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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

POMERENE HOSPITAL

Millersburg, OH · CCN 360148 · Rates published

1,982 distinct procedures filed
35 distinct payers
98,291 rate rows
2026-07-15 last MRF observed
Data quality

93,501 of 98,291 rate rows are consumer-grade (95.1%)

4,790 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 3,189
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 1,567
exceeds 10× this hospital's gross charge — excluded from medians 16
exceeds 3× this hospital's gross charge for a DRG stay — excluded 10
placeholder amount (≤ $0.02) — excluded from medians 8
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://irp.cdn-website.com/94898d03/files/uploaded/311518658_pomerene-hospital_standardcharges.csv
Found on page https://www.pomerenehospital.org/financial-services#PricingInformation
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-21
Content fingerprint 707167841194bb84… · 91,972,082 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
C1820
HCPCS 		Eterna 16-channel W/controller & Charger 34 $48,926.82 $69,052.50 $65,525.62 nat. median
$21,100
outlier · 3.1×
C1772
HCPCS 		Eterna Implantable System 34 $1,600.70 $69,052.50 $65,525.62 nat. median
$18,271
outlier · 3.6×
C1767
HCPCS 		Clik X Anchor 34 $930.19 $76,725.00 $50,977.21 nat. median
$25,172
outlier · 2.0×
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 18 $31,558.00 $34,593.84 $33,901.96 nat. median
$34,733
1.0× median
981
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 18 $32,258.69 $36,151.35 $32,903.86 nat. median
$33,546
1.0× median
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 18 $31,624.15 $58,383.06 $32,256.63 nat. median
$33,435
1.0× median
956
MS_DRG 		Limb Reattachment Hip And Femur Procedures For Multiple Significant Trauma 18 $26,074.43 $33,831.29 $26,595.92 nat. median
$27,340
1.0× median
987
MS_DRG 		Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 18 $17,508.92 $24,333.21 $23,846.55 nat. median
$24,316
1.0× median
C1762
HCPCS 		Amnion Thick, 3x8 34 $14,565.74 $22,507.86 $21,358.26 nat. median
$2,848
outlier · 7.5×
29826
HCPCS 		Surgical Arthroscopy Sho W-coracoacrm Ligm Rls 8 $142.24 $22,519.99 $21,309.24 nat. median
$3,950
outlier · 5.4×
480
MS_DRG 		Hip And Femur Procedures Except Major Joint With Mcc 18 $20,410.19 $28,716.04 $20,818.38 nat. median
$21,963
0.9× median
521
MS_DRG 		Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 18 $20,129.88 $31,142.89 $20,532.47 nat. median
$21,753
0.9× median
863
MS_DRG 		Postoperative And Post-traumatic Infections Without Mcc 18 $19,127.22 $48,905.40 $19,509.76 nat. median
$7,491
outlier · 2.6×
7204
APR_DRG 		Septicemia And Disseminated Infections 8 $18,825.85 $19,767.14 $19,061.17 nat. median
$19,607
1.0× median
983
APR_DRG 		Other Ear, Nose, Mouth & Throat Procedures 17 $17,942.48 $18,839.60 $18,391.04 nat. median
$17,909
1.0× median
95
MS_DRG 		Bacterial And Tuberculous Infections Of Nervous System With Cc 18 $11,991.50 $18,563.56 $18,192.29 nat. median
$17,673
1.0× median
783
MS_DRG 		Cesarean Section With Sterilization With Mcc 18 $17,366.00 $19,728.96 $17,713.32 nat. median
$13,196
1.3× median
982
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 18 $13,556.92 $17,743.51 $17,388.64 nat. median
$17,763
1.0× median
330
MS_DRG 		Major Small And Large Bowel Procedures With Cc 18 $16,980.48 $27,463.03 $17,320.09 nat. median
$17,741
1.0× median
397
MS_DRG 		Appendix Procedures With Mcc 18 $16,965.16 $35,911.07 $17,304.47 nat. median
$17,303
1.0× median
417
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. With Mcc 18 $16,908.56 $19,464.08 $17,246.73 nat. median
$17,369
1.0× median
357
MS_DRG 		Other Digestive System O.r. Procedures With Cc 18 $16,503.07 $22,954.19 $16,833.14 nat. median
$16,355
1.0× median
793
MS_DRG 		Full Term Neonate With Major Problems 8 $2,619.00 $15,777.98 $15,777.98 nat. median
$15,882
1.0× median
522
MS_DRG 		Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 18 $15,119.47 $23,789.44 $15,421.86 nat. median
$15,839
1.0× median
481
MS_DRG 		Hip And Femur Procedures Except Major Joint With Cc 18 $14,965.00 $26,710.73 $15,264.30 nat. median
$15,706
1.0× median
415
MS_DRG 		Cholecystectomy Except By Laparoscope Without C.d.e. With Cc 18 $14,779.90 $31,835.44 $15,075.50 nat. median
$14,731
1.0× median
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 18 $14,409.03 $17,459.68 $14,697.21 nat. median
$14,700
1.0× median
494
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip Foot And Femur Without Cc-mcc 18 $14,379.07 $22,902.58 $14,666.65 nat. median
$14,553
1.0× median
854
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Cc 18 $14,323.14 $24,205.10 $14,609.60 nat. median
$14,550
1.0× median
908
MS_DRG 		Other O.r. Procedures For Injuries With Cc 18 $14,303.84 $37,511.07 $14,589.91 nat. median
$14,655
1.0× median
432
MS_DRG 		Cirrhosis And Alcoholic Hepatitis With Mcc 18 $14,124.04 $15,148.06 $14,406.53 nat. median
$14,126
1.0× median
3082
APR_DRG 		Hip & Femur Fracture Repair 8 $14,063.08 $14,766.23 $14,238.87 nat. median
$14,320
1.0× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv Greater Than 96 Hours With Mcc 18 $13,952.94 $15,332.64 $14,231.99 nat. median
$14,442
1.0× median
470
MS_DRG 		Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without… 18 $13,862.37 $24,953.58 $14,139.63 nat. median
$14,330
1.0× median
906
MS_DRG 		Hand Procedures For Injuries 18 $12,826.02 $14,385.81 $14,098.09 nat. median
$13,671
1.0× median
100
MS_DRG 		Seizures With Mcc 18 $10,625.00 $14,198.96 $13,914.98 nat. median
$13,848
1.0× median
617
MS_DRG 		Amputation Of Lower Limb For Endocrine Nutritional And Metabolic Disorders With… 18 $13,472.21 $14,149.12 $13,741.65 nat. median
$13,927
1.0× median
504
MS_DRG 		Foot Procedures With Cc 18 $13,464.88 $15,509.19 $13,734.17 nat. median
$13,331
1.0× median
559
MS_DRG 		Aftercare Musculoskeletal System And Connective Tissue With Mcc 18 $13,436.25 $14,019.85 $13,704.98 nat. median
$13,403
1.0× median
377
MS_DRG 		Gastrointestinal Hemorrhage With Mcc 18 $13,190.56 $14,453.67 $13,454.36 nat. median
$13,124
1.0× median
371
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 18 $12,825.01 $16,994.40 $13,081.50 nat. median
$12,655
1.0× median
580
MS_DRG 		Other Skin Subcutaneous Tissue And Breast Procedures With Cc 18 $12,524.72 $15,513.77 $12,775.22 nat. median
$12,953
1.0× median
983
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc-mcc 18 $12,431.51 $13,903.55 $12,680.13 nat. median
$12,192
1.0× median
418
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. With Cc 18 $12,282.36 $22,298.74 $12,528.01 nat. median
$12,668
1.0× median
720
MS_DRG 		Not Specified 8 $12,519.25 $12,519.25 $12,519.25 nat. median
$22,040
0.6× median
331
MS_DRG 		Major Small And Large Bowel Procedures Without Cc-mcc 18 $12,224.43 $27,273.29 $12,468.92 nat. median
$12,648
1.0× median
444
MS_DRG 		Disorders Of The Biliary Tract With Mcc 18 $12,144.53 $15,372.97 $12,387.43 nat. median
$12,165
1.0× median
769
MS_DRG 		Postpartum And Post Abortion Diagnoses With O.r. Procedures 18 $6,865.50 $12,520.80 $12,270.38 nat. median
$11,539
1.1× median
551
MS_DRG 		Medical Back Problems With Mcc 18 $11,150.58 $12,427.71 $12,179.16 nat. median
$11,966
1.0× median
27130
HCPCS 		Arthrp Acetblr-prox Fem Prostc Agrft-algrft 19 $1,106.71 $35,251.53 $12,141.52 nat. median
$12,734
1.0× median

Other procedures at this hospital

Browse this hospital's 1,982 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
             
C1772 HCPCS Eterna Implantable System 55 34 $74,250.00 $59,400.00 20% off $1,600.70 $69,052.50 $65,525.62 2026-07-15
C1820 HCPCS Eterna 16-channel W/controller & Charger 48 34 $74,250.00 $59,400.00 20% off $48,926.82 $69,052.50 $65,525.62 2026-07-15
C1767 HCPCS Clik X Anchor 76 34 $58,594.00 $46,875.20 20% off $930.19 $76,725.00 $50,977.21 2026-07-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 18 18 $34,158.28 $27,326.62 20% off $31,558.00 $34,593.84 $33,901.96 2026-07-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 18 18 $43,058.08 $34,446.46 20% off $32,258.69 $36,151.35 $32,903.86 2026-07-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 18 18 $91,550.50 $73,240.40 20% off $31,624.15 $58,383.06 $32,256.63 2026-07-15
956 MS_DRG Limb Reattachment Hip And Femur Procedures For Multiple Significant Trauma 18 18 $44,718.44 $35,774.75 20% off $26,074.43 $33,831.29 $26,595.92 2026-07-15
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 18 18 $17,508.92 $14,007.14 $17,508.92 $24,333.21 $23,846.55 2026-07-15
C1762 HCPCS Amnion Thick, 3x8 41 34 $24,202.00 $19,361.60 20% off $14,565.74 $22,507.86 $21,358.26 2026-07-15
29826 HCPCS Surgical Arthroscopy Sho W-coracoacrm Ligm Rls 8 8 $24,215.04 $19,372.03 20% off $142.24 $22,519.99 $21,309.24 2026-07-15
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 18 18 $39,808.50 $31,846.80 20% off $20,410.19 $28,716.04 $20,818.38 2026-07-15
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 18 18 $45,328.92 $36,263.14 $20,129.88 $31,142.89 $20,532.47 2026-07-15
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 18 18 $84,606.00 $67,684.80 $19,127.22 $48,905.40 $19,509.76 2026-07-15
7204 APR_DRG Septicemia And Disseminated Infections 8 8 $39,687.50 $31,750.00 20% off $18,825.85 $19,767.14 $19,061.17 2026-07-15
983 APR_DRG Other Ear, Nose, Mouth & Throat Procedures 17 17 $28,936.00 $23,148.80 20% off $17,942.48 $18,839.60 $18,391.04 2026-07-15
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 18 18 $11,991.50 $9,593.20 $11,991.50 $18,563.56 $18,192.29 2026-07-15
783 MS_DRG Cesarean Section With Sterilization With Mcc 18 18 $23,754.75 $19,003.80 20% off $17,366.00 $19,728.96 $17,713.32 2026-07-15
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 18 18 $13,556.92 $10,845.54 $13,556.92 $17,743.51 $17,388.64 2026-07-15
330 MS_DRG Major Small And Large Bowel Procedures With Cc 18 18 $40,801.70 $32,641.36 $16,980.48 $27,463.03 $17,320.09 2026-07-15
397 MS_DRG Appendix Procedures With Mcc 18 18 $58,986.00 $47,188.80 $16,965.16 $35,911.07 $17,304.47 2026-07-15
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 18 18 $23,677.00 $18,941.60 20% off $16,908.56 $19,464.08 $17,246.73 2026-07-15
357 MS_DRG Other Digestive System O.r. Procedures With Cc 18 18 $31,618.60 $25,294.88 $16,503.07 $22,954.19 $16,833.14 2026-07-15
793 MS_DRG Full Term Neonate With Major Problems 8 8 $2,619.00 $2,095.20 20% off $2,619.00 $15,777.98 $15,777.98 2026-07-15
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 18 18 $34,902.58 $27,922.06 20% off $15,119.47 $23,789.44 $15,421.86 2026-07-15
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 18 18 $41,351.03 $33,080.82 20% off $14,965.00 $26,710.73 $15,264.30 2026-07-15
415 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Cc 18 18 $52,570.96 $42,056.77 $14,779.90 $31,835.44 $15,075.50 2026-07-15
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 18 18 $22,054.12 $17,643.30 $14,409.03 $17,459.68 $14,697.21 2026-07-15
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip Foot And Femur Without Cc-mcc 18 18 $33,791.50 $27,033.20 20% off $14,379.07 $22,902.58 $14,666.65 2026-07-15
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 18 18 $36,652.75 $29,322.20 20% off $14,323.14 $24,205.10 $14,609.60 2026-07-15
908 MS_DRG Other O.r. Procedures For Injuries With Cc 18 18 $65,288.50 $52,230.80 $14,303.84 $37,511.07 $14,589.91 2026-07-15
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 18 18 $17,389.32 $13,911.46 $14,124.04 $15,148.06 $14,406.53 2026-07-15
3082 APR_DRG Hip & Femur Fracture Repair 8 8 $47,214.85 $37,771.88 20% off $14,063.08 $14,766.23 $14,238.87 2026-07-15
871 MS_DRG Septicemia Or Severe Sepsis Without Mv Greater Than 96 Hours With Mcc 18 18 $17,970.26 $14,376.21 $13,952.94 $15,332.64 $14,231.99 2026-07-15
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 18 18 $38,757.83 $31,006.26 20% off $13,862.37 $24,953.58 $14,139.63 2026-07-15
906 MS_DRG Hand Procedures For Injuries 18 18 $13,492.50 $10,794.00 20% off $12,826.02 $14,385.81 $14,098.09 2026-07-15
100 MS_DRG Seizures With Mcc 18 18 $10,625.00 $8,500.00 20% off $10,625.00 $14,198.96 $13,914.98 2026-07-15
617 MS_DRG Amputation Of Lower Limb For Endocrine Nutritional And Metabolic Disorders With … 18 18 $16,033.00 $12,826.40 20% off $13,472.21 $14,149.12 $13,741.65 2026-07-15
504 MS_DRG Foot Procedures With Cc 18 18 $18,874.73 $15,099.78 20% off $13,464.88 $15,509.19 $13,734.17 2026-07-15
559 MS_DRG Aftercare Musculoskeletal System And Connective Tissue With Mcc 18 18 $15,886.52 $12,709.22 $13,436.25 $14,019.85 $13,704.98 2026-07-15
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 18 18 $16,899.75 $13,519.80 20% off $13,190.56 $14,453.67 $13,454.36 2026-07-15
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 18 18 $22,756.76 $18,205.41 $12,825.01 $16,994.40 $13,081.50 2026-07-15
580 MS_DRG Other Skin Subcutaneous Tissue And Breast Procedures With Cc 18 18 $19,895.50 $15,916.40 20% off $12,524.72 $15,513.77 $12,775.22 2026-07-15
983 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc-mcc 18 18 $16,532.88 $13,226.30 20% off $12,431.51 $13,903.55 $12,680.13 2026-07-15
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 18 18 $34,747.44 $27,797.95 20% off $12,282.36 $22,298.74 $12,528.01 2026-07-15
720 MS_DRG Not Specified 8 8 $14,186.12 $11,348.90 $12,519.25 $12,519.25 $12,519.25 2026-07-15
331 MS_DRG Major Small And Large Bowel Procedures Without Cc-mcc 18 18 $45,507.70 $36,406.16 $12,224.43 $27,273.29 $12,468.92 2026-07-15
444 MS_DRG Disorders Of The Biliary Tract With Mcc 18 18 $20,001.50 $16,001.20 $12,144.53 $15,372.97 $12,387.43 2026-07-15
769 MS_DRG Postpartum And Post Abortion Diagnoses With O.r. Procedures 18 18 $6,865.50 $5,492.40 20% off $6,865.50 $12,520.80 $12,270.38 2026-07-15
551 MS_DRG Medical Back Problems With Mcc 18 18 $11,824.50 $9,459.60 $11,150.58 $12,427.71 $12,179.16 2026-07-15
27130 HCPCS Arthrp Acetblr-prox Fem Prostc Agrft-algrft 19 19 $37,904.87 $30,323.90 $1,106.71 $35,251.53 $12,141.52 2026-07-15
27447 HCPCS Arthrp Kne Condyleandplatu Medialandlat Compartments 38 19 $41,264.97 $33,011.98 $1,104.23 $47,018.94 $12,141.52 2026-07-15
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc-mcc 18 18 $35,455.83 $28,364.66 20% off $11,878.86 $22,426.39 $12,116.45 2026-07-15
70 MS_DRG Nonspecific Cerebrovascular Disorders With Mcc 18 18 $11,014.62 $8,811.70 $10,774.07 $12,350.93 $12,103.91 2026-07-15
786 MS_DRG Cesarean Section Without Sterilization With Mcc 18 18 $9,876.50 $7,901.20 20% off $9,876.50 $12,246.98 $12,002.04 2026-07-15
280 MS_DRG Acute Myocardial Infarction Discharged Alive With Mcc 18 18 $21,466.20 $17,172.96 20% off $11,699.76 $15,831.67 $11,933.75 2026-07-15
299 MS_DRG Peripheral Vascular Disorders With Mcc 18 18 $10,577.84 $8,462.27 20% off $10,482.67 $12,132.84 $11,890.18 2026-07-15
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 18 18 $11,503.96 $9,203.17 $10,860.83 $12,115.86 $11,873.54 2026-07-15
J3101 HCPCS TENECTEPLASE(TNKase):25 Mgdose(50mg/vial 35 35 $16,148.00 $12,918.40 20% off $8,438.83 $15,017.64 $11,728.24 2026-07-15
177 MS_DRG Respiratory Infections And Inflammations With Mcc 18 18 $17,736.77 $14,189.42 $11,424.10 $13,959.65 $11,652.59 2026-07-15
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 18 18 $5,556.00 $4,444.80 $5,556.00 $11,695.97 $11,462.05 2026-07-15
398 MS_DRG Appendix Procedures With Cc 18 18 $33,667.45 $26,933.96 $11,097.18 $21,203.96 $11,319.12 2026-07-15
3081 APR_DRG Hip & Femur Fracture Repair 8 8 $40,800.25 $32,640.20 20% off $11,131.78 $11,688.37 $11,270.93 2026-07-15
183 MS_DRG Major Chest Trauma With Mcc 18 18 $9,699.04 $7,759.23 20% off $9,699.04 $11,434.40 $11,205.71 2026-07-15
388 MS_DRG Gastrointestinal Obstruction With Mcc 18 18 $22,709.25 $18,167.40 $10,852.15 $15,985.88 $11,069.19 2026-07-15
682 MS_DRG Renal Failure With Mcc 18 18 $10,535.25 $8,428.20 $9,949.54 $11,102.15 $10,880.11 2026-07-15
794 MS_DRG Neonate With Other Significant Problems 18 18 $3,746.50 $2,997.20 20% off $3,746.50 $11,067.50 $10,846.15 2026-07-15
637 MS_DRG Diabetes With Mcc 18 18 $18,227.75 $14,582.20 $10,585.15 $13,768.48 $10,796.85 2026-07-15
562 MS_DRG Fracture Sprain Strain And Dislocation Except Femur Hip Pelvis And Thigh With Mc… 18 18 $16,639.50 $13,311.60 20% off $10,505.90 $12,990.32 $10,716.03 2026-07-15
7102 APR_DRG Infectious & Parasitic Diseases Including HIV W O.r. Procedure 8 8 $27,443.50 $21,954.80 20% off $10,528.07 $11,054.47 $10,659.67 2026-07-15
811 MS_DRG Red Blood Cell Disorders With Mcc 18 18 $38,042.25 $30,433.80 20% off $10,369.43 $22,874.36 $10,576.82 2026-07-15
885 MS_DRG Psychoses 18 18 $12,940.00 $10,352.00 20% off $10,319.48 $11,176.84 $10,525.87 2026-07-15
602 MS_DRG Cellulitis With Mcc 18 18 $11,544.25 $9,235.40 20% off $10,187.80 $10,696.55 $10,482.62 2026-07-15
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc-mcc 18 18 $30,158.89 $24,127.11 20% off $10,113.07 $19,080.42 $10,315.33 2026-07-15
99 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis Without Cc-mcc 18 18 $23,137.92 $18,510.34 $10,090.43 $15,804.35 $10,292.24 2026-07-15
502 MS_DRG Soft Tissue Procedures Without Cc-mcc 18 18 $21,437.00 $17,149.60 20% off $9,980.56 $14,958.49 $10,180.18 2026-07-15
355 MS_DRG Hernia Procedures Except Inguinal And Femoral Without Cc-mcc 18 18 $20,173.55 $16,138.84 $9,974.58 $14,367.99 $10,174.07 2026-07-15
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 18 18 $11,207.75 $8,966.20 $9,890.84 $10,372.46 $10,165.01 2026-07-15
640 MS_DRG Miscellaneous Disorders Of Nutrition Metabolism Fluids And Electrolytes With Mcc 18 18 $13,893.40 $11,114.72 20% off $9,911.99 $11,416.42 $10,110.24 2026-07-15
627 MS_DRG Thyroid Parathyroid And Thyroglossal Procedures Without Cc-mcc 18 18 $19,503.12 $15,602.50 $9,863.39 $14,000.65 $10,060.65 2026-07-15
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 18 18 $16,269.22 $13,015.38 $9,770.84 $12,450.60 $9,966.25 2026-07-15
909 MS_DRG Other O.r. Procedures For Injuries Without Cc-mcc 18 18 $29,605.00 $23,684.00 20% off $9,759.52 $18,646.08 $9,954.70 2026-07-15
540 MS_DRG Osteomyelitis With Cc 18 18 $12,770.50 $10,216.40 20% off $9,650.32 $10,763.44 $9,843.34 2026-07-15
291 MS_DRG Heart Failure And Shock With Mcc 18 18 $12,419.70 $9,935.76 20% off $9,567.09 $10,558.70 $9,758.44 2026-07-15
391 MS_DRG Esophagitis Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 18 18 $16,423.50 $13,138.80 20% off $9,463.89 $12,368.88 $9,653.17 2026-07-15
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 18 18 $7,270.00 $5,816.00 20% off $7,270.00 $9,842.51 $9,645.66 2026-07-15
535 MS_DRG Fractures Of Hip And Pelvis With Mcc 18 18 $5,522.00 $4,417.60 $5,522.00 $9,750.11 $9,555.11 2026-07-15
743 MS_DRG Uterine And Adnexa Procedures For Non-malignancy Without Cc-mcc 18 18 $22,396.00 $17,916.80 20% off $9,280.11 $15,054.19 $9,465.71 2026-07-15
189 MS_DRG Pulmonary Edema And Respiratory Failure 18 18 $17,740.33 $14,192.26 20% off $9,244.83 $12,871.67 $9,429.73 2026-07-15
4693 APR_DRG Acute Kidney Injury 8 8 $11,447.00 $9,157.60 $9,236.65 $9,698.48 $9,352.11 2026-07-15
375 MS_DRG Digestive Malignancy With Cc 18 18 $13,646.50 $10,917.20 $9,073.05 $10,882.15 $9,254.50 2026-07-15
1404 APR_DRG Chronic Obstructive Pulmonary Disease 8 8 $19,691.50 $15,753.20 $9,117.62 $9,573.50 $9,231.59 2026-07-15
J2997 HCPCS Activase 100mg Vial 54 35 $17,160.00 $13,728.00 20% off $183.91 $15,958.80 $9,225.67 2026-07-15
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 18 18 $19,077.11 $15,261.69 $9,035.77 $13,388.74 $9,216.48 2026-07-15
831 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Mcc 18 18 $10,437.00 $8,349.60 $9,025.77 $9,210.66 $9,206.29 2026-07-15
593 MS_DRG Skin Ulcers With Cc 18 18 $10,342.50 $8,274.00 20% off $8,917.90 $9,127.25 $9,096.26 2026-07-15
352 MS_DRG Inguinal And Femoral Hernia Procedures Without Cc-mcc 18 18 $19,677.50 $15,742.00 20% off $8,794.73 $13,547.41 $8,970.62 2026-07-15
796 MS_DRG Vaginal Delivery With Sterilization And-or Dandc With Mcc 18 18 $14,292.20 $11,433.76 20% off $8,789.39 $11,040.57 $8,965.19 2026-07-15
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 18 18 $11,813.50 $9,450.80 20% off $8,744.78 $9,865.67 $8,919.67 2026-07-15
1343 APR_DRG Pulmonary Embolism 8 8 $17,286.00 $13,828.80 20% off $8,790.77 $9,230.31 $8,900.66 2026-07-15
399 MS_DRG Appendix Procedures Without Cc-mcc 18 18 $22,308.94 $17,847.15 20% off $8,640.91 $14,694.11 $8,813.74 2026-07-15
787 MS_DRG Cesarean Section Without Sterilization With Cc 18 18 $11,199.25 $8,959.40 20% off $8,455.15 $9,435.23 $8,624.24 2026-07-15
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 18 18 $17,013.40 $13,610.72 20% off $8,394.56 $12,108.51 $8,562.46 2026-07-15
560 MS_DRG Aftercare Musculoskeletal System And Connective Tissue With Cc 18 18 $8,424.52 $6,739.62 $7,862.68 $8,690.89 $8,517.07 2026-07-15
445 MS_DRG Disorders Of The Biliary Tract With Cc 18 18 $15,153.50 $12,122.80 20% off $8,306.01 $11,199.39 $8,472.13 2026-07-15
1943 APR_DRG Heart Failure 8 8 $19,273.00 $15,418.40 20% off $8,349.60 $8,767.08 $8,453.97 2026-07-15
596 MS_DRG Major Skin Disorders Without Mcc 18 18 $11,432.50 $9,146.00 20% off $8,226.77 $9,429.50 $8,391.30 2026-07-15
805 MS_DRG Vaginal Delivery Without Sterilization Or Dandc With Mcc 18 18 $9,587.07 $7,669.66 $8,204.80 $8,460.59 $8,368.89 2026-07-15
200 MS_DRG Pneumothorax With Cc 18 18 $7,581.50 $6,065.20 20% off $7,419.68 $8,508.80 $8,338.62 2026-07-15
300 MS_DRG Peripheral Vascular Disorders With Cc 18 18 $12,227.28 $9,781.82 20% off $8,126.90 $9,749.14 $8,289.43 2026-07-15
784 MS_DRG Cesarean Section With Sterilization With Cc 18 18 $14,183.00 $11,346.40 20% off $8,077.62 $10,633.91 $8,239.17 2026-07-15
768 MS_DRG Vaginal Delivery With O.r. Procedures Except Sterilization And-or Dandc 18 18 $9,192.95 $7,354.36 20% off $8,112.77 $8,320.61 $8,154.20 2026-07-15
4633 APR_DRG Kidney And Urinary Tract Infections 8 8 $23,130.50 $18,504.40 $7,976.22 $8,375.03 $8,075.92 2026-07-15
71 MS_DRG Nonspecific Cerebrovascular Disorders With Cc 18 18 $15,902.90 $12,722.32 20% off $7,850.57 $11,320.14 $8,007.59 2026-07-15
872 MS_DRG Septicemia Or Severe Sepsis Without Mv Greater Than 96 Hours Without Mcc 18 18 $15,332.73 $12,266.18 20% off $7,832.59 $11,046.01 $7,989.24 2026-07-15
92 MS_DRG Other Disorders Of Nervous System With Cc 18 18 $16,891.50 $13,513.20 $7,830.60 $11,769.85 $7,987.22 2026-07-15
789 MS_DRG Neonates Died Or Transferred To Another Acute Care Facility 8 8 $3,198.33 $2,558.66 20% off $3,198.33 $7,977.53 $7,977.53 2026-07-15
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 18 18 $10,797.50 $8,638.00 20% off $7,817.27 $8,929.48 $7,973.62 2026-07-15
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 18 18 $14,630.64 $11,704.51 20% off $7,746.04 $10,676.27 $7,900.96 2026-07-15
770 MS_DRG Abortion With Dandc Aspiration Curettage Or Hysterotomy 18 18 $16,014.63 $12,811.70 20% off $7,695.44 $11,294.52 $7,849.35 2026-07-15
920 MS_DRG Complications Of Treatment With Cc 18 18 $27,740.00 $22,192.00 20% off $7,692.76 $16,745.48 $7,846.62 2026-07-15
378 MS_DRG Gastrointestinal Hemorrhage With Cc 18 18 $17,564.58 $14,051.66 20% off $7,548.95 $11,942.00 $7,699.93 2026-07-15
178 MS_DRG Respiratory Infections And Inflammations With Cc 18 18 $16,906.62 $13,525.30 $7,517.66 $11,620.41 $7,668.01 2026-07-15
4223 APR_DRG Hypovolemia & Related Electrolyte Disorders 8 8 $21,693.00 $17,354.40 $7,554.14 $7,931.85 $7,648.57 2026-07-15
202 MS_DRG Bronchitis And Asthma With Cc-mcc 18 18 $11,496.00 $9,196.80 20% off $7,485.69 $9,088.49 $7,635.41 2026-07-15
442 MS_DRG Disorders Of Liver Except Malignancy Cirrhosis Or Alcoholic Hepatitis With Cc 18 18 $10,722.66 $8,578.13 $7,446.41 $8,709.24 $7,595.34 2026-07-15
452 APR_DRG Cva And Precerebral Occlusion With Infarction 8 8 $12,717.50 $10,174.00 20% off $7,478.37 $7,852.29 $7,571.85 2026-07-15
552 MS_DRG Medical Back Problems Without Mcc 18 18 $11,095.00 $8,876.00 20% off $7,419.78 $8,869.07 $7,568.17 2026-07-15
788 MS_DRG Cesarean Section Without Sterilization Without Cc-mcc 18 18 $12,441.39 $9,953.11 20% off $7,403.14 $9,486.82 $7,551.19 2026-07-15
785 MS_DRG Cesarean Section With Sterilization Without Cc-mcc 18 18 $12,807.25 $10,245.80 20% off $7,396.47 $9,653.60 $7,544.40 2026-07-15
798 MS_DRG Vaginal Delivery With Sterilization And-or Dandc Without Cc-mcc 18 18 $13,838.06 $11,070.45 $7,391.81 $10,130.60 $7,539.64 2026-07-15
315 MS_DRG Other Circulatory System Diagnoses With Cc 18 18 $5,958.50 $4,766.80 20% off $5,958.50 $7,584.78 $7,433.08 2026-07-15
394 MS_DRG Other Digestive System Diagnoses With Cc 18 18 $13,470.60 $10,776.48 20% off $7,249.32 $9,888.49 $7,394.32 2026-07-15
5191 APR_DRG Uterine & Adnexa Procedures For Leiomyoma 8 8 $14,324.50 $11,459.60 20% off $7,283.80 $7,647.99 $7,374.85 2026-07-15
281 MS_DRG Acute Myocardial Infarction Discharged Alive With Cc 18 18 $13,699.00 $10,959.20 $7,138.80 $9,939.43 $7,281.58 2026-07-15
812 MS_DRG Red Blood Cell Disorders Without Mcc 18 18 $16,620.90 $13,296.72 20% off $7,132.80 $11,295.12 $7,275.46 2026-07-15
1372 APR_DRG Major Respiratory Infections & Inflammations 8 8 $21,038.50 $16,830.80 20% off $7,093.90 $7,448.60 $7,182.57 2026-07-15
376 MS_DRG Digestive Malignancy Without Cc-mcc 18 18 $4,437.50 $3,550.00 20% off $4,437.50 $7,319.81 $7,173.41 2026-07-15
101 MS_DRG Seizures Without Mcc 18 18 $15,525.87 $12,420.70 $7,028.93 $10,734.00 $7,169.51 2026-07-15
1393 APR_DRG Other Pneumonia 8 8 $20,495.62 $16,396.50 $7,080.98 $7,435.03 $7,169.49 2026-07-15
638 MS_DRG Diabetes With Cc 18 18 $16,447.61 $13,158.09 $6,986.31 $11,141.30 $7,126.04 2026-07-15
563 MS_DRG Fracture Sprain Strain And Dislocation Except Femur Hip Pelvis And Thigh Without… 18 18 $10,537.50 $8,430.00 20% off $6,981.67 $8,390.77 $7,121.30 2026-07-15
864 MS_DRG Fever And Inflammatory Conditions 18 18 $13,346.25 $10,677.00 20% off $6,929.72 $9,670.86 $7,068.31 2026-07-15
914 MS_DRG Traumatic Injury Without Mcc 18 18 $16,375.84 $13,100.67 20% off $6,915.08 $11,072.31 $7,053.37 2026-07-15
683 MS_DRG Renal Failure With Cc 18 18 $15,801.81 $12,641.45 $6,850.48 $10,773.08 $6,987.50 2026-07-15
C1889 HCPCS Latera Absorbable Nasal Implant 41 34 $7,903.50 $6,322.80 20% off $6,599.42 $7,350.72 $6,974.84 2026-07-15
312 MS_DRG Syncope And Collapse 18 18 $15,059.41 $12,047.53 $6,822.52 $10,413.89 $6,958.98 2026-07-15
603 MS_DRG Cellulitis Without Mcc 18 18 $14,626.26 $11,701.01 $6,817.87 $10,210.15 $6,954.23 2026-07-15
866 MS_DRG Viral Illness Without Mcc 18 18 $14,718.40 $11,774.72 20% off $6,809.20 $10,248.66 $6,945.38 2026-07-15
2432 APR_DRG Other Esophageal Disorders 8 8 $20,662.00 $16,529.60 20% off $6,821.95 $7,163.05 $6,907.23 2026-07-15
1332 APR_DRG Respiratory Failure 8 8 $15,445.50 $12,356.40 20% off $6,809.37 $7,149.84 $6,894.49 2026-07-15
819 MS_DRG Other Antepartum Diagnoses With O.r. Procedures Without Cc-mcc 18 18 $11,800.36 $9,440.29 $6,744.62 $8,859.48 $6,879.52 2026-07-15
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 18 18 $11,065.50 $8,852.40 20% off $6,725.98 $8,508.45 $6,860.51 2026-07-15
292 MS_DRG Heart Failure And Shock With Cc 18 18 $9,620.70 $7,696.56 20% off $6,672.05 $7,809.65 $6,805.48 2026-07-15
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 18 18 $13,143.00 $10,514.40 20% off $6,632.10 $9,427.55 $6,764.74 2026-07-15
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 18 18 $10,327.50 $8,262.00 20% off $6,620.12 $8,112.35 $6,752.51 2026-07-15
779 MS_DRG Abortion Without Dandc 18 18 $6,548.50 $5,238.80 20% off $6,111.94 $6,755.89 $6,620.77 2026-07-15
3441 APR_DRG Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections 8 8 $14,699.00 $11,759.20 $6,477.36 $6,801.23 $6,558.33 2026-07-15
728 MS_DRG Inflammation Of The Male Reproductive System Without Mcc 18 18 $14,600.25 $11,680.20 $6,420.36 $9,999.30 $6,548.77 2026-07-15
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 18 18 $10,134.21 $8,107.37 $6,409.05 $7,916.94 $6,537.24 2026-07-15
446 MS_DRG Disorders Of The Biliary Tract Without Cc-mcc 18 18 $7,016.00 $5,612.80 20% off $6,259.56 $6,660.77 $6,527.55 2026-07-15
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 18 18 $8,836.66 $7,069.33 $6,396.40 $7,307.24 $6,524.33 2026-07-15
204 MS_DRG Respiratory Signs And Symptoms 18 18 $9,672.00 $7,737.60 $6,395.06 $7,695.01 $6,522.96 2026-07-15
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 18 18 $13,480.92 $10,784.74 $6,385.06 $9,461.16 $6,512.77 2026-07-15
176 MS_DRG Pulmonary Embolism Without Mcc 18 18 $9,079.75 $7,263.80 20% off $6,379.07 $7,411.62 $6,506.66 2026-07-15
948 MS_DRG Signs And Symptoms Without Mcc 18 18 $9,311.25 $7,449.00 20% off $6,349.13 $7,504.30 $6,476.10 2026-07-15
69 MS_DRG Transient Ischemia Without Thrombolytic 18 18 $13,068.16 $10,454.53 $6,337.80 $9,245.59 $6,464.55 2026-07-15
389 MS_DRG Gastrointestinal Obstruction With Cc 18 18 $22,157.04 $17,725.63 20% off $6,277.87 $13,441.96 $6,403.43 2026-07-15
1403 APR_DRG Chronic Obstructive Pulmonary Disease 8 8 $18,340.67 $14,672.54 $6,279.50 $6,593.48 $6,357.99 2026-07-15
694 MS_DRG Urinary Stones Without Mcc 18 18 $7,328.88 $5,863.10 20% off $6,223.94 $6,467.73 $6,348.42 2026-07-15
392 MS_DRG Esophagitis Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 18 18 $11,941.53 $9,553.22 20% off $6,209.97 $8,657.80 $6,334.16 2026-07-15
641 MS_DRG Miscellaneous Disorders Of Nutrition Metabolism Fluids And Electrolytes Without … 18 18 $11,178.40 $8,942.72 20% off $6,200.64 $8,298.27 $6,324.65 2026-07-15
C1886 HCPCS Clarifix 34 34 $7,133.00 $5,706.40 20% off $5,956.06 $6,633.69 $6,294.88 2026-07-15
6632 APR_DRG Other Anemia And Disorders Of Blood And Blood-forming Organs 8 8 $14,542.00 $11,633.60 20% off $6,134.35 $6,441.07 $6,211.03 2026-07-15
Q4152 HCPCS Dermapure 4cm X 6cm 26 19 $7,244.00 $5,795.20 20% off $113.87 $7,362.81 $6,175.51 2026-07-15
72 MS_DRG Nonspecific Cerebrovascular Disorders Without Cc-mcc 18 18 $10,265.32 $8,212.26 $6,054.17 $7,800.46 $6,175.24 2026-07-15
179 MS_DRG Respiratory Infections And Inflammations Without Cc-mcc 18 18 $22,690.50 $18,152.40 $6,046.16 $13,574.16 $6,167.08 2026-07-15
806 MS_DRG Vaginal Delivery Without Sterilization Or Dandc With Cc 18 18 $9,565.65 $7,652.52 $6,039.50 $7,467.77 $6,160.30 2026-07-15
149 MS_DRG Dysequilibrium 18 18 $16,162.50 $12,930.00 20% off $6,023.52 $10,527.32 $6,143.99 2026-07-15
2472 APR_DRG Intestinal Obstruction 8 8 $21,293.00 $17,034.40 $6,052.74 $6,355.38 $6,128.40 2026-07-15
5391 APR_DRG Cesarean Section W Sterilization 8 8 $12,529.50 $10,023.60 20% off $6,028.24 $6,329.65 $6,103.59 2026-07-15
5411 APR_DRG Vaginal Delivery W/sterilization &/or D&c 8 8 $19,742.50 $15,794.00 20% off $6,023.31 $6,324.48 $6,098.60 2026-07-15
4701 APR_DRG Chronic Kidney Disease 8 8 $10,931.50 $8,745.20 $6,008.67 $6,309.10 $6,083.78 2026-07-15
153 MS_DRG Otitis Media And Uri Without Mcc 18 18 $10,249.46 $8,199.57 $5,934.31 $7,733.15 $6,053.00 2026-07-15
5603 APR_DRG Vaginal Delivery 8 8 $7,769.50 $6,215.60 $5,962.46 $6,260.58 $6,036.99 2026-07-15
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 18 18 $15,524.55 $12,419.64 20% off $5,917.66 $10,177.75 $6,036.02 2026-07-15
7202 APR_DRG Septicemia And Disseminated Infections 8 8 $17,685.75 $14,148.60 20% off $5,958.25 $6,256.16 $6,032.73 2026-07-15
282 MS_DRG Acute Myocardial Infarction Discharged Alive Without Cc-mcc 18 18 $12,387.00 $9,909.60 20% off $5,833.76 $8,676.83 $5,950.44 2026-07-15
832 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Cc 18 18 $11,888.24 $9,510.59 20% off $5,823.78 $8,439.92 $5,940.25 2026-07-15
313 MS_DRG Chest Pain 18 18 $13,881.87 $11,105.50 $5,813.12 $9,361.63 $5,929.39 2026-07-15
151 MS_DRG Epistaxis Without Mcc 18 18 $4,746.56 $3,797.25 $4,746.56 $6,026.87 $5,906.33 2026-07-15
2532 APR_DRG Other & Unspecified Gastrointestinal Hemorrhage 8 8 $10,350.50 $8,280.40 20% off $5,821.81 $6,112.90 $5,894.58 2026-07-15
301 MS_DRG Peripheral Vascular Disorders Without Cc-mcc 18 18 $6,231.50 $4,985.20 20% off $5,566.51 $5,929.72 $5,811.13 2026-07-15
311 MS_DRG Angina Pectoris 18 18 $10,101.52 $8,081.22 $5,692.60 $7,543.51 $5,806.46 2026-07-15
443 MS_DRG Disorders Of Liver Except Malignancy Cirrhosis Or Alcoholic Hepatitis Without Cc… 18 18 $11,782.16 $9,425.73 $5,677.95 $8,317.68 $5,791.52 2026-07-15
2492 APR_DRG Other Gastroenteritis, Nausea & Vomiting 8 8 $5,464.00 $4,371.20 20% off $5,464.00 $6,058.64 $5,770.13 2026-07-15
5401 APR_DRG Cesarean Delivery 8 8 $11,695.37 $9,356.30 $5,665.30 $5,948.56 $5,736.11 2026-07-15
47562 HCPCS Laparoscopy Surg Cholecystectomy 19 19 $14,082.76 $11,266.21 $602.81 $13,096.97 $5,717.24 2026-07-15
44970 HCPCS Laparoscopic Appendectomy 19 19 $18,157.03 $14,525.62 20% off $550.94 $16,886.04 $5,717.24 2026-07-15
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc-mcc 18 18 $13,813.00 $11,050.40 20% off $5,576.08 $9,211.08 $5,687.61 2026-07-15
3832 APR_DRG Cellulitis & Other Bacterial Skin Infections 8 8 $14,500.50 $11,600.40 20% off $5,612.25 $5,892.86 $5,682.40 2026-07-15
316 MS_DRG Other Circulatory System Diagnoses Without Cc-mcc 18 18 $16,466.50 $13,173.20 $5,560.76 $10,437.30 $5,671.99 2026-07-15
2822 APR_DRG Disorders Of Pancreas Except Malignancy 8 8 $19,805.00 $15,844.00 20% off $5,595.47 $5,875.24 $5,665.41 2026-07-15
284 MS_DRG Acute Myocardial Infarction Expired With Cc 18 18 $4,262.00 $3,409.60 20% off $4,262.00 $5,742.88 $5,628.02 2026-07-15
998 MS_DRG Principal Diagnosis Invalid As Discharge Diagnosis 8 8 $6,373.76 $5,099.01 $5,624.85 $5,624.85 $5,624.85 2026-07-15
807 MS_DRG Vaginal Delivery Without Sterilization Or Dandc Without Cc-mcc 18 18 $7,905.51 $6,324.41 $5,508.17 $6,430.15 $5,618.33 2026-07-15
2541 APR_DRG Other Digestive System Diagnoses 8 8 $18,478.50 $14,782.80 20% off $5,523.24 $5,799.40 $5,592.28 2026-07-15
203 MS_DRG Bronchitis And Asthma Without Cc-mcc 18 18 $16,025.75 $12,820.60 20% off $5,480.21 $10,192.08 $5,589.81 2026-07-15
42820 HCPCS Tonsillectomy And Adenoidectomy Less Than Age 12 19 19 $6,162.36 $4,929.89 $246.94 $5,730.99 $5,488.61 2026-07-15
776 MS_DRG Postpartum And Post Abortion Diagnoses Without O.r. Procedures 18 18 $7,413.57 $5,930.86 $5,378.33 $6,136.48 $5,485.89 2026-07-15
395 MS_DRG Other Digestive System Diagnoses Without Cc-mcc 18 18 $12,732.75 $10,186.20 $5,340.37 $8,590.92 $5,447.18 2026-07-15
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc-mcc 18 18 $11,510.25 $9,208.20 $5,293.77 $7,999.15 $5,399.65 2026-07-15
5613 APR_DRG Postpartum & Post Abortion Diagnoses Without Procedure 8 8 $7,423.50 $5,938.80 20% off $5,308.14 $5,573.55 $5,374.49 2026-07-15
379 MS_DRG Gastrointestinal Hemorrhage Without Cc-mcc 18 18 $13,851.50 $11,081.20 $5,216.54 $9,049.22 $5,320.87 2026-07-15
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc-mcc 18 18 $11,526.33 $9,221.06 20% off $5,203.89 $7,961.69 $5,307.96 2026-07-15
1392 APR_DRG Other Pneumonia 8 8 $16,779.00 $13,423.20 $5,224.08 $5,485.28 $5,289.38 2026-07-15
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc-mcc 18 18 $14,853.50 $11,882.80 20% off $5,156.61 $9,485.18 $5,259.75 2026-07-15
639 MS_DRG Diabetes Without Cc-mcc 18 18 $8,340.50 $6,672.40 20% off $5,155.27 $6,455.97 $5,258.38 2026-07-15
684 MS_DRG Renal Failure Without Cc-mcc 18 18 $10,827.50 $8,662.00 20% off $5,016.11 $7,542.85 $5,116.43 2026-07-15
5602 APR_DRG Vaginal Delivery 8 8 $8,828.30 $7,062.64 $4,955.25 $5,203.01 $5,017.19 2026-07-15
4202 APR_DRG Diabetes 8 8 $12,055.00 $9,644.00 20% off $4,947.09 $5,194.44 $5,008.93 2026-07-15
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc-mcc 18 18 $10,418.82 $8,335.06 $4,788.41 $7,238.95 $4,884.17 2026-07-15
293 MS_DRG Heart Failure And Shock Without Cc-mcc 18 18 $9,409.33 $7,527.46 20% off $4,787.73 $6,769.20 $4,883.49 2026-07-15
49505 HCPCS Rpr 1st Ingun Hrna Age 5 Yrs-greater Than Reducible 35 35 $9,964.63 $7,971.70 20% off $483.02 $9,267.11 $4,875.06 2026-07-15
451 APR_DRG Cva & Precerebral Occulusion W/infarct 17 17 $18,633.00 $14,906.40 20% off $4,706.53 $4,941.86 $4,824.19 2026-07-15
390 MS_DRG Gastrointestinal Obstruction Without Cc-mcc 18 18 $14,343.32 $11,474.66 $4,641.26 $8,990.27 $4,734.09 2026-07-15
5601 APR_DRG Vaginal Delivery 8 8 $8,435.87 $6,748.70 $4,494.17 $4,718.88 $4,550.35 2026-07-15
29881 HCPCS Arthrs Kne Surg W-meniscectomy Med-lat W-shvg 35 35 $9,213.07 $7,370.46 $485.29 $8,568.16 $4,526.73 2026-07-15
833 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures Without Cc-mcc 18 18 $3,052.95 $2,442.36 $3,052.95 $4,592.61 $4,500.76 2026-07-15
A9900 HCPCS Medtronic Ptm Handset 34 34 $5,039.00 $4,031.20 20% off $4,207.56 $4,686.27 $4,446.91 2026-07-15
J7168 HCPCS Factor Cplx(pcc) 4factor Per 1000units 34 34 $7,312.00 $5,849.60 $2,051.14 $6,800.16 $4,425.65 2026-07-15
3831 APR_DRG Cellulitis & Other Bacterial Skin Infections 8 8 $20,637.50 $16,510.00 20% off $4,352.03 $4,569.63 $4,406.43 2026-07-15
S4989 HCPCS Essure Permanent Birth Control Device 34 34 $4,950.00 $3,960.00 20% off $4,133.25 $4,603.50 $4,368.38 2026-07-15
2011 APR_DRG Cardiac Arrhythmia And Conduction Disorders 8 8 $12,105.50 $9,684.40 20% off $4,009.09 $4,209.54 $4,059.20 2026-07-15
4691 APR_DRG Acute Kidney Disease 8 8 $19,343.50 $15,474.80 20% off $3,999.96 $4,199.96 $4,049.96 2026-07-15
J0129 HCPCS Abatacept (orencia) : 250mg Pwvl 35 35 $3,805.00 $3,044.00 20% off $3,177.18 $4,476.90 $3,827.04 2026-07-15
J3262 HCPCS Tocilizumab Inj(actemra):400mg/20ml Vial 35 35 $5,620.00 $4,496.00 20% off $2,198.73 $5,226.60 $3,712.66 2026-07-15
19120 HCPCS Exc Cyst-aberrant Breast Tissue Open 1-greater Than Lesion 35 35 $4,881.00 $3,904.80 $533.77 $4,539.33 $3,630.21 2026-07-15
11770 HCPCS Excision Pilonidal Cyst-sinus Simple 35 35 $7,305.01 $5,844.01 $358.33 $6,793.66 $3,575.99 2026-07-15
88358 HCPCS Morphometric [aultman Pathology] 11 11 $3,972.00 $3,177.60 20% off $119.30 $3,693.96 $3,455.64 2026-07-15
49591 HCPCS Rpr Aa Hernia 1st Less Than 3 Cm Reducible 19 19 $11,828.37 $9,462.70 $303.59 $11,000.38 $3,385.97 2026-07-15
L8606 HCPCS Kit Bulking Urethral 34 34 $3,795.00 $3,036.00 20% off $3,168.82 $3,529.35 $3,349.09 2026-07-15
L8681 HCPCS Inspire Patient Programmer Dme 41 34 $3,697.00 $2,957.60 20% off $2,879.08 $3,438.21 $3,262.61 2026-07-15
C2625 HCPCS Propel Implant Contour 55 34 $3,555.00 $2,844.00 20% off $207.08 $3,477.27 $3,137.28 2026-07-15
42830 HCPCS Adenoidectomy Primary Less Than Age 12 19 19 $4,369.00 $3,495.20 20% off $183.36 $4,063.17 $3,135.42 2026-07-15
42826 HCPCS Tonsillectomy Primary-secondary Age 12-greater Than 19 19 $7,425.17 $5,940.14 $218.17 $6,905.41 $3,135.42 2026-07-15
42821 HCPCS Tonsillectomy And Adenoidectomy Age 12-greater Than 19 19 $6,465.00 $5,172.00 20% off $257.56 $6,012.45 $3,135.42 2026-07-15
59412 HCPCS External Version For Breech Baby 19 19 $1,237.00 $989.60 20% off $90.83 $3,062.57 $3,001.32 2026-07-15
C1776 HCPCS 1.6mm Straight Plate 18 Hole 2,050 34 $3,419.00 $2,735.20 20% off $71.81 $23,064.00 $2,993.59 2026-07-15
L8699 HCPCS Telexflex Uro Lift Implant Cartridge 41 34 $3,382.00 $2,705.60 20% off $2,823.97 $3,146.19 $2,984.61 2026-07-15
36585 HCPCS Rplcmt Compl Prph Ctr Vad W/subq Port 35 35 $4,724.00 $3,779.20 20% off $1,352.68 $4,393.32 $2,927.48 2026-07-15
C1771 HCPCS Desara Blue Sling Overlapping Sling 55 34 $3,300.00 $2,640.00 20% off $2,328.82 $3,402.87 $2,912.25 2026-07-15
43249 HCPCS Egd Balloon Dilation Esophagus Less Than 30 Mm Diam 35 35 $4,574.30 $3,659.44 20% off $1,064.48 $4,254.10 $2,659.29 2026-07-15
C1787 HCPCS 50cm Surpass Surgical 48 34 $3,000.00 $2,400.00 20% off $606.21 $3,207.57 $2,647.50 2026-07-15
C1773 HCPCS Intrafx Advbr Scw8x30 W Smshth 34 34 $2,973.00 $2,378.40 $2,482.46 $2,764.89 $2,623.68 2026-07-15
26587 HCPCS Removal Of Extra Digit 35 35 $2,946.00 $2,356.80 $918.69 $3,095.56 $2,459.91 2026-07-15
C1781 HCPCS 8 X 12 Allomx 1mm Surgical Graft 244 34 $2,688.00 $2,150.40 $131.93 $16,203.39 $2,365.44 2026-07-15
795 MS_DRG Normal Newborn 18 18 $2,189.06 $1,751.25 $2,112.64 $2,397.40 $2,349.45 2026-07-15
57135 HCPCS Excision Of Vaginal Mucosa Tag 35 35 $2,785.00 $2,228.00 20% off $226.49 $3,062.57 $2,325.48 2026-07-15
6261 APR_DRG Neonate, Bwt 2000-2499g, Normal Newborn Or Neonate W Oth Prob 10 8 $1,904.00 $1,523.20 20% off $1,904.00 $2,416.84 $2,231.09 2026-07-15
C1897 HCPCS Blue Perc Lead Kit 41 34 $2,475.00 $1,980.00 20% off $2,066.62 $3,069.00 $2,184.18 2026-07-15
64721 HCPCS Neuroplasty And-transpos Median Nrv Carpal Tunnel BILATERAL,Bilateral Procedure 70 35 $5,136.00 $4,108.80 $448.73 $5,831.10 $2,085.30 2026-07-15
45385 HCPCS Colsc Flx W-rmvl Of Tumor Polyp Lesion Snare Tq 35 35 $3,819.55 $3,055.64 20% off $461.67 $3,552.18 $2,006.92 2026-07-15
43239 HCPCS Egd Transoral Biopsy Single-multiple 35 35 $3,900.46 $3,120.37 $382.24 $3,627.43 $2,004.84 2026-07-15
45380 HCPCS Colonoscopy W-biopsy Single-multiple 35 35 $3,794.19 $3,035.35 20% off $440.64 $3,528.60 $1,984.62 2026-07-15
Q4211 HCPCS Amnion Patch 2 Cm X 2 Cm 26 19 $4,620.00 $3,696.00 20% off $113.87 $4,296.60 $1,969.28 2026-07-15
43235 HCPCS Esophagogastroduodenoscopy Transoral Diagnostic 35 35 $3,853.45 $3,082.76 $295.24 $3,583.71 $1,939.47 2026-07-15
C1763 HCPCS Prolaryn Gel Injectable Implant 41 34 $2,145.00 $1,716.00 20% off $1,791.08 $11,371.11 $1,892.96 2026-07-15
47531 HCPCS Cholangio T Tube 35 35 $990.00 $792.00 20% off $360.58 $3,387.33 $1,873.95 2026-07-15
6401 APR_DRG Neonate Birthwt Greater Than 2499g Normal Newborn Or Neonate W Other Problem 8 8 $2,189.46 $1,751.57 $1,819.68 $1,910.66 $1,842.43 2026-07-15
59409 HCPCS Vaginal Delivery 57 35 $1,598.00 $1,278.40 $637.72 $3,062.57 $1,819.52 2026-07-15
64635 HCPCS Dstr Nrolytc Agnt Parverteb Fct Sngl Lmbr-sacral 35 35 $3,186.00 $2,548.80 $426.13 $2,962.98 $1,810.48 2026-07-15
J7195 HCPCS Factor Ix (benefix) Per 1000 Units 54 35 $5,630.00 $4,504.00 20% off $1.79 $5,235.90 $1,804.67 2026-07-15
81229 HCPCS Cytog Alys Chrml Abnr Snpcgh 35 35 $2,507.00 $2,005.60 20% off $1,136.80 $2,331.51 $1,734.15 2026-07-15
Q4100 HCPCS Acell 5x5 Surgical Matrix 48 34 $1,944.00 $1,555.20 20% off $99.36 $3,093.18 $1,715.58 2026-07-15
45378 HCPCS Colonoscopy Flx Dx W-collj Spec When Pfrmd 35 35 $3,311.29 $2,649.03 20% off $348.64 $3,079.50 $1,714.07 2026-07-15
G0121 HCPCS Colon Ca Scrn Not Hi Rsk Ind 35 35 $3,291.78 $2,633.42 20% off $348.96 $3,061.36 $1,705.16 2026-07-15
78452 HCPCS Nm Cardiac Stress (spect) W/adenosine 42 35 $3,250.00 $2,600.00 20% off $387.74 $3,913.44 $1,705.12 2026-07-15
27087 HCPCS Removal Foreign Body Pelvis/hip Deep 57 35 $1,244.00 $995.20 $369.67 $4,962.48 $1,701.66 2026-07-15
69436 HCPCS Tympanostomy General Anesthesia BILATERAL,Bilateral Procedure 35 35 $3,417.75 $2,734.20 20% off $203.79 $3,178.51 $1,691.15 2026-07-15
G0105 HCPCS Colorectal Scrn; Hi Risk Ind 35 35 $3,161.30 $2,529.04 20% off $348.64 $2,940.01 $1,644.33 2026-07-15
59300 HCPCS Episiot / Vag Repair Other Than Attendin 35 35 $1,349.00 $1,079.20 $210.78 $3,062.57 $1,636.67 2026-07-15
49440 HCPCS Percut Placement Gastrostom Tube Rad Sup 35 35 $1,957.00 $1,565.60 20% off $717.54 $1,820.01 $1,634.10 2026-07-15
70549 HCPCS Mr MRA Neck W/wo Contrast 35 35 $3,121.00 $2,496.80 $312.64 $2,902.53 $1,607.59 2026-07-15
32408 HCPCS Lung Or Mediastinum Biopsy US Guided 35 35 $2,670.00 $2,136.00 20% off $729.52 $2,483.10 $1,606.31 2026-07-15
36556 HCPCS Insert Central Line > 5 Yr Old 58 35 $2,987.00 $2,389.60 20% off $112.77 $2,987.22 $1,602.79 2026-07-15
C1778 HCPCS Blue Lead Extension Kit 97 34 $1,800.00 $1,440.00 20% off $192.88 $10,358.34 $1,588.50 2026-07-15
70553 HCPCS Mr MRI Brain W/wo Contrast 35 35 $3,094.00 $2,475.20 20% off $290.46 $2,877.42 $1,583.94 2026-07-15
19083 HCPCS US Core Bx Breast Bilateral 1st LESIO,Bilateral Procedure 105 35 $2,520.00 $2,016.00 20% off $435.22 $3,829.74 $1,561.91 2026-07-15
74183 HCPCS Mr Abdomen W & Without Contrast 35 35 $3,000.00 $2,400.00 20% off $307.27 $2,790.00 $1,548.63 2026-07-15
70546 HCPCS Mr MRA Brain W/wo Contrast 42 35 $3,001.00 $2,400.80 $297.65 $2,902.53 $1,544.29 2026-07-15
38505 HCPCS Lymph Node Biopsy Needle US Guided 35 35 $2,403.00 $1,922.40 $157.36 $2,234.79 $1,531.29 2026-07-15
49180 HCPCS Abdominal Biopsy US Guided 35 35 $2,403.00 $1,922.40 $157.79 $2,234.79 $1,531.29 2026-07-15
27040 HCPCS Pelvis Biopsy US Guided 35 35 $2,670.00 $2,136.00 20% off $315.48 $2,483.10 $1,531.29 2026-07-15
23333 HCPCS Remove Shoulder Fb Deep 57 35 $965.00 $772.00 20% off $362.37 $4,357.05 $1,527.74 2026-07-15
73720 HCPCS Mr Femur W/wo LT,Left Side 70 35 $2,953.00 $2,362.40 $306.19 $2,746.29 $1,526.24 2026-07-15
73723 HCPCS Mr Ankle W/wo LT,Left Side 70 35 $2,924.00 $2,339.20 20% off $323.46 $2,719.32 $1,521.39 2026-07-15
24201 HCPCS Rmvl Fb Upper Arm/elbw Deep 57 35 $817.00 $653.60 20% off $285.16 $4,357.05 $1,489.14 2026-07-15
70543 HCPCS Mr Orbit,face,neck,w/wo Contrast 35 35 $2,868.00 $2,294.40 $307.98 $2,667.24 $1,487.61 2026-07-15
71552 HCPCS Mr Chest W/wo Contrast 35 35 $2,812.00 $2,249.60 20% off $323.46 $2,615.16 $1,469.31 2026-07-15
C8920 HCPCS Mr MRA Pelvis C-c+ 34 34 $2,812.00 $2,249.60 20% off $323.46 $2,615.16 $1,469.31 2026-07-15
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