Hospital

MADISON COUNTY MEMORIAL HOSPITAL

Madison, FL · CCN 101311 · Rates published

4,553 distinct procedures filed

25 distinct payers

46,905 rate rows

2026-05-08 last MRF observed

Data quality

43,993 of 46,905 rate rows are consumer-grade (93.8%)

2,912 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
template filing: same amount across many unrelated codes — excluded	1,831
per-diem day rate — not a per-procedure price	1,028
exceeds 10× this hospital's gross charge — excluded from medians	35
placeholder amount (≤ $0.02) — excluded from medians	14
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	4

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

Source MRF file	https://madisoncounty.pg.quadax.revenuemasters.com/cdm-files/592319288_madison-county-memorial-hospital_standardcharges.csv
Found on page	https://madisoncounty.pg.quadax.revenuemasters.com/disclaimer?
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-08-18
Content fingerprint	df82eaef65e53e85… · 21,176,748 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
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	1	$144,972.85	$144,972.85	$144,972.85	nat. median $2 outlier · 85278.1×
215 OTHER	Other Heart Assist System Implant	1	$56,181.40	$56,181.40	$56,181.40	nat. median $76,591 0.7× median
216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	1	$53,379.15	$53,379.15	$53,379.15	nat. median $74,644 0.7× median
456 OTHER	Motorized Wheelchair Accessories	1	$46,361.70	$46,361.70	$46,361.70	nat. median $72,806 0.6× median
231 OTHER	Coronary Bypass With Ptca With Mcc	1	$44,633.60	$44,633.60	$44,633.60	nat. median $67,378 0.7× median
219 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	1	$42,411.60	$42,411.60	$42,411.60	nat. median $65,837 0.6× median
957 OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	1	$39,778.75	$39,778.75	$39,778.75	nat. median $65,173 0.6× median
275 OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	1	$38,696.90	$38,696.90	$38,696.90	nat. median $20,809 1.9× median
969 OTHER	HIV With Extensive O.r. Procedures With Mcc	1	$37,799.30	$37,799.30	$37,799.30	nat. median $256 outlier · 147.9×
573 OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	1	$34,199.55	$34,199.55	$34,199.55	nat. median $50,637 0.7× median
955 OTHER	Craniotomy For Multiple Significant Trauma	1	$33,496.10	$33,496.10	$33,496.10	nat. median $62,018 0.5× median
457 OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	1	$33,414.15	$33,414.15	$33,414.15	nat. median $52,802 0.6× median
232 OTHER	Coronary Bypass With Ptca Without Mcc	1	$32,717.30	$32,717.30	$32,717.30	nat. median $52,973 0.6× median
326 OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	1	$27,934.50	$27,934.50	$27,934.50	nat. median $41,032 0.7× median
837 OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	1	$26,161.30	$26,161.30	$26,161.30	nat. median $72 outlier · 361.4×
163 OTHER	Major Chest Procedures With Mcc	1	$25,924.80	$25,924.80	$25,924.80	nat. median $47,193 0.5× median
221 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	1	$25,567.30	$25,567.30	$25,567.30	nat. median $43,630 0.6× median
120 OTHER	Car T-cell Immunotherapy	23	$16.46	$25,394.18	$25,394.18	nat. median $473 outlier · 53.7×
856 OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	1	$24,356.20	$24,356.20	$24,356.20	nat. median $25,682 0.9× median
793 OTHER	Full Term Neonate With Major Problems	1	$23,151.15	$23,151.15	$23,151.15	nat. median $28,479 0.8× median
791 OTHER	Prematurity With Major Problems	1	$22,537.35	$22,537.35	$22,537.35	nat. median $30,037 0.8× median
958 OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	1	$22,246.40	$22,246.40	$22,246.40	nat. median $39,243 0.6× median
236 OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	1	$22,226.60	$22,226.60	$22,226.60	nat. median $40,110 0.6× median
246 OTHER	Class IV Therapeutic Radiopharmaceuticals	14	$21,586.94	$21,586.94	$21,586.94	nat. median $21,587 1.0× median
273 OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	1	$21,433.50	$21,433.50	$21,433.50	nat. median $34,342 0.6× median
736 OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	1	$21,379.60	$21,379.60	$21,379.60	nat. median $27 outlier · 793.6×
739 OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	1	$19,889.65	$19,889.65	$19,889.65	nat. median $14 outlier · 1388.0×
495 OTHER	Minor Chemotherapy Drugs	1	$19,696.60	$19,696.60	$19,696.60	nat. median $33,118 0.6× median
3060 OTHER	Ventricular Assist Device Procedures	14	$19,412.02	$19,412.02	$19,412.02	nat. median $19,412 1.0× median
467 OTHER	Revision Of Hip Or Knee Replacement With Cc	1	$19,174.65	$19,174.65	$19,174.65	nat. median $31,288 0.6× median
987 OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	1	$18,571.85	$18,571.85	$18,571.85	nat. median $552 outlier · 33.6×
469 OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	1	$18,313.90	$18,313.90	$18,313.90	nat. median $25,851 0.7× median
500 OTHER	Soft Tissue Procedures With Mcc	1	$17,835.40	$17,835.40	$17,835.40	nat. median $24,508 0.7× median
274 OTHER	Percutaneous And Other Intracardiac Procedures Without Mcc	1	$17,824.40	$17,824.40	$17,824.40	nat. median $370 outlier · 48.2×
929 OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	1	$17,685.25	$17,685.25	$17,685.25	nat. median $77 outlier · 230.3×
939 OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	1	$17,684.15	$17,684.15	$17,684.15	nat. median $31,153 0.6× median
515 OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	1	$17,388.25	$17,388.25	$17,388.25	nat. median $30,429 0.6× median
933 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	1	$16,676.00	$16,676.00	$16,676.00	nat. median $33,213 0.5× median
480 OTHER	Hip And Femur Procedures Except Major Joint With Mcc	1	$16,218.95	$16,218.95	$16,218.95	nat. median $1,155 outlier · 14.0×
411 OTHER	Cholecystectomy With C.d.e. With Mcc	1	$15,842.75	$15,842.75	$15,842.75	nat. median $27,395 0.6× median
668 OTHER	Transurethral Procedures With Mcc	1	$15,499.00	$15,499.00	$15,499.00	nat. median $27,134 0.6× median
61 OTHER	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	1	$15,415.40	$15,415.40	$15,415.40	nat. median $29,208 0.5× median
250 OTHER	Cochlear Device Implantation	15	$12,929.40	$15,214.43	$15,214.43	nat. median $50 outlier · 303.7×
466 OTHER	Class Xiv Combined Chemotherapy And Pharmacotherapy	15	$15,210.00	$28,526.30	$15,210.00	nat. median $45,865 outlier · 0.3×
510 OTHER	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc	1	$14,963.30	$14,963.30	$14,963.30	nat. median $213 outlier · 70.3×
468 OTHER	Revision Of Hip Or Knee Replacement Without Cc/mcc	1	$14,682.80	$14,682.80	$14,682.80	nat. median $25,043 0.6× median
97 OTHER	Aicd And Related Cardiac Device Insertion Or Replacement	24	$12.25	$13,944.05	$13,944.05	nat. median $36,786 outlier · 0.4×
959 OTHER	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	1	$13,928.20	$13,928.20	$13,928.20	nat. median $24,521 0.6× median
749 OTHER	Other Female Reproductive System O.r. Procedures With Cc/mcc	1	$13,844.60	$13,844.60	$13,844.60	nat. median $217 outlier · 63.8×
982 OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	1	$13,673.00	$13,673.00	$13,673.00	nat. median $375 outlier · 36.4×

Other procedures at this hospital

Browse this hospital's 4,553 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

927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	1	1	—	—	$144,972.85	$144,972.85	$144,972.85	2026-05-08
215	OTHER	Other Heart Assist System Implant	1	1	—	—	$56,181.40	$56,181.40	$56,181.40	2026-05-08
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	1	1	—	—	$53,379.15	$53,379.15	$53,379.15	2026-05-08
456	OTHER	Motorized Wheelchair Accessories	1	1	—	—	$46,361.70	$46,361.70	$46,361.70	2026-05-08
231	OTHER	Coronary Bypass With Ptca With Mcc	1	1	—	—	$44,633.60	$44,633.60	$44,633.60	2026-05-08
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	1	1	—	—	$42,411.60	$42,411.60	$42,411.60	2026-05-08
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	1	1	—	—	$39,778.75	$39,778.75	$39,778.75	2026-05-08
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	1	1	—	—	$38,696.90	$38,696.90	$38,696.90	2026-05-08
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	1	1	—	—	$37,799.30	$37,799.30	$37,799.30	2026-05-08
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	1	1	—	—	$34,199.55	$34,199.55	$34,199.55	2026-05-08
955	OTHER	Craniotomy For Multiple Significant Trauma	1	1	—	—	$33,496.10	$33,496.10	$33,496.10	2026-05-08
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	1	1	—	—	$33,414.15	$33,414.15	$33,414.15	2026-05-08
232	OTHER	Coronary Bypass With Ptca Without Mcc	1	1	—	—	$32,717.30	$32,717.30	$32,717.30	2026-05-08
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	1	1	—	—	$27,934.50	$27,934.50	$27,934.50	2026-05-08
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	1	1	—	—	$26,161.30	$26,161.30	$26,161.30	2026-05-08
163	OTHER	Major Chest Procedures With Mcc	1	1	—	—	$25,924.80	$25,924.80	$25,924.80	2026-05-08
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	1	1	—	—	$25,567.30	$25,567.30	$25,567.30	2026-05-08
120	OTHER	Car T-cell Immunotherapy	24	23	$381.00	$190.50 50% off	$16.46	$25,394.18	$25,394.18	2026-05-08
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	1	1	—	—	$24,356.20	$24,356.20	$24,356.20	2026-05-08
793	OTHER	Full Term Neonate With Major Problems	1	1	—	—	$23,151.15	$23,151.15	$23,151.15	2026-05-08
791	OTHER	Prematurity With Major Problems	1	1	—	—	$22,537.35	$22,537.35	$22,537.35	2026-05-08
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	1	1	—	—	$22,246.40	$22,246.40	$22,246.40	2026-05-08
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	1	1	—	—	$22,226.60	$22,226.60	$22,226.60	2026-05-08
246	OTHER	Class IV Therapeutic Radiopharmaceuticals	14	14	—	—	$21,586.94	$21,586.94	$21,586.94	2026-05-08
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	1	1	—	—	$21,433.50	$21,433.50	$21,433.50	2026-05-08
736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	1	1	—	—	$21,379.60	$21,379.60	$21,379.60	2026-05-08
739	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	1	1	—	—	$19,889.65	$19,889.65	$19,889.65	2026-05-08
495	OTHER	Minor Chemotherapy Drugs	1	1	—	—	$19,696.60	$19,696.60	$19,696.60	2026-05-08
3060	OTHER	Ventricular Assist Device Procedures	14	14	—	—	$19,412.02	$19,412.02	$19,412.02	2026-05-08
467	OTHER	Revision Of Hip Or Knee Replacement With Cc	1	1	—	—	$19,174.65	$19,174.65	$19,174.65	2026-05-08
987	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	1	1	—	—	$18,571.85	$18,571.85	$18,571.85	2026-05-08
469	OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	1	1	—	—	$18,313.90	$18,313.90	$18,313.90	2026-05-08
500	OTHER	Soft Tissue Procedures With Mcc	1	1	—	—	$17,835.40	$17,835.40	$17,835.40	2026-05-08
274	OTHER	Percutaneous And Other Intracardiac Procedures Without Mcc	1	1	—	—	$17,824.40	$17,824.40	$17,824.40	2026-05-08
929	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	1	1	—	—	$17,685.25	$17,685.25	$17,685.25	2026-05-08
939	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	1	1	—	—	$17,684.15	$17,684.15	$17,684.15	2026-05-08
515	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	1	1	—	—	$17,388.25	$17,388.25	$17,388.25	2026-05-08
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	1	1	—	—	$16,676.00	$16,676.00	$16,676.00	2026-05-08
480	OTHER	Hip And Femur Procedures Except Major Joint With Mcc	1	1	—	—	$16,218.95	$16,218.95	$16,218.95	2026-05-08
411	OTHER	Cholecystectomy With C.d.e. With Mcc	1	1	—	—	$15,842.75	$15,842.75	$15,842.75	2026-05-08
668	OTHER	Transurethral Procedures With Mcc	1	1	—	—	$15,499.00	$15,499.00	$15,499.00	2026-05-08
61	OTHER	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	1	1	—	—	$15,415.40	$15,415.40	$15,415.40	2026-05-08
250	OTHER	Cochlear Device Implantation	15	15	—	—	$12,929.40	$15,214.43	$15,214.43	2026-05-08
466	OTHER	Class Xiv Combined Chemotherapy And Pharmacotherapy	15	15	—	—	$15,210.00	$28,526.30	$15,210.00	2026-05-08
510	OTHER	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc	1	1	—	—	$14,963.30	$14,963.30	$14,963.30	2026-05-08
468	OTHER	Revision Of Hip Or Knee Replacement Without Cc/mcc	1	1	—	—	$14,682.80	$14,682.80	$14,682.80	2026-05-08
97	OTHER	Aicd And Related Cardiac Device Insertion Or Replacement	27	24	$185.00	$92.50 50% off	$12.25	$13,944.05	$13,944.05	2026-05-08
959	OTHER	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	1	1	—	—	$13,928.20	$13,928.20	$13,928.20	2026-05-08
749	OTHER	Other Female Reproductive System O.r. Procedures With Cc/mcc	1	1	—	—	$13,844.60	$13,844.60	$13,844.60	2026-05-08
982	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	1	1	—	—	$13,673.00	$13,673.00	$13,673.00	2026-05-08
792	OTHER	Prematurity Without Major Problems	1	1	—	—	$13,598.75	$13,598.75	$13,598.75	2026-05-08
846	OTHER	Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc	1	1	—	—	$13,442.00	$13,442.00	$13,442.00	2026-05-08
970	OTHER	HIV With Extensive O.r. Procedures Without Mcc	1	1	—	—	$13,224.20	$13,224.20	$13,224.20	2026-05-08
243	OTHER	Class I Therapeutic Radiopharmaceuticals	1	1	—	—	$12,526.80	$12,526.80	$12,526.80	2026-05-08
614	OTHER	Adrenal And Pituitary Procedures With Cc/mcc	1	1	—	—	$12,388.20	$12,388.20	$12,388.20	2026-05-08
835	OTHER	Acute Leukemia With Cc	1	1	—	—	$12,295.25	$12,295.25	$12,295.25	2026-05-08
224	OTHER	Level Ii Neurostimulator And Related Device Implantation	25	24	$772.50	$386.25 50% off	$52.13	$12,125.39	$12,125.39	2026-05-08
734	OTHER	Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc	1	1	—	—	$11,954.80	$11,954.80	$11,954.80	2026-05-08
940	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc	1	1	—	—	$11,916.30	$11,916.30	$11,916.30	2026-05-08
32	OTHER	Ventricular Shunt Procedures With Cc	1	1	—	—	$11,845.90	$11,845.90	$11,845.90	2026-05-08
857	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc	1	1	—	—	$11,746.35	$11,746.35	$11,746.35	2026-05-08
507	OTHER	Major Shoulder Or Elbow Joint Procedures With Cc/mcc	1	1	—	—	$11,724.35	$11,724.35	$11,724.35	2026-05-08
314	OTHER	Other Circulatory System Diagnoses With Mcc	1	1	—	—	$11,514.25	$11,514.25	$11,514.25	2026-05-08
424	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Cc	1	1	—	—	$11,485.00	$11,485.00	$11,485.00	2026-05-08
481	OTHER	Hip And Femur Procedures Except Major Joint With Cc	1	1	—	—	$11,411.95	$11,411.95	$11,411.95	2026-05-08
935	OTHER	Non-extensive Burns	1	1	—	—	$11,226.50	$11,226.50	$11,226.50	2026-05-08
516	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc	1	1	—	—	$11,224.40	$11,224.40	$11,224.40	2026-05-08
82	OTHER	Comprehensive Cardiac Electrophysiologic Procedures With Ablation	24	23	$422.00	$211.00 50% off	$53.67	$11,096.66	$11,096.66	2026-05-08
465	OTHER	Class Xiii Combined Chemotherapy And Pharmacotherapy	15	15	—	—	$1,289.40	$10,579.85	$10,579.85	2026-05-08
57	OTHER	Level Iii Spine Procedures	25	24	$327.83	$163.92 50% off	$52.72	$10,287.39	$10,287.39	2026-05-08
104	OTHER	Major Open Coronary Artery Procedures Including Cabg	25	23	$480.00	$240.00 50% off	$17.73	$10,199.49	$10,199.49	2026-05-08
717	OTHER	Other Male Reproductive System O.r. Procedures Except Malignancy With Cc/mcc	1	1	—	—	$9,975.35	$9,975.35	$9,975.35	2026-05-08
896	OTHER	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc	1	1	—	—	$9,779.55	$9,779.55	$9,779.55	2026-05-08
915	OTHER	Allergic Reactions With Mcc	1	1	—	—	$9,757.00	$9,757.00	$9,757.00	2026-05-08
435	OTHER	Class I Pharmacotherapy	1	1	—	—	$9,679.45	$9,679.45	$9,679.45	2026-05-08
884	OTHER	Organic Disturbances And Intellectual Disability	1	1	—	—	$9,662.95	$9,662.95	$9,662.95	2026-05-08
786	OTHER	Cesarean Section Without Sterilization With Mcc	1	1	—	—	$9,622.25	$9,622.25	$9,622.25	2026-05-08
922	OTHER	Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc	1	1	—	—	$9,596.95	$9,596.95	$9,596.95	2026-05-08
501	OTHER	Soft Tissue Procedures With Cc	1	1	—	—	$9,546.35	$9,546.35	$9,546.35	2026-05-08
144	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc	1	1	—	—	$9,517.75	$9,517.75	$9,517.75	2026-05-08
504	OTHER	Foot Procedures With Cc	1	1	—	—	$9,499.50	$9,499.50	$9,499.50	2026-05-08
666	OTHER	Prostatectomy With Cc	1	1	—	—	$9,445.70	$9,445.70	$9,445.70	2026-05-08
505	OTHER	Foot Procedures Without Cc/mcc	1	1	—	—	$9,381.35	$9,381.35	$9,381.35	2026-05-08
855	OTHER	Infectious And Parasitic Diseases With O.r. Procedures Without Cc/mcc	1	1	—	—	$9,359.90	$9,359.90	$9,359.90	2026-05-08
988	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	1	1	—	—	$9,333.50	$9,333.50	$9,333.50	2026-05-08
886	OTHER	Behavioral And Developmental Disorders	1	1	—	—	$9,249.35	$9,249.35	$9,249.35	2026-05-08
746	OTHER	Vagina, Cervix And Vulva Procedures With Cc/mcc	1	1	—	—	$9,218.55	$9,218.55	$9,218.55	2026-05-08
122	OTHER	Percutaneous Intra-abdominal Or Intrathoracic Vascular Procedures	25	24	$341.00	$170.50 50% off	$16.46	$9,029.15	$9,029.15	2026-05-08
983	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc	1	1	—	—	$8,993.60	$8,993.60	$8,993.60	2026-05-08
121	OTHER	Level Ii Percutaneous Coronary And Intracardiac Interventional Procedures	25	24	$341.00	$170.50 50% off	$16.46	$8,986.54	$8,986.54	2026-05-08
513	OTHER	Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/mcc	1	1	—	—	$8,915.50	$8,915.50	$8,915.50	2026-05-08
512	OTHER	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/…	1	1	—	—	$8,875.90	$8,875.90	$8,875.90	2026-05-08
578	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/mcc	1	1	—	—	$8,857.75	$8,857.75	$8,857.75	2026-05-08
895	OTHER	Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy	1	1	—	—	$8,848.40	$8,848.40	$8,848.40	2026-05-08
334	OTHER	Rectal Resection Without Cc/mcc	1	1	—	—	$8,828.50	$8,828.50	$8,828.50	2026-05-08
296	OTHER	Cardiac Arrest, Unexplained With Mcc	1	1	—	—	$8,817.60	$8,817.60	$8,817.60	2026-05-08
917	OTHER	Poisoning And Toxic Effects Of Drugs With Mcc	1	1	—	—	$8,777.45	$8,777.45	$8,777.45	2026-05-08
482	OTHER	Hip And Femur Procedures Except Major Joint Without Cc/mcc	1	1	—	—	$8,736.20	$8,736.20	$8,736.20	2026-05-08
606	OTHER	Minor Skin Disorders With Mcc	1	1	—	—	$8,721.90	$8,721.90	$8,721.90	2026-05-08
182	OTHER	Insertion Of Penile Prosthesis	15	15	—	—	$4,174.50	$8,662.88	$8,662.88	2026-05-08
265	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	15	15	—	—	$8,647.63	$19,437.55	$8,647.63	2026-05-08
186	OTHER	Pleural Effusion With Mcc	1	1	—	—	$8,536.55	$8,536.55	$8,536.55	2026-05-08
487	OTHER	Knee Procedures With Principal Diagnosis Of Infection Without Cc/mcc	1	1	—	—	$8,496.95	$8,496.95	$8,496.95	2026-05-08
245	OTHER	Class Iii Therapeutic Radiopharmaceuticals	15	15	—	—	$8,492.31	$24,922.70	$8,492.31	2026-05-08
769	OTHER	Postpartum And Post Abortion Diagnoses With O.r. Procedures	1	1	—	—	$8,491.45	$8,491.45	$8,491.45	2026-05-08
345	OTHER	Minor Small And Large Bowel Procedures With Cc	1	1	—	—	$8,473.30	$8,473.30	$8,473.30	2026-05-08
3061932	OTHER	Nf-nystatin Not Applicable Powder 5billi	7	7	$41,681.00	$20,840.50 50% off	$53.67	$8,336.20	$8,336.20	2026-05-08
3061585	OTHER	Nf-nystatin Not Applicable Powder 5billi	7	7	$41,681.00	$20,840.50 50% off	$53.67	$8,336.20	$8,336.20	2026-05-08
964	OTHER	Other Multiple Significant Trauma With Cc	1	1	—	—	$8,255.50	$8,255.50	$8,255.50	2026-05-08
682	OTHER	Renal Failure With Mcc	1	1	—	—	$8,254.40	$8,254.40	$8,254.40	2026-05-08
913	OTHER	Traumatic Injury With Mcc	1	1	—	—	$8,219.75	$8,219.75	$8,219.75	2026-05-08
517	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/mc…	1	1	—	—	$8,219.20	$8,219.20	$8,219.20	2026-05-08
794	OTHER	Neonate With Other Significant Problems	1	1	—	—	$8,194.45	$8,194.45	$8,194.45	2026-05-08
3051	OTHER	Heart And/or Lung Transplant	14	14	—	—	$8,177.97	$8,177.97	$8,177.97	2026-05-08
508	OTHER	Major Shoulder Or Elbow Joint Procedures Without Cc/mcc	1	1	—	—	$7,887.00	$7,887.00	$7,887.00	2026-05-08
3030	OTHER	Spinal Implantation Of Drug Infusion Device	14	14	—	—	$7,836.58	$7,836.58	$7,836.58	2026-05-08
716	OTHER	Other Male Reproductive System O.r. Procedures For Malignancy Without Cc/mcc	1	1	—	—	$7,822.10	$7,822.10	$7,822.10	2026-05-08
693	OTHER	Urinary Stones With Mcc	1	1	—	—	$7,789.65	$7,789.65	$7,789.65	2026-05-08
977	OTHER	HIV With Or Without Other Related Condition	1	1	—	—	$7,788.55	$7,788.55	$7,788.55	2026-05-08
748	OTHER	Female Reproductive System Reconstructive Procedures	1	1	—	—	$7,726.95	$7,726.95	$7,726.95	2026-05-08
811	OTHER	Red Blood Cell Disorders With Mcc	1	1	—	—	$7,719.80	$7,719.80	$7,719.80	2026-05-08
885	OTHER	Psychoses	1	1	—	—	$7,515.20	$7,515.20	$7,515.20	2026-05-08
975	OTHER	HIV With Major Related Condition With Cc	1	1	—	—	$7,498.15	$7,498.15	$7,498.15	2026-05-08
105	OTHER	Major Open Cardiac And Cardiac Valve Procedures	25	23	$480.00	$240.00 50% off	$17.73	$7,471.28	$7,471.28	2026-05-08
909	OTHER	Other O.r. Procedures For Injuries Without Cc/mcc	1	1	—	—	$7,459.65	$7,459.65	$7,459.65	2026-05-08
416	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. Without Cc/mcc	1	1	—	—	$7,365.60	$7,365.60	$7,365.60	2026-05-08
337	OTHER	Class Iii Brachytherapy Sources	15	15	—	—	$823.20	$7,327.05	$7,327.05	2026-05-08
509	OTHER	Arthroscopy	1	1	—	—	$7,294.10	$7,294.10	$7,294.10	2026-05-08
3000603	OTHER	Tenecteplase [ Mg/10ml] Inj	9	9	$11,145.48	$5,572.74 50% off	$2,229.10	$9,512.25	$7,244.56	2026-05-08
640	OTHER	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…	1	1	—	—	$7,233.60	$7,233.60	$7,233.60	2026-05-08
55	OTHER	Level Ii Hip And Femur Procedures	15	15	—	—	$592.60	$7,209.41	$7,209.41	2026-05-08
839	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Without Cc/mcc	1	1	—	—	$7,167.50	$7,167.50	$7,167.50	2026-05-08
887	OTHER	Other Mental Disorder Diagnoses	1	1	—	—	$7,125.80	$7,125.80	$7,125.80	2026-05-08
85	OTHER	Level Iii Peripheral Endovascular And Transcatheter Procedures	27	24	$433.00	$216.50 50% off	$5.86	$6,998.38	$6,998.38	2026-05-08
735	OTHER	Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/mcc	1	1	—	—	$6,931.10	$6,931.10	$6,931.10	2026-05-08
947	OTHER	Signs And Symptoms With Mcc	1	1	—	—	$6,883.80	$6,883.80	$6,883.80	2026-05-08
903	OTHER	Wound Debridements For Injuries Without Cc/mcc	1	1	—	—	$6,828.25	$6,828.25	$6,828.25	2026-05-08
147	OTHER	Ear, Nose, Mouth And Throat Malignancy With Cc	1	1	—	—	$6,796.90	$6,796.90	$6,796.90	2026-05-08
145	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc	1	1	—	—	$6,716.50	$6,716.50	$6,716.50	2026-05-08
847	OTHER	Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc	1	1	—	—	$6,669.30	$6,669.30	$6,669.30	2026-05-08
593	OTHER	Skin Ulcers With Cc	1	1	—	—	$6,654.45	$6,654.45	$6,654.45	2026-05-08
549	OTHER	Septic Arthritis With Cc	1	1	—	—	$6,634.10	$6,634.10	$6,634.10	2026-05-08
546	OTHER	Connective Tissue Disorders With Cc	1	1	—	—	$6,596.15	$6,596.15	$6,596.15	2026-05-08
836	OTHER	Acute Leukemia Without Cc/mcc	1	1	—	—	$6,585.15	$6,585.15	$6,585.15	2026-05-08
139	OTHER	Salivary Gland Procedures	1	1	—	—	$6,532.35	$6,532.35	$6,532.35	2026-05-08
718	OTHER	Other Male Reproductive System O.r. Procedures Except Malignancy Without Cc/mcc	1	1	—	—	$6,466.90	$6,466.90	$6,466.90	2026-05-08
29	OTHER	Level Ii Spine Procedures	27	24	$608.00	$304.00 50% off	$22.37	$18,855.10	$6,463.58	2026-05-08
689	OTHER	Kidney And Urinary Tract Infections With Mcc	1	1	—	—	$6,459.20	$6,459.20	$6,459.20	2026-05-08
818	OTHER	Other Antepartum Diagnoses With O.r. Procedures With Cc	1	1	—	—	$6,452.50	$6,452.50	$6,452.50	2026-05-08
844	OTHER	Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…	1	1	—	—	$6,364.60	$6,364.60	$6,364.60	2026-05-08
58	OTHER	Level Ii Shoulder And Upper Arm Procedures	25	24	$1,159.00	$579.50 50% off	$53.67	$6,235.22	$6,235.22	2026-05-08
697	OTHER	Urethral Stricture	1	1	—	—	$6,122.50	$6,122.50	$6,122.50	2026-05-08
543	OTHER	Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…	1	1	—	—	$5,998.85	$5,998.85	$5,998.85	2026-05-08
445	OTHER	Disorders Of The Biliary Tract With Cc	1	1	—	—	$5,977.40	$5,977.40	$5,977.40	2026-05-08
755	OTHER	Malignancy, Female Reproductive System With Cc	1	1	—	—	$5,965.85	$5,965.85	$5,965.85	2026-05-08
47	OTHER	Level Ii Arthroplasty	25	23	$300.00	$150.00 50% off	$6.00	$5,956.44	$5,956.44	2026-05-08
287	OTHER	Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc	1	1	—	—	$5,948.80	$5,948.80	$5,948.80	2026-05-08
989	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc	1	1	—	—	$5,941.65	$5,941.65	$5,941.65	2026-05-08
644	OTHER	Endocrine Disorders With Cc	1	1	—	—	$5,839.35	$5,839.35	$5,839.35	2026-05-08
664	OTHER	Minor Bladder Procedures Without Cc/mcc	1	1	—	—	$5,838.80	$5,838.80	$5,838.80	2026-05-08
667	OTHER	Prostatectomy Without Cc/mcc	1	1	—	—	$5,772.80	$5,772.80	$5,772.80	2026-05-08
661	OTHER	Kidney And Ureter Procedures For Non-neoplasm Without Cc/mcc	1	1	—	—	$5,766.20	$5,766.20	$5,766.20	2026-05-08
687	OTHER	Kidney And Urinary Tract Neoplasms With Cc	1	1	—	—	$5,749.15	$5,749.15	$5,749.15	2026-05-08
514	OTHER	Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/mcc	1	1	—	—	$5,728.25	$5,728.25	$5,728.25	2026-05-08
949	OTHER	Aftercare With Cc/mcc	1	1	—	—	$5,698.55	$5,698.55	$5,698.55	2026-05-08
745	OTHER	D&c, Conization, Laparoscopy And Tubal Interruption Without Cc/mcc	1	1	—	—	$5,697.45	$5,697.45	$5,697.45	2026-05-08
920	OTHER	Complications Of Treatment With Cc	1	1	—	—	$5,685.90	$5,685.90	$5,685.90	2026-05-08
784	OTHER	Cesarean Section With Sterilization With Cc	1	1	—	—	$5,632.55	$5,632.55	$5,632.55	2026-05-08
699	OTHER	Other Kidney And Urinary Tract Diagnoses With Cc	1	1	—	—	$5,614.40	$5,614.40	$5,614.40	2026-05-08
3011	OTHER	Bone Conduction Hearing Device Implantation	14	14	—	—	$5,593.18	$5,593.18	$5,593.18	2026-05-08
99	OTHER	Level I Percutaneous Coronary And Intracardiac Interventional Procedures	24	23	$489.00	$244.50 50% off	$53.67	$7,261.10	$5,575.57	2026-05-08
946	OTHER	Rehabilitation Without Cc/mcc	1	1	—	—	$5,569.85	$5,569.85	$5,569.85	2026-05-08
923	OTHER	Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc	1	1	—	—	$5,562.70	$5,562.70	$5,562.70	2026-05-08
565	OTHER	Other Musculoskeletal System And Connective Tissue Diagnoses With Cc	1	1	—	—	$5,496.70	$5,496.70	$5,496.70	2026-05-08
797	OTHER	Vaginal Delivery With Sterilization And/or D&c With Cc	1	1	—	—	$5,477.45	$5,477.45	$5,477.45	2026-05-08
815	OTHER	Reticuloendothelial And Immunity Disorders With Cc	1	1	—	—	$5,468.10	$5,468.10	$5,468.10	2026-05-08
758	OTHER	Infections, Female Reproductive System With Cc	1	1	—	—	$5,459.30	$5,459.30	$5,459.30	2026-05-08
756	OTHER	Malignancy, Female Reproductive System Without Cc/mcc	1	1	—	—	$5,443.35	$5,443.35	$5,443.35	2026-05-08
106	OTHER	Major Open Abdominal And Thoracic Vascular Procedures	24	23	$371.83	$185.92 50% off	$53.67	$5,417.87	$5,417.87	2026-05-08
349	OTHER	Anal And Stomal Procedures Without Cc/mcc	1	1	—	—	$5,366.90	$5,366.90	$5,366.90	2026-05-08
965	OTHER	Other Multiple Significant Trauma Without Cc/mcc	1	1	—	—	$5,257.45	$5,257.45	$5,257.45	2026-05-08
442	OTHER	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc	1	1	—	—	$5,233.25	$5,233.25	$5,233.25	2026-05-08
307	OTHER	Insertion Or Removal Of Drug Delivery Device	1	1	—	—	$5,184.30	$5,184.30	$5,184.30	2026-05-08
3070	OTHER	Extracorporeal Membrane Oxygenation (ecmo) Procedures	14	14	—	—	$5,042.93	$5,042.93	$5,042.93	2026-05-08
914	OTHER	Traumatic Injury Without Mcc	1	1	—	—	$4,992.35	$4,992.35	$4,992.35	2026-05-08
819	OTHER	Other Antepartum Diagnoses With O.r. Procedures Without Cc/mcc	1	1	—	—	$4,989.60	$4,989.60	$4,989.60	2026-05-08
683	OTHER	Renal Failure With Cc	1	1	—	—	$4,954.40	$4,954.40	$4,954.40	2026-05-08
86	OTHER	Pacemaker And Other Cardiovascular Device Insertion And Replacement	27	24	$433.00	$216.50 50% off	$5.86	$7,244.50	$4,952.40	2026-05-08
148	OTHER	Ear, Nose, Mouth And Throat Malignancy Without Cc/mcc	1	1	—	—	$4,893.35	$4,893.35	$4,893.35	2026-05-08
52	OTHER	Level Ii Knee And Lower Leg Procedures	25	24	$1,049.00	$524.50 50% off	$29.80	$4,888.92	$4,888.92	2026-05-08
747	OTHER	Vagina, Cervix And Vulva Procedures Without Cc/mcc	1	1	—	—	$4,879.60	$4,879.60	$4,879.60	2026-05-08
22	OTHER	Level Ii Mastectomy And Reconstructive Breast Procedures	25	24	$381.00	$190.50 50% off	$16.46	$19,121.85	$4,866.46	2026-05-08
603	OTHER	Cellulitis Without Mcc	1	1	—	—	$4,865.85	$4,865.85	$4,865.85	2026-05-08
3052	OTHER	Kidney Transplant	14	14	—	—	$4,860.18	$4,860.18	$4,860.18	2026-05-08
864	OTHER	Fever And Inflammatory Conditions	1	1	—	—	$4,855.40	$4,855.40	$4,855.40	2026-05-08
3061874	OTHER	Tenecteplase Inj [ Mg/10 Ml] *ais	9	9	$24,214.17	$12,107.09 50% off	$2,582.40	$19,371.34	$4,842.83	2026-05-08
845	OTHER	Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…	1	1	—	—	$4,756.95	$4,756.95	$4,756.95	2026-05-08
918	OTHER	Poisoning And Toxic Effects Of Drugs Without Mcc	1	1	—	—	$4,734.95	$4,734.95	$4,734.95	2026-05-08
541	OTHER	Osteomyelitis Without Cc/mcc	1	1	—	—	$4,718.45	$4,718.45	$4,718.45	2026-05-08
464	OTHER	Class Xii Combined Chemotherapy And Pharmacotherapy	15	15	—	—	$1,657.70	$4,703.47	$4,703.47	2026-05-08
976	OTHER	HIV With Major Related Condition Without Cc/mcc	1	1	—	—	$4,649.15	$4,649.15	$4,649.15	2026-05-08
172	OTHER	Level Iii Kidney And Ureteral Procedures	14	14	—	—	$4,560.56	$4,560.56	$4,560.56	2026-05-08
554	OTHER	Bone Diseases And Arthropathies Without Mcc	1	1	—	—	$4,519.90	$4,519.90	$4,519.90	2026-05-08
547	OTHER	Connective Tissue Disorders Without Cc/mcc	1	1	—	—	$4,473.70	$4,473.70	$4,473.70	2026-05-08
798	OTHER	Vaginal Delivery With Sterilization And/or D&c Without Cc/mcc	1	1	—	—	$4,461.60	$4,461.60	$4,461.60	2026-05-08
79	OTHER	Level Ii Peripheral Endovascular And Transcatheter Procedures	27	24	$464.00	$232.00 50% off	$5.86	$4,370.76	$4,370.76	2026-05-08
73	OTHER	Diaphragmatic Procedures And Related Hernia Repair	27	24	$455.00	$227.50 50% off	$19.17	$8,321.50	$4,323.11	2026-05-08
688	OTHER	Kidney And Urinary Tract Neoplasms Without Cc/mcc	1	1	—	—	$4,294.95	$4,294.95	$4,294.95	2026-05-08
87	OTHER	Removal Or Revision Of Pacemakers And Other Cardiovascular Devices	27	24	$370.00	$185.00 50% off	$17.41	$4,874.10	$4,252.19	2026-05-08
96	OTHER	Cardiac Electrophysiologic Procedures Including Pacing And Recording	26	24	$185.00	$92.50 50% off	$12.25	$11,988.35	$4,249.80	2026-05-08
544	OTHER	Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…	1	1	—	—	$4,221.25	$4,221.25	$4,221.25	2026-05-08
645	OTHER	Endocrine Disorders Without Cc/mcc	1	1	—	—	$4,184.95	$4,184.95	$4,184.95	2026-05-08
848	OTHER	Chemotherapy Without Acute Leukemia As Secondary Diagnosis Without Cc/mcc	1	1	—	—	$4,177.25	$4,177.25	$4,177.25	2026-05-08
185	OTHER	Major Chest Trauma Without Cc/mcc	1	1	—	—	$4,156.35	$4,156.35	$4,156.35	2026-05-08
267	OTHER	Other Craniotomy Procedures Including Cranioplasty	15	15	—	—	$4,134.39	$26,841.10	$4,134.39	2026-05-08
313	OTHER	Chest Pain	1	1	—	—	$3,979.80	$3,979.80	$3,979.80	2026-05-08
776	OTHER	Postpartum And Post Abortion Diagnoses Without O.r. Procedures	1	1	—	—	$3,941.85	$3,941.85	$3,941.85	2026-05-08
700	OTHER	Other Kidney And Urinary Tract Diagnoses Without Cc/mcc	1	1	—	—	$3,895.65	$3,895.65	$3,895.65	2026-05-08
223	OTHER	Level I Neurostimulator And Related Device Implantation	14	14	—	—	$3,892.20	$3,892.20	$3,892.20	2026-05-08
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	1	1	—	—	$3,858.35	$3,858.35	$3,858.35	2026-05-08
167	OTHER	Level Ii Urethral Procedures	15	15	—	—	$18.90	$3,855.64	$3,855.64	2026-05-08
311	OTHER	Angina Pectoris	1	1	—	—	$3,839.55	$3,839.55	$3,839.55	2026-05-08
921	OTHER	Complications Of Treatment Without Cc/mcc	1	1	—	—	$3,837.90	$3,837.90	$3,837.90	2026-05-08
206	OTHER	Level Ii Hysterectomy And Myomectomy Procedures	25	23	$1,854.00	$927.00 50% off	$26.78	$3,804.95	$3,804.95	2026-05-08
36	OTHER	Level Ii Foot Procedures	25	24	$567.00	$283.50 50% off	$17.41	$9,945.10	$3,802.37	2026-05-08
834	OTHER	Acute Leukemia With Mcc	1	1	—	—	$3,794.50	$3,794.50	$3,794.50	2026-05-08
268	OTHER	Cranial And Spinal Shunt Procedures	15	15	—	—	$377.85	$3,757.68	$3,757.68	2026-05-08
24	OTHER	Level Ii Forearm And Wrist Procedures	24	23	$489.00	$244.50 50% off	$53.67	$3,670.51	$3,670.51	2026-05-08
916	OTHER	Allergic Reactions Without Mcc	1	1	—	—	$3,623.40	$3,623.40	$3,623.40	2026-05-08
303	OTHER	Atherosclerosis Without Mcc	1	1	—	—	$3,619.55	$3,619.55	$3,619.55	2026-05-08
152	OTHER	Level Ii Hepatobiliary And Pancreas Procedures	15	15	—	—	$3,606.87	$6,535.10	$3,606.87	2026-05-08
189	OTHER	Level Ii Perineal And Vaginal Gynecological Procedures	15	15	—	—	$3,601.78	$6,776.00	$3,601.78	2026-05-08
3050	OTHER	Other Transplant Procedures	14	14	—	—	$3,589.15	$3,589.15	$3,589.15	2026-05-08
38	OTHER	Level Ii Arthroscopy	25	24	$577.00	$288.50 50% off	$17.41	$8,799.45	$3,585.72	2026-05-08
759	OTHER	Infections, Female Reproductive System Without Cc/mcc	1	1	—	—	$3,554.10	$3,554.10	$3,554.10	2026-05-08
43	OTHER	Open Or Percutaneous Treatment Of Fractures	26	23	$773.00	$386.50 50% off	$37.86	$3,542.42	$3,542.42	2026-05-08
70	OTHER	Level Ii Thoracic And Chest Procedures	26	24	$505.00	$252.50 50% off	$11.00	$9,842.25	$3,468.96	2026-05-08
950	OTHER	Aftercare Without Cc/mcc	1	1	—	—	$3,455.10	$3,455.10	$3,455.10	2026-05-08
730	OTHER	Other Male Reproductive System Diagnoses Without Cc/mcc	1	1	—	—	$3,418.80	$3,418.80	$3,418.80	2026-05-08
228	OTHER	Level Ii Craniofacial Bone Procedures	15	15	—	—	$3,412.68	$27,712.85	$3,412.68	2026-05-08
123	OTHER	Peripheral Vascular Bypass Procedures	25	24	$341.00	$170.50 50% off	$16.46	$4,422.00	$3,384.37	2026-05-08
684	OTHER	Renal Failure Without Cc/mcc	1	1	—	—	$3,346.75	$3,346.75	$3,346.75	2026-05-08
218	OTHER	Level Ii Peripheral Nerve Procedures	15	15	—	—	$3,322.04	$31,331.85	$3,322.04	2026-05-08
129	OTHER	Esophagogastric Restrictive Procedures And Gastric Fundoplication	22	22	$7.21	$3.61 50% off	$1.44	$3,306.90	$3,306.90	2026-05-08
28	OTHER	Level I Spine Procedures	24	23	$422.00	$211.00 50% off	$53.67	$33,143.55	$3,256.13	2026-05-08
951	OTHER	Other Factors Influencing Health Status	1	1	—	—	$3,245.00	$3,245.00	$3,245.00	2026-05-08
346	OTHER	Radiosurgery	15	15	—	—	$782.90	$3,226.23	$3,226.23	2026-05-08
175	OTHER	Level Iii Bladder And Ureteral Procedures	24	24	$3.09	$1.55 50% off	$0.62	$7,716.50	$3,174.92	2026-05-08
894	OTHER	Alcohol, Drug Abuse Or Dependence, Left Ama	1	1	—	—	$3,159.75	$3,159.75	$3,159.75	2026-05-08
25	OTHER	Level I Shoulder And Upper Arm Procedures	26	24	$427.00	$213.50 50% off	$14.22	$24,288.00	$3,105.77	2026-05-08
266	OTHER	Open Intracranial And Extracranial Vascular Procedures	15	15	—	—	$3,094.10	$34,353.55	$3,094.10	2026-05-08
280	OTHER	Level Iii Vascular Radiological Procedures	15	15	—	—	$3,080.85	$8,725.75	$3,080.85	2026-05-08
184	OTHER	Level Ii Prostate Procedures	15	15	—	—	$3,039.59	$5,785.45	$3,039.59	2026-05-08
153	OTHER	Level Ii Ercp And Related Endoscopic Procedures	15	15	—	—	$441.40	$2,862.39	$2,862.39	2026-05-08
263	OTHER	Thyroid And Parathyroid Procedures	15	15	—	—	$2,861.08	$15,538.60	$2,861.08	2026-05-08
255	OTHER	Level IV Ear, Nose, Mouth And Throat Procedures	15	15	—	—	$1,511.70	$2,861.01	$2,861.01	2026-05-08
208	OTHER	Level Ii Other Uterine And Adnexa Gynecological Procedures	25	23	$1,854.00	$927.00 50% off	$8.34	$2,855.65	$2,855.65	2026-05-08
463	OTHER	Class Xi Combined Chemotherapy And Pharmacotherapy	15	15	—	—	$2,838.20	$3,115.35	$2,838.20	2026-05-08
833	OTHER	Other Antepartum Diagnoses Without O.r. Procedures Without Cc/mcc	1	1	—	—	$2,814.90	$2,814.90	$2,814.90	2026-05-08
155	OTHER	Level Iii Blood Product Exchange Services	15	15	—	—	$526.30	$2,784.31	$2,784.31	2026-05-08
140	OTHER	Major Head And Neck Procedures With Mcc	1	1	—	—	$2,779.55	$2,779.55	$2,779.55	2026-05-08
3000017	OTHER	Alteplase - Tpa [100 Mg] Inj (bolus)	8	8	$13,639.11	$6,819.56 50% off	$1,911.29	$11,593.24	$2,727.82	2026-05-08
3060778	OTHER	Alteplase - Tpa [100 Mg] IV	8	8	$13,639.11	$6,819.56 50% off	$1,911.29	$11,593.24	$2,727.82	2026-05-08
799	OTHER	Splenic Procedures With Mcc	1	1	—	—	$2,725.30	$2,725.30	$2,725.30	2026-05-08
174	OTHER	Level Ii Bladder And Ureteral Procedures	14	14	—	—	$2,721.36	$2,721.36	$2,721.36	2026-05-08
462	OTHER	Class X Combined Chemotherapy And Pharmacotherapy	15	15	—	—	$2,695.75	$15,654.65	$2,695.75	2026-05-08
285	OTHER	Acute Myocardial Infarction, Expired Without Cc/mcc	1	1	—	—	$2,687.85	$2,687.85	$2,687.85	2026-05-08
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	1	1	—	—	$2,672.20	$2,672.20	$2,672.20	2026-05-08
297	OTHER	Magnetocephalography	15	15	—	—	$47.30	$2,667.01	$2,667.01	2026-05-08
71	OTHER	Level Ii Lower Airway Endoscopy	25	24	$358.00	$179.00 50% off	$17.41	$5,839.90	$2,654.87	2026-05-08
264	OTHER	Major Craniotomy And Craniectomy Surgical Procedures	15	15	—	—	$2,644.32	$17,963.00	$2,644.32	2026-05-08
154	OTHER	Level Iii Upper Gi Endoscopy	15	15	—	—	$846.00	$2,625.44	$2,625.44	2026-05-08
128	OTHER	Level Ii Small And Large Intestine Surgical Procedures	25	23	$335.00	$167.50 50% off	$15.82	$2,609.73	$2,609.73	2026-05-08
3035	OTHER	Abdominal Hernia Repair	14	14	—	—	$2,544.82	$2,544.82	$2,544.82	2026-05-08
77	OTHER	Level I Peripheral Endovascular And Transcatheter Procedures	27	24	$505.00	$252.50 50% off	$11.00	$2,543.39	$2,543.39	2026-05-08
27	OTHER	Level I Hip And Femur Procedures	27	24	$464.00	$232.00 50% off	$5.86	$2,515.12	$2,515.12	2026-05-08
3033	OTHER	Inguinal, Femoral And Umbilical Hernia Repair	14	14	—	—	$2,499.94	$2,499.94	$2,499.94	2026-05-08
3061900	OTHER	Nf-humira Pen SubQ Soln 40mg/0.4ml	7	7	$12,460.00	$6,230.00 50% off	$53.67	$2,492.00	$2,492.00	2026-05-08
91	OTHER	Level Ii Peripheral Vascular Repair, Ligation Or Reconstruction	26	24	$158.62	$79.31 50% off	$13.10	$2,479.98	$2,479.98	2026-05-08
179	OTHER	Ectopic Pregnancy Procedures	15	15	—	—	$2,471.28	$4,198.15	$2,471.28	2026-05-08
907	OTHER	Other O.r. Procedures For Injuries With Mcc	1	1	—	—	$2,457.25	$2,457.25	$2,457.25	2026-05-08
126	OTHER	Level Ii Esophageal And Gastric Surgical Procedures	14	14	—	—	$2,445.35	$2,445.35	$2,445.35	2026-05-08
3000133	OTHER	Crotalidae Polyvalent Immune Fab	8	8	$5,731.49	$2,865.75 50% off	$1,146.30	$4,871.77	$2,435.89	2026-05-08
225	OTHER	Other Intracranial Neurosurgery Procedures	14	14	—	—	$2,430.52	$2,430.52	$2,430.52	2026-05-08
298	OTHER	Cardiac Arrest, Unexplained Without Cc/mcc	1	1	—	—	$2,413.95	$2,413.95	$2,413.95	2026-05-08
108	OTHER	Other Intra-abdominal And Intraperitoneal Surgical Procedures	23	22	$433.63	$216.82 50% off	$53.67	$2,409.03	$2,409.03	2026-05-08
107	OTHER	Cholecystectomy And Related Biliary Procedures	24	23	$371.83	$185.92 50% off	$53.67	$2,398.13	$2,398.13	2026-05-08
901	OTHER	Wound Debridements For Injuries With Mcc	1	1	—	—	$2,382.90	$2,382.90	$2,382.90	2026-05-08
125	OTHER	Level I Esophageal And Gastric Surgical Procedures	27	24	$77.25	$38.63 50% off	$2.37	$4,386.25	$2,335.80	2026-05-08
59	OTHER	Arteriovenous Fistula Creation Or Revision For Hemodialysis	25	24	$257.19	$128.60 50% off	$39.46	$6,529.60	$2,313.49	2026-05-08
46	OTHER	Level I Arthroplasty	26	23	$404.00	$202.00 50% off	$3.67	$2,304.05	$2,304.05	2026-05-08
21	OTHER	Level I Mastectomy And Reconstructive Breast Procedures	26	24	$480.00	$240.00 50% off	$17.73	$33,777.70	$2,243.27	2026-05-08
254	OTHER	Level Iii Ear, Nose, Mouth And Throat Procedures	15	15	—	—	$2,243.07	$9,543.50	$2,243.07	2026-05-08
235	OTHER	Level Ii Anterior Chamber Eye Procedures	15	15	—	—	$2,177.20	$32,343.30	$2,177.20	2026-05-08
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	1	1	—	—	$2,133.00	$2,133.00	$2,133.00	2026-05-08
248	OTHER	Level Ii Corneal And Other Anterior Surface Eye Procedures	14	14	—	—	$2,115.07	$2,115.07	$2,115.07	2026-05-08
26	OTHER	Level I Knee And Lower Leg Procedures	15	15	—	—	$2,095.34	$16,242.50	$2,095.34	2026-05-08
115	OTHER	Deep Lymph Structure Procedures	25	24	$381.00	$190.50 50% off	$16.46	$2,079.86	$2,079.86	2026-05-08
238	OTHER	Level Ii Intravitreal, Retinal And Other Posterior Chamber Eye Procedures	14	14	—	—	$2,061.10	$2,061.10	$2,061.10	2026-05-08
276	OTHER	Procedures For Revision Or Removal Of Neurostimulator Devices	15	15	—	—	$2,052.08	$34,156.10	$2,052.08	2026-05-08

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