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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

NORTHEASTERN NEVADA REGIONAL HOSPITAL

Elko, NV · CCN 290008 · Rates published

Your selected procedure

You selected 807 (MS_DRG)

Vaginal Delivery without Steri

This hospital’s price: $6,627 across 13 payers · range $4,295-$7,176

Source: https://www.nnrhospital.com/docs/ahnortheasternnevadaregionalhospitallibraries/hcl/mrf3q26/621740235_northeastern-nevada-regional-elko_standardcharges.csv · observed 2026-07-15

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

2,049 distinct procedures filed
21 distinct payers
104,033 rate rows
2026-07-10 last MRF observed
Data quality

47,843 of 104,033 rate rows are consumer-grade (46.0%)

56,190 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 51,470
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 4,720
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.nnrhospital.com/docs/ahnortheasternnevadaregionalhospitallibraries/hcl/mrf3q26/621740235_northeastern-nevada-regional-elko_standardcharges.csv
Found on page https://www.nnrhospital.com/hospital-charges-listing
Discovered viaCMS hospital list
Last fetch success · 2026-09-21
Content fingerprint 329286335e0c7442… · 17,449,937 bytes · first seen 2026-08-17

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
215
MS_DRG 		Other Heart Assist System Impl 11 $108,465.21 $119,294.91 $110,173.74 nat. median
$73,023
1.5× median
326
MS_DRG 		Stomach, Esophageal And Duoden 11 $49,413.00 $57,188.32 $52,815.76 nat. median
$35,986
1.5× median
853
MS_DRG 		Infectious And Parasitic Disea 11 $48,492.64 $56,313.44 $52,007.77 nat. median
$34,733
1.5× median
329
MS_DRG 		Major Small And Large Bowel Pr 11 $39,914.90 $51,703.69 $47,750.48 nat. median
$33,435
1.4× median
166
MS_DRG 		Other Respiratory System O.r. 11 $35,521.73 $43,353.45 $40,038.69 nat. median
$26,952
1.5× median
40
MS_DRG 		Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 11 $39,225.50 $51,165.77 $39,225.50 nat. median
$27,156
1.4× median
987
MS_DRG 		Non-extensive O.r. Procedures 11 $33,891.67 $39,439.56 $36,424.05 nat. median
$24,316
1.5× median
469
MS_DRG 		Major Hip And Knee Joint Repla 11 $33,990.72 $36,804.78 $33,990.72 nat. median
$22,918
1.5× median
480
MS_DRG 		Hip And Femur Procedures Excep 11 $30,583.02 $43,286.48 $30,583.02 nat. median
$21,963
1.4× median
521
MS_DRG 		Hip Replacement With Principal 11 $30,309.53 $33,084.82 $30,309.53 nat. median
$21,753
1.4× median
321
MS_DRG 		Percutaneous Cardiovascular Pr 11 $29,603.45 $33,073.58 $29,603.45 nat. median
$20,638
1.4× median
208
MS_DRG 		Respiratory System Diagnosis W 11 $23,096.90 $30,218.94 $27,908.43 nat. median
$19,623
1.4× median
56
MS_DRG 		Degenerative Nervous System Disorders With Mcc 11 $24,743.31 $28,195.57 $26,039.76 nat. median
$14,194
1.8× median
982
MS_DRG 		Extensive O.r. Procedures Unre 11 $24,307.68 $27,567.27 $25,459.50 nat. median
$17,763
1.4× median
327
MS_DRG 		Stomach, Esophageal And Duoden 11 $25,249.45 $27,339.82 $25,249.45 nat. median
$18,223
1.4× median
493
MS_DRG 		Lower Extremity And Humerus Pr 11 $24,967.64 $29,129.33 $24,967.64 nat. median
$18,426
1.4× median
417
MS_DRG 		Laparoscopic Cholecystectomy W 11 $21,471.95 $26,758.82 $24,712.87 nat. median
$17,369
1.4× median
347
MS_DRG 		Anal And Stomal Procedures Wit 11 $24,612.00 $26,865.25 $24,612.00 nat. median
$16,717
1.5× median
330
MS_DRG 		Major Small And Large Bowel Pr 11 $23,697.17 $26,614.69 $24,579.76 nat. median
$17,741
1.4× median
J9332
HCPCS 		Injection, Efgartigimod Alfa-fcab, 2mg 1 $24,299.63 $24,299.63 $24,299.63 nat. median
$84
outlier · 287.6×
243
MS_DRG 		Permanent Cardiac Pacemaker IM 11 $23,284.03 $25,365.99 $23,426.53 nat. median
$16,535
1.4× median
357
MS_DRG 		Other Digestive System O.r. Pr 11 $19,933.93 $25,356.98 $23,418.21 nat. median
$16,355
1.4× median
286
MS_DRG 		Circulatory Disorders Except A 11 $20,845.09 $24,921.23 $23,015.77 nat. median
$16,072
1.4× median
817
MS_DRG 		Other Antepartum Diagnoses Wit 11 $14,433.26 $24,612.71 $22,730.85 nat. median
$15,634
1.5× median
314
MS_DRG 		Other Circulatory System Diagn 11 $20,153.79 $24,247.89 $22,393.92 nat. median
$15,450
1.4× median
486
MS_DRG 		Knee Procedures With Principal 11 $17,862.10 $23,880.82 $22,054.92 nat. median
$15,126
1.5× median
336
MS_DRG 		Peritoneal Adhesiolysis With C 11 $19,404.21 $23,783.99 $21,965.49 nat. median
$15,633
1.4× median
522
MS_DRG 		Hip Replacement With Principal 11 $21,921.82 $23,736.70 $21,921.82 nat. median
$15,839
1.4× median
814
MS_DRG 		Reticuloendothelial And Immuni 11 $19,697.71 $23,538.53 $21,738.80 nat. median
$14,947
1.5× median
481
MS_DRG 		Hip And Femur Procedures Excep 11 $21,576.57 $28,630.29 $21,576.57 nat. median
$15,706
1.4× median
854
MS_DRG 		Infectious And Parasitic Disea 11 $15,860.84 $22,498.13 $20,777.94 nat. median
$14,550
1.4× median
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 11 $20,685.39 $22,397.91 $20,685.39 nat. median
$14,700
1.4× median
100
MS_DRG 		Seizures With Mcc 11 $16,277.04 $22,354.00 $20,644.84 nat. median
$13,848
1.5× median
871
MS_DRG 		Septicemia Or Severe Sepsis Wi 11 $16,745.40 $22,092.78 $20,403.58 nat. median
$14,442
1.4× median
283
MS_DRG 		Acute Myocardial Infarction, E 11 $20,333.91 $28,916.63 $20,333.91 nat. median
$13,931
1.5× median
623
MS_DRG 		Skin Grafts And Wound Debridem 11 $18,259.90 $21,537.67 $19,890.92 nat. median
$13,380
1.5× median
843
MS_DRG 		Other Myeloproliferative Disor 11 $14,802.42 $21,318.10 $19,688.14 nat. median
$13,716
1.4× median
441
MS_DRG 		Disorders Of Liver Except Mali 11 $18,494.08 $21,285.45 $19,657.99 nat. median
$13,138
1.5× median
470
MS_DRG 		Major Hip And Knee Joint Repla 11 $19,607.03 $22,183.70 $19,607.03 nat. median
$14,330
1.4× median
559
MS_DRG 		Aftercare, Musculoskeletal Sys 11 $19,303.39 $21,071.09 $19,303.39 nat. median
$13,403
1.4× median
862
MS_DRG 		Postoperative And Post-traumat 11 $13,511.88 $20,703.32 $19,120.37 nat. median
$13,176
1.5× median
919
MS_DRG 		Complications Of Treatment Wit 11 $14,581.54 $20,533.30 $18,963.34 nat. median
$13,090
1.4× median
91
MS_DRG 		Other Disorders Of Nervous System With Mcc 11 $18,956.06 $20,720.33 $18,956.06 nat. median
$12,760
1.5× median
377
MS_DRG 		Gastrointestinal Hemorrhage Wi 11 $17,324.21 $20,472.50 $18,907.19 nat. median
$13,124
1.4× median
322
MS_DRG 		Percutaneous Cardiovascular Pr 11 $18,813.60 $25,070.55 $18,813.60 nat. median
$13,595
1.4× median
896
MS_DRG 		Alcohol, Drug Abuse Or Depende 11 $11,988.17 $20,051.38 $18,518.27 nat. median
$9,938
1.9× median
580
MS_DRG 		Other Skin, Subcutaneous Tissu 11 $18,437.16 $22,683.76 $18,437.16 nat. median
$12,953
1.4× median
199
MS_DRG 		Pneumothorax With Mcc 11 $8,551.15 $19,876.85 $18,357.09 nat. median
$12,470
1.5× median
371
MS_DRG 		Major Gastrointestinal Disorde 11 $16,309.77 $19,682.06 $18,177.19 nat. median
$12,655
1.4× median
180
MS_DRG 		Respiratory Neoplasms With Mcc 11 $18,175.11 $24,014.19 $18,175.11 nat. median
$12,731
1.4× median

Other procedures at this hospital

Browse this hospital's 2,049 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
215 MS_DRG Other Heart Assist System Impl 11 11 — — $108,465.21 $119,294.91 $110,173.74 2026-07-10
326 MS_DRG Stomach, Esophageal And Duoden 11 11 — — $49,413.00 $57,188.32 $52,815.76 2026-07-10
853 MS_DRG Infectious And Parasitic Disea 11 11 — — $48,492.64 $56,313.44 $52,007.77 2026-07-10
329 MS_DRG Major Small And Large Bowel Pr 11 11 — — $39,914.90 $51,703.69 $47,750.48 2026-07-10
166 MS_DRG Other Respiratory System O.r. 11 11 — — $35,521.73 $43,353.45 $40,038.69 2026-07-10
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 11 11 — — $39,225.50 $51,165.77 $39,225.50 2026-07-10
987 MS_DRG Non-extensive O.r. Procedures 11 11 — — $33,891.67 $39,439.56 $36,424.05 2026-07-10
469 MS_DRG Major Hip And Knee Joint Repla 11 11 — — $33,990.72 $36,804.78 $33,990.72 2026-07-10
480 MS_DRG Hip And Femur Procedures Excep 11 11 — — $30,583.02 $43,286.48 $30,583.02 2026-07-10
521 MS_DRG Hip Replacement With Principal 11 11 — — $30,309.53 $33,084.82 $30,309.53 2026-07-10
321 MS_DRG Percutaneous Cardiovascular Pr 11 11 — — $29,603.45 $33,073.58 $29,603.45 2026-07-10
208 MS_DRG Respiratory System Diagnosis W 11 11 — — $23,096.90 $30,218.94 $27,908.43 2026-07-10
56 MS_DRG Degenerative Nervous System Disorders With Mcc 11 11 — — $24,743.31 $28,195.57 $26,039.76 2026-07-10
982 MS_DRG Extensive O.r. Procedures Unre 11 11 — — $24,307.68 $27,567.27 $25,459.50 2026-07-10
327 MS_DRG Stomach, Esophageal And Duoden 11 11 — — $25,249.45 $27,339.82 $25,249.45 2026-07-10
493 MS_DRG Lower Extremity And Humerus Pr 11 11 — — $24,967.64 $29,129.33 $24,967.64 2026-07-10
417 MS_DRG Laparoscopic Cholecystectomy W 11 11 — — $21,471.95 $26,758.82 $24,712.87 2026-07-10
347 MS_DRG Anal And Stomal Procedures Wit 11 11 — — $24,612.00 $26,865.25 $24,612.00 2026-07-10
330 MS_DRG Major Small And Large Bowel Pr 11 11 — — $23,697.17 $26,614.69 $24,579.76 2026-07-10
J9332 HCPCS Injection, Efgartigimod Alfa-fcab, 2mg 1 1 — — $24,299.63 $24,299.63 $24,299.63 2026-07-10
243 MS_DRG Permanent Cardiac Pacemaker IM 11 11 — — $23,284.03 $25,365.99 $23,426.53 2026-07-10
357 MS_DRG Other Digestive System O.r. Pr 11 11 — — $19,933.93 $25,356.98 $23,418.21 2026-07-10
286 MS_DRG Circulatory Disorders Except A 11 11 — — $20,845.09 $24,921.23 $23,015.77 2026-07-10
817 MS_DRG Other Antepartum Diagnoses Wit 11 11 — — $14,433.26 $24,612.71 $22,730.85 2026-07-10
314 MS_DRG Other Circulatory System Diagn 11 11 — — $20,153.79 $24,247.89 $22,393.92 2026-07-10
486 MS_DRG Knee Procedures With Principal 11 11 — — $17,862.10 $23,880.82 $22,054.92 2026-07-10
336 MS_DRG Peritoneal Adhesiolysis With C 11 11 — — $19,404.21 $23,783.99 $21,965.49 2026-07-10
522 MS_DRG Hip Replacement With Principal 11 11 — — $21,921.82 $23,736.70 $21,921.82 2026-07-10
814 MS_DRG Reticuloendothelial And Immuni 11 11 — — $19,697.71 $23,538.53 $21,738.80 2026-07-10
481 MS_DRG Hip And Femur Procedures Excep 11 11 — — $21,576.57 $28,630.29 $21,576.57 2026-07-10
854 MS_DRG Infectious And Parasitic Disea 11 11 — — $15,860.84 $22,498.13 $20,777.94 2026-07-10
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 11 11 — — $20,685.39 $22,397.91 $20,685.39 2026-07-10
100 MS_DRG Seizures With Mcc 11 11 — — $16,277.04 $22,354.00 $20,644.84 2026-07-10
871 MS_DRG Septicemia Or Severe Sepsis Wi 11 11 — — $16,745.40 $22,092.78 $20,403.58 2026-07-10
283 MS_DRG Acute Myocardial Infarction, E 11 11 — — $20,333.91 $28,916.63 $20,333.91 2026-07-10
623 MS_DRG Skin Grafts And Wound Debridem 11 11 — — $18,259.90 $21,537.67 $19,890.92 2026-07-10
843 MS_DRG Other Myeloproliferative Disor 11 11 — — $14,802.42 $21,318.10 $19,688.14 2026-07-10
441 MS_DRG Disorders Of Liver Except Mali 11 11 — — $18,494.08 $21,285.45 $19,657.99 2026-07-10
470 MS_DRG Major Hip And Knee Joint Repla 11 11 — — $19,607.03 $22,183.70 $19,607.03 2026-07-10
559 MS_DRG Aftercare, Musculoskeletal Sys 11 11 — — $19,303.39 $21,071.09 $19,303.39 2026-07-10
862 MS_DRG Postoperative And Post-traumat 11 11 — — $13,511.88 $20,703.32 $19,120.37 2026-07-10
919 MS_DRG Complications Of Treatment Wit 11 11 — — $14,581.54 $20,533.30 $18,963.34 2026-07-10
91 MS_DRG Other Disorders Of Nervous System With Mcc 11 11 — — $18,956.06 $20,720.33 $18,956.06 2026-07-10
377 MS_DRG Gastrointestinal Hemorrhage Wi 11 11 — — $17,324.21 $20,472.50 $18,907.19 2026-07-10
322 MS_DRG Percutaneous Cardiovascular Pr 11 11 — — $18,813.60 $25,070.55 $18,813.60 2026-07-10
896 MS_DRG Alcohol, Drug Abuse Or Depende 11 11 — — $11,988.17 $20,051.38 $18,518.27 2026-07-10
580 MS_DRG Other Skin, Subcutaneous Tissu 11 11 — — $18,437.16 $22,683.76 $18,437.16 2026-07-10
199 MS_DRG Pneumothorax With Mcc 11 11 — — $8,551.15 $19,876.85 $18,357.09 2026-07-10
371 MS_DRG Major Gastrointestinal Disorde 11 11 — — $16,309.77 $19,682.06 $18,177.19 2026-07-10
180 MS_DRG Respiratory Neoplasms With Mcc 11 11 — — $18,175.11 $24,014.19 $18,175.11 2026-07-10
70 MS_DRG Other Cerebrovascular Disorders With Mcc 11 11 — — $18,081.52 $22,407.65 $18,081.52 2026-07-10
915 MS_DRG Allergic Reactions With Mcc 11 11 — — $15,746.30 $19,568.34 $18,072.16 2026-07-10
551 MS_DRG Medical Back Problems With Mcc 11 11 — — $11,729.45 $19,213.65 $17,744.60 2026-07-10
444 MS_DRG Disorders Of The Biliary Tract 11 11 — — $13,693.90 $18,965.94 $17,515.82 2026-07-10
698 MS_DRG Other Kidney And Urinary Tract 11 11 — — $14,342.25 $18,926.53 $17,479.43 2026-07-10
884 MS_DRG Organic Disturbances And Intel 11 11 — — $13,293.04 $18,806.05 $17,368.16 2026-07-10
983 MS_DRG Extensive O.r. Procedures Unre 11 11 — — $12,987.27 $18,783.53 $17,347.36 2026-07-10
438 MS_DRG Disorders Of Pancreas Except M 11 11 — — $16,695.29 $18,732.86 $17,300.57 2026-07-10
418 MS_DRG Laparoscopic Cholecystectomy W 11 11 — — $17,245.45 $18,949.15 $17,245.45 2026-07-10
643 MS_DRG Endocrine Disorders With Mcc 11 11 — — $15,161.36 $18,660.80 $17,234.01 2026-07-10
393 MS_DRG Other Digestive System Diagnos 11 11 — — $14,292.14 $18,646.16 $17,220.50 2026-07-10
331 MS_DRG Major Small And Large Bowel Pr 11 11 — — $17,168.50 $19,790.76 $17,168.50 2026-07-10
280 MS_DRG Acute Myocardial Infarction, D 11 11 — — $15,578.59 $18,481.77 $17,068.67 2026-07-10
917 MS_DRG Poisoning And Toxic Effects Of 11 11 — — $13,587.55 $18,462.63 $17,050.99 2026-07-10
299 MS_DRG Peripheral Vascular Disorders 11 11 — — $9,703.64 $18,213.79 $16,821.18 2026-07-10
177 MS_DRG Respiratory Infections And Inf 11 11 — — $13,027.16 $18,201.40 $16,809.74 2026-07-10
786 MS_DRG Cesarean Section Without Steri 11 11 — — $16,524.52 $18,194.65 $16,803.50 2026-07-10
328 MS_DRG Stomach, Esophageal And Duoden 11 11 — — $16,570.57 $19,497.27 $16,570.57 2026-07-10
482 MS_DRG Hip And Femur Procedures Excep 11 11 — — $16,496.74 $19,782.58 $16,496.74 2026-07-10
186 MS_DRG Pleural Effusion With Mcc 11 11 — — $12,141.57 $17,790.42 $16,430.18 2026-07-10
564 MS_DRG Other Musculoskeletal System A 11 11 — — $16,317.88 $18,443.97 $16,317.88 2026-07-10
557 MS_DRG Tendonitis, Myositis And Bursi 11 11 — — $10,647.52 $17,449.25 $16,115.10 2026-07-10
73 MS_DRG Cranial And Peripheral Nerve Disorders With Mcc 11 11 — — $15,388.39 $17,403.09 $16,072.46 2026-07-10
398 MS_DRG Appendix Procedures With Cc 11 11 — — $15,735.54 $26,744.58 $15,735.54 2026-07-10
351 MS_DRG Inguinal And Femoral Hernia Pr 11 11 — — $15,645.07 $17,077.75 $15,645.07 2026-07-10
682 MS_DRG Renal Failure With Mcc 11 11 — — $13,500.63 $16,911.03 $15,618.03 2026-07-10
306 MS_DRG Cardiac Congenital And Valvula 11 11 — — $15,571.24 $16,996.97 $15,571.24 2026-07-10
604 MS_DRG Trauma To The Skin, Subcutaneo 11 11 — — $15,449.57 $16,864.03 $15,449.57 2026-07-10
388 MS_DRG Gastrointestinal Obstruction W 11 11 — — $12,796.04 $16,550.72 $15,285.27 2026-07-10
602 MS_DRG Cellulitis With Mcc 11 11 — — $12,979.09 $16,542.84 $15,277.99 2026-07-10
562 MS_DRG Fracture, Sprain, Strain And D 11 11 — — $13,307.35 $16,478.66 $15,218.72 2026-07-10
637 MS_DRG Diabetes With Mcc 11 11 — — $10,935.90 $16,397.59 $15,143.85 2026-07-10
865 MS_DRG Viral Illness With Mcc 11 11 — — $11,246.77 $16,332.28 $15,083.53 2026-07-10
757 MS_DRG Infections, Female Reproductiv 11 11 — — $10,016.56 $15,935.94 $14,717.49 2026-07-10
885 MS_DRG Psychoses 11 11 — — $5,440.34 $15,871.76 $14,658.22 2026-07-10
175 MS_DRG Pulmonary Embolism With Mcc Or 11 11 — — $10,980.89 $15,866.13 $14,653.02 2026-07-10
811 MS_DRG Red Blood Cell Disorders With 11 11 — — $13,109.99 $15,841.36 $14,630.14 2026-07-10
769 MS_DRG Postpartum And Post Abortion D 11 11 — — $14,311.94 $16,006.05 $14,311.94 2026-07-10
416 MS_DRG Cholecystectomy Except By Lapa 11 11 — — $14,248.50 $23,233.93 $14,248.50 2026-07-10
555 MS_DRG Signs And Symptoms Of Musculos 11 11 — — $14,003.09 $15,285.10 $14,003.09 2026-07-10
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 11 11 — — $13,876.23 $16,523.49 $13,876.23 2026-07-10
355 MS_DRG Hernia Procedures Except Ingui 11 11 — — $13,863.75 $15,011.51 $13,863.75 2026-07-10
535 MS_DRG Fractures Of Hip And Pelvis Wi 11 11 — — $13,829.43 $15,095.92 $13,829.43 2026-07-10
640 MS_DRG Miscellaneous Disorders Of Nut 11 11 — — $13,809.67 $14,952.96 $13,809.67 2026-07-10
193 MS_DRG Simple Pneumonia And Pleurisy 11 11 — — $10,067.69 $14,836.99 $13,702.56 2026-07-10
419 MS_DRG Laparoscopic Cholecystectomy W 11 11 — — $13,701.52 $15,997.87 $13,701.52 2026-07-10
553 MS_DRG Bone Diseases And Arthropathie 11 11 — — $13,580.90 $14,824.92 $13,580.90 2026-07-10
291 MS_DRG Heart Failure And Shock With M 11 11 — — $11,034.07 $14,691.73 $13,568.42 2026-07-10
947 MS_DRG Signs And Symptoms With Mcc 11 11 — — $12,865.58 $14,482.30 $13,375.00 2026-07-10
391 MS_DRG Esophagitis, Gastroenteritis A 11 11 — — $10,591.28 $14,463.16 $13,357.32 2026-07-10
383 MS_DRG Uncomplicated Peptic Ulcer Wit 11 11 — — $13,146.23 $14,350.43 $13,146.23 2026-07-10
725 MS_DRG Benign Prostatic Hypertrophy W 11 11 — — $13,129.59 $14,332.02 $13,129.59 2026-07-10
348 MS_DRG Anal And Stomal Procedures Wit 11 11 — — $13,091.11 $14,174.91 $13,091.11 2026-07-10
189 MS_DRG Pulmonary Edema And Respirator 11 11 — — $7,999.96 $13,932.83 $12,867.54 2026-07-10
308 MS_DRG Cardiac Arrhythmia And Conduct 11 11 — — $9,807.95 $13,578.14 $12,539.97 2026-07-10
743 MS_DRG Uterine And Adnexa Procedures 11 11 — — $12,465.10 $13,497.07 $12,465.10 2026-07-10
887 MS_DRG Other Mental Disorder Diagnose 11 11 — — $12,368.39 $13,392.36 $12,368.39 2026-07-10
689 MS_DRG Kidney And Urinary Tract Infec 11 11 — — $11,402.21 $13,177.30 $12,169.77 2026-07-10
302 MS_DRG Atherosclerosis With Mcc 11 11 — — $12,096.98 $13,205.09 $12,096.98 2026-07-10
546 MS_DRG Connective Tissue Disorders Wi 11 11 — — $12,038.75 $13,035.42 $12,038.75 2026-07-10
989 MS_DRG Non-extensive O.r. Procedures 11 11 — — $10,990.10 $13,010.65 $12,015.87 2026-07-10
152 MS_DRG Otitis Media And Uri With Mcc 11 11 — — $10,229.27 $12,777.58 $11,800.61 2026-07-10
436 MS_DRG Malignancy Of Hepatobiliary Sy 11 11 — — $8,824.19 $12,697.63 $11,726.78 2026-07-10
399 MS_DRG Appendix Procedures Without Cc 11 11 — — $11,686.23 $17,202.51 $11,686.23 2026-07-10
190 MS_DRG Chronic Obstructive Pulmonary 11 11 — — $9,234.26 $12,644.71 $11,677.91 2026-07-10
200 MS_DRG Pneumothorax With Cc 11 11 — — $8,082.79 $12,470.18 $11,516.73 2026-07-10
55 MS_DRG Nervous System Neoplasms Without Mcc 11 11 — — $9,902.03 $12,284.40 $11,345.15 2026-07-10
287 MS_DRG Circulatory Disorders Except A 11 11 — — $11,331.63 $12,395.18 $11,331.63 2026-07-10
381 MS_DRG Complicated Peptic Ulcer With 11 11 — — $10,267.10 $12,263.00 $11,325.39 2026-07-10
445 MS_DRG Disorders Of The Biliary Tract 11 11 — — $8,983.72 $12,211.21 $11,277.55 2026-07-10
784 MS_DRG Cesarean Section With Steriliz 11 11 — — $9,391.74 $12,194.32 $11,261.95 2026-07-10
29888 CPT Arthroscopically Aided Anterior Cruciate Ligament Repair/augmentation Or Reconst… 1 1 — — $11,158.00 $11,158.00 $11,158.00 2026-07-10
29828 CPT Arthroscopy, Shoulder, Surgical; Biceps Tenodesis 1 1 — — $11,158.00 $11,158.00 $11,158.00 2026-07-10
29827 CPT Arthroscopy, Shoulder, Surgical; With Rotator Cuff Repair 1 1 — — $11,158.00 $11,158.00 $11,158.00 2026-07-10
29807 CPT Arthroscopy, Shoulder, Surgical; Repair Of Slap Lesion 1 1 — — $11,158.00 $11,158.00 $11,158.00 2026-07-10
89 MS_DRG Concussion With Cc 11 11 — — $11,148.61 $15,556.10 $11,148.61 2026-07-10
300 MS_DRG Peripheral Vascular Disorders 11 11 — — $9,735.34 $12,054.70 $11,133.01 2026-07-10
433 MS_DRG Cirrhosis And Alcoholic Hepati 11 11 — — $10,321.30 $12,045.69 $11,124.69 2026-07-10
184 MS_DRG Major Chest Trauma With Cc 11 11 — — $9,281.30 $12,026.55 $11,107.01 2026-07-10
787 MS_DRG Cesarean Section Without Steri 11 11 — — $11,041.50 $13,901.50 $11,041.50 2026-07-10
92 MS_DRG Other Disorders Of Nervous System With Cc 11 11 — — $9,688.30 $11,920.71 $11,009.26 2026-07-10
71 MS_DRG Other Cerebrovascular Disorders With Cc 11 11 — — $9,514.46 $11,866.66 $10,959.35 2026-07-10
687 MS_DRG Kidney And Urinary Tract Neopl 11 11 — — $10,946.87 $11,853.15 $10,946.87 2026-07-10
644 MS_DRG Endocrine Disorders With Cc 11 11 — — $8,394.69 $11,635.84 $10,746.17 2026-07-10
872 MS_DRG Septicemia Or Severe Sepsis Wi 11 11 — — $7,694.19 $11,608.81 $10,721.21 2026-07-10
372 MS_DRG Major Gastrointestinal Disorde 11 11 — — $8,346.62 $11,589.67 $10,703.54 2026-07-10
923 MS_DRG Other Injury, Poisoning And To 11 11 — — $5,306.38 $11,483.83 $10,605.79 2026-07-10
699 MS_DRG Other Kidney And Urinary Tract 11 11 — — $8,870.21 $11,483.83 $10,605.79 2026-07-10
758 MS_DRG Infections, Female Reproductiv 11 11 — — $7,376.16 $11,477.07 $10,599.55 2026-07-10
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 11 11 — — $10,574.59 $11,450.05 $10,574.59 2026-07-10
920 MS_DRG Complications Of Treatment Wit 11 11 — — $8,445.82 $11,438.79 $10,564.19 2026-07-10
768 MS_DRG Vaginal Delivery With O.r. Pro 11 11 — — $5,878.02 $11,385.87 $10,515.32 2026-07-10
805 MS_DRG Vaginal Delivery Without Steri 11 11 — — $5,908.70 $11,237.24 $10,378.05 2026-07-10
386 MS_DRG Inflammatory Bowel Disease Wit 11 11 — — $9,766.02 $11,175.31 $10,320.86 2026-07-10
178 MS_DRG Respiratory Infections And Inf 11 11 — — $8,558.31 $11,170.81 $10,316.70 2026-07-10
818 MS_DRG Other Antepartum Diagnoses Wit 11 11 — — $10,288.62 $12,302.12 $10,288.62 2026-07-10
378 MS_DRG Gastrointestinal Hemorrhage Wi 11 11 — — $8,943.83 $11,101.00 $10,252.23 2026-07-10
760 MS_DRG Menstrual And Other Female Rep 11 11 — — $5,223.54 $11,097.62 $10,249.11 2026-07-10
202 MS_DRG Bronchitis And Asthma With Cc/ 11 11 — — $7,480.47 $10,884.81 $10,052.57 2026-07-10
442 MS_DRG Disorders Of Liver Except Mali 11 11 — — $9,536.95 $10,879.18 $10,047.37 2026-07-10
552 MS_DRG Medical Back Problems Without 11 11 — — $7,817.93 $10,852.16 $10,022.41 2026-07-10
315 MS_DRG Other Circulatory System Diagn 11 11 — — $9,393.79 $10,835.27 $10,006.81 2026-07-10
880 MS_DRG Acute Adjustment Reaction And 11 11 — — $6,717.59 $10,793.61 $9,968.34 2026-07-10
394 MS_DRG Other Digestive System Diagnos 11 11 — — $8,134.94 $10,598.81 $9,788.44 2026-07-10
158 MS_DRG Dental And Oral Diseases With 11 11 — — $8,392.64 $10,590.93 $9,781.16 2026-07-10
779 MS_DRG Abortion Without D&c 11 11 — — $4,690.76 $10,525.62 $9,720.84 2026-07-10
605 MS_DRG Trauma To The Skin, Subcutaneo 11 11 — — $6,656.23 $10,400.64 $9,605.42 2026-07-10
812 MS_DRG Red Blood Cell Disorders Witho 11 11 — — $7,361.84 $10,391.63 $9,597.10 2026-07-10
281 MS_DRG Acute Myocardial Infarction, D 11 11 — — $9,585.66 $10,502.31 $9,585.66 2026-07-10
101 MS_DRG Seizures Without Mcc 11 11 — — $6,820.88 $10,378.12 $9,584.62 2026-07-10
638 MS_DRG Diabetes With Cc 11 11 — — $6,476.25 $10,327.45 $9,537.83 2026-07-10
914 MS_DRG Traumatic Injury Without Mcc 11 11 — — $8,205.50 $10,318.44 $9,529.51 2026-07-10
81 MS_DRG Nontraumatic Stupor And Coma Without Mcc 11 11 — — $7,154.25 $10,187.83 $9,408.88 2026-07-10
788 MS_DRG Cesarean Section Without Steri 11 11 — — $9,407.84 $10,186.70 $9,407.84 2026-07-10
864 MS_DRG Fever And Inflammatory Conditi 11 11 — — $6,458.87 $10,111.26 $9,338.17 2026-07-10
563 MS_DRG Fracture, Sprain, Strain And D 11 11 — — $7,521.37 $10,063.97 $9,294.49 2026-07-10
683 MS_DRG Renal Failure With Cc 11 11 — — $6,734.98 $10,008.80 $9,243.54 2026-07-10
866 MS_DRG Viral Illness Without Mcc 11 11 — — $5,999.71 $9,962.64 $9,200.90 2026-07-10
918 MS_DRG Poisoning And Toxic Effects Of 11 11 — — $5,667.36 $9,960.38 $9,198.82 2026-07-10
87 MS_DRG Traumatic Stupor And Coma <1 Hour Without Cc/mcc 11 11 — — $7,965.19 $9,953.63 $9,192.58 2026-07-10
897 MS_DRG Alcohol, Drug Abuse Or Depende 11 11 — — $9,021.55 $9,933.36 $9,173.87 2026-07-10
68 MS_DRG Precerebral Occlusion Without Infarction Without Mcc 11 11 — — $9,166.59 $10,417.43 $9,166.59 2026-07-10
349 MS_DRG Anal And Stomal Procedures Wit 11 11 — — $7,546.94 $9,918.72 $9,160.35 2026-07-10
603 MS_DRG Cellulitis Without Mcc 11 11 — — $5,841.21 $9,917.60 $9,159.31 2026-07-10
541 MS_DRG Osteomyelitis Without Cc/mcc 11 11 — — $5,634.64 $9,851.16 $9,097.95 2026-07-10
785 MS_DRG Cesarean Section With Steriliz 11 11 — — $7,792.36 $9,835.40 $9,083.40 2026-07-10
312 MS_DRG Syncope And Collapse 11 11 — — $7,346.50 $9,810.63 $9,060.52 2026-07-10
558 MS_DRG Tendonitis, Myositis And Bursi 11 11 — — $5,143.78 $9,726.18 $8,982.53 2026-07-10
292 MS_DRG Heart Failure And Shock With C 11 11 — — $8,561.37 $9,696.91 $8,955.49 2026-07-10
439 MS_DRG Disorders Of Pancreas Except M 11 11 — — $7,793.39 $9,685.65 $8,945.09 2026-07-10
191 MS_DRG Chronic Obstructive Pulmonary 11 11 — — $8,215.73 $9,673.26 $8,933.65 2026-07-10
125 MS_DRG Other Disorders Of The Eye Wit 11 11 — — $7,817.93 $9,297.18 $8,586.33 2026-07-10
194 MS_DRG Simple Pneumonia And Pleurisy 11 11 — — $7,178.79 $9,233.00 $8,527.06 2026-07-10
728 MS_DRG Inflammation Of The Male Repro 11 11 — — $6,240.03 $9,200.35 $8,496.90 2026-07-10
176 MS_DRG Pulmonary Embolism Without Mcc 11 11 — — $6,635.78 $9,171.07 $8,469.86 2026-07-10
536 MS_DRG Fractures Of Hip And Pelvis Wi 11 11 — — $6,517.16 $9,130.54 $8,432.43 2026-07-10
123 MS_DRG Neurological Eye Disorders 11 11 — — $8,352.36 $9,125.86 $8,352.36 2026-07-10
690 MS_DRG Kidney And Urinary Tract Infec 11 11 — — $6,430.23 $9,037.08 $8,346.12 2026-07-10
389 MS_DRG Gastrointestinal Obstruction W 11 11 — — $5,905.63 $9,025.82 $8,335.72 2026-07-10
69 MS_DRG Transient Ischemia Without Thrombolytic 11 11 — — $8,320.12 $9,008.93 $8,320.12 2026-07-10
93 MS_DRG Other Disorders Of Nervous System Without Cc/mcc 11 11 — — $8,207.81 $9,487.87 $8,207.81 2026-07-10
694 MS_DRG Urinary Stones Without Mcc 11 11 — — $5,939.38 $8,798.38 $8,125.66 2026-07-10
641 MS_DRG Miscellaneous Disorders Of Nut 11 11 — — $6,406.71 $8,798.38 $8,125.66 2026-07-10
392 MS_DRG Esophagitis, Gastroenteritis A 11 11 — — $6,594.88 $8,785.99 $8,114.22 2026-07-10
185 MS_DRG Major Chest Trauma Without Cc/ 11 11 — — $6,599.99 $8,756.72 $8,087.19 2026-07-10
305 MS_DRG Hypertension Without Mcc 11 11 — — $6,373.99 $8,452.70 $7,806.42 2026-07-10
72 MS_DRG Other Cerebrovascular Disorders Without Cc/mcc 11 11 — — $7,801.22 $9,181.08 $7,801.22 2026-07-10
149 MS_DRG Dysequilibrium 11 11 — — $7,773.14 $8,416.67 $7,773.14 2026-07-10
832 MS_DRG Other Antepartum Diagnoses Wit 11 11 — — $4,557.82 $8,415.54 $7,772.10 2026-07-10
309 MS_DRG Cardiac Arrhythmia And Conduct 11 11 — — $5,429.09 $8,324.34 $7,687.87 2026-07-10
373 MS_DRG Major Gastrointestinal Disorde 11 11 — — $5,752.24 $8,167.83 $7,543.33 2026-07-10
282 MS_DRG Acute Myocardial Infarction, D 11 11 — — $7,540.21 $9,420.38 $7,540.21 2026-07-10
806 MS_DRG Vaginal Delivery Without Steri 11 11 — — $4,909.60 $8,147.56 $7,524.61 2026-07-10
869 MS_DRG Other Infectious And Parasitic 11 11 — — $6,430.23 $8,102.52 $7,483.01 2026-07-10
776 MS_DRG Postpartum And Post Abortion D 11 11 — — $4,083.32 $8,033.84 $7,419.58 2026-07-10
313 MS_DRG Chest Pain 11 11 — — $6,702.25 $8,032.71 $7,418.54 2026-07-10
153 MS_DRG Otitis Media And Uri Without M 11 11 — — $4,876.87 $8,013.57 $7,400.86 2026-07-10
311 MS_DRG Angina Pectoris 11 11 — — $6,751.34 $7,862.69 $7,261.52 2026-07-10
203 MS_DRG Bronchitis And Asthma Without 11 11 — — $4,834.95 $7,843.55 $7,243.84 2026-07-10
434 MS_DRG Cirrhosis And Alcoholic Hepati 11 11 — — $6,798.38 $7,842.42 $7,242.80 2026-07-10
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 11 11 — — $7,157.53 $9,331.41 $7,157.53 2026-07-10
819 MS_DRG Other Antepartum Diagnoses Wit 11 11 — — $7,023.38 $8,491.84 $7,023.38 2026-07-10
303 MS_DRG Atherosclerosis Without Mcc 11 11 — — $5,327.85 $7,571.06 $6,992.19 2026-07-10
916 MS_DRG Allergic Reactions Without Mcc 11 11 — — $4,516.91 $7,477.61 $6,905.88 2026-07-10
159 MS_DRG Dental And Oral Diseases Witho 11 11 — — $5,959.83 $7,426.94 $6,859.08 2026-07-10
192 MS_DRG Chronic Obstructive Pulmonary 11 11 — — $5,120.26 $7,287.32 $6,730.14 2026-07-10
807 MS_DRG Vaginal Delivery Without Steri 11 11 — — $4,295.00 $7,175.85 $6,627.19 2026-07-10
379 MS_DRG Gastrointestinal Hemorrhage Wi 11 11 — — $6,620.95 $7,169.09 $6,620.95 2026-07-10
395 MS_DRG Other Digestive System Diagnos 11 11 — — $6,259.46 $7,165.71 $6,617.83 2026-07-10
639 MS_DRG Diabetes Without Cc/mcc 11 11 — — $4,689.74 $7,055.37 $6,515.92 2026-07-10
894 MS_DRG Alcohol, Drug Abuse Or Depende 11 11 — — $3,945.27 $7,027.22 $6,489.92 2026-07-10
195 MS_DRG Simple Pneumonia And Pleurisy 11 11 — — $5,718.49 $7,011.45 $6,475.36 2026-07-10
440 MS_DRG Disorders Of Pancreas Except M 11 11 — — $5,857.57 $6,925.88 $6,396.33 2026-07-10
684 MS_DRG Renal Failure Without Cc/mcc 11 11 — — $4,811.43 $6,839.18 $6,316.26 2026-07-10
730 MS_DRG Other Male Reproductive System 11 11 — — $3,603.71 $6,833.55 $6,311.06 2026-07-10
951 MS_DRG Other Factors Influencing Heal 11 11 — — $4,095.59 $6,384.28 $5,896.15 2026-07-10
310 MS_DRG Cardiac Arrhythmia And Conduct 11 11 — — $4,612.02 $6,299.84 $5,818.16 2026-07-10
293 MS_DRG Heart Failure And Shock Withou 11 11 — — $5,353.42 $6,178.23 $5,705.85 2026-07-10
390 MS_DRG Gastrointestinal Obstruction W 11 11 — — $4,376.81 $6,161.34 $5,690.25 2026-07-10
833 MS_DRG Other Antepartum Diagnoses Wit 11 11 — — $3,002.41 $5,852.82 $5,405.32 2026-07-10
29881 CPT Arthroscopy, Knee, Surgical; With Meniscectomy (medial Or Lateral, Including Any… 1 1 — — $5,126.00 $5,126.00 $5,126.00 2026-07-10
29823 CPT Arthroscopy, Shoulder, Surgical; Debridement, Extensive, 3 Or More Discrete Stru… 1 1 — — $5,126.00 $5,126.00 $5,126.00 2026-07-10
J0897 HCPCS Injection, Denosumab, 1 Mg 1 1 — — $3,508.80 $3,508.80 $3,508.80 2026-07-10
C1889 HCPCS Implantable/insertable Device, Not Otherwise Classified 2 1 — — $1,168.22 $5,362.50 $3,265.36 2026-07-10
Q5104 HCPCS Injection, Infliximab-abda, Biosimilar, (renflexis), 10 Mg 1 1 — — $3,006.00 $3,006.00 $3,006.00 2026-07-10
J0132 HCPCS Injection, Acetylcysteine, 100 Mg 1 1 — — $1,838.61 $1,838.61 $1,838.61 2026-07-10
J3489 HCPCS Injection, Zoledronic Acid, 1 Mg 4 4 — — $471.34 $1,977.57 $1,744.61 2026-07-10
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 1 1 — — $1,699.28 $1,699.28 $1,699.28 2026-07-10
J1756 HCPCS Injection, Iron Sucrose, 1 Mg 2 2 — — $409.68 $1,721.33 $1,065.50 2026-07-10
A9500 HCPCS Technetium Tc-99m Sestamibi, Diagnostic, Per Study Dose 10 5 — — $112.66 $1,099.61 $815.77 2026-07-10
J2248 HCPCS Injection, Micafungin Sodium, 1 Mg 1 1 — — $779.39 $779.39 $779.39 2026-07-10
J0282 HCPCS Injection, Amiodarone Hydrochloride, 30 Mg 1 1 — — $768.57 $768.57 $768.57 2026-07-10
J0834 HCPCS Injection, Cosyntropin, 0.25 Mg 3 3 — — $221.63 $628.83 $628.83 2026-07-10
Q9968 HCPCS Injection, Non-radioactive, Non-contrast, Visualization Adjunct (e.g., Methylene… 1 1 — — $557.69 $557.69 $557.69 2026-07-10
J0613 HCPCS Injection, Calcium Gluconate (wg Critical Care), Not Therapeutically Equivalent … 2 2 — — $189.59 $707.26 $448.42 2026-07-10
A9516 HCPCS Iodine I-123 Sodium Iodide, Diagnostic, Per 100 Microcuries, Up To 999 Microcuri… 1 1 — — $370.29 $370.29 $370.29 2026-07-10
J2785 HCPCS Injection, Regadenoson, 0.1 Mg 9 4 — — $39.25 $730.89 $333.53 2026-07-10
A9541 HCPCS Technetium Tc-99m Sulfur Colloid, Diagnostic, Per Study Dose, Up To 20 Millicuri… 1 1 — — $315.30 $315.30 $315.30 2026-07-10
A9510 HCPCS Technetium Tc-99m Disofenin, Diagnostic, Per Study Dose, Up To 15 Millicuries 4 4 — — $178.36 $338.93 $300.68 2026-07-10
J0131 HCPCS Injection, Acetaminophen, Not Otherwise Specified,10 Mg 9 5 — — $71.73 $485.51 $290.15 2026-07-10
Q0138 HCPCS Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd … 2 2 — — $192.27 $381.69 $286.98 2026-07-10
J2354 HCPCS Injection, Octreotide, Non-depot Form For Subcutaneous Or Intravenous Injection,… 2 2 — — $71.26 $446.22 $258.74 2026-07-10
J0153 HCPCS Injection, Adenosine, 1 Mg (not To Be Used To Report Any Adenosine Phosphate Com… 2 2 — — $34.30 $479.05 $256.68 2026-07-10
J2790 HCPCS Injection, Rho D Immune Globulin, Human, Full Dose, 300 Micrograms (1500 I.u.) 7 5 — — $148.74 $985.03 $241.53 2026-07-10
J1335 HCPCS Injection, Ertapenem Sodium, 500 Mg 4 2 — — $94.82 $294.29 $184.88 2026-07-10
J3430 HCPCS Injection, Phytonadione (vitamin K), Per 1 Mg 2 2 — — $54.76 $307.71 $181.23 2026-07-10
J0133 HCPCS Injection, Acyclovir, 5 Mg 1 1 — — $175.47 $175.47 $175.47 2026-07-10
J3360 HCPCS Injection, Diazepam, Up To 5 Mg 8 4 — — $104.76 $266.88 $171.75 2026-07-10
J3230 HCPCS Injection, Chlorpromazine Hcl, Up To 50 Mg 3 2 — — $81.12 $181.52 $170.37 2026-07-10
J0702 HCPCS Injection, Betamethasone Acetate 3 Mg And Betamethasone Sodium Phosphate 3 Mg 7 5 — — $13.92 $238.21 $166.36 2026-07-10
J2540 HCPCS Injection, Penicillin G Potassium, Up To 600,000 Units 2 1 — — $160.98 $164.16 $162.57 2026-07-10
J1953 HCPCS Injection, Levetiracetam, 10 Mg 13 5 — — $5.00 $541.33 $149.25 2026-07-10
Q5106 HCPCS Injection, Epoetin Alfa-epbx, Biosimilar, (retacrit) (for Non-esrd Use), 1000 Un… 1 1 — — $141.40 $141.40 $141.40 2026-07-10
J0290 HCPCS Injection, Ampicillin Sodium, 500 Mg 4 3 — — $8.63 $215.41 $130.07 2026-07-10
90698 HCPCS Diphtheria, Tetanus Toxoids, Acellular Pertussis Vaccine, Haemophilus Influenzae… 2 2 — — $104.74 $114.51 $109.62 2026-07-10
J0595 HCPCS Injection, Butorphanol Tartrate, 1 Mg 3 2 — — $38.74 $111.18 $108.47 2026-07-10
J2543 HCPCS Injection, Piperacillin Sodium/tazobactam Sodium, 1 Gram/0.125 Grams (1.125 Gram… 27 5 — — $17.26 $426.37 $107.69 2026-07-10
90715 HCPCS Tetanus, Diphtheria Toxoids And Acellular Pertussis Vaccine (Tdap), When Adminis… 9 5 — — $36.35 $187.30 $95.84 2026-07-10
J9260 HCPCS Injection, Methotrexate Sodium, 50 Mg 2 2 — — $69.52 $118.71 $94.11 2026-07-10
J2210 HCPCS Injection, Methylergonovine Maleate, Up To 0.2 Mg 4 2 — — $39.74 $272.69 $88.25 2026-07-10
J0330 HCPCS Injection, Succinylcholine Chloride, Up To 20 Mg 7 5 — — $33.80 $404.41 $84.43 2026-07-10
J0456 HCPCS Injection, Azithromycin, 500 Mg 3 2 — — $27.47 $104.58 $83.60 2026-07-10
J0461 HCPCS Injection, Atropine Sulfate, 0.01 Mg 2 2 — — $77.17 $90.01 $83.59 2026-07-10
J7042 HCPCS 5% Dextrose/normal Saline (500 Ml = 1 Unit) 3 3 — — $71.60 $80.19 $80.19 2026-07-10
A9503 HCPCS Technetium Tc-99m Medronate, Diagnostic, Per Study Dose, Up To 30 Millicuries 3 3 — — $70.62 $89.23 $70.62 2026-07-10
J3475 HCPCS Injection, Magnesium Sulfate, Per 500 Mg 21 5 — — $1.77 $344.95 $65.18 2026-07-10
J1815 HCPCS Injection, Insulin, Per 5 Units 5 2 — — $17.71 $120.00 $63.34 2026-07-10
J0295 HCPCS Injection, Ampicillin Sodium/sulbactam Sodium, Per 1.5 Gm 7 3 — — $19.32 $239.40 $62.13 2026-07-10
J2704 HCPCS Injection, Propofol, 10 Mg 56 5 — — $5.55 $398.25 $59.54 2026-07-10
J1580 HCPCS Injection, Garamycin, Gentamicin, Up To 80 Mg 2 1 — — $24.09 $76.95 $50.52 2026-07-10
J0744 HCPCS Injection, Ciprofloxacin For Intravenous Infusion, 200 Mg 3 2 — — $15.94 $258.07 $48.27 2026-07-10
J0696 HCPCS Injection, Ceftriaxone Sodium, Per 250 Mg 27 5 — — $8.91 $534.85 $47.20 2026-07-10
J2404 HCPCS Injection, Nicardipine, 0.1 Mg 3 2 — — $0.10 $610.20 $46.21 2026-07-10
J1956 HCPCS Injection, Levofloxacin, 250 Mg 5 2 — — $5.98 $150.84 $44.22 2026-07-10
J1938 HCPCS Injection, Furosemide, 1 Mg 11 5 — — $4.89 $78.00 $41.95 2026-07-10
J1720 HCPCS Injection, Hydrocortisone Sodium Succinate, Up To 100 Mg 2 1 — — $40.64 $40.88 $40.76 2026-07-10
J0694 HCPCS Injection, Cefoxitin Sodium, 1 Gm 3 1 — — $26.72 $40.77 $39.40 2026-07-10
J0692 HCPCS Injection, Cefepime Hydrochloride, 500 Mg 5 3 — — $24.06 $328.15 $36.47 2026-07-10
J0780 HCPCS Injection, Prochlorperazine, Up To 10 Mg 5 5 — — $11.64 $59.81 $32.40 2026-07-10
J7060 HCPCS 5% Dextrose/water (500 Ml = 1 Unit) 2 1 — — $6.89 $57.82 $32.35 2026-07-10
J3480 HCPCS Injection, Potassium Chloride, Per 2 Meq 13 5 — — $12.40 $175.88 $32.16 2026-07-10
J1644 HCPCS Injection, Heparin Sodium, Per 1000 Units 22 5 — — $2.85 $346.75 $29.71 2026-07-10
J7050 HCPCS Infusion, Normal Saline Solution, 250 Cc 13 5 — — $0.84 $538.00 $28.80 2026-07-10
J1630 HCPCS Injection, Haloperidol, Up To 5 Mg 15 5 — — $4.63 $269.40 $26.34 2026-07-10
J2590 HCPCS Injection, Oxytocin, Up To 10 Units 1 1 — — $25.50 $25.50 $25.50 2026-07-10
J3410 HCPCS Injection, Hydroxyzine Hcl, Up To 25 Mg 1 1 — — $24.99 $24.99 $24.99 2026-07-10
J1171 HCPCS Injection, Hydromorphone, 0.1 Mg 38 5 — — $1.55 $118.34 $24.21 2026-07-10
J0690 HCPCS Injection, Cefazolin Sodium, 500 Mg 19 5 — — $5.74 $123.65 $24.21 2026-07-10
J3301 HCPCS Injection, Triamcinolone Acetonide, Not Otherwise Specified, 10 Mg 8 4 — — $11.37 $60.19 $22.62 2026-07-10
J3486 HCPCS Injection, Ziprasidone Mesylate, 10 Mg 1 1 — — $22.52 $22.52 $22.52 2026-07-10
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