Hospital

CEDAR COUNTY MEMORIAL HOSPITAL

El Dorado Springs, MO · CCN 261323 · Rates published

4,241 distinct procedures filed

30 distinct payers

139,363 rate rows

2026-05-13 last MRF observed

Data quality

58,874 of 139,363 rate rows are consumer-grade (42.2%)

80,489 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	66,353
per-diem day rate — not a per-procedure price	11,667
exceeds 10× this hospital's gross charge — excluded from medians	2,469

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

Source MRF file	https://apim.services.craneware.com/api-pricing-transparency/api/public/8b80f2763a22d42cf1f9d60ca4234c13/charges/mrf
Found on page	https://www.cedarcomem.com/cms-hpt.txt
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-10-12
Content fingerprint	2c6010c3f5b2d4be… · 17,186,102 bytes · first seen 2026-05-13

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
27428 OTHER	Reconstruction Knee	29	$10,712.91	$10,712.91	$10,712.91	—
27870 OTHER	Fusion Of Ankle Joint Open	29	$10,712.91	$10,712.91	$10,712.91	—
27447 OTHER	Total Knee Arthroplasty	29	$10,712.91	$10,712.91	$10,712.91	—
25810 OTHER	Arthrd Wrst Iliac/oth Agrft	29	$10,712.91	$10,712.91	$10,712.91	—
29856 OTHER	Tibial Arthroscopy/surgery	29	$10,712.91	$10,712.91	$10,712.91	—
28730 OTHER	Fusion Of Foot Bones	29	$10,712.91	$10,712.91	$10,712.91	—
27130 OTHER	Total Hip Arthroplasty	29	$10,712.91	$10,712.91	$10,712.91	—
28070 OTHER	Removal Of Foot Joint Lining	29	$5,823.26	$5,823.26	$5,823.26	—
28103 OTHER	Remove/graft Foot Lesion	29	$5,823.26	$5,823.26	$5,823.26	—
28202 OTHER	Repair/graft Of Foot Tendon	29	$5,823.26	$5,823.26	$5,823.26	—
27695 OTHER	Repair Of Ankle Ligament	29	$5,823.26	$5,823.26	$5,823.26	—
27654 OTHER	Repair Of Achilles Tendon	29	$5,823.26	$5,823.26	$5,823.26	—
27792 OTHER	Treatment Of Ankle Fracture	29	$5,823.26	$5,823.26	$5,823.26	—
27814 OTHER	Treatment Of Ankle Fracture	29	$5,823.26	$5,823.26	$5,823.26	—
27386 OTHER	Repair/graft Of Thigh Muscle	29	$5,823.26	$5,823.26	$5,823.26	—
25805 OTHER	Arthrd Wrist W/sliding Graft	29	$5,823.26	$5,823.26	$5,823.26	—
27405 OTHER	Repair Of Knee Ligament	29	$5,823.26	$5,823.26	$5,823.26	—
25320 OTHER	Repair/revise Wrist Joint	29	$5,823.26	$5,823.26	$5,823.26	—
25526 OTHER	Optx Rdl Shft Fx&dstl Rad/ul	29	$5,823.26	$5,823.26	$5,823.26	—
25609 OTHER	Optx Dst Rd Xart Fx/ep Sep3+	29	$5,823.26	$5,823.26	$5,823.26	—
26841 OTHER	Fusion Of Thumb	29	$5,823.26	$5,823.26	$5,823.26	—
27385 OTHER	Repair Of Thigh Muscle	29	$5,823.26	$5,823.26	$5,823.26	—
27524 OTHER	Treat Kneecap Fracture	29	$5,823.26	$5,823.26	$5,823.26	—
24342 OTHER	Repair Of Ruptured Tendon	29	$5,823.26	$5,823.26	$5,823.26	—
27650 OTHER	Repair Achilles Tendon	29	$5,823.26	$5,823.26	$5,823.26	—
27652 OTHER	Repair/graft Achilles Tendon	29	$5,823.26	$5,823.26	$5,823.26	—
27698 OTHER	Repair Of Ankle Ligament	29	$5,823.26	$5,823.26	$5,823.26	—
27766 OTHER	Optx Medial Ankle Fx	26	$5,823.26	$5,823.26	$5,823.26	—
25360 OTHER	Revision Of Ulna	29	$5,823.26	$5,823.26	$5,823.26	—
27826 OTHER	Treat Lower Leg Fracture	29	$5,823.26	$5,823.26	$5,823.26	—
23455 OTHER	Repair Shoulder Capsule	29	$5,823.26	$5,823.26	$5,823.26	—
23420 OTHER	Repair Of Shoulder	29	$5,823.26	$5,823.26	$5,823.26	—
23460 OTHER	Repair Shoulder Capsule	29	$5,823.26	$5,823.26	$5,823.26	—
23410 OTHER	Repair Rotator Cuff Acute	29	$5,823.26	$5,823.26	$5,823.26	—
24340 OTHER	Tenodesis Biceps Tdn At Elbw	29	$5,823.26	$5,823.26	$5,823.26	—
24341 OTHER	Rpr Tdn/musc Upr A/e Each	29	$5,823.26	$5,823.26	$5,823.26	—
24400 OTHER	Revision Of Humerus	29	$5,823.26	$5,823.26	$5,823.26	—
24685 OTHER	Treat Ulnar Fracture	29	$5,823.26	$5,823.26	$5,823.26	—
25515 OTHER	Optx Radial Shaft Fracture	29	$5,823.26	$5,823.26	$5,823.26	—
25525 OTHER	Optx Rdl Shft Fx&cltx Rad/ul	29	$5,823.26	$5,823.26	$5,823.26	—
25607 OTHER	Optx Dst Rd Xartc Fx/epi Sep	29	$5,823.26	$5,823.26	$5,823.26	—
25608 OTHER	Optx Dst Rd Xart Fx/epi Sep2	29	$5,823.26	$5,823.26	$5,823.26	—
23412 OTHER	Repair Rotator Cuff Chronic	29	$5,823.26	$5,823.26	$5,823.26	—
26531 OTHER	Revise Knuckle With Implant	29	$5,823.26	$5,823.26	$5,823.26	—
23515 OTHER	Optx Clavicular Fx W/int Fix	29	$5,823.26	$5,823.26	$5,823.26	—
27235 OTHER	Treat Thigh Fracture	29	$5,823.26	$5,823.26	$5,823.26	—
27427 OTHER	Reconstruction Knee	29	$5,823.26	$5,823.26	$5,823.26	—
27422 OTHER	Revision Of Unstable Kneecap	29	$5,823.26	$5,823.26	$5,823.26	—
25390 OTHER	Shorten Radius Or Ulna	29	$5,823.26	$5,823.26	$5,823.26	—
27420 OTHER	Revision Of Unstable Kneecap	29	$5,823.26	$5,823.26	$5,823.26	—

Other procedures at this hospital

Browse this hospital's 4,241 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

28730	OTHER	Fusion Of Foot Bones	30	29	$2,112.00	$1,267.20 40% off	$10,712.91	$10,712.91	$10,712.91	2026-05-13
27870	OTHER	Fusion Of Ankle Joint Open	30	29	$2,938.00	$1,762.80 40% off	$10,712.91	$10,712.91	$10,712.91	2026-05-13
27428	OTHER	Reconstruction Knee	30	29	$3,237.00	$1,942.20 40% off	$10,712.91	$10,712.91	$10,712.91	2026-05-13
27447	OTHER	Total Knee Arthroplasty	30	29	$3,730.00	$2,238.00 40% off	$10,712.91	$10,712.91	$10,712.91	2026-05-13
25810	OTHER	Arthrd Wrst Iliac/oth Agrft	30	29	$2,517.00	$1,510.20 40% off	$10,712.91	$10,712.91	$10,712.91	2026-05-13
27130	OTHER	Total Hip Arthroplasty	30	29	$3,734.00	$2,240.40 40% off	$10,712.91	$10,712.91	$10,712.91	2026-05-13
29856	OTHER	Tibial Arthroscopy/surgery	30	29	$2,881.00	$1,728.60 40% off	$10,712.91	$10,712.91	$10,712.91	2026-05-13
29807	OTHER	Sho Arthrs Srg Rpr Slap Les	30	29	$2,999.00	$1,799.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
29887	OTHER	Knee Arthroscopy/surgery	30	29	$2,183.00	$1,309.80 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
28456	OTHER	Treat Midfoot Fracture	30	29	$1,079.00	$647.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27427	OTHER	Reconstruction Knee	30	29	$2,064.00	$1,238.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
26841	OTHER	Fusion Of Thumb	30	29	$719.15	$431.49 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
25608	OTHER	Optx Dst Rd Xart Fx/epi Sep2	30	29	$2,461.00	$1,476.60 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27792	OTHER	Treatment Of Ankle Fracture	30	29	$1,873.00	$1,123.80 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
28070	OTHER	Removal Of Foot Joint Lining	30	29	$1,257.00	$754.20 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
24685	OTHER	Treat Ulnar Fracture	30	29	$632.00	$379.20 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
23455	OTHER	Repair Shoulder Capsule	30	29	$2,876.00	$1,725.60 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
28531	OTHER	Treat Sesamoid Bone Fracture	30	29	$735.00	$441.00 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27235	OTHER	Treat Thigh Fracture	30	29	$2,631.00	$1,578.60 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
24400	OTHER	Revision Of Humerus	30	29	$2,404.00	$1,442.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27654	OTHER	Repair Of Achilles Tendon	30	29	$2,739.00	$1,643.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
29905	OTHER	Subtalar Arthro W/exc	30	29	$2,637.00	$1,582.20 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
23410	OTHER	Repair Rotator Cuff Acute	30	29	$2,382.00	$1,429.20 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27650	OTHER	Repair Achilles Tendon	30	29	$1,907.00	$1,144.20 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
23460	OTHER	Repair Shoulder Capsule	30	29	$3,167.00	$1,900.20 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
25526	OTHER	Optx Rdl Shft Fx&dstl Rad/ul	30	29	$2,776.00	$1,665.60 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
28615	OTHER	Repair Foot Dislocation	30	29	$2,384.00	$1,430.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
29888	OTHER	Knee Arthroscopy/surgery	30	29	$2,698.00	$1,618.80 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
28750	OTHER	Fusion Of Big Toe Joint	30	29	$2,413.00	$1,447.80 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
28291	OTHER	Corrj Halux Rigdus W/implt	30	29	$1,730.00	$1,038.00 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
25525	OTHER	Optx Rdl Shft Fx&cltx Rad/ul	30	29	$2,296.00	$1,377.60 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
29820	OTHER	Sho Arthrs Srg Prtl Synvct	30	29	$1,549.00	$929.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27652	OTHER	Repair/graft Achilles Tendon	30	29	$1,937.00	$1,162.20 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
29827	OTHER	Sho Arthrs Srg Rt8tr Cuf Rpr	30	29	$3,104.00	$1,862.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
23420	OTHER	Repair Of Shoulder	30	29	$2,826.00	$1,695.60 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
26531	OTHER	Revise Knuckle With Implant	30	29	$1,833.00	$1,099.80 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
28202	OTHER	Repair/graft Of Foot Tendon	30	29	$2,268.00	$1,360.80 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
28103	OTHER	Remove/graft Foot Lesion	30	29	$1,689.00	$1,013.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27524	OTHER	Treat Kneecap Fracture	30	29	$2,189.00	$1,313.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
25515	OTHER	Optx Radial Shaft Fracture	30	29	$1,945.00	$1,167.00 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
23412	OTHER	Repair Rotator Cuff Chronic	30	29	$2,475.00	$1,485.00 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
24341	OTHER	Rpr Tdn/musc Upr A/e Each	30	29	$2,162.00	$1,297.20 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
25607	OTHER	Optx Dst Rd Xartc Fx/epi Sep	30	29	$3,404.85	$2,042.91 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27405	OTHER	Repair Of Knee Ligament	30	29	$1,963.00	$1,177.80 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
28485	OTHER	Treat Metatarsal Fracture	30	29	$1,650.00	$990.00 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
29892	OTHER	Ankle Arthroscopy/surgery	30	29	$2,183.00	$1,309.80 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27420	OTHER	Revision Of Unstable Kneecap	30	29	$2,169.00	$1,301.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
29828	OTHER	Sho Arthrs Srg Bicp Tenodsis	30	29	$2,659.00	$1,595.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
28309	OTHER	Incision Of Metatarsals	30	29	$2,621.00	$1,572.60 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27698	OTHER	Repair Of Ankle Ligament	30	29	$1,818.25	$1,090.95 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
25609	OTHER	Optx Dst Rd Xart Fx/ep Sep3+	30	29	$2,977.00	$1,786.20 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
24342	OTHER	Repair Of Ruptured Tendon	30	29	$2,253.00	$1,351.80 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
23515	OTHER	Optx Clavicular Fx W/int Fix	30	29	$2,790.00	$1,674.00 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
25320	OTHER	Repair/revise Wrist Joint	30	29	$2,856.00	$1,713.60 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27814	OTHER	Treatment Of Ankle Fracture	30	29	$2,221.00	$1,332.60 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
28130	OTHER	Removal Of Ankle Bone	30	29	$2,102.00	$1,261.20 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
29806	OTHER	Sho Arthrs Srg Capsulorraphy	30	29	$3,068.00	$1,840.80 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27385	OTHER	Repair Of Thigh Muscle	30	29	$1,749.00	$1,049.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27766	OTHER	Optx Medial Ankle Fx	27	26	$558.20	$334.92 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
24340	OTHER	Tenodesis Biceps Tdn At Elbw	30	29	$1,746.00	$1,047.60 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27826	OTHER	Treat Lower Leg Fracture	30	29	$2,470.00	$1,482.00 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27695	OTHER	Repair Of Ankle Ligament	30	29	$1,404.00	$842.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
25390	OTHER	Shorten Radius Or Ulna	30	29	$2,236.00	$1,341.60 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
25360	OTHER	Revision Of Ulna	30	29	$1,906.00	$1,143.60 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
25805	OTHER	Arthrd Wrist W/sliding Graft	30	29	$2,464.00	$1,478.40 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27386	OTHER	Repair/graft Of Thigh Muscle	30	29	$2,748.00	$1,648.80 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
27422	OTHER	Revision Of Unstable Kneecap	30	29	$2,156.00	$1,293.60 40% off	$5,823.26	$5,823.26	$5,823.26	2026-05-13
J0485	HCPCS	Injection; Belatacept; 1 Mg	1	1	$6,595.20	$3,957.12 40% off	$5,368.49	$5,368.49	$5,368.49	2026-05-13
49320	OTHER	Diag Laparo Separate Proc	30	29	$1,125.00	$675.00 40% off	$4,696.65	$4,696.65	$4,696.65	2026-05-13
49650	OTHER	Lap Ing Hernia Repair Init	30	29	$1,967.00	$1,180.20 40% off	$4,696.65	$4,696.65	$4,696.65	2026-05-13
44180	OTHER	Lap Enterolysis	30	29	$3,666.00	$2,199.60 40% off	$4,696.65	$4,696.65	$4,696.65	2026-05-13
47563	OTHER	Laparo Cholecystectomy/graph	30	29	$2,593.00	$1,555.80 40% off	$4,696.65	$4,696.65	$4,696.65	2026-05-13
49592	OTHER	Rpr Aa Hrn 1st < 3 Ncr/strn	30	29	$1,298.75	$779.25 40% off	$4,696.65	$4,696.65	$4,696.65	2026-05-13
47562	OTHER	Laparoscopic Cholecystectomy	30	29	$4,525.00	$2,715.00 40% off	$4,696.65	$4,696.65	$4,696.65	2026-05-13
787	OTHER	Cesarean Section Without Sterilization With Cc	14	14	—	—	$3,786.00	$3,786.00	$3,786.00	2026-05-13
786	OTHER	Cesarean Section Without Sterilization With Mcc	14	14	—	—	$3,786.00	$3,786.00	$3,786.00	2026-05-13
783	OTHER	Cesarean Section With Sterilization With Mcc	14	14	—	—	$3,786.00	$3,786.00	$3,786.00	2026-05-13
788	OTHER	Cesarean Section Without Sterilization Without Cc/mcc	14	14	—	—	$3,786.00	$3,786.00	$3,786.00	2026-05-13
784	OTHER	Cesarean Section With Sterilization With Cc	14	14	—	—	$3,786.00	$3,786.00	$3,786.00	2026-05-13
785	OTHER	Cesarean Section With Sterilization Without Cc/mcc	14	14	—	—	$3,786.00	$3,786.00	$3,786.00	2026-05-13
73223	OTHER	MRI Joint Upr Extr W/O&with Contrast	2	2	$4,757.00	$2,854.20 40% off	$2,521.21	$4,757.00	$3,639.11	2026-05-13
73206	OTHER	CT Scan Of Blood Vessels Of Arm With Contrast	1	1	$3,410.00	$2,046.00 40% off	$3,410.00	$3,410.00	$3,410.00	2026-05-13
65820	OTHER	Goniotomy	30	29	$2,552.00	$1,531.20 40% off	$3,309.51	$3,309.51	$3,309.51	2026-05-13
73720	OTHER	MRI Lwr Extremity W/O&with Contrast	2	2	$4,757.00	$2,854.20 40% off	$1,558.14	$4,757.00	$3,157.57	2026-05-13
38525	OTHER	Biopsy/removal Lymph Nodes	30	29	$1,941.00	$1,164.60 40% off	$3,102.68	$3,102.68	$3,102.68	2026-05-13
19120	OTHER	Removal Of Breast Lesion	30	29	$1,826.00	$1,095.60 40% off	$3,102.68	$3,102.68	$3,102.68	2026-05-13
158	OTHER	Dental And Oral Diseases With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
088	OTHER	Concussion With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
163	OTHER	Major Chest Procedures With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
116	OTHER	Intraocular Procedures With Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
135	OTHER	Sinus And Mastoid Procedures With Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
136	OTHER	Sinus And Mastoid Procedures Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
143	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
144	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
153	OTHER	Otitis Media And Uri Without Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
094	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
137	OTHER	Mouth Procedures With Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
164	OTHER	Major Chest Procedures With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
168	OTHER	Other Respiratory System O.r. Procedures Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
1700	OTHER	Airborne Isolation Rm Level 2	14	14	$1,973.00	$1,183.80 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
040	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
033	OTHER	Ventricular Shunt Procedures Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
095	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
141	OTHER	Major Head And Neck Procedures With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
026	OTHER	Craniotomy And Endovascular Intracranial Procedures With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
02687	OTHER	Sodium Bicarb 8.4% Syringe 50m	14	14	$32.50	$19.50 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
032	OTHER	Ventricular Shunt Procedures With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
039	OTHER	Extracranial Procedures Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
038	OTHER	Extracranial Procedures With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
060	OTHER	Multiple Sclerosis And Cerebellar Ataxia Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
054	OTHER	Nervous System Neoplasms With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
059	OTHER	Multiple Sclerosis And Cerebellar Ataxia With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
058	OTHER	Multiple Sclerosis And Cerebellar Ataxia With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
06609	OTHER	Mko (midaz-keta-ond) 3-25-2 Mg	14	14	$55.45	$33.27 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
090	OTHER	Concussion Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
115	OTHER	Extraocular Procedures Except Orbit	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
122	OTHER	Acute Major Eye Infections Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
100	OTHER	Seizures With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
089	OTHER	Concussion With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
10119002003B	OTHER	Advanced Eye Relief Dry Eye	14	14	$33.90	$20.34 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
074	OTHER	Cranial And Peripheral Nerve Disorders Without Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
076	OTHER	Viral Meningitis Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
081	OTHER	Nontraumatic Stupor & Coma Without Comorbity	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
087	OTHER	Traumatic Stupor And Coma <1 Hour Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
086	OTHER	Traumatic Stupor And Coma <1 Hour With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
04071-4131-00	OTHER	Low Osmolar Contrast Material; 300-399 Mg/ml Iodine Concentration; Per Ml	14	14	$120.00	$72.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
027	OTHER	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
10019064164	OTHER	Suprane	14	14	$480.70	$288.42 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
139	OTHER	Salivary Gland Procedures	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
149	OTHER	Dysequilibrium	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
012	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
013	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
014	OTHER	Allogeneic Bone Marrow Transplant	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00990-7983-03	OTHER	Sodium Chloride	1	1	$15.75	$9.45 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00990798436D	OTHER	Sodium Chloride	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
093	OTHER	Other Disorders Of Nervous System Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
10122031401A	OTHER	Cardene IV	14	14	$365.95	$219.57 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
041	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
1100	OTHER	Swingbed Baria Level 2	14	14	$1,277.00	$766.20 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
091	OTHER	Other Disorders Of Nervous System With Comorbity	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00990-7922-02	OTHER	Dextrose	1	1	$15.75	$9.45 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
092	OTHER	Other Disorders Of Nervous System With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
123	OTHER	Neurological Eye Disorders	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
142	OTHER	Major Head And Neck Procedures Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
154	OTHER	Other Ear, Nose, Mouth And Throat Diagnoses With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
178	OTHER	Respiratory Infections & Inflammations With Complication	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7227-61	OTHER	clonazePAM	14	14	$3.00	$1.80 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7276-41	OTHER	Nystatin	14	14	$3.15	$1.89 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
173	OTHER	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
101	OTHER	Seizures Without Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
151	OTHER	Epistaxis Without Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
17238090099	OTHER	Bio Glo	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
17478020605A	OTHER	Phenylephrine HCl	14	14	$120.00	$72.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-6557-61	OTHER	Morphine Sulfate	14	14	$3.00	$1.80 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7304-61	OTHER	Promethazine HCl	14	14	$8.25	$4.95 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
152	OTHER	Otitis Media And Uri With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7269-66	OTHER	Sucralfate	14	14	$32.58	$19.55 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
12870000101	OTHER	Silver Nitrate	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
146	OTHER	Ear, Nose, Mouth And Throat Malignancy With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
1600	OTHER	Airborne Isolation Rm Level 1	14	14	$1,879.00	$1,127.40 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
17478040401	OTHER	Ful-glo	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
007	OTHER	Lung Transplant	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00641601501A	OTHER	dilTIAZem HCl	14	14	$32.80	$19.68 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00781-2020-01	OTHER	Amoxicillin	14	14	$22.00	$13.20 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
1300	OTHER	Swingbed Private Level 2	14	14	$897.00	$538.20 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00536-1107-88	OTHER	Nicotine Transdermal System	14	14	$4.80	$2.88 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00536122497A	OTHER	Eye Wash	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
140	OTHER	Major Head And Neck Procedures With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
006	OTHER	Liver Transplant Without Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00641601310A	OTHER	dilTIAZem HCl	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00603-1880-10	OTHER	Lidocaine	1	1	$7.05	$4.23 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-5677-61	OTHER	PARoxetine HCl	14	14	$5.50	$3.30 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
008	OTHER	Simultaneous Pancreas And Kidney Transplant	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-0523-61	OTHER	Vitamin C	14	14	$2.75	$1.65 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00884629730A	OTHER	Phenol Ez Swabs	14	14	$62.20	$37.32 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-6427-61	OTHER	Escitalopram	14	14	$2.75	$1.65 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-5854-61	OTHER	Ibuprofen	14	14	$2.75	$1.65 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-6351-61	OTHER	levoFLOXacin	1	1	$2.75	$1.65 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-6322-06	OTHER	Metoprolol Succinate	14	14	$2.75	$1.65 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-6987-61	OTHER	Dicyclomine HCl	14	14	$22.00	$13.20 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-6666-61	OTHER	Gabapentin	14	14	$11.00	$6.60 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-6938-06	OTHER	Butalbital-acetaminophen-caffeine	14	14	$8.20	$4.92 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-6925-61	OTHER	Sertraline HCl	14	14	$8.25	$4.95 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7156-61	OTHER	metroNIDAZOLE	14	14	$5.50	$3.30 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7044-61	OTHER	DULoxetine HCl	14	14	$6.50	$3.90 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7122-61	OTHER	busPIRone HCl	14	14	$5.50	$3.30 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00019-1323-90	OTHER	Optiray 320	14	14	$225.00	$135.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00536108691	OTHER	Artificial Tears	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7350-06	OTHER	Azithromycin	14	14	$8.70	$5.22 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7346-61	OTHER	FLUoxetine HCl	14	14	$2.75	$1.65 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7337-35	OTHER	Cephalexin	14	14	$8.25	$4.95 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7470-66	OTHER	Sucralfate	14	14	$32.60	$19.56 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7383-61	OTHER	Tamsulosin HCl	1	1	$2.75	$1.65 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7442-61	OTHER	cloNIDine HCl	14	14	$2.75	$1.65 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00904-7401-61	OTHER	Cyclobenzaprine HCl	14	14	$2.75	$1.65 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00990792609A	OTHER	Dextrose-sodium Chloride	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00990792409A	OTHER	Dextrose-sodium Chloride	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00990793003A	OTHER	Dextrose	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00990-7983-02	OTHER	Sodium Chloride	14	14	$15.75	$9.45 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00998020615	OTHER	Isopto Carpine	14	14	$299.20	$179.52 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00027-0111-02	OTHER	Injection; Gadolinium-based Magnetic Resonance Contrast Agent; Not Otherwise Spe…	14	14	$270.00	$162.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
010	OTHER	Pancreas Transplant	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
011	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
022	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
024	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
029	OTHER	Spinal Procedures With Cc Or Spinal Neurostimulators	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
028	OTHER	Spinal Procedures With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
030	OTHER	Spinal Procedures Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
031	OTHER	Ventricular Shunt Procedures With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
035	OTHER	Carotid Artery Stent Procedures With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
034	OTHER	Carotid Artery Stent Procedures With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
036	OTHER	Carotid Artery Stent Procedures Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
037	OTHER	Extracranial Procedures With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
05017	OTHER	Gelatin Sponge,absorb/porcine	14	14	$82.30	$49.38 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
042	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
053	OTHER	Spinal Disorders And Injuries Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
052	OTHER	Spinal Disorders And Injuries With Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
056	OTHER	Degenerative Nervous System Disorders With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
055	OTHER	Nervous System Neoplasms Without Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
057	OTHER	Degenerative Nervous System Disorders Without Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
05719	OTHER	H20 For Inhalation	14	14	$16.00	$9.60 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
066	OTHER	Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
063	OTHER	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
062	OTHER	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
061	OTHER	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
065	OTHER	Intracranial Hemorrhage Or Cerebral Infarction With Complication Or Tpa In 24 Hr…	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
064	OTHER	Intracranial Hemorrhage Or Cerebral Infarction With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
1200	OTHER	Swingbed Private Level 1	14	14	$736.00	$441.60 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
06466	OTHER	Phenyl-cyclo-trop-keto Ophth 1	14	14	$537.00	$322.20 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
069	OTHER	Transient Ischemia Without Thrombolytic	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
06611	OTHER	Ketamine 50 Mg/5 Ml-0.9% Nacl	14	14	$56.80	$34.08 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
068	OTHER	Precerebral Occlusion Without Infarction Without Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
067	OTHER	Precerebral Occlusion Without Infarction With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
073	OTHER	Cranial And Peripheral Nerve Disorders With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
070	OTHER	Other Cerebrovascular Disorders With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
072	OTHER	Other Cerebrovascular Disorders Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
071	OTHER	Other Cerebrovascular Disorders With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
G0237	HCPCS	Therapeutic Procd Strg Endur	14	14	$49.00	$29.40 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
075	OTHER	Viral Meningitis With Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
08065183905	OTHER	Viscoat	14	14	$594.85	$356.91 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
080	OTHER	Nontraumatic Stupor And Coma With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
083	OTHER	Traumatic Stupor And Coma >1 Hour With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
082	OTHER	Traumatic Stupor And Coma >1 Hour With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
084	OTHER	Traumatic Stupor And Coma >1 Hour Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
085	OTHER	Traumatic Stupor And Coma <1 Hour With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00574-0275-00	OTHER	Potassium Chloride	14	14	$2.75	$1.65 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
124	OTHER	Other Disorders Of The Eye With Mcc Or Thrombolytic Agent	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
1400	OTHER	Pediatric Room-level 1	14	14	$1,418.00	$850.80 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
159	OTHER	Dental And Oral Diseases Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00487278401	OTHER	Asthmanefrin	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00496052348	OTHER	Mastisol	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409664816	OTHER	Dextrose	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409724813A	OTHER	Hetastarch/Sodium Chloride	14	14	$51.25	$30.75 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
096	OTHER	Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
147	OTHER	Ear, Nose, Mouth And Throat Malignancy With Cc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409488810A	OTHER	Sodium Chloride	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409553434	OTHER	Sodium Bicarbonate	14	14	$32.45	$19.47 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409658101	OTHER	Marcaine With EPINEPHrine Novaplus	14	14	$33.10	$19.86 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409-4887-20	OTHER	Water For Injection	14	14	$9.50	$5.70 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409488720A	OTHER	Water For Injection	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00517760425	OTHER	Acetylcysteine	14	14	$43.35	$26.01 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
125	OTHER	Other Disorders Of The Eye Without Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
165	OTHER	Major Chest Procedures Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
17478071710B	OTHER	Ketotifen Fumarate	14	14	$27.45	$16.47 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
176	OTHER	Pulmonary Embolism Without Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00006542312	OTHER	Bridion	14	14	$408.45	$245.07 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409166050	OTHER	Precedex	14	14	$84.00	$50.40 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409233924A	OTHER	Labetalol HCl	14	14	$27.25	$16.35 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409163201B	OTHER	Vecuronium Bromide	14	14	$22.05	$13.23 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409175250	OTHER	Marcaine With EPINEPHrine	14	14	$51.00	$30.60 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409427601A	OTHER	Lidocaine HCl	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
117	OTHER	Intraocular Procedures Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409115919B	OTHER	BUPivacaine HCl	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409116318	OTHER	BUPivacaine HCl	14	14	$20.00	$12.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
099	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00409158750	OTHER	Marcaine HCl	14	14	$23.55	$14.13 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00003256016A	OTHER	Azactam	14	14	$89.20	$53.52 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
10019012001	OTHER	Esmolol HCl	14	14	$36.50	$21.90 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
138	OTHER	Mouth Procedures Without Cc/mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
157	OTHER	Dental And Oral Diseases With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00406-0123-62	OTHER	HYDROcodone Bitartrate-acetaminophen	28	14	$9.00	$5.40 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00407-1413-63	OTHER	Omnipaque 300	14	14	$120.00	$72.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
097	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00338955324A	OTHER	Clindamycin Phosphate-sodium Chloride	14	14	$39.15	$23.49 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00386000104	OTHER	Gebauer's Ethyl Chloride	14	14	$110.00	$66.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00407-2223-17	OTHER	Visipaque	14	14	$300.00	$180.00 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00093-3160-06	OTHER	Cefdinir	14	14	$13.45	$8.07 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00003-0894-21	OTHER	Eliquis	14	14	$22.75	$13.65 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	14	14	—	—	$2,839.00	$2,839.00	$2,839.00	2026-05-13
00386000803	OTHER	Gebauer's Pain Ease	14	14	$104.50	$62.70 40% off	$2,839.00	$2,839.00	$2,839.00	2026-05-13

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