Hospital

Madonna Rehabilitation Specialty Hospital Omaha

Omaha, NE · CCN 282003 · Rates published

2,734 distinct procedures filed

11 distinct payers

30,775 rate rows

2026-05-04 last MRF observed

Data quality

30,239 of 30,775 rate rows are consumer-grade (98.3%)

536 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
per-diem day rate — not a per-procedure price	506
percent-of-charges filed in the dollar field — excluded from medians	30

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

Source MRF file	https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbMRHOOMAHANE&type=CDMWithoutLabel&fileType=CSV
Found on page	https://apps.para-hcfs.com/PTT/FinalLinks/Madonna_Omaha_V2.aspx
Discovered via	Discovered by HANK
Last fetch	success · 2026-05-19
Content fingerprint	7427c75039af903b… · 10,368,758 bytes · first seen 2026-05-06

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
856 MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	9	$292,061.31	$413,753.52	$340,738.19	nat. median $43,966 outlier · 7.7×
501 MS_DRG	Soft Tissue Procedures With Cc	9	$253,658.57	$359,349.64	$295,935.00	nat. median $17,880 outlier · 16.6×
939 MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	8	$215,415.78	$305,172.35	$242,342.75	nat. median $33,732 outlier · 7.2×
385 MS_DRG	Inflammatory Bowel Disease With Mcc	9	$193,799.27	$274,548.97	$226,099.15	nat. median $16,227 outlier · 13.9×
865 MS_DRG	Viral Illness With Mcc	9	$177,488.49	$251,442.03	$207,069.91	nat. median $15,238 outlier · 13.6×
940 MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc	8	$182,500.83	$258,542.84	$205,313.43	nat. median $22,722 outlier · 9.0×
392 MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc	8	$169,167.04	$239,653.31	$190,312.92	nat. median $8,731 outlier · 21.8×
854 MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Cc	8	$163,279.42	$231,312.51	$183,689.35	nat. median $20,421 outlier · 9.0×
549 MS_DRG	Septic Arthritis With Cc	8	$161,594.91	$228,926.12	$181,794.27	nat. median $12,850 outlier · 14.1×
981 MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	9	$154,793.69	$219,291.06	$180,592.64	nat. median $46,084 outlier · 3.9×
280 MS_DRG	Acute Myocardial Infarction, Discharged Alive With Mcc	9	$154,573.99	$218,979.82	$180,336.32	nat. median $16,529 outlier · 10.9×
571 MS_DRG	Skin Debridement With Cc	9	$149,379.50	$211,620.96	$174,276.08	nat. median $17,262 outlier · 10.1×
542 MS_DRG	Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…	8	$150,476.80	$213,175.46	$169,286.40	nat. median $18,074 outlier · 9.4×
493 MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc	8	$149,690.13	$212,061.02	$168,401.40	nat. median $24,757 outlier · 6.8×
147 MS_DRG	Ear, Nose, Mouth And Throat Malignancy With Cc	9	$140,153.68	$198,551.04	$163,512.62	nat. median $13,305 outlier · 12.3×
843 MS_DRG	Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…	9	$135,110.50	$191,406.54	$157,628.92	nat. median $19,627 outlier · 8.0×
463 MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective…	9	$133,737.47	$189,461.42	$156,027.05	nat. median $52,753 outlier · 3.0×
37 MS_DRG	Extracranial Procedures With Mcc	9	$124,589.68	$176,502.04	$145,354.62	nat. median $32,921 outlier · 4.4×
593 MS_DRG	Skin Ulcers With Cc	8	$123,649.17	$175,169.66	$139,105.32	nat. median $12,573 outlier · 11.1×
53 MS_DRG	Spinal Disorders And Injuries Without Cc/mcc	8	$121,928.50	$172,732.04	$137,169.55	nat. median $10,564 outlier · 13.0×
40 MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	9	$117,427.37	$166,355.44	$136,998.60	nat. median $37,698 outlier · 3.6×
124 MS_DRG	Other Disorders Of The Eye With Mcc Or Thrombolytic Agent	8	$121,529.80	$172,167.21	$136,721.02	nat. median $13,811 outlier · 9.9×
94 MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	8	$120,878.44	$171,244.46	$135,988.25	nat. median $35,264 outlier · 3.9×
41 MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…	8	$118,797.22	$168,296.06	$133,646.88	nat. median $22,580 outlier · 5.9×
606 MS_DRG	Minor Skin Disorders With Mcc	9	$114,422.60	$162,098.68	$133,493.03	nat. median $15,783 outlier · 8.5×
97 MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	8	$117,358.06	$166,257.25	$132,027.82	nat. median $35,069 outlier · 3.8×
964 MS_DRG	Other Multiple Significant Trauma With Cc	9	$112,287.58	$159,074.07	$131,002.17	nat. median $15,735 outlier · 8.3×
698 MS_DRG	Other Kidney And Urinary Tract Diagnoses With Mcc	9	$111,923.10	$158,557.72	$130,576.95	nat. median $16,677 outlier · 7.8×
540 MS_DRG	Osteomyelitis With Cc	8	$115,215.22	$163,221.57	$129,617.12	nat. median $13,478 outlier · 9.6×
539 MS_DRG	Osteomyelitis With Mcc	9	$110,712.76	$156,843.07	$129,164.88	nat. median $19,718 outlier · 6.6×
59 MS_DRG	Multiple Sclerosis And Cerebellar Ataxia With Cc	8	$114,390.15	$162,052.71	$128,688.92	nat. median $13,000 outlier · 9.9×
264 MS_DRG	Other Circulatory System O.r. Procedures	9	$99,278.89	$140,645.09	$115,825.37	nat. median $33,061 outlier · 3.5×
393 MS_DRG	Other Digestive System Diagnoses With Mcc	8	$101,538.15	$143,845.72	$114,230.42	nat. median $16,482 outlier · 6.9×
72 MS_DRG	Other Cerebrovascular Disorders Without Cc/mcc	8	$100,750.86	$142,730.39	$113,344.72	nat. median $8,635 outlier · 13.1×
300 MS_DRG	Peripheral Vascular Disorders With Cc	9	$95,925.95	$135,895.09	$111,913.61	nat. median $11,433 outlier · 9.8×
197 MS_DRG	Interstitial Lung Disease With Cc	8	$99,074.80	$140,355.97	$111,459.15	nat. median $10,548 outlier · 10.6×
907 MS_DRG	Other O.r. Procedures For Injuries With Mcc	9	$94,902.17	$134,444.74	$110,719.20	nat. median $38,112 outlier · 2.9×
91 MS_DRG	Other Disorders Of Nervous System With Mcc	8	$97,607.86	$138,277.80	$109,808.85	nat. median $17,987 outlier · 6.1×
500 MS_DRG	Soft Tissue Procedures With Mcc	8	$97,483.96	$138,102.27	$109,669.45	nat. median $31,070 outlier · 3.5×
541 MS_DRG	Osteomyelitis Without Cc/mcc	8	$96,948.36	$137,343.51	$109,066.90	nat. median $9,247 outlier · 11.8×
902 MS_DRG	Wound Debridements For Injuries With Cc	9	$92,433.01	$130,946.77	$107,838.51	nat. median $19,364 outlier · 5.6×
372 MS_DRG	Major Gastrointestinal Disorders And Peritoneal Infections With Cc	9	$91,922.96	$130,224.20	$107,243.46	nat. median $11,088 outlier · 9.7×
394 MS_DRG	Other Digestive System Diagnoses With Cc	8	$94,232.47	$133,496.00	$106,011.54	nat. median $10,260 outlier · 10.3×
570 MS_DRG	Skin Debridement With Mcc	9	$90,693.37	$128,482.27	$105,808.93	nat. median $29,069 outlier · 3.6×
548 MS_DRG	Septic Arthritis With Mcc	8	$93,874.63	$132,989.05	$105,608.95	nat. median $19,687 outlier · 5.4×
82 MS_DRG	Traumatic Stupor And Coma >1 Hour With Mcc	9	$90,511.79	$128,225.03	$105,597.09	nat. median $22,770 outlier · 4.6×
207 MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	9	$90,277.32	$127,892.87	$105,323.54	nat. median $62,134 1.7× median
558 MS_DRG	Tendonitis, Myositis And Bursitis Without Mcc	8	$90,854.45	$128,710.48	$102,211.26	nat. median $9,624 outlier · 10.6×
546 MS_DRG	Connective Tissue Disorders With Cc	8	$89,750.48	$127,146.51	$100,969.29	nat. median $12,462 outlier · 8.1×
205 MS_DRG	Other Respiratory System Diagnoses With Mcc	8	$88,290.91	$125,078.79	$99,327.28	nat. median $18,295 outlier · 5.4×

Other procedures at this hospital

Browse this hospital's 2,734 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

856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	9	9	$486,768.85	$486,768.85	$292,061.31	$413,753.52	$340,738.19	2026-05-04
501	MS_DRG	Soft Tissue Procedures With Cc	9	9	$422,764.28	$422,764.28	$253,658.57	$359,349.64	$295,935.00	2026-05-04
939	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	8	8	$359,026.30	$359,026.30	$215,415.78	$305,172.35	$242,342.75	2026-05-04
385	MS_DRG	Inflammatory Bowel Disease With Mcc	9	9	$322,998.79	$322,998.79	$193,799.27	$274,548.97	$226,099.15	2026-05-04
865	MS_DRG	Viral Illness With Mcc	9	9	$295,814.15	$295,814.15	$177,488.49	$251,442.03	$207,069.91	2026-05-04
940	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc	8	8	$304,168.05	$304,168.05	$182,500.83	$258,542.84	$205,313.43	2026-05-04
392	MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc	8	8	$281,945.07	$281,945.07	$169,167.04	$239,653.31	$190,312.92	2026-05-04
854	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Cc	8	8	$272,132.37	$272,132.37	$163,279.42	$231,312.51	$183,689.35	2026-05-04
549	MS_DRG	Septic Arthritis With Cc	8	8	$269,324.85	$269,324.85	$161,594.91	$228,926.12	$181,794.27	2026-05-04
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	9	9	$257,989.48	$257,989.48	$154,793.69	$219,291.06	$180,592.64	2026-05-04
280	MS_DRG	Acute Myocardial Infarction, Discharged Alive With Mcc	9	9	$257,623.32	$257,623.32	$154,573.99	$218,979.82	$180,336.32	2026-05-04
571	MS_DRG	Skin Debridement With Cc	9	9	$248,965.83	$248,965.83	$149,379.50	$211,620.96	$174,276.08	2026-05-04
542	MS_DRG	Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…	8	8	$250,794.66	$250,794.66	$150,476.80	$213,175.46	$169,286.40	2026-05-04
493	MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc	8	8	$249,483.55	$249,483.55	$149,690.13	$212,061.02	$168,401.40	2026-05-04
147	MS_DRG	Ear, Nose, Mouth And Throat Malignancy With Cc	9	9	$233,589.46	$233,589.46	$140,153.68	$198,551.04	$163,512.62	2026-05-04
843	MS_DRG	Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…	9	9	$225,184.17	$225,184.17	$135,110.50	$191,406.54	$157,628.92	2026-05-04
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	9	9	$222,895.79	$222,895.79	$133,737.47	$189,461.42	$156,027.05	2026-05-04
37	MS_DRG	Extracranial Procedures With Mcc	9	9	$207,649.46	$207,649.46	$124,589.68	$176,502.04	$145,354.62	2026-05-04
593	MS_DRG	Skin Ulcers With Cc	8	8	$206,081.95	$206,081.95	$123,649.17	$175,169.66	$139,105.32	2026-05-04
53	MS_DRG	Spinal Disorders And Injuries Without Cc/mcc	8	8	$203,214.16	$203,214.16	$121,928.50	$172,732.04	$137,169.55	2026-05-04
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	9	9	$195,712.28	$195,712.28	$117,427.37	$166,355.44	$136,998.60	2026-05-04
124	MS_DRG	Other Disorders Of The Eye With Mcc Or Thrombolytic Agent	8	8	$202,549.66	$202,549.66	$121,529.80	$172,167.21	$136,721.02	2026-05-04
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	8	8	$201,464.07	$201,464.07	$120,878.44	$171,244.46	$135,988.25	2026-05-04
41	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…	8	8	$197,995.37	$197,995.37	$118,797.22	$168,296.06	$133,646.88	2026-05-04
606	MS_DRG	Minor Skin Disorders With Mcc	9	9	$190,704.33	$190,704.33	$114,422.60	$162,098.68	$133,493.03	2026-05-04
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	8	8	$195,596.77	$195,596.77	$117,358.06	$166,257.25	$132,027.82	2026-05-04
964	MS_DRG	Other Multiple Significant Trauma With Cc	9	9	$187,145.96	$187,145.96	$112,287.58	$159,074.07	$131,002.17	2026-05-04
698	MS_DRG	Other Kidney And Urinary Tract Diagnoses With Mcc	9	9	$186,538.50	$186,538.50	$111,923.10	$158,557.72	$130,576.95	2026-05-04
540	MS_DRG	Osteomyelitis With Cc	8	8	$192,025.37	$192,025.37	$115,215.22	$163,221.57	$129,617.12	2026-05-04
539	MS_DRG	Osteomyelitis With Mcc	9	9	$184,521.26	$184,521.26	$110,712.76	$156,843.07	$129,164.88	2026-05-04
59	MS_DRG	Multiple Sclerosis And Cerebellar Ataxia With Cc	8	8	$190,650.25	$190,650.25	$114,390.15	$162,052.71	$128,688.92	2026-05-04
264	MS_DRG	Other Circulatory System O.r. Procedures	9	9	$165,464.81	$165,464.81	$99,278.89	$140,645.09	$115,825.37	2026-05-04
393	MS_DRG	Other Digestive System Diagnoses With Mcc	8	8	$169,230.26	$169,230.26	$101,538.15	$143,845.72	$114,230.42	2026-05-04
72	MS_DRG	Other Cerebrovascular Disorders Without Cc/mcc	8	8	$167,918.10	$167,918.10	$100,750.86	$142,730.39	$113,344.72	2026-05-04
300	MS_DRG	Peripheral Vascular Disorders With Cc	9	9	$159,876.58	$159,876.58	$95,925.95	$135,895.09	$111,913.61	2026-05-04
197	MS_DRG	Interstitial Lung Disease With Cc	8	8	$165,124.67	$165,124.67	$99,074.80	$140,355.97	$111,459.15	2026-05-04
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	9	9	$158,170.28	$158,170.28	$94,902.17	$134,444.74	$110,719.20	2026-05-04
91	MS_DRG	Other Disorders Of Nervous System With Mcc	8	8	$162,679.77	$162,679.77	$97,607.86	$138,277.80	$109,808.85	2026-05-04
500	MS_DRG	Soft Tissue Procedures With Mcc	8	8	$162,473.26	$162,473.26	$97,483.96	$138,102.27	$109,669.45	2026-05-04
541	MS_DRG	Osteomyelitis Without Cc/mcc	8	8	$161,580.60	$161,580.60	$96,948.36	$137,343.51	$109,066.90	2026-05-04
902	MS_DRG	Wound Debridements For Injuries With Cc	9	9	$154,055.02	$154,055.02	$92,433.01	$130,946.77	$107,838.51	2026-05-04
372	MS_DRG	Major Gastrointestinal Disorders And Peritoneal Infections With Cc	9	9	$153,204.94	$153,204.94	$91,922.96	$130,224.20	$107,243.46	2026-05-04
394	MS_DRG	Other Digestive System Diagnoses With Cc	8	8	$157,054.12	$157,054.12	$94,232.47	$133,496.00	$106,011.54	2026-05-04
570	MS_DRG	Skin Debridement With Mcc	9	9	$151,155.61	$151,155.61	$90,693.37	$128,482.27	$105,808.93	2026-05-04
548	MS_DRG	Septic Arthritis With Mcc	8	8	$156,457.71	$156,457.71	$93,874.63	$132,989.05	$105,608.95	2026-05-04
82	MS_DRG	Traumatic Stupor And Coma >1 Hour With Mcc	9	9	$150,852.98	$150,852.98	$90,511.79	$128,225.03	$105,597.09	2026-05-04
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	9	9	$150,462.20	$150,462.20	$90,277.32	$127,892.87	$105,323.54	2026-05-04
558	MS_DRG	Tendonitis, Myositis And Bursitis Without Mcc	8	8	$151,424.09	$151,424.09	$90,854.45	$128,710.48	$102,211.26	2026-05-04
546	MS_DRG	Connective Tissue Disorders With Cc	8	8	$149,584.13	$149,584.13	$89,750.48	$127,146.51	$100,969.29	2026-05-04
205	MS_DRG	Other Respiratory System Diagnoses With Mcc	8	8	$147,151.52	$147,151.52	$88,290.91	$125,078.79	$99,327.28	2026-05-04
920	MS_DRG	Complications Of Treatment With Cc	8	8	$146,273.58	$146,273.58	$87,764.15	$124,332.55	$98,734.67	2026-05-04
371	MS_DRG	Major Gastrointestinal Disorders And Peritoneal Infections With Mcc	9	9	$140,328.19	$140,328.19	$84,196.91	$119,278.96	$98,229.73	2026-05-04
844	MS_DRG	Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…	9	9	$140,152.11	$140,152.11	$84,091.27	$119,129.29	$98,106.48	2026-05-04
292	MS_DRG	Heart Failure And Shock With Cc	8	8	$145,034.84	$145,034.84	$87,020.90	$123,279.61	$97,898.52	2026-05-04
71	MS_DRG	Other Cerebrovascular Disorders With Cc	8	8	$144,676.08	$144,676.08	$86,805.65	$122,974.67	$97,656.35	2026-05-04
74	MS_DRG	Cranial And Peripheral Nerve Disorders Without Mcc	8	8	$144,389.17	$144,389.17	$86,633.50	$122,730.80	$97,462.69	2026-05-04
866	MS_DRG	Viral Illness Without Mcc	8	8	$144,300.90	$144,300.90	$86,580.54	$122,655.77	$97,403.11	2026-05-04
86	MS_DRG	Traumatic Stupor And Coma <1 Hour With Cc	9	9	$138,184.92	$138,184.92	$82,910.95	$117,457.18	$96,729.44	2026-05-04
56	MS_DRG	Degenerative Nervous System Disorders With Mcc	9	8	$137,063.57	$137,063.57	$82,238.14	$116,504.04	$95,944.50	2026-05-04
551	MS_DRG	Medical Back Problems With Mcc	8	8	$141,619.94	$141,619.94	$84,971.97	$120,376.95	$95,593.46	2026-05-04
975	MS_DRG	HIV With Major Related Condition With Cc	8	8	$140,865.61	$140,865.61	$84,519.37	$119,735.77	$95,084.29	2026-05-04
683	MS_DRG	Renal Failure With Cc	8	8	$140,273.77	$140,273.77	$84,164.26	$119,232.71	$94,684.79	2026-05-04
189	MS_DRG	Pulmonary Edema And Respiratory Failure	8	8	$130,076.56	$130,076.56	$78,045.94	$110,565.08	$87,801.67	2026-05-04
83	MS_DRG	Traumatic Stupor And Coma >1 Hour With Cc	9	9	$124,959.31	$124,959.31	$74,975.58	$106,215.41	$87,471.51	2026-05-04
368	MS_DRG	Major Esophageal Disorders With Mcc	9	9	$121,549.56	$121,549.56	$72,929.74	$103,317.13	$85,084.69	2026-05-04
557	MS_DRG	Tendonitis, Myositis And Bursitis With Mcc	9	9	$119,630.55	$119,630.55	$71,778.33	$101,685.97	$83,741.39	2026-05-04
58	MS_DRG	Multiple Sclerosis And Cerebellar Ataxia With Mcc	8	8	$123,876.76	$123,876.76	$74,326.06	$105,295.25	$83,616.81	2026-05-04
564	MS_DRG	Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc	9	9	$119,450.22	$119,450.22	$71,670.13	$101,532.69	$83,615.15	2026-05-04
87	MS_DRG	Traumatic Stupor And Coma <1 Hour Without Cc/mcc	9	9	$119,330.32	$119,330.32	$71,598.19	$101,430.77	$83,531.22	2026-05-04
565	MS_DRG	Other Musculoskeletal System And Connective Tissue Diagnoses With Cc	8	8	$122,247.60	$122,247.60	$73,348.56	$103,910.46	$82,517.13	2026-05-04
438	MS_DRG	Disorders Of Pancreas Except Malignancy With Mcc	8	8	$120,611.68	$120,611.68	$72,367.01	$102,519.92	$81,412.88	2026-05-04
863	MS_DRG	Postoperative And Post-traumatic Infections Without Mcc	8	8	$120,473.96	$120,473.96	$72,284.38	$102,402.87	$81,319.93	2026-05-04
375	MS_DRG	Digestive Malignancy With Cc	8	8	$119,448.64	$119,448.64	$71,669.18	$101,531.34	$80,627.83	2026-05-04
81	MS_DRG	Nontraumatic Stupor And Coma Without Mcc	8	8	$118,117.89	$118,117.89	$70,870.73	$100,400.21	$79,729.58	2026-05-04
208	MS_DRG	Respiratory System Diagnosis With Ventilator Support <=96 Hours	9	9	$112,485.87	$112,485.87	$67,491.52	$95,612.99	$78,740.11	2026-05-04
445	MS_DRG	Disorders Of The Biliary Tract With Cc	9	9	$111,046.54	$111,046.54	$66,627.92	$94,389.56	$77,732.58	2026-05-04
95	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Cc	8	8	$115,114.56	$115,114.56	$69,068.74	$97,847.38	$77,702.33	2026-05-04
579	MS_DRG	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	9	9	$110,234.78	$110,234.78	$66,140.87	$93,699.56	$77,164.35	2026-05-04
559	MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue With Mcc	8	8	$109,765.75	$109,765.75	$65,859.45	$93,300.88	$74,091.88	2026-05-04
57	MS_DRG	Degenerative Nervous System Disorders Without Mcc	9	8	$105,477.12	$105,477.12	$63,286.27	$89,655.55	$73,833.99	2026-05-04
100	MS_DRG	Seizures With Mcc	8	8	$109,153.78	$109,153.78	$65,492.27	$92,780.71	$73,678.79	2026-05-04
834	MS_DRG	Acute Leukemia With Mcc	9	9	$105,023.06	$105,023.06	$63,013.84	$89,269.60	$73,516.14	2026-05-04
812	MS_DRG	Red Blood Cell Disorders Without Mcc	8	8	$108,218.04	$108,218.04	$64,930.82	$91,985.33	$73,047.18	2026-05-04
949	MS_DRG	Aftercare With Cc/mcc	10	8	$111,972.22	$111,972.22	$67,183.33	$95,176.39	$72,781.95	2026-05-04
862	MS_DRG	Postoperative And Post-traumatic Infections With Mcc	11	9	$111,617.75	$111,617.75	$66,970.65	$94,875.09	$72,551.54	2026-05-04
641	MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…	8	8	$106,077.91	$106,077.91	$63,646.74	$90,166.22	$71,602.58	2026-05-04
54	MS_DRG	Nervous System Neoplasms With Mcc	9	8	$102,191.24	$102,191.24	$61,314.74	$86,862.55	$71,533.87	2026-05-04
432	MS_DRG	Cirrhosis And Alcoholic Hepatitis With Mcc	8	8	$103,691.39	$103,691.39	$62,214.83	$88,137.68	$69,991.68	2026-05-04
598	MS_DRG	Malignant Breast Disorders With Cc	8	8	$103,643.93	$103,643.93	$62,186.36	$88,097.34	$69,959.65	2026-05-04
464	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	8	8	$103,492.51	$103,492.51	$62,095.51	$87,968.63	$69,857.45	2026-05-04
919	MS_DRG	Complications Of Treatment With Mcc	8	8	$102,655.08	$102,655.08	$61,593.05	$87,256.81	$69,292.18	2026-05-04
552	MS_DRG	Medical Back Problems Without Mcc	8	8	$101,699.52	$101,699.52	$61,019.71	$86,444.59	$68,647.18	2026-05-04
640	MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…	8	8	$100,376.50	$100,376.50	$60,225.90	$85,320.03	$67,754.14	2026-05-04
289	MS_DRG	Acute And Subacute Endocarditis With Cc	9	9	$96,051.35	$96,051.35	$57,630.81	$81,643.65	$67,235.95	2026-05-04
988	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	8	8	$99,274.93	$99,274.93	$59,564.96	$84,383.69	$67,010.57	2026-05-04
545	MS_DRG	Connective Tissue Disorders With Mcc	9	9	$94,770.43	$94,770.43	$56,862.26	$80,554.87	$66,339.30	2026-05-04
98	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc	8	8	$98,055.06	$98,055.06	$58,833.04	$83,346.80	$66,187.16	2026-05-04
314	MS_DRG	Other Circulatory System Diagnoses With Mcc	9	9	$92,771.19	$92,771.19	$55,662.71	$78,855.51	$64,939.83	2026-05-04
947	MS_DRG	Signs And Symptoms With Mcc	8	8	$95,805.10	$95,805.10	$57,483.06	$81,434.34	$64,668.45	2026-05-04
637	MS_DRG	Diabetes With Mcc	8	8	$94,806.89	$94,806.89	$56,884.13	$80,585.85	$63,994.65	2026-05-04
872	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc	8	8	$91,580.56	$91,580.56	$54,948.34	$77,843.48	$61,816.88	2026-05-04
96	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc	8	8	$91,480.89	$91,480.89	$54,888.53	$77,758.75	$61,749.60	2026-05-04
835	MS_DRG	Acute Leukemia With Cc	8	8	$91,298.42	$91,298.42	$54,779.05	$77,603.66	$61,626.43	2026-05-04
502	MS_DRG	Soft Tissue Procedures Without Cc/mcc	8	8	$90,958.43	$90,958.43	$54,575.06	$77,314.67	$61,396.94	2026-05-04
643	MS_DRG	Endocrine Disorders With Mcc	8	8	$90,850.38	$90,850.38	$54,510.23	$77,222.82	$61,324.01	2026-05-04
638	MS_DRG	Diabetes With Cc	8	8	$90,694.56	$90,694.56	$54,416.74	$77,090.38	$61,218.82	2026-05-04
950	MS_DRG	Aftercare Without Cc/mcc	9	8	$86,439.17	$86,439.17	$51,863.50	$73,473.30	$60,507.42	2026-05-04
194	MS_DRG	Simple Pneumonia And Pleurisy With Cc	8	8	$88,063.95	$88,063.95	$52,838.37	$74,854.36	$59,443.17	2026-05-04
60	MS_DRG	Multiple Sclerosis And Cerebellar Ataxia Without Cc/mcc	8	8	$88,063.47	$88,063.47	$52,838.08	$74,853.95	$59,442.84	2026-05-04
603	MS_DRG	Cellulitis Without Mcc	8	8	$88,004.03	$88,004.03	$52,802.42	$74,803.42	$59,402.72	2026-05-04
92	MS_DRG	Other Disorders Of Nervous System With Cc	8	8	$87,326.83	$87,326.83	$52,396.10	$74,227.81	$58,945.61	2026-05-04
871	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	9	9	$81,335.34	$81,335.34	$48,801.20	$69,135.04	$56,934.74	2026-05-04
52	MS_DRG	Spinal Disorders And Injuries With Cc/mcc	8	8	$83,912.49	$83,912.49	$50,347.49	$71,325.62	$56,640.93	2026-05-04
560	MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue With Cc	11	8	$84,872.93	$84,872.93	$50,923.76	$72,141.99	$55,167.41	2026-05-04
880	MS_DRG	Acute Adjustment Reaction And Psychosocial Dysfunction	8	8	$80,697.92	$80,697.92	$48,418.75	$68,593.23	$54,471.10	2026-05-04
758	MS_DRG	Infections, Female Reproductive System With Cc	9	9	$77,745.90	$77,745.90	$46,647.54	$66,084.02	$54,422.13	2026-05-04
70	MS_DRG	Other Cerebrovascular Disorders With Mcc	8	8	$80,260.56	$80,260.56	$48,156.33	$68,221.47	$54,175.88	2026-05-04
543	MS_DRG	Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…	8	8	$79,716.46	$79,716.46	$47,829.88	$67,758.99	$53,808.61	2026-05-04
682	MS_DRG	Renal Failure With Mcc	8	8	$79,046.64	$79,046.64	$47,427.98	$67,189.64	$53,356.49	2026-05-04
303	MS_DRG	Atherosclerosis Without Mcc	9	9	$75,567.95	$75,567.95	$45,340.77	$64,232.76	$52,897.57	2026-05-04
180	MS_DRG	Respiratory Neoplasms With Mcc	8	8	$77,971.37	$77,971.37	$46,782.82	$66,275.66	$52,630.68	2026-05-04
55	MS_DRG	Nervous System Neoplasms Without Mcc	8	8	$77,200.95	$77,200.95	$46,320.57	$65,620.81	$52,110.64	2026-05-04
312	MS_DRG	Syncope And Collapse	9	9	$73,539.07	$73,539.07	$44,123.44	$62,508.21	$51,477.35	2026-05-04
561	MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc	10	8	$78,928.15	$78,928.15	$47,356.89	$67,088.92	$51,303.30	2026-05-04
93	MS_DRG	Other Disorders Of Nervous System Without Cc/mcc	8	8	$75,522.03	$75,522.03	$45,313.22	$64,193.72	$50,977.37	2026-05-04
101	MS_DRG	Seizures Without Mcc	8	8	$74,526.46	$74,526.46	$44,715.87	$63,347.49	$50,305.36	2026-05-04
436	MS_DRG	Malignancy Of Hepatobiliary System Or Pancreas With Cc	8	8	$73,788.11	$73,788.11	$44,272.87	$62,719.89	$49,806.97	2026-05-04
157	MS_DRG	Dental And Oral Diseases With Mcc	9	9	$68,873.96	$68,873.96	$41,324.38	$58,542.87	$48,211.77	2026-05-04
974	MS_DRG	HIV With Major Related Condition With Mcc	8	8	$69,275.80	$69,275.80	$41,565.48	$58,884.43	$46,761.16	2026-05-04
378	MS_DRG	Gastrointestinal Hemorrhage With Cc	8	8	$69,266.04	$69,266.04	$41,559.62	$58,876.13	$46,754.58	2026-05-04
948	MS_DRG	Signs And Symptoms Without Mcc	10	8	$71,844.75	$71,844.75	$43,106.85	$61,068.04	$46,699.09	2026-05-04
193	MS_DRG	Simple Pneumonia And Pleurisy With Mcc	8	8	$66,940.71	$66,940.71	$40,164.43	$56,899.60	$45,184.98	2026-05-04
444	MS_DRG	Disorders Of The Biliary Tract With Mcc	8	8	$64,506.37	$64,506.37	$38,703.82	$54,830.41	$43,541.80	2026-05-04
439	MS_DRG	Disorders Of Pancreas Except Malignancy With Cc	8	8	$64,005.64	$64,005.64	$38,403.38	$54,404.79	$43,203.81	2026-05-04
152	MS_DRG	Otitis Media And Uri With Mcc	9	9	$61,282.69	$61,282.69	$36,769.61	$52,090.29	$42,897.88	2026-05-04
177	MS_DRG	Respiratory Infections And Inflammations With Mcc	8	8	$61,186.86	$61,186.86	$36,712.12	$52,008.83	$41,301.13	2026-05-04
841	MS_DRG	Lymphoma And Non-acute Leukemia With Cc	8	8	$60,952.28	$60,952.28	$36,571.37	$51,809.44	$41,142.79	2026-05-04
181	MS_DRG	Respiratory Neoplasms With Cc	8	8	$60,527.04	$60,527.04	$36,316.22	$51,447.98	$40,855.76	2026-05-04
690	MS_DRG	Kidney And Urinary Tract Infections Without Mcc	9	9	$58,153.25	$58,153.25	$34,891.95	$49,430.26	$40,707.28	2026-05-04
176	MS_DRG	Pulmonary Embolism Without Mcc	8	8	$60,068.74	$60,068.74	$36,041.24	$51,058.43	$40,546.40	2026-05-04
288	MS_DRG	Acute And Subacute Endocarditis With Mcc	8	8	$59,283.05	$59,283.05	$35,569.83	$50,390.59	$40,016.06	2026-05-04
374	MS_DRG	Digestive Malignancy With Mcc	8	8	$59,119.13	$59,119.13	$35,471.48	$50,251.26	$39,905.41	2026-05-04
755	MS_DRG	Malignancy, Female Reproductive System With Cc	8	8	$59,060.90	$59,060.90	$35,436.54	$50,201.77	$39,866.11	2026-05-04
389	MS_DRG	Gastrointestinal Obstruction With Cc	8	8	$58,843.30	$58,843.30	$35,305.98	$50,016.80	$39,719.22	2026-05-04
921	MS_DRG	Complications Of Treatment Without Cc/mcc	8	8	$57,784.49	$57,784.49	$34,670.69	$49,116.82	$39,004.53	2026-05-04
281	MS_DRG	Acute Myocardial Infarction, Discharged Alive With Cc	8	8	$56,929.20	$56,929.20	$34,157.52	$48,389.82	$38,427.21	2026-05-04
441	MS_DRG	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc	8	8	$56,179.83	$56,179.83	$33,707.90	$47,752.86	$37,921.38	2026-05-04
728	MS_DRG	Inflammation Of The Male Reproductive System Without Mcc	9	9	$54,049.96	$54,049.96	$32,429.98	$45,942.47	$37,834.97	2026-05-04
442	MS_DRG	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc	8	8	$55,215.21	$55,215.21	$33,129.13	$46,932.93	$37,270.27	2026-05-04
566	MS_DRG	Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/mcc	8	8	$54,125.09	$54,125.09	$32,475.05	$46,006.33	$36,534.43	2026-05-04
884	MS_DRG	Organic Disturbances And Intellectual Disability	8	8	$53,402.73	$53,402.73	$32,041.64	$45,392.32	$36,046.84	2026-05-04
178	MS_DRG	Respiratory Infections And Inflammations With Cc	8	8	$53,166.28	$53,166.28	$31,899.77	$45,191.34	$35,887.24	2026-05-04
99	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis Without Cc/mcc	8	8	$52,833.75	$52,833.75	$31,700.25	$44,908.69	$35,662.79	2026-05-04
315	MS_DRG	Other Circulatory System Diagnoses With Cc	8	8	$52,480.06	$52,480.06	$31,488.04	$44,608.05	$35,424.04	2026-05-04
592	MS_DRG	Skin Ulcers With Mcc	9	9	$50,451.83	$50,451.83	$30,271.10	$42,884.05	$35,316.28	2026-05-04
187	MS_DRG	Pleural Effusion With Cc	8	8	$49,588.27	$49,588.27	$29,752.96	$42,150.03	$33,472.08	2026-05-04
602	MS_DRG	Cellulitis With Mcc	8	8	$47,782.13	$47,782.13	$28,669.28	$40,614.81	$32,252.93	2026-05-04
555	MS_DRG	Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc	8	8	$46,880.40	$46,880.40	$28,128.24	$39,848.34	$31,644.27	2026-05-04
840	MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	9	9	$43,932.03	$43,932.03	$26,359.22	$37,342.23	$30,752.42	2026-05-04
291	MS_DRG	Heart Failure And Shock With Mcc	8	8	$44,229.23	$44,229.23	$26,537.54	$37,594.84	$29,854.73	2026-05-04
811	MS_DRG	Red Blood Cell Disorders With Mcc	9	9	$40,759.51	$40,759.51	$24,455.71	$34,645.58	$28,531.66	2026-05-04
179	MS_DRG	Respiratory Infections And Inflammations Without Cc/mcc	8	8	$42,113.60	$42,113.60	$25,268.16	$35,796.56	$28,426.68	2026-05-04
842	MS_DRG	Lymphoma And Non-acute Leukemia Without Cc/mcc	8	8	$39,228.86	$39,228.86	$23,537.32	$33,344.53	$26,479.48	2026-05-04
433	MS_DRG	Cirrhosis And Alcoholic Hepatitis With Cc	8	8	$38,171.88	$38,171.88	$22,903.13	$32,446.10	$25,766.02	2026-05-04
282	MS_DRG	Acute Myocardial Infarction, Discharged Alive Without Cc/mcc	8	8	$37,671.17	$37,671.17	$22,602.70	$32,020.49	$25,428.04	2026-05-04
73	MS_DRG	Cranial And Peripheral Nerve Disorders With Mcc	8	8	$37,227.75	$37,227.75	$22,336.65	$31,643.59	$25,128.74	2026-05-04
897	MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc	8	8	$32,162.00	$32,162.00	$19,297.20	$27,337.70	$21,709.35	2026-05-04
554	MS_DRG	Bone Diseases And Arthropathies Without Mcc	9	9	$27,264.00	$27,264.00	$16,358.40	$23,174.40	$19,084.80	2026-05-04
94006075_1	CDM	Operating Room Services - Minor Surgery	10	10	$24,837.33	$24,837.33	$7,451.20	$21,111.73	$16,765.20	2026-05-04
11044	HCPCS	Removal Of Bone, 20.0 Sq Cm Or Less	10	10	$24,671.00	$24,671.00	$7,401.30	$20,970.35	$16,652.92	2026-05-04
867	MS_DRG	Other Infectious And Parasitic Diseases Diagnoses With Mcc	9	9	$23,323.11	$23,323.11	$13,993.87	$19,824.64	$16,326.18	2026-05-04
951	MS_DRG	Other Factors Influencing Health Status	9	9	$20,010.26	$20,010.26	$12,006.16	$17,008.72	$14,007.18	2026-05-04
94006115_1	CDM	PET Scan	10	10	$15,338.00	$15,338.00	$4,601.40	$13,037.30	$10,353.15	2026-05-04
94007639_1	CDM	Other Imag Svcs-positron Emmis	10	10	$13,000.00	$13,000.00	$3,900.00	$11,050.00	$8,775.00	2026-05-04
94007640_1	CDM	Cadilolgy-cardiac Cath Lab	10	10	$12,110.67	$12,110.67	$3,633.20	$10,294.07	$8,174.70	2026-05-04
25096673_1	CDM	Mercaptopurine 20 Mg/ml Suspen	10	10	$11,679.53	$11,679.53	$3,503.86	$9,927.60	$7,883.68	2026-05-04
45380	HCPCS	Biopsy Of Large Bowel Using A Flexible Endoscope	10	10	$11,059.00	$11,059.00	$3,317.70	$9,400.15	$7,464.83	2026-05-04
94006072_1	CDM	MRI-spine	10	10	$9,088.00	$9,088.00	$2,726.40	$7,724.80	$6,134.40	2026-05-04
94007609_1	CDM	Operating Room Services - General Classification	10	10	$8,510.60	$8,510.60	$2,553.18	$7,234.01	$5,744.66	2026-05-04
11710133_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$8,425.00	$8,425.00	$5,055.00	$7,161.25	$5,686.88	2026-05-04
94006023_1	CDM	MRI	10	10	$8,322.00	$8,322.00	$2,496.60	$7,073.70	$5,617.35	2026-05-04
94006114_1	CDM	Drugs Id/detail Code	10	10	$7,721.50	$7,721.50	$2,316.45	$6,563.28	$5,212.01	2026-05-04
94007647_1	CDM	Gastro - Intestinal (gi) Services - General Classification	10	10	$7,705.00	$7,705.00	$2,311.50	$6,549.25	$5,200.88	2026-05-04
25096949_1	CDM	Clobazam 2.5 Mg/ml Suspension	10	10	$7,410.55	$7,410.55	$2,223.17	$6,298.97	$5,002.12	2026-05-04
25096433_1	CDM	Calcitonin-salmon 400 Unit/2ml	10	10	$7,399.00	$7,399.00	$2,219.70	$6,289.15	$4,994.33	2026-05-04
94006062_1	CDM	Radiation Therapy	10	10	$7,181.50	$7,181.50	$2,154.45	$6,104.28	$4,847.51	2026-05-04
G1004	HCPCS	Cdsm Ndsc	10	10	$7,152.00	$7,152.00	$2,145.60	$6,079.20	$4,827.60	2026-05-04
74178	HCPCS	CT Scan Of Abdomen And Pelvis Before And After Contrast	20	10	$6,948.75	$6,948.75	$1,817.40	$6,663.58	$4,684.18	2026-05-04
94006105_1	CDM	MRI-brain	10	10	$6,720.00	$6,720.00	$2,016.00	$5,712.00	$4,536.00	2026-05-04
74177	HCPCS	CT Scan Of Abdomen And Pelvis With Contrast	20	10	$6,390.10	$6,390.10	$1,563.46	$6,433.37	$4,221.35	2026-05-04
94006050_1	CDM	CT Scan-body	10	10	$6,237.00	$6,237.00	$1,871.10	$5,301.45	$4,209.98	2026-05-04
918	MS_DRG	Poisoning And Toxic Effects Of Drugs Without Mcc	9	9	$5,845.56	$5,845.56	$3,507.34	$4,968.73	$4,091.89	2026-05-04
74170	HCPCS	CT Scan Of Abdomen Before And After Contrast	10	10	$6,058.00	$6,058.00	$1,817.40	$5,149.30	$4,089.15	2026-05-04
94007570_1	CDM	Gastro - Intestinal (gi) Services - General Classification	10	10	$6,040.00	$6,040.00	$1,812.00	$5,134.00	$4,077.00	2026-05-04
70470	HCPCS	CT Scan Of Head Or Brain Before And After Contrast	10	10	$5,969.20	$5,969.20	$1,790.76	$5,073.82	$4,029.21	2026-05-04
71270	HCPCS	CT Scan Of Chest Before And After Contrast	10	10	$5,910.00	$5,910.00	$1,773.00	$5,023.50	$3,989.25	2026-05-04
71275	HCPCS	CT Scan Of Blood Vessels Of Chest With Contrast	10	10	$5,728.63	$5,728.63	$1,718.59	$4,869.33	$3,866.82	2026-05-04
25094442_1	CDM	Mycophenolate 200 Mg/ml Susp	10	10	$5,689.39	$5,689.39	$1,706.82	$4,835.98	$3,840.34	2026-05-04
70496	HCPCS	CT Scan Of Blood Vessels Of Head With Contrast	10	10	$5,625.50	$5,625.50	$1,687.65	$4,781.68	$3,797.22	2026-05-04
94006074_1	CDM	Supply/implants	10	10	$5,598.84	$5,598.84	$1,679.65	$4,759.01	$3,779.22	2026-05-04
70498	HCPCS	CT Scan Of Blood Vessels Of Neck With Contrast	10	10	$5,579.67	$5,579.67	$1,673.90	$4,742.72	$3,766.28	2026-05-04
73201	HCPCS	CT Scan Of Arm With Contrast	10	10	$5,467.00	$5,467.00	$1,640.10	$4,646.95	$3,690.23	2026-05-04
70491	HCPCS	CT Scan Of Soft Tissue Of Neck With Contrast	10	10	$5,467.00	$5,467.00	$1,640.10	$4,646.95	$3,690.23	2026-05-04
70487	HCPCS	CT Scan Of Face With Contrast	10	10	$5,467.00	$5,467.00	$1,640.10	$4,646.95	$3,690.23	2026-05-04
11210130_1	CDM	Intensive Care Unit - Medical	9	9	$5,173.00	$5,173.00	$3,103.80	$4,397.05	$3,621.10	2026-05-04
70460	HCPCS	CT Scan Head Or Brain With Contrast	10	10	$5,336.50	$5,336.50	$1,600.95	$4,536.03	$3,602.14	2026-05-04
73701	HCPCS	CT Scan Of Leg With Contrast Material	30	10	$5,293.00	$5,293.00	$1,561.80	$4,646.95	$3,598.88	2026-05-04
72193	HCPCS	CT Scan Of Pelvis With Contrast	10	10	$5,319.00	$5,319.00	$1,595.70	$4,521.15	$3,590.32	2026-05-04
74160	HCPCS	CT Scan Of Abdomen With Contrast	10	10	$5,319.00	$5,319.00	$1,595.70	$4,521.15	$3,590.32	2026-05-04
71260	HCPCS	CT Scan Of Chest With Contrast	10	10	$5,273.11	$5,273.11	$1,581.93	$4,482.15	$3,559.35	2026-05-04
72132	HCPCS	CT Scan Of Lower Spine With Contrast	10	10	$5,271.25	$5,271.25	$1,581.38	$4,480.56	$3,558.10	2026-05-04
74174	HCPCS	CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast	10	10	$5,219.40	$5,219.40	$1,565.82	$4,436.49	$3,523.10	2026-05-04
72129	HCPCS	CT Scan Of Middle Spine With Contrast	10	10	$5,206.00	$5,206.00	$1,561.80	$4,425.10	$3,514.05	2026-05-04
11310101_1	CDM	Room & Board - Semi-private (two Beds) - Medical/surgical/gyn	9	9	$5,012.43	$5,012.43	$3,007.46	$4,260.56	$3,508.70	2026-05-04
25093745_1	CDM	Temozolomide 250 Mg Capsule	10	10	$5,145.14	$5,145.14	$1,543.54	$4,373.37	$3,472.97	2026-05-04
11310102_1	CDM	Room & Board - Semi-private (two Beds) - Medical/surgical/gyn	9	9	$4,941.43	$4,941.43	$2,964.86	$4,200.21	$3,459.00	2026-05-04
11210101_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$5,055.80	$5,055.80	$3,033.48	$4,297.43	$3,412.66	2026-05-04
74176	HCPCS	CT Scan Of Abdomen And Pelvis Without Contrast	20	10	$5,011.68	$5,011.68	$1,438.90	$4,442.95	$3,377.49	2026-05-04
94006077_1	CDM	CT Scan	10	10	$5,002.00	$5,002.00	$1,500.60	$4,251.70	$3,376.35	2026-05-04
11710103_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$4,787.52	$4,787.52	$2,872.51	$4,069.40	$3,231.58	2026-05-04
73200	HCPCS	CT Scan Of Arm Without Contrast	10	10	$4,727.00	$4,727.00	$1,418.10	$4,017.95	$3,190.73	2026-05-04
72131	HCPCS	CT Scan Of Lower Spine Without Contrast	10	10	$4,727.00	$4,727.00	$1,418.10	$4,017.95	$3,190.73	2026-05-04
72128	HCPCS	CT Scan Of Middle Spine Without Contrast	10	10	$4,727.00	$4,727.00	$1,418.10	$4,017.95	$3,190.73	2026-05-04
70490	HCPCS	CT Scan Of Soft Tissue Of Neck Without Contrast	10	10	$4,727.00	$4,727.00	$1,418.10	$4,017.95	$3,190.73	2026-05-04
70480	HCPCS	CT Scan Of Cranial Cavity Without Contrast	10	10	$4,727.00	$4,727.00	$1,418.10	$4,017.95	$3,190.73	2026-05-04
94007619_1	CDM	MRI-brain	10	10	$4,700.00	$4,700.00	$1,410.00	$3,995.00	$3,172.50	2026-05-04
94007665_1	CDM	MRI-spinal Cord(incl. Spine)	10	10	$4,700.00	$4,700.00	$1,410.00	$3,995.00	$3,172.50	2026-05-04
70450	HCPCS	CT Scan Head Or Brain Without Contrast	20	10	$4,694.48	$4,694.48	$1,382.26	$4,064.21	$3,166.60	2026-05-04
73206	HCPCS	CT Scan Of Blood Vessels Of Arm With Contrast	10	10	$4,670.00	$4,670.00	$1,401.00	$3,969.50	$3,152.25	2026-05-04
72125	HCPCS	CT Scan Of Upper Spine Without Contrast	10	10	$4,651.67	$4,651.67	$1,395.50	$3,953.92	$3,139.88	2026-05-04
72192	HCPCS	CT Scan Of Pelvis Without Contrast	10	10	$4,644.00	$4,644.00	$1,393.20	$3,947.40	$3,134.70	2026-05-04
74150	HCPCS	CT Scan Of Abdomen Without Contrast	10	10	$4,644.00	$4,644.00	$1,393.20	$3,947.40	$3,134.70	2026-05-04
11710001_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$4,617.93	$4,617.93	$2,770.76	$3,925.24	$3,117.10	2026-05-04
25093633_1	CDM	Spiriva Respimat 2.5 Mcg Inh	10	10	$4,611.80	$4,611.80	$1,383.54	$3,920.03	$3,112.97	2026-05-04
73700	HCPCS	CT Scan Of Leg Without Contrast	30	10	$4,614.00	$4,614.00	$1,350.30	$4,017.95	$3,111.62	2026-05-04
11210001_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$4,532.90	$4,532.90	$2,719.74	$3,852.96	$3,059.70	2026-05-04
25097402_1	CDM	Remdesivir (veklury) Injection	10	10	$4,506.53	$4,506.53	$1,351.96	$3,830.55	$3,041.90	2026-05-04
70486	HCPCS	CT Scan Of Face Without Contrast	10	10	$4,501.00	$4,501.00	$1,350.30	$3,825.85	$3,038.18	2026-05-04
71250	HCPCS	CT Scan Of Chest Without Contrast	10	10	$4,481.45	$4,481.45	$1,344.44	$3,809.24	$3,024.98	2026-05-04
25097465_1	CDM	Xarelto 1 Mg/ml Suspension	10	10	$4,432.64	$4,432.64	$1,329.79	$3,767.74	$2,992.03	2026-05-04
25097578_1	CDM	Everolimus 5 Mg Tablet	10	10	$4,329.76	$4,329.76	$1,298.93	$3,680.30	$2,922.59	2026-05-04
11310001_1	CDM	Room & Board - Semi-private (two Beds) - Medical/surgical/gyn	9	9	$4,117.65	$4,117.65	$2,470.59	$3,500.00	$2,882.35	2026-05-04
25096764_1	CDM	Combivent Respimat 20-100 Mcg	10	10	$4,261.52	$4,261.52	$1,278.45	$3,622.29	$2,876.52	2026-05-04
11310002_1	CDM	Room & Board - Semi-private (two Beds) - Medical/surgical/gyn	9	9	$4,010.04	$4,010.04	$2,406.02	$3,408.53	$2,807.02	2026-05-04
94007610_1	CDM	Operating Room Services - Minor Surgery	10	10	$4,090.27	$4,090.27	$1,227.08	$3,476.73	$2,760.93	2026-05-04
11310003_1	CDM	Subacute Care - General Classification	9	9	$3,908.00	$3,908.00	$2,344.80	$3,321.80	$2,735.60	2026-05-04
25094371_1	CDM	Atrovent 17 Mcg Hfa Inhaler	10	10	$4,050.32	$4,050.32	$1,215.10	$3,442.77	$2,733.97	2026-05-04
11310033_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$4,020.00	$4,020.00	$2,412.00	$3,417.00	$2,713.50	2026-05-04
11710105_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$4,009.43	$4,009.43	$2,405.66	$3,408.01	$2,706.36	2026-05-04
25097523_1	CDM	Bevespi Aerosphere Inhaler	10	10	$3,922.02	$3,922.02	$1,176.61	$3,333.72	$2,647.37	2026-05-04
11710003_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$3,907.90	$3,907.90	$2,344.74	$3,321.72	$2,637.84	2026-05-04
25095790_1	CDM	Clobetasol 0.05% Ointment	10	10	$3,761.04	$3,761.04	$1,128.31	$3,196.88	$2,538.69	2026-05-04
94007641_1	CDM	Echocardiology	10	10	$3,712.86	$3,712.86	$1,113.86	$3,155.93	$2,506.18	2026-05-04
11310137_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$3,576.00	$3,576.00	$2,145.60	$3,039.60	$2,413.80	2026-05-04
25097437_1	CDM	Nuzyra 100 Mg Vial	10	10	$3,566.19	$3,566.19	$1,069.86	$3,031.26	$2,407.18	2026-05-04
25091547_1	CDM	Avycaz 2.5 Gram Vial	10	10	$3,563.83	$3,563.83	$1,069.15	$3,029.26	$2,405.59	2026-05-04
11710107_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$3,511.00	$3,511.00	$2,106.60	$2,984.35	$2,369.93	2026-05-04
L0637	HCPCS	Lumbar-sacral Orthosis, Sagittal-coronal Control, With Rigid Anterior And Poster…	10	10	$3,470.00	$3,470.00	$1,041.00	$2,949.50	$2,342.25	2026-05-04
73221	HCPCS	MRI Scan Of Arm Joint Without Contrast	10	10	$3,450.00	$3,450.00	$1,035.00	$2,932.50	$2,328.75	2026-05-04
25097517_1	CDM	Konvomep 2-84 Mg/ml Oral Susp	10	10	$3,399.92	$3,399.92	$1,019.98	$2,889.94	$2,294.95	2026-05-04
76830	HCPCS	Ultrasound Scan Of Uterus, Ovaries, Tubes, Cervix And Pelvic Area Through Vagina	10	10	$3,304.00	$3,304.00	$991.20	$2,808.40	$2,230.20	2026-05-04
94007633_1	CDM	CT Scan-body Scan	10	10	$3,265.00	$3,265.00	$979.50	$2,775.25	$2,203.88	2026-05-04
11310035_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$3,254.00	$3,254.00	$1,952.40	$2,765.90	$2,196.45	2026-05-04
25097368_1	CDM	Granix 480 Mcg/0.8 Ml Safe Syr	10	10	$3,223.84	$3,223.84	$967.15	$2,740.26	$2,176.10	2026-05-04
94007601_1	CDM	Oncology-general	10	10	$3,168.80	$3,168.80	$950.64	$2,693.48	$2,138.94	2026-05-04
11710005_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$3,151.39	$3,151.39	$1,890.83	$2,678.68	$2,127.18	2026-05-04
25092586_1	CDM	Lotemax 0.5% Eye Ointment	10	10	$3,127.75	$3,127.75	$938.33	$2,658.59	$2,111.23	2026-05-04
94007628_1	CDM	Recovery Room - General Classification	10	10	$3,076.14	$3,076.14	$922.84	$2,614.72	$2,076.39	2026-05-04
94007627_1	CDM	Anesthesia	10	10	$3,068.57	$3,068.57	$920.57	$2,608.29	$2,071.28	2026-05-04
25096512_1	CDM	Dulera 100 Mcg-5 Mcg Inhaler	10	10	$2,992.50	$2,992.50	$897.75	$2,543.63	$2,019.94	2026-05-04
25097550_1	CDM	Dulera 200 Mcg-5 Mcg Inhaler	10	10	$2,988.30	$2,988.30	$896.49	$2,540.06	$2,017.11	2026-05-04
25097199_1	CDM	Temozolomide 140 Mg Capsule	10	10	$2,971.10	$2,971.10	$891.33	$2,525.44	$2,005.49	2026-05-04
25093400_1	CDM	Acyclovir 5% Ointment	10	10	$2,917.30	$2,917.30	$875.19	$2,479.71	$1,969.18	2026-05-04
25095693_1	CDM	Budesonide-formoterol 160-4.5	10	10	$2,881.17	$2,881.17	$864.35	$2,448.99	$1,944.79	2026-05-04
25096514_1	CDM	Privigen 10% Vial	10	10	$2,848.50	$2,848.50	$854.55	$2,421.23	$1,922.74	2026-05-04
94006054_1	CDM	Anesthesia	10	10	$2,766.86	$2,766.86	$830.06	$2,351.83	$1,867.63	2026-05-04
25092992_1	CDM	Epogen 20,000 Units/ml Vial	10	10	$2,731.72	$2,731.72	$819.52	$2,321.96	$1,843.91	2026-05-04
11310037_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$2,681.00	$2,681.00	$1,608.60	$2,278.85	$1,809.68	2026-05-04
25077710_1	CDM	Itraconazole 10 Mg/ml Solution	10	10	$2,678.29	$2,678.29	$803.49	$2,276.54	$1,807.85	2026-05-04
25092313_1	CDM	Santyl Ointment	10	10	$2,667.06	$2,667.06	$800.12	$2,267.00	$1,800.26	2026-05-04
25092008_1	CDM	Estradiol 0.01% Cream	10	10	$2,631.14	$2,631.14	$789.34	$2,236.47	$1,776.02	2026-05-04
11710007_1	CDM	Room & Board - Semi-private (two Beds) - Rehabilitation	8	8	$2,602.85	$2,602.85	$1,561.71	$2,212.42	$1,756.92	2026-05-04
25235151_1	CDM	Tobradex Eye Ointment	10	10	$2,561.03	$2,561.03	$768.31	$2,176.87	$1,728.70	2026-05-04
94007637_1	CDM	Lab Pathological-histology	10	10	$2,515.54	$2,515.54	$754.66	$2,138.21	$1,697.99	2026-05-04
L1932	HCPCS	Ankle Foot Orthosis, Rigid Anterior Tibial Section, Total Carbon Fiber Or Equal …	10	10	$2,500.80	$2,500.80	$750.24	$2,125.68	$1,688.04	2026-05-04
L1843	HCPCS	Knee Orthosis, Single Upright, Thigh And Calf, With Adjustable Flexion And Exten…	10	10	$2,489.00	$2,489.00	$746.70	$2,115.65	$1,680.07	2026-05-04
A6513	HCPCS	Compression Burn Mask, Face And/or Neck, Plastic Or Equal, Custom Fabricated	10	10	$2,470.46	$2,470.46	$741.14	$2,099.89	$1,667.56	2026-05-04
27442466_1	CDM	Ankle Foot Orthosis	10	10	$2,409.00	$2,409.00	$722.70	$2,047.65	$1,626.07	2026-05-04
25095640_1	CDM	Fluticasone Prop Hfa 110 Mcg	10	10	$2,406.07	$2,406.07	$721.82	$2,045.16	$1,624.10	2026-05-04
25234907_1	CDM	Tobrex 0.3% Eye Ointment	10	10	$2,402.40	$2,402.40	$720.72	$2,042.04	$1,621.62	2026-05-04
25094310_1	CDM	Procrit 10,000 Units/ml Vial	10	10	$2,394.53	$2,394.53	$718.36	$2,035.35	$1,616.31	2026-05-04
L1951	HCPCS	Ankle Foot Orthosis, Spiral, (institute Of Rehabilitative Medicine Type), Plasti…	10	10	$2,378.75	$2,378.75	$713.63	$2,021.94	$1,605.66	2026-05-04
25096755_1	CDM	Dificid 200 Mg Tablet	10	10	$2,345.37	$2,345.37	$703.61	$1,993.56	$1,583.12	2026-05-04
94007621_1	CDM	Drugs Identification-drugs Requiring Detail Codes	10	10	$2,303.26	$2,303.26	$690.98	$1,957.77	$1,554.70	2026-05-04
25168451_1	CDM	Lidocaine 5% Ointment	10	10	$2,302.09	$2,302.09	$690.63	$1,956.78	$1,553.91	2026-05-04
25097377_1	CDM	Ambisome 50 Mg Vial	10	10	$2,256.69	$2,256.69	$677.01	$1,918.19	$1,523.26	2026-05-04
25096598_1	CDM	Cyclosporine Modified 100mg/ml	10	10	$2,249.62	$2,249.62	$674.89	$1,912.18	$1,518.49	2026-05-04
93970	HCPCS	Ultrasound Study Of Arm Or Leg Veins With Compression And Maneuvers	30	10	$2,306.69	$2,306.69	$469.80	$2,070.60	$1,480.47	2026-05-04
25096021_1	CDM	Dexmethylphenidate ER 20 Mg Cp	10	10	$2,192.03	$2,192.03	$657.61	$1,863.23	$1,479.62	2026-05-04
94006073_1	CDM	Recovery Room - General Classification	10	10	$2,152.50	$2,152.50	$645.75	$1,829.63	$1,452.94	2026-05-04

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