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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

COMMUNITY HOSPITALS AND WELLNESS CENTERS

Montpelier, OH · CCN 361327 · Rates published

953 distinct procedures filed
16 distinct payers
16,686 rate rows
2026-04-01 last MRF observed
Data quality

577 of 16,686 rate rows are consumer-grade (3.5%)

16,109 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 16,109
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.parkview.com/-/media/parkview-media/file/price-transparency/341048666_parkview-bryan-hospital_standardcharges.ashx
Found on page https://www.parkview.com/patients-and-visitors/billing-and-insurance/request-an-estimate
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-10-21
Content fingerprint 2177569480dd2457… · 17,382,211 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
947
MS_DRG 		Signs And Symptoms With Mcc 2 $33,618.03 $79,605.00 $56,611.51 nat. median
$12,117
outlier · 4.7×
264
MS_DRG 		Other Circulatory System O.r. Procedures 1 $54,041.89 $54,041.89 $54,041.89 nat. median
$31,185
1.7× median
192
MS_DRG 		Chronic Obstructive Pulmonary Disease Without Cc/Mcc 1 $53,825.52 $53,825.52 $53,825.52 nat. median
$7,110
outlier · 7.6×
68
MS_DRG 		Precerebral Occlusion Without Infarction Without Mcc 1 $53,825.52 $53,825.52 $53,825.52 nat. median
$9,206
outlier · 5.8×
811
MS_DRG 		Red Blood Cell Disorders With Mcc 1 $49,340.06 $49,340.06 $49,340.06 nat. median
$13,626
outlier · 3.6×
57
MS_DRG 		Degenerative Nervous System Disorders Without Mcc 3 $22,754.48 $82,349.99 $49,315.71 nat. median
$12,554
outlier · 3.9×
540
MS_DRG 		Osteomyelitis With Cc 1 $38,420.61 $38,420.61 $38,420.61 nat. median
$12,766
outlier · 3.0×
291
MS_DRG 		Heart Failure And Shock With Mcc 2 $32,940.00 $40,897.03 $36,918.51 nat. median
$12,770
outlier · 2.9×
559
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Mcc 5 $7,203.27 $45,620.67 $36,751.35 nat. median
$18,115
outlier · 2.0×
552
MS_DRG 		Medical Back Problems Without Mcc 1 $36,751.35 $36,751.35 $36,751.35 nat. median
$9,830
outlier · 3.7×
312
MS_DRG 		Syncope And Collapse 2 $31,851.17 $41,174.99 $36,513.08 nat. median
$8,945
outlier · 4.1×
292
MS_DRG 		Heart Failure And Shock With Cc 1 $36,413.26 $36,413.26 $36,413.26 nat. median
$8,952
outlier · 4.1×
189
MS_DRG 		Pulmonary Edema And Respiratory Failure 2 $36,016.33 $36,751.35 $36,383.84 nat. median
$12,282
outlier · 3.0×
949
MS_DRG 		Aftercare With Cc/Mcc 4 $16,274.09 $43,219.59 $33,615.23 nat. median
$11,796
outlier · 2.8×
280
MS_DRG 		Acute Myocardial Infarction, Discharged Alive With Mcc 1 $33,615.23 $33,615.23 $33,615.23 nat. median
$15,657
outlier · 2.1×
948
MS_DRG 		Signs And Symptoms Without Mcc 5 $19,910.17 $40,149.24 $31,398.22 nat. median
$7,969
outlier · 3.9×
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 3 $26,950.99 $48,027.66 $31,214.15 nat. median
$8,376
outlier · 3.7×
560
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Cc 4 $27,450.00 $41,651.53 $29,798.04 nat. median
$11,479
outlier · 2.6×
549
MS_DRG 		Septic Arthritis With Cc 1 $29,401.08 $29,401.08 $29,401.08 nat. median
$12,095
outlier · 2.4×
566
MS_DRG 		Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/Mcc 1 $26,971.56 $26,971.56 $26,971.56 nat. median
$7,959
outlier · 3.4×
281
MS_DRG 		Acute Myocardial Infarction, Discharged Alive With Cc 1 $26,950.99 $26,950.99 $26,950.99 nat. median
$9,714
outlier · 2.8×
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 2 $8,990.52 $41,175.00 $25,082.76 nat. median
$15,388
1.6× median
373
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc 1 $24,704.99 $24,704.99 $24,704.99 nat. median
$7,839
outlier · 3.2×
603
MS_DRG 		Cellulitis Without Mcc 1 $22,408.16 $22,408.16 $22,408.16 nat. median
$8,986
outlier · 2.5×
55
MS_DRG 		Nervous System Neoplasms Without Mcc 1 $19,607.14 $19,607.14 $19,607.14 nat. median
$10,747
1.8× median
698
MS_DRG 		Other Kidney And Urinary Tract Diagnoses With Mcc 1 $19,600.72 $19,600.72 $19,600.72 nat. median
$15,903
1.2× median
561
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc 4 $2,401.29 $27,450.00 $18,607.31 nat. median
$8,655
outlier · 2.1×
884
MS_DRG 		Organic Disturbances And Intellectual Disability 2 $14,700.54 $22,375.31 $18,537.93 nat. median
$14,244
1.3× median
683
MS_DRG 		Renal Failure With Cc 1 $16,807.62 $16,807.62 $16,807.62 nat. median
$9,108
1.8× median
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 $14,700.54 $14,700.54 $14,700.54 nat. median
$10,401
1.4× median
372
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Cc 1 $14,205.11 $14,205.11 $14,205.11 nat. median
$10,410
1.4× median
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 1 $13,725.00 $13,725.00 $13,725.00 nat. median
$12,539
1.1× median
640
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 2 $8,045.02 $19,146.40 $13,595.71 nat. median
$12,850
1.1× median
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 1 $13,325.01 $13,325.01 $13,325.01 nat. median
$19,252
0.7× median
374
MS_DRG 		Digestive Malignancy With Mcc 1 $12,250.45 $12,250.45 $12,250.45 nat. median
$20,145
0.6× median
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 3 $8,093.34 $17,098.69 $9,604.35 nat. median
$12,868
0.7× median
149
MS_DRG 		Dysequilibrium 1 $9,604.35 $9,604.35 $9,604.35 nat. median
$7,943
1.2× median
638
MS_DRG 		Diabetes With Cc 1 $9,565.15 $9,565.15 $9,565.15 nat. median
$9,225
1.0× median
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 1 $8,883.34 $8,883.34 $8,883.34 nat. median
$11,514
0.8× median
75
MS_DRG 		Viral Meningitis With Cc/Mcc 1 $8,816.74 $8,816.74 $8,816.74 nat. median
$17,723
outlier · 0.5×
91
MS_DRG 		Other Disorders Of Nervous System With Mcc 1 $8,362.27 $8,362.27 $8,362.27 nat. median
$17,061
outlier · 0.5×
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 1 $7,350.27 $7,350.27 $7,350.27 nat. median
$8,516
0.9× median
5594
OTHER 		Level 4 Nuclear Medicine And Related Services 1 $5,913.24 $5,913.24 $5,913.24 nat. median
$1,584
outlier · 3.7×
371
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 1 $5,490.00 $5,490.00 $5,490.00 nat. median
$16,910
outlier · 0.3×
5183
OTHER 		Level 3 Vascular Procedures 2 $2,901.31 $6,828.48 $4,864.89 nat. median
$3,363
1.4× median
67
MS_DRG 		Precerebral Occlusion Without Infarction With Mcc 1 $4,586.03 $4,586.03 $4,586.03 nat. median
$14,428
outlier · 0.3×
5161
OTHER 		Level 1 ENT Procedures 5 $1,617.55 $5,036.37 $4,574.00 nat. median
$252
outlier · 18.1×
682
MS_DRG 		Renal Failure With Mcc 1 $4,046.67 $4,046.67 $4,046.67 nat. median
$14,434
outlier · 0.3×
5182
OTHER 		Level 2 Vascular Procedures 5 $3,400.68 $5,621.99 $3,890.62 nat. median
$1,668
outlier · 2.3×
9536
OTHER 		Platelets Pheresis Path Redu 3 $3,346.96 $5,538.69 $3,586.36 nat. median
$623
outlier · 5.8×

Other procedures at this hospital

Browse this hospital's 953 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
             
947 MS_DRG Signs And Symptoms With Mcc 2 2 — — $33,618.03 $79,605.00 $56,611.51 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 1 1 — — $54,041.89 $54,041.89 $54,041.89 2026-04-01
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/Mcc 1 1 — — $53,825.52 $53,825.52 $53,825.52 2026-04-01
68 MS_DRG Precerebral Occlusion Without Infarction Without Mcc 1 1 — — $53,825.52 $53,825.52 $53,825.52 2026-04-01
811 MS_DRG Red Blood Cell Disorders With Mcc 1 1 — — $49,340.06 $49,340.06 $49,340.06 2026-04-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 3 3 — — $22,754.48 $82,349.99 $49,315.71 2026-04-01
540 MS_DRG Osteomyelitis With Cc 1 1 — — $38,420.61 $38,420.61 $38,420.61 2026-04-01
291 MS_DRG Heart Failure And Shock With Mcc 2 2 — — $32,940.00 $40,897.03 $36,918.51 2026-04-01
552 MS_DRG Medical Back Problems Without Mcc 1 1 — — $36,751.35 $36,751.35 $36,751.35 2026-04-01
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 5 5 — — $7,203.27 $45,620.67 $36,751.35 2026-04-01
312 MS_DRG Syncope And Collapse 2 2 — — $31,851.17 $41,174.99 $36,513.08 2026-04-01
292 MS_DRG Heart Failure And Shock With Cc 1 1 — — $36,413.26 $36,413.26 $36,413.26 2026-04-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 2 2 — — $36,016.33 $36,751.35 $36,383.84 2026-04-01
949 MS_DRG Aftercare With Cc/Mcc 5 4 — — $16,274.09 $43,219.59 $33,615.23 2026-04-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 1 1 — — $33,615.23 $33,615.23 $33,615.23 2026-04-01
948 MS_DRG Signs And Symptoms Without Mcc 5 5 — — $19,910.17 $40,149.24 $31,398.22 2026-04-01
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 3 3 — — $26,950.99 $48,027.66 $31,214.15 2026-04-01
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 4 4 — — $27,450.00 $41,651.53 $29,798.04 2026-04-01
549 MS_DRG Septic Arthritis With Cc 1 1 — — $29,401.08 $29,401.08 $29,401.08 2026-04-01
566 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/Mcc 1 1 — — $26,971.56 $26,971.56 $26,971.56 2026-04-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 1 1 — — $26,950.99 $26,950.99 $26,950.99 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 2 2 — — $8,990.52 $41,175.00 $25,082.76 2026-04-01
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc 1 1 — — $24,704.99 $24,704.99 $24,704.99 2026-04-01
603 MS_DRG Cellulitis Without Mcc 1 1 — — $22,408.16 $22,408.16 $22,408.16 2026-04-01
55 MS_DRG Nervous System Neoplasms Without Mcc 1 1 — — $19,607.14 $19,607.14 $19,607.14 2026-04-01
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 1 1 — — $19,600.72 $19,600.72 $19,600.72 2026-04-01
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc 4 4 — — $2,401.29 $27,450.00 $18,607.31 2026-04-01
884 MS_DRG Organic Disturbances And Intellectual Disability 2 2 — — $14,700.54 $22,375.31 $18,537.93 2026-04-01
683 MS_DRG Renal Failure With Cc 1 1 — — $16,807.62 $16,807.62 $16,807.62 2026-04-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 1 — — $14,700.54 $14,700.54 $14,700.54 2026-04-01
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 1 1 — — $14,205.11 $14,205.11 $14,205.11 2026-04-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 1 1 — — $13,725.00 $13,725.00 $13,725.00 2026-04-01
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 2 2 — — $8,045.02 $19,146.40 $13,595.71 2026-04-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 1 1 — — $13,325.01 $13,325.01 $13,325.01 2026-04-01
374 MS_DRG Digestive Malignancy With Mcc 1 1 — — $12,250.45 $12,250.45 $12,250.45 2026-04-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 3 3 — — $8,093.34 $17,098.69 $9,604.35 2026-04-01
149 MS_DRG Dysequilibrium 1 1 — — $9,604.35 $9,604.35 $9,604.35 2026-04-01
638 MS_DRG Diabetes With Cc 1 1 — — $9,565.15 $9,565.15 $9,565.15 2026-04-01
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 1 1 — — $8,883.34 $8,883.34 $8,883.34 2026-04-01
75 MS_DRG Viral Meningitis With Cc/Mcc 1 1 — — $8,816.74 $8,816.74 $8,816.74 2026-04-01
91 MS_DRG Other Disorders Of Nervous System With Mcc 1 1 — — $8,362.27 $8,362.27 $8,362.27 2026-04-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 1 1 — — $7,350.27 $7,350.27 $7,350.27 2026-04-01
5594 OTHER Level 4 Nuclear Medicine And Related Services 1 1 — — $5,913.24 $5,913.24 $5,913.24 2026-04-01
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 1 1 — — $5,490.00 $5,490.00 $5,490.00 2026-04-01
5183 OTHER Level 3 Vascular Procedures 2 2 — — $2,901.31 $6,828.48 $4,864.89 2026-04-01
67 MS_DRG Precerebral Occlusion Without Infarction With Mcc 1 1 — — $4,586.03 $4,586.03 $4,586.03 2026-04-01
5161 OTHER Level 1 ENT Procedures 5 5 — — $1,617.55 $5,036.37 $4,574.00 2026-04-01
682 MS_DRG Renal Failure With Mcc 1 1 — — $4,046.67 $4,046.67 $4,046.67 2026-04-01
5182 OTHER Level 2 Vascular Procedures 5 5 — — $3,400.68 $5,621.99 $3,890.62 2026-04-01
9536 OTHER Platelets Pheresis Path Redu 4 3 — — $3,346.96 $5,538.69 $3,586.36 2026-04-01
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/Mcc 1 1 — — $3,183.84 $3,183.84 $3,183.84 2026-04-01
5041 OTHER Critical Care 9 7 — — $1,412.60 $6,131.54 $2,892.59 2026-04-01
5691 OTHER Level 1 Drug Administration 6 6 — — $954.40 $11,258.05 $2,581.18 2026-04-01
5025 OTHER Level 5 Type A Ed Visits 25 14 — — $132.35 $5,617.62 $2,073.27 2026-04-01
5113 OTHER Level 3 Musculoskeletal Procedures 1 1 — — $2,054.63 $2,054.63 $2,054.63 2026-04-01
5524 OTHER Level 4 Imaging Without Contrast 1 1 — — $1,969.46 $1,969.46 $1,969.46 2026-04-01
5742 OTHER Level 2 Electronic Analysis Of Devices 1 1 — — $1,645.35 $1,645.35 $1,645.35 2026-04-01
5724 OTHER Level 4 Diagnostic Tests And Related Services 21 10 — — $716.53 $3,231.06 $1,474.90 2026-04-01
5112 OTHER Level 2 Musculoskeletal Procedures 2 2 — — $687.90 $2,172.94 $1,430.42 2026-04-01
5572 OTHER Level 2 Imaging With Contrast 14 10 — — $678.51 $2,540.30 $1,416.88 2026-04-01
5024 OTHER Level 4 Type A Ed Visits 26 14 — — $322.20 $3,797.38 $1,262.84 2026-04-01
5052 OTHER Level 2 Skin Procedures 6 5 — — $309.63 $6,423.69 $1,136.70 2026-04-01
5072 OTHER Level 2 Excision/ Biopsy/ Incision And Drainage 1 1 — — $1,128.97 $1,128.97 $1,128.97 2026-04-01
5241 OTHER Level 1 Blood Product Exchange And Related Services 9 6 — — $901.60 $2,118.98 $1,092.75 2026-04-01
5694 OTHER Level 4 Drug Administration 10 6 — — $483.24 $46,650.96 $1,052.69 2026-04-01
5571 OTHER Level 1 Imaging With Contrast 14 10 — — $536.16 $3,544.66 $957.25 2026-04-01
5673 OTHER Level 3 Pathology 1 1 — — $889.56 $889.56 $889.56 2026-04-01
5672 OTHER Level 2 Pathology 3 2 — — $727.09 $1,180.51 $823.38 2026-04-01
5111 OTHER Level 1 Musculoskeletal Procedures 3 2 — — $744.67 $1,452.67 $776.85 2026-04-01
5523 OTHER Level 3 Imaging Without Contrast 15 10 — — $454.21 $1,702.40 $772.50 2026-04-01
N801 OTHER Therapy Services 24 14 — — $164.02 $3,850.50 $764.07 2026-04-01
5722 OTHER Level 2 Diagnostic Tests And Related Services 1 1 — — $679.13 $679.13 $679.13 2026-04-01
5101 OTHER Level 1 Strapping And Cast Application 6 4 — — $196.08 $3,487.61 $674.42 2026-04-01
5721 OTHER Level 1 Diagnostic Tests And Related Services 18 11 — — $143.51 $1,092.50 $555.77 2026-04-01
5441 OTHER Level 1 Nerve Injections 1 1 — — $493.23 $493.23 $493.23 2026-04-01
5693 OTHER Level 3 Drug Administration 21 12 — — $17.64 $9,507.41 $492.41 2026-04-01
5051 OTHER Level 1 Skin Procedures 19 11 — — $242.90 $1,908.89 $464.44 2026-04-01
5522 OTHER Level 2 Imaging Without Contrast 20 13 — — $94.40 $1,662.75 $444.75 2026-04-01
N809 OTHER Other Medicine 16 9 — — $201.24 $892.05 $421.08 2026-04-01
5791 OTHER Pulmonary Treatment 9 5 — — $231.26 $832.89 $413.71 2026-04-01
5023 OTHER Level 3 Type A Ed Visits 26 15 — — $64.17 $1,094.52 $404.26 2026-04-01
5692 OTHER Level 2 Drug Administration 11 8 — — $57.55 $17,607.74 $365.89 2026-04-01
5734 OTHER Level 4 Minor Procedures 19 13 — — $110.68 $1,294.45 $349.99 2026-04-01
90670 HCPCS Pcv13 Vaccine IM 1 1 — — $257.99 $257.99 $257.99 2026-04-01
5022 OTHER Level 2 Type A Ed Visits 22 13 — — $94.37 $969.00 $256.32 2026-04-01
5521 OTHER Level 1 Imaging Without Contrast 24 13 — — $94.40 $1,112.77 $251.27 2026-04-01
5021 OTHER Level 1 Type A Ed Visits 6 5 — — $132.19 $242.25 $173.90 2026-04-01
90739 HCPCS Hepatitis B Vacc-cpg 1018 (pf) 20 Mcg/0.5 Ml IM Syrg 1 1 — — $168.30 $168.30 $168.30 2026-04-01
90740 HCPCS Hepb Vacc 3 Dose Immunsup IM 1 1 — — $158.15 $158.15 $158.15 2026-04-01
90747 HCPCS Hepb Vacc 4 Dose Immunsup IM 1 1 — — $140.75 $140.75 $140.75 2026-04-01
90732 HCPCS Pneumococcal 23-val Ps Vaccine 25 Mcg/0.5 Ml Inj Syrg 1 1 — — $133.47 $133.47 $133.47 2026-04-01
5733 OTHER Level 3 Minor Procedures 16 11 — — $67.76 $236.85 $93.07 2026-04-01
77067 HCPCS Scr Mammo Bi Incl Cad 1 1 — — $82.67 $82.67 $82.67 2026-04-01
5012 OTHER Clinic Visits And Related Services 5 5 — — $30.80 $148.79 $81.93 2026-04-01
90694 HCPCS Vacc Aiiv4 No Prsrv 0.5ml IM 1 1 — — $77.36 $77.36 $77.36 2026-04-01
90743 HCPCS Hepb Vacc 2 Dose Adolesc IM 1 1 — — $75.15 $75.15 $75.15 2026-04-01
90662 HCPCS Flu Vacc Ts2024-25(65yr Up)-pf 180 Mcg/0.5 Ml IM Syrg 1 1 — — $73.40 $73.40 $73.40 2026-04-01
90682 HCPCS Riv4 Vacc Recombinant DNA IM 1 1 — — $73.40 $73.40 $73.40 2026-04-01
90746 HCPCS Hepatitis B Virus Vacc.rec(pf) 20 Mcg/ml IM Susp 1 1 — — $70.38 $70.38 $70.38 2026-04-01
N700 OTHER Non-opps Clinic Services 6 6 — — $11.29 $165.49 $68.68 2026-04-01
N800 OTHER Clinical Diagnostic Lab Services 25 14 — — $4.39 $341.19 $61.32 2026-04-01
1478 OTHER Inj Human Fibrinogen Con Nos 1 1 — — $51.84 $51.84 $51.84 2026-04-01
90674 HCPCS Cciiv4 Vac No Prsv 0.5 Ml IM 1 1 — — $34.17 $34.17 $34.17 2026-04-01
90744 HCPCS Hepatitis B Virus Vacc.rec(pf) 5 Mcg/0.5 Ml IM Susp 1 1 — — $30.77 $30.77 $30.77 2026-04-01
90756 HCPCS Cciiv4 Vacc Abx Free IM 1 1 — — $30.58 $30.58 $30.58 2026-04-01
90672 HCPCS Laiv4 Vaccine Intranasal 1 1 — — $27.79 $27.79 $27.79 2026-04-01
90686 HCPCS Iiv4 Vacc No Prsv 0.5 Ml IM 1 1 — — $22.35 $22.35 $22.35 2026-04-01
77063 HCPCS Breast Tomosynthesis Bi 1 1 — — $21.48 $21.48 $21.48 2026-04-01
90688 HCPCS Iiv4 Vaccine Splt 0.5 Ml IM 1 1 — — $20.88 $20.88 $20.88 2026-04-01
90687 HCPCS Iiv4 Vaccine Splt 0.25 Ml IM 1 1 — — $10.44 $10.44 $10.44 2026-04-01
138 MS_DRG Mouth Procedures Without Cc/Mcc 0 0 — — — — — 2026-04-01
137 MS_DRG Mouth Procedures With Cc/Mcc 0 0 — — — — — 2026-04-01
109 MS_DRG No Longer Valid 0 0 — — — — — 2026-04-01
136 MS_DRG Sinus And Mastoid Procedures Without Cc/Mcc 0 0 — — — — — 2026-04-01
300 MS_DRG Peripheral Vascular Disorders With Cc 0 0 — — — — — 2026-04-01
30 MS_DRG Spinal Procedures Without Cc/Mcc 0 0 — — — — — 2026-04-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/Mcc 0 0 — — — — — 2026-04-01
108 MS_DRG Other Cardiothoracic Procedures 0 0 — — — — — 2026-04-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 0 0 — — — — — 2026-04-01
301 MS_DRG Peripheral Vascular Disorders Without Cc/Mcc 0 0 — — — — — 2026-04-01
303 MS_DRG Atherosclerosis Without Mcc 0 0 — — — — — 2026-04-01
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/Mcc 0 0 — — — — — 2026-04-01
196 MS_DRG Interstitial Lung Disease With Mcc 0 0 — — — — — 2026-04-01
197 MS_DRG Interstitial Lung Disease With Cc 0 0 — — — — — 2026-04-01
198 MS_DRG Interstitial Lung Disease Without Cc/Mcc 0 0 — — — — — 2026-04-01
199 MS_DRG Pneumothorax With Mcc 0 0 — — — — — 2026-04-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 0 0 — — — — — 2026-04-01
134 MS_DRG Other Ear, Nose, Mouth & Throat O.r. Procedures Without Cc/Mcc 0 0 — — — — — 2026-04-01
295 MS_DRG Deep Vein Thrombophlebitis Without Cc/Mcc 0 0 — — — — — 2026-04-01
293 MS_DRG Heart Failure And Shock Without Cc/Mcc 0 0 — — — — — 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 0 0 — — — — — 2026-04-01
133 MS_DRG Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/Mcc 0 0 — — — — — 2026-04-01
188 MS_DRG Pleural Effusion Without Cc/Mcc 0 0 — — — — — 2026-04-01
187 MS_DRG Pleural Effusion With Cc 0 0 — — — — — 2026-04-01
132 MS_DRG Cranial/Facial Procedures Without Cc/Mcc 0 0 — — — — — 2026-04-01
186 MS_DRG Pleural Effusion With Mcc 0 0 — — — — — 2026-04-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 0 0 — — — — — 2026-04-01
185 MS_DRG Major Chest Trauma Without Cc/Mcc 0 0 — — — — — 2026-04-01
131 MS_DRG Cranial/Facial Procedures W Cc/Mcc 0 0 — — — — — 2026-04-01
107 MS_DRG No Longer Valid 0 0 — — — — — 2026-04-01
106 MS_DRG Coronary Bypass W Ptca 0 0 — — — — — 2026-04-01
184 MS_DRG Major Chest Trauma With Cc 0 0 — — — — — 2026-04-01
183 MS_DRG Major Chest Trauma With Mcc 0 0 — — — — — 2026-04-01
130 MS_DRG Major Head & Neck Procedures Without Cc/Mcc 0 0 — — — — — 2026-04-01
182 MS_DRG Respiratory Neoplasms Without Cc/Mcc 0 0 — — — — — 2026-04-01
181 MS_DRG Respiratory Neoplasms With Cc 0 0 — — — — — 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 0 0 — — — — — 2026-04-01
105 MS_DRG Cardiac Valve & Oth Major Cardiothoracic Proc Without Cardiac Cath 0 0 — — — — — 2026-04-01
180 MS_DRG Respiratory Neoplasms With Mcc 0 0 — — — — — 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 0 0 — — — — — 2026-04-01
129 MS_DRG Major Head & Neck Procedures W Cc/Mcc Or Major Device 0 0 — — — — — 2026-04-01
179 MS_DRG Respiratory Infections And Inflammations Without Cc/Mcc 0 0 — — — — — 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 0 0 — — — — — 2026-04-01
178 MS_DRG Respiratory Infections And Inflammations With Cc 0 0 — — — — — 2026-04-01
128 MS_DRG Deep Vein Thrombophlebitis 0 0 — — — — — 2026-04-01
104 MS_DRG Cardiac Valve & Oth Major Cardiothoracic Proc W Cardiac Cath 0 0 — — — — — 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 0 0 — — — — — 2026-04-01
176 MS_DRG Pulmonary Embolism Without Mcc 0 0 — — — — — 2026-04-01
127 MS_DRG Heart Failure & Shock 0 0 — — — — — 2026-04-01
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 0 0 — — — — — 2026-04-01
265 MS_DRG Aicd Lead Procedures 0 0 — — — — — 2026-04-01
174 MS_DRG G.i. Hemorrhage W Cc 0 0 — — — — — 2026-04-01
126 MS_DRG Acute & Subacute Endocarditis 0 0 — — — — — 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 0 0 — — — — — 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 0 0 — — — — — 2026-04-01
171 MS_DRG Other Digestive System O.r. Procedures Without Cc 0 0 — — — — — 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 0 0 — — — — — 2026-04-01
257 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/Mcc 0 0 — — — — — 2026-04-01
169 MS_DRG Mouth Procedures Without Cc 0 0 — — — — — 2026-04-01
125 MS_DRG Other Disorders Of The Eye Without Mcc 0 0 — — — — — 2026-04-01
124 MS_DRG Other Disorders Of The Eye With Mcc Or Thrombolytic Agent 0 0 — — — — — 2026-04-01
103 MS_DRG Headaches Without Mcc 0 0 — — — — — 2026-04-01
102 MS_DRG Headaches With Mcc 0 0 — — — — — 2026-04-01
168 MS_DRG Other Respiratory System O.r. Procedures Without Cc/Mcc 0 0 — — — — — 2026-04-01
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 0 0 — — — — — 2026-04-01
123 MS_DRG Neurological Eye Disorders 0 0 — — — — — 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 0 0 — — — — — 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 0 0 — — — — — 2026-04-01
165 MS_DRG Major Chest Procedures Without Cc/Mcc 0 0 — — — — — 2026-04-01
122 MS_DRG Acute Major Eye Infections Without Cc/Mcc 0 0 — — — — — 2026-04-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 0 0 — — — — — 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 0 0 — — — — — 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 0 0 — — — — — 2026-04-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 0 0 — — — — — 2026-04-01
251 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 0 0 — — — — — 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 0 0 — — — — — 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 0 0 — — — — — 2026-04-01
254 MS_DRG Other Vascular Procedures Without Cc/Mcc 0 0 — — — — — 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 0 0 — — — — — 2026-04-01
256 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Cc 0 0 — — — — — 2026-04-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 0 0 — — — — — 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 0 0 — — — — — 2026-04-01
259 MS_DRG Cardiac Pacemaker Device Replacement Without Mcc 0 0 — — — — — 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 0 0 — — — — — 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 0 0 — — — — — 2026-04-01
261 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Cc 0 0 — — — — — 2026-04-01
262 MS_DRG Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc 0 0 — — — — — 2026-04-01
263 MS_DRG Vein Ligation And Stripping 0 0 — — — — — 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 0 0 — — — — — 2026-04-01
121 MS_DRG Acute Major Eye Infections With Cc/Mcc 0 0 — — — — — 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 0 0 — — — — — 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 0 0 — — — — — 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 0 0 — — — — — 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 0 0 — — — — — 2026-04-01
245 MS_DRG Aicd Generator Procedures 0 0 — — — — — 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 0 0 — — — — — 2026-04-01
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/Mcc 0 0 — — — — — 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 0 0 — — — — — 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 0 0 — — — — — 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 0 0 — — — — — 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 0 0 — — — — — 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 0 0 — — — — — 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 0 0 — — — — — 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 0 0 — — — — — 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 0 0 — — — — — 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 0 0 — — — — — 2026-04-01
162 MS_DRG Inguinal & Femoral Hernia Procedures Age >17 Without Cc 0 0 — — — — — 2026-04-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 0 0 — — — — — 2026-04-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 0 0 — — — — — 2026-04-01
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 0 0 — — — — — 2026-04-01
284 MS_DRG Acute Myocardial Infarction, Expired With Cc 0 0 — — — — — 2026-04-01
285 MS_DRG Acute Myocardial Infarction, Expired Without Cc/Mcc 0 0 — — — — — 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 0 0 — — — — — 2026-04-01
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc 0 0 — — — — — 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 0 0 — — — — — 2026-04-01
289 MS_DRG Acute And Subacute Endocarditis With Cc 0 0 — — — — — 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 0 0 — — — — — 2026-04-01
290 MS_DRG Acute And Subacute Endocarditis Without Cc/Mcc 0 0 — — — — — 2026-04-01
161 MS_DRG Inguinal & Femoral Hernia Procedures Age >17 W Cc 0 0 — — — — — 2026-04-01
120 MS_DRG Other Circulatory System O.r. Procedures 0 0 — — — — — 2026-04-01
101 MS_DRG Seizures Without Mcc 0 0 — — — — — 2026-04-01
294 MS_DRG Deep Vein Thrombophlebitis With Cc/Mcc 0 0 — — — — — 2026-04-01
241 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 0 0 — — — — — 2026-04-01
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 0 0 — — — — — 2026-04-01
297 MS_DRG Cardiac Arrest, Unexplained With Cc 0 0 — — — — — 2026-04-01
298 MS_DRG Cardiac Arrest, Unexplained Without Cc/Mcc 0 0 — — — — — 2026-04-01
299 MS_DRG Peripheral Vascular Disorders With Mcc 0 0 — — — — — 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 0 0 — — — — — 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 0 0 — — — — — 2026-04-01
160 MS_DRG Hernia Procedures Except Inguinal & Femoral Age >17 Without Cc 0 0 — — — — — 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 0 0 — — — — — 2026-04-01
302 MS_DRG Atherosclerosis With Mcc 0 0 — — — — — 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 0 0 — — — — — 2026-04-01
304 MS_DRG Hypertension With Mcc 0 0 — — — — — 2026-04-01
305 MS_DRG Hypertension Without Mcc 0 0 — — — — — 2026-04-01
306 MS_DRG Cardiac Congenital And Valvular Disorders With Mcc 0 0 — — — — — 2026-04-01
307 MS_DRG Cardiac Congenital And Valvular Disorders Without Mcc 0 0 — — — — — 2026-04-01
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 0 0 — — — — — 2026-04-01
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 0 0 — — — — — 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 0 0 — — — — — 2026-04-01
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc 0 0 — — — — — 2026-04-01
311 MS_DRG Angina Pectoris 0 0 — — — — — 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 0 0 — — — — — 2026-04-01
313 MS_DRG Chest Pain 0 0 — — — — — 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 0 0 — — — — — 2026-04-01
238 MS_DRG Major Cardiovasc Procedures Without Mcc 0 0 — — — — — 2026-04-01
237 MS_DRG Major Cardiovasc Procedures W Mcc 0 0 — — — — — 2026-04-01
159 MS_DRG Dental And Oral Diseases Without Cc/Mcc 0 0 — — — — — 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 0 0 — — — — — 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 0 0 — — — — — 2026-04-01
158 MS_DRG Dental And Oral Diseases With Cc 0 0 — — — — — 2026-04-01
119 MS_DRG Vein Ligation & Stripping 0 0 — — — — — 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 0 0 — — — — — 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 0 0 — — — — — 2026-04-01
157 MS_DRG Dental And Oral Diseases With Mcc 0 0 — — — — — 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 0 0 — — — — — 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 0 0 — — — — — 2026-04-01
156 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/Mcc 0 0 — — — — — 2026-04-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 0 0 — — — — — 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 0 0 — — — — — 2026-04-01
155 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Cc 0 0 — — — — — 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 0 0 — — — — — 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 0 0 — — — — — 2026-04-01
154 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 0 0 — — — — — 2026-04-01
118 MS_DRG Cardiac Pacemaker Device Replacement 0 0 — — — — — 2026-04-01
117 MS_DRG Intraocular Procedures Without Cc/Mcc 0 0 — — — — — 2026-04-01
100 MS_DRG Seizures With Mcc 0 0 — — — — — 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 0 0 — — — — — 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 0 0 — — — — — 2026-04-01
153 MS_DRG Otitis Media And Uri Without Mcc 0 0 — — — — — 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 0 0 — — — — — 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 0 0 — — — — — 2026-04-01
152 MS_DRG Otitis Media And Uri With Mcc 0 0 — — — — — 2026-04-01
116 MS_DRG Intraocular Procedures With Cc/Mcc 0 0 — — — — — 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 0 0 — — — — — 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 0 0 — — — — — 2026-04-01
151 MS_DRG Epistaxis Without Mcc 0 0 — — — — — 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 0 0 — — — — — 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 0 0 — — — — — 2026-04-01
150 MS_DRG Epistaxis With Mcc 0 0 — — — — — 2026-04-01
115 MS_DRG Extraocular Procedures Except Orbit 0 0 — — — — — 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 0 0 — — — — — 2026-04-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 0 0 — — — — — 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 0 0 — — — — — 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 0 0 — — — — — 2026-04-01
352 MS_DRG Inguinal And Femoral Hernia Procedures Without Cc/Mcc 0 0 — — — — — 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 0 0 — — — — — 2026-04-01
351 MS_DRG Inguinal And Femoral Hernia Procedures With Cc 0 0 — — — — — 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 0 0 — — — — — 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 0 0 — — — — — 2026-04-01
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