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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

BONNER GENERAL HOSPITAL

Sandpoint, ID · CCN 131328 · Rates published

4,931 distinct procedures filed
21 distinct payers
153,277 rate rows
2026-01-16 last MRF observed
Data quality

151,395 of 153,277 rate rows are consumer-grade (98.8%)

1,882 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 1,630
percent-of-charges filed in the dollar field — excluded from medians 168
exceeds 3× this hospital's gross charge for a DRG stay — excluded 71
exceeds 10× this hospital's gross charge — excluded from medians 7
placeholder amount (≤ $0.02) — excluded from medians 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbBGHSSANDPOINTID&type=CDMWithoutLabel
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Bonner_V2.aspx
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint 24edc8d9139a4319… · 59,034,513 bytes · first seen 2026-05-07

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
940
MS_DRG 		O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 14 $19,863.65 $122,473.29 $110,600.88 nat. median
$22,722
outlier · 4.9×
380
MS_DRG 		Complicated Peptic Ulcer With Mcc 14 $16,678.70 $114,409.97 $103,319.21 nat. median
$19,315
outlier · 5.3×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 14 $54,694.95 $96,806.71 $88,904.12 nat. median
$62,134
1.4× median
570
MS_DRG 		Skin Debridement With Mcc 14 $24,999.35 $88,614.94 $80,024.72 nat. median
$29,069
outlier · 2.8×
56
MS_DRG 		Degenerative Nervous System Disorders With Mcc 14 $17,558.03 $75,221.05 $67,929.21 nat. median
$22,354
outlier · 3.0×
11
MS_DRG 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 14 $43,239.23 $73,022.23 $65,943.54 nat. median
$52,857
1.2× median
466
MS_DRG 		Revision Of Hip Or Knee Replacement With Mcc 14 $44,245.90 $69,621.03 $62,872.06 nat. median
$49,191
1.3× median
907
MS_DRG 		Other O.r. Procedures For Injuries With Mcc 15 $32,634.05 $146,338.76 $61,746.80 nat. median
$38,112
1.6× median
C1822
HCPCS 		Generator, Neurostimulator (implantable), High Frequency, With Rechargeable Batt… 21 $33,193.60 $186,894.40 $57,006.40 nat. median
$31,540
1.8× median
397
MS_DRG 		Appendix Procedures With Mcc 14 $20,356.65 $61,295.04 $55,353.18 nat. median
$24,166
outlier · 2.3×
464
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 14 $26,474.95 $52,624.45 $47,523.10 nat. median
$30,264
1.6× median
981
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 15 $36,743.69 $100,812.38 $44,891.60 nat. median
$46,084
1.0× median
521
MS_DRG 		Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 14 $24,396.70 $48,291.60 $43,610.28 nat. median
$28,962
1.5× median
483
MS_DRG 		Major Joint Or Limb Reattachment Procedures Of Upper Extremities 14 $23,561.15 $48,121.78 $43,456.91 nat. median
$26,699
1.6× median
834
MS_DRG 		Acute Leukemia With Mcc 15 $33,908.79 $109,987.72 $42,951.13 nat. median
$53,173
0.8× median
470
MS_DRG 		Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without… 14 $16,395.65 $44,841.20 $40,494.35 nat. median
$20,059
outlier · 2.0×
522
MS_DRG 		Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 14 $18,000.45 $42,272.59 $38,174.74 nat. median
$21,762
1.8× median
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 15 $29,635.14 $87,015.92 $37,537.84 nat. median
$52,753
0.7× median
956
MS_DRG 		Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 14 $28,261.70 $48,548.26 $37,345.82 nat. median
$37,664
1.0× median
473
MS_DRG 		Cervical Spinal Fusion Without Cc/mcc 14 $20,751.05 $41,216.27 $37,220.82 nat. median
$24,796
1.5× median
C1820
HCPCS 		Generator, Neurostimulator (implantable), With Rechargeable Battery And Charging… 21 $10,287.39 $124,242.30 $35,305.92 nat. median
$22,013
1.6× median
164
MS_DRG 		Major Chest Procedures With Cc 15 $21,454.00 $76,095.49 $33,506.90 nat. median
$25,707
1.3× median
296
MS_DRG 		Cardiac Arrest, Unexplained With Mcc 14 $13,276.15 $36,479.78 $32,943.48 nat. median
$16,632
2.0× median
417
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. With Mcc 14 $20,284.40 $36,289.69 $32,771.82 nat. median
$23,832
1.4× median
283
MS_DRG 		Acute Myocardial Infarction, Expired With Mcc 14 $16,246.34 $35,529.38 $32,085.21 nat. median
$19,749
1.6× median
356
MS_DRG 		Other Digestive System O.r. Procedures With Mcc 14 $25,221.08 $44,894.42 $31,946.70 nat. median
$42,444
0.8× median
338
MS_DRG 		Appendectomy With Complicated Principal Diagnosis With Mcc 14 $22,580.25 $33,975.38 $30,681.85 nat. median
$27,044
1.1× median
534
MS_DRG 		Fractures Of Femur Without Mcc 14 $6,417.53 $33,859.27 $30,577.00 nat. median
$8,991
outlier · 3.4×
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 14 $23,610.38 $56,252.73 $29,906.48 nat. median
$44,810
0.7× median
398
MS_DRG 		Appendix Procedures With Cc 15 $12,865.60 $70,965.49 $28,889.90 nat. median
$15,924
1.8× median
C1767
HCPCS 		Generator, Neurostimulator (implantable), Non-rechargeable 21 $10,287.39 $101,269.00 $28,777.60 nat. median
$22,478
1.3× median
480
MS_DRG 		Hip And Femur Procedures Except Major Joint With Mcc 14 $23,038.71 $31,382.95 $28,337.85 nat. median
$29,218
1.0× median
330
MS_DRG 		Major Small And Large Bowel Procedures With Cc 14 $20,376.20 $29,908.11 $27,008.85 nat. median
$24,346
1.1× median
655
MS_DRG 		Major Bladder Procedures Without Cc/mcc 14 $17,991.10 $29,086.36 $26,266.76 nat. median
$21,451
1.2× median
493
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 14 $21,466.00 $28,048.90 $25,759.20 nat. median
$24,757
1.0× median
486
MS_DRG 		Knee Procedures With Principal Diagnosis Of Infection With Cc 14 $17,774.35 $28,512.59 $25,748.61 nat. median
$21,380
1.2× median
346
MS_DRG 		Minor Small And Large Bowel Procedures Without Cc/mcc 14 $10,082.70 $28,474.73 $25,714.43 nat. median
$13,114
2.0× median
166
MS_DRG 		Other Respiratory System O.r. Procedures With Mcc 15 $20,284.46 $57,274.74 $25,693.64 nat. median
$37,476
0.7× median
385
MS_DRG 		Inflammatory Bowel Disease With Mcc 14 $13,449.55 $28,077.54 $25,355.74 nat. median
$16,227
1.6× median
654
MS_DRG 		Major Bladder Procedures With Cc 14 $20,449.08 $31,200.60 $25,220.53 nat. median
$27,847
0.9× median
512
MS_DRG 		Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/… 14 $12,811.75 $27,559.43 $24,887.85 nat. median
$16,947
1.5× median
C1778
HCPCS 		Lead, Neurostimulator (implantable) 21 $2,347.54 $87,024.00 $24,729.60 nat. median
$4,307
outlier · 5.7×
481
MS_DRG 		Hip And Femur Procedures Except Major Joint With Cc 14 $17,803.25 $26,868.92 $24,264.28 nat. median
$21,532
1.1× median
288
MS_DRG 		Acute And Subacute Endocarditis With Mcc 15 $18,962.56 $60,370.41 $24,019.24 nat. median
$26,899
0.9× median
556
MS_DRG 		Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 15 $7,060.10 $65,530.18 $23,998.12 nat. median
$9,145
outlier · 2.6×
909
MS_DRG 		Other O.r. Procedures For Injuries Without Cc/mcc 14 $11,157.95 $26,483.37 $23,916.10 nat. median
$13,888
1.7× median
983
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc 14 $14,569.00 $26,439.29 $23,876.30 nat. median
$17,513
1.4× median
95
MS_DRG 		Bacterial And Tuberculous Infections Of Nervous System With Cc 15 $18,813.13 $59,631.37 $23,829.96 nat. median
$24,991
1.0× median
82
MS_DRG 		Traumatic Stupor And Coma >1 Hour With Mcc 15 $19,427.60 $55,887.41 $23,578.57 nat. median
$22,770
1.0× median
335
MS_DRG 		Peritoneal Adhesiolysis With Mcc 14 $18,498.35 $53,014.74 $23,431.24 nat. median
$35,058
0.7× median

Other procedures at this hospital

Browse this hospital's 4,931 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 14 14 $124,972.74 $99,978.19 20% off $19,863.65 $122,473.29 $110,600.88 2026-01-16
380 MS_DRG Complicated Peptic Ulcer With Mcc 14 14 $116,744.87 $93,395.90 $16,678.70 $114,409.97 $103,319.21 2026-01-16
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 14 14 $98,782.36 $79,025.88 20% off $54,694.95 $96,806.71 $88,904.12 2026-01-16
570 MS_DRG Skin Debridement With Mcc 14 14 $90,423.41 $72,338.73 $24,999.35 $88,614.94 $80,024.72 2026-01-16
56 MS_DRG Degenerative Nervous System Disorders With Mcc 14 14 $76,756.17 $61,404.94 $17,558.03 $75,221.05 $67,929.21 2026-01-16
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 14 14 $74,512.48 $59,609.98 20% off $43,239.23 $73,022.23 $65,943.54 2026-01-16
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 14 14 $71,041.87 $56,833.50 $44,245.90 $69,621.03 $62,872.06 2026-01-16
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 15 15 $68,607.56 $54,886.05 $32,634.05 $146,338.76 $61,746.80 2026-01-16
C1822 HCPCS Generator, Neurostimulator (implantable), High Frequency, With Rechargeable Batt… 21 21 $72,160.00 $57,728.00 20% off $33,193.60 $186,894.40 $57,006.40 2026-01-16
397 MS_DRG Appendix Procedures With Mcc 14 14 $62,545.96 $50,036.77 $20,356.65 $61,295.04 $55,353.18 2026-01-16
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 14 14 $53,698.42 $42,958.74 $26,474.95 $52,624.45 $47,523.10 2026-01-16
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 15 15 $48,991.58 $39,193.27 $36,743.69 $100,812.38 $44,891.60 2026-01-16
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 14 14 $49,277.15 $39,421.72 20% off $24,396.70 $48,291.60 $43,610.28 2026-01-16
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 14 14 $49,103.86 $39,283.08 20% off $23,561.15 $48,121.78 $43,456.91 2026-01-16
834 MS_DRG Acute Leukemia With Mcc 15 15 $45,211.72 $36,169.38 $33,908.79 $109,987.72 $42,951.13 2026-01-16
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 14 14 $45,756.33 $36,605.06 20% off $16,395.65 $44,841.20 $40,494.35 2026-01-16
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 14 14 $43,135.30 $34,508.24 20% off $18,000.45 $42,272.59 $38,174.74 2026-01-16
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 15 15 $39,513.52 $31,610.82 $29,635.14 $87,015.92 $37,537.84 2026-01-16
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 14 14 $40,373.86 $32,299.09 $28,261.70 $48,548.26 $37,345.82 2026-01-16
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 14 14 $42,057.42 $33,645.94 $20,751.05 $41,216.27 $37,220.82 2026-01-16
C1820 HCPCS Generator, Neurostimulator (implantable), With Rechargeable Battery And Charging… 21 21 $47,970.00 $38,376.00 20% off $10,287.39 $124,242.30 $35,305.92 2026-01-16
164 MS_DRG Major Chest Procedures With Cc 15 15 $37,229.89 $29,783.91 20% off $21,454.00 $76,095.49 $33,506.90 2026-01-16
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 14 14 $37,224.27 $29,779.42 $13,276.15 $36,479.78 $32,943.48 2026-01-16
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 14 14 $37,030.30 $29,624.24 20% off $20,284.40 $36,289.69 $32,771.82 2026-01-16
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 14 14 $36,254.47 $29,003.58 $16,246.34 $35,529.38 $32,085.21 2026-01-16
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 14 14 $33,628.11 $26,902.49 $25,221.08 $44,894.42 $31,946.70 2026-01-16
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 14 14 $34,668.76 $27,735.01 $22,580.25 $33,975.38 $30,681.85 2026-01-16
534 MS_DRG Fractures Of Femur Without Mcc 14 14 $34,550.28 $27,640.22 20% off $6,417.53 $33,859.27 $30,577.00 2026-01-16
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 14 14 $31,480.50 $25,184.40 $23,610.38 $56,252.73 $29,906.48 2026-01-16
398 MS_DRG Appendix Procedures With Cc 15 15 $32,099.89 $25,679.91 20% off $12,865.60 $70,965.49 $28,889.90 2026-01-16
C1767 HCPCS Generator, Neurostimulator (implantable), Non-rechargeable 21 21 $39,100.00 $31,280.00 20% off $10,287.39 $101,269.00 $28,777.60 2026-01-16
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 14 14 $30,718.29 $24,574.63 20% off $23,038.71 $31,382.95 $28,337.85 2026-01-16
330 MS_DRG Major Small And Large Bowel Procedures With Cc 14 14 $30,518.48 $24,414.78 20% off $20,376.20 $29,908.11 $27,008.85 2026-01-16
655 MS_DRG Major Bladder Procedures Without Cc/mcc 14 14 $29,679.96 $23,743.97 $17,991.10 $29,086.36 $26,266.76 2026-01-16
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 14 14 $28,621.33 $22,897.06 20% off $21,466.00 $28,048.90 $25,759.20 2026-01-16
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 14 14 $29,094.48 $23,275.58 20% off $17,774.35 $28,512.59 $25,748.61 2026-01-16
346 MS_DRG Minor Small And Large Bowel Procedures Without Cc/mcc 14 14 $29,055.85 $23,244.68 $10,082.70 $28,474.73 $25,714.43 2026-01-16
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 15 15 $27,045.94 $21,636.75 20% off $20,284.46 $57,274.74 $25,693.64 2026-01-16
385 MS_DRG Inflammatory Bowel Disease With Mcc 14 14 $28,650.55 $22,920.44 20% off $13,449.55 $28,077.54 $25,355.74 2026-01-16
654 MS_DRG Major Bladder Procedures With Cc 14 14 $27,265.45 $21,812.36 20% off $20,449.08 $31,200.60 $25,220.53 2026-01-16
512 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/… 14 14 $28,121.87 $22,497.50 $12,811.75 $27,559.43 $24,887.85 2026-01-16
C1778 HCPCS Lead, Neurostimulator (implantable) 21 21 $33,600.00 $26,880.00 20% off $2,347.54 $87,024.00 $24,729.60 2026-01-16
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 14 14 $27,417.26 $21,933.81 $17,803.25 $26,868.92 $24,264.28 2026-01-16
288 MS_DRG Acute And Subacute Endocarditis With Mcc 15 15 $25,283.41 $20,226.73 $18,962.56 $60,370.41 $24,019.24 2026-01-16
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 15 15 $26,664.58 $21,331.66 20% off $7,060.10 $65,530.18 $23,998.12 2026-01-16
909 MS_DRG Other O.r. Procedures For Injuries Without Cc/mcc 14 14 $27,023.85 $21,619.08 $11,157.95 $26,483.37 $23,916.10 2026-01-16
983 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc 14 14 $26,978.87 $21,583.10 $14,569.00 $26,439.29 $23,876.30 2026-01-16
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 15 15 $25,084.17 $20,067.34 $18,813.13 $59,631.37 $23,829.96 2026-01-16
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 15 15 $26,198.41 $20,958.73 $19,427.60 $55,887.41 $23,578.57 2026-01-16
335 MS_DRG Peritoneal Adhesiolysis With Mcc 14 14 $24,664.46 $19,731.57 $18,498.35 $53,014.74 $23,431.24 2026-01-16
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc 14 14 $25,180.49 $20,144.39 20% off $15,154.37 $24,676.88 $22,284.74 2026-01-16
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 14 14 $24,729.22 $19,783.37 20% off $14,271.03 $24,234.63 $21,885.35 2026-01-16
73 MS_DRG Cranial And Peripheral Nerve Disorders With Mcc 14 14 $23,651.93 $18,921.54 20% off $12,754.04 $23,178.89 $20,931.96 2026-01-16
552 MS_DRG Medical Back Problems Without Mcc 14 14 $22,837.79 $18,270.23 20% off $8,171.05 $22,381.03 $20,211.44 2026-01-16
505 MS_DRG Foot Procedures Without Cc/mcc 14 14 $22,289.96 $17,831.97 $11,577.73 $21,844.16 $19,726.61 2026-01-16
337 MS_DRG Peritoneal Adhesiolysis Without Cc/mcc 14 14 $22,136.20 $17,708.96 20% off $13,047.50 $21,693.48 $19,590.54 2026-01-16
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 14 14 $20,517.70 $16,414.16 20% off $15,388.28 $28,091.71 $19,491.82 2026-01-16
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 15 15 $20,262.22 $16,209.78 $15,196.67 $46,172.62 $18,931.87 2026-01-16
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 16 16 $19,857.56 $15,886.05 $14,893.17 $54,404.76 $18,864.68 2026-01-16
92 MS_DRG Other Disorders Of Nervous System With Cc 15 15 $20,570.51 $16,456.41 $8,695.50 $42,162.51 $18,513.46 2026-01-16
517 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/mc… 14 14 $20,498.34 $16,398.67 20% off $13,061.95 $20,088.37 $18,448.51 2026-01-16
571 MS_DRG Skin Debridement With Cc 14 14 $20,114.38 $16,091.50 20% off $14,120.11 $19,712.09 $17,801.22 2026-01-16
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/mcc 14 14 $19,567.43 $15,653.94 20% off $14,304.65 $19,176.08 $17,610.69 2026-01-16
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 16 16 $18,241.63 $14,593.30 20% off $13,681.22 $52,788.83 $17,603.17 2026-01-16
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 15 15 $19,263.65 $15,410.92 20% off $13,856.70 $40,855.65 $17,337.29 2026-01-16
336 MS_DRG Peritoneal Adhesiolysis With Cc 15 15 $18,130.10 $14,504.08 $13,597.57 $44,040.50 $17,223.59 2026-01-16
J2350 HCPCS Injection, Ocrelizumab, 1 Mg 20 20 $21,000.00 $16,800.00 20% off $74.57 $54,390.00 $16,863.00 2026-01-16
638 MS_DRG Diabetes With Cc 15 15 $18,680.39 $14,944.31 20% off $6,581.76 $40,272.39 $16,812.35 2026-01-16
375 MS_DRG Digestive Malignancy With Cc 15 15 $18,575.44 $14,860.35 20% off $10,281.60 $50,963.44 $16,717.90 2026-01-16
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/mcc 14 14 $18,372.12 $14,697.69 20% off $13,779.09 $18,004.68 $16,534.91 2026-01-16
503 MS_DRG Foot Procedures With Mcc 15 15 $17,013.34 $13,610.67 20% off $12,760.01 $42,923.74 $16,162.67 2026-01-16
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 14 14 $16,930.35 $13,544.28 $12,697.76 $26,340.61 $16,083.83 2026-01-16
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 14 14 $17,710.92 $14,168.74 $13,283.19 $18,751.66 $15,972.68 2026-01-16
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 20 20 $19,682.37 $15,745.90 $27.12 $50,977.34 $15,804.94 2026-01-16
487 MS_DRG Knee Procedures With Principal Diagnosis Of Infection Without Cc/mcc 14 14 $17,415.28 $13,932.22 20% off $13,061.46 $17,066.97 $15,673.75 2026-01-16
168 MS_DRG Other Respiratory System O.r. Procedures Without Cc/mcc 14 14 $17,690.19 $14,152.15 20% off $11,614.40 $17,336.39 $15,655.82 2026-01-16
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc 14 14 $17,622.75 $14,098.20 $11,609.30 $17,270.29 $15,596.13 2026-01-16
C1772 HCPCS Infusion Pump, Programmable (implantable) 21 21 $21,000.00 $16,800.00 20% off $492.23 $54,390.00 $15,456.00 2026-01-16
351 MS_DRG Inguinal And Femoral Hernia Procedures With Cc 15 15 $16,867.45 $13,493.96 20% off $12,280.19 $38,459.45 $15,180.71 2026-01-16
145 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc 14 14 $17,043.64 $13,634.91 20% off $10,219.55 $16,702.77 $15,083.62 2026-01-16
803 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Cc 14 14 $15,855.37 $12,684.30 $11,891.53 $22,781.10 $15,062.60 2026-01-16
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 14 14 $15,817.89 $12,654.31 20% off $11,863.42 $23,706.07 $15,027.00 2026-01-16
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 12 12 $15,973.98 $12,779.18 20% off $11,980.49 $15,973.98 $14,775.93 2026-01-16
71 MS_DRG Other Cerebrovascular Disorders With Cc 14 14 $16,356.65 $13,085.32 20% off $8,721.00 $16,029.51 $14,475.63 2026-01-16
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 14 14 $15,591.50 $12,473.20 $11,693.63 $17,649.99 $14,422.14 2026-01-16
J2323 HCPCS Injection, Natalizumab, 1 Mg 20 20 $17,954.39 $14,363.51 20% off $37.23 $46,501.87 $14,417.38 2026-01-16
604 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 14 14 $15,567.09 $12,453.67 20% off $11,675.31 $15,921.22 $14,368.75 2026-01-16
399 MS_DRG Appendix Procedures Without Cc/mcc 14 14 $16,095.70 $12,876.56 20% off $9,678.34 $15,773.78 $14,244.69 2026-01-16
546 MS_DRG Connective Tissue Disorders With Cc 14 14 $15,747.82 $12,598.26 $9,803.90 $15,432.86 $13,936.82 2026-01-16
178 MS_DRG Respiratory Infections And Inflammations With Cc 15 15 $15,447.59 $12,358.07 20% off $8,296.00 $37,039.59 $13,902.83 2026-01-16
412 MS_DRG Cholecystectomy With C.d.e. With Cc 14 14 $14,592.15 $11,673.72 20% off $10,944.11 $25,109.72 $13,862.54 2026-01-16
963 MS_DRG Other Multiple Significant Trauma With Mcc 15 15 $14,475.35 $11,580.28 20% off $10,132.75 $36,067.35 $13,751.58 2026-01-16
177 MS_DRG Respiratory Infections And Inflammations With Mcc 14 14 $14,271.76 $11,417.41 $10,703.82 $20,744.01 $13,420.56 2026-01-16
914 MS_DRG Traumatic Injury Without Mcc 15 15 $14,788.22 $11,830.58 $6,648.35 $32,061.82 $13,309.40 2026-01-16
644 MS_DRG Endocrine Disorders With Cc 14 14 $14,731.42 $11,785.14 $8,712.50 $14,436.79 $13,037.31 2026-01-16
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 15 15 $13,628.48 $10,902.78 20% off $10,221.36 $30,902.08 $12,947.05 2026-01-16
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 14 14 $14,383.94 $11,507.16 $10,787.96 $14,096.27 $12,945.55 2026-01-16
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 15 15 $13,577.96 $10,862.36 20% off $10,183.47 $30,851.56 $12,899.06 2026-01-16
388 MS_DRG Gastrointestinal Obstruction With Mcc 14 14 $13,804.34 $11,043.47 20% off $10,353.25 $15,321.37 $12,833.46 2026-01-16
183 MS_DRG Major Chest Trauma With Mcc 16 16 $13,316.75 $10,653.40 20% off $9,987.56 $39,227.15 $12,827.53 2026-01-16
348 MS_DRG Anal And Stomal Procedures With Cc 14 14 $13,826.49 $11,061.19 20% off $10,369.87 $14,030.49 $12,711.02 2026-01-16
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 14 14 $13,356.31 $10,685.05 $10,017.23 $20,552.42 $12,688.50 2026-01-16
726 MS_DRG Benign Prostatic Hypertrophy Without Mcc 15 15 $14,053.77 $11,243.02 $6,137.00 $35,645.77 $12,648.39 2026-01-16
502 MS_DRG Soft Tissue Procedures Without Cc/mcc 14 14 $13,957.73 $11,166.18 20% off $10,468.30 $13,755.10 $12,561.96 2026-01-16
988 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 14 14 $13,188.41 $10,550.72 20% off $9,891.30 $17,763.96 $12,528.98 2026-01-16
884 MS_DRG Organic Disturbances And Intellectual Disability 15 15 $13,106.07 $10,484.85 20% off $9,829.55 $34,698.07 $12,450.76 2026-01-16
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 16 16 $13,799.94 $11,039.95 20% off $9,862.55 $39,710.34 $12,419.95 2026-01-16
602 MS_DRG Cellulitis With Mcc 15 15 $13,071.98 $10,457.58 20% off $9,803.98 $29,265.98 $12,418.38 2026-01-16
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc 14 14 $13,943.52 $11,154.82 $6,182.90 $13,664.65 $12,340.01 2026-01-16
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 15 15 $12,884.60 $10,307.68 20% off $9,663.45 $25,839.80 $12,240.37 2026-01-16
506 MS_DRG Major Thumb Or Joint Procedures 14 14 $13,504.53 $10,803.62 20% off $10,128.40 $14,326.82 $12,206.99 2026-01-16
100 MS_DRG Seizures With Mcc 14 14 $12,834.96 $10,267.97 $9,626.22 $19,794.10 $12,193.21 2026-01-16
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 15 15 $12,462.33 $9,969.86 20% off $9,346.75 $29,735.93 $11,839.21 2026-01-16
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 14 14 $13,263.97 $10,611.17 20% off $7,812.35 $12,998.69 $11,738.61 2026-01-16
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 15 15 $12,349.51 $9,879.61 $9,262.13 $25,304.71 $11,732.03 2026-01-16
355 MS_DRG Hernia Procedures Except Inguinal And Femoral Without Cc/mcc 14 14 $12,656.06 $10,124.84 20% off $9,492.04 $13,745.90 $11,727.88 2026-01-16
291 MS_DRG Heart Failure And Shock With Mcc 15 15 $12,309.28 $9,847.42 20% off $9,231.96 $29,582.88 $11,693.82 2026-01-16
696 MS_DRG Kidney And Urinary Tract Signs And Symptoms Without Mcc 16 16 $12,917.13 $10,333.70 20% off $5,856.50 $34,509.13 $11,625.42 2026-01-16
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 16 16 $12,823.28 $10,258.62 20% off $8,977.70 $34,415.28 $11,540.95 2026-01-16
637 MS_DRG Diabetes With Mcc 14 14 $12,335.92 $9,868.74 $9,251.94 $14,683.07 $11,521.92 2026-01-16
186 MS_DRG Pleural Effusion With Mcc 15 15 $11,982.75 $9,586.20 $8,987.06 $30,875.75 $11,383.61 2026-01-16
C1785 HCPCS Pacemaker, Dual Chamber, Rate-responsive (implantable) 21 21 $15,432.00 $12,345.60 20% off $5,372.47 $39,968.88 $11,357.95 2026-01-16
500 MS_DRG Soft Tissue Procedures With Mcc 13 13 $11,906.80 $9,525.44 $8,930.10 $32,344.26 $11,311.46 2026-01-16
312 MS_DRG Syncope And Collapse 16 16 $12,537.97 $10,030.38 $6,929.11 $34,129.97 $11,284.18 2026-01-16
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 15 15 $11,809.98 $9,447.98 20% off $8,857.48 $24,765.18 $11,219.48 2026-01-16
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 15 15 $11,807.50 $9,446.00 20% off $8,855.63 $27,713.07 $11,217.13 2026-01-16
189 MS_DRG Pulmonary Edema And Respiratory Failure 15 15 $11,699.76 $9,359.81 $8,774.82 $28,973.36 $11,114.78 2026-01-16
386 MS_DRG Inflammatory Bowel Disease With Cc 14 14 $12,272.15 $9,817.72 20% off $8,298.55 $12,229.74 $11,044.94 2026-01-16
948 MS_DRG Signs And Symptoms Without Mcc 15 15 $12,163.46 $9,730.77 $6,804.25 $29,437.06 $10,947.11 2026-01-16
C1786 HCPCS Pacemaker, Single Chamber, Rate-responsive (implantable) 21 21 $14,812.00 $11,849.60 20% off $4,555.38 $38,363.08 $10,901.63 2026-01-16
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 14 14 $12,006.98 $9,605.58 20% off $8,619.00 $12,634.04 $10,806.28 2026-01-16
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 14 14 $12,167.28 $9,733.82 20% off $5,457.00 $11,923.93 $10,768.04 2026-01-16
83 MS_DRG Traumatic Stupor And Coma >1 Hour With Cc 14 14 $11,322.24 $9,057.79 20% off $8,491.68 $14,930.27 $10,756.13 2026-01-16
908 MS_DRG Other O.r. Procedures For Injuries With Cc 16 16 $11,026.05 $8,820.84 $8,269.54 $32,618.05 $10,640.14 2026-01-16
200 MS_DRG Pneumothorax With Cc 15 15 $11,616.06 $9,292.85 $8,712.05 $24,571.26 $10,454.45 2026-01-16
416 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. Without Cc/mcc 15 15 $10,967.66 $8,774.13 $8,225.75 $23,922.86 $10,419.28 2026-01-16
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 15 15 $10,899.24 $8,719.39 20% off $8,174.43 $23,854.44 $10,354.28 2026-01-16
101 MS_DRG Seizures Without Mcc 14 14 $11,682.56 $9,346.04 20% off $7,146.61 $11,448.90 $10,339.06 2026-01-16
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 14 14 $10,881.09 $8,704.87 20% off $8,160.82 $20,115.00 $10,337.04 2026-01-16
292 MS_DRG Heart Failure And Shock With Cc 14 14 $11,667.38 $9,333.91 $7,216.50 $11,434.04 $10,325.64 2026-01-16
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 15 15 $10,791.86 $8,633.48 20% off $8,093.89 $24,286.86 $10,252.26 2026-01-16
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 14 14 $10,700.89 $8,560.71 20% off $8,025.67 $12,496.08 $10,165.84 2026-01-16
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 14 14 $11,146.91 $8,917.53 $8,360.19 $10,923.98 $10,032.22 2026-01-16
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 15 15 $10,903.94 $8,723.15 20% off $8,177.96 $28,177.54 $10,000.82 2026-01-16
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 15 15 $10,495.11 $8,396.09 $7,871.33 $26,689.11 $9,970.35 2026-01-16
184 MS_DRG Major Chest Trauma With Cc 15 15 $10,433.73 $8,346.99 $7,825.30 $23,388.93 $9,912.05 2026-01-16
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 16 16 $10,231.72 $8,185.38 $7,673.79 $27,505.32 $9,873.61 2026-01-16
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 14 14 $10,780.82 $8,624.66 $7,887.91 $23,736.02 $9,702.74 2026-01-16
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 14 14 $10,209.61 $8,167.68 20% off $7,657.20 $16,029.05 $9,699.12 2026-01-16
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 14 14 $10,198.73 $8,158.98 20% off $7,649.05 $18,638.21 $9,688.79 2026-01-16
381 MS_DRG Complicated Peptic Ulcer With Cc 15 15 $10,082.71 $8,066.17 $7,562.03 $20,878.71 $9,578.57 2026-01-16
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 16 16 $9,951.57 $7,961.26 $7,463.68 $27,225.17 $9,453.99 2026-01-16
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 13 13 $9,934.17 $7,947.33 20% off $7,450.62 $18,053.63 $9,437.46 2026-01-16
543 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 15 15 $9,679.09 $7,743.27 20% off $7,259.32 $22,634.29 $9,195.14 2026-01-16
C1764 HCPCS Event Recorder, Cardiac (implantable) 21 21 $12,443.25 $9,954.60 20% off $3,331.02 $32,228.02 $9,158.23 2026-01-16
811 MS_DRG Red Blood Cell Disorders With Mcc 14 14 $9,633.20 $7,706.56 20% off $7,224.90 $17,804.75 $9,151.54 2026-01-16
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 15 15 $9,931.32 $7,945.06 $7,448.49 $23,426.32 $8,938.19 2026-01-16
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 14 14 $9,831.32 $7,865.06 $7,373.49 $9,865.37 $8,848.19 2026-01-16
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 15 15 $9,723.20 $7,778.56 20% off $6,864.60 $23,218.20 $8,750.88 2026-01-16
55 MS_DRG Nervous System Neoplasms Without Mcc 14 14 $9,284.88 $7,427.90 20% off $6,963.66 $11,729.47 $8,743.62 2026-01-16
81 MS_DRG Nontraumatic Stupor And Coma Without Mcc 14 14 $9,664.05 $7,731.24 $6,611.73 $9,470.77 $8,697.65 2026-01-16
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 14 14 $9,123.89 $7,299.11 20% off $6,842.91 $22,079.09 $8,667.69 2026-01-16
78 MS_DRG Hypertensive Encephalopathy With Cc 14 14 $9,255.04 $7,404.03 20% off $6,941.28 $10,197.52 $8,636.80 2026-01-16
947 MS_DRG Signs And Symptoms With Mcc 16 16 $8,909.93 $7,127.94 20% off $6,682.45 $26,183.53 $8,598.08 2026-01-16
687 MS_DRG Kidney And Urinary Tract Neoplasms With Cc 16 16 $8,866.33 $7,093.06 20% off $6,649.75 $26,139.93 $8,556.01 2026-01-16
539 MS_DRG Osteomyelitis With Mcc 14 14 $9,003.11 $7,202.49 $6,752.33 $26,276.71 $8,552.95 2026-01-16
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 15 15 $8,955.66 $7,164.52 20% off $6,716.74 $23,453.88 $8,507.87 2026-01-16
74 MS_DRG Cranial And Peripheral Nerve Disorders Without Mcc 15 15 $8,942.57 $7,154.06 $6,706.93 $19,738.57 $8,495.44 2026-01-16
256 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Cc 16 16 $8,799.01 $7,039.21 $6,599.26 $26,072.61 $8,491.05 2026-01-16
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 15 15 $8,909.53 $7,127.62 20% off $6,682.15 $21,864.73 $8,464.05 2026-01-16
70 MS_DRG Other Cerebrovascular Disorders With Mcc 14 14 $8,844.59 $7,075.67 20% off $6,633.44 $17,014.26 $8,402.36 2026-01-16
551 MS_DRG Medical Back Problems With Mcc 15 15 $8,721.74 $6,977.39 20% off $6,541.31 $21,676.94 $8,285.66 2026-01-16
544 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 15 15 $9,186.93 $7,349.54 20% off $6,414.10 $19,982.93 $8,268.24 2026-01-16
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 16 16 $9,138.27 $7,310.62 $6,614.70 $26,411.87 $8,224.45 2026-01-16
695 MS_DRG Kidney And Urinary Tract Signs And Symptoms With Mcc 15 15 $8,612.21 $6,889.77 $6,459.16 $24,806.21 $8,181.60 2026-01-16
369 MS_DRG Major Esophageal Disorders With Cc 15 15 $8,489.80 $6,791.84 $6,367.35 $19,285.80 $8,065.31 2026-01-16
566 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/mcc 16 16 $8,951.88 $7,161.50 20% off $6,369.05 $26,225.48 $8,056.69 2026-01-16
643 MS_DRG Endocrine Disorders With Mcc 14 14 $8,266.48 $6,613.19 $6,199.86 $16,823.14 $7,853.16 2026-01-16
345 MS_DRG Minor Small And Large Bowel Procedures With Cc 14 14 $8,238.31 $6,590.65 $6,178.73 $15,378.03 $7,826.39 2026-01-16
203 MS_DRG Bronchitis And Asthma Without Cc/mcc 14 14 $8,842.89 $7,074.31 20% off $5,695.00 $8,666.03 $7,825.95 2026-01-16
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 14 14 $8,197.03 $6,557.62 20% off $6,147.77 $21,580.20 $7,787.18 2026-01-16
989 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc 15 15 $8,132.76 $6,506.21 $6,099.57 $21,087.96 $7,726.12 2026-01-16
920 MS_DRG Complications Of Treatment With Cc 15 15 $8,094.74 $6,475.79 20% off $6,071.06 $16,731.54 $7,690.00 2026-01-16
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 15 15 $8,475.28 $6,780.22 20% off $6,253.45 $21,430.48 $7,627.75 2026-01-16
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 15 15 $8,471.76 $6,777.40 20% off $6,353.82 $19,267.76 $7,624.58 2026-01-16
769 MS_DRG Postpartum And Post Abortion Diagnoses With O.r. Procedures 14 14 $8,004.86 $6,403.89 $6,003.65 $21,776.95 $7,604.62 2026-01-16
603 MS_DRG Cellulitis Without Mcc 15 15 $8,448.22 $6,758.58 $6,336.17 $21,943.22 $7,603.40 2026-01-16
683 MS_DRG Renal Failure With Cc 15 15 $7,994.87 $6,395.90 $5,996.15 $16,631.67 $7,595.13 2026-01-16
378 MS_DRG Gastrointestinal Hemorrhage With Cc 16 16 $7,889.23 $6,311.39 $5,916.92 $20,844.43 $7,494.77 2026-01-16
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 16 16 $7,886.39 $6,309.11 20% off $5,914.79 $20,841.59 $7,492.07 2026-01-16
549 MS_DRG Septic Arthritis With Cc 15 15 $7,817.47 $6,253.98 $5,863.10 $16,454.27 $7,426.60 2026-01-16
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 15 15 $7,797.84 $6,238.27 20% off $5,848.38 $18,593.84 $7,407.95 2026-01-16
SSU002852 CDM Probe, Cautery Arthroscopic 21 21 $9,974.85 $7,979.88 20% off $4,588.43 $9,775.35 $7,341.49 2026-01-16
J0180 HCPCS Injection, Agalsidase Beta, 1 Mg 39 20 $19,599.81 $15,679.85 $325.51 $50,763.51 $7,319.81 2026-01-16
72 MS_DRG Other Cerebrovascular Disorders Without Cc/mcc 14 14 $8,129.44 $6,503.55 20% off $6,097.08 $7,966.85 $7,316.50 2026-01-16
197 MS_DRG Interstitial Lung Disease With Cc 15 15 $7,657.14 $6,125.71 20% off $5,742.86 $16,293.94 $7,274.28 2026-01-16
776 MS_DRG Postpartum And Post Abortion Diagnoses Without O.r. Procedures 14 14 $8,120.87 $6,496.70 $5,320.01 $7,958.45 $7,186.97 2026-01-16
547 MS_DRG Connective Tissue Disorders Without Cc/mcc 14 14 $7,627.85 $6,102.28 20% off $5,720.89 $8,545.96 $7,177.08 2026-01-16
557 MS_DRG Tendonitis, Myositis And Bursitis With Mcc 16 16 $7,385.50 $5,908.40 20% off $5,539.12 $20,340.70 $7,127.01 2026-01-16
J1162 HCPCS Injection, Digoxin Immune Fab (ovine), Per Vial 21 21 $9,683.27 $7,746.62 $837.06 $25,079.67 $7,126.89 2026-01-16
444 MS_DRG Disorders Of The Biliary Tract With Mcc 14 14 $7,354.95 $5,883.96 20% off $5,516.21 $17,200.10 $6,987.20 2026-01-16
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 15 15 $7,724.00 $6,179.20 20% off $5,793.00 $18,520.00 $6,972.39 2026-01-16
180 MS_DRG Respiratory Neoplasms With Mcc 14 14 $7,308.14 $5,846.51 20% off $5,481.11 $20,409.30 $6,942.73 2026-01-16
69 MS_DRG Transient Ischemia Without Thrombolytic 16 16 $7,092.61 $5,674.09 $5,319.46 $20,047.81 $6,737.98 2026-01-16
682 MS_DRG Renal Failure With Mcc 14 14 $7,052.30 $5,641.84 20% off $5,289.22 $15,689.10 $6,699.68 2026-01-16
394 MS_DRG Other Digestive System Diagnoses With Cc 15 15 $7,049.04 $5,639.23 20% off $5,286.78 $15,685.84 $6,696.58 2026-01-16
352 MS_DRG Inguinal And Femoral Hernia Procedures Without Cc/mcc 14 14 $7,013.23 $5,610.58 20% off $5,259.92 $11,934.92 $6,662.57 2026-01-16
728 MS_DRG Inflammation Of The Male Reproductive System Without Mcc 16 16 $6,898.44 $5,518.75 20% off $5,173.83 $19,853.64 $6,657.00 2026-01-16
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 14 14 $6,935.69 $5,548.55 20% off $5,201.77 $9,618.04 $6,588.91 2026-01-16
201 MS_DRG Pneumothorax Without Cc/mcc 15 15 $6,849.36 $5,479.48 20% off $5,137.02 $15,486.16 $6,506.89 2026-01-16
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 15 15 $7,162.56 $5,730.05 $5,281.90 $15,799.36 $6,446.30 2026-01-16
812 MS_DRG Red Blood Cell Disorders Without Mcc 15 15 $6,727.60 $5,382.08 20% off $5,045.70 $15,364.40 $6,391.22 2026-01-16
J1306 HCPCS Injection, Inclisiran, 1 Mg 21 21 $8,029.56 $6,423.65 $3,693.60 $20,796.56 $6,343.35 2026-01-16
305 MS_DRG Hypertension Without Mcc 14 14 $6,898.72 $5,518.98 $5,174.04 $7,717.12 $6,333.05 2026-01-16
597 MS_DRG Malignant Breast Disorders With Mcc 14 14 $6,664.92 $5,331.94 $4,998.69 $17,037.76 $6,331.67 2026-01-16
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 15 15 $6,643.14 $5,314.52 $4,982.36 $17,439.14 $6,310.99 2026-01-16
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 16 16 $6,589.58 $5,271.66 20% off $4,942.18 $19,544.78 $6,260.10 2026-01-16
313 MS_DRG Chest Pain 14 14 $6,953.13 $5,562.50 20% off $5,214.85 $7,358.40 $6,257.82 2026-01-16
315 MS_DRG Other Circulatory System Diagnoses With Cc 14 14 $6,545.87 $5,236.70 $4,909.40 $10,359.41 $6,218.58 2026-01-16
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 21 21 $7,675.50 $6,140.40 20% off $3,530.73 $19,879.55 $6,063.65 2026-01-16
C1776 HCPCS Joint Device (implantable) 21 21 $8,100.00 $6,480.00 20% off $3,726.00 $20,979.00 $5,961.60 2026-01-16
A9507 HCPCS Indium In-111 Capromab Pendetide, Diagnostic, Per Study Dose, Up To 10 Millicuri… 21 21 $8,044.00 $6,435.20 20% off $3,700.24 $20,833.96 $5,920.38 2026-01-16
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 15 15 $6,214.83 $4,971.87 $4,661.13 $14,851.63 $5,904.09 2026-01-16
C1763 HCPCS Connective Tissue, Non-human (includes Synthetic) 21 21 $7,894.00 $6,315.20 20% off $1,537.88 $20,445.46 $5,809.98 2026-01-16
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 15 15 $6,085.17 $4,868.13 20% off $4,563.87 $14,182.17 $5,780.91 2026-01-16
389 MS_DRG Gastrointestinal Obstruction With Cc 15 15 $6,064.66 $4,851.72 20% off $4,548.49 $14,701.46 $5,761.42 2026-01-16
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 15 15 $5,935.61 $4,748.48 20% off $4,451.70 $15,875.63 $5,638.82 2026-01-16
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 15 15 $5,865.54 $4,692.43 20% off $4,399.15 $14,502.34 $5,572.26 2026-01-16
153 MS_DRG Otitis Media And Uri Without Mcc 15 15 $5,745.93 $4,596.74 20% off $4,309.44 $13,842.93 $5,458.63 2026-01-16
Q5123 HCPCS Injection, Rituximab-arrx, Biosimilar, (riabni), 10 Mg 21 21 $6,694.74 $5,355.79 20% off $3,079.58 $17,339.38 $5,288.84 2026-01-16
639 MS_DRG Diabetes Without Cc/mcc 15 15 $5,653.02 $4,522.41 20% off $4,239.76 $14,289.82 $5,280.20 2026-01-16
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 14 14 $5,511.27 $4,409.01 20% off $4,133.45 $10,434.62 $5,235.70 2026-01-16
J7192 HCPCS Factor Viii (antihemophilic Factor, Recombinant) Per I.u., Not Otherwise Specifi… 39 20 $11,377.75 $9,102.20 $2.25 $29,468.37 $5,233.77 2026-01-16
C1783 HCPCS Ocular Implant, Aqueous Drainage Assist Device 21 21 $6,412.50 $5,130.00 20% off $2,949.75 $16,608.38 $5,065.88 2026-01-16
607 MS_DRG Minor Skin Disorders Without Mcc 15 15 $5,296.85 $4,237.48 20% off $3,972.64 $13,393.85 $5,032.01 2026-01-16
390 MS_DRG Gastrointestinal Obstruction Without Cc/mcc 15 15 $5,154.59 $4,123.67 20% off $3,865.94 $10,552.59 $4,896.86 2026-01-16
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 21 21 $6,181.71 $4,945.37 $2,843.59 $16,010.63 $4,883.55 2026-01-16
555 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc 14 14 $5,104.66 $4,083.73 $3,828.50 $13,508.80 $4,849.43 2026-01-16
125 MS_DRG Other Disorders Of The Eye Without Mcc 15 15 $5,088.81 $4,071.05 $3,816.61 $13,185.81 $4,834.37 2026-01-16
A9570 HCPCS Indium In-111 Labeled Autologous White Blood Cells, Diagnostic, Per Study Dose 21 21 $6,088.00 $4,870.40 20% off $2,800.48 $15,767.92 $4,809.52 2026-01-16
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 15 15 $5,058.85 $4,047.08 20% off $3,794.14 $13,155.85 $4,805.91 2026-01-16
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 21 21 $5,904.98 $4,723.98 20% off $2,716.29 $15,293.90 $4,664.93 2026-01-16
J3590 HCPCS Unclassified Biologics 21 21 $5,868.25 $4,694.60 $2,699.40 $15,198.77 $4,635.92 2026-01-16
SSU020130 CDM Patch, Everras - 2x4 21 21 $6,192.43 $4,953.94 20% off $2,848.52 $6,068.58 $4,557.63 2026-01-16
Q4107 HCPCS Graftjacket, Per Square Centimeter 21 21 $6,130.00 $4,904.00 20% off $101.51 $15,876.70 $4,511.68 2026-01-16
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 14 14 $4,730.23 $3,784.18 20% off $3,547.67 $13,367.03 $4,493.72 2026-01-16
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 14 14 $4,693.67 $3,754.94 $3,520.25 $10,739.71 $4,458.99 2026-01-16
311 MS_DRG Angina Pectoris 14 14 $4,565.91 $3,652.73 $3,424.43 $7,173.42 $4,337.61 2026-01-16
J2353 HCPCS Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 21 21 $5,876.56 $4,701.25 $131.52 $15,220.29 $4,325.15 2026-01-16
694 MS_DRG Urinary Stones Without Mcc 14 14 $4,440.24 $3,552.19 20% off $3,330.18 $7,988.97 $4,218.23 2026-01-16
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 15 15 $4,315.03 $3,452.02 20% off $3,236.27 $9,713.03 $4,099.28 2026-01-16
J3358 HCPCS Ustekinumab, For Intravenous Injection, 1 Mg 20 20 $5,096.00 $4,076.80 $15.31 $13,198.64 $4,092.09 2026-01-16
535 MS_DRG Fractures Of Hip And Pelvis With Mcc 12 12 $4,366.99 $3,493.59 20% off $3,275.24 $4,366.99 $4,039.47 2026-01-16
188 MS_DRG Pleural Effusion Without Cc/mcc 14 14 $4,249.55 $3,399.64 20% off $3,187.16 $9,356.46 $4,037.07 2026-01-16
C1771 HCPCS Repair Device, Urinary, Incontinence, With Sling Graft 21 21 $5,463.99 $4,371.19 20% off $975.88 $14,151.73 $4,021.50 2026-01-16
684 MS_DRG Renal Failure Without Cc/mcc 15 15 $4,211.29 $3,369.03 20% off $3,158.47 $8,529.69 $4,000.73 2026-01-16
91 MS_DRG Other Disorders Of Nervous System With Mcc 12 12 $4,305.39 $3,444.31 20% off $3,229.04 $4,305.39 $3,982.48 2026-01-16
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 21 21 $5,019.89 $4,015.91 20% off $2,309.15 $13,001.52 $3,965.71 2026-01-16
J2355 HCPCS Injection, Oprelvekin, 5 Mg 21 21 $5,331.60 $4,265.28 20% off $473.38 $13,808.84 $3,924.06 2026-01-16
CSU00274 CDM Brace Tlso Aplr Prefab 21 21 $5,137.50 $4,110.00 20% off $2,363.25 $5,034.75 $3,781.20 2026-01-16
158 MS_DRG Dental And Oral Diseases With Cc 15 15 $3,961.33 $3,169.06 20% off $2,971.00 $9,359.33 $3,763.26 2026-01-16
J3032 HCPCS Injection, Eptinezumab-jjmr, 1 Mg 21 21 $4,751.51 $3,801.21 $2,185.69 $12,306.41 $3,753.69 2026-01-16
81435 HCPCS Test For Detecting Genes Associated With Inherited Colon Cancer-related Disorder… 21 21 $4,696.70 $3,757.36 $2,160.48 $12,164.45 $3,710.39 2026-01-16
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 15 15 $3,811.94 $3,049.55 20% off $2,858.96 $9,209.94 $3,621.34 2026-01-16
383 MS_DRG Uncomplicated Peptic Ulcer With Mcc 13 13 $3,794.53 $3,035.62 20% off $2,845.90 $9,192.53 $3,604.80 2026-01-16
A9572 HCPCS Indium In-111 Pentetreotide, Diagnostic, Per Study Dose, Up To 6 Millicuries 21 21 $4,532.00 $3,625.60 20% off $2,084.72 $11,737.88 $3,580.28 2026-01-16
300 MS_DRG Peripheral Vascular Disorders With Cc 14 14 $3,710.85 $2,968.68 20% off $2,783.14 $10,909.85 $3,525.31 2026-01-16
C1762 HCPCS Connective Tissue, Human (includes Fascia Lata) 40 21 $3,690.50 $2,952.40 20% off $1,697.63 $12,779.71 $3,453.98 2026-01-16
81439 HCPCS Test For Detecting Genes Associated With Inherited Disease Of Heart Muscle 42 21 $4,273.50 $3,418.80 $1,841.84 $11,766.37 $3,413.57 2026-01-16
J2182 HCPCS Injection, Mepolizumab, 1 Mg 21 21 $4,320.22 $3,456.18 $1,987.30 $11,189.37 $3,412.97 2026-01-16
A4264 HCPCS Permanent Implantable Contraceptive Intratubal Occlusion Device(s) And Delivery … 21 21 $3,700.00 $2,960.00 20% off $1,702.00 $9,583.00 $3,330.00 2026-01-16
J1602 HCPCS Injection, Golimumab, 1 Mg, For Intravenous Use 20 20 $4,079.84 $3,263.87 20% off $17.31 $10,566.79 $3,276.11 2026-01-16
81443 HCPCS Genomic Sequence Analysis Panel For Severe Inherited Conditions With Sequencing … 21 21 $4,140.90 $3,312.72 20% off $1,904.81 $10,724.93 $3,271.31 2026-01-16
SSU024999 CDM Device, Fetal Pillow 21 21 $4,378.00 $3,502.40 20% off $2,013.88 $4,290.44 $3,222.21 2026-01-16
SSUA19337 CDM Absorbatack, Mesh Tacker 21 21 $4,307.66 $3,446.13 $1,981.52 $4,221.51 $3,170.44 2026-01-16
SSU019337 CDM Absorbatack, Mesh Tacker 21 21 $4,307.66 $3,446.13 $1,981.52 $4,221.51 $3,170.44 2026-01-16
C1889 HCPCS Implantable/insertable Device, Not Otherwise Classified 21 21 $3,990.00 $3,192.00 20% off $1,835.40 $10,334.10 $3,152.10 2026-01-16
J0897 HCPCS Injection, Denosumab, 1 Mg 21 21 $4,098.53 $3,278.82 20% off $15.37 $10,615.19 $3,016.52 2026-01-16
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc 14 14 $3,110.47 $2,488.38 $2,332.85 $9,237.69 $2,954.95 2026-01-16
Q5119 HCPCS Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg 39 20 $6,363.51 $5,090.81 $40.85 $16,481.49 $2,927.21 2026-01-16
SSU024712 CDM Balloon 6x20 Loprofile Xpress 21 21 $3,950.00 $3,160.00 20% off $1,817.00 $3,871.00 $2,907.20 2026-01-16
J1568 HCPCS Injection, Immune Globulin, (octagam), Intravenous, Non-lyophilized (e.g., Liqui… 39 20 $2,398.00 $1,918.40 $64.16 $16,319.33 $2,898.41 2026-01-16
81437 HCPCS Test For Detecting Genes Associated With Inherited Neuroendocrine Tumor-related … 21 21 $3,642.30 $2,913.84 20% off $1,675.46 $9,433.56 $2,877.42 2026-01-16
J1569 HCPCS Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),… 77 20 $5,273.48 $4,218.78 20% off $71.18 $23,375.06 $2,857.89 2026-01-16
SSU022556 CDM Fixator Frame 21 21 $3,880.80 $3,104.64 20% off $1,785.17 $3,803.18 $2,856.27 2026-01-16
81410 HCPCS Test For Detecting Genes Associated With Heart Disease, Genomic Sequence Analysi… 21 21 $3,603.60 $2,882.88 $1,657.66 $9,333.32 $2,846.84 2026-01-16
SSU017782 CDM Novasure, Ablation Balloon 21 21 $3,843.75 $3,075.00 20% off $1,768.13 $3,766.88 $2,829.00 2026-01-16
Q5115 HCPCS Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg 39 20 $6,027.58 $4,822.06 20% off $61.04 $15,611.43 $2,772.69 2026-01-16
793 MS_DRG Full Term Neonate With Major Problems 13 13 $2,886.19 $2,308.95 20% off $2,164.64 $8,284.19 $2,741.88 2026-01-16
A2006 HCPCS Novosorb Synpath Dermal Matrix, Per Square Centimeter 21 21 $3,450.00 $2,760.00 20% off $1,587.00 $8,935.50 $2,725.50 2026-01-16
395 MS_DRG Other Digestive System Diagnoses Without Cc/mcc 15 15 $2,835.69 $2,268.55 20% off $2,126.77 $8,233.69 $2,693.91 2026-01-16
SSU0000PM CDM Pain Mngt Sterile Supply 21 21 $3,580.00 $2,864.00 20% off $1,646.80 $3,508.40 $2,634.88 2026-01-16
SSU009423 CDM Mammosite Catheter 21 21 $3,575.00 $2,860.00 20% off $1,644.50 $3,503.50 $2,631.20 2026-01-16
27134 HCPCS Revision Of Thigh Bone And Hip Joint Prosthesis 21 21 $4,525.00 $3,620.00 20% off $1,544.91 $4,525.00 $2,626.35 2026-01-16
J9312 HCPCS Injection, Rituximab, 10 Mg 39 20 $5,637.12 $4,509.70 $102.19 $14,600.14 $2,593.08 2026-01-16
794 MS_DRG Neonate With Other Significant Problems 14 14 $2,852.40 $2,281.92 20% off $2,139.30 $8,250.40 $2,567.16 2026-01-16
ROM6010011 CDM Room & Board - Other - Sterile Environment 12 12 $2,850.00 $2,280.00 20% off $1,713.71 $2,793.00 $2,565.00 2026-01-16
20822 HCPCS Reattachment Of Part Of Cutoff Finger 21 21 $4,662.00 $3,729.60 20% off $1,461.10 $4,662.00 $2,483.87 2026-01-16
792 MS_DRG Prematurity Without Major Problems 12 12 $2,680.78 $2,144.62 20% off $2,010.59 $2,680.78 $2,479.72 2026-01-16
J0490 HCPCS Injection, Belimumab, 10 Mg 78 20 $2,792.29 $2,233.83 20% off $78.44 $13,779.78 $2,447.37 2026-01-16
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