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

187,210 of 229,403 rate rows are consumer-grade (81.6%)

42,193 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	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	1,324
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	144

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 via	Discovered by HANK
Last fetch	not_modified · 2026-07-31
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 $9,555 outlier · 2.4×
602 OTHER	Cellulitis With Mcc	7	$7,400.00	$23,614.15	$21,497.07	nat. median $13,735 1.6× median
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 $23,981 0.9× 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 $17,028 1.2× median
229 OTHER	Other Cardiothoracic Procedures Without Mcc	7	$7,400.00	$19,380.00	$19,004.19	nat. median $31,547 0.6× median
811 OTHER	Red Blood Cell Disorders With Mcc	7	$7,400.00	$19,380.00	$18,676.44	nat. median $173 outlier · 107.8×
101 OTHER	Seizures Without Mcc	7	$7,400.00	$19,380.00	$17,969.29	nat. median $7,661 outlier · 2.3×
425 OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures Without Cc/mcc	7	$7,400.00	$19,380.00	$16,842.71	nat. median $13,100 1.3× median
558 OTHER	Tendonitis, Myositis And Bursitis Without Mcc	7	$7,400.00	$19,380.00	$15,576.33	nat. median $8,428 1.8× median
314 OTHER	Other Circulatory System Diagnoses With Mcc	7	$7,400.00	$19,380.00	$15,040.15	nat. median $19,084 0.8× median
178 OTHER	Respiratory Infections And Inflammations With Cc	7	$7,400.00	$19,380.00	$14,651.08	nat. median $10,148 1.4× median
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 $23,032 0.6× median
690 OTHER	Kidney And Urinary Tract Infections Without Mcc	7	$7,400.00	$19,380.00	$13,944.60	nat. median $7,892 1.8× median
175 OTHER	Pulmonary Embolism With Mcc Or Acute Cor Pulmonale	7	$7,400.00	$19,380.00	$13,782.81	nat. median $13,708 1.0× median
683 OTHER	Renal Failure With Cc	7	$7,400.00	$19,380.00	$13,660.78	nat. median $8,468 1.6× median
244 OTHER	Permanent Cardiac Pacemaker Implant Without Cc/mcc	7	$7,400.00	$19,380.00	$13,541.34	nat. median $18,368 0.7× 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 $11,027 1.2× median
816 OTHER	Reticuloendothelial And Immunity Disorders Without Cc/mcc	7	$7,400.00	$19,380.00	$13,416.41	nat. median $3,067 outlier · 4.4×
66 OTHER	Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc	7	$7,400.00	$19,380.00	$13,240.93	nat. median $7,850 1.7× median
540 OTHER	Osteomyelitis With Cc	7	$7,400.00	$19,380.00	$13,079.47	nat. median $9,785 1.3× median
189 OTHER	Pulmonary Edema And Respiratory Failure	7	$7,400.00	$19,380.00	$13,035.22	nat. median $11,871 1.1× median
83 OTHER	Traumatic Stupor And Coma >1 Hour With Cc	7	$7,400.00	$19,380.00	$12,959.46	nat. median $15,058 0.9× median
308 OTHER	Cardiac Arrhythmia And Conduction Disorders With Mcc	7	$7,400.00	$19,380.00	$12,777.31	nat. median $11,351 1.1× median
639 OTHER	Diabetes Without Cc/mcc	7	$7,400.00	$19,380.00	$12,580.11	nat. median $6,413 2.0× median
638 OTHER	Diabetes With Cc	7	$7,400.00	$19,380.00	$12,494.05	nat. median $8,657 1.4× median
854 OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Cc	7	$7,400.00	$19,380.00	$12,380.49	nat. median $10,882 1.1× median
815 OTHER	Reticuloendothelial And Immunity Disorders With Cc	7	$7,400.00	$19,380.00	$11,857.29	nat. median $1,000 outlier · 11.9×
641 OTHER	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…	7	$7,400.00	$19,380.00	$11,824.49	nat. median $7,654 1.5× median
263 OTHER	Vein Ligation And Stripping	7	$7,400.00	$19,380.00	$11,543.74	nat. median $24,673 outlier · 0.5×
871 OTHER	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	7	$7,400.00	$19,380.00	$11,501.02	nat. median $10,044 1.1× median
204 OTHER	Respiratory Signs And Symptoms	7	$7,400.00	$19,380.00	$11,399.38	nat. median $8,072 1.4× median
193 OTHER	Simple Pneumonia And Pleurisy With Mcc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $12,650 0.9× median
264 OTHER	Other Circulatory System O.r. Procedures	7	$7,400.00	$19,380.00	$11,399.38	nat. median $31,414 outlier · 0.4×
136 OTHER	Sinus And Mastoid Procedures Without Cc/mcc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $10,090 1.1× median
281 OTHER	Acute Myocardial Infarction, Discharged Alive With Cc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $9,448 1.2× median
309 OTHER	Cardiac Arrhythmia And Conduction Disorders With Cc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $398 outlier · 28.6×
195 OTHER	Simple Pneumonia And Pleurisy Without Cc/mcc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $6,484 1.8× median
190 OTHER	Chronic Obstructive Pulmonary Disease With Mcc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $8,973 1.3× median
141 OTHER	Major Head And Neck Procedures With Cc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $18,645 0.6× median
179 OTHER	Respiratory Infections And Inflammations Without Cc/mcc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $7,889 1.4× median
313 OTHER	Chest Pain	7	$7,400.00	$19,380.00	$11,399.38	nat. median $7,251 1.6× median
344 OTHER	Minor Small And Large Bowel Procedures With Mcc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $20,126 0.6× median
192 OTHER	Chronic Obstructive Pulmonary Disease Without Cc/mcc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $6,283 1.8× median
140 OTHER	Major Head And Neck Procedures With Mcc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $30,208 outlier · 0.4×
283 OTHER	Acute Myocardial Infarction, Expired With Mcc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $18,681 0.6× median
201 OTHER	Pneumothorax Without Cc/mcc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $6,960 1.6× median
291 OTHER	Heart Failure And Shock With Mcc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $12,475 0.9× median
292 OTHER	Heart Failure And Shock With Cc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $8,637 1.3× median
303 OTHER	Atherosclerosis Without Mcc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $6,367 1.8× median
199 OTHER	Pneumothorax With Mcc	7	$7,400.00	$19,380.00	$11,399.38	nat. median $16,831 0.7× median

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.

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

9602988601	OTHER	Pb - Critical Access Knee Scope,drill Osteit Dissec	10	5	$2,848.00	$2,848.00	$425.92	$13,383.33	$2,910.99	2026-05-09
9602982501	OTHER	Pb - Critical Access Shldr Arthroscop,lyse Adhesns	10	5	$1,692.00	$1,692.00	$393.77	$13,383.33	$2,910.99	2026-05-09
9602983801	OTHER	Pb - Critical Access Elbow Arthroscop,exten Debride	10	5	$2,616.00	$2,616.00	$398.19	$13,383.33	$2,910.99	2026-05-09
9602987601	OTHER	Pb - Critical Access Knee Scope,full Synovect	10	5	$1,594.00	$1,594.00	$437.55	$13,383.33	$2,910.99	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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
7504479901	OTHER	Hc - Chromendoscopy	28	12	$1,887.00	$1,887.00	$1,188.49	$6,649.00	$3,626.42	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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
9605260101	OTHER	Prostatectomy (turp)	10	5	$3,395.00	$3,395.00	$484.99	$21,394.34	$4,300.02	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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
311	OTHER	Angina Pectoris	8	7	$21,162.76	$21,162.76	$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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
313	OTHER	Chest Pain	8	7	$4,792.92	$4,792.92	$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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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

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