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

THE UNIVERSITY OF VERMONT HEALTH NETWORK-ALICE HY

Malone, NY · CCN 331321 · Rates published

10,067 distinct procedures filed
13 distinct payers
229,403 rate rows
2026-05-09 last MRF observed
Data quality

187,156 of 229,403 rate rows are consumer-grade (81.6%)

42,247 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 38,282
per-diem day rate — not a per-procedure price 1,524
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 1,380
exceeds 10× this hospital's gross charge — excluded from medians 760
placeholder amount (≤ $0.02) — excluded from medians 159
template filing: same amount across many unrelated codes — excluded 142
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.alicehyde.com/data/files/150346515_alice-hyde-medical-center_standardcharges.csv
Found on page https://www.alicehyde.com/Patients-and-Visitors/Price-Transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-20
Content fingerprint 2222290b456edaa5… · 12,072,548 bytes · first seen 2026-05-09

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
644
OTHER 		Endocrine Disorders With Cc 7 $7,400.00 $27,001.64 $23,190.82 nat. median
$4,871
outlier · 4.8×
602
OTHER 		Cellulitis With Mcc 7 $7,400.00 $23,614.15 $21,497.07 nat. median
$2,374
outlier · 9.1×
464
OTHER 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 7 $7,400.00 $23,371.67 $21,375.83 nat. median
$18,068
1.2× median
522
OTHER 		Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 7 $7,400.00 $21,481.18 $20,430.59 nat. median
$78
outlier · 260.8×
229
OTHER 		Other Cardiothoracic Procedures Without Mcc 7 $7,400.00 $19,380.00 $19,004.19 nat. median
$20,945
0.9× median
811
OTHER 		Red Blood Cell Disorders With Mcc 7 $7,400.00 $19,380.00 $18,676.44 nat. median
$22
outlier · 858.7×
101
OTHER 		Seizures Without Mcc 7 $7,400.00 $19,380.00 $17,969.29 nat. median
$2,374
outlier · 7.6×
425
OTHER 		Other Hepatobiliary Or Pancreas O.r. Procedures Without Cc/mcc 7 $7,400.00 $19,380.00 $16,842.71 nat. median
$9,098
1.9× median
558
OTHER 		Tendonitis, Myositis And Bursitis Without Mcc 7 $7,400.00 $19,380.00 $15,576.33 nat. median
$2,452
outlier · 6.4×
314
OTHER 		Other Circulatory System Diagnoses With Mcc 7 $7,400.00 $19,380.00 $15,040.15 nat. median
$9,440
1.6× median
178
OTHER 		Respiratory Infections And Inflammations With Cc 7 $7,400.00 $19,380.00 $14,651.08 nat. median
$4,049
outlier · 3.6×
493
OTHER 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 7 $7,400.00 $19,380.00 $14,442.89 nat. median
$14,753
1.0× median
690
OTHER 		Kidney And Urinary Tract Infections Without Mcc 7 $7,400.00 $19,380.00 $13,944.60 nat. median
$3,106
outlier · 4.5×
175
OTHER 		Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 7 $7,400.00 $19,380.00 $13,782.81 nat. median
$15,591
0.9× median
683
OTHER 		Renal Failure With Cc 7 $7,400.00 $19,380.00 $13,660.78 nat. median
$3,742
outlier · 3.7×
244
OTHER 		Permanent Cardiac Pacemaker Implant Without Cc/mcc 7 $7,400.00 $19,380.00 $13,541.34 nat. median
$11,238
1.2× median
809
OTHER 		Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 7 $7,400.00 $19,380.00 $13,422.12 nat. median
$5,276
outlier · 2.5×
816
OTHER 		Reticuloendothelial And Immunity Disorders Without Cc/mcc 7 $7,400.00 $19,380.00 $13,416.41 nat. median
$2,171
outlier · 6.2×
66
OTHER 		Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 7 $7,400.00 $19,380.00 $13,240.93 nat. median
$6,781
2.0× median
540
OTHER 		Osteomyelitis With Cc 7 $7,400.00 $19,380.00 $13,079.47 nat. median
$336
outlier · 38.9×
189
OTHER 		Pulmonary Edema And Respiratory Failure 7 $7,400.00 $19,380.00 $13,035.22 nat. median
$4,199
outlier · 3.1×
83
OTHER 		Traumatic Stupor And Coma >1 Hour With Cc 7 $7,400.00 $19,380.00 $12,959.46 nat. median
$4,964
outlier · 2.6×
308
OTHER 		Cardiac Arrhythmia And Conduction Disorders With Mcc 7 $7,400.00 $19,380.00 $12,777.31 nat. median
$5,784
outlier · 2.2×
639
OTHER 		Diabetes Without Cc/mcc 7 $7,400.00 $19,380.00 $12,580.11 nat. median
$2,354
outlier · 5.3×
638
OTHER 		Diabetes With Cc 7 $7,400.00 $19,380.00 $12,494.05 nat. median
$3,587
outlier · 3.5×
854
OTHER 		Infectious And Parasitic Diseases With O.r. Procedures With Cc 7 $7,400.00 $19,380.00 $12,380.49 nat. median
$1,903
outlier · 6.5×
815
OTHER 		Reticuloendothelial And Immunity Disorders With Cc 7 $7,400.00 $19,380.00 $11,857.29 nat. median
$61
outlier · 195.2×
641
OTHER 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 7 $7,400.00 $19,380.00 $11,824.49 nat. median
$3,520
outlier · 3.4×
263
OTHER 		Vein Ligation And Stripping 7 $7,400.00 $19,380.00 $11,543.74 nat. median
$21,883
0.5× median
871
OTHER 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 7 $7,400.00 $19,380.00 $11,501.02 nat. median
$12
outlier · 986.4×
190
OTHER 		Chronic Obstructive Pulmonary Disease With Mcc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$114
outlier · 100.4×
280
OTHER 		Acute Myocardial Infarction, Discharged Alive With Mcc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$7,207
1.6× median
192
OTHER 		Chronic Obstructive Pulmonary Disease Without Cc/mcc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$178
outlier · 64.1×
292
OTHER 		Heart Failure And Shock With Cc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$3,994
outlier · 2.9×
176
OTHER 		Pulmonary Embolism Without Mcc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$178
outlier · 64.1×
141
OTHER 		Major Head And Neck Procedures With Cc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$2,140
outlier · 5.3×
241
OTHER 		Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$7,594
1.5× median
201
OTHER 		Pneumothorax Without Cc/mcc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$2,186
outlier · 5.2×
282
OTHER 		Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$4,531
outlier · 2.5×
309
OTHER 		Cardiac Arrhythmia And Conduction Disorders With Cc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$3,044
outlier · 3.7×
311
OTHER 		Angina Pectoris 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$2,640
outlier · 4.3×
344
OTHER 		Minor Small And Large Bowel Procedures With Mcc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$11,573
1.0× median
140
OTHER 		Major Head And Neck Procedures With Mcc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$91
outlier · 125.5×
177
OTHER 		Respiratory Infections And Inflammations With Mcc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$13,701
0.8× median
191
OTHER 		Chronic Obstructive Pulmonary Disease With Cc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$3,709
outlier · 3.1×
193
OTHER 		Simple Pneumonia And Pleurisy With Mcc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$5,431
outlier · 2.1×
198
OTHER 		Interstitial Lung Disease Without Cc/mcc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$4,427
outlier · 2.6×
194
OTHER 		Simple Pneumonia And Pleurisy With Cc 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$3,935
outlier · 2.9×
139
OTHER 		Salivary Gland Procedures 7 $7,400.00 $19,380.00 $11,399.38 nat. median
$6,757
1.7× median
249
OTHER 		Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 7 $7,400.00 $19,380.00 $11,399.38 —

Other procedures at this hospital

Browse this hospital's 10,067 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
             
644 OTHER Endocrine Disorders With Cc 8 7 $63,230.66 $63,230.66 $7,400.00 $27,001.64 $23,190.82 2026-05-09
602 OTHER Cellulitis With Mcc 8 7 $54,761.93 $54,761.93 $7,400.00 $23,614.15 $21,497.07 2026-05-09
464 OTHER Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 8 7 $54,155.74 $54,155.74 $7,400.00 $23,371.67 $21,375.83 2026-05-09
522 OTHER Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 8 7 $49,429.51 $49,429.51 $7,400.00 $21,481.18 $20,430.59 2026-05-09
229 OTHER Other Cardiothoracic Procedures Without Mcc 8 7 $43,237.03 $43,237.03 $7,400.00 $19,380.00 $19,004.19 2026-05-09
811 OTHER Red Blood Cell Disorders With Mcc 8 7 $42,417.65 $42,417.65 $7,400.00 $19,380.00 $18,676.44 2026-05-09
101 OTHER Seizures Without Mcc 8 7 $40,649.80 $40,649.80 $7,400.00 $19,380.00 $17,969.29 2026-05-09
425 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures Without Cc/mcc 8 7 $37,833.34 $37,833.34 $7,400.00 $19,380.00 $16,842.71 2026-05-09
558 OTHER Tendonitis, Myositis And Bursitis Without Mcc 8 7 $34,667.40 $34,667.40 $7,400.00 $19,380.00 $15,576.33 2026-05-09
314 OTHER Other Circulatory System Diagnoses With Mcc 8 7 $33,326.94 $33,326.94 $7,400.00 $19,380.00 $15,040.15 2026-05-09
178 OTHER Respiratory Infections And Inflammations With Cc 8 7 $32,354.26 $32,354.26 $7,400.00 $19,380.00 $14,651.08 2026-05-09
493 OTHER Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 8 7 $31,833.78 $31,833.78 $7,400.00 $19,380.00 $14,442.89 2026-05-09
690 OTHER Kidney And Urinary Tract Infections Without Mcc 8 7 $30,588.08 $30,588.08 $7,400.00 $19,380.00 $13,944.60 2026-05-09
175 OTHER Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 8 7 $30,183.58 $30,183.58 $7,400.00 $19,380.00 $13,782.81 2026-05-09
683 OTHER Renal Failure With Cc 8 7 $29,878.52 $29,878.52 $7,400.00 $19,380.00 $13,660.78 2026-05-09
244 OTHER Permanent Cardiac Pacemaker Implant Without Cc/mcc 8 7 $29,579.91 $29,579.91 $7,400.00 $19,380.00 $13,541.34 2026-05-09
809 OTHER Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 8 7 $29,281.86 $29,281.86 $7,400.00 $19,380.00 $13,422.12 2026-05-09
816 OTHER Reticuloendothelial And Immunity Disorders Without Cc/mcc 8 7 $29,267.58 $29,267.58 $7,400.00 $19,380.00 $13,416.41 2026-05-09
66 OTHER Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 8 7 $28,828.90 $28,828.90 $7,400.00 $19,380.00 $13,240.93 2026-05-09
540 OTHER Osteomyelitis With Cc 8 7 $28,425.23 $28,425.23 $7,400.00 $19,380.00 $13,079.47 2026-05-09
189 OTHER Pulmonary Edema And Respiratory Failure 8 7 $28,314.62 $28,314.62 $7,400.00 $19,380.00 $13,035.22 2026-05-09
83 OTHER Traumatic Stupor And Coma >1 Hour With Cc 8 7 $28,125.22 $28,125.22 $7,400.00 $19,380.00 $12,959.46 2026-05-09
308 OTHER Cardiac Arrhythmia And Conduction Disorders With Mcc 8 7 $27,669.84 $27,669.84 $7,400.00 $19,380.00 $12,777.31 2026-05-09
639 OTHER Diabetes Without Cc/mcc 8 7 $27,176.83 $27,176.83 $7,400.00 $19,380.00 $12,580.11 2026-05-09
638 OTHER Diabetes With Cc 8 7 $26,961.67 $26,961.67 $7,400.00 $19,380.00 $12,494.05 2026-05-09
854 OTHER Infectious And Parasitic Diseases With O.r. Procedures With Cc 8 7 $26,677.77 $26,677.77 $7,400.00 $19,380.00 $12,380.49 2026-05-09
815 OTHER Reticuloendothelial And Immunity Disorders With Cc 8 7 $25,369.79 $25,369.79 $7,400.00 $19,380.00 $11,857.29 2026-05-09
641 OTHER Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 8 7 $25,287.79 $25,287.79 $7,400.00 $19,380.00 $11,824.49 2026-05-09
263 OTHER Vein Ligation And Stripping 8 7 $24,585.90 $24,585.90 $7,400.00 $19,380.00 $11,543.74 2026-05-09
871 OTHER Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 8 7 $24,479.13 $24,479.13 $7,400.00 $19,380.00 $11,501.02 2026-05-09
442 OTHER Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 8 7 $21,033.16 $21,033.16 $7,400.00 $19,380.00 $11,399.38 2026-05-09
136 OTHER Sinus And Mastoid Procedures Without Cc/mcc 8 7 $15,677.61 $15,677.61 $7,400.00 $19,380.00 $11,399.38 2026-05-09
292 OTHER Heart Failure And Shock With Cc 8 7 $17,660.26 $17,660.26 $7,400.00 $19,380.00 $11,399.38 2026-05-09
241 OTHER Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 8 7 $19,395.26 $19,395.26 $7,400.00 $19,380.00 $11,399.38 2026-05-09
463 OTHER Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 8 7 $15,875.82 $15,875.82 $7,400.00 $19,380.00 $11,399.38 2026-05-09
291 OTHER Heart Failure And Shock With Mcc 8 7 $20,028.02 $20,028.02 $7,400.00 $19,380.00 $11,399.38 2026-05-09
812 OTHER Red Blood Cell Disorders Without Mcc 8 7 $9,095.18 $9,095.18 $7,400.00 $19,380.00 $11,399.38 2026-05-09
190 OTHER Chronic Obstructive Pulmonary Disease With Mcc 8 7 $22,323.74 $22,323.74 $7,400.00 $19,380.00 $11,399.38 2026-05-09
58 OTHER Multiple Sclerosis And Cerebellar Ataxia With Mcc 8 7 $13,941.44 $13,941.44 $7,400.00 $19,380.00 $11,399.38 2026-05-09
378 OTHER Gastrointestinal Hemorrhage With Cc 8 7 $16,767.53 $16,767.53 $7,400.00 $19,380.00 $11,399.38 2026-05-09
438 OTHER Disorders Of Pancreas Except Malignancy With Mcc 8 7 $13,982.01 $13,982.01 $7,400.00 $19,380.00 $11,399.38 2026-05-09
391 OTHER Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 8 7 $12,079.81 $12,079.81 $7,400.00 $19,380.00 $11,399.38 2026-05-09
57 OTHER Degenerative Nervous System Disorders Without Mcc 8 7 $14,939.44 $14,939.44 $7,400.00 $19,380.00 $11,399.38 2026-05-09
113 OTHER Orbital Procedures With Cc/mcc 8 7 $14,014.93 $14,014.93 $7,400.00 $19,380.00 $11,399.38 2026-05-09
192 OTHER Chronic Obstructive Pulmonary Disease Without Cc/mcc 8 7 $17,881.89 $17,881.89 $7,400.00 $19,380.00 $11,399.38 2026-05-09
140 OTHER Major Head And Neck Procedures With Mcc 8 7 $15,285.94 $15,285.94 $7,400.00 $19,380.00 $11,399.38 2026-05-09
420 OTHER Hepatobiliary Diagnostic Procedures With Mcc 8 7 $19,261.81 $19,261.81 $7,400.00 $19,380.00 $11,399.38 2026-05-09
388 OTHER Gastrointestinal Obstruction With Mcc 8 7 $14,598.02 $14,598.02 $7,400.00 $19,380.00 $11,399.38 2026-05-09
281 OTHER Acute Myocardial Infarction, Discharged Alive With Cc 8 7 $18,010.94 $18,010.94 $7,400.00 $19,380.00 $11,399.38 2026-05-09
536 OTHER Fractures Of Hip And Pelvis Without Mcc 8 7 $9,807.17 $9,807.17 $7,400.00 $19,380.00 $11,399.38 2026-05-09
193 OTHER Simple Pneumonia And Pleurisy With Mcc 8 7 $21,031.65 $21,031.65 $7,400.00 $19,380.00 $11,399.38 2026-05-09
191 OTHER Chronic Obstructive Pulmonary Disease With Cc 8 7 $12,050.48 $12,050.48 $7,400.00 $19,380.00 $11,399.38 2026-05-09
552 OTHER Medical Back Problems Without Mcc 8 7 $16,691.27 $16,691.27 $7,400.00 $19,380.00 $11,399.38 2026-05-09
393 OTHER Other Digestive System Diagnoses With Mcc 8 7 $7,614.98 $7,614.98 $7,400.00 $19,380.00 $11,399.38 2026-05-09
179 OTHER Respiratory Infections And Inflammations Without Cc/mcc 8 7 $14,417.27 $14,417.27 $7,400.00 $19,380.00 $11,399.38 2026-05-09
640 OTHER Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 8 7 $16,395.54 $16,395.54 $7,400.00 $19,380.00 $11,399.38 2026-05-09
441 OTHER Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 8 7 $14,177.69 $14,177.69 $7,400.00 $19,380.00 $11,399.38 2026-05-09
282 OTHER Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 8 7 $16,783.50 $16,783.50 $7,400.00 $19,380.00 $11,399.38 2026-05-09
724 OTHER Malignancy, Male Reproductive System Without Cc/mcc 8 7 $5,629.70 $5,629.70 $7,400.00 $19,380.00 $11,399.38 2026-05-09
389 OTHER Gastrointestinal Obstruction With Cc 8 7 $16,416.71 $16,416.71 $7,400.00 $19,380.00 $11,399.38 2026-05-09
141 OTHER Major Head And Neck Procedures With Cc 8 7 $19,097.42 $19,097.42 $7,400.00 $19,380.00 $11,399.38 2026-05-09
330 OTHER Major Small And Large Bowel Procedures With Cc 8 7 $18,581.11 $18,581.11 $7,400.00 $19,380.00 $11,399.38 2026-05-09
383 OTHER Uncomplicated Peptic Ulcer With Mcc 8 7 $17,844.18 $17,844.18 $7,400.00 $19,380.00 $11,399.38 2026-05-09
770 OTHER Abortion With D&c, Aspiration Curettage Or Hysterotomy 8 7 $18,700.01 $18,700.01 $7,400.00 $19,380.00 $11,399.38 2026-05-09
857 OTHER Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 8 7 $20,570.32 $20,570.32 $7,400.00 $19,380.00 $11,399.38 2026-05-09
204 OTHER Respiratory Signs And Symptoms 8 7 $9,050.29 $9,050.29 $7,400.00 $19,380.00 $11,399.38 2026-05-09
660 OTHER Kidney And Ureter Procedures For Non-neoplasm With Cc 8 7 $21,082.90 $21,082.90 $7,400.00 $19,380.00 $11,399.38 2026-05-09
563 OTHER Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 8 7 $9,878.52 $9,878.52 $7,400.00 $19,380.00 $11,399.38 2026-05-09
70 OTHER Nonspecific Cerebrovascular Disorders With Mcc 8 7 $21,433.19 $21,433.19 $7,400.00 $19,380.00 $11,399.38 2026-05-09
313 OTHER Chest Pain 8 7 $4,792.92 $4,792.92 $7,400.00 $19,380.00 $11,399.38 2026-05-09
309 OTHER Cardiac Arrhythmia And Conduction Disorders With Cc 8 7 $18,412.31 $18,412.31 $7,400.00 $19,380.00 $11,399.38 2026-05-09
177 OTHER Respiratory Infections And Inflammations With Mcc 8 7 $22,369.90 $22,369.90 $7,400.00 $19,380.00 $11,399.38 2026-05-09
539 OTHER Osteomyelitis With Mcc 8 7 $12,149.10 $12,149.10 $7,400.00 $19,380.00 $11,399.38 2026-05-09
92 OTHER Other Disorders Of Nervous System With Cc 8 7 $18,357.45 $18,357.45 $7,400.00 $19,380.00 $11,399.38 2026-05-09
663 OTHER Minor Bladder Procedures With Cc 8 7 $14,693.32 $14,693.32 $7,400.00 $19,380.00 $11,399.38 2026-05-09
884 OTHER Organic Disturbances And Intellectual Disability 8 7 $18,426.58 $18,426.58 $7,400.00 $19,380.00 $11,399.38 2026-05-09
198 OTHER Interstitial Lung Disease Without Cc/mcc 8 7 $10,809.89 $10,809.89 $7,400.00 $19,380.00 $11,399.38 2026-05-09
643 OTHER Endocrine Disorders With Mcc 8 7 $20,418.29 $20,418.29 $7,400.00 $19,380.00 $11,399.38 2026-05-09
201 OTHER Pneumothorax Without Cc/mcc 8 7 $8,935.09 $8,935.09 $7,400.00 $19,380.00 $11,399.38 2026-05-09
392 OTHER Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 8 7 $20,088.93 $20,088.93 $7,400.00 $19,380.00 $11,399.38 2026-05-09
385 OTHER Inflammatory Bowel Disease With Mcc 8 7 $18,768.87 $18,768.87 $7,400.00 $19,380.00 $11,399.38 2026-05-09
139 OTHER Salivary Gland Procedures 8 7 $12,250.79 $12,250.79 $7,400.00 $19,380.00 $11,399.38 2026-05-09
253 OTHER Other Vascular Procedures With Cc 8 7 $21,262.29 $21,262.29 $7,400.00 $19,380.00 $11,399.38 2026-05-09
390 OTHER Gastrointestinal Obstruction Without Cc/mcc 8 7 $23,593.83 $23,593.83 $7,400.00 $19,380.00 $11,399.38 2026-05-09
283 OTHER Acute Myocardial Infarction, Expired With Mcc 8 7 $23,496.85 $23,496.85 $7,400.00 $19,380.00 $11,399.38 2026-05-09
303 OTHER Atherosclerosis Without Mcc 8 7 $24,059.48 $24,059.48 $7,400.00 $19,380.00 $11,399.38 2026-05-09
65 OTHER Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 8 7 $22,525.42 $22,525.42 $7,400.00 $19,380.00 $11,399.38 2026-05-09
349 OTHER Anal And Stomal Procedures Without Cc/mcc 8 7 $18,828.40 $18,828.40 $7,400.00 $19,380.00 $11,399.38 2026-05-09
344 OTHER Minor Small And Large Bowel Procedures With Mcc 8 7 $18,928.35 $18,928.35 $7,400.00 $19,380.00 $11,399.38 2026-05-09
917 OTHER Poisoning And Toxic Effects Of Drugs With Mcc 8 7 $17,898.86 $17,898.86 $7,400.00 $19,380.00 $11,399.38 2026-05-09
64 OTHER Intracranial Hemorrhage Or Cerebral Infarction With Mcc 8 7 $18,629.58 $18,629.58 $7,400.00 $19,380.00 $11,399.38 2026-05-09
310 OTHER Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 8 7 $13,923.43 $13,923.43 $7,400.00 $19,380.00 $11,399.38 2026-05-09
387 OTHER Inflammatory Bowel Disease Without Cc/mcc 8 7 $17,518.35 $17,518.35 $7,400.00 $19,380.00 $11,399.38 2026-05-09
249 OTHER Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 8 7 $13,486.28 $13,486.28 $7,400.00 $19,380.00 $11,399.38 2026-05-09
689 OTHER Kidney And Urinary Tract Infections With Mcc 8 7 $20,742.50 $20,742.50 $7,400.00 $19,380.00 $11,399.38 2026-05-09
645 OTHER Endocrine Disorders Without Cc/mcc 8 7 $17,511.04 $17,511.04 $7,400.00 $19,380.00 $11,399.38 2026-05-09
264 OTHER Other Circulatory System O.r. Procedures 8 7 $20,456.50 $20,456.50 $7,400.00 $19,380.00 $11,399.38 2026-05-09
469 OTHER Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 8 7 $9,868.48 $9,868.48 $7,400.00 $19,380.00 $11,399.38 2026-05-09
372 OTHER Major Gastrointestinal Disorders And Peritoneal Infections With Cc 8 7 $9,034.05 $9,034.05 $7,400.00 $19,380.00 $11,399.38 2026-05-09
439 OTHER Disorders Of Pancreas Except Malignancy With Cc 8 7 $23,709.64 $23,709.64 $7,400.00 $19,380.00 $11,399.38 2026-05-09
436 OTHER Malignancy Of Hepatobiliary System Or Pancreas With Cc 8 7 $9,837.65 $9,837.65 $7,400.00 $19,380.00 $11,399.38 2026-05-09
710 OTHER Penis Procedures Without Cc/mcc 8 7 $18,969.74 $18,969.74 $7,400.00 $19,380.00 $11,399.38 2026-05-09
713 OTHER Transurethral Prostatectomy With Cc/mcc 8 7 $17,547.72 $17,547.72 $7,400.00 $19,380.00 $11,399.38 2026-05-09
137 OTHER Mouth Procedures With Cc/mcc 8 7 $15,372.51 $15,372.51 $7,400.00 $19,380.00 $11,399.38 2026-05-09
603 OTHER Cellulitis Without Mcc 8 7 $19,255.62 $19,255.62 $7,400.00 $19,380.00 $11,399.38 2026-05-09
862 OTHER Postoperative And Post-traumatic Infections With Mcc 8 7 $11,503.81 $11,503.81 $7,400.00 $19,380.00 $11,399.38 2026-05-09
351 OTHER Inguinal And Femoral Hernia Procedures With Cc 8 7 $9,843.30 $9,843.30 $7,400.00 $19,380.00 $11,399.38 2026-05-09
445 OTHER Disorders Of The Biliary Tract With Cc 8 7 $12,549.09 $12,549.09 $7,400.00 $19,380.00 $11,399.38 2026-05-09
422 OTHER Hepatobiliary Diagnostic Procedures Without Cc/mcc 8 7 $4,442.76 $4,442.76 $7,400.00 $19,380.00 $11,399.38 2026-05-09
989 OTHER Non-extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc 8 7 $12,770.40 $12,770.40 $7,400.00 $19,380.00 $11,399.38 2026-05-09
684 OTHER Renal Failure Without Cc/mcc 8 7 $8,719.13 $8,719.13 $7,400.00 $19,380.00 $11,399.38 2026-05-09
698 OTHER Other Kidney And Urinary Tract Diagnoses With Mcc 8 7 $6,037.49 $6,037.49 $7,400.00 $19,380.00 $11,399.38 2026-05-09
176 OTHER Pulmonary Embolism Without Mcc 8 7 $8,577.11 $8,577.11 $7,400.00 $19,380.00 $11,399.38 2026-05-09
682 OTHER Renal Failure With Mcc 8 7 $18,401.34 $18,401.34 $7,400.00 $19,380.00 $11,399.38 2026-05-09
948 OTHER Signs And Symptoms Without Mcc 8 7 $21,093.56 $21,093.56 $7,400.00 $19,380.00 $11,399.38 2026-05-09
93 OTHER Other Disorders Of Nervous System Without Cc/mcc 8 7 $10,739.95 $10,739.95 $7,400.00 $19,380.00 $11,399.38 2026-05-09
195 OTHER Simple Pneumonia And Pleurisy Without Cc/mcc 8 7 $21,677.60 $21,677.60 $7,400.00 $19,380.00 $11,399.38 2026-05-09
872 OTHER Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 8 7 $19,455.81 $19,455.81 $7,400.00 $19,380.00 $11,399.38 2026-05-09
254 OTHER Other Vascular Procedures Without Cc/mcc 8 7 $13,927.25 $13,927.25 $7,400.00 $19,380.00 $11,399.38 2026-05-09
564 OTHER Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 8 7 $5,889.93 $5,889.93 $7,400.00 $19,380.00 $11,399.38 2026-05-09
199 OTHER Pneumothorax With Mcc 8 7 $12,688.13 $12,688.13 $7,400.00 $19,380.00 $11,399.38 2026-05-09
947 OTHER Signs And Symptoms With Mcc 8 7 $18,859.50 $18,859.50 $7,400.00 $19,380.00 $11,399.38 2026-05-09
951 OTHER Other Factors Influencing Health Status 8 7 $9,730.23 $9,730.23 $7,400.00 $19,380.00 $11,399.38 2026-05-09
138 OTHER Mouth Procedures Without Cc/mcc 8 7 $8,598.43 $8,598.43 $7,400.00 $19,380.00 $11,399.38 2026-05-09
280 OTHER Acute Myocardial Infarction, Discharged Alive With Mcc 8 7 $18,984.61 $18,984.61 $7,400.00 $19,380.00 $11,399.38 2026-05-09
311 OTHER Angina Pectoris 8 7 $21,162.76 $21,162.76 $7,400.00 $19,380.00 $11,399.38 2026-05-09
194 OTHER Simple Pneumonia And Pleurisy With Cc 8 7 $20,676.22 $20,676.22 $7,400.00 $19,380.00 $11,399.38 2026-05-09
50633012011 OTHER Digoxin Immune Fab 40 Mg IV Solution 21 13 $16,625.48 $16,625.48 $4,777.44 $17,117.57 $10,947.50 2026-05-09
00074366303 OTHER Leuprolide 11.25 Mg (3 Month) Intramuscular Syringe Kit 21 13 $17,857.79 $17,857.79 $1,576.12 $8,916.43 $8,916.43 2026-05-09
53666 CPT Neurostimulator Interstimstim Medtronic X 16 10 $11,680.00 $11,680.00 $7,242.77 $7,242.77 $7,242.77 2026-05-09
9605961201 OTHER Pb - Critical Access Vag Deliv Only,prev C-sectn 29 12 $3,974.00 $3,974.00 $781.40 $12,926.53 $6,853.97 2026-05-09
7205940901 OTHER Hc - Vaginal Delivery Only 29 12 $4,037.00 $4,037.00 $694.58 $12,926.53 $6,810.56 2026-05-09
9605940901 OTHER Pb - Critical Access Obstetrical Care,vag Deliv Only 29 12 $2,785.00 $2,785.00 $694.58 $12,926.53 $6,810.56 2026-05-09
00074228203 OTHER Leuprolide 11.25 Mg Intramuscular Kit 21 13 $13,002.56 $13,002.56 $1,576.12 $6,706.51 $6,706.51 2026-05-09
00002758901 OTHER Bebtelovimab 175 Mg/2 Ml (87.5 Mg/ml) Intravenous Solution (unapp) 18 11 $7,909.43 $7,909.43 $3,116.67 $10,388.91 $6,483.74 2026-05-09
50633011012 OTHER Crotalidae Polyval Immune Fab Solution For Injection 21 13 $4,471.65 $4,471.65 $1,979.87 $7,093.88 $6,254.98 2026-05-09
9605961801 OTHER Pb - Critical Access Rout OB Care,c-sec,prev C-sec 23 12 $10,308.00 $10,308.00 $2,316.61 $9,207.92 $5,901.02 2026-05-09
9605951001 OTHER Pb - Critical Access Full Rout Obste Care,cesarean Deliv 23 12 $7,930.00 $7,930.00 $2,293.10 $9,113.79 $5,703.44 2026-05-09
00187520030 OTHER Fluorouracil 0.5 % Topical Cream 10 8 $8,830.11 $8,830.11 $5,580.95 $5,580.95 $5,580.95 2026-05-09
9602744701 OTHER Pb - Critical Access Total Knee Arthroplasty 10 5 $5,897.00 $5,897.00 $855.18 $54,417.24 $5,577.20 2026-05-09
9602713001 OTHER Pb - Critical Access Total Hip Arthroplasty 10 5 $5,515.00 $5,515.00 $856.03 $54,417.24 $5,577.20 2026-05-09
9602982701 OTHER Pb - Critical Access Shldr Arthroscop,surg,w/rotat Cuff Repr 10 5 $3,114.00 $3,114.00 $714.52 $29,579.85 $5,532.03 2026-05-09
9602980601 OTHER Pb - Critical Access Shldr Arthroscop,surg,capsulorrhaphy 10 5 $3,068.00 $3,068.00 $708.17 $29,579.85 $5,532.03 2026-05-09
9602980701 OTHER Pb - Critical Access Shldr Arthroscop,surg,repair,slap Lesion 10 5 $2,989.00 $2,989.00 $690.84 $29,579.85 $5,532.03 2026-05-09
9602988801 OTHER Pb - Critical Access Knee Scope,aid Ant Cruciate Repair 10 5 $3,781.00 $3,781.00 $653.27 $29,579.85 $5,532.03 2026-05-09
9602743801 OTHER Pb - Critical Access Arthroplasty Patella With Implant 9 5 $3,757.00 $3,757.00 $562.56 $17,255.57 $5,422.28 2026-05-09
9602347201 OTHER Pb - Critical Access Reconstr Total Shoulder Implant 9 5 $4,310.00 $4,310.00 $964.99 $24,433.73 $5,422.28 2026-05-09
9602744601 OTHER Pb - Critical Access Plasty Knee,med Or Lat Compartmt 9 5 $3,552.00 $3,552.00 $769.59 $17,255.57 $5,422.28 2026-05-09
9602744201 OTHER Pb - Critical Access Arthroplasty Fem Condyles/tibial Plateau Knee 9 5 $3,721.00 $3,721.00 $582.80 $17,255.57 $5,422.28 2026-05-09
9602982801 OTHER Pb - Critical Access Arthroscopy Shoulder Surgical Biceps Tenodesis 9 5 $2,663.00 $2,663.00 $613.19 $9,379.69 $5,378.37 2026-05-09
3337730101 OTHER Hc - Ntsty Modul Radthx Pln Dose-vol Histos 23 12 $9,921.00 $9,921.00 $1,216.00 $5,729.11 $5,172.65 2026-05-09
3417881601 OTHER Hc - PET Imaging For CT Attenuation Whole Body 23 12 $9,803.00 $9,803.00 $1,059.54 $6,468.53 $5,040.13 2026-05-09
3417881501 OTHER Hc - PET Imaging CT Attenuation Skull Base Mid-thigh 23 12 $9,803.00 $9,803.00 $1,058.75 $6,468.53 $5,039.73 2026-05-09
3417881401 OTHER Hc - PET Imaging CT For Attenuation Limited Area 23 12 $9,803.00 $9,803.00 $1,051.13 $6,468.53 $5,035.93 2026-05-09
9605940001 OTHER Pb - Critical Access Full Rout Obste Care,vaginal Deliv 29 12 $7,135.00 $7,135.00 $1,772.95 $8,223.67 $4,998.31 2026-05-09
9602782201 OTHER Pb - Critical Access Open Tx Trimalleolar Ankle Fx Without Fix Pst Lip 10 5 $3,234.00 $3,234.00 $589.63 $29,579.85 $4,732.61 2026-05-09
9602723501 OTHER Pb - Critical Access Percut Fix Prox/neck Femur Fx 10 5 $3,332.00 $3,332.00 $606.94 $29,579.85 $4,732.61 2026-05-09
9602560801 OTHER Pb - Critical Access Open Rx Distal Radius Fx, Intra-articular, 2 Frag 10 5 $2,976.00 $2,976.00 $554.20 $29,579.85 $4,732.61 2026-05-09
00069032401 OTHER Pegfilgrastim-apgf 6 Mg/0.6 Ml Subcutaneous Syringe 15 10 $7,502.81 $7,502.81 $4,652.49 $4,652.49 $4,652.49 2026-05-09
58468003002 OTHER Thyrotropin Alfa 0.9 Mg Intramuscular Solution 21 13 $7,449.08 $7,449.08 $2,022.37 $7,246.14 $4,634.26 2026-05-09
9602779201 OTHER Pb - Critical Access Open Tx Distal Fibular Fracture Lat Malleolus 9 5 $2,709.00 $2,709.00 $433.19 $9,379.69 $4,601.15 2026-05-09
9602468501 OTHER Pb - Critical Access Open Tx Ulnar Fracture Prox End 9 5 $2,372.00 $2,372.00 $438.72 $9,379.69 $4,601.15 2026-05-09
9602458601 OTHER Pb - Critical Access Open Rx Periartic Fx/disloc Elbow 9 5 $3,130.00 $3,130.00 $726.52 $17,255.57 $4,601.15 2026-05-09
9602776601 OTHER Pb - Critical Access Open Treatment Medial Malleolus Fracture 9 5 $1,763.00 $1,763.00 $405.98 $9,379.69 $4,601.15 2026-05-09
9602782801 OTHER Pb - Critical Access Open Treatment Fracture Distal Tibia & Fibula 9 5 $3,749.00 $3,749.00 $892.15 $17,255.57 $4,601.15 2026-05-09
9602782901 OTHER Pb - Critical Access Open Tx Distal Tibiofibular Joint Disruption 9 5 $1,978.00 $1,978.00 $476.97 $9,379.69 $4,601.15 2026-05-09
9602457501 OTHER Pb - Critical Access Open Tx Humeral Epicondylar Fracture 9 5 $2,669.00 $2,669.00 $490.93 $17,255.57 $4,601.15 2026-05-09
9602775901 OTHER Pb - Critical Access Treat Tibial Shaft Fx, Intramed Implant 9 5 $3,819.00 $3,819.00 $666.60 $17,255.57 $4,601.15 2026-05-09
9602752401 OTHER Pb - Critical Access Open Rx Patella Fx 9 5 $2,866.00 $2,866.00 $504.97 $9,379.69 $4,601.15 2026-05-09
9602782301 OTHER Pb - Critical Access Open Tx Trimalleolar Ankle Fx W Fix Pst Lip 9 5 $2,240.00 $2,240.00 $662.29 $9,379.69 $4,601.15 2026-05-09
9602848501 OTHER Pb - Critical Access Open Treatment Metatarsal Fracture Each 9 5 $1,265.00 $1,265.00 $377.47 $9,379.69 $4,601.15 2026-05-09
9602454501 OTHER Pb - Critical Access Open Tx Humeral Supracondylar Fracture Without Xtn 9 5 $3,377.00 $3,377.00 $621.03 $17,255.57 $4,601.15 2026-05-09
9602782701 OTHER Pb - Critical Access Open Treatment Fracture Distal Tibia Only 9 5 $3,140.00 $3,140.00 $752.49 $17,255.57 $4,601.15 2026-05-09
9602781401 OTHER Pb - Critical Access Open Treatment Bimalleolar Ankle Fracture 9 5 $2,955.00 $2,955.00 $512.50 $9,379.69 $4,601.15 2026-05-09
9602772001 OTHER Pb - Critical Access Rnon/malunion Tibia 9 5 $2,673.00 $2,673.00 $585.42 $9,379.69 $4,601.15 2026-05-09
9602560701 OTHER Pb - Critical Access Open Rx Distal Radius Fx, Extra-articular 9 5 $2,649.00 $2,649.00 $495.25 $9,379.69 $4,601.15 2026-05-09
9602551501 OTHER Pb - Critical Access Open Treatment Radial Shaft Fracture 9 5 $1,987.00 $1,987.00 $449.45 $9,379.69 $4,601.15 2026-05-09
9602451601 OTHER Pb - Critical Access Open Rod Fixatn Humeral Shaft Fx 9 5 $2,479.00 $2,479.00 $575.25 $17,255.57 $4,601.15 2026-05-09
9602775801 OTHER Pb - Critical Access Open Rx Tibia Shaft Fx,screws 9 5 $2,507.00 $2,507.00 $600.01 $17,255.57 $4,601.15 2026-05-09
73594931001 OTHER Ferric Derisomaltose 100 Mg Iron/ml Intravenous Solution 15 10 $7,338.90 $7,338.90 $4,550.85 $4,550.85 $4,550.85 2026-05-09
70720095130 OTHER Goserelin 10.8 Mg Subq Implant 21 13 $10,445.99 $10,445.99 $599.34 $4,550.24 $4,550.24 2026-05-09
9604756201 OTHER Pb - Critical Access Lap,cholecystectomy 10 5 $6,163.00 $6,163.00 $442.69 $23,857.08 $4,303.24 2026-05-09
9604756301 OTHER Pb - Critical Access Lap,cholecystectomy/graph 10 5 $5,950.00 $5,950.00 $481.71 $23,857.08 $4,303.24 2026-05-09
9605260101 OTHER Prostatectomy (turp) 10 5 $3,395.00 $3,395.00 $484.99 $21,394.34 $4,300.02 2026-05-09
9602674601 OTHER Pb - Critical Access Open Tx Articular Fracture Mcp/ip Joint Ea 9 5 $1,066.00 $1,066.00 $498.12 $5,311.04 $4,243.82 2026-05-09
9602672701 OTHER Pb - Critical Access Percut Rx Prox/mid Fing Shft Fx 10 5 $1,703.00 $1,703.00 $319.81 $13,383.33 $4,243.82 2026-05-09
9602661501 OTHER Pb - Critical Access Open Tx Metacarpal Fracture Single Ea Bone 9 5 $1,288.00 $1,288.00 $386.55 $5,311.04 $4,243.82 2026-05-09
9602673501 OTHER Pb - Critical Access Open Tx Phalangeal Shaft Fracture Prox/middle Ea 10 5 $1,391.00 $1,391.00 $399.40 $13,383.33 $4,243.82 2026-05-09
9602665001 OTHER Pb - Critical Access Prq Skel Fixation Carp/mtcrpl Fx Dislocate Thumb 10 5 $1,732.00 $1,732.00 $324.68 $13,383.33 $4,243.82 2026-05-09
9602544701 OTHER Pb - Critical Access Repair Intercarp/carp-metacarp Jt 10 5 $1,962.00 $1,962.00 $556.59 $13,383.33 $4,243.82 2026-05-09
9602676501 OTHER Pb - Critical Access Open Tx Distal Phalangeal Fracture Each 10 5 $1,851.00 $1,851.00 $337.65 $13,383.33 $4,243.82 2026-05-09
9602852501 OTHER Pb - Critical Access Open Tx Fracture Phalanx/phalanges Not Great Toe 9 5 $1,209.00 $1,209.00 $271.39 $5,311.04 $4,243.82 2026-05-09
9602678501 OTHER Pb - Critical Access Open Tx Interphalangeal Joint Dislocation 1 10 5 $1,946.00 $1,946.00 $367.15 $13,383.33 $4,243.82 2026-05-09
9602660801 OTHER Pb - Critical Access Closed Rx Metacarpal Fx,percut 10 5 $1,729.00 $1,729.00 $324.92 $13,383.33 $4,243.82 2026-05-09
9602847601 OTHER Pb - Critical Access Percut Rx Metatarsal Fx 9 5 $902.00 $902.00 $262.23 $5,311.04 $4,243.82 2026-05-09
9602864501 OTHER Pb - Critical Access Open Tx Metatarsophalangeal Joint Dislocation 10 5 $1,468.00 $1,468.00 $324.86 $13,383.33 $4,243.82 2026-05-09
4803321001 OTHER Hc - Insj/rplcmt Temp Transvns 1chmbr Eltrd/pm Cath 10 5 $9,521.00 $9,521.00 $107.15 $35,127.02 $4,194.93 2026-05-09
9606471801 OTHER Pb - Critical Access Revise Ulnar Nerve At Elbow 29 12 $1,710.00 $1,710.00 $402.18 $7,983.17 $4,192.68 2026-05-09
3613586001 OTHER Hc - Expl Po Hemrrg Thrombosis/infctj Xtr 11 5 $3,892.00 $3,892.00 $162.52 $13,179.28 $4,179.11 2026-05-09
3613520601 OTHER Hc - Repair Blood Vessel Direct Upper Extremity 11 5 $4,070.00 $4,070.00 $162.52 $13,179.28 $4,179.11 2026-05-09
4047860801 OTHER Hc - Brain Imaging PET Metabolic Evaluation 23 12 $7,837.00 $7,837.00 $1,028.33 $6,468.53 $4,119.97 2026-05-09
9603586001 OTHER Pb - Critical Access Expl Po Hemrrg Thrombosis/infctj Xtr 10 5 $8,018.00 $8,018.00 $552.70 $13,179.28 $4,072.99 2026-05-09
9604418001 OTHER Pb - Critical Access Lap, Surg Enterolysis 10 5 $6,163.00 $6,163.00 $615.03 $23,857.08 $4,026.49 2026-05-09
9604497001 OTHER Pb - Critical Access Lap,appendectomy 10 5 $6,163.00 $6,163.00 $403.72 $23,857.08 $4,026.49 2026-05-09
9601402101 OTHER Pb - Critical Access Adj Tiss Xfer Scalp,extrem 10.1-30 Sqcm 29 12 $4,578.00 $4,578.00 $469.41 $7,540.10 $4,004.76 2026-05-09
9601404001 OTHER Pb - Critical Access Adj Tiss Xfer Head,fac,hand <10 Sqcm 29 12 $1,759.00 $1,759.00 $412.83 $7,540.10 $3,976.47 2026-05-09
9604495001 OTHER Pb - Critical Access Appendectomy 9 5 $2,401.00 $2,401.00 $429.98 $9,919.21 $3,914.65 2026-05-09
9602713401 OTHER Pb - Critical Access Revise Total Hip Replacement 29 12 $7,094.00 $7,094.00 $1,268.04 $6,478.85 $3,897.97 2026-05-09
9602748701 OTHER Pb - Critical Access Revise Knee Joint Replace,all Parts 29 12 $5,281.00 $5,281.00 $1,167.39 $6,258.86 $3,713.12 2026-05-09
9602347401 OTHER Pb - Revis Shoulder Arthrplsty Humeral&glenoid Compnt 29 12 $5,099.00 $5,099.00 $1,160.17 $6,258.86 $3,709.51 2026-05-09
9602346601 OTHER Pb - Critical Access Repair Shldr Capsu For Instability 10 5 $3,178.00 $3,178.00 $748.58 $29,579.85 $3,637.18 2026-05-09
9602312001 OTHER Pb - Critical Access Partial Removal, Clavicle 10 5 $2,202.00 $2,202.00 $394.22 $13,383.33 $3,637.18 2026-05-09
7504479901 OTHER Hc - Chromendoscopy 28 12 $1,887.00 $1,887.00 $1,188.49 $6,649.00 $3,626.42 2026-05-09
00074364103 OTHER Leuprolide 3.75 Mg Intramuscular Syringe Kit 21 13 $5,957.47 $5,957.47 $1,576.12 $5,647.23 $3,611.68 2026-05-09
9602748601 OTHER Pb - Critical Access Revise Knee Joint Replace,1 Part 29 12 $4,203.00 $4,203.00 $935.71 $6,258.86 $3,597.28 2026-05-09
3612699001 OTHER Hc - I&d Pelvis/hip Jt Area Deep Abscess/hematoma 11 5 $4,001.00 $4,001.00 $162.52 $13,383.33 $3,596.25 2026-05-09
9602725201 OTHER Pb - Critical Access Closed Rx Trauma Hip Disloc,anesth 29 12 $2,314.00 $2,314.00 $506.23 $6,645.28 $3,575.76 2026-05-09
9601930301 OTHER Pb - Critical Access Mastectomy, Simple, Complete 10 5 $3,705.00 $3,705.00 $641.03 $26,962.68 $3,541.03 2026-05-09
9602434201 OTHER Pb - Critical Access Reinsert Bi/triceps Tendon,distal 9 5 $1,815.00 $1,815.00 $519.79 $9,379.69 $3,536.15 2026-05-09
9602343001 OTHER Pb - Critical Access Repair Biceps Long Tendon 9 5 $1,815.00 $1,815.00 $499.17 $9,379.69 $3,536.15 2026-05-09
9602443001 OTHER Pb - Critical Access Repair Non/malunion Humerus 9 5 $3,862.00 $3,862.00 $705.04 $17,255.57 $3,536.15 2026-05-09
9602641801 OTHER Pb - Critical Access Repair Exten Tendon,dorsum Fingr,ea 29 12 $1,684.00 $1,684.00 $426.99 $6,645.28 $3,536.14 2026-05-09
9602641001 OTHER Pb - Critical Access Repair Exten Tendon,dorsum Hand,ea 29 12 $2,146.00 $2,146.00 $412.01 $6,645.28 $3,528.64 2026-05-09
9602611601 OTHER Pb - Critical Access Exc Tum/vas Mal Sft Tis Hand/fngr Subfasc<1.5cm 29 12 $1,575.00 $1,575.00 $351.97 $6,703.54 $3,527.76 2026-05-09
9602726601 OTHER Pb - Critical Access Closed Rx Post Hip Fix Disloc,anesth 29 12 $2,203.00 $2,203.00 $393.03 $6,645.28 $3,519.16 2026-05-09
9602713201 OTHER Pb - Critical Access Conv Prev Hip Surg To Tot Hip Arthroplas 29 12 $2,409.00 $2,409.00 $1,112.83 $6,258.86 $3,514.87 2026-05-09
9602453501 OTHER Pb - Critical Access Cltx Sprcndylr/transcndylr Humeral Fx W/manj 29 12 $1,821.00 $1,821.00 $383.42 $6,645.28 $3,514.35 2026-05-09
9602544001 OTHER Pb - Critical Access Repair Nonunion Scaphoid Carpal Bone 9 5 $2,335.00 $2,335.00 $514.79 $9,379.69 $3,514.17 2026-05-09
9602643201 OTHER Pb - Critical Access Cltx Dstl Xtnsr Tdn Insj W/wo Percutan Pinning 29 12 $1,809.00 $1,809.00 $372.88 $6,645.28 $3,509.08 2026-05-09
9602699001 OTHER Pb - Critical Access Incis/drain Pelvis/hip,deep Abscess 10 5 $2,326.00 $2,326.00 $459.75 $13,383.33 $3,499.06 2026-05-09
9602735501 OTHER Pb - Critical Access Remv Benign Femur Lesion 10 5 $1,736.00 $1,736.00 $408.75 $13,383.33 $3,499.06 2026-05-09
9602560501 OTHER Pb - Critical Access Closed Rx Dist Rad/ulna Fx,manipul 29 12 $2,328.00 $2,328.00 $345.29 $6,645.28 $3,495.28 2026-05-09
9602784201 OTHER Pb - Critical Access Closed Rx Ankle Dislocatn,anesth 29 12 $2,104.00 $2,104.00 $334.37 $6,645.28 $3,489.82 2026-05-09
3612201001 OTHER Hc - I&d Deep Abscess Pst Spine Crv Thrc/cervicothr 11 5 $1,412.00 $1,412.00 $162.52 $7,011.59 $3,471.09 2026-05-09
3612201501 OTHER Hc - I&d Deep Abscess Pst Spine Lumbar Sac/lumbosac 11 5 $1,398.00 $1,398.00 $162.52 $7,011.59 $3,471.09 2026-05-09
58406043504 OTHER Etanercept 50 Mg/ml (0.98 Ml) Sub-q Syringe 19 11 $6,973.66 $6,973.66 $961.24 $3,404.55 $3,404.55 2026-05-09
9602743001 OTHER Pb - Critical Access Revision Quadriceps 9 5 $2,133.00 $2,133.00 $497.93 $9,379.69 $3,401.86 2026-05-09
9602738501 OTHER Pb - Critical Access Fix Quad/hamstr Musc Rupt,primary 9 5 $1,718.00 $1,718.00 $409.94 $9,379.69 $3,401.86 2026-05-09
9604414301 OTHER Pb - Critical Access Part Removal Colon W End Colostomy 29 12 $4,744.00 $4,744.00 $1,105.37 $5,584.14 $3,344.76 2026-05-09
9604414501 OTHER Pb - Critical Access Part Removal Colon W Coloproctostomy 29 12 $4,996.00 $4,996.00 $1,100.04 $5,586.22 $3,343.13 2026-05-09
9602654601 OTHER Pb - Critical Access Rpr Non-union Mtcrpl/phalanx 10 5 $3,582.00 $3,582.00 $702.36 $29,579.85 $3,341.38 2026-05-09
9602612101 OTHER Pb - Critical Access Palmar Fasciectomy 10 5 $2,176.00 $2,176.00 $402.51 $13,383.33 $3,341.38 2026-05-09
9602829601 OTHER Pb - Critical Access Corrj Hlx Vlgs Bncty Sesmdc Dstl Metar Osteot 10 5 $2,743.00 $2,743.00 $343.05 $13,383.33 $3,329.72 2026-05-09
9602829201 OTHER Pb - Critical Access Corrj Corrj Hlx Vlgs Bncty Sesmdc Rescj Prox Phlx Base 10 5 $1,870.00 $1,870.00 $321.94 $13,383.33 $3,329.72 2026-05-09
9602828901 OTHER Pb - Critical Access Hallux Rigidus W/cheilectomy 1st Mp Jt Without Implt 10 5 $1,627.00 $1,627.00 $306.70 $13,383.33 $3,329.72 2026-05-09
9604952501 OTHER Pb - Critical Access Repair Sliding Inguinal Hernia 10 5 $1,733.00 $1,733.00 $385.04 $14,304.66 $3,326.31 2026-05-09
9604950501 OTHER Pb - Critical Access Repair Ing Hernia,5+y/o,reducibl 10 5 $1,574.00 $1,574.00 $350.90 $14,304.66 $3,326.31 2026-05-09
9604955301 OTHER Pb - Critical Access Repair Femoral Hernia,strang 10 5 $1,886.00 $1,886.00 $424.67 $14,304.66 $3,326.31 2026-05-09
9604952001 OTHER Pb - Critical Access Repair Recurr Inguin Hern,reducibl 10 5 $4,100.00 $4,100.00 $425.00 $14,304.66 $3,326.31 2026-05-09
9604950701 OTHER Pb - Critical Access Repair Ing Hernia,5+y/o,strang 10 5 $4,100.00 $4,100.00 $394.05 $14,304.66 $3,326.31 2026-05-09
9604955001 OTHER Pb - Critical Access Repair Femoral Hernia,reducible 10 5 $1,721.00 $1,721.00 $386.90 $14,304.66 $3,326.31 2026-05-09
9601177101 OTHER Pb - Critical Access Remv Pilonidal Lesion Extens 10 5 $1,287.00 $1,287.00 $300.90 $11,748.69 $3,309.31 2026-05-09
00002850101 OTHER Insulin Regular Human U-500"concentrate" 500 Unit/ml Subcutaneous Soln 10 8 $5,205.51 $5,205.51 $3,290.09 $3,290.09 $3,290.09 2026-05-09
47361 CPT Pr Mgmt Lvr Hemrrg Expl Wnd Dbrdmt Coagj/sutr 30 13 $8,550.00 $8,550.00 $2,011.00 $5,435.95 $3,289.39 2026-05-09
9605855001 OTHER Pb - Critical Access Lap,vag Hyst,uterus 250gms/< 10 5 $2,881.00 $2,881.00 $593.44 $23,857.08 $3,279.12 2026-05-09
3612502801 OTHER Hc - I&d Forearm&/wrist Deep Abscess/hematoma 11 5 $4,001.00 $4,001.00 $162.52 $13,383.33 $3,259.84 2026-05-09
9602875001 OTHER Pb - Critical Access Fusion Big Toe,mt-p Jt 9 5 $2,508.00 $2,508.00 $387.73 $9,379.69 $3,237.23 2026-05-09
9602811001 OTHER Pb - Critical Access Part Excis 5th Metatarsal Head 9 5 $1,040.00 $1,040.00 $194.38 $4,243.82 $3,237.23 2026-05-09
9602832201 OTHER Pb - Critical Access Repair Non/malunion Metatarsal 9 5 $1,746.00 $1,746.00 $385.81 $9,379.69 $3,237.23 2026-05-09
9602812201 OTHER Pb - Critical Access Part Remv Othr Tarsal/metatarsal 9 5 $1,337.00 $1,337.00 $292.90 $4,243.82 $3,237.23 2026-05-09
9604902001 OTHER Pb - Critical Access Drain Abd Abscess Open 29 12 $4,832.00 $4,832.00 $1,065.08 $5,408.36 $3,236.72 2026-05-09
9604965001 OTHER Pb - Critical Access Lap,inguinal Hernia Repr,initial 9 5 $1,221.00 $1,221.00 $290.26 $7,565.02 $3,233.91 2026-05-09
9604965101 OTHER Pb - Critical Access Lap,inguinal Hernia Repr,recur 9 5 $1,589.00 $1,589.00 $378.96 $7,565.02 $3,233.91 2026-05-09
9604932101 OTHER Pb - Critical Access Lap,dx Surgical Abd W/biopsy 9 5 $1,308.00 $1,308.00 $230.60 $7,565.02 $3,227.60 2026-05-09
9604932201 OTHER Pb - Critical Access Lap,abdomen,aspirate Cyst 9 5 $1,406.00 $1,406.00 $251.07 $7,565.02 $3,227.60 2026-05-09
9604932001 OTHER Pb - Critical Access Lap,diagnostic Abdomen 9 5 $1,238.00 $1,238.00 $219.82 $7,565.02 $3,227.60 2026-05-09
9604462601 OTHER Pb - Critical Access Clsr Ntrstm Lg/sm Rescj & Colorectal Anastomosis 29 12 $4,570.00 $4,570.00 $1,063.00 $5,374.03 $3,218.51 2026-05-09
9601142601 OTHER Pb - Critical Access Exc Skin Benig >4 Cm Remaindr Body 9 5 $733.00 $733.00 $181.01 $3,725.48 $3,217.39 2026-05-09
9601583901 OTHER Pb - Critical Access Excision Excessive Skin & Subq Tissue Other Area 9 5 $458.00 $458.00 $493.16 $3,725.48 $3,217.39 2026-05-09
9601144601 OTHER Pb - Critical Access Exc Skin Benig >4 Cm Face,facial 9 5 $514.00 $514.00 $212.96 $3,725.48 $3,217.39 2026-05-09
9601177201 OTHER Pb - Critical Access Excision Pilonidal Cyst/sinus Complicated 9 5 $978.00 $978.00 $389.59 $3,725.48 $3,217.39 2026-05-09
9602764001 OTHER Pb - Critical Access Partial Removal Of Tibia 10 5 $2,496.00 $2,496.00 $557.44 $13,383.33 $3,193.44 2026-05-09
9605235601 OTHER Cysto/uretero W/lithotripsy 11 5 $1,111.00 $1,111.00 $274.51 $6,784.09 $3,192.73 2026-05-09
9605857301 OTHER Pb - Critical Access Laparoscopy Tot Hysterectomy Uterus >250 Gram W Tube/ovary 9 5 $3,830.00 $3,830.00 $818.23 $13,496.08 $3,188.04 2026-05-09
9605855201 OTHER Pb - Critical Access Lap,vag Hyst,uterus 250gms/<,salp-ooph 9 5 $2,353.00 $2,353.00 $659.37 $13,496.08 $3,188.04 2026-05-09
9605857001 OTHER Pb - Critical Access Laparoscopy W Tot Hysterect Uterus 250 Gram Or Less 9 5 $3,589.00 $3,589.00 $542.24 $13,496.08 $3,188.04 2026-05-09
9605857101 OTHER Pb - Critical Access Laparoscopy W Tot Hysterectuterus <=250 Gram W Tube/ovary 9 5 $3,974.00 $3,974.00 $610.69 $13,496.08 $3,188.04 2026-05-09
3008799901 OTHER Hc - Sterilizer Test 19 11 $5,128.00 $5,128.00 $3,179.88 $3,179.88 $3,179.88 2026-05-09
9602407301 OTHER Pb - Critical Access Exc Tumor Soft Tiss Upper Arm/elbw Subfasc 5+cm 10 5 $2,958.00 $2,958.00 $463.84 $11,748.69 $3,171.74 2026-05-09
9602435801 OTHER Pb - Critical Access Tenotomy Elbow Lateral/medial Debride Open 10 5 $1,906.00 $1,906.00 $355.79 $13,383.33 $3,171.74 2026-05-09
9602507301 OTHER Pb - Critical Access Exc Tumor Sft Tiss Forearm&//wrist Subfasc 3+cm 10 5 $1,577.00 $1,577.00 $358.77 $11,748.69 $3,171.74 2026-05-09
9602526001 OTHER Pb - Critical Access Reforearm Tend/musc,flex,prim,ea 10 5 $2,709.00 $2,709.00 $426.27 $13,383.33 $3,171.74 2026-05-09
6197155201 OTHER Hc - MRI Chest Without & W/contrast Material 23 12 $6,272.00 $6,272.00 $317.25 $6,001.00 $3,159.12 2026-05-09
9604420401 OTHER Pb - Critical Access Lap,surg,colectomy, Partial, W/anast 29 12 $4,387.00 $4,387.00 $1,024.45 $5,196.35 $3,110.40 2026-05-09
9602787001 OTHER Pb - Critical Access Arthrodesis,ankle,open 9 5 $2,999.00 $2,999.00 $677.12 $17,255.57 $3,104.73 2026-05-09
9602769501 OTHER Pb - Critical Access Repair 1 Collat Ankle Ligmnt,primary 9 5 $1,177.00 $1,177.00 $322.11 $9,379.69 $3,104.73 2026-05-09
9602765401 OTHER Pb - Critical Access Repair Achilles Tendon,secondary 9 5 $1,666.00 $1,666.00 $478.51 $9,379.69 $3,104.73 2026-05-09
9602712501 OTHER Pb - Critical Access Partial Hip Replacement 29 12 $4,322.00 $4,322.00 $755.09 $5,447.95 $3,101.52 2026-05-09
9602510101 OTHER Pb - Critical Access Arthrotomy Wrist W/wo Explore, Drain, Fb Removal 9 5 $1,197.00 $1,197.00 $272.78 $4,243.82 $3,083.63 2026-05-09
9602723601 OTHER Pb - Critical Access Femoral Fx, Open Tx 29 12 $4,563.00 $4,563.00 $796.33 $5,311.04 $3,053.68 2026-05-09
59618 CPT Pr Routine Obstetrical Care Attempted Vbac 29 13 $10,308.00 $10,308.00 $2,184.41 $5,215.40 $3,041.00 2026-05-09
59510 CPT Pr OB Antepartum Care Cesarean Dlvr & Postpartum 29 13 $7,930.00 $7,930.00 $2,162.08 $4,883.05 $3,009.91 2026-05-09
9602750701 OTHER Pb - Critical Access Open Rx Femur Fx+plate/screw 29 12 $2,282.00 $2,282.00 $646.58 $5,311.04 $2,978.81 2026-05-09
9602751401 OTHER Pb - Critical Access Open Tx Femoral Fracture Distal Med/lat Condyle 29 12 $2,270.00 $2,270.00 $645.80 $5,311.04 $2,978.42 2026-05-09
3612150101 OTHER Hc - I&d Deep Absc/hmtma Soft Tissue Neck/thorax 11 5 $3,627.00 $3,627.00 $162.52 $11,748.69 $2,946.46 2026-05-09
3612150201 OTHER Hc - I&d Dp Absc/hmtma Soft Tiss Nck/thorax Prtl Ri 11 5 $4,001.00 $4,001.00 $162.52 $13,383.33 $2,946.46 2026-05-09
9602988401 OTHER Pb - Critical Access Knee Scope,lysis Of Adhesns 10 5 $1,506.00 $1,506.00 $414.17 $13,383.33 $2,910.99 2026-05-09
9602988201 OTHER Pb - Critical Access Knee Scope,med Or Lat Menis Repair 10 5 $2,134.00 $2,134.00 $461.26 $13,383.33 $2,910.99 2026-05-09
9602982401 OTHER Pb - Critical Access Shldr Arthroscop,surg,dis Claviculectomy 10 5 $1,958.00 $1,958.00 $453.85 $13,383.33 $2,910.99 2026-05-09
9602980501 OTHER Pb - Critical Access Shldr Arthroscop,diagnostic 10 5 $1,364.00 $1,364.00 $314.47 $13,383.33 $2,910.99 2026-05-09
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