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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

Your selected procedure

You selected 93306 (HCPCS)

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This hospital’s price: $1,301 across 21 payers · range $813-$4,579

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbBGHSSANDPOINTID&type=CDMWithoutLabel · observed 2026-01-16

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.

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

149,184 of 153,277 rate rows are consumer-grade (97.3%)

4,093 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2,205
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
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 6
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 not_modified · 2026-10-18
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
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 5 $54,694.95 $89,643.98 $82,920.68 nat. median
$59,384
1.4× 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
466
MS_DRG 		Revision Of Hip Or Knee Replacement With Mcc 5 $44,245.90 $63,937.68 $53,199.19 nat. median
$46,420
1.1× median
834
MS_DRG 		Acute Leukemia With Mcc 6 $40,690.55 $109,987.72 $50,659.25 nat. median
$50,391
1.0× median
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 6 $35,562.17 $87,015.92 $48,881.21 nat. median
$49,960
1.0× median
11
MS_DRG 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 5 $43,239.23 $67,061.23 $46,745.11 nat. median
$50,083
0.9× median
981
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 6 $39,880.30 $100,812.38 $46,420.90 nat. median
$43,741
1.1× median
570
MS_DRG 		Skin Debridement With Mcc 5 $24,999.35 $81,381.07 $45,605.16 nat. median
$28,050
1.6× median
956
MS_DRG 		Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 4 $36,336.47 $48,548.26 $39,415.86 nat. median
$35,512
1.1× median
907
MS_DRG 		Other O.r. Procedures For Injuries With Mcc 6 $32,634.05 $146,338.76 $38,424.12 nat. median
$36,018
1.1× median
616
MS_DRG 		Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 7 $16,417.47 $52,788.83 $35,641.23 nat. median
$33,758
1.1× median
C1820
HCPCS 		Generator, Neurostimulator (implantable), With Rechargeable Battery And Charging… 21 $10,287.39 $124,242.30 $35,305.92 nat. median
$22,969
1.5× median
521
MS_DRG 		Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 5 $24,396.70 $44,349.43 $34,015.21 nat. median
$27,642
1.2× median
356
MS_DRG 		Other Digestive System O.r. Procedures With Mcc 5 $30,265.30 $44,894.42 $33,628.11 nat. median
$40,230
0.8× median
166
MS_DRG 		Other Respiratory System O.r. Procedures With Mcc 6 $24,341.35 $57,274.74 $32,622.61 nat. median
$35,721
0.9× median
464
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 5 $26,474.95 $48,328.58 $31,744.06 nat. median
$28,673
1.1× median
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 5 $28,332.45 $56,252.73 $31,480.50 nat. median
$42,662
0.7× median
480
MS_DRG 		Hip And Femur Procedures Except Major Joint With Mcc 5 $24,754.55 $31,382.95 $29,029.23 nat. median
$27,846
1.0× median
C1767
HCPCS 		Generator, Neurostimulator (implantable), Non-rechargeable 21 $10,287.39 $101,269.00 $28,777.60 nat. median
$23,881
1.2× median
164
MS_DRG 		Major Chest Procedures With Cc 6 $21,454.00 $76,095.49 $28,728.07 nat. median
$24,272
1.2× median
963
MS_DRG 		Other Multiple Significant Trauma With Mcc 5 $13,027.82 $36,067.35 $27,939.44 nat. median
$25,757
1.1× median
654
MS_DRG 		Major Bladder Procedures With Cc 5 $23,794.05 $31,200.60 $27,265.45 nat. median
$26,744
1.0× median
338
MS_DRG 		Appendectomy With Complicated Principal Diagnosis With Mcc 5 $22,580.25 $31,201.88 $27,149.43 nat. median
$17,928
1.5× median
288
MS_DRG 		Acute And Subacute Endocarditis With Mcc 6 $22,755.07 $60,370.41 $26,470.39 nat. median
$25,719
1.0× median
483
MS_DRG 		Major Joint Or Limb Reattachment Procedures Of Upper Extremities 5 $23,561.15 $44,193.47 $26,147.46 nat. median
$25,358
1.0× median
95
MS_DRG 		Bacterial And Tuberculous Infections Of Nervous System With Cc 6 $21,923.20 $59,631.37 $25,721.79 nat. median
$23,643
1.1× median
493
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 5 $21,556.85 $25,918.94 $25,457.63 nat. median
$23,553
1.1× median
473
MS_DRG 		Cervical Spinal Fusion Without Cc/mcc 5 $20,751.05 $37,851.68 $24,950.09 nat. median
$23,504
1.1× median
C1778
HCPCS 		Lead, Neurostimulator (implantable) 21 $2,347.54 $87,024.00 $24,729.60 nat. median
$4,400
outlier · 5.6×
335
MS_DRG 		Peritoneal Adhesiolysis With Mcc 5 $22,198.01 $53,014.74 $24,664.46 nat. median
$33,175
0.7× median
397
MS_DRG 		Appendix Procedures With Mcc 3 $20,356.65 $56,291.36 $24,475.88 nat. median
$22,985
1.1× median
522
MS_DRG 		Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 5 $18,000.45 $38,821.77 $24,350.64 nat. median
$20,545
1.2× median
940
MS_DRG 		O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 5 $19,863.65 $112,475.47 $24,255.20 nat. median
$21,612
1.1× median
330
MS_DRG 		Major Small And Large Bowel Procedures With Cc 5 $20,376.20 $27,466.63 $24,169.16 nat. median
$22,965
1.1× median
655
MS_DRG 		Major Bladder Procedures Without Cc/mcc 5 $17,991.10 $26,711.96 $23,863.47 nat. median
$20,505
1.2× median
417
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. With Mcc 5 $20,284.40 $33,327.27 $23,834.44 nat. median
$22,587
1.1× median
82
MS_DRG 		Traumatic Stupor And Coma >1 Hour With Mcc 6 $19,427.60 $55,887.41 $22,741.25 nat. median
$21,717
1.0× median
398
MS_DRG 		Appendix Procedures With Cc 4 $12,865.60 $70,965.49 $22,179.44 nat. median
$15,023
1.5× median
503
MS_DRG 		Foot Procedures With Mcc 6 $15,312.01 $42,923.74 $21,476.62 nat. median
$25,947
0.8× median
481
MS_DRG 		Hip And Femur Procedures Except Major Joint With Cc 5 $17,803.25 $24,675.53 $21,405.79 nat. median
$20,312
1.1× median
867
MS_DRG 		Other Infectious And Parasitic Diseases Diagnoses With Mcc 7 $17,792.20 $54,404.76 $21,392.50 nat. median
$20,269
1.1× median
486
MS_DRG 		Knee Procedures With Principal Diagnosis Of Infection With Cc 5 $17,774.35 $26,185.03 $21,371.04 nat. median
$20,234
1.1× median
85
MS_DRG 		Traumatic Stupor And Coma <1 Hour With Mcc 7 $9,208.55 $27,505.32 $21,027.72 nat. median
$21,337
1.0× median
470
MS_DRG 		Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without… 5 $16,395.65 $41,180.69 $20,981.52 nat. median
$18,831
1.1× median
208
MS_DRG 		Respiratory System Diagnosis With Ventilator Support <=96 Hours 5 $18,465.93 $28,091.71 $20,517.70 nat. median
$25,409
0.8× median
908
MS_DRG 		Other O.r. Procedures For Injuries With Cc 7 $9,923.45 $32,618.05 $20,195.75 nat. median
$19,340
1.0× median
336
MS_DRG 		Peritoneal Adhesiolysis With Cc 6 $16,317.09 $44,040.50 $19,840.50 nat. median
$20,323
1.0× median
380
MS_DRG 		Complicated Peptic Ulcer With Mcc 5 $16,678.70 $105,070.38 $19,779.45 nat. median
$18,519
1.1× median
56
MS_DRG 		Degenerative Nervous System Disorders With Mcc 5 $17,558.03 $69,080.55 $19,746.35 nat. median
$21,152
0.9× median
857
MS_DRG 		Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 6 $18,202.75 $46,172.62 $19,699.38 nat. median
$20,398
1.0× 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
             
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 5 5 $98,782.36 $79,025.88 20% off $54,694.95 $89,643.98 $82,920.68 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
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 5 5 $71,041.87 $56,833.50 $44,245.90 $63,937.68 $53,199.19 2026-01-16
834 MS_DRG Acute Leukemia With Mcc 6 6 $45,211.72 $36,169.38 $40,690.55 $109,987.72 $50,659.25 2026-01-16
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 6 6 $39,513.52 $31,610.82 $35,562.17 $87,015.92 $48,881.21 2026-01-16
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 5 5 $74,512.48 $59,609.98 20% off $43,239.23 $67,061.23 $46,745.11 2026-01-16
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 6 6 $48,991.58 $39,193.27 $39,880.30 $100,812.38 $46,420.90 2026-01-16
570 MS_DRG Skin Debridement With Mcc 5 5 $90,423.41 $72,338.73 $24,999.35 $81,381.07 $45,605.16 2026-01-16
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 4 4 $40,373.86 $32,299.09 $36,336.47 $48,548.26 $39,415.86 2026-01-16
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 6 6 $68,607.56 $54,886.05 $32,634.05 $146,338.76 $38,424.12 2026-01-16
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 7 7 $18,241.63 $14,593.30 20% off $16,417.47 $52,788.83 $35,641.23 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
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 5 5 $49,277.15 $39,421.72 20% off $24,396.70 $44,349.43 $34,015.21 2026-01-16
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 5 5 $33,628.11 $26,902.49 $30,265.30 $44,894.42 $33,628.11 2026-01-16
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 6 6 $27,045.94 $21,636.75 20% off $24,341.35 $57,274.74 $32,622.61 2026-01-16
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 5 5 $53,698.42 $42,958.74 $26,474.95 $48,328.58 $31,744.06 2026-01-16
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 5 5 $31,480.50 $25,184.40 $28,332.45 $56,252.73 $31,480.50 2026-01-16
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 5 5 $30,718.29 $24,574.63 20% off $24,754.55 $31,382.95 $29,029.23 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
164 MS_DRG Major Chest Procedures With Cc 6 6 $37,229.89 $29,783.91 20% off $21,454.00 $76,095.49 $28,728.07 2026-01-16
963 MS_DRG Other Multiple Significant Trauma With Mcc 5 5 $14,475.35 $11,580.28 20% off $13,027.82 $36,067.35 $27,939.44 2026-01-16
654 MS_DRG Major Bladder Procedures With Cc 5 5 $27,265.45 $21,812.36 20% off $23,794.05 $31,200.60 $27,265.45 2026-01-16
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 5 5 $34,668.76 $27,735.01 $22,580.25 $31,201.88 $27,149.43 2026-01-16
288 MS_DRG Acute And Subacute Endocarditis With Mcc 6 6 $25,283.41 $20,226.73 $22,755.07 $60,370.41 $26,470.39 2026-01-16
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 5 5 $49,103.86 $39,283.08 20% off $23,561.15 $44,193.47 $26,147.46 2026-01-16
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 6 6 $25,084.17 $20,067.34 $21,923.20 $59,631.37 $25,721.79 2026-01-16
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 5 5 $28,621.33 $22,897.06 20% off $21,556.85 $25,918.94 $25,457.63 2026-01-16
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 5 5 $42,057.42 $33,645.94 $20,751.05 $37,851.68 $24,950.09 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
335 MS_DRG Peritoneal Adhesiolysis With Mcc 5 5 $24,664.46 $19,731.57 $22,198.01 $53,014.74 $24,664.46 2026-01-16
397 MS_DRG Appendix Procedures With Mcc 3 3 $62,545.96 $50,036.77 $20,356.65 $56,291.36 $24,475.88 2026-01-16
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 5 5 $43,135.30 $34,508.24 20% off $18,000.45 $38,821.77 $24,350.64 2026-01-16
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 5 5 $124,972.74 $99,978.19 20% off $19,863.65 $112,475.47 $24,255.20 2026-01-16
330 MS_DRG Major Small And Large Bowel Procedures With Cc 5 5 $30,518.48 $24,414.78 20% off $20,376.20 $27,466.63 $24,169.16 2026-01-16
655 MS_DRG Major Bladder Procedures Without Cc/mcc 5 5 $29,679.96 $23,743.97 $17,991.10 $26,711.96 $23,863.47 2026-01-16
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 5 5 $37,030.30 $29,624.24 20% off $20,284.40 $33,327.27 $23,834.44 2026-01-16
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 6 6 $26,198.41 $20,958.73 $19,427.60 $55,887.41 $22,741.25 2026-01-16
398 MS_DRG Appendix Procedures With Cc 4 4 $32,099.89 $25,679.91 20% off $12,865.60 $70,965.49 $22,179.44 2026-01-16
503 MS_DRG Foot Procedures With Mcc 6 6 $17,013.34 $13,610.67 20% off $15,312.01 $42,923.74 $21,476.62 2026-01-16
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 5 5 $27,417.26 $21,933.81 $17,803.25 $24,675.53 $21,405.79 2026-01-16
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 7 7 $19,857.56 $15,886.05 $17,792.20 $54,404.76 $21,392.50 2026-01-16
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 5 5 $29,094.48 $23,275.58 20% off $17,774.35 $26,185.03 $21,371.04 2026-01-16
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 7 7 $10,231.72 $8,185.38 $9,208.55 $27,505.32 $21,027.72 2026-01-16
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 5 5 $45,756.33 $36,605.06 20% off $16,395.65 $41,180.69 $20,981.52 2026-01-16
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 5 5 $20,517.70 $16,414.16 20% off $18,465.93 $28,091.71 $20,517.70 2026-01-16
908 MS_DRG Other O.r. Procedures For Injuries With Cc 7 7 $11,026.05 $8,820.84 $9,923.45 $32,618.05 $20,195.75 2026-01-16
336 MS_DRG Peritoneal Adhesiolysis With Cc 6 6 $18,130.10 $14,504.08 $16,317.09 $44,040.50 $19,840.50 2026-01-16
380 MS_DRG Complicated Peptic Ulcer With Mcc 5 5 $116,744.87 $93,395.90 $16,678.70 $105,070.38 $19,779.45 2026-01-16
56 MS_DRG Degenerative Nervous System Disorders With Mcc 5 5 $76,756.17 $61,404.94 $17,558.03 $69,080.55 $19,746.35 2026-01-16
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 6 6 $20,262.22 $16,209.78 $18,202.75 $46,172.62 $19,699.38 2026-01-16
884 MS_DRG Organic Disturbances And Intellectual Disability 6 6 $13,106.07 $10,484.85 20% off $11,795.46 $34,698.07 $19,026.58 2026-01-16
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 6 6 $19,263.65 $15,410.92 20% off $13,856.70 $40,855.65 $18,300.47 2026-01-16
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 5 5 $8,197.03 $6,557.62 20% off $7,377.33 $21,580.20 $17,834.92 2026-01-16
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 5 5 $36,254.47 $29,003.58 $16,246.34 $32,629.02 $17,563.61 2026-01-16
983 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc 5 5 $26,978.87 $21,583.10 $14,569.00 $24,280.98 $17,517.08 2026-01-16
256 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Cc 7 7 $8,799.01 $7,039.21 $7,919.11 $26,072.61 $17,352.54 2026-01-16
517 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/mc… 5 5 $20,498.34 $16,398.67 20% off $13,061.95 $18,750.11 $17,343.85 2026-01-16
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/mcc 5 5 $19,567.43 $15,653.94 20% off $14,304.65 $18,030.29 $17,199.24 2026-01-16
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 6 6 $11,807.50 $9,446.00 20% off $10,626.75 $27,713.07 $17,186.12 2026-01-16
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc 5 5 $25,180.49 $20,144.39 20% off $15,154.37 $22,662.44 $17,055.25 2026-01-16
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 5 5 $16,930.35 $13,544.28 $15,237.31 $26,340.61 $16,930.35 2026-01-16
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 6 6 $10,495.11 $8,396.09 $9,445.60 $26,689.11 $16,876.38 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
337 MS_DRG Peritoneal Adhesiolysis Without Cc/mcc 5 5 $22,136.20 $17,708.96 20% off $13,047.50 $19,922.58 $16,704.65 2026-01-16
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 6 6 $13,628.48 $10,902.78 20% off $12,265.63 $30,902.08 $16,544.40 2026-01-16
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 6 6 $10,899.24 $8,719.39 20% off $9,809.32 $23,854.44 $16,373.49 2026-01-16
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 5 5 $17,710.92 $14,168.74 $15,595.80 $18,751.66 $16,005.53 2026-01-16
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 3 $15,973.98 $12,779.18 20% off $14,376.58 $15,973.98 $15,973.98 2026-01-16
803 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Cc 5 5 $15,855.37 $12,684.30 $14,269.83 $22,781.10 $15,855.37 2026-01-16
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 5 5 $15,817.89 $12,654.31 20% off $14,236.10 $23,706.07 $15,817.89 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
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/mcc 5 5 $18,372.12 $14,697.69 20% off $13,863.50 $16,668.82 $15,705.27 2026-01-16
487 MS_DRG Knee Procedures With Principal Diagnosis Of Infection Without Cc/mcc 5 5 $17,415.28 $13,932.22 20% off $13,312.70 $16,800.60 $15,673.75 2026-01-16
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 5 5 $15,591.50 $12,473.20 $13,619.55 $17,649.99 $15,591.50 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
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 5 5 $24,729.22 $19,783.37 20% off $14,271.03 $22,256.29 $15,428.14 2026-01-16
385 MS_DRG Inflammatory Bowel Disease With Mcc 5 5 $28,650.55 $22,920.44 20% off $13,449.55 $25,785.50 $15,392.15 2026-01-16
571 MS_DRG Skin Debridement With Cc 5 5 $20,114.38 $16,091.50 20% off $14,120.11 $18,102.94 $15,264.98 2026-01-16
505 MS_DRG Foot Procedures Without Cc/mcc 5 5 $22,289.96 $17,831.97 $11,577.73 $20,060.96 $15,238.80 2026-01-16
557 MS_DRG Tendonitis, Myositis And Bursitis With Mcc 7 7 $7,385.50 $5,908.40 20% off $6,646.95 $20,340.70 $15,196.12 2026-01-16
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 5 5 $37,224.27 $29,779.42 $13,276.15 $33,501.84 $14,908.67 2026-01-16
604 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 5 5 $15,567.09 $12,453.67 20% off $12,512.85 $15,921.22 $14,727.13 2026-01-16
178 MS_DRG Respiratory Infections And Inflammations With Cc 6 6 $15,447.59 $12,358.07 20% off $8,296.00 $37,039.59 $14,675.21 2026-01-16
412 MS_DRG Cholecystectomy With C.d.e. With Cc 5 5 $14,592.15 $11,673.72 20% off $13,132.94 $25,109.72 $14,592.15 2026-01-16
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 6 6 $12,884.60 $10,307.68 20% off $11,596.14 $25,839.80 $14,590.66 2026-01-16
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 6 6 $13,577.96 $10,862.36 20% off $12,220.16 $30,851.56 $14,528.24 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
177 MS_DRG Respiratory Infections And Inflammations With Mcc 5 5 $14,271.76 $11,417.41 $12,844.58 $20,744.01 $14,271.76 2026-01-16
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 6 6 $8,955.66 $7,164.52 20% off $8,060.09 $23,453.88 $14,270.98 2026-01-16
351 MS_DRG Inguinal And Femoral Hernia Procedures With Cc 6 6 $16,867.45 $13,493.96 20% off $12,280.19 $38,459.45 $14,228.29 2026-01-16
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 6 6 $11,809.98 $9,447.98 20% off $10,628.98 $24,765.18 $14,170.92 2026-01-16
183 MS_DRG Major Chest Trauma With Mcc 7 7 $13,316.75 $10,653.40 20% off $11,985.08 $39,227.15 $14,092.88 2026-01-16
512 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/… 5 5 $28,121.87 $22,497.50 $12,811.75 $25,309.68 $14,070.90 2026-01-16
168 MS_DRG Other Respiratory System O.r. Procedures Without Cc/mcc 5 5 $17,690.19 $14,152.15 20% off $11,614.40 $15,921.17 $13,964.61 2026-01-16
186 MS_DRG Pleural Effusion With Mcc 6 6 $11,982.75 $9,586.20 $10,784.48 $30,875.75 $13,955.31 2026-01-16
388 MS_DRG Gastrointestinal Obstruction With Mcc 5 5 $13,804.34 $11,043.47 20% off $12,423.90 $15,321.37 $13,804.34 2026-01-16
602 MS_DRG Cellulitis With Mcc 6 6 $13,071.98 $10,457.58 20% off $11,764.78 $29,265.98 $13,798.83 2026-01-16
73 MS_DRG Cranial And Peripheral Nerve Disorders With Mcc 5 5 $23,651.93 $18,921.54 20% off $12,754.04 $21,286.74 $13,788.15 2026-01-16
145 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc 5 5 $17,043.64 $13,634.91 20% off $10,219.55 $15,339.28 $13,515.31 2026-01-16
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 6 6 $10,791.86 $8,633.48 20% off $9,712.67 $24,286.86 $13,433.92 2026-01-16
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 5 5 $13,356.31 $10,685.05 $12,020.68 $20,552.42 $13,356.31 2026-01-16
988 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 5 5 $13,188.41 $10,550.72 20% off $11,869.56 $17,763.96 $13,188.41 2026-01-16
348 MS_DRG Anal And Stomal Procedures With Cc 5 5 $13,826.49 $11,061.19 20% off $11,124.80 $14,030.49 $12,978.20 2026-01-16
947 MS_DRG Signs And Symptoms With Mcc 7 7 $8,909.93 $7,127.94 20% off $8,018.93 $26,183.53 $12,973.27 2026-01-16
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc 5 5 $17,622.75 $14,098.20 $11,609.30 $15,860.47 $12,921.97 2026-01-16
909 MS_DRG Other O.r. Procedures For Injuries Without Cc/mcc 5 5 $27,023.85 $21,619.08 $11,157.95 $24,321.46 $12,879.98 2026-01-16
100 MS_DRG Seizures With Mcc 5 5 $12,834.96 $10,267.97 $11,551.46 $19,794.10 $12,834.96 2026-01-16
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 6 6 $12,462.33 $9,969.86 20% off $11,172.40 $29,735.93 $12,811.52 2026-01-16
291 MS_DRG Heart Failure And Shock With Mcc 6 6 $12,309.28 $9,847.42 20% off $10,912.30 $29,582.88 $12,714.86 2026-01-16
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 6 6 $12,349.51 $9,879.61 $10,760.15 $25,304.71 $12,627.15 2026-01-16
551 MS_DRG Medical Back Problems With Mcc 6 6 $8,721.74 $6,977.39 20% off $7,849.57 $21,676.94 $12,590.81 2026-01-16
502 MS_DRG Soft Tissue Procedures Without Cc/mcc 5 5 $13,957.73 $11,166.18 20% off $11,440.15 $13,755.10 $12,561.96 2026-01-16
375 MS_DRG Digestive Malignancy With Cc 6 6 $18,575.44 $14,860.35 20% off $10,281.60 $50,963.44 $12,472.88 2026-01-16
416 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. Without Cc/mcc 6 6 $10,967.66 $8,774.13 $9,870.89 $23,922.86 $12,450.30 2026-01-16
355 MS_DRG Hernia Procedures Except Inguinal And Femoral Without Cc/mcc 5 5 $12,656.06 $10,124.84 20% off $11,390.45 $13,745.90 $12,407.81 2026-01-16
346 MS_DRG Minor Small And Large Bowel Procedures Without Cc/mcc 5 5 $29,055.85 $23,244.68 $10,082.70 $26,150.27 $12,402.26 2026-01-16
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 5 5 $14,383.94 $11,507.16 $11,423.48 $14,038.19 $12,349.71 2026-01-16
506 MS_DRG Major Thumb Or Joint Procedures 5 5 $13,504.53 $10,803.62 20% off $10,196.60 $14,326.82 $12,259.91 2026-01-16
637 MS_DRG Diabetes With Mcc 5 5 $12,335.92 $9,868.74 $11,102.33 $14,683.07 $12,211.95 2026-01-16
189 MS_DRG Pulmonary Edema And Respiratory Failure 6 6 $11,699.76 $9,359.81 $10,500.90 $28,973.36 $12,162.78 2026-01-16
546 MS_DRG Connective Tissue Disorders With Cc 5 5 $15,747.82 $12,598.26 $9,803.90 $14,173.04 $12,021.62 2026-01-16
500 MS_DRG Soft Tissue Procedures With Mcc 4 4 $11,906.80 $9,525.44 $10,716.12 $32,344.26 $11,906.80 2026-01-16
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 7 7 $13,799.94 $11,039.95 20% off $9,862.55 $39,710.34 $11,858.27 2026-01-16
399 MS_DRG Appendix Procedures Without Cc/mcc 3 3 $16,095.70 $12,876.56 20% off $9,729.95 $14,486.13 $11,698.83 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
83 MS_DRG Traumatic Stupor And Coma >1 Hour With Cc 5 5 $11,322.24 $9,057.79 20% off $10,190.02 $14,930.27 $11,322.24 2026-01-16
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 7 7 $9,951.57 $7,961.26 $8,956.41 $27,225.17 $11,320.69 2026-01-16
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 6 6 $8,909.53 $7,127.62 20% off $8,018.57 $21,864.73 $11,279.68 2026-01-16
386 MS_DRG Inflammatory Bowel Disease With Cc 5 5 $12,272.15 $9,817.72 20% off $8,298.55 $12,229.74 $11,044.94 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
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 5 5 $10,881.09 $8,704.87 20% off $9,792.98 $20,115.00 $10,881.09 2026-01-16
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 5 5 $12,006.98 $9,605.58 20% off $8,619.00 $12,634.04 $10,806.28 2026-01-16
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 7 7 $12,823.28 $10,258.62 20% off $8,977.70 $34,415.28 $10,794.36 2026-01-16
687 MS_DRG Kidney And Urinary Tract Neoplasms With Cc 7 7 $8,866.33 $7,093.06 20% off $7,979.70 $26,139.93 $10,708.52 2026-01-16
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 5 5 $10,700.89 $8,560.71 20% off $9,630.80 $12,496.08 $10,700.89 2026-01-16
184 MS_DRG Major Chest Trauma With Cc 6 6 $10,433.73 $8,346.99 $9,044.85 $23,388.93 $10,654.42 2026-01-16
381 MS_DRG Complicated Peptic Ulcer With Cc 6 6 $10,082.71 $8,066.17 $9,074.44 $20,878.71 $10,578.04 2026-01-16
71 MS_DRG Other Cerebrovascular Disorders With Cc 5 5 $16,356.65 $13,085.32 20% off $8,721.00 $14,720.98 $10,485.72 2026-01-16
200 MS_DRG Pneumothorax With Cc 6 6 $11,616.06 $9,292.85 $9,257.31 $24,571.26 $10,231.17 2026-01-16
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 5 5 $10,209.61 $8,167.68 20% off $9,188.64 $16,029.05 $10,209.61 2026-01-16
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 5 5 $10,198.73 $8,158.98 20% off $9,178.86 $18,638.21 $10,198.73 2026-01-16
695 MS_DRG Kidney And Urinary Tract Signs And Symptoms With Mcc 6 6 $8,612.21 $6,889.77 $7,750.99 $24,806.21 $10,150.92 2026-01-16
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 6 6 $10,903.94 $8,723.15 20% off $8,482.15 $28,177.54 $10,099.68 2026-01-16
543 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 6 6 $9,679.09 $7,743.27 20% off $8,711.18 $22,634.29 $10,092.62 2026-01-16
549 MS_DRG Septic Arthritis With Cc 6 6 $7,817.47 $6,253.98 $7,035.72 $16,454.27 $10,077.52 2026-01-16
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 5 5 $11,146.91 $8,917.53 $8,587.55 $10,497.38 $10,032.22 2026-01-16
92 MS_DRG Other Disorders Of Nervous System With Cc 6 6 $20,570.51 $16,456.41 $8,695.50 $42,162.51 $9,993.34 2026-01-16
989 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc 6 6 $8,132.76 $6,506.21 $7,319.48 $21,087.96 $9,988.10 2026-01-16
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 6 6 $7,797.84 $6,238.27 20% off $7,018.06 $18,593.84 $9,953.81 2026-01-16
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 4 4 $9,934.17 $7,947.33 20% off $8,940.75 $18,053.63 $9,934.17 2026-01-16
948 MS_DRG Signs And Symptoms Without Mcc 6 6 $12,163.46 $9,730.77 $6,804.25 $29,437.06 $9,684.56 2026-01-16
644 MS_DRG Endocrine Disorders With Cc 5 5 $14,731.42 $11,785.14 $8,712.50 $13,258.28 $9,659.98 2026-01-16
811 MS_DRG Red Blood Cell Disorders With Mcc 5 5 $9,633.20 $7,706.56 20% off $8,669.88 $17,804.75 $9,633.20 2026-01-16
74 MS_DRG Cranial And Peripheral Nerve Disorders Without Mcc 6 6 $8,942.57 $7,154.06 $8,048.31 $19,738.57 $9,629.99 2026-01-16
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 6 6 $5,935.61 $4,748.48 20% off $5,342.04 $15,875.63 $9,588.32 2026-01-16
55 MS_DRG Nervous System Neoplasms Without Mcc 5 5 $9,284.88 $7,427.90 20% off $8,356.39 $11,729.47 $9,284.88 2026-01-16
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 6 6 $9,931.32 $7,945.06 $8,698.05 $23,426.32 $9,242.10 2026-01-16
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 5 5 $13,263.97 $10,611.17 20% off $7,812.35 $11,937.57 $9,216.10 2026-01-16
920 MS_DRG Complications Of Treatment With Cc 6 6 $8,094.74 $6,475.79 20% off $7,285.27 $16,731.54 $9,167.69 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
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 5 5 $9,123.89 $7,299.11 20% off $8,211.50 $22,079.09 $9,123.89 2026-01-16
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 5 5 $10,780.82 $8,624.66 $7,887.91 $23,736.02 $9,022.22 2026-01-16
539 MS_DRG Osteomyelitis With Mcc 5 5 $9,003.11 $7,202.49 $8,102.80 $26,276.71 $9,003.11 2026-01-16
312 MS_DRG Syncope And Collapse 7 7 $12,537.97 $10,030.38 $6,929.11 $34,129.97 $8,907.75 2026-01-16
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 6 6 $26,664.58 $21,331.66 20% off $7,060.10 $65,530.18 $8,861.26 2026-01-16
552 MS_DRG Medical Back Problems Without Mcc 5 5 $22,837.79 $18,270.23 20% off $8,171.05 $20,554.01 $8,854.99 2026-01-16
369 MS_DRG Major Esophageal Disorders With Cc 6 6 $8,489.80 $6,791.84 $7,640.82 $19,285.80 $8,849.35 2026-01-16
70 MS_DRG Other Cerebrovascular Disorders With Mcc 5 5 $8,844.59 $7,075.67 20% off $7,960.13 $17,014.26 $8,844.59 2026-01-16
78 MS_DRG Hypertensive Encephalopathy With Cc 5 5 $9,255.04 $7,404.03 20% off $8,329.54 $10,197.52 $8,833.39 2026-01-16
197 MS_DRG Interstitial Lung Disease With Cc 6 6 $7,657.14 $6,125.71 20% off $6,891.43 $16,293.94 $8,678.47 2026-01-16
292 MS_DRG Heart Failure And Shock With Cc 5 5 $11,667.38 $9,333.91 $7,216.50 $10,500.65 $8,676.78 2026-01-16
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 7 7 $7,886.39 $6,309.11 20% off $7,097.75 $20,841.59 $8,615.46 2026-01-16
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 5 5 $9,831.32 $7,865.06 $7,922.31 $9,865.37 $8,564.66 2026-01-16
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 6 6 $9,723.20 $7,778.56 20% off $6,864.60 $23,218.20 $8,502.27 2026-01-16
683 MS_DRG Renal Failure With Cc 6 6 $7,994.87 $6,395.90 $7,195.38 $16,631.67 $8,472.77 2026-01-16
638 MS_DRG Diabetes With Cc 6 6 $18,680.39 $14,944.31 20% off $6,581.76 $40,272.39 $8,388.43 2026-01-16
394 MS_DRG Other Digestive System Diagnoses With Cc 6 6 $7,049.04 $5,639.23 20% off $6,344.13 $15,685.84 $8,305.94 2026-01-16
728 MS_DRG Inflammation Of The Male Reproductive System Without Mcc 7 7 $6,898.44 $5,518.75 20% off $6,208.60 $19,853.64 $8,290.46 2026-01-16
914 MS_DRG Traumatic Injury Without Mcc 6 6 $14,788.22 $11,830.58 $6,648.35 $32,061.82 $8,288.28 2026-01-16
643 MS_DRG Endocrine Disorders With Mcc 5 5 $8,266.48 $6,613.19 $7,439.83 $16,823.14 $8,266.48 2026-01-16
345 MS_DRG Minor Small And Large Bowel Procedures With Cc 5 5 $8,238.31 $6,590.65 $7,414.48 $15,378.03 $8,238.31 2026-01-16
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc 5 5 $13,943.52 $11,154.82 $6,182.90 $12,549.17 $8,200.85 2026-01-16
378 MS_DRG Gastrointestinal Hemorrhage With Cc 7 7 $7,889.23 $6,311.39 $7,100.31 $20,844.43 $8,089.58 2026-01-16
544 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 6 6 $9,186.93 $7,349.54 20% off $6,414.10 $19,982.93 $8,073.08 2026-01-16
769 MS_DRG Postpartum And Post Abortion Diagnoses With O.r. Procedures 5 5 $8,004.86 $6,403.89 $7,204.37 $21,776.95 $8,004.86 2026-01-16
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 7 7 $9,138.27 $7,310.62 $6,614.70 $26,411.87 $7,953.20 2026-01-16
603 MS_DRG Cellulitis Without Mcc 6 6 $8,448.22 $6,758.58 $7,402.65 $21,943.22 $7,851.28 2026-01-16
101 MS_DRG Seizures Without Mcc 5 5 $11,682.56 $9,346.04 20% off $7,146.61 $10,514.30 $7,726.07 2026-01-16
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 6 6 $8,475.28 $6,780.22 20% off $6,253.45 $21,430.48 $7,660.18 2026-01-16
566 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/mcc 7 7 $8,951.88 $7,161.50 20% off $6,369.05 $26,225.48 $7,657.85 2026-01-16
547 MS_DRG Connective Tissue Disorders Without Cc/mcc 5 5 $7,627.85 $6,102.28 20% off $6,865.07 $8,545.96 $7,627.85 2026-01-16
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 6 6 $8,471.76 $6,777.40 20% off $6,871.40 $19,267.76 $7,618.16 2026-01-16
81 MS_DRG Nontraumatic Stupor And Coma Without Mcc 5 5 $9,664.05 $7,731.24 $6,611.73 $9,153.03 $7,612.60 2026-01-16
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 6 6 $6,214.83 $4,971.87 $5,593.35 $14,851.63 $7,405.94 2026-01-16
444 MS_DRG Disorders Of The Biliary Tract With Mcc 5 5 $7,354.95 $5,883.96 20% off $6,619.46 $17,200.10 $7,354.95 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 5 5 $8,129.44 $6,503.55 20% off $6,427.70 $7,728.36 $7,316.50 2026-01-16
180 MS_DRG Respiratory Neoplasms With Mcc 5 5 $7,308.14 $5,846.51 20% off $6,577.33 $20,409.30 $7,308.14 2026-01-16
726 MS_DRG Benign Prostatic Hypertrophy Without Mcc 6 6 $14,053.77 $11,243.02 $6,137.00 $35,645.77 $7,288.52 2026-01-16
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 6 6 $7,724.00 $6,179.20 20% off $6,626.60 $18,520.00 $7,255.06 2026-01-16
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 6 6 $6,085.17 $4,868.13 20% off $5,476.65 $14,182.17 $7,245.73 2026-01-16
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 6 6 $6,643.14 $5,314.52 $5,978.83 $17,439.14 $7,184.01 2026-01-16
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 5 5 $12,167.28 $9,733.82 20% off $5,457.00 $10,950.55 $7,175.47 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
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 6 6 $5,865.54 $4,692.43 20% off $5,278.98 $14,502.34 $7,111.33 2026-01-16
201 MS_DRG Pneumothorax Without Cc/mcc 6 6 $6,849.36 $5,479.48 20% off $6,078.35 $15,486.16 $7,078.84 2026-01-16
389 MS_DRG Gastrointestinal Obstruction With Cc 6 6 $6,064.66 $4,851.72 20% off $5,458.19 $14,701.46 $7,068.21 2026-01-16
812 MS_DRG Red Blood Cell Disorders Without Mcc 6 6 $6,727.60 $5,382.08 20% off $6,054.84 $15,364.40 $7,063.68 2026-01-16
682 MS_DRG Renal Failure With Mcc 5 5 $7,052.30 $5,641.84 20% off $6,347.07 $15,689.10 $7,052.30 2026-01-16
696 MS_DRG Kidney And Urinary Tract Signs And Symptoms Without Mcc 7 7 $12,917.13 $10,333.70 20% off $5,856.50 $34,509.13 $7,041.58 2026-01-16
352 MS_DRG Inguinal And Femoral Hernia Procedures Without Cc/mcc 5 5 $7,013.23 $5,610.58 20% off $6,311.91 $11,934.92 $7,013.23 2026-01-16
69 MS_DRG Transient Ischemia Without Thrombolytic 7 7 $7,092.61 $5,674.09 $6,383.35 $20,047.81 $6,997.85 2026-01-16
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 7 7 $6,589.58 $5,271.66 20% off $5,817.40 $19,544.78 $6,994.57 2026-01-16
534 MS_DRG Fractures Of Femur Without Mcc 5 5 $34,550.28 $27,640.22 20% off $6,417.53 $31,095.25 $6,937.87 2026-01-16
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 5 5 $6,935.69 $5,548.55 20% off $6,242.12 $9,618.04 $6,935.69 2026-01-16
203 MS_DRG Bronchitis And Asthma Without Cc/mcc 5 5 $8,842.89 $7,074.31 20% off $5,695.00 $7,958.60 $6,847.40 2026-01-16
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 6 6 $7,162.56 $5,730.05 $5,281.90 $15,799.36 $6,804.43 2026-01-16
597 MS_DRG Malignant Breast Disorders With Mcc 5 5 $6,664.92 $5,331.94 $5,998.43 $17,037.76 $6,664.92 2026-01-16
315 MS_DRG Other Circulatory System Diagnoses With Cc 5 5 $6,545.87 $5,236.70 $5,891.28 $10,359.41 $6,545.87 2026-01-16
305 MS_DRG Hypertension Without Mcc 5 5 $6,898.72 $5,518.98 $6,208.85 $7,717.12 $6,418.35 2026-01-16
158 MS_DRG Dental And Oral Diseases With Cc 6 6 $3,961.33 $3,169.06 20% off $3,565.20 $9,359.33 $6,414.76 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
313 MS_DRG Chest Pain 5 5 $6,953.13 $5,562.50 20% off $5,739.48 $7,358.40 $6,204.85 2026-01-16
607 MS_DRG Minor Skin Disorders Without Mcc 6 6 $5,296.85 $4,237.48 20% off $4,767.17 $13,393.85 $6,122.76 2026-01-16
153 MS_DRG Otitis Media And Uri Without Mcc 6 6 $5,745.93 $4,596.74 20% off $5,171.33 $13,842.93 $6,079.16 2026-01-16
125 MS_DRG Other Disorders Of The Eye Without Mcc 6 6 $5,088.81 $4,071.05 $4,579.93 $13,185.81 $6,069.12 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
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 6 6 $3,811.94 $3,049.55 20% off $3,430.75 $9,209.94 $6,024.12 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
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
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 6 6 $4,315.03 $3,452.02 20% off $3,883.53 $9,713.03 $5,756.61 2026-01-16
776 MS_DRG Postpartum And Post Abortion Diagnoses Without O.r. Procedures 5 5 $8,120.87 $6,496.70 $5,320.01 $7,308.78 $5,751.36 2026-01-16
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 5 5 $5,511.27 $4,409.01 20% off $4,960.14 $10,434.62 $5,511.27 2026-01-16
639 MS_DRG Diabetes Without Cc/mcc 6 6 $5,653.02 $4,522.41 20% off $5,087.71 $14,289.82 $5,460.59 2026-01-16
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 6 6 $5,058.85 $4,047.08 20% off $4,552.96 $13,155.85 $5,419.50 2026-01-16
390 MS_DRG Gastrointestinal Obstruction Without Cc/mcc 6 6 $5,154.59 $4,123.67 20% off $4,624.00 $10,552.59 $5,357.14 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
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
684 MS_DRG Renal Failure Without Cc/mcc 6 6 $4,211.29 $3,369.03 20% off $3,790.16 $8,529.69 $5,173.18 2026-01-16
555 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc 5 5 $5,104.66 $4,083.73 $4,594.19 $13,508.80 $5,104.66 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
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
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
395 MS_DRG Other Digestive System Diagnoses Without Cc/mcc 6 6 $2,835.69 $2,268.55 20% off $2,552.12 $8,233.69 $4,734.23 2026-01-16
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 5 5 $4,730.23 $3,784.18 20% off $4,257.21 $13,367.03 $4,730.23 2026-01-16
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 5 5 $4,693.67 $3,754.94 $4,224.30 $10,739.71 $4,693.67 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
311 MS_DRG Angina Pectoris 5 5 $4,565.91 $3,652.73 $4,109.32 $7,173.42 $4,565.91 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
694 MS_DRG Urinary Stones Without Mcc 5 5 $4,440.24 $3,552.19 20% off $3,996.22 $7,988.97 $4,440.24 2026-01-16
535 MS_DRG Fractures Of Hip And Pelvis With Mcc 3 3 $4,366.99 $3,493.59 20% off $3,930.29 $4,366.99 $4,366.99 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
91 MS_DRG Other Disorders Of Nervous System With Mcc 3 3 $4,305.39 $3,444.31 20% off $3,874.85 $4,305.39 $4,305.39 2026-01-16
188 MS_DRG Pleural Effusion Without Cc/mcc 5 5 $4,249.55 $3,399.64 20% off $3,824.60 $9,356.46 $4,249.55 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
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
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
965 MS_DRG Other Multiple Significant Trauma Without Cc/mcc 4 4 $2,599.67 $2,079.74 $2,339.70 $6,918.07 $3,949.17 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
383 MS_DRG Uncomplicated Peptic Ulcer With Mcc 4 4 $3,794.53 $3,035.62 20% off $3,415.08 $9,192.53 $3,794.53 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
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
300 MS_DRG Peripheral Vascular Disorders With Cc 5 5 $3,710.85 $2,968.68 20% off $3,339.77 $10,909.85 $3,710.85 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
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
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
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
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
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
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc 5 5 $3,110.47 $2,488.38 $2,799.42 $9,237.69 $3,110.47 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
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
793 MS_DRG Full Term Neonate With Major Problems 4 4 $2,886.19 $2,308.95 20% off $2,597.57 $8,284.19 $2,886.19 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
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
792 MS_DRG Prematurity Without Major Problems 3 3 $2,680.78 $2,144.62 20% off $2,412.70 $2,680.78 $2,680.78 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 5 5 $2,852.40 $2,281.92 20% off $2,212.79 $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
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