Price Transparency Hospital negotiated rates

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

OSF HOLY FAMILY MEDICAL CENTER

Monmouth, IL · CCN 141318 · Rates published

955 distinct procedures filed
15 distinct payers
15,932 rate rows
2026-03-31 last MRF observed
Data quality

736 of 15,932 rate rows are consumer-grade (4.6%)

15,196 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 15,196
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://osf-p-001.sitecorecontenthub.cloud/api/public/content/370813229_1548393184_osf-healthcare-system_standardcharges.json
Found on page https://www.osfhealthcare.org/patients-visitors/billing-insurance/price-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 3eeeeaedc4779706… · 8,471,796 bytes · first seen 2026-05-08

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
549
MS_DRG 		Septic Arthritis With Cc 1 $59,868.60 $59,868.60 $59,868.60 nat. median
$12,850
outlier · 4.7×
540
MS_DRG 		Osteomyelitis With Cc 1 $55,478.14 $55,478.14 $55,478.14 nat. median
$13,478
outlier · 4.1×
292
MS_DRG 		Heart Failure And Shock With Cc 1 $41,903.12 $41,903.12 $41,903.12 nat. median
$9,636
outlier · 4.3×
561
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc 1 $35,376.90 $35,376.90 $35,376.90 nat. median
$9,193
outlier · 3.8×
559
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Mcc 1 $35,376.90 $35,376.90 $35,376.90 nat. median
$19,049
1.9× median
923
MS_DRG 		Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc 1 $26,233.56 $26,233.56 $26,233.56 nat. median
$10,772
outlier · 2.4×
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 2 $15,991.54 $34,671.96 $25,331.75 nat. median
$10,875
outlier · 2.3×
176
MS_DRG 		Pulmonary Embolism Without Mcc 1 $24,906.47 $24,906.47 $24,906.47 nat. median
$9,177
outlier · 2.7×
638
MS_DRG 		Diabetes With Cc 3 $3,721.25 $40,009.11 $22,146.75 nat. median
$9,826
outlier · 2.3×
560
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Cc 3 $6,498.45 $34,702.88 $21,770.40 nat. median
$12,148
1.8× median
948
MS_DRG 		Signs And Symptoms Without Mcc 4 $10,007.32 $28,943.22 $20,617.17 nat. median
$8,516
outlier · 2.4×
92
MS_DRG 		Other Disorders Of Nervous System With Cc 1 $19,292.28 $19,292.28 $19,292.28 nat. median
$11,294
1.7× median
556
MS_DRG 		Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 1 $19,049.10 $19,049.10 $19,049.10 nat. median
$9,145
outlier · 2.1×
563
MS_DRG 		Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 $17,393.25 $17,393.25 $17,393.25 nat. median
$9,671
1.8× median
682
MS_DRG 		Renal Failure With Mcc 1 $6,266.80 $27,520.13 $16,893.47 nat. median
$15,223
1.1× median
5091
OTHER 		Level 1 Breast/Lymphatic Surgery And Related Procedures 1 $16,009.10 $16,009.10 $16,009.10 nat. median
$4,330
outlier · 3.7×
834
MS_DRG 		Acute Leukemia With Mcc 1 $16,000.91 $16,000.91 $16,000.91 nat. median
$53,173
outlier · 0.3×
603
MS_DRG 		Cellulitis Without Mcc 4 $9,467.25 $29,529.00 $15,075.14 nat. median
$9,571
1.6× median
390
MS_DRG 		Gastrointestinal Obstruction Without Cc/Mcc 1 $14,764.50 $14,764.50 $14,764.50 nat. median
$6,565
outlier · 2.2×
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 4 $6,469.37 $47,910.24 $14,313.02 nat. median
$19,635
0.7× median
372
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Cc 1 $13,967.71 $13,967.71 $13,967.71 nat. median
$11,088
1.3× median
5341
OTHER 		Level 1 Abdominal/Peritoneal/Biliary And Related Procedures 2 $3,228.15 $24,032.74 $13,630.44 nat. median
$3,927
outlier · 3.5×
196
MS_DRG 		Interstitial Lung Disease With Mcc 1 $13,341.59 $13,341.59 $13,341.59 nat. median
$18,723
0.7× median
175
MS_DRG 		Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 1 $11,965.73 $11,965.73 $11,965.73 nat. median
$14,625
0.8× median
565
MS_DRG 		Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 2 $4,921.50 $18,808.59 $11,865.05 nat. median
$10,732
1.1× median
558
MS_DRG 		Tendonitis, Myositis And Bursitis Without Mcc 1 $10,885.20 $10,885.20 $10,885.20 nat. median
$9,624
1.1× median
373
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc 1 $10,856.40 $10,856.40 $10,856.40 nat. median
$8,371
1.3× median
190
MS_DRG 		Chronic Obstructive Pulmonary Disease With Mcc 5 $4,406.80 $26,006.56 $10,675.27 nat. median
$11,700
0.9× median
159
MS_DRG 		Dental And Oral Diseases Without Cc/Mcc 1 $10,638.19 $10,638.19 $10,638.19 nat. median
$7,917
1.3× median
5691
OTHER 		Level 1 Drug Administration 2 $2,236.67 $18,053.84 $10,145.26 nat. median
$106
outlier · 96.1×
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 3 $1,767.36 $24,902.29 $10,007.32 nat. median
$8,979
1.1× median
192
MS_DRG 		Chronic Obstructive Pulmonary Disease Without Cc/Mcc 2 $5,428.20 $13,955.05 $9,691.62 nat. median
$7,581
1.3× median
392
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 3 $3,486.78 $26,672.74 $9,467.25 nat. median
$8,731
1.1× median
5113
OTHER 		Level 3 Musculoskeletal Procedures 2 $4,208.25 $14,622.34 $9,415.30 nat. median
$4,273
outlier · 2.2×
291
MS_DRG 		Heart Failure And Shock With Mcc 3 $5,003.66 $9,467.25 $8,142.30 nat. median
$13,522
0.6× median
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 3 $5,003.66 $14,746.16 $8,034.14 nat. median
$12,152
0.7× median
552
MS_DRG 		Medical Back Problems Without Mcc 2 $5,428.20 $10,007.32 $7,717.76 nat. median
$10,424
0.7× median
312
MS_DRG 		Syncope And Collapse 2 $4,321.99 $10,856.40 $7,589.19 nat. median
$9,479
0.8× median
195
MS_DRG 		Simple Pneumonia And Pleurisy Without Cc/Mcc 1 $7,374.58 $7,374.58 $7,374.58 nat. median
$7,339
1.0× median
5491
OTHER 		Level 1 Intraocular Procedures 7 $2,721.51 $20,381.00 $7,258.85 nat. median
$2,434
outlier · 3.0×
315
MS_DRG 		Other Circulatory System Diagnoses With Cc 1 $7,234.60 $7,234.60 $7,234.60 nat. median
$10,515
0.7× median
5311
OTHER 		Level 1 Lower Gi Procedures 6 $1,542.58 $10,203.59 $7,057.77 nat. median
$1,264
outlier · 5.6×
5183
OTHER 		Level 3 Vascular Procedures 4 $3,200.69 $17,145.65 $6,826.51 nat. median
$3,524
1.9× median
371
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 2 $4,903.59 $8,142.30 $6,522.94 nat. median
$17,809
outlier · 0.4×
5073
OTHER 		Level 3 Excision/ Biopsy/ Incision And Drainage 2 $3,786.26 $9,234.29 $6,510.28 nat. median
$3,139
outlier · 2.1×
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 3 $5,439.88 $10,856.40 $6,317.80 nat. median
$9,125
0.7× median
5594
OTHER 		Level 4 Nuclear Medicine And Related Services 8 $1,127.81 $8,716.00 $5,674.34 nat. median
$1,609
outlier · 3.5×
57
MS_DRG 		Degenerative Nervous System Disorders Without Mcc 1 $5,439.28 $5,439.28 $5,439.28 nat. median
$13,201
outlier · 0.4×
191
MS_DRG 		Chronic Obstructive Pulmonary Disease With Cc 5 $445.00 $30,972.41 $5,435.28 nat. median
$9,408
0.6× median
5182
OTHER 		Level 2 Vascular Procedures 4 $545.33 $7,161.64 $5,413.83 nat. median
$1,724
outlier · 3.1×

Other procedures at this hospital

Browse this hospital's 955 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
             
33 MS_DRG Ventricular Shunt Procedures Without Cc/Mcc 0 0 — — — — — 2026-03-31
31 MS_DRG Ventricular Shunt Procedures With Mcc 0 0 — — — — — 2026-03-31
32 MS_DRG Ventricular Shunt Procedures With Cc 0 0 — — — — — 2026-03-31
263 MS_DRG Vein Ligation And Stripping 0 0 — — — — — 2026-03-31
119 MS_DRG Vein Ligation & Stripping 0 0 — — — — — 2026-03-31
257 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/Mcc 0 0 — — — — — 2026-03-31
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 0 0 — — — — — 2026-03-31
256 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Cc 0 0 — — — — — 2026-03-31
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 0 0 — — — — — 2026-03-31
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 0 0 — — — — — 2026-03-31
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 0 0 — — — — — 2026-03-31
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 0 0 — — — — — 2026-03-31
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 0 0 — — — — — 2026-03-31
N801 OTHER Therapy Services 16 11 — — $48.00 $1,351.84 $213.60 2026-03-31
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 1 1 — — $10,885.20 $10,885.20 $10,885.20 2026-03-31
312 MS_DRG Syncope And Collapse 2 2 — — $4,321.99 $10,856.40 $7,589.19 2026-03-31
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc 0 0 — — — — — 2026-03-31
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 0 0 — — — — — 2026-03-31
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 0 0 — — — — — 2026-03-31
30 MS_DRG Spinal Procedures Without Cc/Mcc 0 0 — — — — — 2026-03-31
28 MS_DRG Spinal Procedures With Mcc 0 0 — — — — — 2026-03-31
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 0 0 — — — — — 2026-03-31
136 MS_DRG Sinus And Mastoid Procedures Without Cc/Mcc 0 0 — — — — — 2026-03-31
135 MS_DRG Sinus And Mastoid Procedures With Cc/Mcc 0 0 — — — — — 2026-03-31
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 0 0 — — — — — 2026-03-31
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/Mcc 1 1 — — $7,374.58 $7,374.58 $7,374.58 2026-03-31
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 3 3 — — $1,860.00 $5,255.36 $2,714.10 2026-03-31
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 3 3 — — $5,439.88 $10,856.40 $6,317.80 2026-03-31
948 MS_DRG Signs And Symptoms Without Mcc 4 4 — — $10,007.32 $28,943.22 $20,617.17 2026-03-31
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 1 1 — — $19,049.10 $19,049.10 $19,049.10 2026-03-31
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 4 4 — — $4,909.43 $33,060.53 $5,003.66 2026-03-31
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 4 4 — — $6,469.37 $47,910.24 $14,313.02 2026-03-31
548 MS_DRG Septic Arthritis With Mcc 1 1 — — $1,257.00 $1,257.00 $1,257.00 2026-03-31
549 MS_DRG Septic Arthritis With Cc 1 1 — — $59,868.60 $59,868.60 $59,868.60 2026-03-31
100 MS_DRG Seizures With Mcc 0 0 — — — — — 2026-03-31
139 MS_DRG Salivary Gland Procedures 0 0 — — — — — 2026-03-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 0 0 — — — — — 2026-03-31
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 0 0 — — — — — 2026-03-31
204 MS_DRG Respiratory Signs And Symptoms 0 0 — — — — — 2026-03-31
182 MS_DRG Respiratory Neoplasms Without Cc/Mcc 0 0 — — — — — 2026-03-31
180 MS_DRG Respiratory Neoplasms With Mcc 0 0 — — — — — 2026-03-31
181 MS_DRG Respiratory Neoplasms With Cc 0 0 — — — — — 2026-03-31
179 MS_DRG Respiratory Infections And Inflammations Without Cc/Mcc 0 0 — — — — — 2026-03-31
177 MS_DRG Respiratory Infections And Inflammations With Mcc 1 1 — — $5,385.83 $5,385.83 $5,385.83 2026-03-31
178 MS_DRG Respiratory Infections And Inflammations With Cc 2 2 — — $15,991.54 $34,671.96 $25,331.75 2026-03-31
682 MS_DRG Renal Failure With Mcc 2 1 — — $6,266.80 $27,520.13 $16,893.47 2026-03-31
683 MS_DRG Renal Failure With Cc 1 1 — — $331.52 $331.52 $331.52 2026-03-31
9522 OTHER Rbc Leukoreduced Irradiated 3 3 — — $895.98 $900.93 $897.74 2026-03-31
176 MS_DRG Pulmonary Embolism Without Mcc 1 1 — — $24,906.47 $24,906.47 $24,906.47 2026-03-31
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 1 1 — — $11,965.73 $11,965.73 $11,965.73 2026-03-31
189 MS_DRG Pulmonary Edema And Respiratory Failure 3 3 — — $2,501.83 $11,548.55 $4,921.59 2026-03-31
201 MS_DRG Pneumothorax Without Cc/Mcc 0 0 — — — — — 2026-03-31
199 MS_DRG Pneumothorax With Mcc 0 0 — — — — — 2026-03-31
200 MS_DRG Pneumothorax With Cc 0 0 — — — — — 2026-03-31
188 MS_DRG Pleural Effusion Without Cc/Mcc 0 0 — — — — — 2026-03-31
186 MS_DRG Pleural Effusion With Mcc 0 0 — — — — — 2026-03-31
187 MS_DRG Pleural Effusion With Cc 0 0 — — — — — 2026-03-31
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/Mcc 0 0 — — — — — 2026-03-31
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 0 0 — — — — — 2026-03-31
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 0 0 — — — — — 2026-03-31
301 MS_DRG Peripheral Vascular Disorders Without Cc/Mcc 0 0 — — — — — 2026-03-31
299 MS_DRG Peripheral Vascular Disorders With Mcc 0 0 — — — — — 2026-03-31
300 MS_DRG Peripheral Vascular Disorders With Cc 0 0 — — — — — 2026-03-31
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 0 0 — — — — — 2026-03-31
251 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 0 0 — — — — — 2026-03-31
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 0 0 — — — — — 2026-03-31
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 0 0 — — — — — 2026-03-31
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 0 0 — — — — — 2026-03-31
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 0 0 — — — — — 2026-03-31
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 0 0 — — — — — 2026-03-31
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 0 0 — — — — — 2026-03-31
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 0 0 — — — — — 2026-03-31
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 0 0 — — — — — 2026-03-31
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 0 0 — — — — — 2026-03-31
N902 OTHER Packaged Services 5 4 — — $150.45 $602.00 $170.79 2026-03-31
153 MS_DRG Otitis Media And Uri Without Mcc 0 0 — — — — — 2026-03-31
152 MS_DRG Otitis Media And Uri With Mcc 0 0 — — — — — 2026-03-31
254 MS_DRG Other Vascular Procedures Without Cc/Mcc 0 0 — — — — — 2026-03-31
252 MS_DRG Other Vascular Procedures With Mcc 0 0 — — — — — 2026-03-31
253 MS_DRG Other Vascular Procedures With Cc 0 0 — — — — — 2026-03-31
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 0 0 — — — — — 2026-03-31
205 MS_DRG Other Respiratory System Diagnoses With Mcc 0 0 — — — — — 2026-03-31
565 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 2 2 — — $4,921.50 $18,808.59 $11,865.05 2026-03-31
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 0 0 — — — — — 2026-03-31
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 0 0 — — — — — 2026-03-31
271 MS_DRG Other Major Cardiovascular Procedures With Cc 0 0 — — — — — 2026-03-31
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 2 2 — — $2,117.15 $4,061.74 $3,089.44 2026-03-31
923 MS_DRG Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc 1 1 — — $26,233.56 $26,233.56 $26,233.56 2026-03-31
215 MS_DRG Other Heart Assist System Implant 0 0 — — — — — 2026-03-31
951 MS_DRG Other Factors Influencing Health Status 2 2 — — $107.82 $128.45 $118.13 2026-03-31
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 0 0 — — — — — 2026-03-31
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 0 0 — — — — — 2026-03-31
145 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/Mcc 0 0 — — — — — 2026-03-31
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 0 0 — — — — — 2026-03-31
144 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 0 0 — — — — — 2026-03-31
156 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/Mcc 0 0 — — — — — 2026-03-31
154 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 0 0 — — — — — 2026-03-31
155 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Cc 0 0 — — — — — 2026-03-31
134 MS_DRG Other Ear, Nose, Mouth & Throat O.r. Procedures Without Cc/Mcc 0 0 — — — — — 2026-03-31
125 MS_DRG Other Disorders Of The Eye Without Mcc 0 0 — — — — — 2026-03-31
124 MS_DRG Other Disorders Of The Eye With Mcc Or Thrombolytic Agent 0 0 — — — — — 2026-03-31
92 MS_DRG Other Disorders Of Nervous System With Cc 1 1 — — $19,292.28 $19,292.28 $19,292.28 2026-03-31
171 MS_DRG Other Digestive System O.r. Procedures Without Cc 0 0 — — — — — 2026-03-31
394 MS_DRG Other Digestive System Diagnoses With Cc 1 1 — — $5,003.66 $5,003.66 $5,003.66 2026-03-31
120 MS_DRG Other Circulatory System O.r. Procedures 0 0 — — — — — 2026-03-31
264 MS_DRG Other Circulatory System O.r. Procedures 0 0 — — — — — 2026-03-31
316 MS_DRG Other Circulatory System Diagnoses Without Cc/Mcc 0 0 — — — — — 2026-03-31
314 MS_DRG Other Circulatory System Diagnoses With Mcc 0 0 — — — — — 2026-03-31
315 MS_DRG Other Circulatory System Diagnoses With Cc 1 1 — — $7,234.60 $7,234.60 $7,234.60 2026-03-31
108 MS_DRG Other Cardiothoracic Procedures 0 0 — — — — — 2026-03-31
540 MS_DRG Osteomyelitis With Cc 1 1 — — $55,478.14 $55,478.14 $55,478.14 2026-03-31
N905 OTHER Not Recognized By Opps 1 1 — — $215.00 $215.00 $215.00 2026-03-31
N700 OTHER Non-opps Clinic Services 10 8 — — $24.72 $722.31 $144.00 2026-03-31
N900 OTHER Non-covered Services 6 4 — — $99.41 $2,431.00 $1,107.86 2026-03-31
214 MS_DRG No Longer Valid 0 0 — — — — — 2026-03-31
109 MS_DRG No Longer Valid 0 0 — — — — — 2026-03-31
107 MS_DRG No Longer Valid 0 0 — — — — — 2026-03-31
123 MS_DRG Neurological Eye Disorders 0 0 — — — — — 2026-03-31
138 MS_DRG Mouth Procedures Without Cc/Mcc 0 0 — — — — — 2026-03-31
137 MS_DRG Mouth Procedures With Cc/Mcc 0 0 — — — — — 2026-03-31
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 1 1 — — $2,668.82 $2,668.82 $2,668.82 2026-03-31
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 1 1 — — $4,898.33 $4,898.33 $4,898.33 2026-03-31
552 MS_DRG Medical Back Problems Without Mcc 2 2 — — $5,428.20 $10,007.32 $7,717.76 2026-03-31
N804 OTHER Mammography Services 19 11 — — $112.27 $716.00 $304.65 2026-03-31
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 0 0 — — — — — 2026-03-31
330 MS_DRG Major Small And Large Bowel Procedures With Cc 0 0 — — — — — 2026-03-31
142 MS_DRG Major Head And Neck Procedures Without Cc/Mcc 0 0 — — — — — 2026-03-31
140 MS_DRG Major Head And Neck Procedures With Mcc 0 0 — — — — — 2026-03-31
141 MS_DRG Major Head And Neck Procedures With Cc 0 0 — — — — — 2026-03-31
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc 1 1 — — $10,856.40 $10,856.40 $10,856.40 2026-03-31
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 2 2 — — $4,903.59 $8,142.30 $6,522.94 2026-03-31
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 1 1 — — $13,967.71 $13,967.71 $13,967.71 2026-03-31
185 MS_DRG Major Chest Trauma Without Cc/Mcc 0 0 — — — — — 2026-03-31
183 MS_DRG Major Chest Trauma With Mcc 0 0 — — — — — 2026-03-31
184 MS_DRG Major Chest Trauma With Cc 0 0 — — — — — 2026-03-31
111 MS_DRG Major Cardiovascular Procedures Without Cc 0 0 — — — — — 2026-03-31
110 MS_DRG Major Cardiovascular Procedures W Cc 0 0 — — — — — 2026-03-31
5025 OTHER Level 5 Type A Ed Visits 21 14 — — $686.47 $17,120.01 $2,208.59 2026-03-31
5024 OTHER Level 4 Type A Ed Visits 21 13 — — $552.96 $5,118.30 $1,925.35 2026-03-31
5054 OTHER Level 4 Skin Procedures 6 5 — — $2,810.03 $16,002.00 $3,362.87 2026-03-31
5594 OTHER Level 4 Nuclear Medicine And Related Services 15 8 — — $1,127.81 $8,716.00 $5,674.34 2026-03-31
5734 OTHER Level 4 Minor Procedures 15 10 — — $78.54 $4,181.59 $356.75 2026-03-31
5524 OTHER Level 4 Imaging Without Contrast 16 10 — — $712.99 $4,675.00 $1,960.99 2026-03-31
5694 OTHER Level 4 Drug Administration 3 3 — — $2,285.90 $9,577.88 $2,515.09 2026-03-31
5724 OTHER Level 4 Diagnostic Tests And Related Services 7 6 — — $888.25 $5,225.00 $1,680.72 2026-03-31
5183 OTHER Level 3 Vascular Procedures 4 4 — — $3,200.69 $17,145.65 $6,826.51 2026-03-31
5023 OTHER Level 3 Type A Ed Visits 20 13 — — $225.10 $2,123.20 $821.19 2026-03-31
5053 OTHER Level 3 Skin Procedures 10 7 — — $72.68 $1,848.00 $855.00 2026-03-31
5673 OTHER Level 3 Pathology 2 2 — — $1,259.52 $3,562.20 $2,410.86 2026-03-31
5593 OTHER Level 3 Nuclear Medicine And Related Services 8 7 — — $1,497.00 $10,721.65 $3,590.54 2026-03-31
5113 OTHER Level 3 Musculoskeletal Procedures 2 2 — — $4,208.25 $14,622.34 $9,415.30 2026-03-31
5733 OTHER Level 3 Minor Procedures 16 9 — — $92.16 $2,278.33 $111.98 2026-03-31
5493 OTHER Level 3 Intraocular Procedures 2 2 — — $1,529.80 $5,184.35 $3,357.07 2026-03-31
5523 OTHER Level 3 Imaging Without Contrast 20 12 — — $361.80 $6,681.04 $1,026.20 2026-03-31
5573 OTHER Level 3 Imaging With Contrast 4 4 — — $705.95 $717.97 $717.97 2026-03-31
5503 OTHER Level 3 Extraocular, Repair, And Plastic Eye Procedures 2 2 — — $2,103.31 $7,288.49 $4,695.90 2026-03-31
5073 OTHER Level 3 Excision/ Biopsy/ Incision And Drainage 2 2 — — $3,786.26 $9,234.29 $6,510.28 2026-03-31
5693 OTHER Level 3 Drug Administration 9 7 — — $96.79 $1,123.45 $196.99 2026-03-31
5182 OTHER Level 2 Vascular Procedures 4 4 — — $545.33 $7,161.64 $5,413.83 2026-03-31
5022 OTHER Level 2 Type A Ed Visits 19 11 — — $73.76 $886.00 $405.68 2026-03-31
5102 OTHER Level 2 Strapping And Cast Application 7 6 — — $77.69 $520.00 $397.28 2026-03-31
5052 OTHER Level 2 Skin Procedures 15 9 — — $95.95 $1,623.60 $548.55 2026-03-31
5672 OTHER Level 2 Pathology 2 2 — — $5.90 $405.68 $205.79 2026-03-31
5592 OTHER Level 2 Nuclear Medicine And Related Services 7 6 — — $746.23 $4,968.95 $3,431.15 2026-03-31
5442 OTHER Level 2 Nerve Injections 8 6 — — $1,212.92 $3,994.69 $2,360.55 2026-03-31
5732 OTHER Level 2 Minor Procedures 13 8 — — $42.08 $263.00 $208.56 2026-03-31
5312 OTHER Level 2 Lower Gi Procedures 13 7 — — $1,697.65 $10,936.70 $4,191.24 2026-03-31
5522 OTHER Level 2 Imaging Without Contrast 21 13 — — $139.78 $4,230.00 $464.81 2026-03-31
5572 OTHER Level 2 Imaging With Contrast 19 12 — — $10.38 $7,840.00 $1,731.41 2026-03-31
5412 OTHER Level 2 Gynecologic Procedures 1 1 — — $3,905.53 $3,905.53 $3,905.53 2026-03-31
5072 OTHER Level 2 Excision/ Biopsy/ Incision And Drainage 9 6 — — $602.93 $10,367.05 $2,943.77 2026-03-31
5692 OTHER Level 2 Drug Administration 8 6 — — $37.79 $6,254.35 $1,113.38 2026-03-31
5722 OTHER Level 2 Diagnostic Tests And Related Services 18 11 — — $386.69 $2,412.20 $903.23 2026-03-31
5301 OTHER Level 1 Upper Gi Procedures 11 7 — — $1,630.01 $10,554.30 $4,101.75 2026-03-31
5021 OTHER Level 1 Type A Ed Visits 6 5 — — $169.61 $1,021.01 $591.13 2026-03-31
5101 OTHER Level 1 Strapping And Cast Application 8 7 — — $47.82 $764.76 $82.57 2026-03-31
5051 OTHER Level 1 Skin Procedures 13 9 — — $60.84 $775.15 $307.68 2026-03-31
5671 OTHER Level 1 Pathology 13 9 — — $100.80 $11,793.72 $481.32 2026-03-31
5591 OTHER Level 1 Nuclear Medicine And Related Services 4 3 — — $795.94 $4,089.00 $2,073.91 2026-03-31
5441 OTHER Level 1 Nerve Injections 3 3 — — $375.71 $3,162.95 $1,662.08 2026-03-31
5731 OTHER Level 1 Minor Procedures 4 4 — — $39.70 $124.74 $39.70 2026-03-31
5311 OTHER Level 1 Lower Gi Procedures 9 6 — — $1,542.58 $10,203.59 $7,057.77 2026-03-31
5491 OTHER Level 1 Intraocular Procedures 13 7 — — $2,721.51 $20,381.00 $7,258.85 2026-03-31
5521 OTHER Level 1 Imaging Without Contrast 19 12 — — $105.98 $1,233.76 $238.84 2026-03-31
5571 OTHER Level 1 Imaging With Contrast 18 12 — — $665.37 $11,271.00 $1,292.83 2026-03-31
5071 OTHER Level 1 Excision/ Biopsy/ Incision And Drainage 3 3 — — $1,522.20 $2,474.12 $2,297.31 2026-03-31
5691 OTHER Level 1 Drug Administration 2 2 — — $2,236.67 $18,053.84 $10,145.26 2026-03-31
5721 OTHER Level 1 Diagnostic Tests And Related Services 17 11 — — $171.58 $1,117.00 $645.65 2026-03-31
5091 OTHER Level 1 Breast/Lymphatic Surgery And Related Procedures 1 1 — — $16,009.10 $16,009.10 $16,009.10 2026-03-31
5241 OTHER Level 1 Blood Product Exchange And Related Services 4 4 — — $502.21 $2,985.56 $1,744.05 2026-03-31
5341 OTHER Level 1 Abdominal/Peritoneal/Biliary And Related Procedures 2 2 — — $3,228.15 $24,032.74 $13,630.44 2026-03-31
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 3 3 — — $1,767.36 $24,902.29 $10,007.32 2026-03-31
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 3 3 — — $5,003.66 $14,746.16 $8,034.14 2026-03-31
117 MS_DRG Intraocular Procedures Without Cc/Mcc 0 0 — — — — — 2026-03-31
116 MS_DRG Intraocular Procedures With Cc/Mcc 0 0 — — — — — 2026-03-31
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 0 0 — — — — — 2026-03-31
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 0 0 — — — — — 2026-03-31
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc 1 1 — — $3,763.94 $3,763.94 $3,763.94 2026-03-31
198 MS_DRG Interstitial Lung Disease Without Cc/Mcc 0 0 — — — — — 2026-03-31
196 MS_DRG Interstitial Lung Disease With Mcc 1 1 — — $13,341.59 $13,341.59 $13,341.59 2026-03-31
197 MS_DRG Interstitial Lung Disease With Cc 0 0 — — — — — 2026-03-31
0792 OTHER Inj, Glycopyrrolate, 0.1 Mg 1 1 — — $1,186.07 $1,186.07 $1,186.07 2026-03-31
305 MS_DRG Hypertension Without Mcc 0 0 — — — — — 2026-03-31
304 MS_DRG Hypertension With Mcc 1 1 — — $2,714.10 $2,714.10 $2,714.10 2026-03-31
211 MS_DRG Hip & Femur Procedures Except Major Joint Age >17 Without Cc 0 0 — — — — — 2026-03-31
210 MS_DRG Hip & Femur Procedures Except Major Joint Age >17 W Cc 0 0 — — — — — 2026-03-31
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 0 0 — — — — — 2026-03-31
293 MS_DRG Heart Failure And Shock Without Cc/Mcc 0 0 — — — — — 2026-03-31
291 MS_DRG Heart Failure And Shock With Mcc 3 3 — — $5,003.66 $9,467.25 $8,142.30 2026-03-31
292 MS_DRG Heart Failure And Shock With Cc 1 1 — — $41,903.12 $41,903.12 $41,903.12 2026-03-31
103 MS_DRG Headaches Without Mcc 0 0 — — — — — 2026-03-31
102 MS_DRG Headaches With Mcc 0 0 — — — — — 2026-03-31
390 MS_DRG Gastrointestinal Obstruction Without Cc/Mcc 1 1 — — $14,764.50 $14,764.50 $14,764.50 2026-03-31
174 MS_DRG G.i. Hemorrhage W Cc 0 0 — — — — — 2026-03-31
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 1 — — $17,393.25 $17,393.25 $17,393.25 2026-03-31
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 3 3 — — $3,486.78 $26,672.74 $9,467.25 2026-03-31
151 MS_DRG Epistaxis Without Mcc 0 0 — — — — — 2026-03-31
150 MS_DRG Epistaxis With Mcc 0 0 — — — — — 2026-03-31
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 0 0 — — — — — 2026-03-31
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 0 0 — — — — — 2026-03-31
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 0 0 — — — — — 2026-03-31
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 0 0 — — — — — 2026-03-31
148 MS_DRG Ear, Nose, Mouth And Throat Malignancy Without Cc/Mcc 0 0 — — — — — 2026-03-31
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 0 0 — — — — — 2026-03-31
147 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Cc 0 0 — — — — — 2026-03-31
149 MS_DRG Dysequilibrium 0 0 — — — — — 2026-03-31
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 1 1 — — $3,190.41 $3,190.41 $3,190.41 2026-03-31
638 MS_DRG Diabetes With Cc 3 3 — — $3,721.25 $40,009.11 $22,146.75 2026-03-31
159 MS_DRG Dental And Oral Diseases Without Cc/Mcc 1 1 — — $10,638.19 $10,638.19 $10,638.19 2026-03-31
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 1 1 — — $5,439.28 $5,439.28 $5,439.28 2026-03-31
295 MS_DRG Deep Vein Thrombophlebitis Without Cc/Mcc 0 0 — — — — — 2026-03-31
294 MS_DRG Deep Vein Thrombophlebitis With Cc/Mcc 0 0 — — — — — 2026-03-31
5041 OTHER Critical Care 13 10 — — $523.63 $26,470.25 $2,205.57 2026-03-31
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 0 0 — — — — — 2026-03-31
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 0 0 — — — — — 2026-03-31
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 0 0 — — — — — 2026-03-31
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 0 0 — — — — — 2026-03-31
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 0 0 — — — — — 2026-03-31
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 0 0 — — — — — 2026-03-31
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 0 0 — — — — — 2026-03-31
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 0 0 — — — — — 2026-03-31
209 MS_DRG Complex Aortic Arch Procedures 0 0 — — — — — 2026-03-31
N800 OTHER Clinical Diagnostic Lab Services 22 14 — — $59.36 $676.80 $136.61 2026-03-31
5012 OTHER Clinic Visits And Related Services 15 9 — — $23.99 $722.31 $126.72 2026-03-31
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc 0 0 — — — — — 2026-03-31
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 0 0 — — — — — 2026-03-31
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/Mcc 2 2 — — $5,428.20 $13,955.05 $9,691.62 2026-03-31
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 5 5 — — $4,406.80 $26,006.56 $10,675.27 2026-03-31
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 5 5 — — $445.00 $30,972.41 $5,435.28 2026-03-31
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 0 0 — — — — — 2026-03-31
313 MS_DRG Chest Pain 0 0 — — — — — 2026-03-31
603 MS_DRG Cellulitis Without Mcc 4 4 — — $9,467.25 $29,529.00 $15,075.14 2026-03-31
104 MS_DRG Cardiac Valve & Oth Major Cardiothoracic Proc W Cardiac Cath 0 0 — — — — — 2026-03-31
5771 OTHER Cardiac Rehabilitation 3 3 — — $50.49 $297.00 $129.24 2026-03-31
262 MS_DRG Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc 0 0 — — — — — 2026-03-31
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 0 0 — — — — — 2026-03-31
261 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Cc 0 0 — — — — — 2026-03-31
259 MS_DRG Cardiac Pacemaker Device Replacement Without Mcc 0 0 — — — — — 2026-03-31
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 0 0 — — — — — 2026-03-31
118 MS_DRG Cardiac Pacemaker Device Replacement 0 0 — — — — — 2026-03-31
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 0 0 — — — — — 2026-03-31
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 0 0 — — — — — 2026-03-31
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 0 0 — — — — — 2026-03-31
307 MS_DRG Cardiac Congenital And Valvular Disorders Without Mcc 0 0 — — — — — 2026-03-31
306 MS_DRG Cardiac Congenital And Valvular Disorders With Mcc 0 0 — — — — — 2026-03-31
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc 0 0 — — — — — 2026-03-31
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 0 0 — — — — — 2026-03-31
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 0 0 — — — — — 2026-03-31
298 MS_DRG Cardiac Arrest, Unexplained Without Cc/Mcc 0 0 — — — — — 2026-03-31
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 0 0 — — — — — 2026-03-31
297 MS_DRG Cardiac Arrest, Unexplained With Cc 0 0 — — — — — 2026-03-31
203 MS_DRG Bronchitis And Asthma Without Cc/Mcc 0 0 — — — — — 2026-03-31
202 MS_DRG Bronchitis And Asthma With Cc/Mcc 0 0 — — — — — 2026-03-31
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 0 0 — — — — — 2026-03-31
303 MS_DRG Atherosclerosis Without Mcc 0 0 — — — — — 2026-03-31
302 MS_DRG Atherosclerosis With Mcc 0 0 — — — — — 2026-03-31
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 0 0 — — — — — 2026-03-31
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 0 0 — — — — — 2026-03-31
311 MS_DRG Angina Pectoris 0 0 — — — — — 2026-03-31
241 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 0 0 — — — — — 2026-03-31
14 MS_DRG Allogeneic Bone Marrow Transplant 0 0 — — — — — 2026-03-31
265 MS_DRG Aicd Lead Procedures 0 0 — — — — — 2026-03-31
245 MS_DRG Aicd Generator Procedures 0 0 — — — — — 2026-03-31
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc 1 1 — — $35,376.90 $35,376.90 $35,376.90 2026-03-31
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 1 1 — — $35,376.90 $35,376.90 $35,376.90 2026-03-31
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 3 3 — — $6,498.45 $34,702.88 $21,770.40 2026-03-31
949 MS_DRG Aftercare With Cc/Mcc 1 1 — — $331.52 $331.52 $331.52 2026-03-31
285 MS_DRG Acute Myocardial Infarction, Expired Without Cc/Mcc 0 0 — — — — — 2026-03-31
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 0 0 — — — — — 2026-03-31
284 MS_DRG Acute Myocardial Infarction, Expired With Cc 0 0 — — — — — 2026-03-31
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 0 0 — — — — — 2026-03-31
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 1 1 — — $4,161.31 $4,161.31 $4,161.31 2026-03-31
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 0 0 — — — — — 2026-03-31
122 MS_DRG Acute Major Eye Infections Without Cc/Mcc 0 0 — — — — — 2026-03-31
121 MS_DRG Acute Major Eye Infections With Cc/Mcc 0 0 — — — — — 2026-03-31
834 MS_DRG Acute Leukemia With Mcc 1 1 — — $16,000.91 $16,000.91 $16,000.91 2026-03-31
290 MS_DRG Acute And Subacute Endocarditis Without Cc/Mcc 0 0 — — — — — 2026-03-31
288 MS_DRG Acute And Subacute Endocarditis With Mcc 0 0 — — — — — 2026-03-31
289 MS_DRG Acute And Subacute Endocarditis With Cc 0 0 — — — — — 2026-03-31
126 MS_DRG Acute & Subacute Endocarditis 0 0 — — — — — 2026-03-31
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