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 →

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Hospital

LEXINGTON REGIONAL HEALTH CENTER

Lexington, NE · CCN 281361 · Rates published

7,335 distinct procedures filed
7 distinct payers
63,623 rate rows
2025-12-28 last MRF observed
Data quality

58,577 of 63,623 rate rows are consumer-grade (92.1%)

5,046 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2,940
template filing: same amount across many unrelated codes — excluded 2,005
percent-of-charges filed in the dollar field — excluded from medians 56
per-diem day rate — not a per-procedure price 37
placeholder amount (≤ $0.02) — excluded from medians 8
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://lexington.pt.panaceainc.com/MRFDownload/lexington/lexington
Found on page https://lexingtonregional.org/financial-assistance/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-18
Content fingerprint b593d5ad4a6d9304… · 926,605 bytes · first seen 2026-05-08

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
12318036
CDM 		Wavewriter Alpha Prime 32 Ipg Kit (sc-1432) 7 $51,337.50 $102,675.00 $65,712.00 nat. median
$65,712
1.0× median
12318275
CDM 		Wavewriter Alpha 32 Ipg Kit (sc-1232) 7 $51,337.50 $102,675.00 $65,712.00 nat. median
$65,712
1.0× median
8343480
CDM 		Adaptivestim Pain (97715) 7 $28,687.50 $57,375.00 $36,720.00 nat. median
$36,720
1.0× median
8343479
CDM 		Restore Sensor #97714 7 $27,437.50 $54,875.00 $35,120.00 nat. median
$35,120
1.0× median
189
MS_DRG 		Pulmonary Edema And Respiratory Failure 1 $30,900.00 $30,900.00 $30,900.00 nat. median
$12,892
outlier · 2.4×
12596876
CDM 		Inbone Talar Dome Sz 2 Sulcus (220220902) 7 $22,654.34 $45,308.68 $28,997.56 nat. median
$28,998
1.0× median
139
MS_DRG 		Salivary Gland Procedures 1 $25,796.00 $25,796.00 $25,796.00 nat. median
$13,303
1.9× median
863
MS_DRG 		Postoperative And Post-traumatic Infections Without Mcc 1 $25,306.00 $25,306.00 $25,306.00 nat. median
$10,698
outlier · 2.4×
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 2 $23,282.00 $23,650.00 $23,466.00 nat. median
$9,038
outlier · 2.6×
12884115
CDM 		Infinity Adaptis Taldome Sz2 (33680022) 7 $17,285.98 $34,571.95 $22,126.05 nat. median
$22,126
1.0× median
787
MS_DRG 		Cesarean Section Without Sterilization With Cc 1 $22,004.00 $22,004.00 $22,004.00 nat. median
$11,354
1.9× median
13020326
CDM 		Attune Crs Femoral Rt Sz 3 (150440203) 7 $17,137.25 $34,274.50 $21,935.68 nat. median
$21,936
1.0× median
11545743
CDM 		Infinity Adaptis Taldome Sz1 (33680021) 7 $16,292.50 $32,585.00 $20,854.40 nat. median
$20,854
1.0× median
11545744
CDM 		Infinity Adaptis Tib Sz 2 (33680002) 7 $16,292.03 $32,584.05 $20,853.79 nat. median
$20,854
1.0× median
12090596
CDM 		Puraply 6 X 9 (515-018 Implant Surgery) 7 $16,031.25 $32,062.50 $20,520.00 nat. median
$20,520
1.0× median
784
MS_DRG 		Cesarean Section With Sterilization With Cc 1 $20,342.00 $20,342.00 $20,342.00 nat. median
$11,063
1.8× median
11584219
CDM 		Infinity Adaptis Tib Sz 1 Infinity Adaptis (33680001) 7 $15,356.25 $30,712.50 $19,656.00 nat. median
$19,656
1.0× median
10869747
CDM 		Interstim X Neurotransmitter (97800) 7 $15,330.00 $30,660.00 $19,622.40 nat. median
$19,622
1.0× median
9663869
CDM 		Inbone Talar Dome Sz 3 Sulcus (220220903) 7 $14,842.50 $29,685.00 $18,998.40 nat. median
$18,998
1.0× median
10038634
CDM 		Flatcut Talar Dome Sz 4 (33680034) 7 $14,766.25 $29,532.50 $18,900.80 nat. median
$0
8342801
CDM 		Interstim Ii Neurostimulator 3058 7 $14,600.00 $29,200.00 $18,688.00 nat. median
$18,688
1.0× median
788
MS_DRG 		Cesarean Section Without Sterilization Without Cc/mcc 1 $18,466.00 $18,466.00 $18,466.00 nat. median
$10,065
1.8× median
785
MS_DRG 		Cesarean Section With Sterilization Without Cc/mcc 1 $18,317.00 $18,317.00 $18,317.00 nat. median
$9,922
1.8× median
J2327
HCPCS 		Risankizumab 150 mg/mL Sol [lrhc] 7 $14,231.42 $28,462.84 $18,216.22 nat. median
$961
outlier · 19.0×
J2350
HCPCS 		Ocrelizumab 300 Mg/10 Ml Sol (Ocrevus) 7 $14,226.86 $28,453.71 $18,210.37 nat. median
$331
outlier · 55.1×
8342802
CDM 		Lag Screw 10.5x85mm 7 $14,031.25 $28,062.50 $17,960.00 nat. median
$17,960
1.0× median
291
MS_DRG 		Heart Failure And Shock With Mcc 1 $17,944.00 $17,944.00 $17,944.00 nat. median
$13,359
1.3× median
897
MS_DRG 		Alcohol/drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 1 $17,926.00 $17,926.00 $17,926.00 nat. median
$8,661
outlier · 2.1×
10038633
CDM 		Infinity Adaptis Tib Sz 5 (33680005) 7 $13,917.50 $27,835.00 $17,814.40 nat. median
$17,814
1.0× median
11912426
CDM 		Attune Crs Femoral Rt Sz 7 Cem (150440207) 7 $13,662.19 $27,324.38 $17,487.60 nat. median
$17,488
1.0× median
10232520
CDM 		Psn Rev Fem Cemt Ccr Std Sz 7-l ( 42-5046-062-01 Revision) 7 $12,914.07 $25,828.13 $16,530.00 nat. median
$16,530
1.0× median
11758927
CDM 		Cygnus Dual 4x4cm (585-002) 7 $12,275.00 $24,550.00 $15,712.00 nat. median
$15,712
1.0× median
9386144
CDM 		Infinity Talar Dome Sz 2 (33630022) 7 $11,970.00 $23,940.00 $15,321.60 nat. median
$15,322
1.0× median
12705276
CDM 		Axolotl Dual Grafta 4cm X 6cm (hadg46) 7 $11,730.00 $23,460.00 $15,014.40 nat. median
$15,014
1.0× median
8342398
CDM 		Tibial Platform Sz 2 25mm(1294-35-225) 7 $11,600.07 $23,200.13 $14,848.08 nat. median
$14,848
1.0× median
8342399
CDM 		Uni Femoral Sleeve 40mm(1294-53-236) 7 $11,600.07 $23,200.13 $14,848.08 nat. median
$14,848
1.0× median
603
MS_DRG 		Cellulitis Without Mcc 1 $14,790.00 $14,790.00 $14,790.00 nat. median
$9,525
1.6× median
J9334
HCPCS 		Efgartigimod Alfa-hyaluronidase Qvfc 1008-11200 Units/ 5.6 Ml Sol (Hytrulo) [lrh… 7 $11,379.06 $22,758.12 $14,565.20 nat. median
$77
outlier · 189.8×
9394284
CDM 		Infinity Tibial Tray Size 3 ( 33650003) 7 $11,282.50 $22,565.00 $14,441.60 nat. median
$14,442
1.0× median
9203347
CDM 		Infintiy Tibial Tray Sz 4 Long (33650014) 7 $11,282.50 $22,565.00 $14,441.60 nat. median
$14,442
1.0× median
9386158
CDM 		Infinity Tibial Tray Size 2 (33650002) 7 $11,282.50 $22,565.00 $14,441.60 nat. median
$14,442
1.0× median
12304854
CDM 		Artisan Lead 70 Cm ( Sc-8216-70) 7 $11,275.00 $22,550.00 $14,432.00 nat. median
$14,432
1.0× median
12665441
CDM 		Mobic-c Implant 15x19 H4.5 (mb3594) 7 $11,125.00 $22,250.00 $14,240.00 nat. median
$14,240
1.0× median
11527378
CDM 		Mobi-c Implant 17 X 17 Cervical Disc Prosthesis (mb3776) 7 $11,125.00 $22,250.00 $14,240.00 nat. median
$14,240
1.0× median
12445698
CDM 		Mobic- C Implant 17x19 Hs US (mb3795) 7 $11,125.00 $22,250.00 $14,240.00 nat. median
$14,240
1.0× median
8343636
CDM 		Cervical Disc Prosthesis 17x17 Mb3775 7 $11,125.00 $22,250.00 $14,240.00 nat. median
$14,240
1.0× median
12596877
CDM 		Inbone Everlast Sz 2+ 8mm Total Ankle System (22023208) 7 $10,968.87 $21,937.73 $14,040.15 nat. median
$14,040
1.0× median
J3241
HCPCS 		Teprotumumab Trbw 500 Mg Pow [lrhc] 7 $10,760.50 $21,521.00 $13,773.44 nat. median
$682
outlier · 20.2×
J3357
HCPCS 		Ustekinumab 45 Mg/0.5 Ml Pfs [lrhc] 7 $6,871.45 $27,440.80 $13,731.65 nat. median
$12,959
1.1× median
9526259
CDM 		Attune Crs Femoral Rt Sz 5 Cem (150440205) 7 $10,554.38 $21,108.75 $13,509.60 nat. median
$13,510
1.0× median

Other procedures at this hospital

Browse this hospital's 7,335 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
             
12318036 CDM Wavewriter Alpha Prime 32 Ipg Kit (sc-1432) 8 7 $102,675.00 $98,568.00 $51,337.50 $102,675.00 $65,712.00 2025-12-28
12318275 CDM Wavewriter Alpha 32 Ipg Kit (sc-1232) 8 7 $102,675.00 $98,568.00 $51,337.50 $102,675.00 $65,712.00 2025-12-28
8343480 CDM Adaptivestim Pain (97715) 8 7 $57,375.00 $55,080.00 $28,687.50 $57,375.00 $36,720.00 2025-12-28
8343479 CDM Restore Sensor #97714 8 7 $54,875.00 $52,680.00 $27,437.50 $54,875.00 $35,120.00 2025-12-28
12596876 CDM Inbone Talar Dome Sz 2 Sulcus (220220902) 8 7 $45,308.68 $43,496.33 $22,654.34 $45,308.68 $28,997.56 2025-12-28
12884115 CDM Infinity Adaptis Taldome Sz2 (33680022) 8 7 $34,571.95 $33,189.07 $17,285.98 $34,571.95 $22,126.05 2025-12-28
13020326 CDM Attune Crs Femoral Rt Sz 3 (150440203) 8 7 $34,274.50 $32,903.52 $17,137.25 $34,274.50 $21,935.68 2025-12-28
11545743 CDM Infinity Adaptis Taldome Sz1 (33680021) 8 7 $32,585.00 $31,281.60 $16,292.50 $32,585.00 $20,854.40 2025-12-28
11545744 CDM Infinity Adaptis Tib Sz 2 (33680002) 8 7 $32,584.05 $31,280.69 $16,292.03 $32,584.05 $20,853.79 2025-12-28
12090596 CDM Puraply 6 X 9 (515-018 Implant Surgery) 8 7 $32,062.50 $30,780.00 $16,031.25 $32,062.50 $20,520.00 2025-12-28
11584219 CDM Infinity Adaptis Tib Sz 1 Infinity Adaptis (33680001) 8 7 $30,712.50 $29,484.00 $15,356.25 $30,712.50 $19,656.00 2025-12-28
10869747 CDM Interstim X Neurotransmitter (97800) 8 7 $30,660.00 $29,433.60 $15,330.00 $30,660.00 $19,622.40 2025-12-28
9663869 CDM Inbone Talar Dome Sz 3 Sulcus (220220903) 8 7 $29,685.00 $28,497.60 $14,842.50 $29,685.00 $18,998.40 2025-12-28
10038634 CDM Flatcut Talar Dome Sz 4 (33680034) 8 7 $29,532.50 $28,351.20 $14,766.25 $29,532.50 $18,900.80 2025-12-28
8342801 CDM Interstim Ii Neurostimulator 3058 8 7 $29,200.00 $28,032.00 $14,600.00 $29,200.00 $18,688.00 2025-12-28
J2327 HCPCS Risankizumab 150 mg/mL Sol [lrhc] 8 7 $28,462.84 $27,324.33 $14,231.42 $28,462.84 $18,216.22 2025-12-28
J2350 HCPCS Ocrelizumab 300 Mg/10 Ml Sol (Ocrevus) 8 7 $28,453.71 $27,315.56 $14,226.86 $28,453.71 $18,210.37 2025-12-28
8342802 CDM Lag Screw 10.5x85mm 8 7 $28,062.50 $26,940.00 $14,031.25 $28,062.50 $17,960.00 2025-12-28
10038633 CDM Infinity Adaptis Tib Sz 5 (33680005) 8 7 $27,835.00 $26,721.60 $13,917.50 $27,835.00 $17,814.40 2025-12-28
11912426 CDM Attune Crs Femoral Rt Sz 7 Cem (150440207) 8 7 $27,324.38 $26,231.40 $13,662.19 $27,324.38 $17,487.60 2025-12-28
10232520 CDM Psn Rev Fem Cemt Ccr Std Sz 7-l ( 42-5046-062-01 Revision) 8 7 $25,828.13 $24,795.00 $12,914.07 $25,828.13 $16,530.00 2025-12-28
11758927 CDM Cygnus Dual 4x4cm (585-002) 8 7 $24,550.00 $23,568.00 $12,275.00 $24,550.00 $15,712.00 2025-12-28
9386144 CDM Infinity Talar Dome Sz 2 (33630022) 8 7 $23,940.00 $22,982.40 $11,970.00 $23,940.00 $15,321.60 2025-12-28
12705276 CDM Axolotl Dual Grafta 4cm X 6cm (hadg46) 8 7 $23,460.00 $22,521.60 $11,730.00 $23,460.00 $15,014.40 2025-12-28
8342399 CDM Uni Femoral Sleeve 40mm(1294-53-236) 8 7 $23,200.13 $22,272.12 $11,600.07 $23,200.13 $14,848.08 2025-12-28
8342398 CDM Tibial Platform Sz 2 25mm(1294-35-225) 8 7 $23,200.13 $22,272.12 $11,600.07 $23,200.13 $14,848.08 2025-12-28
J9334 HCPCS Efgartigimod Alfa-hyaluronidase Qvfc 1008-11200 Units/ 5.6 Ml Sol (Hytrulo) [lrh… 8 7 $22,758.12 $21,847.80 $11,379.06 $22,758.12 $14,565.20 2025-12-28
9203347 CDM Infintiy Tibial Tray Sz 4 Long (33650014) 8 7 $22,565.00 $21,662.40 $11,282.50 $22,565.00 $14,441.60 2025-12-28
9386158 CDM Infinity Tibial Tray Size 2 (33650002) 8 7 $22,565.00 $21,662.40 $11,282.50 $22,565.00 $14,441.60 2025-12-28
9394284 CDM Infinity Tibial Tray Size 3 ( 33650003) 8 7 $22,565.00 $21,662.40 $11,282.50 $22,565.00 $14,441.60 2025-12-28
12304854 CDM Artisan Lead 70 Cm ( Sc-8216-70) 8 7 $22,550.00 $21,648.00 $11,275.00 $22,550.00 $14,432.00 2025-12-28
8343636 CDM Cervical Disc Prosthesis 17x17 Mb3775 8 7 $22,250.00 $21,360.00 $11,125.00 $22,250.00 $14,240.00 2025-12-28
11527378 CDM Mobi-c Implant 17 X 17 Cervical Disc Prosthesis (mb3776) 8 7 $22,250.00 $21,360.00 $11,125.00 $22,250.00 $14,240.00 2025-12-28
12665441 CDM Mobic-c Implant 15x19 H4.5 (mb3594) 8 7 $22,250.00 $21,360.00 $11,125.00 $22,250.00 $14,240.00 2025-12-28
12445698 CDM Mobic- C Implant 17x19 Hs US (mb3795) 8 7 $22,250.00 $21,360.00 $11,125.00 $22,250.00 $14,240.00 2025-12-28
12596877 CDM Inbone Everlast Sz 2+ 8mm Total Ankle System (22023208) 8 7 $21,937.73 $21,060.22 $10,968.87 $21,937.73 $14,040.15 2025-12-28
J3241 HCPCS Teprotumumab Trbw 500 Mg Pow [lrhc] 8 7 $21,521.00 $20,660.16 $10,760.50 $21,521.00 $13,773.44 2025-12-28
9526259 CDM Attune Crs Femoral Rt Sz 5 Cem (150440205) 8 7 $21,108.75 $20,264.40 $10,554.38 $21,108.75 $13,509.60 2025-12-28
9602250 CDM Vanguard Knee System Left (cp113641) 8 7 $21,000.00 $20,160.00 $10,500.00 $21,000.00 $13,440.00 2025-12-28
8858745 CDM Vanguard Femoral Ps Right 67.5mm (cp113640) 8 7 $21,000.00 $20,160.00 $10,500.00 $21,000.00 $13,440.00 2025-12-28
9203349 CDM Infinity Talar Done Sz 3 (3360023) 8 7 $20,917.50 $20,080.80 $10,458.75 $20,917.50 $13,387.20 2025-12-28
13105400 CDM Surgiclose Meshed 7x20 Cm (50205n21d0d) 8 7 $20,692.88 $19,865.16 $10,346.44 $20,692.88 $13,243.44 2025-12-28
J3357 HCPCS Ustekinumab 45 Mg/0.5 Ml Pfs [lrhc] 16 7 $20,591.85 $19,768.17 $6,871.45 $27,440.80 $13,731.65 2025-12-28
8341260 CDM Humeral Stem 7mm X 130mm (dwd901) 8 7 $20,562.50 $19,740.00 $10,281.25 $20,562.50 $13,160.00 2025-12-28
8341261 CDM Fx Hemi-prosthesis-adaptor (dwd922) 8 7 $20,562.50 $19,740.00 $10,281.25 $20,562.50 $13,160.00 2025-12-28
9026772 CDM Reclaim Prx Bdy Cone 24x95 (197524095) 8 7 $20,515.63 $19,695.00 $10,257.82 $20,515.63 $13,130.00 2025-12-28
13021877 CDM Attune Rev Rp Tib Base Sz 4 (150660004) 8 7 $20,427.88 $19,610.76 $10,213.94 $20,427.88 $13,073.84 2025-12-28
11887771 CDM Cygnus Dual Amniotic Allograft4x6cm (585-003) 8 7 $20,250.00 $19,440.00 $10,125.00 $20,250.00 $12,960.00 2025-12-28
11912419 CDM Attune Rev Rp Tib Base Sz 7 Cem (150660007) 8 7 $19,833.13 $19,039.80 $9,916.57 $19,833.13 $12,693.20 2025-12-28
9759867 CDM Lapiplasty Mini Incision System -anatomic Implants (sk30) 8 7 $18,987.50 $18,228.00 $9,493.75 $18,987.50 $12,152.00 2025-12-28
8702974 CDM Rise-l 22x45 8-15 6 193.423 8 7 $18,975.00 $18,216.00 $9,487.50 $18,975.00 $12,144.00 2025-12-28
12667414 CDM Cerament G 5-10ml (a0535-05/06) 8 7 $18,592.50 $17,848.80 $9,296.25 $18,592.50 $11,899.20 2025-12-28
10232515 CDM Psn Rev Tib Central Cone Fix Tib (42-5450-005-08 Revision) 8 7 $18,578.13 $17,835.00 $9,289.07 $18,578.13 $11,890.00 2025-12-28
12693628 CDM Exceed Ibf 25 X 10 X 11, 8 Deg (11-5349) 8 7 $18,000.00 $17,280.00 $9,000.00 $18,000.00 $11,520.00 2025-12-28
12596878 CDM Inbone Tib Tray Rt Sz 3 Lng (220222903) 8 7 $17,827.75 $17,114.64 $8,913.88 $17,827.75 $11,409.76 2025-12-28
10072656 CDM Reclaim Prx Bdy Cone 20 X 105 (197520105) 8 7 $17,806.75 $17,094.48 $8,903.38 $17,806.75 $11,396.32 2025-12-28
8343339 CDM Infuse Bone Graft Lg (7510600) 8 7 $17,762.50 $17,052.00 $8,881.25 $17,762.50 $11,368.00 2025-12-28
12514549 CDM Reclaim Distal Tapered 21x190 (1972621190) 8 7 $17,657.25 $16,950.96 $8,828.63 $17,657.25 $11,300.64 2025-12-28
12261788 CDM Minimally Invasive Delivery System Putty (nb6610) 8 7 $17,500.00 $16,800.00 $8,750.00 $17,500.00 $11,200.00 2025-12-28
13212344 CDM Talus,right 8 7 $17,125.00 $16,440.00 $8,562.50 $17,125.00 $10,960.00 2025-12-28
11213569 CDM Pat. Ligament W/quad-zorc Flexigraft (fwplwext) 8 7 $17,057.50 $16,375.20 $8,528.75 $17,057.50 $10,916.80 2025-12-28
9036948 CDM Velocity Lateral Expandable 11-2150 8 7 $17,000.00 $16,320.00 $8,500.00 $17,000.00 $10,880.00 2025-12-28
8342334 CDM Velocity 45mm Lateral Cage(11-2148) 8 7 $17,000.00 $16,320.00 $8,500.00 $17,000.00 $10,880.00 2025-12-28
9725006 CDM Velocity L Expandable Interbody Cartridge (11-2148) 8 7 $17,000.00 $16,320.00 $8,500.00 $17,000.00 $10,880.00 2025-12-28
8342335 CDM Humeral Head Sz 48mm X 21 Mm 8 7 $17,000.00 $16,320.00 $8,500.00 $17,000.00 $10,880.00 2025-12-28
9036947 CDM Velocity Lateral Expandable 11-2149 8 7 $17,000.00 $16,320.00 $8,500.00 $17,000.00 $10,880.00 2025-12-28
10660425 CDM Pinn Dp Revsn W/gription 64mm (121717064) 8 7 $16,950.38 $16,272.36 $8,475.19 $16,950.38 $10,848.24 2025-12-28
8343257 CDM Nexgen Complete Knee Yellow/cd 8 7 $16,800.00 $16,128.00 $8,400.00 $16,800.00 $10,752.00 2025-12-28
10660462 CDM Reclaim Distal Tapered 17 X 190 (197617190) 8 7 $16,638.38 $15,972.84 $8,319.19 $16,638.38 $10,648.56 2025-12-28
10197367 CDM Tin Coated Ps Femur Size 3 Left (kp-0030l-hp) 8 7 $16,500.00 $15,840.00 $8,250.00 $16,500.00 $10,560.00 2025-12-28
8343331 CDM Secure-c Endplate Assembly (714.306s) 8 7 $16,250.00 $15,600.00 $8,125.00 $16,250.00 $10,400.00 2025-12-28
8342312 CDM Mesh Cathcode 40 1335m 8 7 $16,250.00 $15,600.00 $8,125.00 $16,250.00 $10,400.00 2025-12-28
11577309 CDM Magnus Bone Graft 10 Cc Allograft (mg-10) Wray 8 7 $16,000.00 $15,360.00 $8,000.00 $16,000.00 $10,240.00 2025-12-28
8343338 CDM Infuse Bone Graft Med (7510400) 8 7 $15,952.50 $15,314.40 $7,976.25 $15,952.50 $10,209.60 2025-12-28
8343305 CDM Lp Standard Left Plate 8 7 $15,772.50 $15,141.60 $7,886.25 $15,772.50 $10,094.40 2025-12-28
8343304 CDM Accolade Hip Stem Sz 2 8 7 $15,772.50 $15,141.60 $7,886.25 $15,772.50 $10,094.40 2025-12-28
8342347 CDM Humeral Stem W/porocoat 10mm 8 7 $15,765.00 $15,134.40 $7,882.50 $15,765.00 $10,089.60 2025-12-28
8342351 CDM Cr Femoral Left (kc-1145l) 8 7 $15,765.00 $15,134.40 $7,882.50 $15,765.00 $10,089.60 2025-12-28
8342349 CDM Humeral Stem/global 14mm 8 7 $15,765.00 $15,134.40 $7,882.50 $15,765.00 $10,089.60 2025-12-28
10189937 CDM Dynanail Mini Headless Nail (2601-00-7070) 8 7 $15,737.50 $15,108.00 $7,868.75 $15,737.50 $10,072.00 2025-12-28
8343457 CDM Oval Dome Patella 3-peg 32mm 8 7 $15,666.63 $15,039.96 $7,833.32 $15,666.63 $10,026.64 2025-12-28
8343547 CDM Femoral Cr 67.5mm Lt Cp113621 8 7 $15,625.00 $15,000.00 $7,812.50 $15,625.00 $10,000.00 2025-12-28
8343546 CDM Coflex Spine Sizes 8-16 8 7 $15,625.00 $15,000.00 $7,812.50 $15,625.00 $10,000.00 2025-12-28
10592035 CDM Artacent Wound 4 X 8 Cm (art0408) 8 7 $15,580.00 $14,956.80 $7,790.00 $15,580.00 $9,971.20 2025-12-28
9526264 CDM Attune Tib Slv M/l 29mm Full Por (151111201) 8 7 $15,457.00 $14,838.72 $7,728.50 $15,457.00 $9,892.48 2025-12-28
11899262 CDM 3.5 Lcp Periartic Prx Hum Plate 10 H/235/rt (02.123.028) 8 7 $15,437.50 $14,820.00 $7,718.75 $15,437.50 $9,880.00 2025-12-28
9526236 CDM Attune Rev Rp Tib Base Sz 5 (150660005) 8 7 $15,322.13 $14,709.24 $7,661.07 $15,322.13 $9,806.16 2025-12-28
8342350 CDM Humeral Stem 16mm 8 7 $15,305.00 $14,692.80 $7,652.50 $15,305.00 $9,795.20 2025-12-28
8343227 CDM Taper Stem Plug 8 7 $15,225.00 $14,616.00 $7,612.50 $15,225.00 $9,744.00 2025-12-28
11912420 CDM Attune Tib Slv M/l 37mm Full (151111202) 8 7 $15,006.88 $14,406.60 $7,503.44 $15,006.88 $9,604.40 2025-12-28
12386384 CDM Flexband Twist .30 (tw030) 8 7 $14,987.50 $14,388.00 $7,493.75 $14,987.50 $9,592.00 2025-12-28
9880787 CDM Osteoxcell-osteoviable Matrix (osxl-010) 8 7 $14,812.50 $14,220.00 $7,406.25 $14,812.50 $9,480.00 2025-12-28
12204436 CDM Kerecis Shield Adhesive 30mm (8 Billing Units) 8 7 $14,760.00 $14,169.60 $7,380.00 $14,760.00 $9,446.40 2025-12-28
8343637 CDM Io-flex Microblade Shaver 10mm(io-mbs10s 8 7 $14,750.00 $14,160.00 $7,375.00 $14,750.00 $9,440.00 2025-12-28
8343634 CDM Cervical Disc Prosthesis 15x15 Mb3555 8 7 $14,750.00 $14,160.00 $7,375.00 $14,750.00 $9,440.00 2025-12-28
8343635 CDM Cervical Disc Prosthesis 15x17 Mb3576 8 7 $14,750.00 $14,160.00 $7,375.00 $14,750.00 $9,440.00 2025-12-28
11899261 CDM 3.5 Lcp Periartic Prox Hum Pla 8-h/199/rt (02.123.026) 8 7 $14,747.50 $14,157.60 $7,373.75 $14,747.50 $9,438.40 2025-12-28
8342395 CDM Imola 12mm (f12650-12) 8 7 $14,625.00 $14,040.00 $7,312.50 $14,625.00 $9,360.00 2025-12-28
8342394 CDM Imola 10mm(f12650-10) 8 7 $14,625.00 $14,040.00 $7,312.50 $14,625.00 $9,360.00 2025-12-28
11933733 CDM Standard Stem Sz 32 (520002032) 8 7 $14,516.13 $13,935.48 $7,258.07 $14,516.13 $9,290.32 2025-12-28
8805645 CDM Tm Total Ankle Left Talus Sz 3 (00-4500-013-00) 8 7 $14,500.00 $13,920.00 $7,250.00 $14,500.00 $9,280.00 2025-12-28
10072655 CDM Reclaim Distal Tapered 14x140 (197614140) 8 7 $14,477.13 $13,898.04 $7,238.57 $14,477.13 $9,265.36 2025-12-28
8342941 CDM Femoral Stem 17mm Body 8 7 $14,003.98 $13,443.82 $7,001.99 $14,003.98 $8,962.55 2025-12-28
8342937 CDM Femoral Stem 14mm Lm Body Std Ofs 8 7 $14,003.98 $13,443.82 $7,001.99 $14,003.98 $8,962.55 2025-12-28
8342936 CDM Femoral Stem 14x140mm 8 7 $14,003.98 $13,443.82 $7,001.99 $14,003.98 $8,962.55 2025-12-28
8343694 CDM Amnioheal Plus 50mg (tah2050) 8 7 $13,990.00 $13,430.40 $6,995.00 $13,990.00 $8,953.60 2025-12-28
8343693 CDM Amnioheal Plus 4x6cm(tah1406) 8 7 $13,990.00 $13,430.40 $6,995.00 $13,990.00 $8,953.60 2025-12-28
10059764 CDM Attune Tibial Base Sz 5 (150640005) 8 7 $13,521.63 $12,980.76 $6,760.82 $13,521.63 $8,653.84 2025-12-28
12133602 CDM Atune Crs Fb Tib Base Sze 4 (150640004) 8 7 $13,521.63 $12,980.76 $6,760.82 $13,521.63 $8,653.84 2025-12-28
11528156 CDM Standard Stem L 40 (520002040) 8 7 $13,399.50 $12,863.52 $6,699.75 $13,399.50 $8,575.68 2025-12-28
11640825 CDM Standard Stem M 36 (520002036) 8 7 $13,399.50 $12,863.52 $6,699.75 $13,399.50 $8,575.68 2025-12-28
8342939 CDM Femoral Stem 15x 160mm 8 7 $13,300.00 $12,768.00 $6,650.00 $13,300.00 $8,512.00 2025-12-28
8342943 CDM Femoral Stem Sz 13 X 140mm 8 7 $13,300.00 $12,768.00 $6,650.00 $13,300.00 $8,512.00 2025-12-28
8342938 CDM Femoral Stem Sz 15 X 160mm 8 7 $13,300.00 $12,768.00 $6,650.00 $13,300.00 $8,512.00 2025-12-28
8342942 CDM Femoral Stem 18x160mm 8 7 $13,300.00 $12,768.00 $6,650.00 $13,300.00 $8,512.00 2025-12-28
8342935 CDM Femoral Stem 13x160mm 8 7 $13,300.00 $12,768.00 $6,650.00 $13,300.00 $8,512.00 2025-12-28
8342940 CDM Femoral Stem 16x160mm 8 7 $13,300.00 $12,768.00 $6,650.00 $13,300.00 $8,512.00 2025-12-28
11642146 CDM Trelloss-c Sa 14d X 16w X 7h 6 (108n1407) 8 7 $13,187.50 $12,660.00 $6,593.75 $13,187.50 $8,440.00 2025-12-28
9663868 CDM Inbone Talar Stem 10mm Large (200347901) 8 7 $12,975.68 $12,456.65 $6,487.84 $12,975.68 $8,304.44 2025-12-28
10234691 CDM Xtend Modecc Por Sz 1 Right (130740103) 8 7 $12,855.38 $12,341.16 $6,427.69 $12,855.38 $8,227.44 2025-12-28
J1930 HCPCS Lanreotide 120 Mg/0.5 Ml Sc Sol [lrhc] 8 7 $12,850.43 $12,336.41 $6,425.22 $12,850.43 $8,224.28 2025-12-28
11781943 CDM 3.5 Lcp Periartic Prox Hum Pl 2h/91/rt (02.123.020) 8 7 $12,717.50 $12,208.80 $6,358.75 $12,717.50 $8,139.20 2025-12-28
11810693 CDM Peek Interference Eyelet Screw 3.85 X 17mm Includes Driver, Dri 8 7 $12,700.00 $12,192.00 $6,350.00 $12,700.00 $8,128.00 2025-12-28
11825532 CDM 2.7 Ss Val Ant Patella Plate (02.137.000s) 8 7 $12,670.00 $12,163.20 $6,335.00 $12,670.00 $8,108.80 2025-12-28
12987796 CDM 2.7 Val Ant Patella Pl Ss 6-hole/sm/-s (02.137.002s) 8 7 $12,546.00 $12,044.16 $6,273.00 $12,546.00 $8,029.44 2025-12-28
12887343 CDM Infinity Everlast Sz 2/ 8mm Total Ankle System (33682208) 8 7 $12,429.53 $11,932.35 $6,214.77 $12,429.53 $7,954.90 2025-12-28
8343173 CDM Cr Flex Right Gender Minus 5750-015-06 8 7 $12,372.63 $11,877.72 $6,186.32 $12,372.63 $7,918.48 2025-12-28
8343181 CDM Nexgen Complete Knee Size F 8 7 $12,372.63 $11,877.72 $6,186.32 $12,372.63 $7,918.48 2025-12-28
1378482 CDM Operating Room Major Level 8 7 $12,273.00 $11,782.08 $6,136.50 $12,273.00 $7,854.72 2025-12-28
2648960 CDM Operating Room Level 6 8 7 $12,273.00 $11,782.08 $6,136.50 $12,273.00 $7,854.72 2025-12-28
8343174 CDM Cr Flex Left Gender 5750-16-01 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343179 CDM Cr Flex Right Gender 5750-017-02 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343217 CDM Cr Flex Left Minus 5956-14-05 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343216 CDM Cr Flex Right 5956-14-02 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343224 CDM Cr Flex Left 5956-17-01 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343175 CDM Cr Flex Right Gender 5750-016-02 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343221 CDM Cr Flex Right 5956-16-02 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343180 CDM Cr Flex Lt-gender 5750-017-05 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343170 CDM Cr Flex Right Gender Minus 5750-014-06 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343177 CDM Cr Flex Right Gender Minus 5750-016-06 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343169 CDM Cr Flex Lt- Gender 5750-014-05 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343172 CDM Cr Flex Lt- Gender 5750-015-05 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343219 CDM Cr Flex Left Minus 5956-15-05 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343176 CDM Cr Flex Lt-gender 5750-016-05 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343171 CDM Cr Flex Right Gender 5750-015-02 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343222 CDM Cr Flex Left Minus 5956-16-05 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343226 CDM Cr Flex Left Minus 5956-17-05 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343167 CDM Cr Flex Left Gender 5750-13-01 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343225 CDM Cr Flex Right 5956-17-02 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343223 CDM Cr Flex Right Minus 5956-16-06 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8343218 CDM Cr Flex Right 5956-15-02 8 7 $12,250.00 $11,760.00 $6,125.00 $12,250.00 $7,840.00 2025-12-28
8604350 CDM 3-d Bone Filler 10cc 8 7 $12,212.50 $11,724.00 $6,106.25 $12,212.50 $7,816.00 2025-12-28
13020309 CDM Attune Crs Rp Insert Sz 3 6mm (151710306) 8 7 $12,194.00 $11,706.24 $6,097.00 $12,194.00 $7,804.16 2025-12-28
9026774 CDM Reclaim Distal Tapered 18x140 (197618140) 8 7 $12,155.00 $11,668.80 $6,077.50 $12,155.00 $7,779.20 2025-12-28
8343256 CDM Nexgen Lock Femoral Size F-rt 8 7 $12,109.78 $11,625.39 $6,054.89 $12,109.78 $7,750.26 2025-12-28
8343255 CDM Nexgen Complete Knee Sz D Left 8 7 $12,109.78 $11,625.39 $6,054.89 $12,109.78 $7,750.26 2025-12-28
8342955 CDM Amnion Patch (abs-4200-038) 8 7 $12,100.00 $11,616.00 $6,050.00 $12,100.00 $7,744.00 2025-12-28
10697014 CDM 3.5 Va Greater Troch Hook Pl/small/univ (02.221.080) 8 7 $12,077.50 $11,594.40 $6,038.75 $12,077.50 $7,729.60 2025-12-28
8343168 CDM Cr Flex Right Gender 5750-014-02 8 7 $12,012.25 $11,531.76 $6,006.13 $12,012.25 $7,687.84 2025-12-28
8343178 CDM Cr Flex Left Gender 5750-17-01 8 7 $12,012.25 $11,531.76 $6,006.13 $12,012.25 $7,687.84 2025-12-28
9219949 CDM Surescan MRI Compatible Lead Kit (978b128) 8 7 $11,954.25 $11,476.08 $5,977.13 $11,954.25 $7,650.72 2025-12-28
12600774 CDM Augment Injectable Kit 3.0 Cc Injectable (k30003010) 8 7 $11,926.43 $11,449.37 $5,963.22 $11,926.43 $7,632.92 2025-12-28
10301650 CDM Delta Femoral Head 12/14 36mm (136536710) 8 7 $11,893.38 $11,417.64 $5,946.69 $11,893.38 $7,611.76 2025-12-28
11912427 CDM Attune Crs Rp Insrt Sz 7 6mm (151710706) 8 7 $11,838.13 $11,364.60 $5,919.07 $11,838.13 $7,576.40 2025-12-28
8342408 CDM Right Epiphysis (130720103) 8 7 $11,817.00 $11,344.32 $5,908.50 $11,817.00 $7,562.88 2025-12-28
12851062 CDM Acera Surgical Restrata Mini Matrix 500 Mg (rmini-500) 8 7 $11,750.00 $11,280.00 $5,875.00 $11,750.00 $7,520.00 2025-12-28
11545746 CDM Infinity Everlast Sz 1/1+ 6mm Total Ankle System (33681106) 8 7 $11,715.00 $11,246.40 $5,857.50 $11,715.00 $7,497.60 2025-12-28
8343337 CDM Infuse Bone Graft Sm (7510200)call Spine 8 7 $11,652.50 $11,186.40 $5,826.25 $11,652.50 $7,457.60 2025-12-28
8343182 CDM Headed Screw 5791-41 8 7 $11,617.30 $11,152.61 $5,808.65 $11,617.30 $7,435.07 2025-12-28
12099209 CDM Actis Collared Standard Size 10 (101011100) 8 7 $11,500.00 $11,040.00 $5,750.00 $11,500.00 $7,360.00 2025-12-28
12090213 CDM Actis Collared Std Size 5 (101011050) 8 7 $11,500.00 $11,040.00 $5,750.00 $11,500.00 $7,360.00 2025-12-28
11716408 CDM Actis Collared High Sz 6 (101012060) 8 7 $11,500.00 $11,040.00 $5,750.00 $11,500.00 $7,360.00 2025-12-28
11460729 CDM Actis Collared Std Siz 7 (101011070) 8 7 $11,500.00 $11,040.00 $5,750.00 $11,500.00 $7,360.00 2025-12-28
12634599 CDM Actis Collared High Size 9 (101012090) 8 7 $11,500.00 $11,040.00 $5,750.00 $11,500.00 $7,360.00 2025-12-28
11691154 CDM Actis Collared Std Sz 6 (101011060) 8 7 $11,500.00 $11,040.00 $5,750.00 $11,500.00 $7,360.00 2025-12-28
11769300 CDM Actis Collared Std Size 8 (101011080) 8 7 $11,500.00 $11,040.00 $5,750.00 $11,500.00 $7,360.00 2025-12-28
11910887 CDM Actis Collard Std Size 9 (101011090) 8 7 $11,500.00 $11,040.00 $5,750.00 $11,500.00 $7,360.00 2025-12-28
11885529 CDM Actis Collared High Size 7 (101012070) 8 7 $11,500.00 $11,040.00 $5,750.00 $11,500.00 $7,360.00 2025-12-28
12229528 CDM Actis Collared Std Size 3 (101011030) 8 7 $11,500.00 $11,040.00 $5,750.00 $11,500.00 $7,360.00 2025-12-28
12818879 CDM Actis Collared Std Sz 2 (101011020) 8 7 $11,500.00 $11,040.00 $5,750.00 $11,500.00 $7,360.00 2025-12-28
12400280 CDM Actis Collared High Size 8 (101012080) 8 7 $11,500.00 $11,040.00 $5,750.00 $11,500.00 $7,360.00 2025-12-28
9833832 CDM Actis Collared Std Size 4 ( 101011040) 8 7 $11,500.00 $11,040.00 $5,750.00 $11,500.00 $7,360.00 2025-12-28
12987797 CDM 2.7 Va Locking Ant. Patella Plate Ss/core/sile (02.137.003s) 8 7 $11,403.00 $10,946.88 $5,701.50 $11,403.00 $7,297.92 2025-12-28
9028903 CDM Ti Trochanteric Reattachment (498.806s) 8 7 $11,368.75 $10,914.00 $5,684.38 $11,368.75 $7,276.00 2025-12-28
8739743 CDM Left Epiphysis 1307-20-102 8 7 $11,308.38 $10,856.04 $5,654.19 $11,308.38 $7,237.36 2025-12-28
8343542 CDM Cartiva Mtp Implant 8mm(car-8-us) 8 7 $11,250.00 $10,800.00 $5,625.00 $11,250.00 $7,200.00 2025-12-28
11835669 CDM Novabone Strip 50mm X 25mm X 8mm (nb2310 (s) 8 7 $11,250.00 $10,800.00 $5,625.00 $11,250.00 $7,200.00 2025-12-28
11876363 CDM Matriderm (m) 0.2mm (83401-300) 8 7 $11,170.63 $10,723.80 $5,585.32 $11,170.63 $7,149.20 2025-12-28
8805644 CDM Tm Total Ankle Left Sz 3 (00-4500-043-00) 8 7 $11,000.00 $10,560.00 $5,500.00 $11,000.00 $7,040.00 2025-12-28
Q5111 HCPCS Pegfilgrastim Cbqv 6 Mg/0.6 Ml Sol (Udenyca) [lrhc] 8 7 $10,900.00 $10,464.00 $5,450.00 $10,900.00 $6,976.00 2025-12-28
8343570 CDM Flex Humeral Head 8 7 $10,815.00 $10,382.40 $5,407.50 $10,815.00 $6,921.60 2025-12-28
9820831 CDM Biocleanse Achilles Tendon W/lg Calcaneus Block (453042) 8 7 $10,750.00 $10,320.00 $5,375.00 $10,750.00 $6,880.00 2025-12-28
12187314 CDM Infinion 16 Trial Lead Kit (sc-2316-50e) 8 7 $10,725.00 $10,296.00 $5,362.50 $10,725.00 $6,864.00 2025-12-28
9858418 CDM Corplex P 4cc (cp-0040) 8 7 $10,625.00 $10,200.00 $5,312.50 $10,625.00 $6,800.00 2025-12-28
8342348 CDM Humeral Stem Size 12 8 7 $10,625.00 $10,200.00 $5,312.50 $10,625.00 $6,800.00 2025-12-28
9157734 CDM Osteoxcell Viable Bone Matrix (wray) Oxsl-005 8 7 $10,500.00 $10,080.00 $5,250.00 $10,500.00 $6,720.00 2025-12-28
12592276 CDM Imola Lateral Ibf, Peek 18 X 50-8mm, 0 Deg (f01850-8) 8 7 $10,500.00 $10,080.00 $5,250.00 $10,500.00 $6,720.00 2025-12-28
10058600 CDM Sole Mcf Ss Plate Right Large (99-84010r) 8 7 $10,500.00 $10,080.00 $5,250.00 $10,500.00 $6,720.00 2025-12-28
12322422 CDM Imola Lateral Ibf, Peek, 18x45-10mm, 0 Deg (f01845-10) 8 7 $10,500.00 $10,080.00 $5,250.00 $10,500.00 $6,720.00 2025-12-28
11821398 CDM Novabone X-large Irm Macropor (np2510) 8 7 $10,500.00 $10,080.00 $5,250.00 $10,500.00 $6,720.00 2025-12-28
12494418 CDM Imola Lateral Ibf, Peek, 18x50-10mm 0 Deg (f01850-10) 8 7 $10,500.00 $10,080.00 $5,250.00 $10,500.00 $6,720.00 2025-12-28
11671744 CDM Plate, Lapidus, Dual Mode, Left (mpp2200l) 8 7 $10,400.00 $9,984.00 $5,200.00 $10,400.00 $6,656.00 2025-12-28
10442453 CDM Matriderm S 5.2 X 7.4 Cm ( 83404-300) 8 7 $10,375.00 $9,960.00 $5,187.50 $10,375.00 $6,640.00 2025-12-28
8342865 CDM Long Nail Kit 3425-1420s 8 7 $10,275.00 $9,864.00 $5,137.50 $10,275.00 $6,576.00 2025-12-28
Q5120 HCPCS Pegfilgrastim Bmez 6 Mg/0.6 Ml Sol (Ziextenzo) [lrhc] 8 7 $10,251.39 $9,841.33 $5,125.70 $10,251.39 $6,560.89 2025-12-28
9235699 CDM Amnion Membrane Graft (abs-4100-048) 8 7 $10,243.75 $9,834.00 $5,121.88 $10,243.75 $6,556.00 2025-12-28
13168480 CDM Wound Matrix 3-layer 10 X15 Cm (wsr1015) 8 7 $10,207.60 $9,799.30 $5,103.80 $10,207.60 $6,532.86 2025-12-28
11498908 CDM Genex 10cc Kt W/bead Mold Tray (910-010z) 8 7 $10,202.50 $9,794.40 $5,101.25 $10,202.50 $6,529.60 2025-12-28
8342342 CDM CTA Head 48mm X 18mm 8 7 $10,167.50 $9,760.80 $5,083.75 $10,167.50 $6,507.20 2025-12-28
8342343 CDM Cr Femoral Left (kc-1135l) 8 7 $10,167.50 $9,760.80 $5,083.75 $10,167.50 $6,507.20 2025-12-28
8343220 CDM Cr Flex Right Minus 5956-15-06 8 7 $10,121.63 $9,716.76 $5,060.82 $10,121.63 $6,477.84 2025-12-28
8343232 CDM Poly Patella 32mm 5972-065-32 8 7 $10,121.63 $9,716.76 $5,060.82 $10,121.63 $6,477.84 2025-12-28
12318280 CDM Precision Charging System (sc-6412-3) 8 7 $10,075.00 $9,672.00 $5,037.50 $10,075.00 $6,448.00 2025-12-28
8342288 CDM Ti Cann Tfna Left 235mm(04.037.145s) 8 7 $10,025.75 $9,624.72 $5,012.88 $10,025.75 $6,416.48 2025-12-28
12710098 CDM 10/130 Deg Ti Cann. Tfna 235/right -(04.037.044s) 8 7 $10,025.75 $9,624.72 $5,012.88 $10,025.75 $6,416.48 2025-12-28
9859355 CDM Femoral Stem Sz 5 (1570-11-110) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8342525 CDM Aml Lg Stature 13.5mm 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
9040263 CDM Summit Por Taper Sz29 (157011165) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8342310 CDM Tri-lock Bps Sz 2(101204020) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8342532 CDM Femoral Stem Sz 8(1570-11-150) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8342531 CDM Femoral Stem Sz 7 (157011135) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
10113035 CDM Femoral Stem Sz4 (157001100) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8989049 CDM 6 In Aml Sm Stature 12.0 Mm (155401121) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8342530 CDM Femoral Stem Sz8 1570-01-150 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8797770 CDM Femoral Stem 12/14 (157001090) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
11284061 CDM Tibial Nail -advanced /9 345/sterile (04.043.135s) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8342526 CDM Femoral Stem Sz 1(1570-01-070) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
10050983 CDM Summit Por Taper Sz6 Hi Off (157011120) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
9822633 CDM Femoral Stem Sz 2 Std Off (157001080) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8342523 CDM Aml Sm Stature 13.5 Mm(1554-01-135) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
9487164 CDM Summit Por Taper Sz9 Std (157001165) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8342524 CDM Aml Sm Stature 16.5mm 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8342527 CDM Femoral Stem Sz5 1570-01-110 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8342529 CDM Femoral Stem Sz 7 (157001135) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8342528 CDM Femoral Stem Sz 6 (1570-01-120) 8 7 $10,000.00 $9,600.00 $5,000.00 $10,000.00 $6,400.00 2025-12-28
8343692 CDM Amnioheal Plus 4 X 4cm 8 7 $9,990.00 $9,590.40 $4,995.00 $9,990.00 $6,393.60 2025-12-28
9131821 CDM Fastpass, Scorpion, Sl-mf (ar-13999mf) 8 7 $9,987.50 $9,588.00 $4,993.75 $9,987.50 $6,392.00 2025-12-28
8855984 CDM Power Port MRI Implantable Port (bar1808000) 8 7 $9,872.15 $9,477.26 $4,936.08 $9,872.15 $6,318.18 2025-12-28
J2506 HCPCS Pegfilgrastim 6 Mg/0.6 Ml SubQ Inj (Neulasta) [lrhc] 8 7 $9,765.45 $9,374.83 $4,882.73 $9,765.45 $6,249.89 2025-12-28
11584218 CDM Infinity Poly Sz 1/1+6mm Total Ankle System (33651106) 8 7 $9,765.00 $9,374.40 $4,882.50 $9,765.00 $6,249.60 2025-12-28
10038635 CDM Infinity Everlast Sz 4+ 7mm (33685407) 8 7 $9,750.00 $9,360.00 $4,875.00 $9,750.00 $6,240.00 2025-12-28
8343623 CDM Blunt Tip Ligasure Dr. Adam Lf1637 8 7 $9,733.78 $9,344.43 $4,866.89 $9,733.78 $6,229.62 2025-12-28
9286855 CDM 11mm/125deg Ti Can Tfna 235mm/right 04.037.114s 8 7 $9,675.00 $9,288.00 $4,837.50 $9,675.00 $6,192.00 2025-12-28
11496801 CDM Quadriceps Tendon Preshaped , 10mm (qdt-102) 8 7 $9,640.00 $9,254.40 $4,820.00 $9,640.00 $6,169.60 2025-12-28
9376383 CDM Ti Silverstone 26 X 10 X 12 Mm Titanium Cage (sp261012t2) 8 7 $9,625.00 $9,240.00 $4,812.50 $9,625.00 $6,160.00 2025-12-28
9392901 CDM Silverstone Lumbar Ibf Ti 30 X 11 Mm (sp301011t2) 8 7 $9,625.00 $9,240.00 $4,812.50 $9,625.00 $6,160.00 2025-12-28
8343679 CDM Titanium Spacer 26x10x10 Mm (sp261010t2) 8 7 $9,625.00 $9,240.00 $4,812.50 $9,625.00 $6,160.00 2025-12-28
8668806 CDM Titanium Spacer 26x10x9 Mm Sp-261009t2 8 7 $9,625.00 $9,240.00 $4,812.50 $9,625.00 $6,160.00 2025-12-28
10067442 CDM Silverstone Lumbar Ibf, Ti 26x8mm (sp261008t2) 8 7 $9,625.00 $9,240.00 $4,812.50 $9,625.00 $6,160.00 2025-12-28
8855765 CDM Silverstone Ibf Cage Sp261016t2 8 7 $9,625.00 $9,240.00 $4,812.50 $9,625.00 $6,160.00 2025-12-28
8343680 CDM Silverstone P-peek Cage 26 (sp261011t2) 8 7 $9,625.00 $9,240.00 $4,812.50 $9,625.00 $6,160.00 2025-12-28
10717039 CDM Silverstone Lumbar Ibf, Tu 26 X 6mm (sp261006t2) 8 7 $9,625.00 $9,240.00 $4,812.50 $9,625.00 $6,160.00 2025-12-28
8668805 CDM Titanium Spacer 26x10x7 Mm Sp-261007t2 8 7 $9,625.00 $9,240.00 $4,812.50 $9,625.00 $6,160.00 2025-12-28
11452497 CDM Silverstone Lumbar Ibf Ti 30 X 12mm (sp301012t2) 8 7 $9,625.00 $9,240.00 $4,812.50 $9,625.00 $6,160.00 2025-12-28
8343681 CDM Silverstone P-peek Cage 26 (sp261013t2) 8 7 $9,625.00 $9,240.00 $4,812.50 $9,625.00 $6,160.00 2025-12-28
8343682 CDM Titanum Spacer 26x10x14mm Sp-261014t2 8 7 $9,625.00 $9,240.00 $4,812.50 $9,625.00 $6,160.00 2025-12-28
10046928 CDM Xcellederm Dermal Matrix Perforated (xdermp-4451) 8 7 $9,500.00 $9,120.00 $4,750.00 $9,500.00 $6,080.00 2025-12-28
8343328 CDM Ifuse 3d Bone Implant 8 7 $9,487.50 $9,108.00 $4,743.75 $9,487.50 $6,072.00 2025-12-28
9865389 CDM Signafuse 50x25x5mm 10cc (sgfs-010) 8 7 $9,475.00 $9,096.00 $4,737.50 $9,475.00 $6,064.00 2025-12-28
10234672 CDM Psn Rev 3mm Offset Stem Ext 14 X 135 Mm (42-5603-135-14 Revisio 8 7 $9,425.00 $9,048.00 $4,712.50 $9,425.00 $6,032.00 2025-12-28
8342706 CDM Healix Advance Anchor 8 7 $9,375.00 $9,000.00 $4,687.50 $9,375.00 $6,000.00 2025-12-28
8342791 CDM Peak Silverstone P 30x10x13mm 8 7 $9,375.00 $9,000.00 $4,687.50 $9,375.00 $6,000.00 2025-12-28
8342705 CDM Peek Silverstone P 22x10x9mm(sp-221009) 8 7 $9,375.00 $9,000.00 $4,687.50 $9,375.00 $6,000.00 2025-12-28
8343690 CDM Silverstone Peek Cage 28x10x14mm(st52814 8 7 $9,375.00 $9,000.00 $4,687.50 $9,375.00 $6,000.00 2025-12-28
8343691 CDM Amnioheal Plus 2x2 (tah1202) 8 7 $9,375.00 $9,000.00 $4,687.50 $9,375.00 $6,000.00 2025-12-28
10046751 CDM A-grix Te Resorbable Bone Void Filler 10cc (atm0110) 8 7 $9,375.00 $9,000.00 $4,687.50 $9,375.00 $6,000.00 2025-12-28
8343688 CDM Silverstone Peek Cage 10mm (st52810) 8 7 $9,375.00 $9,000.00 $4,687.50 $9,375.00 $6,000.00 2025-12-28
8343687 CDM Silverstone Peek Cage 9mm(st52809) 8 7 $9,375.00 $9,000.00 $4,687.50 $9,375.00 $6,000.00 2025-12-28
8343689 CDM Silverstone Peek Cage 11mm (st52811) 8 7 $9,375.00 $9,000.00 $4,687.50 $9,375.00 $6,000.00 2025-12-28
8343686 CDM Silverstone P Cage 8mm St52808 8 7 $9,375.00 $9,000.00 $4,687.50 $9,375.00 $6,000.00 2025-12-28
8343678 CDM Silverstone Peek Cage 22(sp221013) 8 7 $9,375.00 $9,000.00 $4,687.50 $9,375.00 $6,000.00 2025-12-28
8343685 CDM Silverstone-t 22x09mm 5(st52208) 8 7 $9,375.00 $9,000.00 $4,687.50 $9,375.00 $6,000.00 2025-12-28
11933734 CDM Reverse Humeral Shell S 32+0 (550000320) 8 7 $9,355.13 $8,980.92 $4,677.57 $9,355.13 $5,987.28 2025-12-28
12441869 CDM Distraction Arthodesis Wedge 14mm (psbt-1407) 8 7 $9,312.50 $8,940.00 $4,656.25 $9,312.50 $5,960.00 2025-12-28
9841283 CDM Global Unite Std Stem Sz 8 (110008100) 8 7 $9,304.75 $8,932.56 $4,652.38 $9,304.75 $5,955.04 2025-12-28
8801854 CDM Articular Comptoe2 1.5x3.5mm Mtp Ce 9m52-1535-w 8 7 $9,260.00 $8,889.60 $4,630.00 $9,260.00 $5,926.40 2025-12-28
10232516 CDM Psn Rev Tib Fixed Keel Size D -l (42-5420-067-01 Revision) 8 7 $9,243.75 $8,874.00 $4,621.88 $9,243.75 $5,916.00 2025-12-28
13181894 CDM Puraply Am Surgical 6cm X 9cm (515-067) 8 7 $9,180.00 $8,812.80 $4,590.00 $9,180.00 $5,875.20 2025-12-28
9526263 CDM Attune Crs Rp Insrt Size 5/6mm (151710506) 8 7 $9,145.50 $8,779.68 $4,572.75 $9,145.50 $5,853.12 2025-12-28
8342155 CDM Porous Femoral Stem Sz 0 8 7 $9,000.00 $8,640.00 $4,500.00 $9,000.00 $5,760.00 2025-12-28
9364554 CDM Theraskin X-large 3" X 6"" 116 Sq Cm ( 103tsxl)" 8 7 $8,987.50 $8,628.00 $4,493.75 $8,987.50 $5,752.00 2025-12-28
J2353 HCPCS Octreotide 20 Mg Pow [lrhc] 16 7 $8,352.69 $8,018.58 $3,349.00 $10,007.38 $6,404.72 2025-12-28
189 MS_DRG Pulmonary Edema And Respiratory Failure 1 1 — — $30,900.00 $30,900.00 $30,900.00 2025-12-28
139 MS_DRG Salivary Gland Procedures 1 1 — — $25,796.00 $25,796.00 $25,796.00 2025-12-28
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 1 1 — — $25,306.00 $25,306.00 $25,306.00 2025-12-28
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 2 2 — — $23,282.00 $23,650.00 $23,466.00 2025-12-28
787 MS_DRG Cesarean Section Without Sterilization With Cc 1 1 — — $22,004.00 $22,004.00 $22,004.00 2025-12-28
784 MS_DRG Cesarean Section With Sterilization With Cc 1 1 — — $20,342.00 $20,342.00 $20,342.00 2025-12-28
788 MS_DRG Cesarean Section Without Sterilization Without Cc/mcc 1 1 — — $18,466.00 $18,466.00 $18,466.00 2025-12-28
785 MS_DRG Cesarean Section With Sterilization Without Cc/mcc 1 1 — — $18,317.00 $18,317.00 $18,317.00 2025-12-28
291 MS_DRG Heart Failure And Shock With Mcc 1 1 — — $17,944.00 $17,944.00 $17,944.00 2025-12-28
897 MS_DRG Alcohol/drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 1 1 — — $17,926.00 $17,926.00 $17,926.00 2025-12-28
603 MS_DRG Cellulitis Without Mcc 1 1 — — $14,790.00 $14,790.00 $14,790.00 2025-12-28
798 MS_DRG Vaginal Delivery With Sterilization And/or D&c Without Cc/mcc 1 1 — — $12,965.00 $12,965.00 $12,965.00 2025-12-28
728 MS_DRG Inflammation Of The Male Reproductive System Without Mcc 1 1 — — $11,143.00 $11,143.00 $11,143.00 2025-12-28
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 1 1 — — $9,307.00 $9,307.00 $9,307.00 2025-12-28
805 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Mcc 1 1 — — $8,652.00 $8,652.00 $8,652.00 2025-12-28
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 1 1 — — $7,884.00 $7,884.00 $7,884.00 2025-12-28
683 MS_DRG Renal Failure With Cc 1 1 — — $6,827.00 $6,827.00 $6,827.00 2025-12-28
807 MS_DRG Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc 2 2 — — $5,456.00 $6,207.00 $5,831.50 2025-12-28
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