Hospital

SHRINERS HOSPITALS FOR CHILDREN

Saint Louis, MO · CCN 263304 · Rates published

34,087 distinct procedures filed

28 distinct payers

796,236 rate rows

2026-05-17 last MRF observed

Data quality

85,692 of 796,236 rate rows are consumer-grade (10.8%)

710,544 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	685,732
per-diem day rate — not a per-procedure price	12,625
exceeds 10× this hospital's gross charge — excluded from medians	12,140
placeholder amount (≤ $0.02) — excluded from medians	47

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

Source MRF file	https://apim.services.craneware.com/api-pricing-transparency/api/public/3dcccbedd70608f376ba25fc12104532/charges/mrf
Found on page	https://www.cdmpricing.com/3dcccbedd70608f376ba25fc12104532
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-19
Content fingerprint	a704c78a942fe093… · 195,100,150 bytes · first seen 2026-05-15

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
5834 OTHER	Screw Extern Fixat 6mm Lg 190mm Schanz 50mm Thread Self-tap Blunt Trocar Spade P…	6	$172,113.33	$567,534.58	$172,113.33	nat. median $372,748 outlier · 0.5×
5884 OTHER	Screw Bone Lcp Tomofix 5x46mm Compress Lck Headed Full Thread Self-tap Ti-6al-7n…	6	$141,179.61	$347,604.58	$141,179.61	nat. median $243,175 0.6× median
5833 OTHER	Plate Bone Dcp 10x73mm 6-hole 3.3mm Sm Dynamic Compress Lck Cortic Ss Pelvic F/3…	6	$136,317.04	$323,229.76	$136,317.04	nat. median $252,069 0.5× median
1614 OTHER	Implantable Heart Assist Systems	6	$134,984.47	$242,334.00	$134,984.47	nat. median $194,298 0.7× median
0024 OTHER	Heart And/or Lung Transplant	6	$130,264.05	$324,737.40	$130,264.05	nat. median $235,636 0.6× median
8513 OTHER	Screw Spinal Expedium 5x25mm Polyaxial Pedicle Ss Thoracolum Extend Tab F/6.35mm…	1	$111,361.72	$111,361.72	$111,361.72	nat. median $42,908 outlier · 2.6×
8514 OTHER	Screw Spinal Expedium 5x45mm Polyaxial Pedicle Ss Thoracolum Extend Tab F/6.35mm…	1	$111,361.72	$111,361.72	$111,361.72	nat. median $74,802 1.5× median
1613 OTHER	Implantable Heart Assist Systems	6	$103,411.98	$189,752.63	$103,411.98	nat. median $79 outlier · 1313.7×
6304 OTHER	Screw Bone Lcp 4/5x24mm Cannul Compress Lck 1/2 Long Thread Self-drilling/tappin…	6	$102,473.40	$211,250.82	$102,473.40	nat. median $164,743 0.6× median
5832 OTHER	Plate Bone Lc-dcp 16x103mm 6-hole 4.8mm Broad Dynamic Compress Lck Ss Limit-cont…	6	$100,520.75	$248,180.71	$100,520.75	nat. median $152,272 0.7× median
8414 OTHER	Screw Spinal Expedium 7x40mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…	6	$95,191.53	$215,562.17	$95,191.53	nat. median $161,322 0.6× median
5934 OTHER	Screw Interference Cannul 8x20mm Ti Round Head Without Sheath F/graft Fixat Strl Acl…	6	$92,075.98	$200,404.67	$92,075.98	nat. median $129,842 0.7× median
5883 OTHER	Screw Bone Lcp Tomofix 5x38mm Compress Lck Headed Full Thread Self-tap Ti-6al-7n…	6	$90,953.27	$231,504.29	$90,953.27	nat. median $163,694 0.6× median
5882 OTHER	Screw Bone Lcp Tomofix 5x34mm Compress Lck Headed Full Thread Self-tap Ti-6al-7n…	6	$89,060.94	$198,374.29	$89,060.94	nat. median $119,369 0.7× median
5914 OTHER	Plate Bone Lcp 73mm 3-hole 110deg Pre-contoured Compress Lck Ss Hip F/3.5mm Scre…	6	$88,914.56	$227,941.62	$88,914.56	nat. median $149,152 0.6× median
0114 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	$88,800.28	$324,952.04	$88,800.28	nat. median $125,206 0.7× median
6094 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	6	$88,347.39	$242,185.09	$88,347.39	nat. median $170,784 0.5× median
5831 OTHER	Washer Ortho 13mm Round Thread Spike Ss F/6.5/7/7.3mm Lg Cannul Screw Ns	6	$86,868.09	$222,772.73	$86,868.09	nat. median $139,037 0.6× median
0074 OTHER	Allogeneic Bone Marrow Transplant	6	$85,399.02	$191,192.48	$85,399.02	nat. median $147,645 0.6× median
6314 OTHER	Screw Bone Lcp 7.3/8.2x90mm Cannul Compress Lck 32mm Thread Self-drilling/tappin…	6	$84,817.39	$232,937.98	$84,817.39	nat. median $163,675 0.5× median
0044 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	6	$84,588.13	$182,571.84	$84,588.13	nat. median $138,863 0.6× median
0014 OTHER	Liver Transplant And/or Intestinal Transplant	6	$83,272.84	$180,756.11	$83,272.84	nat. median $147,828 0.6× median
1612 OTHER	Implantable Heart Assist Systems	6	$83,030.88	$139,620.65	$83,030.88	nat. median $84,765 1.0× median
0094 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	6	$82,813.95	$237,565.64	$82,813.95	nat. median $165,362 0.5× median
0023 OTHER	Heart And/or Lung Transplant	6	$80,553.38	$176,889.45	$80,553.38	nat. median $133,752 0.6× median
2994 OTHER	Guidepin Ortho 2.4mm 9in Partial Thread Trocar Tip F/cannulated Screw System	1	$80,156.32	$80,156.32	$80,156.32	nat. median $45,304 1.8× median
1611 OTHER	Implantable Heart Assist Systems	6	$78,879.03	$139,620.65	$78,879.03	nat. median $80,527 1.0× median
6034 OTHER	Nail IM Fassier-duval 4.8mm Std 404mm Short Thread Tibial Humeral Ss F/osteogene…	6	$74,013.64	$110,422.01	$74,013.64	nat. median $92,525 0.8× median
0064 OTHER	Pancreas Transplant	6	$73,539.59	$118,069.05	$73,539.59	nat. median $102,085 0.7× median
6024 OTHER	Screw Bone Lcp 5/4.4x55mm Compress Lck Full Thread Self-tap Ss T25 Stardrive Rec…	6	$66,000.24	$150,972.08	$66,000.24	nat. median $99,381 0.7× median
216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	8	$42,695.55	$126,440.00	$63,833.23	nat. median $90,130 0.7× median
2993 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	1	$62,678.84	$62,678.84	$62,678.84	nat. median $34,698 1.8× median
3004 OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	1	$61,150.66	$61,150.66	$61,150.66	nat. median $44,012 1.4× median
0022 OTHER	Heart And/or Lung Transplant	6	$59,779.35	$133,947.50	$59,779.35	nat. median $96,800 0.6× median
5933 OTHER	Screw Interference Cannul 7x25mm Ti Alloy Round Head W/2mm Nitinol Gw Disp Sheat…	6	$59,210.77	$146,602.20	$59,210.77	nat. median $87,090 0.7× median
5881 OTHER	Screw Bone Lcp 3.5/6x18mm Compress Lck Full Thread Self-tap Lo-pro Cortic Ti 2.5…	6	$58,623.14	$170,035.26	$58,623.14	nat. median $14,014 outlier · 4.2×
0043 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	6	$57,885.96	$125,896.85	$57,885.96	nat. median $89,613 0.6× median
1604 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	6	$57,117.74	$139,112.29	$57,117.74	nat. median $44,507 1.3× median
456 OTHER	Spinal Fus Exc Cerv With Spinal Curv/malig/infec Or Ext Fus With Comorbity	8	$38,109.60	$110,956.00	$55,867.04	nat. median $76,493 0.7× median
0054 OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	6	$55,745.32	$127,186.76	$55,745.32	nat. median $98,692 0.6× median
4284 OTHER	Catheter Foley 2 Way Standard Tip Sterile Cysto-care 18fr 15ml	1	$55,061.58	$55,061.58	$55,061.58	nat. median $28,443 1.9× median
1624 OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	6	$53,832.53	$93,488.84	$53,832.53	nat. median $5 outlier · 11099.5×
5913 OTHER	Plate Bone Lcp 73mm 3-hole 100deg Pre-contoured Compress Lck Ss Hip F/3.5mm Scre…	6	$52,090.45	$171,907.48	$52,090.45	nat. median $115,252 outlier · 0.5×
6023 OTHER	Screw Bone Lcp 7.3/8.2x85mm Cannul Compress Lck 32mm Thread Self-drilling/tappin…	6	$52,042.84	$104,821.78	$52,042.84	nat. median $75,452 0.7× median
5204 OTHER	Other GYN Procedures For Malignancy	1	$51,987.77	$51,987.77	$51,987.77	nat. median $30,710 1.7× median
0063 OTHER	Pancreas Transplant	6	$51,709.16	$90,991.17	$51,709.16	nat. median $74,579 0.7× median
3034 OTHER	Suture Chromic Gut 3-0 27in 1/2 Circ CT-2 Taper Point Natural Brown Undyed 1 Str…	6	$51,465.44	$93,036.96	$51,465.44	nat. median $71,896 0.7× median
0021 OTHER	Heart And/or Lung Transplant	6	$51,246.75	$118,388.45	$51,246.75	nat. median $85,030 0.6× median
6074 OTHER	Screw Bone Expert 4/3.3x36mm Cannul Compress Lck Fully/dual Lead Thread Self-tap…	6	$50,694.04	$116,702.12	$50,694.04	nat. median $85,400 0.6× median
0073 OTHER	Allogeneic Bone Marrow Transplant	6	$50,327.92	$121,600.91	$50,327.92	nat. median $87,821 0.6× median

Other procedures at this hospital

Browse this hospital's 34,087 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

0011	OTHER	Liver Transplant And/or Intestinal Transplant	6	6	—	—	$35,824.86	$63,714.05	$35,824.86	2026-05-17
0012	OTHER	Liver Transplant And/or Intestinal Transplant	6	6	—	—	$40,349.18	$72,523.66	$40,349.18	2026-05-17
0013	OTHER	Liver Transplant And/or Intestinal Transplant	6	6	—	—	$48,142.48	$93,844.18	$48,142.48	2026-05-17
0014	OTHER	Liver Transplant And/or Intestinal Transplant	6	6	—	—	$83,272.84	$180,756.11	$83,272.84	2026-05-17
0021	OTHER	Heart And/or Lung Transplant	6	6	—	—	$51,246.75	$118,388.45	$51,246.75	2026-05-17
0022	OTHER	Heart And/or Lung Transplant	6	6	—	—	$59,779.35	$133,947.50	$59,779.35	2026-05-17
0023	OTHER	Heart And/or Lung Transplant	6	6	—	—	$80,553.38	$176,889.45	$80,553.38	2026-05-17
0024	OTHER	Heart And/or Lung Transplant	6	6	—	—	$130,264.05	$324,737.40	$130,264.05	2026-05-17
0041	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	6	6	—	—	$26,575.89	$55,661.35	$26,575.89	2026-05-17
0042	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	6	6	—	—	$39,796.82	$80,453.13	$39,796.82	2026-05-17
0043	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	6	6	—	—	$57,885.96	$125,896.85	$57,885.96	2026-05-17
0044	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	6	6	—	—	$84,588.13	$182,571.84	$84,588.13	2026-05-17
0052	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	6	6	—	—	$30,047.69	$61,546.06	$30,047.69	2026-05-17
0053	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	6	6	—	—	$41,050.03	$92,302.65	$41,050.03	2026-05-17
0054	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	6	6	—	—	$55,745.32	$127,186.76	$55,745.32	2026-05-17
0061	OTHER	Pancreas Transplant	6	6	—	—	$35,284.50	$54,486.46	$35,284.50	2026-05-17
0062	OTHER	Pancreas Transplant	6	6	—	—	$44,888.66	$78,444.31	$44,888.66	2026-05-17
0063	OTHER	Pancreas Transplant	6	6	—	—	$51,709.16	$90,991.17	$51,709.16	2026-05-17
0064	OTHER	Pancreas Transplant	6	6	—	—	$73,539.59	$118,069.05	$73,539.59	2026-05-17
0071	OTHER	Allogeneic Bone Marrow Transplant	6	6	—	—	$35,053.11	$75,591.31	$35,053.11	2026-05-17
0072	OTHER	Allogeneic Bone Marrow Transplant	6	6	—	—	$39,366.86	$85,632.29	$39,366.86	2026-05-17
0073	OTHER	Allogeneic Bone Marrow Transplant	6	6	—	—	$50,327.92	$121,600.91	$50,327.92	2026-05-17
0074	OTHER	Allogeneic Bone Marrow Transplant	6	6	—	—	$85,399.02	$191,192.48	$85,399.02	2026-05-17
0081	OTHER	Autologous Bone Marrow Transplant	16	15	—	—	$17,102.94	$39,679.17	$21,118.47	2026-05-17
0082	OTHER	Autologous Bone Marrow Transplant	16	15	—	—	$22,759.48	$46,978.06	$24,767.91	2026-05-17
0083	OTHER	Autologous Bone Marrow Transplant	6	6	—	—	$27,202.32	$59,852.53	$27,202.32	2026-05-17
0084	OTHER	Autologous Bone Marrow Transplant	6	6	—	—	$43,199.84	$85,036.63	$43,199.84	2026-05-17
0091	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$22,846.60	$58,679.70	$22,846.60	2026-05-17
0092	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$27,838.62	$80,132.70	$27,838.62	2026-05-17
0093	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$38,168.32	$159,659.47	$38,168.32	2026-05-17
0094	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$82,813.95	$237,565.64	$82,813.95	2026-05-17
0112	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	6	—	—	$23,153.11	$192,254.40	$23,153.11	2026-05-17
0113	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	6	—	—	$43,709.87	$241,833.85	$43,709.87	2026-05-17
0114	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	6	6	—	—	$88,800.28	$324,952.04	$88,800.28	2026-05-17
0203	OTHER	Open Craniotomy For Trauma	16	15	—	—	$19,463.33	$38,128.40	$20,343.08	2026-05-17
0204	OTHER	Open Craniotomy For Trauma	6	6	—	—	$30,427.92	$55,222.82	$30,427.92	2026-05-17
0213	OTHER	Open Craniotomy Except Trauma	16	15	—	—	$21,139.45	$44,484.51	$23,521.13	2026-05-17
0214	OTHER	Open Craniotomy Except Trauma	6	6	—	—	$32,981.60	$63,211.85	$32,981.60	2026-05-17
0224	OTHER	Ventricular Shunt Procedures	16	15	—	—	$25,203.82	$49,395.62	$25,976.69	2026-05-17
0233	OTHER	Spinal Procedures	16	15	—	—	$20,548.29	$39,697.66	$21,127.71	2026-05-17
0234	OTHER	Spinal Procedures	6	6	—	—	$33,439.78	$57,635.24	$33,439.78	2026-05-17
0244	OTHER	Open Extracranial Vascular Procedures	16	15	—	—	$20,439.10	$38,320.45	$20,439.10	2026-05-17
0264	OTHER	Other Nervous System And Related Procedures	16	15	—	—	$23,694.69	$44,831.63	$23,694.69	2026-05-17
0273	OTHER	Other Open Craniotomy	16	15	—	—	$17,632.02	$37,359.18	$19,958.47	2026-05-17
0274	OTHER	Other Open Craniotomy	6	6	—	—	$29,071.37	$53,200.65	$29,071.37	2026-05-17
029	OTHER	Spinal Procedures With Complication Or Spinal Neurostimulators	19	17	—	—	$14,539.95	$43,977.00	$23,267.38	2026-05-17
0293	OTHER	Other Percutaneous Intracranial Procedures	16	15	—	—	$14,269.56	$33,787.27	$18,172.51	2026-05-17
0294	OTHER	Other Percutaneous Intracranial Procedures	16	15	—	—	$23,568.97	$45,112.00	$23,834.88	2026-05-17
0303	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	16	15	—	—	$19,170.24	$35,782.73	$19,170.24	2026-05-17
0304	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	16	15	—	—	$25,388.73	$48,219.70	$25,388.73	2026-05-17
0434	OTHER	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies	16	15	—	—	$17,354.08	$42,332.94	$22,445.35	2026-05-17
0494	OTHER	Bacterial And Tuberculous Infections Of Nervous System	16	15	—	—	$18,129.90	$33,702.03	$18,129.90	2026-05-17
0504	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	16	15	—	—	$20,626.60	$39,088.65	$20,823.21	2026-05-17
0734	OTHER	Orbit And Eye Procedures	16	15	—	—	$19,629.11	$37,851.11	$20,204.44	2026-05-17
0893	OTHER	Major Cranial Or Facial Bone Procedures	16	15	—	—	$21,548.95	$41,153.94	$21,855.85	2026-05-17
0894	OTHER	Major Cranial Or Facial Bone Procedures	6	6	—	—	$31,028.96	$55,189.95	$31,028.96	2026-05-17
0913	OTHER	Other Major Head And Neck Procedures	16	15	—	—	$22,278.73	$42,956.33	$22,757.04	2026-05-17
0914	OTHER	Other Major Head And Neck Procedures	6	6	—	—	$34,904.62	$64,289.17	$34,904.62	2026-05-17
0924	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	6	6	—	—	$27,612.88	$52,610.13	$27,612.88	2026-05-17
0954	OTHER	Cleft Lip And Palate Repair	16	15	—	—	$12,112.69	$34,335.69	$18,446.72	2026-05-17
0984	OTHER	Other Ear, Nose, Mouth, Throat, Craniofacial, And Neck Procedures	16	15	—	—	$18,742.38	$39,847.60	$21,202.68	2026-05-17
1203	OTHER	Major Respiratory And Chest Procedures	16	15	—	—	$17,363.25	$35,866.95	$19,212.35	2026-05-17
1204	OTHER	Suture Nylon Ethilon 4-0 18in 3/8 Circ Fs-2 Revers Cut Pliabilized Black 1 Stran…	6	6	$4.78	$4.78	$30,287.54	$56,859.86	$30,287.54	2026-05-17
1214	OTHER	Other Respiratory And Chest Procedures	16	15	—	—	$24,763.98	$47,661.02	$25,109.39	2026-05-17
1301	OTHER	Guidewire Ortho 1.1mm 150mm Non-threaded Single-end Spade Point Ss F/3mm Cannul …	9	8	$76.43	$76.43	$15,672.80	$28,787.84	$18,123.36	2026-05-17
1302	OTHER	Guidewire Ortho 3.2mm 400mm Thread Ti F/femoral Tibial Nail Ns	9	8	$248.98	$248.98	$18,127.24	$34,749.57	$18,653.67	2026-05-17
1303	OTHER	Wire Bone Fixat 1.6x150mm Kirschner Temp Trocar Point Ss Ns F/hand Surg	9	8	$22.98	$22.98	$22,189.49	$42,390.45	$22,474.10	2026-05-17
1304	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	6	6	—	—	$28,742.64	$56,191.28	$28,742.64	2026-05-17
1601	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	16	15	—	—	$16,133.32	$34,162.13	$18,359.94	2026-05-17
1602	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	16	15	—	—	$19,871.78	$48,307.00	$25,432.38	2026-05-17
1603	OTHER	Guidewire Ortho 1.25mm 150mm Thread Single-end Trocar Point Cobalt Ss F/3.5/4mm …	6	6	$81.88	$81.88	$30,661.07	$64,478.14	$30,661.07	2026-05-17
1604	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	6	6	—	—	$57,117.74	$139,112.29	$57,117.74	2026-05-17
1611	OTHER	Implantable Heart Assist Systems	6	6	—	—	$78,879.03	$139,620.65	$78,879.03	2026-05-17
1612	OTHER	Implantable Heart Assist Systems	6	6	—	—	$83,030.88	$139,620.65	$83,030.88	2026-05-17
1613	OTHER	Implantable Heart Assist Systems	6	6	—	—	$103,411.98	$189,752.63	$103,411.98	2026-05-17
1614	OTHER	Implantable Heart Assist Systems	6	6	—	—	$134,984.47	$242,334.00	$134,984.47	2026-05-17
1621	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	16	15	—	—	$22,819.18	$43,080.60	$22,819.18	2026-05-17
1622	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	6	6	—	—	$29,221.63	$51,701.23	$29,221.63	2026-05-17
1623	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	6	6	—	—	$36,870.67	$68,386.90	$36,870.67	2026-05-17
1624	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	6	6	—	—	$53,832.53	$93,488.84	$53,832.53	2026-05-17
1631	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	16	15	—	—	$19,467.05	$36,376.34	$19,467.05	2026-05-17
1632	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	16	15	—	—	$22,981.44	$43,405.13	$22,981.44	2026-05-17
1633	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	6	6	—	—	$30,495.65	$58,811.16	$30,495.65	2026-05-17
1634	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	6	6	—	—	$45,808.19	$81,806.71	$45,808.19	2026-05-17
1651	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	16	15	—	—	$21,009.09	$39,460.42	$21,009.09	2026-05-17
1652	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	16	15	—	—	$23,297.24	$44,036.73	$23,297.24	2026-05-17
1653	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	6	6	—	—	$30,939.01	$54,615.86	$30,939.01	2026-05-17
1654	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	6	6	—	—	$41,890.55	$73,495.20	$41,890.55	2026-05-17
1661	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	16	15	—	—	$17,850.04	$33,142.32	$17,850.04	2026-05-17
1662	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	16	15	—	—	$20,524.35	$38,490.93	$20,524.35	2026-05-17
1663	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	16	15	—	—	$25,313.25	$48,068.74	$25,313.25	2026-05-17
1664	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	6	6	—	—	$37,760.58	$65,520.55	$37,760.58	2026-05-17
1672	OTHER	Suture Pds Plus 6-0 Tf Taper Point Monofilament Violet 27in	9	8	$8.35	$8.35	$16,999.60	$33,526.42	$18,042.09	2026-05-17
1673	OTHER	Expander Tissue Softspan 3.6x4.1cm 3.6-4cm Lo-pro 30-60ml Silicone Smooth Lg Rem…	10	9	$1,750.00	$1,750.00	$24,133.22	$45,708.69	$25,664.47	2026-05-17
1674	OTHER	Expander Tissue Softspan 13.7x10.5cm 4-7cm Lo-pro 200-400ml Silicone Smooth Remo…	6	6	$1,625.00	$1,625.00	$41,204.87	$72,011.19	$41,204.87	2026-05-17
1693	OTHER	Suture Polysorb 4-0 30in 1/2 Circ Cv-22 Taper Point Undyed Gl-884 Coat Braid Lac…	9	8	$31.85	$31.85	$21,695.64	$40,833.52	$21,724.61	2026-05-17
1694	OTHER	Major Abdominal Vascular Procedures	6	6	—	—	$35,342.70	$58,415.76	$35,342.70	2026-05-17
1704	OTHER	Guidewire Ortho 2.8mm 450mm Thread Trocar Tip Cobalt Ss F/6.5/7.3mm Cannul Screw…	9	8	$215.63	$215.63	$24,921.29	$48,182.73	$25,370.24	2026-05-17
1714	OTHER	Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock	16	15	—	—	$19,901.76	$39,182.10	$20,869.93	2026-05-17
1744	OTHER	Rod Extern Fixat 4x100mm Connecting Carbon Fiber Dist Radial F/small Fixator Sys…	9	8	$115.50	$115.50	$20,988.03	$39,418.31	$21,101.00	2026-05-17
1754	OTHER	Percutaneous Cardiac Intervention Without Ami	16	15	—	—	$23,316.07	$44,348.94	$23,453.35	2026-05-17
1763	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	16	15	—	—	$17,332.56	$32,909.19	$17,733.47	2026-05-17
1764	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	16	15	—	—	$24,475.73	$46,393.70	$24,475.73	2026-05-17
1774	OTHER	Cardiac Pacemaker And Defibrillator Revision Except Device Replacement	16	15	—	—	$18,082.79	$37,121.94	$19,839.85	2026-05-17
1781	OTHER	External Heart Assist Devices	16	15	—	—	$24,277.01	$45,996.25	$24,277.01	2026-05-17
1782	OTHER	External Heart Assist Devices	16	15	—	—	$26,832.69	$51,107.63	$26,832.69	2026-05-17
1783	OTHER	External Heart Assist Devices	6	6	—	—	$33,662.70	$62,769.21	$33,662.70	2026-05-17
1784	OTHER	External Heart Assist Devices	6	6	—	—	$45,502.39	$77,791.14	$45,502.39	2026-05-17
1791	OTHER	Defibrillator Implants	16	15	—	—	$18,487.29	$34,416.82	$18,487.29	2026-05-17
1792	OTHER	Defibrillator Implants	16	15	—	—	$21,636.59	$40,715.42	$21,636.59	2026-05-17
1793	OTHER	Defibrillator Implants	16	15	—	—	$25,901.72	$49,245.68	$25,901.72	2026-05-17
1794	OTHER	Defibrillator Implants	6	6	—	—	$37,072.07	$64,666.08	$37,072.07	2026-05-17
1804	OTHER	Other Circulatory System Procedures	16	15	—	—	$21,029.05	$39,524.10	$21,040.93	2026-05-17
1813	OTHER	Lower Extremity Vascular Procedures	16	15	—	—	$17,796.12	$33,034.48	$17,796.12	2026-05-17
1814	OTHER	Lower Extremity Vascular Procedures	16	15	—	—	$25,316.84	$48,075.92	$25,316.84	2026-05-17
1824	OTHER	Other Peripheral Vascular And Related Procedures	16	15	—	—	$22,075.63	$41,593.50	$22,075.63	2026-05-17
1831	OTHER	Percutaneous Structural Cardiac Procedures	16	15	—	—	$20,053.98	$37,550.20	$20,053.98	2026-05-17
1832	OTHER	Percutaneous Structural Cardiac Procedures	16	15	—	—	$21,669.45	$40,781.14	$21,669.45	2026-05-17
1833	OTHER	Percutaneous Structural Cardiac Procedures	16	15	—	—	$26,716.65	$50,875.53	$26,716.65	2026-05-17
1834	OTHER	Drain Wound Blake Jackson-pratt 19fr 10mmx20cm Round 4-channel Flute Hubless W/1…	6	6	$260.53	$260.53	$38,829.31	$70,013.67	$38,829.31	2026-05-17
1924	OTHER	Cardiac Catheterization For Other Non-coronary Conditions	16	15	—	—	$15,291.03	$33,017.02	$17,787.39	2026-05-17
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	8	8	—	—	$42,695.55	$126,440.00	$63,833.23	2026-05-17
2203	OTHER	Major Stomach, Esophageal And Duodenal Procedures	16	15	—	—	$17,490.93	$33,361.07	$17,959.42	2026-05-17
2204	OTHER	Guidewire Ortho 1.25mm 150mm Non-threaded Cobalt Ss Ns	6	6	$76.43	$76.43	$31,239.88	$56,005.39	$31,239.88	2026-05-17
2224	OTHER	Other Stomach, Esophageal And Duodenal Procedures	16	15	—	—	$22,047.90	$41,538.04	$22,047.90	2026-05-17
2234	OTHER	Other Small And Large Bowel Procedures	16	15	—	—	$21,122.58	$39,687.39	$21,122.58	2026-05-17
2244	OTHER	Suture Silk Sofsilk 2-0 18in 3/8 Circ C-15 Revers Cut Black Ss-685g Wax Coat Bra…	9	8	$30.15	$30.15	$20,816.01	$39,074.27	$21,419.51	2026-05-17
2274	OTHER	Hernia Procedures Except Inguinal, Femoral And Umbilical	16	15	—	—	$21,183.68	$39,809.60	$21,183.68	2026-05-17
2284	OTHER	Inguinal, Femoral And Umbilical Hernia Procedures	16	15	—	—	$15,384.50	$32,988.27	$17,773.01	2026-05-17
2294	OTHER	Other Digestive System And Abdominal Procedures	16	15	—	—	$21,898.47	$41,239.19	$21,898.47	2026-05-17
2304	OTHER	Major Small Bowel Procedures	16	15	—	—	$24,966.63	$47,375.51	$24,966.63	2026-05-17
2314	OTHER	Major Large Bowel Procedures	16	15	—	—	$22,189.12	$41,820.47	$22,189.12	2026-05-17
2324	OTHER	Allograft Human Tissue Readigraft Cryoskin 1.5:1 Meshed 154sqcm Skin Cryopreserv…	10	9	$763.00	$763.00	$21,195.49	$39,833.22	$23,002.15	2026-05-17
2603	OTHER	Major Pancreas, Liver And Shunt Procedures	16	15	—	—	$17,246.50	$34,892.32	$18,725.04	2026-05-17
2604	OTHER	Major Pancreas, Liver And Shunt Procedures	6	6	—	—	$32,562.22	$58,978.56	$32,562.22	2026-05-17
2614	OTHER	Major Biliary Tract Procedures	6	6	—	—	$28,621.30	$54,839.75	$28,621.30	2026-05-17
2634	OTHER	Cholecystectomy	16	15	—	—	$18,040.82	$35,496.20	$19,026.98	2026-05-17
2644	OTHER	Kit Instrument Maxillofacial Splint Planning Pt Specific Proplan Trumatch F/orth…	9	8	$12,140.00	$12,140.00	$24,654.94	$46,752.12	$25,422.86	2026-05-17
2991	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	11	10	—	—	$20,451.43	$38,345.10	$20,451.43	2026-05-17
2992	OTHER	Kit Distraction Patient Specific Instrument And Planning Sd900.006	4	3	$11,455.00	$11,455.00	$24,328.35	$46,098.95	$24,328.35	2026-05-17
2993	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	1	1	—	—	$62,678.84	$62,678.84	$62,678.84	2026-05-17
2994	OTHER	Guidepin Ortho 2.4mm 9in Partial Thread Trocar Tip F/cannulated Screw System	1	1	$44.43	$44.43	$80,156.32	$80,156.32	$80,156.32	2026-05-17
3003	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	11	10	—	—	$22,656.91	$42,756.06	$22,656.91	2026-05-17
3004	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	1	1	—	—	$61,150.66	$61,150.66	$61,150.66	2026-05-17
3031	OTHER	Suture Deknatel Tevdek 4-0 30in 1/2 Circ T-3 Dbl-arm Taper Needle Point Green 7-…	9	8	$8.73	$8.73	$21,631.97	$40,706.17	$23,571.79	2026-05-17
3032	OTHER	Suture Ethibond Excel 3-0 18in 1/2 Circ Sh Ctrl Release Taper Point Green 8 Stra…	9	8	$28.28	$28.28	$24,758.67	$46,959.57	$28,311.97	2026-05-17
3033	OTHER	Suture Ethibond Excel 4-0 Sh Taper Point Braided Green 26in	6	6	$30.73	$30.73	$38,967.93	$64,567.49	$38,967.93	2026-05-17
3034	OTHER	Suture Chromic Gut 3-0 27in 1/2 Circ CT-2 Taper Point Natural Brown Undyed 1 Str…	6	6	$7.60	$7.60	$51,465.44	$93,036.96	$51,465.44	2026-05-17
3042	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	16	15	—	—	$18,653.67	$34,749.57	$18,653.67	2026-05-17
3043	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	16	15	—	—	$25,464.22	$48,370.67	$25,464.22	2026-05-17
3044	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	6	6	—	—	$39,502.30	$65,614.00	$39,502.30	2026-05-17
3054	OTHER	Amputation Of Lower Limb Except Toes	16	15	—	—	$20,876.61	$39,195.46	$20,876.61	2026-05-17
3094	OTHER	Other Significant Hip And Femur Surgery	16	15	—	—	$21,586.78	$40,615.80	$21,586.78	2026-05-17
3104	OTHER	Vertebral And Intervertebral Spinal Procedures Including Disc Procedures	16	15	—	—	$20,234.22	$37,910.68	$20,234.22	2026-05-17
3123	OTHER	Dressing Biological E-z Derm Roll 3x12in Porcine Xenograft Strl 4/ca	10	9	$222.95	$222.95	$17,301.88	$34,792.71	$18,675.24	2026-05-17
3124	OTHER	Dressing Biological E-z Derm Adherent 3x4in Patch Porcine Xenograft Strl 10/ca	6	6	$653.60	$653.60	$35,088.39	$56,660.62	$35,088.39	2026-05-17
3134	OTHER	Knee And Lower Leg Procedures Except Foot	16	15	—	—	$21,639.15	$40,720.55	$21,639.15	2026-05-17
3154	OTHER	Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement	16	15	—	—	$21,139.45	$39,996.52	$21,277.14	2026-05-17
3174	OTHER	Tendon, Muscle And Other Soft Tissue Procedures	16	15	—	—	$19,415.19	$36,272.61	$19,415.19	2026-05-17
3204	OTHER	Allograft Human Tissue 1:1 Meshed 103sqcm Cryopreserv Skin	10	9	$437.50	$437.50	$20,224.97	$37,892.19	$20,635.06	2026-05-17
3213	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	16	15	—	—	$16,580.57	$37,037.73	$19,797.74	2026-05-17
3214	OTHER	Drain Wound Hemovac 15frx3/16in Round 4-channel Full Flute F/closed Suction W/tr…	9	8	$32.70	$32.70	$25,922.66	$49,427.46	$25,992.61	2026-05-17
3224	OTHER	Allograft Human Tissue Frz-dry Rt Patellar Ligament	10	9	$1,312.50	$1,312.50	$18,595.64	$34,633.52	$19,647.10	2026-05-17
3234	OTHER	Non-elective Or Complex Hip Joint Replacement	16	15	—	—	$19,588.24	$36,618.71	$19,588.24	2026-05-17
3244	OTHER	Elective Hip Joint Replacement	16	15	—	—	$18,792.31	$35,026.86	$18,792.31	2026-05-17
3254	OTHER	Non-elective Or Complex Knee Joint Replacement	16	15	—	—	$21,249.41	$39,941.06	$21,249.41	2026-05-17
3264	OTHER	Elective Knee Joint Replacement	16	15	—	—	$16,712.48	$33,265.56	$17,911.66	2026-05-17
3614	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	6	6	—	—	$29,715.43	$55,128.33	$29,715.43	2026-05-17
3624	OTHER	Expander Tissue Softspan 10.8cm 5-6.4cm Lo-pro 320-380ml Silicone Smooth Remote …	10	9	$1,662.50	$1,662.50	$17,067.47	$31,577.17	$21,823.72	2026-05-17
4014	OTHER	Adrenal Procedures	6	6	—	—	$27,422.06	$52,179.82	$27,422.06	2026-05-17
4034	OTHER	Procedures For Obesity	16	15	—	—	$21,710.15	$46,154.41	$24,356.08	2026-05-17
4044	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures	16	15	—	—	$24,420.78	$46,283.81	$24,420.78	2026-05-17
4054	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	16	15	—	—	$24,700.64	$46,843.52	$24,700.64	2026-05-17
4284	OTHER	Catheter Foley 2 Way Standard Tip Sterile Cysto-care 18fr 15ml	1	1	$7.85	$7.85	$55,061.58	$55,061.58	$55,061.58	2026-05-17
4401	OTHER	Screw Bone Lcp 3.5/6x14mm Compress Lck Full Thread Self-tap Lo-pro Cortic Ss 2.5…	10	9	$82.55	$82.55	$24,698.37	$49,636.96	$26,097.36	2026-05-17
4402	OTHER	Screw Bone Lcp 3.5/6x16mm Compress Lck Full Thread Self-tap Lo-pro Cortic Ss 2.5…	6	6	$82.55	$82.55	$27,660.15	$53,040.44	$27,660.15	2026-05-17
4403	OTHER	Screw Bone Lcp 3.5/6x18mm Compress Lck Full Thread Self-tap Lo-pro Cortic Ss 2.5…	6	6	$82.55	$82.55	$32,250.42	$62,239.28	$32,250.42	2026-05-17
4404	OTHER	Screw Bone Lcp 3.5/6x20mm Compress Lck Full Thread Self-tap Lo-pro Cortic Ss 2.5…	6	6	$82.55	$82.55	$48,926.92	$91,543.70	$48,926.92	2026-05-17
4413	OTHER	Screw Spinal Expedium 6x35mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…	10	9	$2,000.00	$2,000.00	$16,737.17	$35,334.96	$18,946.36	2026-05-17
4414	OTHER	Screw Spinal Expedium 6x40mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…	6	6	$1,976.25	$1,976.25	$32,975.61	$51,462.97	$32,975.61	2026-05-17
4424	OTHER	Screw Spinal Expedium 6x45mm Lck Fully/dual Lead Thread Self-tap Uniplanar Pedic…	10	9	$1,750.00	$1,750.00	$23,173.49	$43,789.23	$23,255.05	2026-05-17
4434	OTHER	Screw Spinal Expedium 5x30mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…	10	9	$1,750.00	$1,750.00	$18,897.57	$37,368.42	$19,963.09	2026-05-17
4444	OTHER	Screw Spinal Expedium 6x30mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…	10	9	$1,750.00	$1,750.00	$19,583.26	$41,135.46	$21,846.61	2026-05-17
4474	OTHER	Screw Bone Eight-plate 4.5x32mm Cannul Solid Cortic Ti Blue F/guided Growth Syst…	10	9	$329.00	$329.00	$23,242.30	$43,926.84	$24,353.41	2026-05-17
4484	OTHER	Other Kidney, Urinary Tract And Related Percutaneous Procedures	11	10	—	—	$23,057.96	$43,558.15	$23,057.96	2026-05-17
456	OTHER	Spinal Fus Exc Cerv With Spinal Curv/malig/infec Or Ext Fus With Comorbity	8	8	—	—	$38,109.60	$110,956.00	$55,867.04	2026-05-17
457	OTHER	Spinal Fus Exc Cerv With Spinal Curv/malig/infec Or Ext Fus With Complication	8	8	—	—	$27,444.60	$75,192.00	$39,193.42	2026-05-17
458	OTHER	Spinal Fus Exc Cerv With Spinal Curv/malig/infec Or Ext Fus Without Complication…	8	8	—	—	$20,476.80	$56,571.00	$32,672.65	2026-05-17
480	OTHER	Hip & Femur Procedures Except Major Joint With Comorbity	19	17	—	—	$14,397.75	$38,533.00	$20,545.38	2026-05-17
4834	OTHER	Penis, Testes And Scrotal Procedures	16	15	—	—	$19,001.98	$40,948.54	$21,753.15	2026-05-17
4844	OTHER	Other Male Reproductive System And Related Procedures	16	15	—	—	$21,120.75	$45,107.89	$23,832.83	2026-05-17
4854	OTHER	Prostatectomy Procedures	11	10	—	—	$23,780.45	$45,003.14	$23,780.45	2026-05-17
5114	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	16	15	—	—	$25,266.95	$49,799.23	$26,178.49	2026-05-17
5124	OTHER	Tray Needle Epidural Tuohy Contin Anesth Perifix 18ga 2in Ped Wing W/25ga Ndl 20…	9	8	$71.80	$71.80	$22,436.39	$47,641.50	$25,099.63	2026-05-17
5134	OTHER	Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma	16	15	—	—	$16,867.68	$40,177.27	$21,367.51	2026-05-17
5144	OTHER	Female Reproductive System Reconstructive Procedures	16	15	—	—	$21,538.02	$42,118.30	$22,338.03	2026-05-17
518	OTHER	Back & Neck Proc Exc Spinal Fusion With Comorbity Or Disc Device/neurostim	19	17	—	—	$16,495.20	$46,955.00	$24,756.38	2026-05-17
5184	OTHER	Other Female Reproductive System And Related Procedures	16	15	—	—	$20,665.39	$41,172.43	$21,865.10	2026-05-17
5194	OTHER	Uterine And Adnexa Procedures For Leiomyoma	16	15	—	—	$20,194.16	$40,323.10	$21,440.43	2026-05-17
5204	OTHER	Other GYN Procedures For Malignancy	1	1	—	—	$51,987.77	$51,987.77	$51,987.77	2026-05-17
5484	OTHER	Postpartum And Post Abortion Diagnosis With O.r. Procedure	16	15	—	—	$18,153.01	$33,748.25	$18,153.01	2026-05-17
5831	OTHER	Washer Ortho 13mm Round Thread Spike Ss F/6.5/7/7.3mm Lg Cannul Screw Ns	6	6	$85.70	$85.70	$86,868.09	$222,772.73	$86,868.09	2026-05-17
5832	OTHER	Plate Bone Lc-dcp 16x103mm 6-hole 4.8mm Broad Dynamic Compress Lck Ss Limit-cont…	6	6	$690.00	$690.00	$100,520.75	$248,180.71	$100,520.75	2026-05-17
5833	OTHER	Plate Bone Dcp 10x73mm 6-hole 3.3mm Sm Dynamic Compress Lck Cortic Ss Pelvic F/3…	6	6	$1,001.00	$1,001.00	$136,317.04	$323,229.76	$136,317.04	2026-05-17
5834	OTHER	Screw Extern Fixat 6mm Lg 190mm Schanz 50mm Thread Self-tap Blunt Trocar Spade P…	6	6	$267.58	$267.58	$172,113.33	$567,534.58	$172,113.33	2026-05-17
5881	OTHER	Screw Bone Lcp 3.5/6x18mm Compress Lck Full Thread Self-tap Lo-pro Cortic Ti 2.5…	6	6	$71.25	$71.25	$58,623.14	$170,035.26	$58,623.14	2026-05-17
5882	OTHER	Screw Bone Lcp Tomofix 5x34mm Compress Lck Headed Full Thread Self-tap Ti-6al-7n…	6	6	$589.88	$589.88	$89,060.94	$198,374.29	$89,060.94	2026-05-17
5883	OTHER	Screw Bone Lcp Tomofix 5x38mm Compress Lck Headed Full Thread Self-tap Ti-6al-7n…	6	6	$737.50	$737.50	$90,953.27	$231,504.29	$90,953.27	2026-05-17
5884	OTHER	Screw Bone Lcp Tomofix 5x46mm Compress Lck Headed Full Thread Self-tap Ti-6al-7n…	6	6	$589.88	$589.88	$141,179.61	$347,604.58	$141,179.61	2026-05-17
5891	OTHER	Screw Bone Lcp 4.5/8x40mm Compress Lck Full Thread Self-drilling/tapping Cortic …	6	6	$73.88	$73.88	$27,583.25	$162,031.84	$27,583.25	2026-05-17
5892	OTHER	Screw Bone Lcp 4.5/8x44mm Compress Lck Full Thread Self-drilling/tapping Cortic …	6	6	$69.88	$69.88	$22,898.45	$162,031.84	$22,898.45	2026-05-17
5893	OTHER	Screw Bone Lcp 4.5/8x48mm Compress Lck Full Thread Self-drilling/tapping Cortic …	6	6	$73.88	$73.88	$18,213.65	$162,031.84	$18,213.65	2026-05-17
5912	OTHER	Screw Bone 4x46mm Cannul 15mm Short Thread Ss Prox Humeral Revers Cut Flute Ns P…	6	6	$465.30	$465.30	$27,718.70	$147,447.42	$27,718.70	2026-05-17
5913	OTHER	Plate Bone Lcp 73mm 3-hole 100deg Pre-contoured Compress Lck Ss Hip F/3.5mm Scre…	6	6	$1,704.73	$1,704.73	$52,090.45	$171,907.48	$52,090.45	2026-05-17
5914	OTHER	Plate Bone Lcp 73mm 3-hole 110deg Pre-contoured Compress Lck Ss Hip F/3.5mm Scre…	6	6	$1,704.73	$1,704.73	$88,914.56	$227,941.62	$88,914.56	2026-05-17
5932	OTHER	Guidepin Ortho 2.4mm Breakaway Femur Tibial F/osteotomy Disp	6	6	$92.50	$92.50	$46,930.19	$117,916.03	$46,930.19	2026-05-17
5933	OTHER	Screw Interference Cannul 7x25mm Ti Alloy Round Head W/2mm Nitinol Gw Disp Sheat…	6	6	$287.50	$287.50	$59,210.77	$146,602.20	$59,210.77	2026-05-17
5934	OTHER	Screw Interference Cannul 8x20mm Ti Round Head Without Sheath F/graft Fixat Strl Acl…	6	6	$237.50	$237.50	$92,075.98	$200,404.67	$92,075.98	2026-05-17
6022	OTHER	Screw Bone Lcp 7.3/8.2x80mm Cannul Compress Lck 32mm Thread Self-drilling/tappin…	6	6	$619.93	$619.93	$39,710.40	$83,759.04	$39,710.40	2026-05-17
6023	OTHER	Screw Bone Lcp 7.3/8.2x85mm Cannul Compress Lck 32mm Thread Self-drilling/tappin…	6	6	$800.75	$800.75	$52,042.84	$104,821.78	$52,042.84	2026-05-17
6024	OTHER	Screw Bone Lcp 5/4.4x55mm Compress Lck Full Thread Self-tap Ss T25 Stardrive Rec…	6	6	$393.68	$393.68	$66,000.24	$150,972.08	$66,000.24	2026-05-17
6032	OTHER	Nail IM Fassier-duval 4mm Std 333mm Short Thread Tibial Humeral Ss F/osteogenesi…	10	9	$6,500.00	$6,500.00	$17,770.64	$51,018.28	$23,965.05	2026-05-17
6033	OTHER	Nail IM Fassier-duval 4.8mm Std 409mm Long Thread Femur Ss F/osteogenesis Imperf…	6	6	$6,875.00	$6,875.00	$36,017.45	$62,527.87	$36,017.45	2026-05-17
6034	OTHER	Nail IM Fassier-duval 4.8mm Std 404mm Short Thread Tibial Humeral Ss F/osteogene…	6	6	$6,500.00	$6,500.00	$74,013.64	$110,422.01	$74,013.64	2026-05-17
6071	OTHER	Screw Bone Expert 4/3.3x58mm Cannul Compress Lck Fully/dual Lead Thread Self-tap…	10	9	$490.28	$490.28	$12,640.00	$42,721.15	$18,838.69	2026-05-17
6072	OTHER	Nail IM Expert 9x360mm 120deg Helical Flute Cannul Lck Antegrad Reconstruct Rt L…	6	6	$4,359.18	$4,359.18	$30,537.27	$59,761.13	$30,537.27	2026-05-17
6073	OTHER	Hook Spinal Veptr Ii Std Extend Vert Expand Ti Prox Thoracolum Rib Ns	6	6	$3,747.48	$3,747.48	$39,437.05	$80,012.54	$39,437.05	2026-05-17
6074	OTHER	Screw Bone Expert 4/3.3x36mm Cannul Compress Lck Fully/dual Lead Thread Self-tap…	6	6	$490.28	$490.28	$50,694.04	$116,702.12	$50,694.04	2026-05-17
6082	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	16	15	—	—	$21,126.17	$39,694.58	$21,126.17	2026-05-17
6083	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	6	6	—	—	$30,568.66	$57,457.57	$30,568.66	2026-05-17
6084	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	6	6	—	—	$32,097.34	$66,562.95	$32,097.34	2026-05-17
6091	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	16	15	—	—	$19,861.20	$44,033.65	$23,295.71	2026-05-17
6092	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	6	6	—	—	$20,906.65	$54,818.18	$20,906.65	2026-05-17
6093	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	6	6	—	—	$44,014.97	$84,011.68	$44,014.97	2026-05-17
6094	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	6	6	—	—	$88,347.39	$242,185.09	$88,347.39	2026-05-17
6113	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	6	6	—	—	$25,091.65	$51,763.88	$25,091.65	2026-05-17
6114	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	6	6	—	—	$38,523.51	$97,061.77	$38,523.51	2026-05-17
6122	OTHER	Wire Bone Fixat 0.7mmx4in Kirschner Temp Dbl-end Diamond Point Ss Ns	9	8	$7.38	$7.38	$19,818.28	$37,078.81	$20,062.60	2026-05-17
6123	OTHER	Wire Bone Fixat 0.9mmx4in Kirschner Temp Dbl-end Diamond Point Ss Ns	6	6	$7.38	$7.38	$25,907.49	$52,948.01	$25,907.49	2026-05-17
6124	OTHER	Wire Bone Fixat 1.4mmx4in Kirschner Temp Dbl-end Diamond Point Ss Ns	6	6	$7.38	$7.38	$36,838.22	$76,459.12	$36,838.22	2026-05-17
6133	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	6	6	—	—	$23,568.26	$51,968.25	$23,568.26	2026-05-17
6134	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	6	6	—	—	$36,142.66	$96,170.33	$36,142.66	2026-05-17
6143	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	16	15	—	—	$22,281.55	$43,338.37	$22,948.06	2026-05-17
6144	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	6	6	—	—	$29,044.92	$64,167.99	$29,044.92	2026-05-17
6213	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	16	15	—	—	$17,740.30	$37,736.09	$20,146.92	2026-05-17
6214	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	6	6	—	—	$30,222.29	$74,982.30	$30,222.29	2026-05-17
6223	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	16	15	—	—	$13,892.50	$33,253.23	$17,905.49	2026-05-17
6224	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	16	15	—	—	$23,854.32	$49,582.53	$26,070.15	2026-05-17
6233	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	16	15	—	—	$18,053.17	$40,285.10	$21,421.43	2026-05-17
6234	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	6	6	—	—	$21,892.50	$53,563.18	$21,892.50	2026-05-17
6254	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	6	6	—	—	$20,168.06	$66,465.39	$20,168.06	2026-05-17
6302	OTHER	Screw Bone Lcp 4/5x18mm Cannul Compress Lck 1/2 Long Thread Self-drilling/tappin…	6	6	$597.50	$597.50	$31,414.12	$53,070.23	$31,414.12	2026-05-17
6303	OTHER	Screw Bone Lcp 4/5x20mm Cannul Compress Lck 1/2 Long Thread Self-drilling/tappin…	6	6	$597.50	$597.50	$49,512.79	$116,446.40	$49,512.79	2026-05-17
6304	OTHER	Screw Bone Lcp 4/5x24mm Cannul Compress Lck 1/2 Long Thread Self-drilling/tappin…	6	6	$597.50	$597.50	$102,473.40	$211,250.82	$102,473.40	2026-05-17
6312	OTHER	Screw Bone Lcp 7.3/8.2x100mm Cannul Compress Lck 16mm Thread Self-drilling/tappi…	10	9	$797.50	$797.50	$19,976.18	$39,436.80	$20,997.28	2026-05-17
6313	OTHER	Screw Bone Lcp 7.3/8.2x55mm Cannul Compress Lck 32mm Thread Self-drilling/tappin…	6	6	$687.83	$687.83	$32,572.10	$68,463.93	$32,572.10	2026-05-17
6314	OTHER	Screw Bone Lcp 7.3/8.2x90mm Cannul Compress Lck 32mm Thread Self-drilling/tappin…	6	6	$800.75	$800.75	$84,817.39	$232,937.98	$84,817.39	2026-05-17
6334	OTHER	Screw Bone Lcp 3.5/6x20mm Compress Lck Self-tap Var Ang Lo-pro Cortic Ss T15 Sta…	6	6	$93.73	$93.73	$27,468.97	$76,258.86	$27,468.97	2026-05-17
6344	OTHER	Endcap Spinal Veptr Ii Sm Hook Extend Ti Thoracolum Rib Ns	10	9	$3,507.75	$3,507.75	$21,053.03	$46,256.08	$24,406.92	2026-05-17
6504	OTHER	Rod Extern Fixat Ilizarov 80mm Thread Slot Ss Foot Ankle F/small Bone System Ns	9	8	$719.00	$719.00	$22,971.17	$43,384.59	$24,728.71	2026-05-17
6514	OTHER	Other Procedures Of Blood And Blood-forming Organs	16	15	—	—	$25,648.56	$48,739.37	$25,648.56	2026-05-17
6803	OTHER	Screw Bone Lcp 2.7/5x22mm Compress Lck Full Thread Self-tap Cortic Ss 2.5mm Sm H…	10	9	$137.00	$137.00	$19,270.75	$36,958.65	$19,758.21	2026-05-17
6804	OTHER	Screw Bone Lcp 2.7/5x24mm Compress Lck Full Thread Self-tap Cortic Ss 2.5mm Sm H…	6	6	$133.00	$133.00	$36,918.29	$67,852.86	$36,918.29	2026-05-17
6814	OTHER	Screw Bone Lcp 3.5/6x50mm Compress Lck Full Thread Self-tap Lo-pro Cortic Ss 2.5…	6	6	$82.55	$82.55	$31,480.79	$56,767.42	$31,480.79	2026-05-17
6903	OTHER	Acute Leukemia	16	15	—	—	$17,307.17	$40,971.14	$21,764.45	2026-05-17
6904	OTHER	Acute Leukemia	6	6	—	—	$30,133.76	$60,651.54	$30,133.76	2026-05-17
6914	OTHER	Lymphoma, Myeloma And Non-acute Leukemia	16	15	—	—	$17,707.85	$38,187.97	$20,372.87	2026-05-17
6924	OTHER	Nail IM Fassier-duval 4mm Std 333mm Short Thread Femur Ss F/osteogenesis Imperfe…	10	9	$6,187.50	$6,187.50	$18,033.36	$33,508.96	$18,804.45	2026-05-17
6954	OTHER	Screw Bone Pro-pak 4.5x36mm Cannul Compress Headless 14mm Long/dual Lead Thread	6	6	$962.15	$962.15	$28,360.29	$55,822.58	$28,360.29	2026-05-17
7104	OTHER	Screw Spinal Expedium 4.35x25mm Lck Dual Lead Polyaxial Thread 1-innie Pedicle S…	10	9	$1,750.00	$1,750.00	$24,570.72	$46,583.69	$25,341.38	2026-05-17
7114	OTHER	Screw Spinal Expedium 4.35x35mm Lck Polyaxial Thread Dual Lead Pedicle Ti Taper …	10	9	$1,750.00	$1,750.00	$23,904.76	$45,417.02	$23,987.39	2026-05-17
7404	OTHER	Hook Spinal Cd Horizon Solera Lg Narrow Blade Ti Medial F/5.5mm Rod Ns	6	6	$1,450.00	$1,450.00	$32,144.95	$57,479.14	$32,144.95	2026-05-17
7524	OTHER	Plate Bone Lcp 17.5x170mm 9-hole 5.2mm Broad Curve Pre-contoured Compress Lck Ss…	10	9	$1,643.88	$1,643.88	$15,184.46	$27,811.16	$21,079.49	2026-05-17
7594	OTHER	Plate Bone Lcp 79mm 3-hole 130deg Pre-contoured Compress Lck Ss Hip F/5mm Screw …	10	9	$2,493.40	$2,493.40	$19,172.05	$35,786.34	$30,079.79	2026-05-17
7924	OTHER	Kit Catheter Intrathecal Ascenda Indura 4-layer Sutureless Pump Conn 2-attached …	9	8	$500.00	$500.00	$25,902.74	$49,247.73	$27,478.85	2026-05-17
7934	OTHER	Screw Bone Lcp 2.7/5x28mm Compress Lck Full Thread Self-tap Cortic Ss T8 Stardri…	10	9	$105.63	$105.63	$20,711.78	$38,865.79	$21,637.13	2026-05-17
7944	OTHER	Non-extensive O.r. Procedures For Other Complications Of Treatment	16	15	—	—	$16,134.03	$37,742.25	$20,150.01	2026-05-17
8412	OTHER	Screw Spinal Expedium 6x55mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…	10	9	$2,000.00	$2,000.00	$10,227.06	$45,933.60	$18,206.48	2026-05-17
8413	OTHER	Screw Spinal Expedium 7x35mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…	6	6	$2,000.00	$2,000.00	$34,934.25	$70,104.05	$34,934.25	2026-05-17
8414	OTHER	Screw Spinal Expedium 7x40mm Lck Fully/dual Lead Thread Polyaxial Self-tap 1-inn…	6	6	$2,000.00	$2,000.00	$95,191.53	$215,562.17	$95,191.53	2026-05-17
8423	OTHER	Hook Spinal Expedium 10mm Lt Offst Ss Pedicle F/5.5mm Rod Ns	10	9	$1,375.00	$1,375.00	$19,839.33	$48,747.58	$24,627.76	2026-05-17
8424	OTHER	Connector Spinal Expedium Open Dual Side/side Ss F/5.5mm Rod Ns	6	6	$1,725.00	$1,725.00	$48,107.21	$120,683.80	$48,107.21	2026-05-17
8503	OTHER	Screw Spinal Expedium 6x75mm Lck Dual Lead Polyaxial Thread 1-innie Pedicle Ss T…	10	9	$1,750.00	$1,750.00	$15,780.25	$35,684.14	$18,947.57	2026-05-17
8504	OTHER	Screw Spinal Expedium 6x80mm Lck Dual Lead Polyaxial Thread 1-innie Pedicle Ss T…	6	6	$1,750.00	$1,750.00	$33,525.85	$63,301.20	$33,525.85	2026-05-17
8512	OTHER	Screw Spinal Expedium 4.35x45mm Polyaxial Pedicle Ss Thoracolum Extend Tab F/6.3…	5	4	$2,000.00	$2,000.00	$18,495.51	$34,433.26	$18,495.51	2026-05-17
8513	OTHER	Screw Spinal Expedium 5x25mm Polyaxial Pedicle Ss Thoracolum Extend Tab F/6.35mm…	1	1	$2,000.00	$2,000.00	$111,361.72	$111,361.72	$111,361.72	2026-05-17
8514	OTHER	Screw Spinal Expedium 5x45mm Polyaxial Pedicle Ss Thoracolum Extend Tab F/6.35mm…	1	1	$1,976.25	$1,976.25	$111,361.72	$111,361.72	$111,361.72	2026-05-17
8633	OTHER	Screw Bone Pediloc 3.5x65mm Cannul Lck Full Thread Self-tap Cortic Ss T15 Hexalo…	10	9	$813.45	$813.45	$24,232.43	$48,562.72	$25,560.24	2026-05-17
8634	OTHER	Wedge Bone Graft 22x22x6mm Allograft Evans Frz-dry Cort/canc Pre-shaped F/osteot…	6	6	$2,697.90	$2,697.90	$37,766.93	$94,930.74	$37,766.93	2026-05-17
9102	OTHER	Plate Bone Lorenz Med 15mm 2/2-hole L-shaped Ti Silver F/1.5mm Screw Rt Midface	10	9	$740.00	$740.00	$14,973.92	$27,390.09	$19,743.04	2026-05-17
9103	OTHER	Plate Bone Lorenz Long 2/2-hole 1mm L-shaped Ti Silver F/2mm Screw Lt Maxillofac…	10	9	$547.50	$547.50	$22,227.23	$45,061.68	$23,809.72	2026-05-17
9104	OTHER	Plate Bone Lorenz Long 2/2-hole 1mm L-shaped Ti Silver F/2mm Screw Lt Cmf	6	6	$547.50	$547.50	$37,303.46	$69,807.24	$37,303.46	2026-05-17
9113	OTHER	Plate Bone Lorenz 6-hole Curve Ti Silver F/2mm Screw Orbital	10	9	$595.00	$595.00	$16,585.15	$38,422.12	$20,110.77	2026-05-17
9114	OTHER	Plate Bone Lorenz 8-hole 0.6mm Curve Ti Silver F/1.5mm Screw Orbital Ns	6	6	$745.00	$745.00	$35,242.17	$66,396.58	$35,242.17	2026-05-17
9123	OTHER	Plate Bone Lorenz Reg 32mm 8-hole Strt Ti Silver F/1.5mm Screw Midface Ns	10	9	$945.00	$945.00	$19,284.50	$39,158.48	$20,858.12	2026-05-17
9124	OTHER	Plate Bone Lorenz Reg 49mm 8-hole Ti Silver F/2mm Screw Cranfac	6	6	$1,207.50	$1,207.50	$34,240.81	$61,735.02	$34,240.81	2026-05-17
9503	OTHER	Connector Extern Fixat Long 50mm Extend Ilizarov Taylor Spatial Frame	9	8	$371.25	$371.25	$16,839.46	$32,940.00	$17,748.88	2026-05-17
9504	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	6	6	—	—	$30,723.15	$54,831.53	$30,723.15	2026-05-17
9514	OTHER	Hook Spinal Expedium Isola 8mm Close Wide Blade Ti Pedicle F/5.5mm Rod Ns	10	9	$1,450.00	$1,450.00	$22,775.53	$42,993.30	$22,834.96	2026-05-17
9524	OTHER	Hook Spinal Expedium Isola 8mm Open Wide Blade Ti Pedicle F/5.5mm Rod Ns	10	9	$1,450.00	$1,450.00	$19,632.64	$39,159.51	$20,858.63	2026-05-17

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