Price Transparencybeta Hospital negotiated rates

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

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Hospital

CHOCTAW MEMORIAL HOSPITAL

Hugo, OK · CCN 370100 · Rates published

1,506 distinct procedures filed
5 distinct payers
19,150 rate rows
2026-04-01 last MRF observed
Data quality

16,464 of 19,150 rate rows are consumer-grade (86.0%)

2,686 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 2,386
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 278
percent-of-charges filed in the dollar field — excluded from medians 10
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 8
exceeds 10× this hospital's gross charge — excluded from medians 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://choctawmemorial.com/wp-content/uploads/2026/04/736060815_choctaw-county-city-of-hugo-hospital-trust-authority-_standardcharges.csv
Found on page https://choctawmemorial.com/financial/
Discovered viaCMS hospital list
Last fetch success · 2026-11-03
Content fingerprint 3a713134147f0682… · 4,419,373 bytes · first seen 2026-11-03

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
314
MS_DRG 		Other Circulatory System Diagnoses With Mcc 2 $2,945.00 $4,415.00 $4,415.00 nat. median
$19,944
outlier · 0.2×
315
MS_DRG 		Other Circulatory System Diagnoses With Cc 2 $2,540.00 $3,605.00 $3,605.00 nat. median
$9,946
outlier · 0.4×
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Dis 2 $2,496.50 $3,518.00 $3,518.00 nat. median
$12,524
outlier · 0.3×
813
MS_DRG 		Coagulation Disorders 3 $1,475.00 $5,204.00 $3,339.50 nat. median
$14,870
outlier · 0.2×
190
MS_DRG 		Blood Bank Forms 3 $1,475.00 $4,900.00 $3,284.00 nat. median
$11,057
outlier · 0.3×
394
MS_DRG 		Other Diestive System Diagnoses With Mcc 2 $2,332.50 $3,190.00 $3,190.00 nat. median
$9,671
outlier · 0.3×
840
MS_DRG 		Lymphoma And Non-acute Leukemia With Mcc 3 $1,475.00 $4,760.00 $3,117.50 nat. median
$29,799
outlier · 0.1×
313
MS_DRG 		Chest Pain 3 $1,475.00 $4,224.00 $2,849.50 nat. median
$7,721
outlier · 0.4×
595
MS_DRG 		Major Skin Disorers With Mcc 3 $1,475.00 $4,169.00 $2,822.00 nat. median
$20,154
outlier · 0.1×
640
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And 3 $1,475.00 $3,846.00 $2,660.50 nat. median
$12,833
outlier · 0.2×
637
MS_DRG 		Diabetes With Mcc 3 $1,475.00 $3,802.00 $2,638.50 nat. median
$13,945
outlier · 0.2×
204
MS_DRG 		Respiratory Signs And Symptoms 3 $1,475.00 $3,770.00 $2,622.50 nat. median
$8,468
outlier · 0.3×
896
MS_DRG 		Alcohol, Drug Abuse Or Dependence Without Rehabilitation The 3 $1,475.00 $3,689.00 $2,582.00 nat. median
$15,465
outlier · 0.2×
206
MS_DRG 		Other Resiratory System Diagnoses Without Mcc 3 $1,475.00 $3,688.00 $2,581.50 nat. median
$9,488
outlier · 0.3×
562
MS_DRG 		Fracture, Sprain, Strain And Dislocation Except Femur Hip 3 $1,475.00 $3,649.00 $2,562.00 nat. median
$13,945
outlier · 0.2×
149
MS_DRG 		Dysequilibrium 3 $1,475.00 $3,630.00 $2,552.50 nat. median
$7,940
outlier · 0.3×
947
MS_DRG 		Signs And Symptoms With Mcc 3 $1,475.00 $3,630.00 $2,552.50 nat. median
$12,107
outlier · 0.2×
312
MS_DRG 		Syncope And Collapse 3 $1,475.00 $3,592.00 $2,533.50 nat. median
$8,944
outlier · 0.3×
308
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders With Mcc 3 $1,475.00 $3,573.00 $2,524.00 nat. median
$11,976
outlier · 0.2×
305
MS_DRG 		Hypertension Without Mcc 3 $1,475.00 $3,565.00 $2,520.00 nat. median
$8,030
outlier · 0.3×
291
MS_DRG 		Heart Failure And Shock With Mcc 3 $1,475.00 $3,550.00 $2,512.50 nat. median
$12,759
outlier · 0.2×
918
MS_DRG 		Poisoning And Toxic Effects Of Drugs Without Mcc 3 $1,475.00 $3,530.00 $2,502.50 nat. median
$8,368
outlier · 0.3×
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 3 $1,475.00 $3,515.00 $2,495.00 nat. median
$15,375
outlier · 0.2×
812
MS_DRG 		Red Blood Cell Disorders Without Mcc 3 $1,475.00 $3,413.00 $2,444.00 nat. median
$9,304
outlier · 0.3×
687
MS_DRG 		Kidney And Urinary Tract Neoplasms With Cc 3 $1,475.00 $3,398.00 $2,436.50 nat. median
$10,752
outlier · 0.2×
605
MS_DRG 		Trauma To The Skin, Subcutaneous Tissue And Breast Without M 3 $1,475.00 $3,391.00 $2,433.00 nat. median
$9,359
outlier · 0.3×
378
MS_DRG 		Gastroinestinal Hemorrhage With Cc 3 $1,475.00 $3,388.00 $2,431.50 nat. median
$10,016
outlier · 0.2×
159
MS_DRG 		Dental And Oral Diseases Without Cc/mcc 3 $1,475.00 $3,313.00 $2,394.00 nat. median
$7,479
outlier · 0.3×
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 3 $1,475.00 $3,303.00 $2,389.00 nat. median
$12,858
outlier · 0.2×
155
MS_DRG 		Other Ear, Nose, Mouth And Throat Diagnoses With Cc 3 $1,475.00 $3,238.00 $2,356.50 nat. median
$9,505
outlier · 0.2×
699
MS_DRG 		Other Kidnwy And Urinary Tract Diagnoses With Cc 3 $1,475.00 $3,237.00 $2,356.00 nat. median
$10,303
outlier · 0.2×
310
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 3 $1,475.00 $3,205.00 $2,340.00 nat. median
$6,284
outlier · 0.4×
191
MS_DRG 		Chronic Obstructive Pulmonary Disease With Cc 3 $1,475.00 $3,205.00 $2,340.00 nat. median
$8,839
outlier · 0.3×
203
MS_DRG 		Bronchitis And Asthma Without Cc/mcc 3 $1,475.00 $3,182.00 $2,328.50 nat. median
$7,240
outlier · 0.3×
884
MS_DRG 		Organic Disturbances And Intellectual Disability 3 $1,475.00 $3,181.00 $2,328.00 nat. median
$14,237
outlier · 0.2×
638
MS_DRG 		Diabetes With Cc 3 $1,475.00 $3,177.00 $2,326.00 nat. median
$9,217
outlier · 0.3×
816
MS_DRG 		Reticuloendothelial & Immunity Disorders Without Cc/mcc 3 $1,475.00 $3,167.00 $2,321.00 nat. median
$7,115
outlier · 0.3×
556
MS_DRG 		Signs And Symptoms Of Musculoskeletal System And Connective 3 $1,475.00 $3,123.00 $2,299.00 nat. median
$8,630
outlier · 0.3×
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 3 $1,475.00 $3,116.00 $2,295.50 nat. median
$10,189
outlier · 0.2×
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metablosim, Fluids And 3 $1,475.00 $3,106.00 $2,290.50 nat. median
$8,103
outlier · 0.3×
948
MS_DRG 		Signs And Symptoms Without Mcc 3 $1,475.00 $3,097.00 $2,286.00 nat. median
$7,968
outlier · 0.3×
683
MS_DRG 		Renal Failure With Cc 3 $1,475.00 $3,048.00 $2,261.50 nat. median
$9,102
outlier · 0.2×
392
MS_DRG 		Esophagitis, Gastroenteritis And Misc Digestive Dis 3 $1,475.00 $3,044.00 $2,259.50 nat. median
$8,173
outlier · 0.3×
863
MS_DRG 		Postoperative And Post-traumatic Infections Without Mcc 3 $1,475.00 $3,028.00 $2,251.50 nat. median
$10,218
outlier · 0.2×
49205
HCPCS 		Excision Endometrioma >10.0cm 5 $2,235.54 $2,235.54 $2,235.54 nat. median
$4,203
0.5× median
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 3 $1,475.00 $2,996.00 $2,235.50 nat. median
$11,506
outlier · 0.2×
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 3 $1,475.00 $2,971.00 $2,223.00 nat. median
$8,511
outlier · 0.3×
563
MS_DRG 		Fracture, Sprain, Strain And Dislocation Except Femur, Hip 3 $1,475.00 $2,971.00 $2,223.00 nat. median
$9,140
outlier · 0.2×
292
MS_DRG 		Heart Failure And Shock With Cc 3 $1,475.00 $2,965.00 $2,220.00 nat. median
$8,945
outlier · 0.2×
179
MS_DRG 		Respiratory Infectins And Inflammations Without Cc/mcc 3 $1,475.00 $2,961.00 $2,218.00 nat. median
$8,185
outlier · 0.3×

Other procedures at this hospital

Browse this hospital's 1,506 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
0120 RC — 1 1 $348.00 $174.00 50% off $1,153.73 $1,153.73 $1,153.73 2026-04-01
0450 RC — 10 5 $171.00 $85.50 50% off $300.00 $300.00 $300.00 2026-04-01
0710 RC — 1 1 $275.00 $137.50 50% off $233.75 $233.75 $233.75 2026-04-01
49900 HCPCS Abdominal Wall Repair -dehiscence/evisc. 10 5 $2,607.00 $1,303.50 50% off $1,045.52 $1,045.52 $1,045.52 2026-04-01
37195 HCPCS Admin. Thrombolysis Cerebral IV Inf - ER 10 5 $839.00 $419.50 50% off $374.71 $374.71 $374.71 2026-04-01
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation The 5 3 $2,906.78 $1,453.39 50% off $1,475.00 $3,689.00 $2,582.00 2026-04-01
26952 HCPCS Amputation Finger With Local Adv. Flaps 10 5 $4,243.00 $2,121.50 50% off $871.29 $871.29 $871.29 2026-04-01
27880 HCPCS Amputation Leg Thru Tibia And Fibula 10 5 $2,855.00 $1,427.50 50% off $1,147.28 $1,147.28 $1,147.28 2026-04-01
28810 HCPCS Amputation Metatarsal With Toe - Single 10 5 $7,316.00 $3,658.00 50% off $539.52 $539.52 $539.52 2026-04-01
27590 HCPCS Amputation Thigh Thru Femur Any Level 10 5 $2,314.00 $1,157.00 50% off $999.95 $999.95 $999.95 2026-04-01
28820 HCPCS Amputation Toe Metatarsophalangeal Joint 10 5 $7,316.00 $3,658.00 50% off $230.00 $230.00 $230.00 2026-04-01
44950 HCPCS Appendectomy - Open 10 5 $8,589.00 $4,294.50 50% off $821.42 $821.42 $821.42 2026-04-01
36561 HCPCS Bard Port Insertion > 5 Yrs Old (or) 10 5 $7,338.00 $3,669.00 50% off $422.89 $422.89 $422.89 2026-04-01
19101 HCPCS Biopsy Breast Incisional Left,procedure Performed On The Lt Side Of The Body 20 5 $7,499.00 $3,749.50 50% off $284.94 $284.94 $284.94 2026-04-01
21925 HCPCS Biopsy Soft Tissue Back/flank Deep 10 5 $3,771.00 $1,885.50 50% off $479.34 $479.34 $479.34 2026-04-01
38500 HCPCS Biopsy/excision Lymph Node Open Super. 10 5 $7,499.00 $3,749.50 50% off $325.38 $325.38 $325.38 2026-04-01
37609 HCPCS Biopsy/ligation Temporal Artery 10 5 $2,887.00 $1,443.50 50% off $259.83 $259.83 $259.83 2026-04-01
190 MS_DRG Blood Bank Forms 6 3 $8,028.03 $4,014.02 50% off $1,475.00 $4,900.00 $3,284.00 2026-04-01
203 MS_DRG Bronchitis And Asthma Without Cc/mcc 5 3 $4,132.55 $2,066.28 50% off $1,475.00 $3,182.00 $2,328.50 2026-04-01
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 5 3 $9,363.78 $4,681.89 50% off $1,475.00 $3,573.00 $2,524.00 2026-04-01
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 5 3 $3,059.28 $1,529.64 50% off $1,475.00 $3,205.00 $2,340.00 2026-04-01
64721 HCPCS Carpal Tunnel Release 10 5 $4,691.00 $2,345.50 50% off $555.53 $555.53 $555.53 2026-04-01
603 MS_DRG Cellulitis Without Mcc 5 3 $6,047.75 $3,023.88 50% off $1,475.00 $2,789.00 $2,132.00 2026-04-01
36558 HCPCS Central Line Placement 12 5 $7,082.00 $3,541.00 50% off $300.00 $330.50 $330.50 2026-04-01
87901 HCPCS Charge Component For CPT Code 87901 10 5 $243.00 $121.50 50% off $257.45 $323.72 $290.58 2026-04-01
87903 HCPCS Charge Component For HIV-1 Phenosense 1 10 5 $1,467.00 $733.50 50% off $614.45 $614.45 $614.45 2026-04-01
313 MS_DRG Chest Pain 5 3 $5,970.07 $2,985.04 50% off $1,475.00 $4,224.00 $2,849.50 2026-04-01
47600 HCPCS Cholecystectomy Open 10 5 $3,450.00 $1,725.00 50% off $1,366.68 $1,366.68 $1,366.68 2026-04-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 5 3 $7,016.25 $3,508.13 50% off $1,475.00 $3,205.00 $2,340.00 2026-04-01
54161 HCPCS Circumcision Surgical Excis >28 Days Old 10 5 $5,207.00 $2,603.50 50% off $251.73 $251.73 $251.73 2026-04-01
24600 HCPCS Closed Tx Elbow Dislocation Without Anesth. 10 5 $966.00 $483.00 50% off $300.00 $444.00 $372.00 2026-04-01
26670 HCPCS Closed Tx Finger Dislocation With Manip. 10 5 $900.00 $450.00 50% off $300.00 $404.16 $352.08 2026-04-01
27550 HCPCS Closed Tx Knee Dislocation Without Anesth. 10 5 $966.00 $483.00 50% off $300.00 $609.21 $454.61 2026-04-01
25505 HCPCS Closed Tx Radial Fracture With Manip. 10 5 $1,428.00 $714.00 50% off $300.00 $595.18 $447.59 2026-04-01
25660 HCPCS Closed Tx Radiocarpal/intercarpal Disloc 10 5 $1,402.00 $701.00 50% off $300.00 $576.48 $438.24 2026-04-01
23650 HCPCS Closed Tx Shoulder Disloc W/man Without Anes 12 5 $558.00 $279.00 50% off $300.00 $387.77 $343.88 2026-04-01
26641 HCPCS Closed Tx Thumb Dislocation With Manip. 10 5 $587.00 $293.50 50% off $300.00 $491.54 $395.77 2026-04-01
813 MS_DRG Coagulation Disorders 5 3 $12,224.13 $6,112.07 50% off $1,475.00 $5,204.00 $3,339.50 2026-04-01
44160 HCPCS Colectomy Partial Removal Terminal Ileum 10 5 $4,021.00 $2,010.50 50% off $1,584.49 $1,584.49 $1,584.49 2026-04-01
G0121 HCPCS Colonoscopy Screening Low Risk Pt 1 1 $1,965.00 $982.50 50% off $858.57 $858.57 $858.57 2026-04-01
45378 HCPCS Colonoscopy W/suction Diagnostic 10 5 $1,965.00 $982.50 50% off $234.37 $1,670.25 $234.37 2026-04-01
45386 HCPCS Colonoscopy With Balloon Dilation 10 5 $1,876.00 $938.00 50% off $268.74 $268.74 $268.74 2026-04-01
45380 HCPCS Colonoscopy With Biopsy 10 5 $2,130.00 $1,065.00 50% off $254.84 $1,099.13 $254.84 2026-04-01
44320 HCPCS Colostomy Or Skin Level Cecostomy 10 5 $3,796.00 $1,898.00 50% off $1,529.91 $1,529.91 $1,529.91 2026-04-01
57522 HCPCS Conization Cervix Leep 10 5 $6,257.00 $3,128.50 50% off $326.76 $326.76 $326.76 2026-04-01
99291 HCPCS Critical Care 30-74 Minutes 12 5 $2,062.00 $1,031.00 50% off $300.00 $401.14 $401.14 2026-04-01
74160 HCPCS CT Abdomen With Contrast 10 5 $2,059.00 $1,029.50 50% off $275.00 $325.77 $300.38 2026-04-01
74150 HCPCS CT Abdomen Without Contrast 10 5 $2,059.00 $1,029.50 50% off $99.53 $275.00 $233.65 2026-04-01
74178 HCPCS CT Abdomen W/wo & Pelvis W Contrast 10 5 $3,152.00 $1,576.00 50% off $275.00 $479.22 $377.11 2026-04-01
74170 HCPCS CT Abdomen W/wo Contrast 10 5 $2,059.00 $1,029.50 50% off $167.65 $333.98 $304.49 2026-04-01
74177 HCPCS CT Abdomen/pelvis With Contrast 10 5 $3,004.00 $1,502.00 50% off $275.00 $428.06 $351.53 2026-04-01
72126 HCPCS CT C-spine With Contrast 10 5 $1,362.00 $681.00 50% off $236.78 $275.00 $255.89 2026-04-01
72125 HCPCS CT C-spine Without Contrast 10 5 $1,329.00 $664.50 50% off $99.13 $275.00 $228.53 2026-04-01
72127 HCPCS CT C-spine W/wo Contrast 10 5 $1,876.00 $938.00 50% off $275.00 $276.57 $275.79 2026-04-01
75571 HCPCS CT Calcium Scoring 10 5 $180.00 $90.00 50% off $275.00 $275.00 $275.00 2026-04-01
70460 HCPCS CT Head With Contrast 10 5 $1,580.00 $790.00 50% off $207.75 $275.00 $241.38 2026-04-01
70470 HCPCS CT Head W/wo Contrast 10 5 $1,580.00 $790.00 50% off $243.62 $275.00 $259.31 2026-04-01
72132 HCPCS CT L-spine With Contrast 10 5 $1,680.00 $840.00 50% off $237.23 $275.00 $256.12 2026-04-01
72133 HCPCS CT L-spine W/wo Contrast 10 5 $1,645.00 $822.50 50% off $275.00 $277.44 $276.22 2026-04-01
73701 HCPCS CT Low Ext Lt With Contrast,procedure Performed On The Lt Side Of The Body 20 5 $1,209.00 $604.50 50% off $233.81 $275.00 $254.41 2026-04-01
73702 HCPCS CT Low Ext Lt W/wo Contrast,procedure Performed On The Lt Side Of The Body 20 5 $1,315.00 $657.50 50% off $273.26 $275.00 $274.13 2026-04-01
70487 HCPCS CT Maxillofacial With Contrast 10 5 $1,240.00 $620.00 50% off $213.47 $275.00 $244.24 2026-04-01
70488 HCPCS CT Maxillofacial W/wo Contrast 10 5 $1,466.00 $733.00 50% off $259.43 $275.00 $267.21 2026-04-01
70481 HCPCS CT Orb/sella/ear With Contrast 10 5 $1,240.00 $620.00 50% off $252.98 $275.00 $263.99 2026-04-01
70480 HCPCS CT Orb/sella/ear Without Contrast 10 5 $1,061.00 $530.50 50% off $223.07 $275.00 $249.03 2026-04-01
70482 HCPCS CT Orb/sella/ear W/wo Contrast 10 5 $1,482.00 $741.00 50% off $275.00 $295.02 $285.01 2026-04-01
72193 HCPCS CT Pelvis With Contrast 10 5 $2,059.00 $1,029.50 50% off $275.00 $318.17 $296.58 2026-04-01
72192 HCPCS CT Pelvis Without Contrast 10 5 $1,959.00 $979.50 50% off $187.32 $275.00 $231.16 2026-04-01
72194 HCPCS CT Pelvis W/wo Contrast 10 5 $2,159.00 $1,079.50 50% off $275.00 $322.02 $298.51 2026-04-01
74176 HCPCS CT Renal For Calculi 10 5 $2,642.00 $1,321.00 50% off $225.33 $275.00 $266.94 2026-04-01
70491 HCPCS CT Soft Tissue Neck With Contrast 10 5 $1,240.00 $620.00 50% off $259.61 $275.00 $267.31 2026-04-01
70490 HCPCS CT Soft Tissue Neck Without Contrast 10 5 $1,061.00 $530.50 50% off $99.13 $275.00 $243.32 2026-04-01
70492 HCPCS CT Soft Tissue Neck W/wo Contrast 10 5 $1,700.00 $850.00 50% off $275.00 $311.46 $293.23 2026-04-01
72129 HCPCS CT T-spine With Contrast 10 5 $1,480.00 $740.00 50% off $238.50 $275.00 $256.75 2026-04-01
72128 HCPCS CT T-spine Without Contrast 10 5 $1,476.00 $738.00 50% off $181.62 $275.00 $228.31 2026-04-01
72130 HCPCS CT T-spine W/wo Contrast 10 5 $1,645.00 $822.50 50% off $275.00 $279.20 $277.10 2026-04-01
71260 HCPCS CT Thorax With Contrast 10 5 $1,430.00 $715.00 50% off $233.81 $405.61 $254.41 2026-04-01
71250 HCPCS CT Thorax Without Contrast 10 5 $1,399.00 $699.50 50% off $100.14 $275.00 $231.13 2026-04-01
71270 HCPCS CT Thorax W/wo Contrast 10 5 $1,755.00 $877.50 50% off $275.00 $407.04 $275.09 2026-04-01
73201 HCPCS CT Upper Ext Lt With Contrast,procedure Performed On The Lt Side Of The Body 20 5 $1,166.00 $583.00 50% off $275.00 $282.14 $278.57 2026-04-01
73200 HCPCS CT Upper Ext Lt Without Contrast,procedure Performed On The Lt Side Of The Body 20 5 $1,054.00 $527.00 50% off $98.06 $275.00 $241.93 2026-04-01
73202 HCPCS CT Upper Ext Lt W/wo Contrast,procedure Performed On The Lt Side Of The Body 20 5 $1,324.00 $662.00 50% off $275.00 $322.02 $298.51 2026-04-01
74174 HCPCS CTA Abdomen / Pelvis W/wo Contrast 10 5 $1,850.00 $925.00 50% off $275.00 $532.85 $403.93 2026-04-01
74175 HCPCS CTA Abdomen W/wo Contrast 10 5 $1,531.00 $765.50 50% off $275.00 $361.67 $318.33 2026-04-01
75635 HCPCS CTA Aorto-iliofemoral Runoff 10 5 $1,963.00 $981.50 50% off $275.00 $398.73 $336.87 2026-04-01
71275 HCPCS CTA Chest W/wo Contrast 10 5 $1,570.00 $785.00 50% off $275.00 $362.10 $318.55 2026-04-01
70496 HCPCS CTA Head W/wo Contrast 10 5 $1,381.00 $690.50 50% off $275.00 $357.75 $316.38 2026-04-01
73706 HCPCS CTA Lower Ext W/wo Contrast 10 5 $1,411.00 $705.50 50% off $275.00 $366.95 $320.98 2026-04-01
70498 HCPCS CTA Neck W/wo Contrast 10 5 $1,381.00 $690.50 50% off $275.00 $357.75 $316.38 2026-04-01
72191 HCPCS CTA Pelvis W/wo Contrast 10 5 $1,531.00 $765.50 50% off $275.00 $360.29 $317.64 2026-04-01
73206 HCPCS CTA Upper Ext W/wo Contrast 10 5 $1,411.00 $705.50 50% off $275.00 $360.29 $317.64 2026-04-01
58925 HCPCS Cystectomy Ovarian 10 5 $12,158.00 $6,079.00 50% off $987.68 $987.68 $987.68 2026-04-01
11005 HCPCS Debridement Necrotizing Tissue Abd Wall 10 5 $2,450.00 $1,225.00 50% off $986.41 $986.41 $986.41 2026-04-01
11004 HCPCS Debridement Necrotizing Tissue Genitalia 10 5 $1,853.00 $926.50 50% off $727.08 $727.08 $727.08 2026-04-01
59409 HCPCS Delivery - Vaginal (er Only) 12 5 $6,257.00 $3,128.50 50% off $300.00 $1,080.03 $690.01 2026-04-01
159 MS_DRG Dental And Oral Diseases Without Cc/mcc 5 3 $4,598.97 $2,299.49 50% off $1,475.00 $3,313.00 $2,394.00 2026-04-01
64633 HCPCS Destruct Bilat Paravert F Jnt C/t W/imag,bilateral Procedure 21 5 $4,691.00 $2,345.50 50% off $244.45 $1,850.18 $244.45 2026-04-01
64635 HCPCS Destruct Bilat Paravert F Jnt L/s W/imag,bilateral Procedure 22 5 $4,691.00 $2,345.50 50% off $244.85 $1,850.18 $244.85 2026-04-01
46924 HCPCS Destruction Of Lesion(s) Anus Surg Exten 10 5 $7,309.00 $3,654.50 50% off $230.76 $230.76 $230.76 2026-04-01
638 MS_DRG Diabetes With Cc 5 3 $7,103.92 $3,551.96 50% off $1,475.00 $3,177.00 $2,326.00 2026-04-01
637 MS_DRG Diabetes With Mcc 5 3 $5,798.41 $2,899.21 50% off $1,475.00 $3,802.00 $2,638.50 2026-04-01
58120 HCPCS Dilation & Curettage Non-OB 10 5 $6,257.00 $3,128.50 50% off $299.67 $299.67 $299.67 2026-04-01
443 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic 5 3 $4,144.54 $2,072.27 50% off $1,475.00 $2,939.00 $2,207.00 2026-04-01
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 5 3 $2,863.79 $1,431.90 50% off $1,475.00 $2,763.00 $2,119.00 2026-04-01
446 MS_DRG Disorders Of The Biliary Tract Without Cc/mcc 3 2 $6,532.93 $3,266.47 50% off $1,475.00 $1,475.00 $1,475.00 2026-04-01
149 MS_DRG Dysequilibrium 5 3 $4,636.87 $2,318.44 50% off $1,475.00 $3,630.00 $2,552.50 2026-04-01
99499 HCPCS Emergency Room Assessment 10 5 $75.00 $37.50 50% off $300.00 $300.00 $300.00 2026-04-01
99285 HCPCS Emergency Room Level V 20 5 $1,213.00 $606.50 50% off $286.31 $300.00 $286.31 2026-04-01
58353 HCPCS Endometrial Ablation Without Hysterocscopy 10 5 $9,527.00 $4,763.50 50% off $297.69 $297.69 $297.69 2026-04-01
58563 HCPCS Endometrial Ablation With Hysterocscopy 10 5 $11,433.00 $5,716.50 50% off $316.57 $316.57 $316.57 2026-04-01
62264 HCPCS Epidural Lysis Bilat On Single Day,bilateral Procedure 20 5 $2,229.00 $1,114.50 50% off $313.08 $313.08 $313.08 2026-04-01
392 MS_DRG Esophagitis, Gastroenteritis And Misc Digestive Dis 5 3 $6,447.10 $3,223.55 50% off $1,475.00 $3,044.00 $2,259.50 2026-04-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Dis 3 2 $7,893.45 $3,946.73 50% off $2,496.50 $3,518.00 $3,518.00 2026-04-01
56740 HCPCS Excision Bartholin's Cyst/gland 10 5 $7,569.00 $3,784.50 50% off $405.29 $405.29 $405.29 2026-04-01
49205 HCPCS Excision Endometrioma >10.0cm 10 5 $5,662.00 $2,831.00 50% off $2,235.54 $2,235.54 $2,235.54 2026-04-01
69110 HCPCS Excision External Ear Partial Simple 10 5 $6,447.00 $3,223.50 50% off $415.68 $415.68 $415.68 2026-04-01
25111 HCPCS Excision Ganglion Wrist Primary 10 5 $3,375.00 $1,687.50 50% off $415.49 $415.49 $415.49 2026-04-01
40812 HCPCS Excision Mucosa/sub. Vestible Simple 10 5 $6,522.00 $3,261.00 50% off $233.61 $233.61 $233.61 2026-04-01
64774 HCPCS Excision Neuroma Surgical Identified 10 5 $4,691.00 $2,345.50 50% off $544.74 $544.74 $544.74 2026-04-01
24105 HCPCS Excision Olecranon Bursa 10 5 $7,316.00 $3,658.00 50% off $459.72 $459.72 $459.72 2026-04-01
42420 HCPCS Excision Parotid Tumor W/preserv. Facial 10 5 $12,393.00 $6,196.50 50% off $1,527.20 $1,527.20 $1,527.20 2026-04-01
11772 HCPCS Excision Pilonidal Cyst Complicated 10 5 $6,447.00 $3,223.50 50% off $734.31 $734.31 $734.31 2026-04-01
45171 HCPCS Excision Rectal Tumor Transanal Approach 10 5 $6,672.00 $3,336.00 50% off $785.14 $785.14 $785.14 2026-04-01
11462 HCPCS Excision Skin Hidradenitis Inguinal Reg 10 5 $6,447.00 $3,223.50 50% off $313.74 $313.74 $313.74 2026-04-01
11603 HCPCS Excision Skin Lesion Arm Malig 2.1 - 3.0 10 5 $1,588.00 $794.00 50% off $245.28 $245.28 $245.28 2026-04-01
11604 HCPCS Excision Skin Lesion Arm Malig 3.1-4.0cm 10 5 $1,747.00 $873.50 50% off $270.27 $270.27 $270.27 2026-04-01
11444 HCPCS Excision Skin Lesion Face Benign 3.1-4.0 10 5 $3,710.00 $1,855.00 50% off $286.46 $286.46 $286.46 2026-04-01
11446 HCPCS Excision Skin Lesion Face Benign >4.0cm 10 5 $6,447.00 $3,223.50 50% off $402.74 $402.74 $402.74 2026-04-01
11642 HCPCS Excision Skin Lesion Face Malig 1.1-2.0c 10 5 $1,922.00 $961.00 50% off $230.27 $230.27 $230.27 2026-04-01
11644 HCPCS Excision Skin Lesion Face Malig 3.1-4.0c 10 5 $3,710.00 $1,855.00 50% off $358.10 $358.10 $358.10 2026-04-01
11646 HCPCS Excision Skin Lesion Face Malig >4.0cm 10 5 $6,447.00 $3,223.50 50% off $496.40 $496.40 $496.40 2026-04-01
11626 HCPCS Excision Skin Lesion Hand Malig >4.0cm 10 5 $6,447.00 $3,223.50 50% off $371.03 $371.03 $371.03 2026-04-01
11606 HCPCS Excision Skin Lesion Leg Malig >4.0cm 10 5 $4,257.00 $2,128.50 50% off $402.35 $402.35 $402.35 2026-04-01
11623 HCPCS Excision Skin Lesion Neck Malig 2.1 - 3. 10 5 $3,771.00 $1,885.50 50% off $266.00 $266.00 $266.00 2026-04-01
11643 HCPCS Excision Skin Lesion Nose Malig 2.1-3.0c 10 5 $3,710.00 $1,855.00 50% off $288.48 $288.48 $288.48 2026-04-01
11426 HCPCS Excision Skin Lesion Scalp Benign >4.0cm 10 5 $6,447.00 $3,223.50 50% off $343.66 $343.66 $343.66 2026-04-01
11624 HCPCS Excision Skin Lesion Scalp Malig 3.1-4.0 10 5 $4,040.00 $2,020.00 50% off $302.16 $302.16 $302.16 2026-04-01
11406 HCPCS Excision Skin Lesion Trunk Benign >4.0cm 10 5 $4,040.00 $2,020.00 50% off $314.82 $314.82 $314.82 2026-04-01
23073 HCPCS Excision Soft Tissue Shoulder IM 5cm+ 10 5 $6,447.00 $3,223.50 50% off $890.14 $890.14 $890.14 2026-04-01
22902 HCPCS Excision Tumor Abd Wall Subq <3cm 10 5 $3,834.00 $1,917.00 50% off $424.34 $424.34 $424.34 2026-04-01
22901 HCPCS Excision Tumor Abdominal Wall Subfa >5cm 10 5 $6,447.00 $3,223.50 50% off $850.67 $850.67 $850.67 2026-04-01
22903 HCPCS Excision Tumor Abdominal Wall Subq >3cm 10 5 $6,447.00 $3,223.50 50% off $562.65 $562.65 $562.65 2026-04-01
21016 HCPCS Excision Tumor Facial Radical >2cm 10 5 $6,447.00 $3,223.50 50% off $1,287.97 $1,287.97 $1,287.97 2026-04-01
21012 HCPCS Excision Tumor Facial Subq >2cm 10 5 $3,834.00 $1,917.00 50% off $431.84 $431.84 $431.84 2026-04-01
25073 HCPCS Excision Tumor Forearm/wrist Subfa >3cm 10 5 $6,447.00 $3,223.50 50% off $686.11 $686.11 $686.11 2026-04-01
21556 HCPCS Excision Tumor Neck/thorax Subfa <5cm 10 5 $6,447.00 $3,223.50 50% off $679.44 $679.44 $679.44 2026-04-01
21930 HCPCS Excision Tumor Soft Tissue Back Sq <3cm 10 5 $1,772.00 $886.00 50% off $463.74 $463.74 $463.74 2026-04-01
21931 HCPCS Excision Tumor Soft Tissue Back Sq >3cm 10 5 $4,115.00 $2,057.50 50% off $599.72 $599.72 $599.72 2026-04-01
21552 HCPCS Excision Tumor Soft Tissue Neck 3cm Or > 10 5 $6,447.00 $3,223.50 50% off $571.10 $571.10 $571.10 2026-04-01
21555 HCPCS Excision Tumor Soft Tissue Neck <3cm 10 5 $3,834.00 $1,917.00 50% off $390.93 $1,516.28 $390.93 2026-04-01
24076 HCPCS Excision Tumor Soft Up. Arm <5cm Subfas 10 5 $6,447.00 $3,223.50 50% off $699.73 $699.73 $699.73 2026-04-01
24071 HCPCS Excision Tumor Soft Up. Arm >3cm Subq 10 5 $3,300.00 $1,650.00 50% off $517.67 $517.67 $517.67 2026-04-01
24073 HCPCS Excision Tumor Soft Up. Arm >5cm Subfas 10 5 $6,447.00 $3,223.50 50% off $885.49 $885.49 $885.49 2026-04-01
27327 HCPCS Excision Tumor Thigh Subq <3cm 10 5 $5,210.00 $2,605.00 50% off $400.88 $400.88 $400.88 2026-04-01
27337 HCPCS Excision Tumor Thigh/knee Subq 3cm Or > 10 5 $6,447.00 $3,223.50 50% off $535.50 $535.50 $535.50 2026-04-01
57135 HCPCS Excision Vaginal Cyst Or Tumor 10 5 $6,257.00 $3,128.50 50% off $241.07 $241.07 $241.07 2026-04-01
55040 HCPCS Exicision Hydrocele Unilateral 10 5 $8,589.00 $4,294.50 50% off $431.10 $431.10 $431.10 2026-04-01
46280 HCPCS Fistulotomy Anal Suprasphincteric 10 5 $6,503.00 $3,251.50 50% off $612.89 $612.89 $612.89 2026-04-01
28192 HCPCS Foreign Body Removal Foot - Deep 12 5 $3,834.00 $1,917.00 50% off $300.00 $396.20 $396.20 2026-04-01
27086 HCPCS Foreign Body Removal Pelivs/hip Subq 12 5 $1,728.00 $864.00 50% off $213.40 $300.00 $256.70 2026-04-01
42809 HCPCS Foreign Body Removal Pharynx 12 5 $789.00 $394.50 50% off $161.71 $300.00 $230.85 2026-04-01
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur Hip 5 3 $11,940.86 $5,970.43 50% off $1,475.00 $3,649.00 $2,562.00 2026-04-01
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip 5 3 $5,449.55 $2,724.78 50% off $1,475.00 $2,971.00 $2,223.00 2026-04-01
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 5 3 $4,801.07 $2,400.54 50% off $1,475.00 $2,722.00 $2,098.50 2026-04-01
174 MS_DRG G.i. Hemorrhage W Cc 3 2 $3,737.24 $1,868.62 50% off $1,475.00 $1,475.00 $1,475.00 2026-04-01
378 MS_DRG Gastroinestinal Hemorrhage With Cc 5 3 $6,345.82 $3,172.91 50% off $1,475.00 $3,388.00 $2,431.50 2026-04-01
389 MS_DRG Gastrointestinal Obstruction With Cc 5 3 $3,101.80 $1,550.90 50% off $1,475.00 $2,718.00 $2,096.50 2026-04-01
87507 HCPCS Gastrointestinal Profile Stool Pcr 10 5 $1,697.00 $848.50 50% off $510.46 $510.46 $510.46 2026-04-01
292 MS_DRG Heart Failure And Shock With Cc 5 3 $7,005.84 $3,502.92 50% off $1,475.00 $2,965.00 $2,220.00 2026-04-01
291 MS_DRG Heart Failure And Shock With Mcc 5 3 $5,026.41 $2,513.21 50% off $1,475.00 $3,550.00 $2,512.50 2026-04-01
293 MS_DRG Heart Failure And Shock Without Cc/mcc 5 3 $4,693.84 $2,346.92 50% off $1,475.00 $2,917.00 $2,196.00 2026-04-01
46221 HCPCS Hemorrhoidectomy Internal Band Ligation 10 5 $2,004.00 $1,002.00 50% off $244.11 $244.11 $244.11 2026-04-01
46947 HCPCS Hemorrhoidopexy By Stapling 10 5 $7,112.00 $3,556.00 50% off $495.93 $495.93 $495.93 2026-04-01
87902 HCPCS Hepatitis C Genotype 10 5 $1,159.00 $579.50 50% off $257.45 $323.72 $290.58 2026-04-01
49553 HCPCS Hernia Repair Femoral Initial I/s 10 5 $8,589.00 $4,294.50 50% off $809.83 $809.83 $809.83 2026-04-01
49507 HCPCS Hernia Repair Inguinal Initial Incar. 10 5 $8,589.00 $4,294.50 50% off $752.16 $752.16 $752.16 2026-04-01
49505 HCPCS Hernia Repair Inguinal Initial Reduc. 10 5 $8,589.00 $4,294.50 50% off $668.17 $668.17 $668.17 2026-04-01
305 MS_DRG Hypertension Without Mcc 5 3 $6,135.03 $3,067.52 50% off $1,475.00 $3,565.00 $2,520.00 2026-04-01
58150 HCPCS Hysterectomy Total Abdominal 10 5 $7,035.00 $3,517.50 50% off $1,305.05 $1,305.05 $1,305.05 2026-04-01
58260 HCPCS Hysterectomy Vag. 250g Or Less Uterus 10 5 $5,993.00 $2,996.50 50% off $1,082.93 $1,082.93 $1,082.93 2026-04-01
58290 HCPCS Hysterectomy Vag. 250g> Uterus 10 5 $17,599.00 $8,799.50 50% off $1,487.76 $1,487.76 $1,487.76 2026-04-01
10061 HCPCS I & D Abcess Complicated/multiple 13 5 $878.00 $439.00 50% off $232.65 $383.57 $232.65 2026-04-01
46040 HCPCS I & D Abcess Perirectal Or Ischiorectal 10 5 $1,673.00 $836.50 50% off $539.99 $539.99 $539.99 2026-04-01
758 MS_DRG Infections, Female Reproductive System W Cc 5 3 $3,320.86 $1,660.43 50% off $1,475.00 $2,784.00 $2,129.50 2026-04-01
46500 HCPCS Injection Sclerosing Sol. Hemorrhoids 10 5 $2,004.00 $1,002.00 50% off $232.35 $232.35 $232.35 2026-04-01
P9612 HCPCS Insertion Cath - Ua Only ER 13 5 $46.00 $23.00 50% off $2.70 $300.00 $300.00 2026-04-01
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 5 3 $7,550.27 $3,775.14 50% off $1,475.00 $2,996.00 $2,235.50 2026-04-01
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 5 3 $5,722.53 $2,861.27 50% off $1,475.00 $2,867.00 $2,171.00 2026-04-01
687 MS_DRG Kidney And Urinary Tract Neoplasms With Cc 5 3 $6,753.00 $3,376.50 50% off $1,475.00 $3,398.00 $2,436.50 2026-04-01
47562 HCPCS Lap Cholecystectomy 10 5 $12,598.00 $6,299.00 50% off $842.93 $842.93 $842.93 2026-04-01
47563 HCPCS Lap Cholecystectomy With Cholangio 10 5 $12,598.00 $6,299.00 50% off $919.00 $919.00 $919.00 2026-04-01
49650 HCPCS Lap Hernia Repair Initial Inguinal 10 5 $12,598.00 $6,299.00 50% off $552.30 $552.30 $552.30 2026-04-01
49651 HCPCS Lap Hernia Repair Recurrent Inguinal 10 5 $12,598.00 $6,299.00 50% off $721.62 $721.62 $721.62 2026-04-01
58661 HCPCS Lap Oophorectomy 10 5 $12,598.00 $6,299.00 50% off $842.08 $842.08 $842.08 2026-04-01
44180 HCPCS Lap Surgical Enterolysis 10 5 $12,598.00 $6,299.00 50% off $1,174.77 $1,174.77 $1,174.77 2026-04-01
58570 HCPCS Lap Surgical Total Hyst 10 5 $20,910.00 $10,455.00 50% off $1,039.61 $1,039.61 $1,039.61 2026-04-01
58571 HCPCS Lap Surgical Total Hyst W/tube Removal 10 5 $20,910.00 $10,455.00 50% off $1,167.59 $1,167.59 $1,167.59 2026-04-01
58670 HCPCS Laparoscopic Tubal Ligation W/wo Trans. 10 5 $12,729.00 $6,364.50 50% off $478.76 $478.76 $478.76 2026-04-01
49320 HCPCS Laparoscopy Diagnostic Abdomen/peri 10 5 $12,598.00 $6,299.00 50% off $419.75 $419.75 $419.75 2026-04-01
49000 HCPCS Laparotomy Exploratory 10 5 $2,492.00 $1,246.00 50% off $981.72 $981.72 $981.72 2026-04-01
58600 HCPCS Ligation Of Tubes Abd Or Vag Approach 10 5 $7,569.00 $3,784.50 50% off $477.96 $477.96 $477.96 2026-04-01
37722 HCPCS Ligation/stripping Long Saphenous Vein 10 5 $7,082.00 $3,541.00 50% off $587.48 $587.48 $587.48 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 5 3 $21,851.07 $10,925.54 50% off $1,475.00 $4,760.00 $3,117.50 2026-04-01
54162 HCPCS Lysis Penile Post-circumcision Adhesion 12 5 $5,207.00 $2,603.50 50% off $255.77 $300.00 $277.88 2026-04-01
595 MS_DRG Major Skin Disorers With Mcc 5 3 $14,938.20 $7,469.10 50% off $1,475.00 $4,169.00 $2,822.00 2026-04-01
19300 HCPCS Mastectomy For Gynecomastia - Male Only 10 5 $7,499.00 $3,749.50 50% off $549.39 $549.39 $549.39 2026-04-01
19301 HCPCS Mastectomy Partial - Lumpectomy 10 5 $7,499.00 $3,749.50 50% off $842.32 $842.32 $842.32 2026-04-01
552 MS_DRG Medical Back Problems Without Mcc 3 2 $6,053.47 $3,026.74 50% off $1,475.00 $1,475.00 $1,475.00 2026-04-01
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metablosim, Fluids And 5 3 $3,650.56 $1,825.28 50% off $1,475.00 $3,106.00 $2,290.50 2026-04-01
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And 5 3 $8,428.53 $4,214.27 50% off $1,475.00 $3,846.00 $2,660.50 2026-04-01
G0378 HCPCS Observation Per Hour 8 4 $17.00 $8.50 50% off $16.73 $350.00 $350.00 2026-04-01
G0379 HCPCS Observation-direct Admit 10 5 $1,467.00 $733.50 50% off $350.00 $1,443.53 $350.00 2026-04-01
884 MS_DRG Organic Disturbances And Intellectual Disability 5 3 $10,169.22 $5,084.61 50% off $1,475.00 $3,181.00 $2,328.00 2026-04-01
315 MS_DRG Other Circulatory System Diagnoses With Cc 3 2 $7,791.23 $3,895.62 50% off $2,540.00 $3,605.00 $3,605.00 2026-04-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 3 2 $11,348.61 $5,674.31 50% off $2,945.00 $4,415.00 $4,415.00 2026-04-01
394 MS_DRG Other Diestive System Diagnoses With Mcc 3 2 $7,601.76 $3,800.88 50% off $2,332.50 $3,190.00 $3,190.00 2026-04-01
155 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Cc 5 3 $7,425.66 $3,712.83 50% off $1,475.00 $3,238.00 $2,356.50 2026-04-01
699 MS_DRG Other Kidnwy And Urinary Tract Diagnoses With Cc 5 3 $7,092.07 $3,546.04 50% off $1,475.00 $3,237.00 $2,356.00 2026-04-01
206 MS_DRG Other Resiratory System Diagnoses Without Mcc 5 3 $6,210.10 $3,105.05 50% off $1,475.00 $3,688.00 $2,581.50 2026-04-01
57285 HCPCS Paravaginal Defect Repair - Vag Approach 10 5 $17,599.00 $8,799.50 50% off $892.85 $892.85 $892.85 2026-04-01
88309 HCPCS Pathology Surgical 88309 10 5 $1,363.00 $681.50 50% off $31.34 $470.39 $250.87 2026-04-01
43246 HCPCS Placement Of Peg Tube 10 5 $4,005.00 $2,002.50 50% off $254.43 $254.43 $254.43 2026-04-01
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 5 3 $5,102.75 $2,551.38 50% off $1,475.00 $3,530.00 $2,502.50 2026-04-01
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 5 3 $6,679.61 $3,339.81 50% off $1,475.00 $3,028.00 $2,251.50 2026-04-01
885 MS_DRG Psychoses 5 3 $10,220.93 $5,110.47 50% off $1,475.00 $2,190.00 $1,832.50 2026-04-01
90377 HCPCS Rabies Immune Globulin 300iu/2ml 10 5 $2,021.00 $1,010.50 50% off $314.94 $314.94 $314.94 2026-04-01
90675 HCPCS Rabies Vac 2.5un Kit 10 5 $1,158.00 $579.00 50% off $452.40 $452.40 $452.40 2026-04-01
57250 HCPCS Rectocele Repair With/without Peri. 10 5 $11,433.00 $5,716.50 50% off $793.82 $793.82 $793.82 2026-04-01
812 MS_DRG Red Blood Cell Disorders Without Mcc 5 3 $3,784.69 $1,892.35 50% off $1,475.00 $3,413.00 $2,444.00 2026-04-01
30310 HCPCS Removal Foreign Body Intranasal W/anest 10 5 $6,522.00 $3,261.00 50% off $264.04 $264.04 $264.04 2026-04-01
24201 HCPCS Removal Of Foreign Body-upper Arm Deep 12 5 $1,125.00 $562.50 50% off $300.00 $468.84 $384.42 2026-04-01
43999 HCPCS Removal Of Peg Tube 1 1 $3,000.00 $1,500.00 50% off $879.90 $879.90 $879.90 2026-04-01
36590 HCPCS Removal Of Port 10 5 $2,549.00 $1,274.50 50% off $241.13 $241.13 $241.13 2026-04-01
57287 HCPCS Removal Or Revision Bladder Sling 10 5 $6,880.00 $3,440.00 50% off $951.66 $951.66 $951.66 2026-04-01
683 MS_DRG Renal Failure With Cc 5 3 $5,676.37 $2,838.19 50% off $1,475.00 $3,048.00 $2,261.50 2026-04-01
684 MS_DRG Renal Failure Without Cc/mcc 5 3 $2,769.73 $1,384.87 50% off $1,475.00 $2,958.00 $2,216.50 2026-04-01
36578 HCPCS Replacement Of Picc Line - Cath Only 10 5 $7,082.00 $3,541.00 50% off $257.85 $257.85 $257.85 2026-04-01
27364 HCPCS Resection Tumor Thigh/knee 5cm Or More 10 5 $6,447.00 $3,223.50 50% off $1,995.01 $1,995.01 $1,995.01 2026-04-01
179 MS_DRG Respiratory Infectins And Inflammations Without Cc/mcc 5 3 $1,641.50 $820.75 50% off $1,475.00 $2,961.00 $2,218.00 2026-04-01
178 MS_DRG Respiratory Infections And Inflammations With Cc 5 3 $7,103.72 $3,551.86 50% off $1,475.00 $3,116.00 $2,295.50 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 5 3 $11,054.76 $5,527.38 50% off $1,475.00 $3,515.00 $2,495.00 2026-04-01
0202U OTHER Respiratory Pathogen Panel 10 5 $1,251.00 $625.50 50% off $500.14 $500.14 $500.14 2026-04-01
204 MS_DRG Respiratory Signs And Symptoms 5 3 $7,262.53 $3,631.27 50% off $1,475.00 $3,770.00 $2,622.50 2026-04-01
87633 HCPCS Respiratory Virus Profile,pcr 10 5 $1,876.00 $938.00 50% off $515.62 $515.62 $515.62 2026-04-01
816 MS_DRG Reticuloendothelial & Immunity Disorders Without Cc/mcc 5 3 $2,722.23 $1,361.12 50% off $1,475.00 $3,167.00 $2,321.00 2026-04-01
13160 HCPCS Secondary Closure Of Surgical Wound Comp 10 5 $4,784.00 $2,392.00 50% off $1,014.42 $1,014.42 $1,014.42 2026-04-01
101 MS_DRG Seizures Without Mcc 3 2 $5,725.40 $2,862.70 50% off $1,475.00 $1,475.00 $1,475.00 2026-04-01
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective 5 3 $6,598.67 $3,299.34 50% off $1,475.00 $3,123.00 $2,299.00 2026-04-01
947 MS_DRG Signs And Symptoms With Mcc 5 3 $8,904.11 $4,452.06 50% off $1,475.00 $3,630.00 $2,552.50 2026-04-01
948 MS_DRG Signs And Symptoms Without Mcc 5 3 $4,804.79 $2,402.40 50% off $1,475.00 $3,097.00 $2,286.00 2026-04-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 5 3 $6,869.92 $3,434.96 50% off $1,475.00 $2,971.00 $2,223.00 2026-04-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 5 3 $8,676.71 $4,338.36 50% off $1,475.00 $3,303.00 $2,389.00 2026-04-01
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 5 3 $3,795.77 $1,897.89 50% off $1,475.00 $2,846.00 $2,160.50 2026-04-01
15220 HCPCS Skin Graft Full Thick Extrem <20sq. Cm 10 5 $4,284.00 $2,142.00 50% off $770.81 $770.81 $770.81 2026-04-01
15240 HCPCS Skin Graft Full Thick Neck <20sq. Cm 10 5 $4,284.00 $2,142.00 50% off $1,004.60 $1,004.60 $1,004.60 2026-04-01
15260 HCPCS Skin Graft Full Thick Nose <20sq. Cm 10 5 $4,284.00 $2,142.00 50% off $1,070.18 $1,070.18 $1,070.18 2026-04-01
57288 HCPCS Sling Operation For Stress Incontinence 10 5 $3,026.00 $1,513.00 50% off $955.31 $955.31 $955.31 2026-04-01
538 MS_DRG Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh 5 3 $4,199.97 $2,099.99 50% off $1,475.00 $2,929.00 $2,202.00 2026-04-01
312 MS_DRG Syncope And Collapse 5 3 $6,014.73 $3,007.37 50% off $1,475.00 $3,592.00 $2,533.50 2026-04-01
558 MS_DRG Tendonitis, Myositis And Buristis Without Mcc 5 3 $5,483.93 $2,741.97 50% off $1,475.00 $2,898.00 $2,186.50 2026-04-01
14040 HCPCS Tissue Transfer/rearrangement Neck <10cm 10 5 $4,284.00 $2,142.00 50% off $789.75 $789.75 $789.75 2026-04-01
42820 HCPCS Tonsil & Adenoid Removal <12yrs Old 10 5 $12,393.00 $6,196.50 50% off $373.68 $373.68 $373.68 2026-04-01
42821 HCPCS Tonsil & Adenoid Removal >12yrs Old 10 5 $6,522.00 $3,261.00 50% off $391.19 $391.19 $391.19 2026-04-01
42826 HCPCS Tonsil Removal >12yrs Old 10 5 $6,522.00 $3,261.00 50% off $327.60 $327.60 $327.60 2026-04-01
69 MS_DRG Transient Ischemia Without Thrombolytic 3 2 $4,955.62 $2,477.81 50% off $1,475.00 $1,475.00 $1,475.00 2026-04-01
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without M 5 3 $5,730.10 $2,865.05 50% off $1,475.00 $3,391.00 $2,433.00 2026-04-01
55250 HCPCS Vasectomy Unilateral Or Bilateral 10 5 $5,207.00 $2,603.50 50% off $290.79 $290.79 $290.79 2026-04-01
13151 HCPCS Wound Repair Complex Eyelid 1.1cm-2.5cm 12 5 $1,360.00 $680.00 50% off $300.00 $353.89 $326.94 2026-04-01
13152 HCPCS Wound Repair Complex Eyelid 2.6cm-7.5cm 12 5 $1,360.00 $680.00 50% off $300.00 $426.97 $363.49 2026-04-01
13153 HCPCS Wound Repair Complex Eyelid Ea Add'l 5cm 12 5 $577.00 $288.50 50% off $174.64 $300.00 $237.32 2026-04-01
13131 HCPCS Wound Repair Complex Forehead 1.1cm-2.5c 12 5 $1,162.00 $581.00 50% off $300.00 $307.06 $303.53 2026-04-01
13132 HCPCS Wound Repair Complex Forehead 2.6cm-7.5c 12 5 $1,360.00 $680.00 50% off $300.00 $385.24 $342.62 2026-04-01
13133 HCPCS Wound Repair Complex Forehead Ea Addl 5c 12 5 $489.00 $244.50 50% off $159.47 $300.00 $229.74 2026-04-01
13120 HCPCS Wound Repair Complex Scalp 1.1cm-2.5cm 12 5 $1,360.00 $680.00 50% off $293.71 $300.00 $296.86 2026-04-01
13121 HCPCS Wound Repair Complex Scalp 2.6cm-7.5cm 12 5 $1,360.00 $680.00 50% off $300.00 $327.06 $313.53 2026-04-01
13100 HCPCS Wound Repair Complex Trunk 1.1cm-2.5cm 12 5 $3,826.00 $1,913.00 50% off $254.64 $300.00 $277.32 2026-04-01
13101 HCPCS Wound Repair Complex Trunk 2.6cm-7.5cm 12 5 $1,360.00 $680.00 50% off $300.00 $313.26 $306.63 2026-04-01
12055 HCPCS Wound Repair Inter. Face 12.6cm-20.0cm 12 5 $878.00 $439.00 50% off $300.00 $381.49 $340.75 2026-04-01
12052 HCPCS Wound Repair Inter. Face 2.6cm-5cm 12 5 $878.00 $439.00 50% off $253.23 $300.00 $276.62 2026-04-01
12056 HCPCS Wound Repair Inter. Face 20.1cm-30.0cm 12 5 $878.00 $439.00 50% off $300.00 $487.40 $393.70 2026-04-01
12053 HCPCS Wound Repair Inter. Face 5.1cm-7.5cm 12 5 $878.00 $439.00 50% off $273.54 $300.00 $286.77 2026-04-01
12054 HCPCS Wound Repair Inter. Face 7.6cm-12.5cm 12 5 $878.00 $439.00 50% off $280.40 $300.00 $290.20 2026-04-01
12051 HCPCS Wound Repair Inter. Face <2.5cm 12 5 $660.00 $330.00 50% off $214.65 $300.00 $257.32 2026-04-01
12057 HCPCS Wound Repair Inter. Face >30.0cm 12 5 $660.00 $330.00 50% off $300.00 $532.16 $416.08 2026-04-01
12045 HCPCS Wound Repair Inter. Neck 12.6cm-20.0cm 12 5 $1,360.00 $680.00 50% off $300.00 $347.87 $323.94 2026-04-01
12042 HCPCS Wound Repair Inter. Neck 2.6cm-7.5cm 12 5 $878.00 $439.00 50% off $247.72 $300.00 $273.86 2026-04-01
12046 HCPCS Wound Repair Inter. Neck 20.1cm-30.0cm 12 5 $878.00 $439.00 50% off $300.00 $401.64 $350.82 2026-04-01
12044 HCPCS Wound Repair Inter. Neck 7.6cm-12.5cm 12 5 $1,360.00 $680.00 50% off $271.52 $300.00 $285.76 2026-04-01
12041 HCPCS Wound Repair Inter. Neck <2.5cm 12 5 $878.00 $439.00 50% off $184.46 $300.00 $242.23 2026-04-01
12047 HCPCS Wound Repair Inter. Neck >30.0cm 12 5 $4,284.00 $2,142.00 50% off $300.00 $447.19 $373.60 2026-04-01
12035 HCPCS Wound Repair Inter. Scalp 12.6cm-20.0cm 12 5 $878.00 $439.00 50% off $300.00 $305.86 $302.93 2026-04-01
12032 HCPCS Wound Repair Inter. Scalp 2.6cm-7.5cm 12 5 $878.00 $439.00 50% off $239.93 $300.00 $269.96 2026-04-01
12036 HCPCS Wound Repair Inter. Scalp 20.1cm-30.0cm 12 5 $1,360.00 $680.00 50% off $300.00 $357.36 $328.68 2026-04-01
12034 HCPCS Wound Repair Inter. Scalp 7.6cm-12.5cm 12 5 $878.00 $439.00 50% off $260.42 $300.00 $280.21 2026-04-01
12031 HCPCS Wound Repair Inter. Scalp <2.5cm 12 5 $878.00 $439.00 50% off $191.71 $300.00 $245.85 2026-04-01
12037 HCPCS Wound Repair Inter. Scalp >30.0cm 12 5 $7,515.00 $3,757.50 50% off $300.00 $415.67 $357.83 2026-04-01
12016 HCPCS Wound Repair Simple Face 12.6cm-20.0cm 12 5 $460.00 $230.00 50% off $165.50 $300.00 $232.75 2026-04-01
12017 HCPCS Wound Repair Simple Face 20.1cm-30.0cm 12 5 $878.00 $439.00 50% off $198.62 $300.00 $249.31 2026-04-01
12018 HCPCS Wound Repair Simple Face >30.0cm 12 5 $690.00 $345.00 50% off $224.35 $300.00 $262.18 2026-04-01
12007 HCPCS Wound Repair Simple Scalp >30.0cm 12 5 $612.00 $306.00 50% off $186.66 $300.00 $243.33 2026-04-01
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