Hospital

GLENCOE REGIONAL HEALTH

Glencoe, MN · CCN 241355 · Rates published

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You selected 59510 (CPT)

PR OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM,Professinal Compenent

This hospital’s price: $5,095 across 3 payers · range $5,037-$6,101

Source: https://glencoehealth.org/wp-content/uploads/2025/04/411949230_glencoe-regional-health-services_standardcharges.csv · observed 2026-05-06

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.

3,242 distinct procedures filed

12 distinct payers

135,082 rate rows

2026-07-20 last MRF observed

Data quality

43,874 of 135,082 rate rows are consumer-grade (32.5%)

91,208 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
professional (physician) fee — not the facility price	90,673
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	408
exceeds 10× this hospital's gross charge — excluded from medians	53
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	45
placeholder amount (≤ $0.02) — excluded from medians	29

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

Source MRF file	https://mrfs.hyvehealthcare.com/GlencoeRegionalHealthServices/411949230_glencoe-regional-health-services_standardcharges.csv
Found on page	https://glencoehealth.org/billing-and-insurance/billing-information/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-10-11
Content fingerprint	ac5b4c84cb61c154… · 32,858,107 bytes · first seen 2026-08-10

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
45388 CPT	Pr Colonoscopy Flx Ablation Tumor Polyp/other Les	3	$599.23	$8,293.33	$6,320.45	nat. median $1,618 outlier · 3.9×
59510 CPT	Pr OB Antepartum Care Cesarean Dlvr & Postpartum	3	$5,037.07	$6,100.57	$5,095.20	nat. median $3,349 1.5× median
111956 OTHER	Hchg Procedure Level 6 (+ Staff + Setup)	4	$4,778.14	$5,919.58	$4,915.84	—
59610 CPT	Pr Routine OB Care Vag Dlvry & Postpartum Care Vb	3	$4,776.59	$5,785.09	$4,831.72	nat. median $3,150 1.5× median
111957 OTHER	Hchg Procedure Level 6 (+ Staff)	4	$4,677.08	$5,794.39	$4,811.88	—
59400 CPT	Pr OB Care Antepartum Vag Dlvr & Postpartum	3	$4,537.95	$5,496.07	$4,590.32	nat. median $2,933 1.6× median
111955 OTHER	Hchg Procedure Level 6 (+ Setup)	4	$4,272.81	$5,293.54	$4,395.95	—
J9225 HCPCS	Pr Histrelin Implant (vantas) 50 Mg	4	$4,250.87	$5,266.35	$4,373.38	nat. median $6,646 0.7× median
111954 OTHER	Hchg Procedure Level 6	4	$4,171.76	$5,168.35	$4,291.98	—
111948 OTHER	Hchg Procedure Level 5 (+ Staff + Setup)	4	$4,148.47	$5,139.50	$4,268.03	—
27134 CPT	Pr Revj Tot Hip Arthrp Bth W/wo Agrft/algrft	3	$4,165.31	$5,044.74	$4,213.38	nat. median $9,347 outlier · 0.5×
111949 OTHER	Hchg Procedure Level 5 (+ Staff)	4	$4,047.39	$5,014.26	$4,164.03	—
44207 CPT	Pr Laps Colectomy Prtl W/colopxtstmy Lw Anast	3	$3,975.59	$4,814.97	$4,021.47	nat. median $4,397 0.9× median
44206 CPT	Pr Laps Colectomy Prtl W/end Clst & Clsr Dstl Sgm	3	$3,824.28	$4,631.72	$3,868.42	nat. median $4,575 0.8× median
27487 CPT	Pr Revj Tot Knee Arthrp Fem&entire Tibial Compone	3	$3,819.02	$4,625.34	$3,863.09	nat. median $11,543 outlier · 0.3×
23474 CPT	Pr Revis Shoulder Arthrplsty Humeral&glenoid Compnt	3	$3,812.23	$4,617.13	$3,856.23	nat. median $12,255 outlier · 0.3×
43282 CPT	Pr Laps Rpr Paraesphgl Hrna Incl Fundplsty W/mesh	3	$3,791.92	$4,592.52	$3,835.68	nat. median $10,473 outlier · 0.4×
111947 OTHER	Hchg Procedure Level 5 (+ Setup)	4	$3,643.14	$4,513.45	$3,748.14	—
44227 CPT	Pr Laps Clsr Ntrstm Lg/sm Int W/rescj & Anastomosis	3	$3,639.84	$4,408.34	$3,681.85	nat. median $3,400 1.1× median
27132 CPT	Pr Conv Prev Hip Tot Hip Arthrp W/wo Agrft/algrft	3	$3,637.60	$4,405.61	$3,679.58	nat. median $12,910 outlier · 0.3×
44143 CPT	Pr Colectomy Prtl W/end Colostomy & Clsr Dstl Sgmt	3	$3,633.82	$4,401.05	$3,675.76	nat. median $4,010 0.9× median
44145 CPT	Pr Colectomy Prtl W/coloproctostomy	3	$3,620.27	$4,384.63	$3,662.05	nat. median $3,388 1.1× median
111946 OTHER	Hchg Procedure Level 5	4	$3,542.08	$4,388.24	$3,644.15	—
111940 OTHER	Hchg Procedure Level 4 (+ Staff + Setup)	4	$3,518.48	$4,359.01	$3,619.88	—
44603 CPT	Pr Enterorrhaphy Multiple Perforations	3	$3,539.71	$4,287.07	$3,580.57	nat. median $2,903 1.2× median
23473 CPT	Pr Revis Shoulder Arthrplsty Humeral/glenoid Compnt	3	$3,529.18	$4,274.31	$3,569.91	nat. median $12,689 outlier · 0.3×
111941 OTHER	Hchg Procedure Level 4 (+ Staff)	4	$3,417.43	$4,233.82	$3,515.92	—
A9569 HCPCS	Nm Dose Tech 99m Ceretec Label Wbc	12	$1,343.51	$5,515.08	$3,411.39	nat. median $1,675 outlier · 2.0×
43281 CPT	Pr Laps Rpr Paraesphgl Hrna Incl Fundplsty Without Mesh	3	$3,371.09	$4,082.84	$3,410.00	nat. median $10,354 outlier · 0.3×
44204 CPT	Pr Laparoscopy Colectomy Partial W/anastomosis	3	$3,359.05	$4,068.26	$3,397.82	nat. median $4,854 0.7× median
49204 CPT	Pr Exc/destruction Open Abdmnl Tumors 5.1-10.0 CM,Professinal Compenent	3	$3,343.99	$4,050.02	$3,382.58	nat. median $5,505 0.6× median
27138 CPT	Pr Revj Tot Hip Arthrp Fem Only W/wo Algrft	3	$3,324.41	$4,026.31	$3,362.78	nat. median $11,000 outlier · 0.3×
27137 CPT	Pr Revj Tot Hip Arthrp Actblr W/wo Agrft/algrft	3	$3,200.20	$3,875.87	$3,237.14	nat. median $10,335 outlier · 0.3×
23472 CPT	Pr Arthroplasty Glenohumeral Joint Total Shoulder	3	$3,160.31	$3,827.56	$3,196.79	nat. median $16,735 outlier · 0.2×
44602 CPT	Pr Enterorrhaphy 1perforation	3	$3,082.02	$3,732.73	$3,117.59	nat. median $3,962 0.8× median
58565 CPT	Pr Hysteroscopy Bi Tube Occlusion W/perm Implnts	3	$927.47	$4,846.89	$3,109.96	nat. median $5,181 0.6× median
111939 OTHER	Hchg Procedure Level 4 (+ Setup)	4	$3,013.16	$3,732.98	$3,100.01	—
27486 CPT	Pr Revj Total Knee Arthrp W/wo Algrft 1 Component	3	$3,053.40	$3,698.08	$3,088.64	nat. median $11,459 outlier · 0.3×
44202 CPT	Pr Laps Enterect Rescj 1 Small Intest Rescj & Ana	3	$3,024.04	$3,662.52	$3,058.94	nat. median $4,575 0.7× median
110749 OTHER	Hchg Birthing Vaginal Complicated	4	$2,972.04	$3,682.02	$3,057.69	—
27415 CPT	Pr Osteochondral Allograft Knee Open	3	$2,982.65	$3,612.39	$3,017.07	nat. median $9,751 outlier · 0.3×
43840 CPT	Pr Gastrorrhaphy Sutr Prf8 Duol/gstr Ulcer Wnd/inj	3	$2,963.82	$3,589.59	$2,998.03	nat. median $4,173 0.7× median
111938 OTHER	Hchg Procedure Level 4	4	$2,912.10	$3,607.77	$2,996.02	—
27130 CPT	Pr Arthrp Acetblr/prox Fem Prostc Agrft/algrft	3	$2,944.25	$3,565.89	$2,978.23	nat. median $12,734 outlier · 0.2×
27447 CPT	Pr Arthrp Kne Condyle&platu Medial&lat Compartments	3	$2,942.74	$3,564.06	$2,976.71	nat. median $12,374 outlier · 0.2×
111930 OTHER	Hchg Procedure Level 3 (+ Staff + Setup)	4	$2,887.55	$3,577.36	$2,970.78	—
44140 CPT	Pr Colectomy Partial W/anastomosis	3	$2,926.94	$3,544.92	$2,960.72	nat. median $3,357 0.9× median
44205 CPT	Pr Laps Colectomy Prtl W/rmvl Terminal Ileum	3	$2,921.67	$3,538.53	$2,955.39	nat. median $4,076 0.7× median
27506 CPT	Pr Optx Fem Shft Fx W/insj Imed Implt W/wo Screw	3	$2,902.09	$3,514.82	$2,935.58	nat. median $5,550 0.5× median
44130 CPT	Pr Enteroenterost Anast Int W/wo Cutan Ntrstm Spx	3	$2,865.20	$3,470.14	$2,898.27	nat. median $2,810 1.0× median

Other procedures at this hospital

Browse this hospital's 3,242 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

45388	CPT	Pr Colonoscopy Flx Ablation Tumor Polyp/other Les	9	3	$8,483.83	$8,483.83	$599.23	$8,293.33	$6,320.45	2026-05-06
59510	CPT	Pr OB Antepartum Care Cesarean Dlvr & Postpartum	3	3	$6,839.20	$6,839.20	$5,037.07	$6,100.57	$5,095.20	2026-05-06
111956	OTHER	Hchg Procedure Level 6 (+ Staff + Setup)	4	4	$6,636.30	$6,636.30	$4,778.14	$5,919.58	$4,915.84	2026-05-06
59610	CPT	Pr Routine OB Care Vag Dlvry & Postpartum Care Vb	3	3	$6,485.53	$6,485.53	$4,776.59	$5,785.09	$4,831.72	2026-05-06
111957	OTHER	Hchg Procedure Level 6 (+ Staff)	4	4	$6,495.95	$6,495.95	$4,677.08	$5,794.39	$4,811.88	2026-05-06
59400	CPT	Pr OB Care Antepartum Vag Dlvr & Postpartum	3	3	$6,161.51	$6,161.51	$4,537.95	$5,496.07	$4,590.32	2026-05-06
111955	OTHER	Hchg Procedure Level 6 (+ Setup)	4	4	$5,934.46	$5,934.46	$4,272.81	$5,293.54	$4,395.95	2026-05-06
J9225	HCPCS	Pr Histrelin Implant (vantas) 50 Mg	4	4	$5,903.98	$5,903.98	$4,250.87	$5,266.35	$4,373.38	2026-05-06
111954	OTHER	Hchg Procedure Level 6	4	4	$5,794.11	$5,794.11	$4,171.76	$5,168.35	$4,291.98	2026-05-06
111948	OTHER	Hchg Procedure Level 5 (+ Staff + Setup)	4	4	$5,761.77	$5,761.77	$4,148.47	$5,139.50	$4,268.03	2026-05-06
27134	CPT	Pr Revj Tot Hip Arthrp Bth W/wo Agrft/algrft	3	3	$5,655.54	$5,655.54	$4,165.31	$5,044.74	$4,213.38	2026-05-06
111949	OTHER	Hchg Procedure Level 5 (+ Staff)	4	4	$5,621.37	$5,621.37	$4,047.39	$5,014.26	$4,164.03	2026-05-06
44207	CPT	Pr Laps Colectomy Prtl W/colopxtstmy Lw Anast	3	3	$5,397.95	$5,397.95	$3,975.59	$4,814.97	$4,021.47	2026-05-06
44206	CPT	Pr Laps Colectomy Prtl W/end Clst & Clsr Dstl Sgm	3	3	$5,192.51	$5,192.51	$3,824.28	$4,631.72	$3,868.42	2026-05-06
27487	CPT	Pr Revj Tot Knee Arthrp Fem&entire Tibial Compone	3	3	$5,185.36	$5,185.36	$3,819.02	$4,625.34	$3,863.09	2026-05-06
23474	CPT	Pr Revis Shoulder Arthrplsty Humeral&glenoid Compnt	3	3	$5,176.15	$5,176.15	$3,812.23	$4,617.13	$3,856.23	2026-05-06
43282	CPT	Pr Laps Rpr Paraesphgl Hrna Incl Fundplsty W/mesh	3	3	$5,148.57	$5,148.57	$3,791.92	$4,592.52	$3,835.68	2026-05-06
111947	OTHER	Hchg Procedure Level 5 (+ Setup)	4	4	$5,059.92	$5,059.92	$3,643.14	$4,513.45	$3,748.14	2026-05-06
44227	CPT	Pr Laps Clsr Ntrstm Lg/sm Int W/rescj & Anastomosis	3	3	$4,942.08	$4,942.08	$3,639.84	$4,408.34	$3,681.85	2026-05-06
27132	CPT	Pr Conv Prev Hip Tot Hip Arthrp W/wo Agrft/algrft	3	3	$4,939.03	$4,939.03	$3,637.60	$4,405.61	$3,679.58	2026-05-06
44143	CPT	Pr Colectomy Prtl W/end Colostomy & Clsr Dstl Sgmt	3	3	$4,933.91	$4,933.91	$3,633.82	$4,401.05	$3,675.76	2026-05-06
44145	CPT	Pr Colectomy Prtl W/coloproctostomy	3	3	$4,915.51	$4,915.51	$3,620.27	$4,384.63	$3,662.05	2026-05-06
111946	OTHER	Hchg Procedure Level 5	4	4	$4,919.55	$4,919.55	$3,542.08	$4,388.24	$3,644.15	2026-05-06
111940	OTHER	Hchg Procedure Level 4 (+ Staff + Setup)	4	4	$4,886.78	$4,886.78	$3,518.48	$4,359.01	$3,619.88	2026-05-06
44603	CPT	Pr Enterorrhaphy Multiple Perforations	3	3	$4,806.13	$4,806.13	$3,539.71	$4,287.07	$3,580.57	2026-05-06
23473	CPT	Pr Revis Shoulder Arthrplsty Humeral/glenoid Compnt	3	3	$4,791.83	$4,791.83	$3,529.18	$4,274.31	$3,569.91	2026-05-06
111941	OTHER	Hchg Procedure Level 4 (+ Staff)	4	4	$4,746.43	$4,746.43	$3,417.43	$4,233.82	$3,515.92	2026-05-06
A9569	HCPCS	Nm Dose Tech 99m Ceretec Label Wbc	27	12	$5,685.65	$5,685.65	$1,343.51	$5,515.08	$3,411.39	2026-07-20
43281	CPT	Pr Laps Rpr Paraesphgl Hrna Incl Fundplsty Without Mesh	3	3	$4,577.18	$4,577.18	$3,371.09	$4,082.84	$3,410.00	2026-05-06
44204	CPT	Pr Laparoscopy Colectomy Partial W/anastomosis	3	3	$4,560.83	$4,560.83	$3,359.05	$4,068.26	$3,397.82	2026-05-06
49204	CPT	Pr Exc/destruction Open Abdmnl Tumors 5.1-10.0 CM,Professinal Compenent	3	3	$4,540.38	$4,540.38	$3,343.99	$4,050.02	$3,382.58	2026-05-06
27138	CPT	Pr Revj Tot Hip Arthrp Fem Only W/wo Algrft	3	3	$4,513.80	$4,513.80	$3,324.41	$4,026.31	$3,362.78	2026-05-06
27137	CPT	Pr Revj Tot Hip Arthrp Actblr W/wo Agrft/algrft	3	3	$4,345.15	$4,345.15	$3,200.20	$3,875.87	$3,237.14	2026-05-06
23472	CPT	Pr Arthroplasty Glenohumeral Joint Total Shoulder	3	3	$4,290.99	$4,290.99	$3,160.31	$3,827.56	$3,196.79	2026-05-06
44602	CPT	Pr Enterorrhaphy 1perforation	3	3	$4,184.68	$4,184.68	$3,082.02	$3,732.73	$3,117.59	2026-05-06
58565	CPT	Pr Hysteroscopy Bi Tube Occlusion W/perm Implnts	9	3	$4,174.44	$4,174.44	$927.47	$4,846.89	$3,109.96	2026-05-06
111939	OTHER	Hchg Procedure Level 4 (+ Setup)	4	4	$4,184.95	$4,184.95	$3,013.16	$3,732.98	$3,100.01	2026-05-06
27486	CPT	Pr Revj Total Knee Arthrp W/wo Algrft 1 Component	3	3	$4,145.83	$4,145.83	$3,053.40	$3,698.08	$3,088.64	2026-05-06
44202	CPT	Pr Laps Enterect Rescj 1 Small Intest Rescj & Ana	3	3	$4,105.96	$4,105.96	$3,024.04	$3,662.52	$3,058.94	2026-05-06
110749	OTHER	Hchg Birthing Vaginal Complicated	4	4	$4,127.83	$4,127.83	$2,972.04	$3,682.02	$3,057.69	2026-05-06
27415	CPT	Pr Osteochondral Allograft Knee Open	3	3	$4,049.76	$4,049.76	$2,982.65	$3,612.39	$3,017.07	2026-05-06
43840	CPT	Pr Gastrorrhaphy Sutr Prf8 Duol/gstr Ulcer Wnd/inj	3	3	$4,024.20	$4,024.20	$2,963.82	$3,589.59	$2,998.03	2026-05-06
111938	OTHER	Hchg Procedure Level 4	4	4	$4,044.58	$4,044.58	$2,912.10	$3,607.77	$2,996.02	2026-05-06
27130	CPT	Pr Arthrp Acetblr/prox Fem Prostc Agrft/algrft	3	3	$3,997.63	$3,997.63	$2,944.25	$3,565.89	$2,978.23	2026-05-06
27447	CPT	Pr Arthrp Kne Condyle&platu Medial&lat Compartments	3	3	$3,995.58	$3,995.58	$2,942.74	$3,564.06	$2,976.71	2026-05-06
111930	OTHER	Hchg Procedure Level 3 (+ Staff + Setup)	4	4	$4,010.49	$4,010.49	$2,887.55	$3,577.36	$2,970.78	2026-05-06
44140	CPT	Pr Colectomy Partial W/anastomosis	3	3	$3,974.12	$3,974.12	$2,926.94	$3,544.92	$2,960.72	2026-05-06
44205	CPT	Pr Laps Colectomy Prtl W/rmvl Terminal Ileum	3	3	$3,966.96	$3,966.96	$2,921.67	$3,538.53	$2,955.39	2026-05-06
27506	CPT	Pr Optx Fem Shft Fx W/insj Imed Implt W/wo Screw	3	3	$3,940.38	$3,940.38	$2,902.09	$3,514.82	$2,935.58	2026-05-06
44130	CPT	Pr Enteroenterost Anast Int W/wo Cutan Ntrstm Spx	3	3	$3,890.29	$3,890.29	$2,865.20	$3,470.14	$2,898.27	2026-05-06
78452	CPT	Hchg Rad Nm Cardiac Myocard Mult Spect Wwo Ef And Wm	7	4	$4,012.06	$4,012.06	$142.86	$3,578.76	$2,888.68	2026-05-06
27828	CPT	Pr Open Treatment Fracture Distal Tibia & Fibula	3	3	$3,864.74	$3,864.74	$2,846.38	$3,447.35	$2,879.23	2026-05-06
15830	CPT	Pr Excision Skin Abd Infraumbilical Panniculectomy	3	3	$3,860.65	$3,860.65	$2,843.37	$3,443.70	$2,876.18	2026-05-06
111931	OTHER	Hchg Procedure Level 3 (+ Staff)	4	4	$3,870.09	$3,870.09	$2,786.46	$3,452.12	$2,866.77	2026-05-06
81229	CPT	Hchg Cma, Poc Mml	4	4	$3,860.39	$3,860.39	$2,779.48	$3,443.47	$2,859.59	2026-05-06
58563	CPT	Pr Hysteroscopy Endometrial Ablation	9	3	$3,797.29	$3,797.29	$588.69	$4,100.17	$2,828.98	2026-05-06
29867	CPT	Pr Arthroscopy Knee Osteochondral Allograft	3	3	$3,771.73	$3,771.73	$2,777.88	$3,364.38	$2,809.94	2026-05-06
23395	CPT	Pr Muscle Transfer Shoulder/upper Arm Single	3	3	$3,769.69	$3,769.69	$2,776.38	$3,362.56	$2,808.42	2026-05-06
44160	CPT	Pr Colectomy Prtl W/rmvl Terminal Ileum & Ileocolos	3	3	$3,678.71	$3,678.71	$2,709.37	$3,281.41	$2,740.64	2026-05-06
44188	CPT	Pr Laparoscopy Surg Colostomy/skn Lvl Cecostomy	3	3	$3,628.63	$3,628.63	$2,672.49	$3,236.74	$2,703.33	2026-05-06
27244	CPT	Pr Tx Inter/pr/subtrchntric Femoral Fx Screw Implt	3	3	$3,627.60	$3,627.60	$2,671.73	$3,235.82	$2,702.56	2026-05-06
44120	CPT	Pr Entrc Rescj Small Intestine 1 Rescj & Anast	3	3	$3,624.53	$3,624.53	$2,669.47	$3,233.08	$2,700.27	2026-05-06
15738	CPT	Pr Musc Myocutaneous/fasciocutaneous Flap Lxtr	9	3	$3,616.35	$3,616.35	$347.80	$3,647.02	$2,694.18	2026-05-06
27245	CPT	Pr Tx Inter/pr/subtrchntric Fem Fx Imed Impltscrew	9	3	$3,627.60	$3,627.60	$17.17	$3,256.61	$2,688.90	2026-05-06
29889	CPT	Pr Arthrs Aided Pst Cruciate Ligm Rpr/agmntj/rcnstj	3	3	$3,598.98	$3,598.98	$2,650.65	$3,210.29	$2,681.24	2026-05-06
36475	CPT	Pr Endoven Abltj Incmptnt Vein Xtr Rf 1st Vein	9	3	$3,568.32	$3,568.32	$614.31	$3,926.95	$2,658.40	2026-05-06
44320	CPT	Pr Colostomy/skin Level Cecostomy	3	3	$3,559.12	$3,559.12	$2,621.29	$3,174.74	$2,651.54	2026-05-06
35840	CPT	Pr Expl Po Hemrrg Thrombosis/infctj Abd	3	3	$3,543.79	$3,543.79	$2,610.00	$3,161.06	$2,640.12	2026-05-06
23470	CPT	Pr Arthroplasty Glenohumrl Jt Hemiarthroplasty	3	3	$3,536.63	$3,536.63	$2,604.73	$3,154.67	$2,634.79	2026-05-06
27488	CPT	Pr Rmvl Prosth Tot Knee Prosth Mma W/wo Insj Spacer	3	3	$3,534.60	$3,534.60	$2,603.23	$3,152.86	$2,633.28	2026-05-06
27236	CPT	Pr Optx Fem Fx Prox End Nck Int Fixj/prostc Rplcmt	3	3	$3,524.37	$3,524.37	$2,595.70	$3,143.74	$2,625.66	2026-05-06
19307	CPT	Pr Mast Modf Rad W/ax Lymph Nod W/wo Pect/alis Min	3	3	$3,520.28	$3,520.28	$2,592.69	$3,140.09	$2,622.61	2026-05-06
44346	CPT	Pr Revj Colostomy W/rpr Paraclst Hernia Spx	3	3	$3,504.95	$3,504.95	$2,581.40	$3,126.42	$2,611.19	2026-05-06
27536	CPT	Pr Optx Tibial Fx Prox Bicondylar W/wo Int Fixj	3	3	$3,501.89	$3,501.89	$2,579.14	$3,123.69	$2,608.91	2026-05-06
27170	CPT	Pr B1 Grf Fem H/n Intertrchntric/subtrchntric Area	3	3	$3,464.08	$3,464.08	$2,551.29	$3,089.96	$2,580.74	2026-05-06
27446	CPT	Pr Arthrp Knee Condyle&plateau Medial/lat Cmprt	3	3	$3,416.02	$3,416.02	$2,515.90	$3,047.09	$2,544.93	2026-05-06
38100	CPT	Pr Splenectomy Total Separate Procedure	3	3	$3,416.02	$3,416.02	$2,515.90	$3,047.09	$2,544.93	2026-05-06
110748	OTHER	Hchg Birthing Vaginal Uncomplicated	4	4	$3,411.12	$3,411.12	$2,456.01	$3,042.72	$2,526.78	2026-05-06
58290	CPT	Pr Vaginal Hysterectomy Uterus > 250 Gm	3	3	$3,340.38	$3,340.38	$2,460.19	$2,979.62	$2,488.58	2026-05-06
27125	CPT	Pr Hemiarthroplasty Hip Partial	3	3	$3,339.35	$3,339.35	$2,459.43	$2,978.70	$2,487.82	2026-05-06
47605	CPT	Pr Cholecystectomy W/cholangiography	3	3	$3,325.06	$3,325.06	$2,448.91	$2,965.95	$2,477.17	2026-05-06
23466	CPT	Pr Capsulorrhaphy Glenohumrl Jt Multi-dirional Ins	3	3	$3,290.29	$3,290.29	$2,423.30	$2,934.94	$2,451.27	2026-05-06
111929	OTHER	Hchg Procedure Level 3 (+ Setup)	4	4	$3,308.63	$3,308.63	$2,382.21	$2,951.30	$2,450.87	2026-05-06
58558	CPT	Pr Hysteroscopy Bx Endometrium&/polypc W/wo D&c	9	3	$3,249.42	$3,249.42	$505.88	$3,511.17	$2,420.82	2026-05-06
44005	CPT	Pr Enterolss Fring Intstinal Adhesion Spx	3	3	$3,243.28	$3,243.28	$2,388.68	$2,893.01	$2,416.24	2026-05-06
27827	CPT	Pr Open Treatment Fracture Distal Tibia Only	3	3	$3,231.03	$3,231.03	$2,379.65	$2,882.08	$2,407.12	2026-05-06
25023	CPT	Pr Dcmprn Fasct F/arm&/wrst Flxr/xtnsr W/dbrdmt	3	3	$3,220.79	$3,220.79	$2,372.11	$2,872.94	$2,399.49	2026-05-06
111920	OTHER	Hchg Procedure Level 2 (+ Staff + Setup)	4	4	$3,212.15	$3,212.15	$2,312.75	$2,865.24	$2,379.40	2026-05-06
A4264	HCPCS	Pr Perm Intratubal Occlsn Device W Deliv Sys Pr1320	4	4	$3,209.08	$3,209.08	$2,310.54	$2,862.50	$2,377.12	2026-05-06
47600	CPT	Pr Cholecystectomy	3	3	$3,158.44	$3,158.44	$2,326.19	$2,817.33	$2,353.04	2026-05-06
111928	OTHER	Hchg Procedure Level 3	4	4	$3,168.26	$3,168.26	$2,281.15	$2,826.09	$2,346.89	2026-05-06
28047	CPT	Pr Rad Resection Tumor Soft Tissue Foot/toe 3 Cm/>	3	3	$3,134.93	$3,134.93	$2,308.88	$2,796.36	$2,335.52	2026-05-06
28445	CPT	Pr Open Treatment Talus Fracture	3	3	$3,127.77	$3,127.77	$2,303.60	$2,789.97	$2,330.19	2026-05-06
29806	CPT	Pr Arthroscopy Shoulder Surgical Capsulorrhaphy	3	3	$3,125.73	$3,125.73	$2,302.10	$2,788.15	$2,328.67	2026-05-06
49596	CPT	Pr Rpr Aa Hernia 1st > 10 Cm Ncrc8/strangulated	3	3	$3,117.55	$3,117.55	$2,296.08	$2,780.85	$2,322.57	2026-05-06
24430	CPT	Pr Repair Non/malunion Humerus Without Graft	3	3	$3,107.33	$3,107.33	$2,288.55	$2,771.74	$2,314.96	2026-05-06
29827	CPT	Pr Arthroscopy Shoulder Rotator Cuff Repair	3	3	$3,103.25	$3,103.25	$2,285.54	$2,768.10	$2,311.92	2026-05-06
44310	CPT	Pr Ileostomy/jejunostomy Non-tube	3	3	$3,093.02	$3,093.02	$2,278.01	$2,758.97	$2,304.30	2026-05-06
59410	CPT	Pr Vaginal Delivery Only W/postpartum Care	3	3	$3,076.66	$3,076.66	$2,265.96	$2,744.38	$2,292.11	2026-05-06
25609	CPT	Pr Optx Dstl Radl I-artic Fx/epiphysl Sep 3 Frag	9	3	$3,074.61	$3,074.61	$16.84	$2,762.94	$2,281.29	2026-05-06
524624	OTHER	Hchg Postpartum Vacuum Pr1200 Affiliate Only	4	4	$3,078.33	$3,078.33	$2,216.40	$2,745.87	$2,280.28	2026-05-06
24546	CPT	Pr Open Tx Humeral Supracondylar Fracture W/xtn	3	3	$3,056.24	$3,056.24	$2,250.92	$2,726.17	$2,276.90	2026-05-06
111927	OTHER	Hchg Procedure Level 2 (+ Staff)	4	4	$3,071.77	$3,071.77	$2,211.67	$2,740.02	$2,275.41	2026-05-06
29807	CPT	Pr Arthroscopy Shoulder Surgical Repair Slap Lesion	3	3	$3,048.05	$3,048.05	$2,244.89	$2,718.86	$2,270.80	2026-05-06
87901	CPT	Pr General Lab 8790100	4	4	$3,043.08	$3,043.08	$2,191.02	$2,714.43	$2,254.16	2026-05-06
95811	CPT	Pr Polysom 6/>yrs Sleep W/cpap 4/> Addl Param Attnd	30	12	$4,466.63	$4,466.63	$446.09	$4,332.63	$2,246.71	2026-07-20
54440	CPT	Pr Plastic Operation Penis Injury	3	3	$3,010.84	$3,010.84	$2,217.48	$2,685.67	$2,243.08	2026-05-06
29915	CPT	Pr Arthroscopy Hip W/acetabuloplasty	3	3	$2,976.50	$2,976.50	$2,192.19	$2,655.04	$2,217.49	2026-05-06
19303	CPT	Pr Mastectomy Simple Complete	3	3	$2,973.43	$2,973.43	$2,189.93	$2,652.30	$2,215.21	2026-05-06
44314	CPT	Pr Revj Ileostomy Complic Rcnstj In-depth Spx	3	3	$2,971.37	$2,971.37	$2,188.41	$2,650.46	$2,213.67	2026-05-06
58150	CPT	Pr Total Abdominal Hysterect W/wo Rmvl Tube Ovary	3	3	$2,965.26	$2,965.26	$2,183.91	$2,645.01	$2,209.12	2026-05-06
27759	CPT	Pr Tx Tibl Shft Fx Imed Implt W/wo Screws&/cercla	3	3	$2,938.68	$2,938.68	$2,164.34	$2,621.30	$2,189.32	2026-05-06
27511	CPT	Pr Open Tx Femoral Supracondylar Fracture Without Xtn	3	3	$2,937.65	$2,937.65	$2,163.58	$2,620.38	$2,188.55	2026-05-06
70546	CPT	Hchg Rad MRI Angio Head Brain Wwo	31	12	$4,651.96	$4,651.96	$133.93	$4,512.40	$2,186.42	2026-07-20
71552	CPT	Hchg Rad MRI Chest Wwo	31	12	$4,651.96	$4,651.96	$204.72	$4,512.40	$2,186.42	2026-07-20
70549	CPT	Hchg Rad MRI Angio Neck Wwo	31	12	$4,651.96	$4,651.96	$163.27	$4,512.40	$2,186.42	2026-07-20
25391	CPT	Pr Osteoplasty Radius/ulna Lengthening W/autograft	3	3	$2,927.44	$2,927.44	$2,156.06	$2,611.28	$2,180.94	2026-05-06
29914	CPT	Pr Arthroscopy Hip W/femoroplasty	3	3	$2,922.32	$2,922.32	$2,152.29	$2,606.71	$2,177.13	2026-05-06
29888	CPT	Pr Arthrs Aided Ant Cruciate Ligm Rpr/agmntj/rcnstj	3	3	$2,900.86	$2,900.86	$2,136.48	$2,587.57	$2,161.14	2026-05-06
90378	CPT	Pr Respiratory Syncytial Virus Ig IM 50 Mg E	4	4	$2,909.56	$2,909.56	$2,094.88	$2,595.33	$2,155.26	2026-05-06
44020	CPT	Pr Enterotomy Sm Int Oth/thn Duo Expl Bx/fb Rmvl	3	3	$2,881.45	$2,881.45	$2,122.19	$2,570.25	$2,146.68	2026-05-06
23585	CPT	Pr Open Tx Scapular Fx W/internal Fixation If Pfrmd	6	3	$2,881.45	$2,881.45	$2,122.19	$2,570.25	$2,146.68	2026-05-06
J9217	HCPCS	Pr Leuprolide Acetate (for Depot Suspension) 7.5 Mg	4	4	$2,894.88	$2,894.88	$2,084.31	$2,582.23	$2,144.39	2026-05-06
58552	CPT	Pr Laps W/vag Hysterect 250 Gm/&rmvl Tube&/ovaries	3	3	$2,873.27	$2,873.27	$2,116.16	$2,562.96	$2,140.59	2026-05-06
99468	CPT	Pr 1st Inpatient Critical Care Pr Day Age 28 Days/<	3	3	$2,872.23	$2,872.23	$2,115.40	$2,562.03	$2,139.81	2026-05-06
112453	OTHER	Hchg Endo Level 6	4	4	$2,885.05	$2,885.05	$2,077.24	$2,573.46	$2,137.10	2026-05-06
27507	CPT	Pr Optx Fem Shft Fx W/plate/screws W/wo Cerclage	3	3	$2,864.05	$2,864.05	$2,109.37	$2,554.73	$2,133.72	2026-05-06
27823	CPT	Pr Open Tx Trimalleolar Ankle Fx W/fixj Pst Lip	3	3	$2,859.97	$2,859.97	$2,106.37	$2,551.09	$2,130.68	2026-05-06
51550	CPT	Pr Cystectomy Partial Simple	3	3	$2,849.74	$2,849.74	$2,098.83	$2,541.97	$2,123.06	2026-05-06
27514	CPT	Pr Open Tx Femoral Fracture Distal Med/lat Condyle	3	3	$2,847.71	$2,847.71	$2,097.34	$2,540.16	$2,121.54	2026-05-06
25415	CPT	Pr Rpr Nonunion/malunion Radius&ulna Without Autograf	3	3	$2,843.61	$2,843.61	$2,094.32	$2,536.50	$2,118.49	2026-05-06
43774	CPT	Pr Laps Gastric Restrictive Px Remove Device & Port	3	3	$2,838.50	$2,838.50	$2,090.56	$2,531.94	$2,114.68	2026-05-06
27726	CPT	Pr Repair Fibula Nonunion/malunion W/int Fixation	3	3	$2,833.40	$2,833.40	$2,086.80	$2,527.39	$2,110.88	2026-05-06
58180	CPT	Pr Supracervical Abdl Hyster W/wo Rmvl Tube Ovary	3	3	$2,803.75	$2,803.75	$2,064.96	$2,500.94	$2,088.79	2026-05-06
111932	OTHER	Hchg Procedure Level 3 (< 2 Staff)	4	4	$2,818.40	$2,818.40	$2,029.25	$2,514.01	$2,087.73	2026-05-06
23485	CPT	Pr Osteotomy Clav W/wo Int Fixj W/bone Grf Non/mal	3	3	$2,800.68	$2,800.68	$2,062.70	$2,498.21	$2,086.51	2026-05-06
44050	CPT	Pr Rdctj Volvulus Intussusception Int Hrna Lapt	3	3	$2,766.95	$2,766.95	$2,037.86	$2,468.12	$2,061.38	2026-05-06
90375	CPT	Pr Rabies Ig IM Sc 150 35-55 Kg Affiliate Only	8	4	$2,707.97	$2,707.97	$899.07	$3,717.17	$2,057.13	2026-05-06
43220	CPT	Pr Esophagoscopy Flex Balloon Dilat <30 Mm Diam	9	3	$2,753.66	$2,753.66	$260.47	$2,771.73	$2,051.48	2026-05-06
49659	CPT	Pr Unlis Laps Px Hrnap Herniorrhaphy HERNIOTOMY,Professinal Compenent	3	3	$2,743.45	$2,743.45	$2,020.55	$2,447.16	$2,043.87	2026-05-06
71550	CPT	Hchg Rad MRI Chest Wo	31	12	$4,318.69	$4,318.69	$132.02	$4,189.12	$2,029.78	2026-07-20
114491	OTHER	Hchg Endo Level 5 (+setup)	4	4	$2,739.52	$2,739.52	$1,972.45	$2,443.65	$2,029.30	2026-05-06
44180	CPT	Pr Laparoscopy Enterolysis Separate Procedure	3	3	$2,721.97	$2,721.97	$2,004.73	$2,428.00	$2,027.87	2026-05-06
59612	CPT	Pr Vaginal Delivery After Cesarean Delivery	3	3	$2,719.93	$2,719.93	$2,003.23	$2,426.18	$2,026.35	2026-05-06
27880	CPT	Pr Amputation Leg Through Tibia&fibula	3	3	$2,718.92	$2,718.92	$2,002.48	$2,425.28	$2,025.60	2026-05-06
59514	CPT	Pr Cesarean Delivery Only	3	3	$2,716.87	$2,716.87	$2,000.97	$2,423.45	$2,024.07	2026-05-06
60240	CPT	Pr Thyroidectomy Total/complete	3	3	$2,706.66	$2,706.66	$1,993.46	$2,414.34	$2,016.46	2026-05-06
29828	CPT	Pr Arthroscopy Shoulder Biceps Tenodesis	3	3	$2,678.02	$2,678.02	$1,972.36	$2,388.79	$1,995.12	2026-05-06
27235	CPT	Pr Prq Skel Fixj Femoral Fx Prox End Neck	3	3	$2,677.01	$2,677.01	$1,971.62	$2,387.89	$1,994.37	2026-05-06
95810	CPT	Hchg Polysomnography => 6yrs =>4 Parameters	30	12	$3,963.78	$3,963.78	$435.54	$3,844.86	$1,993.78	2026-07-20
58262	CPT	Pr Vag Hyst 250 Gm/< W/rmvl Tube&/ovary	3	3	$2,675.99	$2,675.99	$1,970.87	$2,386.98	$1,993.61	2026-05-06
70547	CPT	Hchg Rad MRI Angio Neck Wo	30	12	$4,211.03	$4,211.03	$109.06	$4,084.69	$1,980.87	2026-07-20
19302	CPT	Pr Mastectomy Partial W/axillary Lymphadenectomy	3	3	$2,647.37	$2,647.37	$1,949.79	$2,361.45	$1,972.29	2026-05-06
25575	CPT	Pr Open Tx Radial&ulnar Shaft Fx W/fixj Radius&ulna	3	3	$2,645.31	$2,645.31	$1,948.27	$2,359.62	$1,970.76	2026-05-06
70544	CPT	Hchg Rad MRI Angio Head Wo	30	12	$4,188.51	$4,188.51	$109.06	$4,062.85	$1,970.27	2026-07-20
27535	CPT	Pr Open Tx Tibial Fracture Proximal Unicondylar	3	3	$2,642.25	$2,642.25	$1,946.02	$2,356.89	$1,968.48	2026-05-06
58571	CPT	Pr Laps Total Hysterect 250 Gm/< W/rmvl Tube/ovary	3	3	$2,620.78	$2,620.78	$1,930.20	$2,337.74	$1,952.48	2026-05-06
27758	CPT	Pr Optx Tibial Shft Fx W/plate/screws W/wo Cerclage	3	3	$2,619.76	$2,619.76	$1,929.45	$2,336.83	$1,951.72	2026-05-06
43249	CPT	Pr Egd Balloon Dilation Esophagus <30 Mm Diam	9	3	$2,483.81	$2,483.81	$344.20	$2,627.67	$1,950.69	2026-05-06
70545	CPT	Hchg Rad MRI Angio Head W	30	12	$4,143.73	$4,143.73	$109.06	$4,019.41	$1,949.20	2026-07-20
36571	CPT	Pr Insj Prph Ctr Vad W/subq Port Age 5 Yr/>	9	3	$2,607.49	$2,607.49	$676.03	$3,144.64	$1,942.58	2026-05-06
14301	CPT	Pr Adjnt Tis Trnsfr/reargmt Any Area 30.1-60 Sq Cm	9	3	$2,600.35	$2,600.35	$396.73	$2,800.01	$1,937.26	2026-05-06
23615	CPT	Pr Open Treatment Proximal Humeral Fracture	3	3	$2,598.30	$2,598.30	$1,913.65	$2,317.68	$1,935.73	2026-05-06
81372	CPT	Pb Misc Lab Charge 81372	4	4	$2,611.12	$2,611.12	$1,880.01	$2,329.12	$1,934.18	2026-05-06
38745	CPT	Pr Axillary Lymphadenectomy Complete	3	3	$2,592.17	$2,592.17	$1,909.13	$2,312.22	$1,931.17	2026-05-06
44960	CPT	Pr Appendec Rptd Appendix Absc/pritonitis	3	3	$2,588.09	$2,588.09	$1,906.13	$2,308.58	$1,928.13	2026-05-06
112452	OTHER	Hchg Endo Level 5	4	4	$2,599.14	$2,599.14	$1,871.38	$2,318.43	$1,925.32	2026-05-06
24515	CPT	Pr Optx Humeral Shft Fx W/plate/screws W/wocerclage	3	3	$2,582.95	$2,582.95	$1,902.34	$2,303.99	$1,924.30	2026-05-06
44620	CPT	Pr Closure Enterostomy Lg/small Intestine	3	3	$2,571.71	$2,571.71	$1,894.06	$2,293.97	$1,915.92	2026-05-06
15951	CPT	Pr Exc Trchntric Pr Ulcer W/prim Sutr W/ostectomy	3	3	$2,547.19	$2,547.19	$1,876.01	$2,272.09	$1,897.66	2026-05-06
15260	CPT	Pr Fth/gft Free W/direct Closure N/e/e/l 20 Sq Cm/<	9	3	$2,532.87	$2,532.87	$307.92	$2,632.25	$1,886.99	2026-05-06
81265	CPT	Hchg Mcc, Poc Mml	4	4	$2,541.91	$2,541.91	$1,830.18	$2,267.38	$1,882.92	2026-05-06
24516	CPT	Pr Tx Humral Shaft Fx W/insj Imed Implt W/w Cerclge	3	3	$2,525.72	$2,525.72	$1,860.19	$2,252.94	$1,881.66	2026-05-06
27822	CPT	Pr Open Tx Trimalleolar Ankle Fx Without Fixj Pst Lip	3	3	$2,521.65	$2,521.65	$1,857.20	$2,249.31	$1,878.63	2026-05-06
23412	CPT	Pr Open Repair Of Rotator Cuff Chronic	3	3	$2,502.23	$2,502.23	$1,842.89	$2,231.99	$1,864.16	2026-05-06
52601	CPT	Pr Trurl Electrosurg Rescj Prostate Bleed Complete	3	3	$2,497.11	$2,497.11	$1,839.12	$2,227.42	$1,860.35	2026-05-06
111919	OTHER	Hchg Procedure Level 2 (+ Setup)	4	4	$2,510.33	$2,510.33	$1,807.44	$2,239.21	$1,859.53	2026-05-06
27360	CPT	Pr Prtl Exc Bone Femur Prox Tibia&/fibula	3	3	$2,494.05	$2,494.05	$1,836.87	$2,224.69	$1,858.07	2026-05-06
38760	CPT	Pr Inguinofem Lmphadec Supfc W/cloquets Node Spx	3	3	$2,491.99	$2,491.99	$1,835.35	$2,222.86	$1,856.53	2026-05-06
29883	CPT	Pr Arthroscopy Knee W/meniscus Rpr Medial&lateral	3	3	$2,485.87	$2,485.87	$1,830.84	$2,217.40	$1,851.97	2026-05-06
28114	CPT	Pr Ostc Compl All Metar Heads W/prtl Prox Phalangc	9	3	$2,467.46	$2,467.46	$517.94	$2,828.26	$1,838.26	2026-05-06
27438	CPT	Pr Arthroplasty Patella W/prosthesis	3	3	$2,467.46	$2,467.46	$1,817.28	$2,200.97	$1,838.26	2026-05-06
70543	CPT	Hchg Rad MRI Neck Soft Tissue Orbit Face Wwo	31	12	$3,896.93	$3,896.93	$193.88	$3,780.02	$1,834.00	2026-07-20
114490	OTHER	Hchg Endo Level 4 (+setup)	4	4	$2,473.63	$2,473.63	$1,781.01	$2,206.48	$1,832.34	2026-05-06
24579	CPT	Pr Open Treatment Humeral Condylar Fracture	3	3	$2,459.29	$2,459.29	$1,811.27	$2,193.69	$1,832.17	2026-05-06
81340	CPT	Pb T Cell Beta Pcr	4	4	$2,469.45	$2,469.45	$1,778.00	$2,202.75	$1,829.24	2026-05-06
27640	CPT	Pr Partial Excision Bone Tibia	3	3	$2,452.13	$2,452.13	$1,805.99	$2,187.30	$1,826.84	2026-05-06
26123	CPT	Pr Fasct Prtl Palmar 1 Dgt Prox Iphal Jt W/wo Rpr	3	3	$2,446.00	$2,446.00	$1,801.48	$2,181.83	$1,822.27	2026-05-06
25447	CPT	Pr Arthrp Intercarpal/metacarpal Joints Interpos	3	3	$2,429.66	$2,429.66	$1,789.44	$2,167.26	$1,810.10	2026-05-06
27418	CPT	Pr Anterior Tibial Tubercleplasty	3	3	$2,420.45	$2,420.45	$1,782.66	$2,159.04	$1,803.24	2026-05-06
25608	CPT	Pr Optx Dstl Radl I-artic Fx/epiphysl Sep 2 Frag	3	3	$2,417.38	$2,417.38	$1,780.40	$2,156.30	$1,800.95	2026-05-06
23410	CPT	Pr Open Repair Of Rotator Cuff Acute	3	3	$2,414.32	$2,414.32	$1,778.15	$2,153.57	$1,798.67	2026-05-06
59409	CPT	Pr Vaginal Delivery Only	3	3	$2,410.24	$2,410.24	$1,775.14	$2,149.93	$1,795.63	2026-05-06
58260	CPT	Pr Vaginal Hysterectomy Uterus 250 Gm/<	3	3	$2,397.96	$2,397.96	$1,766.10	$2,138.98	$1,786.48	2026-05-06
81342	CPT	Pb T Cell Gamma Pcr	4	4	$2,381.73	$2,381.73	$1,714.85	$2,124.50	$1,764.27	2026-05-06
15240	CPT	Pr Fth/gft Fr W/dir Clsr F/c/c/m/n/ax/g/h/f 20 Cm/<	9	3	$2,360.13	$2,360.13	$264.25	$2,425.28	$1,758.30	2026-05-06
13160	CPT	Pr Secondary Closure Surg Wound/dehsn Extsv/complic	3	3	$2,359.12	$2,359.12	$1,737.49	$2,104.34	$1,757.54	2026-05-06
111918	OTHER	Hchg Procedure Level 2	4	4	$2,369.95	$2,369.95	$1,706.36	$2,114.00	$1,755.54	2026-05-06
49595	CPT	Pr Rpr Aa Hernia 1st > 10 Cm Reducible	3	3	$2,347.87	$2,347.87	$1,729.21	$2,094.30	$1,749.16	2026-05-06
49255	CPT	Pr Omntc Epiploectomy Rescj Omentum Spx	3	3	$2,339.70	$2,339.70	$1,723.19	$2,087.01	$1,743.08	2026-05-06
81315	CPT	Pr Pml/raralpha Common Breakpoints Qual/quant	4	4	$2,349.52	$2,349.52	$1,691.65	$2,095.77	$1,740.41	2026-05-06
59120	CPT	Pr Tx Ectopic Pregnancy Abdominal/vaginal Appr	3	3	$2,335.62	$2,335.62	$1,720.18	$2,083.37	$1,740.04	2026-05-06
26356	CPT	Pr Rpr/advmnt Flxr Tdn Zone 2 Without Fr Grft Ea Tendon	3	3	$2,322.32	$2,322.32	$1,710.39	$2,071.51	$1,730.13	2026-05-06
112451	OTHER	Hchg Endo Level 4	4	4	$2,333.25	$2,333.25	$1,679.94	$2,081.26	$1,728.36	2026-05-06
11005	CPT	Pr Dbrdmt Skn Subq T/m/f Necro Infctj Abdl Wall	3	3	$2,317.21	$2,317.21	$1,706.63	$2,066.95	$1,726.32	2026-05-06
29855	CPT	Pr Arthrs Aid Tibial Fracture Proximal Unicondylar	3	3	$2,299.83	$2,299.83	$1,693.82	$2,051.45	$1,713.37	2026-05-06
14041	CPT	Pr Adj Tiss Xfer Head Face Neck Hands Feet 10.1-30	9	3	$2,295.74	$2,295.74	$333.49	$2,451.71	$1,710.33	2026-05-06
28725	CPT	Pr Arthrodesis Subtalar	3	3	$2,288.60	$2,288.60	$1,685.55	$2,041.43	$1,705.01	2026-05-06
0335T	CPT	Pr Insertion Of Sinus Tarsi IMPLANT,Professinal Compenent	3	3	$2,288.60	$2,288.60	$1,685.55	$2,041.43	$1,705.01	2026-05-06
49000	CPT	Pr Exploratory Laparotomy Celiotomy W/wo Biopsy Spx	3	3	$2,278.38	$2,278.38	$1,678.03	$2,032.31	$1,697.39	2026-05-06
24342	CPT	Pr Rinsj Rptd Biceps/triceps Tdn Dstl W/wo Tdn Grf	3	3	$2,276.32	$2,276.32	$1,676.51	$2,030.48	$1,695.86	2026-05-06
49594	CPT	Pr Rpr Aa Hernia 1st 3-10 Cm Ncrc8/strangulated	3	3	$2,274.28	$2,274.28	$1,675.01	$2,028.66	$1,694.34	2026-05-06
27814	CPT	Pr Open Treatment Bimalleolar Ankle Fracture	3	3	$2,266.10	$2,266.10	$1,668.98	$2,021.36	$1,688.24	2026-05-06
15574	CPT	Pr Frmj Dir/tube Pedcl W/wotr Fh/ch/ch/m/n/ax/g/h/f	9	3	$2,252.83	$2,252.83	$297.36	$2,369.67	$1,678.36	2026-05-06
72157	CPT	Hchg Rad MRI Spine Thoracic Wwo	31	12	$3,349.66	$3,349.66	$207.28	$3,249.17	$1,674.83	2026-07-20
72156	CPT	Hchg Rad MRI Spine Cervical Wwo	31	12	$3,340.70	$3,340.70	$207.28	$3,240.47	$1,670.35	2026-07-20
27299	CPT	Pr Core Decompression HIP,Professinal Compenent	6	3	$2,102.05	$2,102.05	$1,115.67	$2,398.83	$1,665.94	2026-05-06
91110	CPT	Pr Gi Imag Intraluminal Esophagus-ileum W/i&r	9	3	$2,227.25	$2,227.25	$328.99	$2,385.15	$1,659.30	2026-05-06
72158	CPT	Hchg Rad MRI Spine Lumbar Wwo	31	12	$3,318.30	$3,318.30	$207.28	$3,218.75	$1,659.15	2026-07-20
27252	CPT	Pr Cltx Hip Dislocation Traumatic Req Anesthesia	3	3	$2,226.23	$2,226.23	$1,639.62	$1,985.80	$1,658.54	2026-05-06
70553	CPT	Hchg Rad MRI Head Brain Wwo	31	12	$3,309.33	$3,309.33	$207.28	$3,210.05	$1,654.66	2026-07-20
27339	CPT	Pr Exc Tumor Soft Tissue Thigh/knee Subfasc 5 Cm/>	3	3	$2,219.08	$2,219.08	$1,634.35	$1,979.42	$1,653.21	2026-05-06
23440	CPT	Pr Resection/transplantation Long Tendon Biceps	3	3	$2,216.02	$2,216.02	$1,632.10	$1,976.69	$1,650.93	2026-05-06
59151	CPT	Pr Laps Tx Ectopic Preg W/salping&/oophorectomy	3	3	$2,209.89	$2,209.89	$1,627.58	$1,971.22	$1,646.37	2026-05-06
27524	CPT	Pr Optx Patllr Fx W/int Fixj/patllc&soft Tiss Rpr	3	3	$2,208.86	$2,208.86	$1,626.83	$1,970.30	$1,645.60	2026-05-06
51860	CPT	Pr Cystorrhaphy Sutr Bldr Wnd Inj/rpt Simple	3	3	$2,201.72	$2,201.72	$1,621.57	$1,963.93	$1,640.28	2026-05-06
15572	CPT	Pr Frmj Direct/tube Pedicle W/wo Tr Scalp Arms/legs	9	3	$2,199.65	$2,199.65	$289.83	$2,313.11	$1,638.74	2026-05-06
23430	CPT	Pr Tenodesis Long Tendon Biceps	3	3	$2,188.42	$2,188.42	$1,611.77	$1,952.07	$1,630.37	2026-05-06
24341	CPT	Pr Repair Tendon/muscle Upper Arm/elbow Ea	3	3	$2,188.42	$2,188.42	$1,611.77	$1,952.07	$1,630.37	2026-05-06
78014	CPT	Hchg Rad Nm Thyroid Uptake W Flow Quantitative Measure	5	4	$2,211.87	$2,211.87	$55.31	$1,972.99	$1,629.04	2026-05-06
24538	CPT	Pr Prq Skel Fixj Sprcndylr/transcndylr Humeral Fx	3	3	$2,186.38	$2,186.38	$1,610.27	$1,950.25	$1,628.85	2026-05-06
27248	CPT	Pr Open Treatment Greater Trochanteric Fracture	3	3	$2,184.34	$2,184.34	$1,608.77	$1,948.43	$1,627.33	2026-05-06
70542	CPT	Hchg Rad MRI Neck Soft Tissue Orbit Face W	31	12	$3,250.99	$3,250.99	$147.33	$3,153.46	$1,625.49	2026-07-20
27422	CPT	Pr Rcnstj Dislc Patella W/xtnsr Relignmt&/musc Rl	3	3	$2,180.24	$2,180.24	$1,605.75	$1,944.77	$1,624.28	2026-05-06
21933	CPT	Pr Exc Tumor Soft Tiss Back/flank Subfascial 5 Cm/>	3	3	$2,176.16	$2,176.16	$1,602.74	$1,941.13	$1,621.24	2026-05-06
15570	CPT	Pr Frmj Direct/tubed Pedicle W/wo Transfer Trunk	9	3	$2,163.89	$2,163.89	$366.62	$2,374.22	$1,612.10	2026-05-06
28805	CPT	Pr Amputation Foot Transmetarsal	3	3	$2,158.78	$2,158.78	$1,589.94	$1,925.63	$1,608.29	2026-05-06
58720	CPT	Pr Salpingo-oophorectomy Compl/prtl Uni/bi Spx	3	3	$2,154.69	$2,154.69	$1,586.93	$1,921.98	$1,605.24	2026-05-06
25607	CPT	Pr Optx Dstl Radl X-artic Fx/epiphysl Sep	3	3	$2,154.69	$2,154.69	$1,586.93	$1,921.98	$1,605.24	2026-05-06
28730	CPT	Pr Arthrd Midtarsl/tarsometatarsal Mult/transvrs	3	3	$2,154.69	$2,154.69	$1,586.93	$1,921.98	$1,605.24	2026-05-06
36561	CPT	Pr Insj Tunneled Ctr Vad W/subq Port Age 5 Yr/>	9	3	$2,154.69	$2,154.69	$741.52	$2,820.06	$1,605.24	2026-05-06
21554	CPT	Pr Exc Tumor Soft Tissue Neck/thorax Subfasc 5 Cm/>	3	3	$2,153.67	$2,153.67	$1,586.18	$1,921.07	$1,604.48	2026-05-06
27310	CPT	Pr Arthrt Kne W/expl Drg/rmvl Fb	3	3	$2,145.48	$2,145.48	$1,580.15	$1,913.77	$1,598.38	2026-05-06
25445	CPT	Pr Arthroplasty W/prosthetic Replacement Trapezium	3	3	$2,118.93	$2,118.93	$1,560.59	$1,890.09	$1,578.60	2026-05-06
14021	CPT	Pr Adjt/rearrgmt Scalp/arm/leg 10.1-30.0 Sq Cm	9	3	$2,116.88	$2,116.88	$308.65	$2,262.08	$1,577.08	2026-05-06
23515	CPT	Pr Open Tx Clavicular Fracture Internal Fixation	3	3	$2,114.83	$2,114.83	$1,557.57	$1,886.43	$1,575.55	2026-05-06
47563	CPT	Pr Laps Surg Cholecystectomy W/cholangiography	3	3	$2,112.79	$2,112.79	$1,556.07	$1,884.61	$1,574.03	2026-05-06
15100	CPT	Pr Split Agrft T/a/l 1st 100 Cm/&/1% Bdy Inft/chld	9	3	$2,103.58	$2,103.58	$291.34	$2,229.25	$1,567.17	2026-05-06
J7327	HCPCS	Pr Inj Monovisc Per Dose	4	4	$2,107.29	$2,107.29	$1,517.25	$1,879.70	$1,560.97	2026-05-06
57288	CPT	Pr Sling Operation Stress Incontinence	3	3	$2,088.24	$2,088.24	$1,537.99	$1,862.71	$1,555.74	2026-05-06
44799	CPT	Pr Decompression Small Bowel Constriction	6	3	$1,963.30	$1,963.30	$1,036.61	$2,247.06	$1,555.40	2026-05-06
27427	CPT	Pr Ligamentous Reconstruction Knee Extra-articular	3	3	$2,087.21	$2,087.21	$1,537.23	$1,861.79	$1,554.97	2026-05-06
11006	CPT	Pr Dbrdmt Skn Subq T/m/f Necro Infctj Gent/abdl	3	3	$2,086.20	$2,086.20	$1,536.49	$1,860.89	$1,554.22	2026-05-06
26910	CPT	Pr Amp Mtcrpl W/finger/thumb W/wo Inteross Transfer	3	3	$2,082.12	$2,082.12	$1,533.48	$1,857.25	$1,551.18	2026-05-06
100039	OTHER	Hchg Peds Room	4	4	$2,094.00	$2,094.00	$1,507.68	$1,867.85	$1,551.13	2026-05-06
100024	OTHER	Hchg Med/surg/ob Room	4	4	$2,094.00	$2,094.00	$1,507.68	$1,867.85	$1,551.13	2026-05-06
27654	CPT	Pr Repair Secondary Achilles Tendon W/wo Graft	3	3	$2,079.04	$2,079.04	$1,531.21	$1,854.50	$1,548.88	2026-05-06
24343	CPT	Pr Repair Lateral Collateral Ligament Elbow	3	3	$2,073.96	$2,073.96	$1,527.47	$1,849.97	$1,545.10	2026-05-06
70336	CPT	Hchg Rad MRI Temporomandibular Joint	31	12	$3,125.39	$3,125.39	$133.29	$3,031.62	$1,542.37	2026-07-20
58662	CPT	Pr Laps Fulg/exc Ovary Viscera/peritoneal Surface	3	3	$2,067.81	$2,067.81	$1,522.94	$1,844.49	$1,540.52	2026-05-06
43830	CPT	Pr Gastrostomy Opn Without Constj Gstr Tube Spx	3	3	$2,066.78	$2,066.78	$1,522.18	$1,843.57	$1,539.75	2026-05-06
29882	CPT	Pr Arthroscopy Knee W/meniscus Rpr Medial/lateral	3	3	$2,063.72	$2,063.72	$1,519.93	$1,840.84	$1,537.47	2026-05-06
36582	CPT	Pr Rplcmt Compl Tun Ctr Vad W/subq Port	9	3	$2,063.72	$2,063.72	$636.12	$2,611.27	$1,537.47	2026-05-06
78227	CPT	Hchg Rad Nm Hepatobiliary W Pharm Intervention	8	4	$2,119.25	$2,119.25	$81.00	$3,680.39	$1,535.53	2026-05-06
15120	CPT	Pr Split Agrft F/s/n/h/f/g/m/d Gt 1st 100 Cm/</1 %	9	3	$2,050.43	$2,050.43	$313.93	$2,209.19	$1,527.57	2026-05-06
28737	CPT	Pr Arthrd W/tdn Lngth&advmnt Tarsl Nvclr-cuneifor	3	3	$2,049.42	$2,049.42	$1,509.40	$1,828.08	$1,526.82	2026-05-06
27829	CPT	Pr Open Tx Distal Tibiofibular Joint Disruption	3	3	$2,042.25	$2,042.25	$1,504.12	$1,821.69	$1,521.48	2026-05-06
23020	CPT	Pr Capsular Contracture Release	3	3	$2,023.86	$2,023.86	$1,490.57	$1,805.28	$1,507.78	2026-05-06
15931	CPT	Pr Excision Sacral Pressure Ulcer W/primary Suture	3	3	$2,018.75	$2,018.75	$1,486.81	$1,800.72	$1,503.97	2026-05-06
64831	CPT	Pr Suture Digital Nerve Hand/foot 1 Nerve	3	3	$2,016.70	$2,016.70	$1,485.30	$1,798.90	$1,502.44	2026-05-06
14350	CPT	Pr Filleted Finger/toe Flap W/prepj Recipient Site	3	3	$2,015.68	$2,015.68	$1,484.55	$1,797.99	$1,501.68	2026-05-06
111921	OTHER	Hchg Procedure Level 2 (< 2 Staff)	4	4	$2,020.09	$2,020.09	$1,454.46	$1,801.92	$1,496.38	2026-05-06
27334	CPT	Pr Arthrotomy W/synovectomy Knee Anterior/posterior	3	3	$2,005.45	$2,005.45	$1,477.01	$1,788.86	$1,494.06	2026-05-06
73222	CPT	Hchg Rad MRI Joint Of Upper Extremity W	8	4	$1,918.26	$1,918.26	$147.97	$3,238.86	$1,492.55	2026-05-06
73722	CPT	Hchg Rad MRI Joint Of Lower Extremity W	8	4	$1,937.84	$1,937.84	$147.97	$3,273.79	$1,492.55	2026-05-06
27510	CPT	Pr Cltx Fem Fx Dstl End Medial/lat Condyle W/manj	3	3	$2,002.39	$2,002.39	$1,474.76	$1,786.13	$1,491.78	2026-05-06
73720	CPT	Hchg Rad MRI Non Joint Lower Extremity Wwo	8	4	$2,393.32	$2,393.32	$194.52	$4,028.69	$1,489.19	2026-05-06
74182	CPT	Hchg Rad MRI Abdomen W	8	4	$2,360.47	$2,360.47	$157.53	$4,015.92	$1,489.19	2026-05-06
73223	CPT	Hchg Rad MRI Joint Of Upper Extremity Wwo	8	4	$2,351.72	$2,351.72	$195.16	$3,953.69	$1,489.19	2026-05-06
72197	CPT	Hchg Rad MRI Pelvis Wwo	8	4	$2,396.86	$2,396.86	$199.63	$4,028.69	$1,489.19	2026-05-06
73723	CPT	Hchg Rad MRI Joint Of Lower Extremity Wwo	8	4	$2,355.64	$2,355.64	$194.52	$3,961.47	$1,489.19	2026-05-06
72196	CPT	Hchg Rad MRI Pelvis W	8	4	$2,090.39	$2,090.39	$157.53	$3,534.10	$1,489.19	2026-05-06
73220	CPT	Hchg Rad MRI Non Joint Upper Extremity Wwo	8	4	$2,393.32	$2,393.32	$194.52	$4,028.69	$1,489.19	2026-05-06
74183	CPT	Hchg Rad MRI Abdomen Wwo	8	4	$2,396.86	$2,396.86	$199.63	$4,028.69	$1,489.19	2026-05-06
73719	CPT	Hchg Rad MRI Lower Ext Non Joint W Contrast	8	4	$2,083.30	$2,083.30	$147.33	$3,534.10	$1,489.19	2026-05-06
72142	CPT	Hchg Rad MRI Spine Cervical W	31	12	$2,968.26	$2,968.26	$162.63	$2,879.21	$1,484.13	2026-07-20
28585	CPT	Pr Open Treatment Talotarsal Joint Dislocation	9	3	$1,990.14	$1,990.14	$408.79	$2,270.30	$1,482.65	2026-05-06
14060	CPT	Pr Adj Tiss Xfer Lid Nose Ear Lips <10sqcm	9	3	$1,982.97	$1,982.97	$205.53	$2,017.73	$1,477.31	2026-05-06
15200	CPT	Pr Fth/gft Free W/direct Closure Trunk 20 Cm/<	9	3	$1,978.89	$1,978.89	$325.22	$2,159.06	$1,474.27	2026-05-06
27405	CPT	Pr Rpr Primary Torn Ligm&/capsule Knee Collateral	3	3	$1,977.86	$1,977.86	$1,456.69	$1,764.26	$1,473.51	2026-05-06
25350	CPT	Pr Osteotomy Radius Distal Third	3	3	$1,973.77	$1,973.77	$1,453.68	$1,760.60	$1,470.46	2026-05-06
15576	CPT	Pr Frmj Direct/tubed Pedicle W/wotr E/n/e/l/ntroral	9	3	$1,973.76	$1,973.76	$275.53	$2,094.30	$1,470.45	2026-05-06
58660	CPT	Pr Laparoscopy W/lysis Of Adhesions	3	3	$1,960.48	$1,960.48	$1,443.89	$1,748.75	$1,460.56	2026-05-06
72149	CPT	Hchg Rad MRI Spine Lumbar W	31	12	$2,918.94	$2,918.94	$162.63	$2,831.37	$1,459.47	2026-07-20
72195	CPT	Hchg Rad MRI Pelvis Wo	8	4	$1,940.29	$1,940.29	$132.66	$3,297.13	$1,458.95	2026-05-06
74181	CPT	Hchg Rad MRI Abdomen Wo	8	4	$1,681.15	$1,681.15	$132.66	$2,834.82	$1,458.95	2026-05-06
29824	CPT	Pr Arthroscopy Shoulder Distal Claviculectomy	3	3	$1,957.41	$1,957.41	$1,441.63	$1,746.01	$1,458.27	2026-05-06
75635	CPT	Hchg Rad CT Angio Abdomen Pelvis Lower Extremity Runoff	8	4	$1,752.08	$1,752.08	$214.93	$2,859.43	$1,457.00	2026-05-06
95782	CPT	Hchg Polysomnography <6 Yrs W => 4 Parameters	27	12	$2,427.60	$2,427.60	$573.64	$2,354.77	$1,456.56	2026-07-20
57240	CPT	Pr Anterior Colporraphy Rpr Cystocele W/cysto	3	3	$1,953.33	$1,953.33	$1,438.63	$1,742.37	$1,455.23	2026-05-06

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