	$14,256.23	$84,411.90	$60,964.15	2026-03-01
921477	CDM	Vlv Msc Aor 25 Hldr	23	16	$93,588.00	$93,588.00	$14,225.38	$84,229.20	$60,832.20	2026-03-01
958410	CDM	Rvsc Ami Stn Thrm Sgl Ld	29	16	$94,313.00	$94,313.00	$14,335.58	$84,881.70	$60,360.32	2026-03-01
957985	CDM	Rvsc Ami Stn Thrm Sgl Ri	29	16	$94,313.00	$94,313.00	$14,335.58	$84,881.70	$60,360.32	2026-03-01
957887	CDM	Rvsc Ami Stn Thrm Sgl	29	16	$94,313.00	$94,313.00	$14,335.58	$84,881.70	$60,360.32	2026-03-01
958411	CDM	Rvsc Ami Stn Thrm Sgl Rc	29	16	$94,313.00	$94,313.00	$14,335.58	$84,881.70	$60,360.32	2026-03-01
820519	CDM	Cage Spn 38x28x18mm 12d	23	16	$92,475.00	$92,475.00	$14,056.20	$83,227.50	$60,108.75	2026-03-01
822939	CDM	Cage Spnl 34x24x12mm 8d	23	16	$92,475.00	$92,475.00	$14,056.20	$83,227.50	$60,108.75	2026-03-01
978856	CDM	Cage Spnl 34x24x12mm 12d	23	16	$92,475.00	$92,475.00	$14,056.20	$83,227.50	$60,108.75	2026-03-01
921665	CDM	Cage Spnl 38x32x12mm	23	16	$92,475.00	$92,475.00	$14,056.20	$83,227.50	$60,108.75	2026-03-01
921664	CDM	Cage Spn 38x28x12mm 8d	23	16	$92,475.00	$92,475.00	$14,056.20	$83,227.50	$60,108.75	2026-03-01
796291	CDM	Spacer Spnl 40x31x15-8.2	23	16	$92,383.00	$92,383.00	$14,042.22	$83,144.70	$60,048.95	2026-03-01
995671	CDM	Transcth Stnt Plc In Vn	29	15	$93,048.00	$93,048.00	$14,143.30	$83,743.20	$59,550.72	2026-03-01
994783	CDM	Transcth Stnt Plc In Vn	29	15	$93,048.00	$93,048.00	$14,143.30	$83,743.20	$59,550.72	2026-03-01
994772	CDM	Transcth Stnt Plc Ia	29	15	$93,048.00	$93,048.00	$14,143.30	$83,743.20	$59,550.72	2026-03-01
953001	CDM	Revasc Tib W Angio Init	29	15	$92,986.00	$92,986.00	$14,133.87	$83,687.40	$59,511.04	2026-03-01
952998	CDM	Revasc Fem/pop W Atherct	29	15	$92,986.00	$92,986.00	$14,133.87	$83,687.40	$59,511.04	2026-03-01
953032	CDM	Revasc Fem/pop W Atherct	29	15	$92,986.00	$92,986.00	$14,133.87	$83,687.40	$59,511.04	2026-03-01
997333	CDM	Trnscth Pl Cca/ia Retro	29	15	$92,752.00	$92,752.00	$14,098.30	$83,476.80	$59,361.28	2026-03-01
994099	CDM	Cage Spnl 88mm 17mm 22mm	23	16	$90,993.00	$90,993.00	$13,830.94	$81,893.70	$59,145.45	2026-03-01
773698	CDM	Disc Spn Intbrtb 19x6x17	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
595986	CDM	Disc Spn 17mm 19mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
796494	CDM	Disc Spnl Std 5x17x17mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
587244	CDM	Implant Spn Disc 13x17mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
773942	CDM	Disc Spn Intbrtb 19x5x17	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
851427	CDM	Disc Intvrtb 15x15mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
851426	CDM	Disc Spnl Mobi-c 15x15x5	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
851432	CDM	Disc Intvrtb 15x6x13mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
546711	CDM	Disc Cerv 6x15x15mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
848863	CDM	Disc Intvrtb 15x5x13mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
792941	CDM	Disc Intvrtb 6x17x17mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
850217	CDM	Disc Intvrtb 17x6x13mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
847415	CDM	Disc Spnl 13x17x5mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
596459	CDM	Disc Spn 15x19x4.5mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
847801	CDM	Disc Intvrtb 17mm 5mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
847802	CDM	Disc Intvrtb 19x5x15mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
846578	CDM	Disc Intvrtb 17x6x15mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
578336	CDM	Implant Spn Lg-deep 5mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
594099	CDM	Disc Spnintvrtb4.5x15x15	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
586967	CDM	Implant Spn Lg 5mm	23	16	$90,626.00	$90,626.00	$13,775.15	$81,563.40	$58,906.90	2026-03-01
787138	CDM	Cage Spn Bs 34x24x6mm15d	23	16	$90,349.00	$90,349.00	$13,733.05	$81,314.10	$58,726.85	2026-03-01
891717	CDM	Cage Spnl 15d 8x38x28mm	23	16	$90,349.00	$90,349.00	$13,733.05	$81,314.10	$58,726.85	2026-03-01
891343	CDM	Cage Spnl 38x28x10mm 15d	23	16	$90,349.00	$90,349.00	$13,733.05	$81,314.10	$58,726.85	2026-03-01
786511	CDM	Cage Endoskltn Lg 11mm	23	16	$90,349.00	$90,349.00	$13,733.05	$81,314.10	$58,726.85	2026-03-01
792818	CDM	Cage Spnl 38x28x6mm Bs 2	23	16	$90,349.00	$90,349.00	$13,733.05	$81,314.10	$58,726.85	2026-03-01
926037	CDM	Cage Spnl 8x38x28mm	23	16	$90,349.00	$90,349.00	$13,733.05	$81,314.10	$58,726.85	2026-03-01
898777	CDM	Evas Rpr Infr Ao Nonrupt	29	15	$90,559.00	$90,559.00	$13,764.97	$81,503.10	$57,957.76	2026-03-01
788716	CDM	Cage Spn 14d 30mm 10mm	23	16	$88,961.00	$88,961.00	$13,522.07	$80,064.90	$57,824.65	2026-03-01
783133	CDM	Cage Spn 14d 36x16mm	23	16	$88,961.00	$88,961.00	$13,522.07	$80,064.90	$57,824.65	2026-03-01
995682	CDM	Vasc Emboliz Arterial	29	15	$90,221.00	$90,221.00	$13,713.59	$81,198.90	$57,741.44	2026-03-01
892696	CDM	Vasc Emb/occ Prm Dial	29	15	$90,221.00	$90,221.00	$13,713.59	$81,198.90	$57,741.44	2026-03-01
994799	CDM	Vasc Emboliz Venous	29	15	$90,221.00	$90,221.00	$13,713.59	$81,198.90	$57,741.44	2026-03-01
994800	CDM	Vasc Emboliz Arterial	29	15	$90,221.00	$90,221.00	$13,713.59	$81,198.90	$57,741.44	2026-03-01
994810	CDM	Vasc Embol Art Ven Hem	29	15	$90,221.00	$90,221.00	$13,713.59	$81,198.90	$57,741.44	2026-03-01
987029	CDM	Spacer Spn 24x10x11mm	23	16	$88,610.00	$88,610.00	$13,468.72	$79,749.00	$57,596.50	2026-03-01
993251	CDM	Spacer Spnl 28x10x9mm Op	23	16	$88,610.00	$88,610.00	$13,468.72	$79,749.00	$57,596.50	2026-03-01
952974	CDM	Trns Peri Ath Brch Trnk	29	15	$89,094.00	$89,094.00	$13,542.29	$80,184.60	$57,020.16	2026-03-01
986653	CDM	Valve Aor 23mm	23	16	$87,665.00	$87,665.00	$13,325.08	$78,898.50	$56,982.25	2026-03-01
970120	CDM	Valve Aortic 25mm	23	16	$87,665.00	$87,665.00	$13,325.08	$78,898.50	$56,982.25	2026-03-01
814276	CDM	Valve Trfcta 18x25x31mm	23	16	$87,665.00	$87,665.00	$13,325.08	$78,898.50	$56,982.25	2026-03-01
970702	CDM	Valve Aortic 27mm	23	16	$87,665.00	$87,665.00	$13,325.08	$78,898.50	$56,982.25	2026-03-01
921604	CDM	Valve Mitral 25mm	23	16	$87,665.00	$87,665.00	$13,325.08	$78,898.50	$56,982.25	2026-03-01
920628	CDM	Graft Bn Lgii 8cc 3x4in	23	16	$87,172.00	$87,172.00	$13,250.14	$78,454.80	$56,661.80	2026-03-01
868749	CDM	Endplate Spnl 16x6mm Scr	23	16	$86,927.00	$86,927.00	$13,212.90	$78,234.30	$56,502.55	2026-03-01
963552	CDM	Spacer Spn 0d 8mm 25mm	23	16	$86,712.00	$86,712.00	$13,180.22	$78,040.80	$56,362.80	2026-03-01
940226	CDM	Spacer Spnl 25x11mm	23	16	$86,712.00	$86,712.00	$13,180.22	$78,040.80	$56,362.80	2026-03-01
814277	CDM	Valve Trfcta 16x26x21mm	23	16	$86,203.00	$86,203.00	$13,102.86	$77,582.70	$56,031.95	2026-03-01
813201	CDM	Valve Trfcta 17x28x23mm	23	16	$86,203.00	$86,203.00	$13,102.86	$77,582.70	$56,031.95	2026-03-01
952968	CDM	Trns Peri Ath Renal Art	29	15	$87,503.00	$87,503.00	$13,300.46	$78,752.70	$56,001.92	2026-03-01
932845	CDM	Carotid Stent Wo Emb	29	15	$87,342.00	$87,342.00	$13,275.98	$78,607.80	$55,898.88	2026-03-01
837926	CDM	Filler Bn Ca Phos 10ml	23	16	$85,840.00	$85,840.00	$13,047.68	$77,256.00	$55,796.00	2026-03-01
958404	CDM	Ptca Rvs Gft Stnt Sgl Ld	29	16	$85,826.00	$85,826.00	$13,045.55	$77,243.40	$54,928.64	2026-03-01
957998	CDM	Ptca Rvs Gft Stnt Sgl Lm	29	16	$85,826.00	$85,826.00	$13,045.55	$77,243.40	$54,928.64	2026-03-01
957999	CDM	Ptca Rvs Gft Stnt Sgl Ri	29	16	$85,826.00	$85,826.00	$13,045.55	$77,243.40	$54,928.64	2026-03-01
957885	CDM	Ptca Rvsc Grft Stnt Sgl	29	16	$85,826.00	$85,826.00	$13,045.55	$77,243.40	$54,928.64	2026-03-01
869785	CDM	Sys Reflux Mgmt Bead 17	23	16	$84,403.00	$84,403.00	$12,829.26	$75,962.70	$54,861.95	2026-03-01
869783	CDM	Sys Reflux Mgmt Bead 15	23	16	$84,403.00	$84,403.00	$12,829.26	$75,962.70	$54,861.95	2026-03-01
869781	CDM	System Gs Impl Anrflx	23	16	$84,403.00	$84,403.00	$12,829.26	$75,962.70	$54,861.95	2026-03-01
849355	CDM	Cage 36mm 14mm	23	16	$84,338.00	$84,338.00	$12,819.38	$75,904.20	$54,819.70	2026-03-01
647210	CDM	Cage Spn 6d 40x28x14mm	23	16	$84,338.00	$84,338.00	$12,819.38	$75,904.20	$54,819.70	2026-03-01
877983	CDM	Disc Intvrt 7x16x17.8mm	23	16	$84,153.00	$84,153.00	$12,791.26	$75,737.70	$54,699.45	2026-03-01
876329	CDM	Disc Intvrt 7x18x17.8mm	23	16	$84,153.00	$84,153.00	$12,791.26	$75,737.70	$54,699.45	2026-03-01
796235	CDM	Disc Intvrt 5x16x15mm	23	16	$84,153.00	$84,153.00	$12,791.26	$75,737.70	$54,699.45	2026-03-01
873804	CDM	Disc Spn Cerv 6mm 14mm	23	16	$84,153.00	$84,153.00	$12,791.26	$75,737.70	$54,699.45	2026-03-01
869974	CDM	Disc Intvrt 6x16x17.8mm	23	16	$84,153.00	$84,153.00	$12,791.26	$75,737.70	$54,699.45	2026-03-01
872186	CDM	Disc Intvrt 7x14x17.8mm	23	16	$84,153.00	$84,153.00	$12,791.26	$75,737.70	$54,699.45	2026-03-01
873357	CDM	Disc Intvrt 6x18x17.8mm	23	16	$84,153.00	$84,153.00	$12,791.26	$75,737.70	$54,699.45	2026-03-01
969853	CDM	Valve Aortic Ultra 27mm	23	16	$83,936.00	$83,936.00	$12,758.27	$75,542.40	$54,558.40	2026-03-01
966358	CDM	Valve Aort Mos Ultra 25	23	16	$83,936.00	$83,936.00	$12,758.27	$75,542.40	$54,558.40	2026-03-01
969852	CDM	Valve Aort Mos Ultra 19	23	16	$83,936.00	$83,936.00	$12,758.27	$75,542.40	$54,558.40	2026-03-01
C9610	HCPCS	Cath Blndil 2.50mm 30mm	32	16	$108,147.00	$108,147.00	$16,438.34	$97,332.30	$54,343.87	2026-03-01
575178	CDM	Graft Bn Rt Frz Ulna	23	16	$83,494.00	$83,494.00	$12,691.09	$75,144.60	$54,271.10	2026-03-01
842200	CDM	Cage Spnl 20mm 13mm Ti L	23	16	$83,413.00	$83,413.00	$12,678.78	$75,071.70	$54,218.45	2026-03-01
921241	CDM	Cage Spnl 20mm 15mm	23	16	$83,413.00	$83,413.00	$12,678.78	$75,071.70	$54,218.45	2026-03-01
491599	CDM	Spacer Spnl 17mm 11.7mm	23	16	$83,413.00	$83,413.00	$12,678.78	$75,071.70	$54,218.45	2026-03-01

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