Price Transparencybeta 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 →

Export CSV
Hospital

MADISON HOSPITAL

Madison, MN · CCN 241372 · Rates published

2,427 distinct procedures filed
14 distinct payers
185,908 rate rows
2024-09-26 last MRF observed · ⚠ 25 mo old
Data quality

160,014 of 185,908 rate rows are consumer-grade (86.1%)

25,894 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
professional (physician) fee — not the facility price 25,417
percent-of-charges filed in the dollar field — excluded from medians 250
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 101
per-diem day rate — not a per-procedure price 92
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 34

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 25 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mhsmn.org/wp-content/uploads/2024/12/411653496_madison-healthcare-services_standardcharges.csv
Found on page https://mhsmn.org/patients-visitors/financial-services/current-standard-hospital-charges/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-22
Content fingerprint a88f1b4a9b2c6981… · 43,068,667 bytes · first seen 2026-05-09

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
176
MS_DRG 		Pulmonary Embolism Without Mcc 1 $34,283.05 $34,283.05 $34,283.05 nat. median
$8,588
outlier · 4.0×
281
MS_DRG 		Acute Myocardial Infarction, Discharged Alive With Cc 1 $29,987.94 $29,987.94 $29,987.94 nat. median
$9,714
outlier · 3.1×
539
MS_DRG 		Osteomyelitis With Mcc 1 $28,815.78 $28,815.78 $28,815.78 nat. median
$18,840
1.5× median
831
MS_DRG 		Other Antepartum Diagnoses Without O.r. Procedures With Mcc 1 $26,201.08 $26,201.08 $26,201.08 nat. median
$11,592
outlier · 2.3×
542
MS_DRG 		Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 $25,141.50 $25,141.50 $25,141.50 nat. median
$17,169
1.5× median
445
MS_DRG 		Disorders Of The Biliary Tract With Cc 1 $24,484.67 $24,484.67 $24,484.67 nat. median
$11,041
outlier · 2.2×
982
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 1 $22,485.55 $22,485.55 $22,485.55 nat. median
$23,189
1.0× median
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 1 $21,236.59 $21,236.59 $21,236.59 nat. median
$15,388
1.4× median
480104
LOCAL 		Alteplase 0.09 Mg/kg Bolus - Mhs 14 $9,080.06 $31,682.00 $20,381.03 nat. median
$20,381
1.0× median
157
MS_DRG 		Dental And Oral Diseases With Mcc 1 $19,670.70 $19,670.70 $19,670.70 nat. median
$16,383
1.2× median
179
MS_DRG 		Respiratory Infections And Inflammations Without Cc/mcc 1 $17,498.44 $17,498.44 $17,498.44 nat. median
$8,191
outlier · 2.1×
95
MS_DRG 		Bacterial And Tuberculous Infections Of Nervous System With Cc 1 $17,362.15 $17,362.15 $17,362.15 nat. median
$23,602
0.7× median
388
MS_DRG 		Gastrointestinal Obstruction With Mcc 1 $17,102.85 $17,102.85 $17,102.85 nat. median
$14,318
1.2× median
J3101
HCPCS 		Tenecteplase 50 Mg IV Solr 14 $7,612.67 $26,562.00 $17,087.33 nat. median
$3,820
outlier · 4.5×
191
MS_DRG 		Chronic Obstructive Pulmonary Disease With Cc 1 $16,915.37 $16,915.37 $16,915.37 nat. median
$8,846
1.9× median
603
MS_DRG 		Cellulitis Without Mcc 1 $16,702.44 $16,702.44 $16,702.44 nat. median
$8,986
1.9× median
J2997
HCPCS 		Alteplase 100 Mg IV Solr 14 $225.55 $31,682.00 $15,524.18 nat. median
$500
outlier · 31.0×
J2506
HCPCS 		Pegfilgrastim 6 Mg/0.6 Ml Subq Syrg 14 $6,621.89 $23,105.00 $14,863.44 nat. median
$1,646
outlier · 9.0×
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 1 $14,349.43 $14,349.43 $14,349.43 nat. median
$12,868
1.1× median
292
MS_DRG 		Heart Failure And Shock With Cc 1 $14,306.07 $14,306.07 $14,306.07 nat. median
$8,952
1.6× median
289
MS_DRG 		Acute And Subacute Endocarditis With Cc 1 $14,117.00 $14,117.00 $14,117.00 nat. median
$16,321
0.9× median
884
MS_DRG 		Organic Disturbances And Intellectual Disability 1 $13,877.60 $13,877.60 $13,877.60 nat. median
$14,244
1.0× median
J9217
HCPCS 		Leuprolide (3 Month) 22.5 Mg IM Sykt 14 $2,008.78 $42,051.00 $13,736.66 nat. median
$1,575
outlier · 8.7×
918
MS_DRG 		Poisoning And Toxic Effects Of Drugs Without Mcc 1 $13,020.35 $13,020.35 $13,020.35 nat. median
$8,376
1.6× median
315
MS_DRG 		Other Circulatory System Diagnoses With Cc 1 $12,950.78 $12,950.78 $12,950.78 nat. median
$9,952
1.3× median
640
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 1 $12,900.05 $12,900.05 $12,900.05 nat. median
$12,850
1.0× median
69
MS_DRG 		Transient Ischemia Without Thrombolytic 1 $12,811.77 $12,811.77 $12,811.77 nat. median
$8,419
1.5× median
J0517
HCPCS 		Benralizumab 30 Mg/ml Subq Syrg 14 $5,686.72 $19,842.00 $12,764.36 nat. median
$919
outlier · 13.9×
605
MS_DRG 		Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 1 $12,634.87 $12,634.87 $12,634.87 nat. median
$9,363
1.3× median
809
MS_DRG 		Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 $12,621.70 $12,621.70 $12,621.70 nat. median
$12,518
1.0× median
J0717
HCPCS 		Certolizumab Pegol 400 Mg/2 Ml (200 Mg/ml X 2) Subq Sykt 14 $5,572.36 $19,443.00 $12,507.68 nat. median
$1,598
outlier · 7.8×
390
MS_DRG 		Gastrointestinal Obstruction Without Cc/mcc 1 $12,298.35 $12,298.35 $12,298.35 nat. median
$6,116
outlier · 2.0×
384
MS_DRG 		Uncomplicated Peptic Ulcer Without Mcc 1 $12,254.50 $12,254.50 $12,254.50 nat. median
$8,986
1.4× median
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 $12,179.04 $12,179.04 $12,179.04 nat. median
$10,401
1.2× median
57
MS_DRG 		Degenerative Nervous System Disorders Without Mcc 1 $11,992.23 $11,992.23 $11,992.23 nat. median
$12,554
1.0× median
442
MS_DRG 		Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 1 $11,842.70 $11,842.70 $11,842.70 nat. median
$9,942
1.2× median
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 1 $11,617.00 $11,617.00 $11,617.00 nat. median
$10,198
1.1× median
439
MS_DRG 		Disorders Of Pancreas Except Malignancy With Cc 1 $11,593.80 $11,593.80 $11,593.80 nat. median
$8,937
1.3× median
552
MS_DRG 		Medical Back Problems Without Mcc 1 $11,512.64 $11,512.64 $11,512.64 nat. median
$9,830
1.2× median
897
MS_DRG 		Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 1 $11,383.58 $11,383.58 $11,383.58 nat. median
$8,349
1.4× median
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 1 $11,232.17 $11,232.17 $11,232.17 nat. median
$12,539
0.9× median
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 1 $11,074.32 $11,074.32 $11,074.32 nat. median
$8,109
1.4× median
540
MS_DRG 		Osteomyelitis With Cc 1 $11,030.13 $11,030.13 $11,030.13 nat. median
$12,766
0.9× median
91
MS_DRG 		Other Disorders Of Nervous System With Mcc 1 $10,878.45 $10,878.45 $10,878.45 nat. median
$17,061
0.6× median
65
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 1 $10,793.32 $10,793.32 $10,793.32 nat. median
$10,473
1.0× median
J1162
HCPCS 		Digoxin Immune Fab 40 Mg IV Solr 14 $4,745.24 $16,557.00 $10,651.12 nat. median
$7,141
1.5× median
563
MS_DRG 		Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 $10,466.86 $10,466.86 $10,466.86 nat. median
$9,151
1.1× median
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 1 $10,401.46 $10,401.46 $10,401.46 nat. median
$8,516
1.2× median
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 1 $10,370.86 $10,370.86 $10,370.86 nat. median
$8,376
1.2× median
562
MS_DRG 		Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 $10,287.55 $10,287.55 $10,287.55 nat. median
$13,960
0.7× median

Other procedures at this hospital

Browse this hospital's 2,427 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
176 MS_DRG Pulmonary Embolism Without Mcc 1 1 $38,050.00 $32,342.50 $34,283.05 $34,283.05 $34,283.05 2024-09-26
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 1 1 $33,282.95 $28,290.51 $29,987.94 $29,987.94 $29,987.94 2024-09-26
539 MS_DRG Osteomyelitis With Mcc 1 1 $31,982.00 $27,184.70 $28,815.78 $28,815.78 $28,815.78 2024-09-26
831 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Mcc 1 1 $29,080.00 $24,718.00 $26,201.08 $26,201.08 $26,201.08 2024-09-26
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 1 $27,904.00 $23,718.40 $25,141.50 $25,141.50 $25,141.50 2024-09-26
445 MS_DRG Disorders Of The Biliary Tract With Cc 1 1 $27,175.00 $23,098.75 $24,484.67 $24,484.67 $24,484.67 2024-09-26
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 1 1 $23,669.00 $20,118.65 $22,485.55 $22,485.55 $22,485.55 2024-09-26
177 MS_DRG Respiratory Infections And Inflammations With Mcc 1 1 $22,354.30 $19,001.16 $21,236.59 $21,236.59 $21,236.59 2024-09-26
480104 LOCAL Alteplase 0.09 Mg/kg Bolus - Mhs 54 14 $31,682.00 $26,929.70 $9,080.06 $31,682.00 $20,381.03 2024-09-26
157 MS_DRG Dental And Oral Diseases With Mcc 1 1 $20,706.00 $17,600.10 $19,670.70 $19,670.70 $19,670.70 2024-09-26
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 1 1 $19,421.14 $16,507.97 $17,498.44 $17,498.44 $17,498.44 2024-09-26
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 1 1 $18,275.95 $15,534.56 $17,362.15 $17,362.15 $17,362.15 2024-09-26
388 MS_DRG Gastrointestinal Obstruction With Mcc 1 1 $18,003.00 $15,302.55 $17,102.85 $17,102.85 $17,102.85 2024-09-26
J3101 HCPCS Tenecteplase 50 Mg IV Solr 54 14 $26,562.00 $22,577.70 $7,612.67 $26,562.00 $17,087.33 2024-09-26
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 1 1 $18,774.00 $15,957.90 $16,915.37 $16,915.37 $16,915.37 2024-09-26
603 MS_DRG Cellulitis Without Mcc 1 1 $18,537.67 $15,757.02 $16,702.44 $16,702.44 $16,702.44 2024-09-26
J2997 HCPCS Alteplase 100 Mg IV Solr 91 14 $31,682.00 $26,929.70 $225.55 $31,682.00 $15,524.18 2024-09-26
J2506 HCPCS Pegfilgrastim 6 Mg/0.6 Ml Subq Syrg 54 14 $23,105.00 $19,639.25 $6,621.89 $23,105.00 $14,863.44 2024-09-26
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 1 1 $15,104.67 $12,838.97 $14,349.43 $14,349.43 $14,349.43 2024-09-26
292 MS_DRG Heart Failure And Shock With Cc 1 1 $15,877.99 $13,496.29 $14,306.07 $14,306.07 $14,306.07 2024-09-26
289 MS_DRG Acute And Subacute Endocarditis With Cc 1 1 $14,860.00 $12,631.00 $14,117.00 $14,117.00 $14,117.00 2024-09-26
884 MS_DRG Organic Disturbances And Intellectual Disability 1 1 $14,608.00 $12,416.80 $13,877.60 $13,877.60 $13,877.60 2024-09-26
J9217 HCPCS Leuprolide (3 Month) 22.5 Mg IM Sykt 165 14 $21,025.00 $17,871.25 $2,008.78 $42,051.00 $13,736.66 2024-09-26
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 1 1 $14,451.00 $12,283.35 $13,020.35 $13,020.35 $13,020.35 2024-09-26
315 MS_DRG Other Circulatory System Diagnoses With Cc 1 1 $14,276.00 $12,134.60 $12,950.78 $12,950.78 $12,950.78 2024-09-26
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 1 1 $13,579.00 $11,542.15 $12,900.05 $12,900.05 $12,900.05 2024-09-26
69 MS_DRG Transient Ischemia Without Thrombolytic 1 1 $14,219.50 $12,086.58 $12,811.77 $12,811.77 $12,811.77 2024-09-26
J0517 HCPCS Benralizumab 30 Mg/ml Subq Syrg 54 14 $19,842.00 $16,865.70 $5,686.72 $19,842.00 $12,764.36 2024-09-26
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 1 1 $14,023.17 $11,919.69 $12,634.87 $12,634.87 $12,634.87 2024-09-26
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 1 $13,286.00 $11,293.10 $12,621.70 $12,621.70 $12,621.70 2024-09-26
J0717 HCPCS Certolizumab Pegol 400 Mg/2 Ml (200 Mg/ml X 2) Subq Sykt 54 14 $19,443.00 $16,526.55 $5,572.36 $19,443.00 $12,507.68 2024-09-26
390 MS_DRG Gastrointestinal Obstruction Without Cc/mcc 1 1 $13,649.67 $11,602.22 $12,298.35 $12,298.35 $12,298.35 2024-09-26
384 MS_DRG Uncomplicated Peptic Ulcer Without Mcc 1 1 $13,601.00 $11,560.85 $12,254.50 $12,254.50 $12,254.50 2024-09-26
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 1 $12,820.04 $10,897.03 $12,179.04 $12,179.04 $12,179.04 2024-09-26
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 1 1 $12,623.40 $10,729.89 $11,992.23 $11,992.23 $11,992.23 2024-09-26
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 1 1 $12,466.00 $10,596.10 $11,842.70 $11,842.70 $11,842.70 2024-09-26
178 MS_DRG Respiratory Infections And Inflammations With Cc 1 1 $12,228.42 $10,394.16 $11,617.00 $11,617.00 $11,617.00 2024-09-26
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 1 1 $12,204.00 $10,373.40 $11,593.80 $11,593.80 $11,593.80 2024-09-26
552 MS_DRG Medical Back Problems Without Mcc 1 1 $12,118.57 $10,300.79 $11,512.64 $11,512.64 $11,512.64 2024-09-26
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 1 1 $12,182.00 $10,354.70 $11,383.58 $11,383.58 $11,383.58 2024-09-26
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 1 1 $11,823.33 $10,049.83 $11,232.17 $11,232.17 $11,232.17 2024-09-26
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 1 1 $12,291.14 $10,447.47 $11,074.32 $11,074.32 $11,074.32 2024-09-26
540 MS_DRG Osteomyelitis With Cc 1 1 $11,610.67 $9,869.07 $11,030.13 $11,030.13 $11,030.13 2024-09-26
91 MS_DRG Other Disorders Of Nervous System With Mcc 1 1 $11,451.00 $9,733.35 $10,878.45 $10,878.45 $10,878.45 2024-09-26
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 1 1 $11,361.39 $9,657.18 $10,793.32 $10,793.32 $10,793.32 2024-09-26
J1162 HCPCS Digoxin Immune Fab 40 Mg IV Solr 54 14 $16,557.00 $14,073.45 $4,745.24 $16,557.00 $10,651.12 2024-09-26
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 1 $11,017.75 $9,365.09 $10,466.86 $10,466.86 $10,466.86 2024-09-26
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 1 1 $10,948.91 $9,306.57 $10,401.46 $10,401.46 $10,401.46 2024-09-26
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 1 1 $10,916.70 $9,279.19 $10,370.86 $10,370.86 $10,370.86 2024-09-26
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 1 $10,829.00 $9,204.65 $10,287.55 $10,287.55 $10,287.55 2024-09-26
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 1 1 $10,817.00 $9,194.45 $10,276.15 $10,276.15 $10,276.15 2024-09-26
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 1 1 $10,790.00 $9,171.50 $10,250.50 $10,250.50 $10,250.50 2024-09-26
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 1 1 $10,712.00 $9,105.20 $10,176.40 $10,176.40 $10,176.40 2024-09-26
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 1 1 $10,409.16 $8,847.79 $9,888.70 $9,888.70 $9,888.70 2024-09-26
86 MS_DRG Traumatic Stupor And Coma <1 Hour With Cc 1 1 $10,294.00 $8,749.90 $9,779.30 $9,779.30 $9,779.30 2024-09-26
200 MS_DRG Pneumothorax With Cc 1 1 $10,114.00 $8,596.90 $9,608.30 $9,608.30 $9,608.30 2024-09-26
155 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Cc 1 1 $10,016.00 $8,513.60 $9,515.20 $9,515.20 $9,515.20 2024-09-26
291 MS_DRG Heart Failure And Shock With Mcc 1 1 $9,876.76 $8,395.25 $9,382.92 $9,382.92 $9,382.92 2024-09-26
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 1 1 $10,301.90 $8,756.62 $9,282.01 $9,282.01 $9,282.01 2024-09-26
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 1 1 $9,661.43 $8,212.22 $9,178.36 $9,178.36 $9,178.36 2024-09-26
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 1 1 $9,608.70 $8,167.40 $9,128.27 $9,128.27 $9,128.27 2024-09-26
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 1 1 $9,570.00 $8,134.50 $9,091.50 $9,091.50 $9,091.50 2024-09-26
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 1 1 $9,262.12 $7,872.80 $8,799.01 $8,799.01 $8,799.01 2024-09-26
604 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 1 1 $9,253.00 $7,865.05 $8,790.35 $8,790.35 $8,790.35 2024-09-26
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 1 1 $9,285.00 $7,892.25 $8,719.88 $8,719.88 $8,719.88 2024-09-26
186 MS_DRG Pleural Effusion With Mcc 1 1 $9,011.00 $7,659.35 $8,560.45 $8,560.45 $8,560.45 2024-09-26
89 MS_DRG Concussion With Cc 1 1 $8,881.00 $7,548.85 $8,436.95 $8,436.95 $8,436.95 2024-09-26
948 MS_DRG Signs And Symptoms Without Mcc 1 1 $8,854.08 $7,525.97 $8,411.38 $8,411.38 $8,411.38 2024-09-26
776 MS_DRG Postpartum And Post Abortion Diagnoses Without O.r. Procedures 1 1 $8,740.00 $7,429.00 $8,303.00 $8,303.00 $8,303.00 2024-09-26
92 MS_DRG Other Disorders Of Nervous System With Cc 1 1 $8,641.00 $7,344.85 $8,208.95 $8,208.95 $8,208.95 2024-09-26
389 MS_DRG Gastrointestinal Obstruction With Cc 1 1 $8,485.00 $7,212.25 $8,060.75 $8,060.75 $8,060.75 2024-09-26
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 1 1 $8,391.00 $7,132.35 $7,971.45 $7,971.45 $7,971.45 2024-09-26
305 MS_DRG Hypertension Without Mcc 1 1 $8,336.50 $7,086.02 $7,919.68 $7,919.68 $7,919.68 2024-09-26
203 MS_DRG Bronchitis And Asthma Without Cc/mcc 1 1 $8,324.00 $7,075.40 $7,907.80 $7,907.80 $7,907.80 2024-09-26
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 1 1 $8,312.50 $7,065.63 $7,896.88 $7,896.88 $7,896.88 2024-09-26
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 1 1 $8,152.00 $6,929.20 $7,744.40 $7,744.40 $7,744.40 2024-09-26
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 1 1 $8,048.00 $6,840.80 $7,645.60 $7,645.60 $7,645.60 2024-09-26
204 MS_DRG Respiratory Signs And Symptoms 1 1 $8,033.00 $6,828.05 $7,631.35 $7,631.35 $7,631.35 2024-09-26
683 MS_DRG Renal Failure With Cc 1 1 $8,011.00 $6,809.35 $7,610.45 $7,610.45 $7,610.45 2024-09-26
180 MS_DRG Respiratory Neoplasms With Mcc 1 1 $7,986.00 $6,788.10 $7,586.70 $7,586.70 $7,586.70 2024-09-26
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 1 1 $7,778.50 $6,611.73 $7,389.57 $7,389.57 $7,389.57 2024-09-26
949 MS_DRG Aftercare With Cc/mcc 1 1 $7,620.00 $6,477.00 $7,239.00 $7,239.00 $7,239.00 2024-09-26
696 MS_DRG Kidney And Urinary Tract Signs And Symptoms Without Mcc 1 1 $7,461.50 $6,342.27 $7,088.43 $7,088.43 $7,088.43 2024-09-26
71 MS_DRG Nonspecific Cerebrovascular Disorders With Cc 1 1 $7,318.00 $6,220.30 $6,952.10 $6,952.10 $6,952.10 2024-09-26
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 1 1 $7,178.50 $6,101.73 $6,819.57 $6,819.57 $6,819.57 2024-09-26
112496 LOCAL Dantrolene 250 Mg IV Susr 54 14 $10,531.00 $8,951.35 $3,018.18 $10,531.00 $6,774.59 2024-09-26
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 1 1 $7,012.50 $5,960.63 $6,661.88 $6,661.88 $6,661.88 2024-09-26
394 MS_DRG Other Digestive System Diagnoses With Cc 1 1 $6,825.00 $5,801.25 $6,483.75 $6,483.75 $6,483.75 2024-09-26
602 MS_DRG Cellulitis With Mcc 1 1 $6,696.00 $5,691.60 $6,361.20 $6,361.20 $6,361.20 2024-09-26
J1459 HCPCS Immun Glob G(igg)-pro-iga 0-50 10 % IV Soln 37 14 $12,299.00 $10,454.15 $48.33 $12,299.00 $6,316.77 2024-09-26
378 MS_DRG Gastrointestinal Hemorrhage With Cc 1 1 $6,567.40 $5,582.29 $6,239.03 $6,239.03 $6,239.03 2024-09-26
812 MS_DRG Red Blood Cell Disorders Without Mcc 1 1 $6,378.08 $5,421.37 $6,059.18 $6,059.18 $6,059.18 2024-09-26
395 MS_DRG Other Digestive System Diagnoses Without Cc/mcc 1 1 $6,151.00 $5,228.35 $5,843.45 $5,843.45 $5,843.45 2024-09-26
J2426 HCPCS Paliperidone Palmitate 117 Mg/0.75 Ml IM Syrg 128 14 $8,036.00 $6,830.60 $1,727.34 $12,054.00 $5,635.24 2024-09-26
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 1 1 $5,899.00 $5,014.15 $5,604.05 $5,604.05 $5,604.05 2024-09-26
J0897 HCPCS Denosumab 120 Mg/1.7 Ml (70 Mg/ml) Subq Soln 91 14 $10,758.00 $9,144.30 $1,676.32 $10,758.00 $5,534.99 2024-09-26
880 MS_DRG Acute Adjustment Reaction And Psychosocial Dysfunction 1 1 $5,679.00 $4,827.15 $5,395.05 $5,395.05 $5,395.05 2024-09-26
J7168 HCPCS Hum Prothrombin Cplx(pcc)4fact 1,000 Unit (800-1240 Unit) IV Solr 91 14 $10,728.00 $9,118.80 $1,537.32 $10,728.00 $5,342.54 2024-09-26
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 1 1 $5,591.48 $4,752.76 $5,311.90 $5,311.90 $5,311.90 2024-09-26
25009990 LOCAL Cystourethroscopy, W/Ureteroscopy And/Or Pyeloscopy;with Lithotripsy Including Ins… 54 14 $8,160.00 $6,936.00 $2,338.66 $8,160.00 $5,249.33 2024-09-26
25003326 LOCAL Transurethral Prostratectomy 54 14 $8,160.00 $6,936.00 $2,338.66 $8,160.00 $5,249.33 2024-09-26
885 MS_DRG Psychoses 1 1 $5,450.00 $4,632.50 $5,177.50 $5,177.50 $5,177.50 2024-09-26
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 1 1 $5,238.50 $4,452.73 $4,976.57 $4,976.57 $4,976.57 2024-09-26
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 1 1 $5,153.50 $4,380.48 $4,895.82 $4,895.82 $4,895.82 2024-09-26
25000143 LOCAL Hernia Repair Inguinal Bilateral 54 14 $7,140.00 $6,069.00 $2,046.32 $7,140.00 $4,593.16 2024-09-26
285 MS_DRG Acute Myocardial Infarction, Expired Without Cc/mcc 1 1 $4,587.00 $3,898.95 $4,357.65 $4,357.65 $4,357.65 2024-09-26
25001958 LOCAL Lithotripsy 54 14 $6,752.00 $5,739.20 $1,935.12 $6,752.00 $4,343.56 2024-09-26
684 MS_DRG Renal Failure Without Cc/mcc 1 1 $4,527.50 $3,848.38 $4,301.13 $4,301.13 $4,301.13 2024-09-26
J0178 HCPCS Aflibercept 2 Mg/0.05 Ml Intravitreal Soln 54 14 $6,660.00 $5,661.00 $1,908.76 $6,660.00 $4,284.38 2024-09-26
25003247 LOCAL Thyroidectomy 54 14 $6,222.00 $5,288.70 $1,783.23 $6,222.00 $4,002.61 2024-09-26
25001731 LOCAL Laparoscopic Cholecystectomy W Chol 54 14 $6,120.00 $5,202.00 $1,753.99 $6,120.00 $3,936.99 2024-09-26
25009183 LOCAL Radiofrequency Ablation 54 14 $6,120.00 $5,202.00 $1,753.99 $6,120.00 $3,936.99 2024-09-26
25001714 LOCAL Laparoscopic Appendectomy 54 14 $6,120.00 $5,202.00 $1,753.99 $6,120.00 $3,936.99 2024-09-26
538 MS_DRG Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh Without Cc/mcc 1 1 $4,077.50 $3,465.88 $3,873.63 $3,873.63 $3,873.63 2024-09-26
25001129 LOCAL Hemicolectomy 54 14 $5,993.00 $5,094.05 $1,717.59 $5,993.00 $3,855.30 2024-09-26
25000403 LOCAL Colon/Intestine Resection 54 14 $5,993.00 $5,094.05 $1,717.59 $5,993.00 $3,855.30 2024-09-26
25004031 LOCAL Bunionectomy 54 14 $5,942.00 $5,050.70 $1,702.98 $5,942.00 $3,822.49 2024-09-26
J2315 HCPCS Naltrexone Microspheres 380 Mg IM Ssrr 54 14 $5,725.00 $4,866.25 $1,640.79 $5,725.00 $3,682.89 2024-09-26
393 MS_DRG Other Digestive System Diagnoses With Mcc 1 1 $3,645.00 $3,098.25 $3,462.75 $3,462.75 $3,462.75 2024-09-26
J2778 HCPCS Ranibizumab 0.3 Mg/0.05 Ml Intravitreal Syrg 91 14 $4,212.00 $3,580.20 $1,207.16 $7,020.00 $3,439.80 2024-09-26
25001029 LOCAL Exploratory Laparotomy 54 14 $5,304.00 $4,508.40 $1,520.13 $5,304.00 $3,412.07 2024-09-26
95811 CPT Poly/Split 54 14 $5,202.00 $4,421.70 $1,490.89 $5,202.00 $3,346.45 2024-09-26
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 1 1 $3,454.78 $2,936.56 $3,282.04 $3,282.04 $3,282.04 2024-09-26
25001727 LOCAL Laparoscopic Cholecystectomy 54 14 $5,100.00 $4,335.00 $1,461.66 $5,100.00 $3,280.83 2024-09-26
J0129 HCPCS Abatacept (with Maltose) 250 Mg IV Solr 54 14 $4,968.00 $4,222.80 $1,423.83 $4,968.00 $3,195.91 2024-09-26
25000418 LOCAL Colpocleisis 54 14 $4,947.00 $4,204.95 $1,417.81 $4,947.00 $3,182.41 2024-09-26
J7325 HCPCS Hylan G-f 20 48 Mg/6 Ml Iatc Syrg 54 14 $4,931.00 $4,191.35 $1,413.22 $4,931.00 $3,172.11 2024-09-26
J1439 HCPCS Ferric Carboxymaltose 50 Mg Iron/ml IV Soln 54 14 $4,852.00 $4,124.20 $1,390.58 $4,852.00 $3,121.29 2024-09-26
547 MS_DRG Connective Tissue Disorders Without Cc/mcc 1 1 $3,259.00 $2,770.15 $3,096.05 $3,096.05 $3,096.05 2024-09-26
25000328 LOCAL Cesarean Section 54 14 $4,794.00 $4,074.90 $1,373.96 $4,794.00 $3,083.98 2024-09-26
95810 CPT Polysomnography 54 14 $4,794.00 $4,074.90 $1,373.96 $4,794.00 $3,083.98 2024-09-26
J2357 HCPCS Omalizumab 150 Mg Subq Solr 54 14 $4,704.00 $3,998.40 $1,348.17 $4,704.00 $3,026.09 2024-09-26
25009516 LOCAL Exploratory Laparoscopy 54 14 $4,692.00 $3,988.20 $1,344.73 $4,692.00 $3,018.36 2024-09-26
25001882 LOCAL Laparoscopy W Lysis Of Adhesions 54 14 $4,692.00 $3,988.20 $1,344.73 $4,692.00 $3,018.36 2024-09-26
25001844 LOCAL Laparoscopy Diagnostic 54 14 $4,692.00 $3,988.20 $1,344.73 $4,692.00 $3,018.36 2024-09-26
25001196 LOCAL Hernia Repair Inguinal Laparoscopic 54 14 $4,692.00 $3,988.20 $1,344.73 $4,692.00 $3,018.36 2024-09-26
25010170 LOCAL Total Knee 54 14 $4,692.00 $3,988.20 $1,344.73 $4,692.00 $3,018.36 2024-09-26
25007480 LOCAL Total Abdominal Hysterectomy 54 14 $4,692.00 $3,988.20 $1,344.73 $4,692.00 $3,018.36 2024-09-26
25006386 LOCAL Hernia Repair Umbilical Laparoscopic 54 14 $4,667.00 $3,966.95 $1,337.56 $4,667.00 $3,002.28 2024-09-26
25004257 LOCAL Hernia Repair, Ventral Incisional Open 54 14 $4,641.00 $3,944.85 $1,330.11 $4,641.00 $2,985.55 2024-09-26
25007404 LOCAL Laparoscopic Surgical Repair Of Incisional Hernia Includes Mesh When Used 54 14 $4,616.00 $3,923.60 $1,322.95 $4,616.00 $2,969.47 2024-09-26
25023638 LOCAL Cystoscopy With Basket Stone Extraction 54 14 $4,590.00 $3,901.50 $1,315.49 $4,590.00 $2,952.74 2024-09-26
25003275 LOCAL Tonsilectomy & Adenoidectomy 54 14 $4,590.00 $3,901.50 $1,315.49 $4,590.00 $2,952.74 2024-09-26
C1783 HCPCS Istent Glaukos 54 14 $4,530.50 $3,850.93 $1,298.44 $4,530.50 $2,914.47 2024-09-26
J0881 HCPCS Darbepoetin Alfa In Polysorbat 100 Mcg/0.5 Ml Inj Syrg 239 14 $4,180.00 $3,553.00 $527.34 $13,932.00 $2,900.44 2024-09-26
25000080 LOCAL Appendectomy 54 14 $4,488.00 $3,814.80 $1,286.26 $4,488.00 $2,887.13 2024-09-26
25003232 LOCAL Thyroid Lobectomy Isthmusectomy 54 14 $4,488.00 $3,814.80 $1,286.26 $4,488.00 $2,887.13 2024-09-26
25001134 LOCAL Hemorrhoidectomy 54 14 $4,488.00 $3,814.80 $1,286.26 $4,488.00 $2,887.13 2024-09-26
25011661 LOCAL Uvulopalatopharyngoplasty (Uppp) 54 14 $4,488.00 $3,814.80 $1,286.26 $4,488.00 $2,887.13 2024-09-26
25002246 LOCAL Orchiectomy 54 14 $4,488.00 $3,814.80 $1,286.26 $4,488.00 $2,887.13 2024-09-26
25002937 LOCAL Salpingo-oophorectomy 54 14 $4,483.00 $3,810.55 $1,284.83 $4,483.00 $2,883.91 2024-09-26
25001838 LOCAL Laparoscopic Ventral Hernia Repair 54 14 $4,464.00 $3,794.40 $1,279.38 $4,464.00 $2,871.69 2024-09-26
25000692 LOCAL Endo Pubo-vag Bladder Sling W/Tvt 54 14 $4,437.00 $3,771.45 $1,271.64 $4,437.00 $2,854.32 2024-09-26
25009075 LOCAL Excision Of Submandibular Gland 54 14 $4,437.00 $3,771.45 $1,271.64 $4,437.00 $2,854.32 2024-09-26
25000355 LOCAL Cholecystectomy (Open) 54 14 $4,437.00 $3,771.45 $1,271.64 $4,437.00 $2,854.32 2024-09-26
25002116 LOCAL Mastectomy 54 14 $4,386.00 $3,728.10 $1,257.03 $4,386.00 $2,821.51 2024-09-26
C1734 HCPCS Mini Ignite Power Mix 4cc 128 14 $4,845.00 $4,118.25 $1,237.54 $5,069.03 $2,777.77 2024-09-26
Q0138 HCPCS Ferumoxytol 510 Mg/17 Ml (30 Mg/ml) IV Soln 54 14 $4,298.00 $3,653.30 $1,231.81 $4,298.00 $2,764.91 2024-09-26
25004485 LOCAL Colostomy/Transverse Colostomy 54 14 $4,182.00 $3,554.70 $1,198.56 $4,182.00 $2,690.28 2024-09-26
25001851 LOCAL Laparoscopy Oviduct Ovary Unlisted 54 14 $4,182.00 $3,554.70 $1,198.56 $4,182.00 $2,690.28 2024-09-26
25001792 LOCAL Laparoscopic Supracervical Hysterectomy 54 14 $4,131.00 $3,511.35 $1,183.94 $4,131.00 $2,657.47 2024-09-26
25001823 LOCAL Laparoscopic Tubal Ligation 54 14 $4,080.00 $3,468.00 $1,169.33 $4,080.00 $2,624.66 2024-09-26
25010051 LOCAL Cystocele Repair 54 14 $4,080.00 $3,468.00 $1,169.33 $4,080.00 $2,624.66 2024-09-26
25003187 LOCAL Tendon Repair 54 14 $4,070.00 $3,459.50 $1,166.46 $4,070.00 $2,618.23 2024-09-26
25001202 LOCAL Repair, Hernia, Inguinal, Open 54 14 $3,978.00 $3,381.30 $1,140.09 $3,978.00 $2,559.05 2024-09-26
25003288 LOCAL Tonsillectomy 54 14 $3,978.00 $3,381.30 $1,140.09 $3,978.00 $2,559.05 2024-09-26
25003704 LOCAL Tonsillectomy (Age 12 Or Over) 54 14 $3,978.00 $3,381.30 $1,140.09 $3,978.00 $2,559.05 2024-09-26
C1776 HCPCS All Poly Pat Ve 32mm Diamater 350 14 $3,570.00 $3,034.50 $234.68 $7,913.50 $2,525.63 2024-09-26
293 MS_DRG Heart Failure And Shock Without Cc/mcc 1 1 $2,639.00 $2,243.15 $2,507.05 $2,507.05 $2,507.05 2024-09-26
25000021 LOCAL Amputation, Extremity 54 14 $3,876.00 $3,294.60 $1,110.86 $3,876.00 $2,493.43 2024-09-26
25001312 LOCAL Hysterectomy Vaginal 54 14 $3,876.00 $3,294.60 $1,110.86 $3,876.00 $2,493.43 2024-09-26
25003812 LOCAL Hernia Repair Incisional, Includes Mesh When Used 54 14 $3,871.00 $3,290.35 $1,109.43 $3,871.00 $2,490.22 2024-09-26
25004513 LOCAL Ovarian Cystectomy 54 14 $3,825.00 $3,251.25 $1,096.24 $3,825.00 $2,460.62 2024-09-26
694 MS_DRG Urinary Stones Without Mcc 1 1 $2,583.00 $2,195.55 $2,453.85 $2,453.85 $2,453.85 2024-09-26
25002668 LOCAL Fasciotomy/Fasciectomy, Plantar 54 14 $3,784.00 $3,216.40 $1,084.49 $3,784.00 $2,434.24 2024-09-26
25006724 LOCAL Osteotomy Of Other Phalanges, Any Toe 54 14 $3,698.00 $3,143.30 $1,059.85 $3,698.00 $2,378.93 2024-09-26
25005392 LOCAL Oopherectomy 54 14 $3,672.00 $3,121.20 $1,052.40 $3,672.00 $2,362.20 2024-09-26
25001618 LOCAL Knee Arthroscopy Synovectomy Major 54 14 $3,672.00 $3,121.20 $1,052.40 $3,672.00 $2,362.20 2024-09-26
25001657 LOCAL Knee Arthroscopy W Meniscectomy 54 14 $3,672.00 $3,121.20 $1,052.40 $3,672.00 $2,362.20 2024-09-26
25006753 LOCAL Repair Rectal Prolapse 54 14 $3,672.00 $3,121.20 $1,052.40 $3,672.00 $2,362.20 2024-09-26
78452 CPT Myocardial Perfusion Scan Spect Multiple 54 14 $3,264.00 $2,774.40 $1,437.64 $3,264.00 $2,350.82 2024-09-26
72160029 LOCAL Room Rate Room Rate Special Care Medical/Surgical Mhs 20 11 $2,490.00 $2,116.50 $713.63 $2,490.00 $2,340.60 2024-09-26
25003349 LOCAL Trigger Finger Release 54 14 $3,596.00 $3,056.60 $1,030.61 $3,596.00 $2,313.30 2024-09-26
25004116 LOCAL Adenoidectomy 12 Yrs & Over 54 14 $3,570.00 $3,034.50 $1,023.16 $3,570.00 $2,296.58 2024-09-26
25004103 LOCAL Adenoidectomy < 12 Years Old 54 14 $3,570.00 $3,034.50 $1,023.16 $3,570.00 $2,296.58 2024-09-26
25004167 LOCAL Septoplasty 54 14 $3,468.00 $2,947.80 $993.93 $3,468.00 $2,230.97 2024-09-26
25004373 LOCAL Rhinoplasty 54 14 $3,468.00 $2,947.80 $993.93 $3,468.00 $2,230.97 2024-09-26
25006354 LOCAL Septorhinoplasty 54 14 $3,468.00 $2,947.80 $993.93 $3,468.00 $2,230.97 2024-09-26
25011705 LOCAL Turbinoplasty 54 14 $3,468.00 $2,947.80 $993.93 $3,468.00 $2,230.97 2024-09-26
153 MS_DRG Otitis Media And Uri Without Mcc 1 1 $2,311.00 $1,964.35 $2,195.45 $2,195.45 $2,195.45 2024-09-26
74178 CPT CT Abd And Pelvis Wo W IV Contrast 54 14 $3,774.00 $3,207.90 $561.34 $3,774.00 $2,167.67 2024-09-26
25005160 LOCAL Excision Of Tonsil Tag 54 14 $3,366.00 $2,861.10 $964.70 $3,366.00 $2,165.35 2024-09-26
J1745 HCPCS Infliximab 100 Mg IV Solr 37 14 $4,205.00 $3,574.25 $44.20 $4,205.00 $2,159.69 2024-09-26
25000664 LOCAL Dupuytrens Release 54 14 $3,341.00 $2,839.85 $957.53 $3,341.00 $2,149.26 2024-09-26
A7000 HCPCS Clarifix Ii System With Device And 2 Canisters Cfx-2000 54 14 $3,196.00 $2,716.60 $915.97 $3,196.00 $2,055.99 2024-09-26
25001518 LOCAL Knee Arthroscopy 54 14 $3,162.00 $2,687.70 $906.23 $3,162.00 $2,034.12 2024-09-26
25001995 LOCAL Lumpectomy 54 14 $3,126.00 $2,657.10 $895.91 $3,126.00 $2,010.95 2024-09-26
73220 CPT MRI Upper Extremity Lt Not Jt Wo W Contrast 108 14 $3,254.00 $2,765.90 $747.00 $3,254.00 $2,000.50 2024-09-26
73720 CPT MRI Lower Extremity Lt Not Jt Wo W Contrast 108 14 $3,254.00 $2,765.90 $747.00 $3,254.00 $2,000.50 2024-09-26
73723 CPT MRI Lower Extremity Lt Any Jt Wo W Contrast 108 14 $3,254.00 $2,765.90 $747.00 $3,254.00 $2,000.50 2024-09-26
73223 CPT MRI Upper Extremity Lt Any Jt Wo W Contrast 108 14 $3,254.00 $2,765.90 $747.00 $3,254.00 $2,000.50 2024-09-26
25001261 LOCAL Hydrocelectomy 54 14 $3,060.00 $2,601.00 $877.00 $3,060.00 $1,968.50 2024-09-26
25003105 LOCAL Spermatocelectomy 54 14 $3,060.00 $2,601.00 $877.00 $3,060.00 $1,968.50 2024-09-26
74177 CPT CT Abd And Pelvis With IV Contrast 54 14 $3,366.00 $2,861.10 $561.34 $3,366.00 $1,963.67 2024-09-26
C8902 HCPCS MRA Abdomen Wo W Contrast 37 8 $3,254.00 $2,765.90 $747.00 $3,078.28 $1,912.64 2024-09-26
90375 CPT Rabies Immune Globulin (pf) 150 Unit/ml IM Soln 54 14 $2,953.00 $2,510.05 $846.33 $2,953.00 $1,899.66 2024-09-26
74185 CPT MRA Abdomen Wo W Contrast 54 14 $3,254.00 $2,765.90 $533.91 $3,254.00 $1,893.95 2024-09-26
72158 CPT MRI Lumbar Spine Wo W Contrast 54 14 $3,120.00 $2,652.00 $561.34 $3,120.00 $1,840.67 2024-09-26
72157 CPT MRI Thoracic Spine Wo W Contrast 54 14 $3,120.00 $2,652.00 $561.34 $3,120.00 $1,840.67 2024-09-26
72156 CPT MRI Cervical Spine Wo W Contrast 54 14 $3,120.00 $2,652.00 $561.34 $3,120.00 $1,840.67 2024-09-26
25001474 LOCAL Insertion Of Peripheral Central Catheter 54 14 $2,856.00 $2,427.60 $818.53 $2,856.00 $1,837.27 2024-09-26
73219 CPT MRI Upper Extremity Lt Not Jt W Contrast 108 14 $2,917.00 $2,479.45 $747.00 $2,917.00 $1,832.00 2024-09-26
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 1 1 $1,905.00 $1,619.25 $1,809.75 $1,809.75 $1,809.75 2024-09-26
58002836 LOCAL Egd With Biopsy 54 14 $2,805.00 $2,384.25 $803.91 $2,805.00 $1,804.45 2024-09-26
58002822 LOCAL Colonoscopy With Biopsy 54 14 $2,805.00 $2,384.25 $803.91 $2,805.00 $1,804.45 2024-09-26
25004795 LOCAL Arthrodesis Of Foot 54 14 $2,805.00 $2,384.25 $803.91 $2,805.00 $1,804.45 2024-09-26
72160016 LOCAL Room Rate Medical/Surgical Mhs 20 11 $1,905.00 $1,619.25 $545.97 $2,288.43 $1,790.70 2024-09-26
72160085 LOCAL Room Rate Obstetrics Mhs 20 11 $1,905.00 $1,619.25 $545.97 $2,288.43 $1,790.70 2024-09-26
25002412 LOCAL Orif Of Metatarsal 54 14 $2,774.00 $2,357.90 $795.03 $2,774.00 $1,784.52 2024-09-26
71552 CPT MRI Chest Wo W Contrast 54 14 $2,952.00 $2,509.20 $561.34 $2,952.00 $1,756.67 2024-09-26
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 1 1 $1,843.00 $1,566.55 $1,750.85 $1,750.85 $1,750.85 2024-09-26
97959 LOCAL Hydroxocobalamin 5 Gram IV Solr 54 14 $2,711.00 $2,304.35 $776.97 $2,711.00 $1,743.98 2024-09-26
25001246 LOCAL Repair, Hernia, Umbilical, Open 54 14 $2,708.00 $2,301.80 $776.11 $2,708.00 $1,742.06 2024-09-26
886 MS_DRG Behavioral And Developmental Disorders 1 1 $1,800.00 $1,530.00 $1,710.00 $1,710.00 $1,710.00 2024-09-26
73719 CPT MRI Lower Extremity Lt Not Jt W Contrast 108 14 $2,653.00 $2,255.05 $747.00 $2,653.00 $1,700.00 2024-09-26
73722 CPT MRI Lower Extremity Lt Any Jt W Contrast 108 14 $2,653.00 $2,255.05 $747.00 $2,653.00 $1,700.00 2024-09-26
74176 CPT CT Abd And Pelvis Without IV Contrast 54 14 $2,856.00 $2,427.60 $533.91 $2,856.00 $1,694.95 2024-09-26
71555 CPT MRA Chest Wo W Contrast 54 14 $2,856.00 $2,427.60 $533.91 $2,856.00 $1,694.95 2024-09-26
73222 CPT MRI Upper Extremity Lt Any Jt W Contrast 108 14 $2,625.50 $2,231.68 $744.59 $2,653.00 $1,671.30 2024-09-26
36568 CPT Picc Line Placement, Less Than 5 Years Old, Without Imaging Guidance 54 14 $2,856.00 $2,427.60 $449.00 $2,856.00 $1,652.50 2024-09-26
78451 CPT Myocardial Perfusion Single Study 54 14 $2,550.00 $2,167.50 $730.83 $2,550.00 $1,640.41 2024-09-26
25022572 LOCAL Image Guided Fluid Collection 54 14 $2,550.00 $2,167.50 $730.83 $2,550.00 $1,640.41 2024-09-26
54205 CPT Injection Procedure For Peyronie Disease; With Surgical Exposure Of Plaque 54 14 $2,550.00 $2,167.50 $730.83 $2,550.00 $1,640.41 2024-09-26
25003693 LOCAL Stab Phlebectomy 54 14 $2,550.00 $2,167.50 $730.83 $2,550.00 $1,640.41 2024-09-26
25000767 LOCAL Esophagogastroduodenoscopy W Dilitation 54 14 $2,519.00 $2,141.15 $721.95 $2,519.00 $1,620.47 2024-09-26
25000753 LOCAL Esophagogastroduodenoscopy 54 14 $2,519.00 $2,141.15 $721.95 $2,519.00 $1,620.47 2024-09-26
J0585 HCPCS Onabotulinumtoxina 100 Unit Inj Solr 54 14 $2,511.00 $2,134.35 $719.65 $2,511.00 $1,615.33 2024-09-26
72149 CPT MRI Lumbar Spine W Contrast 54 14 $2,653.00 $2,255.05 $561.34 $2,653.00 $1,607.17 2024-09-26
72147 CPT MRI Thoracic Spine W Contrast 54 14 $2,653.00 $2,255.05 $561.34 $2,653.00 $1,607.17 2024-09-26
72142 CPT MRI Cervical Spine W Contrast 54 14 $2,653.00 $2,255.05 $561.34 $2,653.00 $1,607.17 2024-09-26
74183 CPT MRI Abdomen Wo W Contrast 54 14 $2,652.00 $2,254.20 $561.34 $2,652.00 $1,606.67 2024-09-26
72197 CPT MRI Pelvis Wo W Contrast 54 14 $2,651.00 $2,253.35 $561.34 $2,651.00 $1,606.17 2024-09-26
J1670 HCPCS Tetanus Immune Globulin (pf) 250 Unit/ml IM Syrg 54 14 $2,496.00 $2,121.60 $715.35 $2,496.00 $1,605.67 2024-09-26
25003827 LOCAL Repair Of Rectocele 54 14 $2,448.00 $2,080.80 $701.60 $2,448.00 $1,574.80 2024-09-26
73721 CPT MRI Lower Extremity Lt Any Jt Routine Wo Contrast 108 14 $2,447.00 $2,079.95 $701.31 $2,447.00 $1,574.15 2024-09-26
71551 CPT MRI Chest W Contrast 54 14 $2,550.00 $2,167.50 $564.39 $2,550.00 $1,557.19 2024-09-26
70549 CPT MRA Carotids Neck Wo W Contrast 54 14 $2,550.00 $2,167.50 $561.34 $2,550.00 $1,555.67 2024-09-26
70546 CPT MRA Head Wo W Contrast 54 14 $2,550.00 $2,167.50 $561.34 $2,550.00 $1,555.67 2024-09-26
L8699 HCPCS Dbm Putty W/chips 2.5cc Tensix 91 14 $3,173.90 $2,697.82 $122.52 $3,173.90 $1,555.21 2024-09-26
36569 CPT Picc Line Placement, Age 5 Or Older, Without Imaging Guidance 54 14 $2,652.00 $2,254.20 $449.00 $2,652.00 $1,550.50 2024-09-26
70553 CPT MRI Head Wo W Contrast 54 14 $2,518.00 $2,140.30 $561.34 $2,518.00 $1,539.67 2024-09-26
72196 CPT MRI Pelvis W Contrast 54 14 $2,468.00 $2,097.80 $561.34 $2,468.00 $1,514.67 2024-09-26
25000908 LOCAL Excision Of Axillary Lymph Node 54 14 $2,346.00 $1,994.10 $672.36 $2,346.00 $1,509.18 2024-09-26
75635 CPT CTA Abd Aorta Bil Low Ext Runoff 54 14 $2,346.00 $1,994.10 $672.36 $2,346.00 $1,509.18 2024-09-26
73718 CPT MRI Lower Extremity Lt Not Jt Wo Contrast 108 14 $2,339.00 $1,988.15 $670.36 $2,339.00 $1,504.68 2024-09-26
73221 CPT MRI Upper Extremity Lt Any Jt Wo Contrast 108 14 $2,339.00 $1,988.15 $670.36 $2,339.00 $1,504.68 2024-09-26
73218 CPT MRI Upper Extremity Lt Not Jt Wo Contrast 108 14 $2,339.00 $1,988.15 $670.36 $2,339.00 $1,504.68 2024-09-26
72148 CPT MRI Lumbar Spine Routine Wo Contrast 54 14 $2,468.00 $2,097.80 $533.91 $2,468.00 $1,500.95 2024-09-26
72146 CPT MRI Thoracic Spine Routine Wo Contrast 54 14 $2,468.00 $2,097.80 $533.91 $2,468.00 $1,500.95 2024-09-26
72141 CPT MRI Cervical Spine Routine Wo Contrast 54 14 $2,468.00 $2,097.80 $533.91 $2,468.00 $1,500.95 2024-09-26
64479 CPT Xr CT Foramin Inj Cerv Thor Sngl Lvl W Guid 54 14 $2,550.00 $2,167.50 $449.00 $2,550.00 $1,499.50 2024-09-26
95805 CPT Mslt (Mult Sleep Latency Testing) 54 14 $2,321.00 $1,972.85 $665.20 $2,321.00 $1,493.10 2024-09-26
70543 CPT MRI Neck Orbits Face Wo W Contrast 54 14 $2,410.00 $2,048.50 $561.34 $2,410.00 $1,485.67 2024-09-26
25003169 LOCAL Temporal Artery Biopsy 54 14 $2,305.00 $1,959.25 $660.61 $2,305.00 $1,482.81 2024-09-26
25001088 LOCAL Ganglion Cyst 54 14 $2,305.00 $1,959.25 $660.61 $2,305.00 $1,482.81 2024-09-26
72160051 LOCAL Room Rate Special Care Swing Bed Mhs 6 3 $1,850.00 $1,572.50 $1,110.00 $1,776.56 $1,481.48 2024-09-26
25009203 LOCAL Suprapubic Catheter Placement 54 14 $2,300.00 $1,955.00 $659.18 $2,300.00 $1,479.59 2024-09-26
25001387 LOCAL I&d Abscess Subq Or Cutaneous 54 14 $2,295.00 $1,950.75 $657.75 $2,295.00 $1,476.38 2024-09-26
74182 CPT MRI Abdomen W Contrast 84 14 $2,387.00 $2,028.95 $561.34 $2,754.00 $1,474.17 2024-09-26
25000039 LOCAL Amputation Of Toe 54 14 $2,290.00 $1,946.50 $656.31 $2,290.00 $1,473.15 2024-09-26
25000129 LOCAL Arthroplasty Of Toe 54 14 $2,290.00 $1,946.50 $656.31 $2,290.00 $1,473.15 2024-09-26
25000520 LOCAL Cystourethroscopy W Fulg/Bx 54 14 $2,290.00 $1,946.50 $656.31 $2,290.00 $1,473.15 2024-09-26
25006581 LOCAL Urethral Dilitation 54 14 $2,290.00 $1,946.50 $656.31 $2,290.00 $1,473.15 2024-09-26
C8911 HCPCS MRA Chest Wo W Contrast 33 8 $2,856.00 $2,427.60 $747.00 $1,713.60 $1,469.41 2024-09-26
24073 CPT Excision, Tumor, Soft Tissue Of Upper Arm Or Elbow Area, Subcutaneous; 5 Cm Or G… 36 14 $2,519.00 $2,141.15 $721.95 $2,519.00 $1,465.43 2024-09-26
J0248 HCPCS Remdesivir 100 Mg IV Solr 54 14 $2,264.00 $1,924.40 $648.86 $2,264.00 $1,456.43 2024-09-26
70548 CPT MRA Carotids Neck W Contrast 54 14 $2,346.00 $1,994.10 $561.34 $2,346.00 $1,453.67 2024-09-26
64483 CPT Xr CT Foramin Inj Lumb Sacr Sngl Lvl W Guid 54 14 $2,448.00 $2,080.80 $449.00 $2,448.00 $1,448.50 2024-09-26
25000586 LOCAL D & C 54 14 $2,244.00 $1,907.40 $643.13 $2,244.00 $1,443.57 2024-09-26
58001972 LOCAL Colonoscopy 54 14 $2,244.00 $1,907.40 $643.13 $2,244.00 $1,443.57 2024-09-26
25012603 LOCAL Excision, Prepatellar Bursa 54 14 $2,244.00 $1,907.40 $643.13 $2,244.00 $1,443.57 2024-09-26
25002807 LOCAL Removal/Excision Bartholin Cyst 54 14 $2,244.00 $1,907.40 $643.13 $2,244.00 $1,443.57 2024-09-26
25003093 LOCAL Skin Graft 54 14 $2,244.00 $1,907.40 $643.13 $2,244.00 $1,443.57 2024-09-26
25002768 LOCAL Removal Implant/Hardware 54 14 $2,244.00 $1,907.40 $643.13 $2,244.00 $1,443.57 2024-09-26
25004172 LOCAL Laryngoscopy 54 14 $2,244.00 $1,907.40 $643.13 $2,244.00 $1,443.57 2024-09-26
25000381 LOCAL Circumcision > 28 Old 54 14 $2,244.00 $1,907.40 $643.13 $2,244.00 $1,443.57 2024-09-26
25005059 LOCAL Excision Cyst/Lipoma 54 14 $2,244.00 $1,907.40 $643.13 $2,244.00 $1,443.57 2024-09-26
25000270 LOCAL Carpal Tunnel Release 54 14 $2,244.00 $1,907.40 $643.13 $2,244.00 $1,443.57 2024-09-26
73725 CPT MRA Lower Extremity Wo/W Contrast 54 14 $2,346.00 $1,994.10 $533.91 $2,346.00 $1,439.95 2024-09-26
15100 CPT Split-thick Autograft, Trunk, Arm, Leg; 1St 100 Sq Cm Or Less, Or 1% Of Body Are… 36 14 $2,472.00 $2,101.20 $708.48 $2,472.00 $1,438.09 2024-09-26
72195 CPT MRI Pelvis Routine Wo Contrast 54 14 $2,334.00 $1,983.90 $533.91 $2,334.00 $1,433.95 2024-09-26
62323 CPT Xr Epidural Lumbar Or Sacral Inj 54 14 $2,400.00 $2,040.00 $449.00 $2,400.00 $1,424.50 2024-09-26
62321 CPT Xr Epidural Cervical Thoracic Inj 54 14 $2,400.00 $2,040.00 $449.00 $2,400.00 $1,424.50 2024-09-26
74174 CPT CTA Abdomen And Pelvis 54 14 $2,346.00 $1,994.10 $499.00 $2,346.00 $1,422.50 2024-09-26
25000155 LOCAL Biopsy Of Breast (Needle) 54 14 $2,203.00 $1,872.55 $631.38 $2,203.00 $1,417.19 2024-09-26
70552 CPT MRI Head W Contrast 54 14 $2,244.00 $1,907.40 $561.34 $2,244.00 $1,402.67 2024-09-26
70545 CPT MRA Head W Contrast 54 14 $2,244.00 $1,907.40 $561.34 $2,244.00 $1,402.67 2024-09-26
70542 CPT MRI Neck Orbits Face W Contrast 54 14 $2,244.00 $1,907.40 $561.34 $2,244.00 $1,402.67 2024-09-26
Q4106 HCPCS Sup Skin Subsititute (Dermagraft) Per 1 Sq Cm 54 14 $2,168.00 $1,842.80 $621.35 $2,168.00 $1,394.67 2024-09-26
25002009 LOCAL Lumpectomy W Axillary Node Dissect 54 14 $2,168.00 $1,842.80 $621.35 $2,168.00 $1,394.67 2024-09-26
See an error in this hospital's data? Submit a correction