Hospital

MILLE LACS HEALTH SYSTEM

Onamia, MN · CCN 241356 · Rates published

10,440 distinct procedures filed

59 distinct payers

1,252,388 rate rows

2026-03-04 last MRF observed

Data quality

1,230,867 of 1,252,388 rate rows are consumer-grade (98.3%)

21,521 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
template filing: same amount across many unrelated codes — excluded	9,438
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	6,818
placeholder amount (≤ $0.02) — excluded from medians	5,239
per-diem day rate — not a per-procedure price	26

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

Source MRF file	https://s3.amazonaws.com/ycubaa-production-marlin-1-charge-management-public/facilities/9372d935-a8ce-495b-bbed-e139e5c922cf/410785161_MILLE-LACS-HEALTH-SYSTEM_standardcharges.zip
Found on page	https://www.yourcareeverywhere.com/content/medhost/your-care-everywhere/pricing-estimator-page.html?facility_id=9372d935-a8ce-495b-bbed-e139e5c922cf
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	c849e7d562802c5d… · 174,843,606 bytes · first seen 2026-05-06

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
J3380 CPT	Vedolizumab 300mg	59	$10,951.40	$54,757.00	$54,757.00	nat. median $288 outlier · 190.1×
J2506 CPT	Pegfilgrastim 6mg	59	$6,740.80	$33,704.00	$33,704.00	nat. median $2,076 outlier · 16.2×
J9332 CPT	Vyvgart	59	$6,632.00	$33,160.00	$33,160.00	nat. median $112 outlier · 294.9×
4471535 CDM	Pacemaker	59	$6,376.70	$31,883.50	$31,883.50	nat. median $3,624 outlier · 8.8×
4471699 CDM	Pacer #5820	59	$5,036.40	$25,182.00	$25,182.00	nat. median $636 outlier · 39.6×
4471742 CDM	Pacemaker 5820	59	$5,036.40	$25,182.00	$25,182.00	nat. median $25,182 1.0× median
4471651 CDM	Pacemaker 5826	59	$4,930.05	$24,650.25	$24,650.25	nat. median $24,650 1.0× median
4471841 CDM	Pacemaker #2210	59	$4,615.20	$23,076.00	$23,076.00	nat. median $254 outlier · 91.0×
4471515 CDM	Hip Stem	59	$4,289.55	$21,447.75	$21,447.75	nat. median $2,080 outlier · 10.3×
J2507 CPT	Pegloticase 8mg/ml	59	$4,168.62	$20,843.13	$20,843.13	nat. median $8,558 outlier · 2.4×
4000178 CDM	Or Lithotripsy	59	$4,164.00	$20,820.00	$20,820.00	nat. median $305 outlier · 68.2×
J0565 CPT	Bezlotuxumab 1000mg	59	$3,995.00	$19,975.00	$19,975.00	nat. median $144 outlier · 138.8×
4471739 CDM	Sjm Confirm	59	$3,873.75	$19,368.75	$19,368.75	nat. median $19,369 1.0× median
4471954 CDM	Pacemaker #5826	59	$3,678.55	$18,392.75	$18,392.75	nat. median $18,393 1.0× median
4471904 CDM	Pacer #5620	59	$3,563.05	$17,815.25	$17,815.25	nat. median $280 outlier · 63.6×
4471513 CDM	Laser Fiber	59	$3,135.40	$15,677.00	$15,677.00	nat. median $68 outlier · 232.3×
4471620 CDM	Pegasus Graft	59	$2,889.60	$14,448.00	$14,448.00	nat. median $4,045 outlier · 3.6×
4472005 CDM	Allo Graft 4.5 Cm	59	$2,797.20	$13,986.00	$13,986.00	nat. median $713 outlier · 19.6×
4472068 CDM	Gamma Nail Rt	59	$2,760.55	$13,802.75	$13,802.75	nat. median $360 outlier · 38.3×
43774 CPT	Lap Band & Port Rmvl	59	$2,569.60	$12,848.00	$12,848.00	nat. median $4,650 outlier · 2.8×
43659 CPT	Laparoscope Proc Stom	59	$2,563.80	$12,819.00	$12,819.00	nat. median $6,764 1.9× median
43644 CPT	Lap Gas Bypass Roux-en-y	59	$2,387.40	$11,937.00	$11,937.00	nat. median $5,564 outlier · 2.1×
4471502 CDM	Sling Apogee	59	$2,357.30	$11,786.50	$11,786.50	nat. median $690 outlier · 17.1×
Q9992 CPT	Buprenorphine 300mg	59	$2,319.00	$11,595.00	$11,595.00	nat. median $2,734 outlier · 4.2×
Q9991 CPT	Buprenorpher 100mg	59	$2,319.00	$11,595.00	$11,595.00	nat. median $2,623 outlier · 4.4×
4471506 CDM	Sling Perigee Porcin	59	$2,231.60	$11,158.00	$11,158.00	nat. median $610 outlier · 18.3×
4471509 CDM	Sling Avaulta	59	$2,170.70	$10,853.50	$10,853.50	nat. median $10 outlier · 1085.3×
4473131 CDM	Rlv0015 Radiofrequency Probe	59	$2,133.85	$10,669.25	$10,669.25	nat. median $2,561 outlier · 4.2×
4471507 CDM	Sling Perigee Synth	59	$2,077.35	$10,386.75	$10,386.75	nat. median $1,200 outlier · 8.7×
4472094 CDM	Hernia Patch 6x10	59	$2,002.15	$10,010.75	$10,010.75	nat. median $2,803 outlier · 3.6×
4472092 CDM	Hernia Patch 8x10	59	$1,971.35	$9,856.75	$9,856.75	nat. median $2,760 outlier · 3.6×
4472013 CDM	Allograft Achilles	59	$1,934.90	$9,674.50	$9,674.50	nat. median $2,709 outlier · 3.6×
4471531 CDM	Artelon Cnc Spacer	59	$1,928.65	$9,643.25	$9,643.25	nat. median $1,178 outlier · 8.2×
4472347 CDM	Bard Patch 6.1x10.1	59	$1,925.35	$9,626.75	$9,626.75	nat. median $1,195 outlier · 8.1×
4472345 CDM	Bard Patch 8.7x10.7	59	$1,895.50	$9,477.50	$9,477.50	nat. median $2,654 outlier · 3.6×
J2315 CPT	Naltrexone ER 380mg	59	$1,888.80	$9,444.00	$9,444.00	nat. median $12 outlier · 777.0×
J0875 CPT	Dalbavancin 500mg	59	$1,875.60	$9,378.00	$9,378.00	nat. median $1,069 outlier · 8.8×
44207 CPT	Anastomosis W/colopr	59	$1,871.40	$9,357.00	$9,357.00	nat. median $4,023 outlier · 2.3×
4000185 CDM	Or Major 60 Min Or <	59	$1,857.80	$9,289.00	$9,289.00	nat. median $31 outlier · 299.6×
4471675 CDM	Sling Avaulta	59	$1,846.70	$9,233.50	$9,233.50	nat. median $9,234 1.0× median
4472463 CDM	A Flex 101	59	$1,828.15	$9,140.75	$9,140.75	nat. median $90 outlier · 101.9×
4471658 CDM	Femoral Nail 450844s	59	$1,822.95	$9,114.75	$9,114.75	nat. median $1,537 outlier · 5.9×
4472326 CDM	Balloon Sinuplasaty	59	$1,813.05	$9,065.25	$9,065.25	nat. median $73 outlier · 123.9×
4472159 CDM	Lap Mesh 6x10	59	$1,753.45	$8,767.25	$8,767.25	nat. median $2,104 outlier · 4.2×
4471772 CDM	Mesh Ck Patch	59	$1,740.25	$8,701.25	$8,701.25	nat. median $2,181 outlier · 4.0×
4472093 CDM	Hernia Patch 7x9	59	$1,733.05	$8,665.25	$8,665.25	nat. median $2,426 outlier · 3.6×
44206 CPT	End Colostomy	59	$1,710.80	$8,554.00	$8,554.00	nat. median $4,052 outlier · 2.1×
44150 CPT	Removal Of Colon	59	$1,689.60	$8,448.00	$8,448.00	nat. median $3,298 outlier · 2.6×
4473133 CDM	Mild Kit	59	$1,685.05	$8,425.25	$8,425.25	nat. median $2,022 outlier · 4.2×
4471888 CDM	Mesh Composix 7x9	59	$1,673.30	$8,366.50	$8,366.50	nat. median $2,343 outlier · 3.6×

Other procedures at this hospital

Browse this hospital's 10,440 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

J3380	CPT	Vedolizumab 300mg	119	59	$54,757.00	$38,329.90 30% off	$10,951.40	$54,757.00	$54,757.00	2026-03-04
J2506	CPT	Pegfilgrastim 6mg	119	59	$33,704.00	$23,592.80 30% off	$6,740.80	$33,704.00	$33,704.00	2026-03-04
J9332	CPT	Vyvgart	119	59	$33,160.00	$23,212.00 30% off	$6,632.00	$33,160.00	$33,160.00	2026-03-04
4471535	CDM	Pacemaker	119	59	$31,883.50	$22,318.45 30% off	$6,376.70	$31,883.50	$31,883.50	2026-03-04
4471699	CDM	Pacer #5820	119	59	$25,182.00	$17,627.40 30% off	$5,036.40	$25,182.00	$25,182.00	2026-03-04
4471742	CDM	Pacemaker 5820	119	59	$25,182.00	$17,627.40 30% off	$5,036.40	$25,182.00	$25,182.00	2026-03-04
4471651	CDM	Pacemaker 5826	119	59	$24,650.25	$17,255.17 30% off	$4,930.05	$24,650.25	$24,650.25	2026-03-04
4471841	CDM	Pacemaker #2210	119	59	$23,076.00	$16,153.20 30% off	$4,615.20	$23,076.00	$23,076.00	2026-03-04
4471515	CDM	Hip Stem	119	59	$21,447.75	$15,013.42 30% off	$4,289.55	$21,447.75	$21,447.75	2026-03-04
J2507	CPT	Pegloticase 8mg/ml	119	59	$20,843.13	$14,590.19 30% off	$4,168.62	$20,843.13	$20,843.13	2026-03-04
4000178	CDM	Or Lithotripsy	119	59	$20,820.00	$14,574.00 30% off	$4,164.00	$20,820.00	$20,820.00	2026-03-04
J0565	CPT	Bezlotuxumab 1000mg	119	59	$19,975.00	$13,982.50 30% off	$3,995.00	$19,975.00	$19,975.00	2026-03-04
4471739	CDM	Sjm Confirm	119	59	$19,368.75	$13,558.12 30% off	$3,873.75	$19,368.75	$19,368.75	2026-03-04
4471954	CDM	Pacemaker #5826	119	59	$18,392.75	$12,874.92 30% off	$3,678.55	$18,392.75	$18,392.75	2026-03-04
4471904	CDM	Pacer #5620	119	59	$17,815.25	$12,470.67 30% off	$3,563.05	$17,815.25	$17,815.25	2026-03-04
4471513	CDM	Laser Fiber	119	59	$15,677.00	$10,973.90 30% off	$3,135.40	$15,677.00	$15,677.00	2026-03-04
4471620	CDM	Pegasus Graft	119	59	$14,448.00	$10,113.60 30% off	$2,889.60	$14,448.00	$14,448.00	2026-03-04
4472005	CDM	Allo Graft 4.5 Cm	119	59	$13,986.00	$9,790.20 30% off	$2,797.20	$13,986.00	$13,986.00	2026-03-04
4472068	CDM	Gamma Nail Rt	119	59	$13,802.75	$9,661.92 30% off	$2,760.55	$13,802.75	$13,802.75	2026-03-04
43774	CPT	Lap Band & Port Rmvl	119	59	$12,848.00	$8,993.60 30% off	$2,569.60	$12,848.00	$12,848.00	2026-03-04
43659	CPT	Laparoscope Proc Stom	119	59	$12,819.00	$8,973.30 30% off	$2,563.80	$12,819.00	$12,819.00	2026-03-04
43644	CPT	Lap Gas Bypass Roux-en-y	119	59	$11,937.00	$8,355.90 30% off	$2,387.40	$11,937.00	$11,937.00	2026-03-04
4471502	CDM	Sling Apogee	119	59	$11,786.50	$8,250.55 30% off	$2,357.30	$11,786.50	$11,786.50	2026-03-04
Q9991	CPT	Buprenorpher 100mg	119	59	$11,595.00	$8,116.50 30% off	$2,319.00	$11,595.00	$11,595.00	2026-03-04
Q9992	CPT	Buprenorphine 300mg	119	59	$11,595.00	$8,116.50 30% off	$2,319.00	$11,595.00	$11,595.00	2026-03-04
4471506	CDM	Sling Perigee Porcin	119	59	$11,158.00	$7,810.60 30% off	$2,231.60	$11,158.00	$11,158.00	2026-03-04
4471509	CDM	Sling Avaulta	119	59	$10,853.50	$7,597.45 30% off	$2,170.70	$10,853.50	$10,853.50	2026-03-04
4473131	CDM	Rlv0015 Radiofrequency Probe	119	59	$10,669.25	$7,468.47 30% off	$2,133.85	$10,669.25	$10,669.25	2026-03-04
4471507	CDM	Sling Perigee Synth	119	59	$10,386.75	$7,270.72 30% off	$2,077.35	$10,386.75	$10,386.75	2026-03-04
4472094	CDM	Hernia Patch 6x10	119	59	$10,010.75	$7,007.52 30% off	$2,002.15	$10,010.75	$10,010.75	2026-03-04
4472092	CDM	Hernia Patch 8x10	119	59	$9,856.75	$6,899.72 30% off	$1,971.35	$9,856.75	$9,856.75	2026-03-04
4472013	CDM	Allograft Achilles	119	59	$9,674.50	$6,772.15 30% off	$1,934.90	$9,674.50	$9,674.50	2026-03-04
4471531	CDM	Artelon Cnc Spacer	119	59	$9,643.25	$6,750.27 30% off	$1,928.65	$9,643.25	$9,643.25	2026-03-04
4472347	CDM	Bard Patch 6.1x10.1	119	59	$9,626.75	$6,738.72 30% off	$1,925.35	$9,626.75	$9,626.75	2026-03-04
4472345	CDM	Bard Patch 8.7x10.7	119	59	$9,477.50	$6,634.25 30% off	$1,895.50	$9,477.50	$9,477.50	2026-03-04
J2315	CPT	Naltrexone ER 380mg	119	59	$9,444.00	$6,610.80 30% off	$1,888.80	$9,444.00	$9,444.00	2026-03-04
J0875	CPT	Dalbavancin 500mg	119	59	$9,378.00	$6,564.60 30% off	$1,875.60	$9,378.00	$9,378.00	2026-03-04
44207	CPT	Anastomosis W/colopr	119	59	$9,357.00	$6,549.90 30% off	$1,871.40	$9,357.00	$9,357.00	2026-03-04
4000185	CDM	Or Major 60 Min Or <	119	59	$9,289.00	$6,502.30 30% off	$1,857.80	$9,289.00	$9,289.00	2026-03-04
4471675	CDM	Sling Avaulta	119	59	$9,233.50	$6,463.45 30% off	$1,846.70	$9,233.50	$9,233.50	2026-03-04
4472463	CDM	A Flex 101	119	59	$9,140.75	$6,398.52 30% off	$1,828.15	$9,140.75	$9,140.75	2026-03-04
4471658	CDM	Femoral Nail 450844s	119	59	$9,114.75	$6,380.32 30% off	$1,822.95	$9,114.75	$9,114.75	2026-03-04
4472326	CDM	Balloon Sinuplasaty	119	59	$9,065.25	$6,345.67 30% off	$1,813.05	$9,065.25	$9,065.25	2026-03-04
4472159	CDM	Lap Mesh 6x10	119	59	$8,767.25	$6,137.07 30% off	$1,753.45	$8,767.25	$8,767.25	2026-03-04
4471772	CDM	Mesh Ck Patch	119	59	$8,701.25	$6,090.87 30% off	$1,740.25	$8,701.25	$8,701.25	2026-03-04
4472093	CDM	Hernia Patch 7x9	119	59	$8,665.25	$6,065.67 30% off	$1,733.05	$8,665.25	$8,665.25	2026-03-04
44206	CPT	End Colostomy	119	59	$8,554.00	$5,987.80 30% off	$1,710.80	$8,554.00	$8,554.00	2026-03-04
44150	CPT	Removal Of Colon	119	59	$8,448.00	$5,913.60 30% off	$1,689.60	$8,448.00	$8,448.00	2026-03-04
4473133	CDM	Mild Kit	119	59	$8,425.25	$5,897.67 30% off	$1,685.05	$8,425.25	$8,425.25	2026-03-04
4471888	CDM	Mesh Composix 7x9	119	59	$8,366.50	$5,856.55 30% off	$1,673.30	$8,366.50	$8,366.50	2026-03-04
4472346	CDM	Bard Patch 7.7x9.7	119	59	$8,332.00	$5,832.40 30% off	$1,666.40	$8,332.00	$8,332.00	2026-03-04
4472950	CDM	Resolution Clip	119	59	$8,306.50	$5,814.55 30% off	$1,661.30	$8,306.50	$8,306.50	2026-03-04
4472125	CDM	Wr Claw 2 Hole 25mm	119	59	$8,171.00	$5,719.70 30% off	$1,634.20	$8,171.00	$8,171.00	2026-03-04
4870130	CDM	Obst Care Incl Antep	119	59	$8,093.00	$5,665.10 30% off	$1,618.60	$8,093.00	$8,093.00	2026-03-04
4402581	CDM	Romiplostim 125mcg	119	59	$7,871.00	$5,509.70 30% off	$1,574.20	$7,871.00	$7,871.00	2026-03-04
4473128	CDM	Rlv0055 3 Level Proc Kit	119	59	$7,711.25	$5,397.87 30% off	$1,542.25	$7,711.25	$7,711.25	2026-03-04
4470969	CDM	Wrist Fixator	119	59	$7,698.25	$5,388.77 30% off	$1,539.65	$7,698.25	$7,698.25	2026-03-04
4470839	CDM	Monark Sling	119	59	$7,575.25	$5,302.67 30% off	$1,515.05	$7,575.25	$7,575.25	2026-03-04
4471771	CDM	Mesh Ventrio Large	119	59	$7,550.00	$5,285.00 30% off	$1,510.00	$7,550.00	$7,550.00	2026-03-04
4472208	CDM	Mesh 30x20cm 12x8	119	59	$7,445.50	$5,211.85 30% off	$1,489.10	$7,445.50	$7,445.50	2026-03-04
4471622	CDM	Plate 442.51	119	59	$7,358.25	$5,150.77 30% off	$1,471.65	$7,358.25	$7,358.25	2026-03-04
4402322	CDM	Barium Sulfate 340g	119	59	$7,213.00	$5,049.10 30% off	$1,442.60	$7,213.00	$7,213.00	2026-03-04
43281	CPT	Lap Paraesophag Hernia Repair	119	59	$7,170.00	$5,019.00 30% off	$1,434.00	$7,170.00	$7,170.00	2026-03-04
4871168	CDM	Rtn OB Care Incl Ant	119	59	$7,108.00	$4,975.60 30% off	$1,421.60	$7,108.00	$7,108.00	2026-03-04
4472697	CDM	ENT Dilation System	119	59	$7,045.00	$4,931.50 30% off	$1,409.00	$7,045.00	$7,045.00	2026-03-04
C1783	CPT	Eye Stent	238	59	$8,185.62	$5,729.93 30% off	$1,392.00	$9,411.25	$6,960.00	2026-03-04
4473138	CDM	Nitinol Tc Electr 15	119	59	$6,860.00	$4,802.00 30% off	$1,372.00	$6,860.00	$6,860.00	2026-03-04
4473140	CDM	Nintinol Tc Elect 10	119	59	$6,860.00	$4,802.00 30% off	$1,372.00	$6,860.00	$6,860.00	2026-03-04
C1726	CPT	Sinus Balloon 6x16mm	238	59	$7,434.50	$5,204.15 30% off	$1,367.90	$8,029.50	$6,839.50	2026-03-04
4472371	CDM	Rt Plate 4 Hole	119	59	$6,809.25	$4,766.47 30% off	$1,361.85	$6,809.25	$6,809.25	2026-03-04
4472480	CDM	Acute Ac Repair Kit	119	59	$6,807.75	$4,765.42 30% off	$1,361.55	$6,807.75	$6,807.75	2026-03-04
C1776	CPT	Stem Implant 7mm	119	59	$6,804.75	$4,763.32 30% off	$1,360.95	$6,804.75	$6,804.75	2026-03-04
4471521	CDM	Stent Ureteral Cook	119	59	$6,768.75	$4,738.12 30% off	$1,353.75	$6,768.75	$6,768.75	2026-03-04
4472343	CDM	Bard Patch 5.1x7.0	119	59	$6,721.75	$4,705.22 30% off	$1,344.35	$6,721.75	$6,721.75	2026-03-04
4471516	CDM	Bipolar Head	119	59	$6,689.25	$4,682.47 30% off	$1,337.85	$6,689.25	$6,689.25	2026-03-04
4870003	CDM	Colectomy Part W/col	119	59	$6,666.00	$4,666.20 30% off	$1,333.20	$6,666.00	$6,666.00	2026-03-04
4471983	CDM	Plate Mtp Rt Short	119	59	$6,647.75	$4,653.42 30% off	$1,329.55	$6,647.75	$6,647.75	2026-03-04
4471933	CDM	Plate Ar-8944clp	119	59	$6,647.75	$4,653.42 30% off	$1,329.55	$6,647.75	$6,647.75	2026-03-04
4471676	CDM	Sling Halo	119	59	$6,643.75	$4,650.62 30% off	$1,328.75	$6,643.75	$6,643.75	2026-03-04
4472459	CDM	Ar-1688-cp	119	59	$6,588.50	$4,611.95 30% off	$1,317.70	$6,588.50	$6,588.50	2026-03-04
4472043	CDM	3.5 Clav Plate	119	59	$6,583.75	$4,608.62 30% off	$1,316.75	$6,583.75	$6,583.75	2026-03-04
4471808	CDM	Pelvisoft 6x8	119	59	$6,583.00	$4,608.10 30% off	$1,316.60	$6,583.00	$6,583.00	2026-03-04
4471534	CDM	Pacemaker Leads 1688	119	59	$6,559.00	$4,591.30 30% off	$1,311.80	$6,559.00	$6,559.00	2026-03-04
4472063	CDM	3.5 Clav Plate Left	119	59	$6,549.75	$4,584.82 30% off	$1,309.95	$6,549.75	$6,549.75	2026-03-04
4870161	CDM	Colectomy W/end Colo	119	59	$6,524.00	$4,566.80 30% off	$1,304.80	$6,524.00	$6,524.00	2026-03-04
4472386	CDM	Clavicle Rt 3.5mm	119	59	$6,476.50	$4,533.55 30% off	$1,295.30	$6,476.50	$6,476.50	2026-03-04
4472255	CDM	Sling Tvt Guide	119	59	$6,427.75	$4,499.42 30% off	$1,285.55	$6,427.75	$6,427.75	2026-03-04
4471770	CDM	Mesh Ventrio Med	119	59	$6,422.50	$4,495.75 30% off	$1,284.50	$6,422.50	$6,422.50	2026-03-04
4473041	CDM	Venaseal Kit	119	59	$6,387.75	$4,471.42 30% off	$1,277.55	$6,387.75	$6,387.75	2026-03-04
4870147	CDM	Laparoscopy Esophago	119	59	$6,360.00	$4,452.00 30% off	$1,272.00	$6,360.00	$6,360.00	2026-03-04
4472271	CDM	Distal Bicep Repair Kit Ar-2260	119	59	$6,335.75	$4,435.02 30% off	$1,267.15	$6,335.75	$6,335.75	2026-03-04
4472075	CDM	Mtp Left Plate	119	59	$6,331.50	$4,432.05 30% off	$1,266.30	$6,331.50	$6,331.50	2026-03-04
4471944	CDM	3.5mm Lcp Sup Ant Clavicle	119	59	$6,295.50	$4,406.85 30% off	$1,259.10	$6,295.50	$6,295.50	2026-03-04
C8911	CPT	MRA Chest W&without Cont	119	59	$6,272.00	$4,390.40 30% off	$1,254.40	$6,272.00	$6,272.00	2026-03-04
4471945	CDM	3.5mm Lcp Sup Ant Clavicle Pl	119	59	$6,251.00	$4,375.70 30% off	$1,250.20	$6,251.00	$6,251.00	2026-03-04
4471232	CDM	Vag Sling Aris	119	59	$6,209.25	$4,346.47 30% off	$1,241.85	$6,209.25	$6,209.25	2026-03-04
4000187	CDM	Minor 30 Min Or Less	119	59	$6,103.00	$4,272.10 30% off	$1,220.60	$6,103.00	$6,103.00	2026-03-04
4472207	CDM	Mesh 25x20cm 10x8	119	59	$6,051.50	$4,236.05 30% off	$1,210.30	$6,051.50	$6,051.50	2026-03-04
4471704	CDM	Sling Align	119	59	$6,029.50	$4,220.65 30% off	$1,205.90	$6,029.50	$6,029.50	2026-03-04
4471501	CDM	Sling Tvt	119	59	$5,845.50	$4,091.85 30% off	$1,169.10	$5,845.50	$5,845.50	2026-03-04
4870301	CDM	Inset Cvc W/subcutan	119	59	$5,813.00	$4,069.10 30% off	$1,162.60	$5,813.00	$5,813.00	2026-03-04
4472034	CDM	Dvr Anatomic Standard Left	119	59	$5,800.00	$4,060.00 30% off	$1,160.00	$5,800.00	$5,800.00	2026-03-04
4471915	CDM	Dvr Anatomic Shrt Lt	119	59	$5,799.50	$4,059.65 30% off	$1,159.90	$5,799.50	$5,799.50	2026-03-04
4472018	CDM	Depuy Plate Dvra-r	119	59	$5,799.50	$4,059.65 30% off	$1,159.90	$5,799.50	$5,799.50	2026-03-04
4472373	CDM	Dvr Anatomic Wide Lt	119	59	$5,792.50	$4,054.75 30% off	$1,158.50	$5,792.50	$5,792.50	2026-03-04
4870021	CDM	Laparoscopy Enteroly	119	59	$5,779.00	$4,045.30 30% off	$1,155.80	$5,779.00	$5,779.00	2026-03-04
4471906	CDM	Depuy Shrt Lft Plate	119	59	$5,774.25	$4,041.97 30% off	$1,154.85	$5,774.25	$5,774.25	2026-03-04
4472286	CDM	Alligraft Ac Joint	119	59	$5,768.75	$4,038.12 30% off	$1,153.75	$5,768.75	$5,768.75	2026-03-04
4472344	CDM	Bard Patch 4.3x5.5	119	59	$5,757.00	$4,029.90 30% off	$1,151.40	$5,757.00	$5,757.00	2026-03-04
19307	CPT	Mastectomy Mod Radical	119	59	$5,712.00	$3,998.40 30% off	$1,142.40	$5,712.00	$5,712.00	2026-03-04
4870080	CDM	Colectomy W/skn Lvl	119	59	$5,692.00	$3,984.40 30% off	$1,138.40	$5,692.00	$5,692.00	2026-03-04
4471701	CDM	Pacer Lead #1888	119	59	$5,661.00	$3,962.70 30% off	$1,132.20	$5,661.00	$5,661.00	2026-03-04
4472484	CDM	Ar-2260	119	59	$5,611.50	$3,928.05 30% off	$1,122.30	$5,611.50	$5,611.50	2026-03-04
C1771	CPT	Advantage Fit System M0068502110	238	59	$5,936.38	$4,155.46 30% off	$1,121.05	$6,267.50	$5,605.25	2026-03-04
4472275	CDM	Dvr Anatomic Standard Left	119	59	$5,600.75	$3,920.52 30% off	$1,120.15	$5,600.75	$5,600.75	2026-03-04
4472293	CDM	Dvr Anatomic Narw Left	119	59	$5,600.75	$3,920.52 30% off	$1,120.15	$5,600.75	$5,600.75	2026-03-04
4472308	CDM	Dvr Anatomic Narrow Sh/rt	119	59	$5,600.75	$3,920.52 30% off	$1,120.15	$5,600.75	$5,600.75	2026-03-04
4471885	CDM	Mesh 6x8 Composit	119	59	$5,543.75	$3,880.62 30% off	$1,108.75	$5,543.75	$5,543.75	2026-03-04
4471485	CDM	281.421 Plate	119	59	$5,531.75	$3,872.22 30% off	$1,106.35	$5,531.75	$5,531.75	2026-03-04
4870079	CDM	Colectomy, Partial	119	59	$5,528.00	$3,869.60 30% off	$1,105.60	$5,528.00	$5,528.00	2026-03-04
C8914	CPT	MRA Low Ext W&without	119	59	$5,500.00	$3,850.00 30% off	$1,100.00	$5,500.00	$5,500.00	2026-03-04
C8913	CPT	MRA Lower Ext W&without	119	59	$5,500.00	$3,850.00 30% off	$1,100.00	$5,500.00	$5,500.00	2026-03-04
4870245	CDM	Ligat Esoph Transtho	119	59	$5,470.00	$3,829.00 30% off	$1,094.00	$5,470.00	$5,470.00	2026-03-04
44227	CPT	Lap Close Enterostom	119	59	$5,447.00	$3,812.90 30% off	$1,089.40	$5,447.00	$5,447.00	2026-03-04
4870297	CDM	Lap Cholecystectomy	119	59	$5,447.00	$3,812.90 30% off	$1,089.40	$5,447.00	$5,447.00	2026-03-04
4472364	CDM	Flexigraft	119	59	$5,390.50	$3,773.35 30% off	$1,078.10	$5,390.50	$5,390.50	2026-03-04
4472536	CDM	Dvr Anatomic Narw Rt	119	59	$5,363.00	$3,754.10 30% off	$1,072.60	$5,363.00	$5,363.00	2026-03-04
4870203	CDM	Insert Pcmker Artial	119	59	$5,245.00	$3,671.50 30% off	$1,049.00	$5,245.00	$5,245.00	2026-03-04
4870305	CDM	Clsr Enerostomy W/re	119	59	$5,214.00	$3,649.80 30% off	$1,042.80	$5,214.00	$5,214.00	2026-03-04
44204	CPT	Laparoscopic Colectomy	119	59	$5,186.00	$3,630.20 30% off	$1,037.20	$5,186.00	$5,186.00	2026-03-04
44160	CPT	Removal Of Colon	119	59	$5,179.00	$3,625.30 30% off	$1,035.80	$5,179.00	$5,179.00	2026-03-04
47362	CPT	Repair Liver Wound	119	59	$5,152.00	$3,606.40 30% off	$1,030.40	$5,152.00	$5,152.00	2026-03-04
4870298	CDM	Cholecystectomy W/ch	119	59	$5,128.00	$3,589.60 30% off	$1,025.60	$5,128.00	$5,128.00	2026-03-04
74182	CPT	MRI Abdomen W/contra	119	59	$5,064.00	$3,544.80 30% off	$1,012.80	$5,064.00	$5,064.00	2026-03-04
4871181	CDM	Drn Peritoneal Absce	119	59	$5,042.00	$3,529.40 30% off	$1,008.40	$5,042.00	$5,042.00	2026-03-04
4471604	CDM	Plate Sd241003	119	59	$5,034.50	$3,524.15 30% off	$1,006.90	$5,034.50	$5,034.50	2026-03-04
Q5103	CPT	Infliximab-dyyb	119	59	$5,010.00	$3,507.00 30% off	$1,002.00	$5,010.00	$5,010.00	2026-03-04
4870040	CDM	Suture Lg Intes Without	119	59	$4,988.00	$3,491.60 30% off	$997.60	$4,988.00	$4,988.00	2026-03-04
4472204	CDM	Mesh Round 20cm 8	119	59	$4,965.50	$3,475.85 30% off	$993.10	$4,965.50	$4,965.50	2026-03-04
4471842	CDM	Pacemaker Leads 2088	119	59	$4,964.75	$3,475.32 30% off	$992.95	$4,964.75	$4,964.75	2026-03-04
4471028	CDM	Mesh Circle Lg	119	59	$4,956.75	$3,469.72 30% off	$991.35	$4,956.75	$4,956.75	2026-03-04
49618	CPT	Rpr Aa Hrn Rcr >10 S	119	59	$4,951.00	$3,465.70 30% off	$990.20	$4,951.00	$4,951.00	2026-03-04
19305	CPT	Mastectomy, Radical	119	59	$4,936.00	$3,455.20 30% off	$987.20	$4,936.00	$4,936.00	2026-03-04
4473127	CDM	Rlv0045 2 Level Proc	119	59	$4,896.00	$3,427.20 30% off	$979.20	$4,896.00	$4,896.00	2026-03-04
4470958	CDM	Stapler Ceea 25mm	119	59	$4,895.00	$3,426.50 30% off	$979.00	$4,895.00	$4,895.00	2026-03-04
52240	CPT	Cysto W/ful Lg Tumor	119	59	$4,888.00	$3,421.60 30% off	$977.60	$4,888.00	$4,888.00	2026-03-04
G0260	CPT	CT Bilat Si Jt Inj	119	59	$4,864.00	$3,404.80 30% off	$972.80	$4,864.00	$4,864.00	2026-03-04
J2997	CPT	Alteplase 50mg For I	238	59	$23,329.72	$16,330.80 30% off	$92.48	$46,197.00	$4,850.92	2026-03-04
4472968	CDM	Distal Lat Fibula Pl	119	59	$4,759.25	$3,331.47 30% off	$951.85	$4,759.25	$4,759.25	2026-03-04
4471807	CDM	Pelvisoft 4x7	119	59	$4,684.25	$3,278.97 30% off	$936.85	$4,684.25	$4,684.25	2026-03-04
52601	CPT	Transurethral Resection Of Prostrate	119	59	$4,672.00	$3,270.40 30% off	$934.40	$4,672.00	$4,672.00	2026-03-04
28810	CPT	Amputation Metarsal With Toe	119	59	$4,659.00	$3,261.30 30% off	$931.80	$4,659.00	$4,659.00	2026-03-04
4871327	CDM	Esophagogastric Fund	119	59	$4,596.00	$3,217.20 30% off	$919.20	$4,596.00	$4,596.00	2026-03-04
4870016	CDM	Radical Resec Tumor	119	59	$4,573.00	$3,201.10 30% off	$914.60	$4,573.00	$4,573.00	2026-03-04
15830	CPT	Exc Skin Abd	119	59	$4,562.00	$3,193.40 30% off	$912.40	$4,562.00	$4,562.00	2026-03-04
4870325	CDM	Axillary Lymphad Cmp	119	59	$4,562.00	$3,193.40 30% off	$912.40	$4,562.00	$4,562.00	2026-03-04
44640	CPT	Closure Of Intestinal Cutaneous Fistula	119	59	$4,557.00	$3,189.90 30% off	$911.40	$4,557.00	$4,557.00	2026-03-04
4870311	CDM	Corr Malrotaion By L	119	59	$4,552.00	$3,186.40 30% off	$910.40	$4,552.00	$4,552.00	2026-03-04
J9395	CPT	Fulvestrant 250mg	119	59	$4,549.00	$3,184.30 30% off	$909.80	$4,549.00	$4,549.00	2026-03-04
4870078	CDM	Enterectomy Resct Sm	119	59	$4,466.00	$3,126.20 30% off	$893.20	$4,466.00	$4,466.00	2026-03-04
44125	CPT	Resection Small Intestine W/enterostomy	119	59	$4,464.00	$3,124.80 30% off	$892.80	$4,464.00	$4,464.00	2026-03-04
44188	CPT	Lap Colostomy	119	59	$4,464.00	$3,124.80 30% off	$892.80	$4,464.00	$4,464.00	2026-03-04
4870052	CDM	Amput Thigh Thru Fem	119	59	$4,449.00	$3,114.30 30% off	$889.80	$4,449.00	$4,449.00	2026-03-04
71551	CPT	MRI Chest W/contrast	119	59	$4,443.00	$3,110.10 30% off	$888.60	$4,443.00	$4,443.00	2026-03-04
C8918	CPT	MRA Pelvis W/cont	119	59	$4,443.00	$3,110.10 30% off	$888.60	$4,443.00	$4,443.00	2026-03-04
26123	CPT	Fasciectomy W/wo Z-plasty	119	59	$4,426.00	$3,098.20 30% off	$885.20	$4,426.00	$4,426.00	2026-03-04
4871245	CDM	Insert Cvc > 5yrs	119	59	$4,419.00	$3,093.30 30% off	$883.80	$4,419.00	$4,419.00	2026-03-04
4472072	CDM	Screw Lag #3060-0085	119	59	$4,412.00	$3,088.40 30% off	$882.40	$4,412.00	$4,412.00	2026-03-04
4110033	CDM	General Anesth >30mn	119	59	$4,403.00	$3,082.10 30% off	$880.60	$4,403.00	$4,403.00	2026-03-04
52352	CPT	Cysto With Removal Or Manipulation Calcu	119	59	$4,401.00	$3,080.70 30% off	$880.20	$4,401.00	$4,401.00	2026-03-04
4472843	CDM	Monopty Biop Inst	119	59	$4,391.75	$3,074.22 30% off	$878.35	$4,391.75	$4,391.75	2026-03-04
4870082	CDM	Colostomy Or Skn Lvl	119	59	$4,389.00	$3,072.30 30% off	$877.80	$4,389.00	$4,389.00	2026-03-04
4870270	CDM	Clsr Of Enterostomy	119	59	$4,369.00	$3,058.30 30% off	$873.80	$4,369.00	$4,369.00	2026-03-04
4402137	CDM	Cyanokit 5gm IV	119	59	$4,355.00	$3,048.50 30% off	$871.00	$4,355.00	$4,355.00	2026-03-04
01967	CPT	Anesthesia OB Analge	119	59	$4,349.00	$3,044.30 30% off	$869.80	$4,349.00	$4,349.00	2026-03-04
4471027	CDM	Mesh Circle Med	119	59	$4,318.00	$3,022.60 30% off	$863.60	$4,318.00	$4,318.00	2026-03-04
4870204	CDM	Gastrorrhaphy Suture	119	59	$4,316.00	$3,021.20 30% off	$863.20	$4,316.00	$4,316.00	2026-03-04
4870081	CDM	Colectomy W/colostmy	119	59	$4,297.00	$3,007.90 30% off	$859.40	$4,297.00	$4,297.00	2026-03-04
4870054	CDM	Amput Leg Thru Tibia	119	59	$4,295.00	$3,006.50 30% off	$859.00	$4,295.00	$4,295.00	2026-03-04
J7298	CPT	Mirena IUD	119	59	$4,287.00	$3,000.90 30% off	$857.40	$4,287.00	$4,287.00	2026-03-04
49060	CPT	Drainage Retroperitineal Abscess	119	59	$4,285.00	$2,999.50 30% off	$857.00	$4,285.00	$4,285.00	2026-03-04
4471225	CDM	Premium Lens	119	59	$4,284.00	$2,998.80 30% off	$856.80	$4,284.00	$4,284.00	2026-03-04
4870316	CDM	Rplc Complete Cvc	119	59	$4,277.00	$2,993.90 30% off	$855.40	$4,277.00	$4,277.00	2026-03-04
4870077	CDM	Enterolysis Sep Proc	119	59	$4,277.00	$2,993.90 30% off	$855.40	$4,277.00	$4,277.00	2026-03-04
4870076	CDM	Exc W/roux-en-y Reco	119	59	$4,272.00	$2,990.40 30% off	$854.40	$4,272.00	$4,272.00	2026-03-04
4472120	CDM	Osferion Wedge	119	59	$4,256.75	$2,979.72 30% off	$851.35	$4,256.75	$4,256.75	2026-03-04
4471795	CDM	Gyrus Plasma Cd	119	59	$4,217.75	$2,952.42 30% off	$843.55	$4,217.75	$4,217.75	2026-03-04
4472206	CDM	Mesh 20x15cm 8x6	119	59	$4,216.50	$2,951.55 30% off	$843.30	$4,216.50	$4,216.50	2026-03-04
4471543	CDM	218.240 76mm Plate	119	59	$4,207.25	$2,945.07 30% off	$841.45	$4,207.25	$4,207.25	2026-03-04
4870131	CDM	Cesarean Deliv Only	119	59	$4,205.00	$2,943.50 30% off	$841.00	$4,205.00	$4,205.00	2026-03-04
4870123	CDM	Total Abd Hystrectmy	119	59	$4,201.00	$2,940.70 30% off	$840.20	$4,201.00	$4,201.00	2026-03-04
4870075	CDM	Exc W/gastrojejunost	119	59	$4,187.00	$2,930.90 30% off	$837.40	$4,187.00	$4,187.00	2026-03-04
4471517	CDM	Femoral Head	119	59	$4,138.75	$2,897.12 30% off	$827.75	$4,138.75	$4,138.75	2026-03-04
72195	CPT	MRI Pelvis Without	119	59	$4,103.00	$2,872.10 30% off	$820.60	$4,103.00	$4,103.00	2026-03-04
4472635	CDM	Pleurz Catheter Kit	119	59	$4,101.00	$2,870.70 30% off	$820.20	$4,101.00	$4,101.00	2026-03-04
49596	CPT	Rpr Aa Hrn >10cm Str	119	59	$4,090.00	$2,863.00 30% off	$818.00	$4,090.00	$4,090.00	2026-03-04
J9155	CPT	Degarelix 240mg	119	59	$4,044.00	$2,830.80 30% off	$808.80	$4,044.00	$4,044.00	2026-03-04
76498	CPT	MRI Unlist Ltd Procd	119	59	$4,024.00	$2,816.80 30% off	$804.80	$4,024.00	$4,024.00	2026-03-04
4401318	CDM	Cl Intrauterine Copp	119	59	$4,000.00	$2,800.00 30% off	$800.00	$4,000.00	$4,000.00	2026-03-04
4870250	CDM	Hepatotomy Open Drn	119	59	$3,991.00	$2,793.70 30% off	$798.20	$3,991.00	$3,991.00	2026-03-04
4870185	CDM	Choledochotomy W/exp	119	59	$3,981.00	$2,786.70 30% off	$796.20	$3,981.00	$3,981.00	2026-03-04
4870133	CDM	Thyroid Lobectomy	119	59	$3,969.00	$2,778.30 30% off	$793.80	$3,969.00	$3,969.00	2026-03-04
4471429	CDM	245.121 168mm Plate	119	59	$3,965.50	$2,775.85 30% off	$793.10	$3,965.50	$3,965.50	2026-03-04
4870094	CDM	Cholecyst W/cholango	119	59	$3,961.00	$2,772.70 30% off	$792.20	$3,961.00	$3,961.00	2026-03-04
4870155	CDM	Reduc Of Volvulus In	119	59	$3,940.00	$2,758.00 30% off	$788.00	$3,940.00	$3,940.00	2026-03-04
59612	CPT	Vag Del After C-sect	119	59	$3,928.00	$2,749.60 30% off	$785.60	$3,928.00	$3,928.00	2026-03-04
27596	CPT	Amputation Follow Up Surgery	119	59	$3,914.00	$2,739.80 30% off	$782.80	$3,914.00	$3,914.00	2026-03-04
4471426	CDM	245.071 98mm Plate	119	59	$3,913.50	$2,739.45 30% off	$782.70	$3,913.50	$3,913.50	2026-03-04
4473040	CDM	Closurefast Cath	119	59	$3,913.50	$2,739.45 30% off	$782.70	$3,913.50	$3,913.50	2026-03-04
4470882	CDM	Tct 75 Stapler	119	59	$3,899.25	$2,729.47 30% off	$779.85	$3,899.25	$3,899.25	2026-03-04
L8699	CPT	Urolift Impalant Car	119	59	$3,897.75	$2,728.42 30% off	$779.55	$3,897.75	$3,897.75	2026-03-04
J1212	CPT	Rimso-50	119	59	$3,875.00	$2,712.50 30% off	$775.00	$3,875.00	$3,875.00	2026-03-04
4870027	CDM	Revision Of Colostom	119	59	$3,869.00	$2,708.30 30% off	$773.80	$3,869.00	$3,869.00	2026-03-04
4471408	CDM	223.641 189mm Plate	119	59	$3,855.00	$2,698.50 30% off	$771.00	$3,855.00	$3,855.00	2026-03-04
4870064	CDM	Splenectomy Total	119	59	$3,847.00	$2,692.90 30% off	$769.40	$3,847.00	$3,847.00	2026-03-04
4471591	CDM	Clamp Assembly	119	59	$3,828.50	$2,679.95 30% off	$765.70	$3,828.50	$3,828.50	2026-03-04
4471588	CDM	311.689 Taps	119	59	$3,818.00	$2,672.60 30% off	$763.60	$3,818.00	$3,818.00	2026-03-04
4472524	CDM	Ar-8919ds	119	59	$3,817.50	$2,672.25 30% off	$763.50	$3,817.50	$3,817.50	2026-03-04
4402531	CDM	Vitamin A Palmitate	119	59	$3,817.00	$2,671.90 30% off	$763.40	$3,817.00	$3,817.00	2026-03-04
19303	CPT	Simple Mastectomy Co	119	59	$3,812.00	$2,668.40 30% off	$762.40	$3,812.00	$3,812.00	2026-03-04
23073	CPT	Exc Shoulder Tumor > 5cm	119	59	$3,808.00	$2,665.60 30% off	$761.60	$3,808.00	$3,808.00	2026-03-04
C1782	CPT	Xcise Morcell	119	59	$3,780.25	$2,646.17 30% off	$756.05	$3,780.25	$3,780.25	2026-03-04
4870030	CDM	Full Thickness Graft	119	59	$3,758.00	$2,630.60 30% off	$751.60	$3,758.00	$3,758.00	2026-03-04
4870194	CDM	Cholecystectomy W/ex	119	59	$3,750.00	$2,625.00 30% off	$750.00	$3,750.00	$3,750.00	2026-03-04
52351	CPT	Cysto W/ureteroscopy	119	59	$3,750.00	$2,625.00 30% off	$750.00	$3,750.00	$3,750.00	2026-03-04
4471425	CDM	245.061 84mm Plate	119	59	$3,748.25	$2,623.77 30% off	$749.65	$3,748.25	$3,748.25	2026-03-04
4870249	CDM	Lap W/asp Cavity,cys	119	59	$3,736.00	$2,615.20 30% off	$747.20	$3,736.00	$3,736.00	2026-03-04
4471026	CDM	Mesh Circle Sm	119	59	$3,715.25	$2,600.67 30% off	$743.05	$3,715.25	$3,715.25	2026-03-04
4870093	CDM	Cholecystectomy	119	59	$3,702.00	$2,591.40 30% off	$740.40	$3,702.00	$3,702.00	2026-03-04
C2625	CPT	Propel Large	119	59	$3,698.00	$2,588.60 30% off	$739.60	$3,698.00	$3,698.00	2026-03-04
4471428	CDM	245.101 140mm Plate	119	59	$3,683.25	$2,578.27 30% off	$736.65	$3,683.25	$3,683.25	2026-03-04
45172	CPT	Exc Rectal Tumore Transanal Full	119	59	$3,655.00	$2,558.50 30% off	$731.00	$3,655.00	$3,655.00	2026-03-04
99468	CPT	Initial Inpatient Neonatal Critical Care	119	59	$3,652.00	$2,556.40 30% off	$730.40	$3,652.00	$3,652.00	2026-03-04
4870037	CDM	Gastroduodenostomy	119	59	$3,649.00	$2,554.30 30% off	$729.80	$3,649.00	$3,649.00	2026-03-04
4471692	CDM	Bard Power Port	119	59	$3,628.25	$2,539.77 30% off	$725.65	$3,628.25	$3,628.25	2026-03-04
4870206	CDM	Stab Phleb >20 Incis	119	59	$3,628.00	$2,539.60 30% off	$725.60	$3,628.00	$3,628.00	2026-03-04
4472539	CDM	40-20806 Stryker	119	59	$3,625.25	$2,537.67 30% off	$725.05	$3,625.25	$3,625.25	2026-03-04
50590	CPT	Lithrotripsy	119	59	$3,620.00	$2,534.00 30% off	$724.00	$3,620.00	$3,620.00	2026-03-04
4870320	CDM	Gastrojejunostomy	119	59	$3,620.00	$2,534.00 30% off	$724.00	$3,620.00	$3,620.00	2026-03-04
4870205	CDM	Cesarean Delvry W/po	119	59	$3,610.00	$2,527.00 30% off	$722.00	$3,610.00	$3,610.00	2026-03-04
55060-RT	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060-76	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060	CPT	Repair Of Hydrocele	186	59	$3,608.00	$2,525.60 30% off	$721.60	$3,608.00	$3,608.00	2026-03-04
55060-ST	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060-NU	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060-XS	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060-GO	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060-59	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060-51	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060-95	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060-25	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060-AT	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060-50	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060-LT	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060-52	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
55060-GF	CPT	Repair Of Hydrocele	67	44	$3,608.00	$2,525.60 30% off	$3,608.00	$3,608.00	$3,608.00	2026-03-04
PER CASE	LOCAL	Plan Pays Per Case	6	3	—	—	$104.00	$7,094.00	$3,599.00	2026-03-04
C8901	CPT	MRA Abdomen Without Cont	119	59	$3,598.00	$2,518.60 30% off	$719.60	$3,598.00	$3,598.00	2026-03-04
4471427	CDM	245.081 112mm Plate	119	59	$3,584.50	$2,509.15 30% off	$716.90	$3,584.50	$3,584.50	2026-03-04
44310	CPT	Ileostomy/jujunostom	119	59	$3,570.00	$2,499.00 30% off	$714.00	$3,570.00	$3,570.00	2026-03-04
4870034	CDM	Colotomy For Explora	119	59	$3,568.00	$2,497.60 30% off	$713.60	$3,568.00	$3,568.00	2026-03-04
4871169	CDM	Vaginal Delivery Onl	119	59	$3,563.00	$2,494.10 30% off	$712.60	$3,563.00	$3,563.00	2026-03-04
4471274	CDM	Stapler Sulete Ii	119	59	$3,556.00	$2,489.20 30% off	$711.20	$3,556.00	$3,556.00	2026-03-04
52235	CPT	Cysto W/ful Med Tumo	119	59	$3,546.00	$2,482.20 30% off	$709.20	$3,546.00	$3,546.00	2026-03-04
4472396	CDM	Ar-2324bcct	119	59	$3,545.50	$2,481.85 30% off	$709.10	$3,545.50	$3,545.50	2026-03-04
4472399	CDM	Ar-2324bcctt	119	59	$3,545.50	$2,481.85 30% off	$709.10	$3,545.50	$3,545.50	2026-03-04
49617	CPT	Rpr Aa Hrn Rcr >10	119	59	$3,538.00	$2,476.60 30% off	$707.60	$3,538.00	$3,538.00	2026-03-04
4472203	CDM	Mesh Round 15cm 6	119	59	$3,525.25	$2,467.67 30% off	$705.05	$3,525.25	$3,525.25	2026-03-04
4870257	CDM	Lap Vag Hyst W/rmvl	119	59	$3,499.00	$2,449.30 30% off	$699.80	$3,499.00	$3,499.00	2026-03-04
4870007	CDM	Expl Abd Post-op Hem	119	59	$3,491.00	$2,443.70 30% off	$698.20	$3,491.00	$3,491.00	2026-03-04
4472104	CDM	Plate #442.503	119	59	$3,458.50	$2,420.95 30% off	$691.70	$3,458.50	$3,458.50	2026-03-04
J7296	CPT	Kyleena IUD	238	59	$3,866.88	$2,706.81 30% off	$689.35	$4,287.00	$3,446.75	2026-03-04
4870211	CDM	Thyroidectomy Total	119	59	$3,440.00	$2,408.00 30% off	$688.00	$3,440.00	$3,440.00	2026-03-04
4471411	CDM	241.171 87mm Plate	119	59	$3,431.50	$2,402.05 30% off	$686.30	$3,431.50	$3,431.50	2026-03-04
4473091	CDM	Closurefast 3x60cm	119	59	$3,427.25	$2,399.07 30% off	$685.45	$3,427.25	$3,427.25	2026-03-04
4471689	CDM	Femoral Intrafix 7	119	59	$3,425.00	$2,397.50 30% off	$685.00	$3,425.00	$3,425.00	2026-03-04
49616	CPT	Rpr Aa Hrn Rcr Ncr	119	59	$3,424.00	$2,396.80 30% off	$684.80	$3,424.00	$3,424.00	2026-03-04
J9217	CPT	Lupron 45mg Inj	357	59	$10,251.33	$7,175.93 30% off	$492.13	$12,204.83	$3,417.35	2026-03-04
58700	CPT	Salpingectomy Complete Or Partial	119	59	$3,412.00	$2,388.40 30% off	$682.40	$3,412.00	$3,412.00	2026-03-04
4470975	CDM	Minimag Implant	119	59	$3,408.00	$2,385.60 30% off	$681.60	$3,408.00	$3,408.00	2026-03-04
4470951	CDM	Magnum Implant	119	59	$3,408.00	$2,385.60 30% off	$681.60	$3,408.00	$3,408.00	2026-03-04
4870086	CDM	Appedectomy Ruptured	119	59	$3,407.00	$2,384.90 30% off	$681.40	$3,407.00	$3,407.00	2026-03-04
4473000	CDM	Fibertag Tightrope	119	59	$3,399.75	$2,379.82 30% off	$679.95	$3,399.75	$3,399.75	2026-03-04
4472755	CDM	Sorbafix	119	59	$3,394.00	$2,375.80 30% off	$678.80	$3,394.00	$3,394.00	2026-03-04
15832	CPT	Excise Excessive Skin Tissue-thigh	119	59	$3,393.00	$2,375.10 30% off	$678.60	$3,393.00	$3,393.00	2026-03-04
4471896	CDM	Pushlock Ar-1922ps	119	59	$3,382.00	$2,367.40 30% off	$676.40	$3,382.00	$3,382.00	2026-03-04
81420	CPT	Qnatal Advanced	119	59	$3,368.00	$2,357.60 30% off	$673.60	$3,368.00	$3,368.00	2026-03-04
3100073	CDM	Room Private	119	59	$3,361.00	$2,352.70 30% off	$672.20	$3,361.00	$3,361.00	2026-03-04
3100056	CDM	Room Private	119	59	$3,361.00	$2,352.70 30% off	$672.20	$3,361.00	$3,361.00	2026-03-04
3100057	CDM	Room Isolation	119	59	$3,361.00	$2,352.70 30% off	$672.20	$3,361.00	$3,361.00	2026-03-04
3100074	CDM	Room Isolation	119	59	$3,361.00	$2,352.70 30% off	$672.20	$3,361.00	$3,361.00	2026-03-04
3100084	CDM	Inpatient Telemetry	119	59	$3,361.00	$2,352.70 30% off	$672.20	$3,361.00	$3,361.00	2026-03-04
4471477	CDM	310.67 2.7mm Bit	119	59	$3,325.00	$2,327.50 30% off	$665.00	$3,325.00	$3,325.00	2026-03-04
4870248	CDM	Suture Sm Intestine	119	59	$3,323.00	$2,326.10 30% off	$664.60	$3,323.00	$3,323.00	2026-03-04
4471659	CDM	1.7 Cable 29880101s	119	59	$3,308.00	$2,315.60 30% off	$661.60	$3,308.00	$3,308.00	2026-03-04
49650	CPT	Lap Repair Initial Ing Hernia	119	59	$3,302.00	$2,311.40 30% off	$660.40	$3,302.00	$3,302.00	2026-03-04
4000136	CDM	Or Colon,reml By Sna	119	59	$3,300.00	$2,310.00 30% off	$660.00	$3,300.00	$3,300.00	2026-03-04
4870178	CDM	Parathyroidectomy Ex	119	59	$3,297.00	$2,307.90 30% off	$659.40	$3,297.00	$3,297.00	2026-03-04
26765	CPT	Treat Finger Fx	119	59	$3,282.00	$2,297.40 30% off	$656.40	$3,282.00	$3,282.00	2026-03-04
21933	CPT	Exc Back Tumor 5cm	119	59	$3,282.00	$2,297.40 30% off	$656.40	$3,282.00	$3,282.00	2026-03-04

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