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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

WEATHERFORD REGIONAL HOSPITAL, INC OF WEATHERFORD

Weatherford, OK · CCN 371323 · Rates published

2,731 distinct procedures filed
13 distinct payers
30,592 rate rows
2026-01-05 last MRF observed
Data quality

30,067 of 30,592 rate rows are consumer-grade (98.3%)

525 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
per-diem day rate — not a per-procedure price 214
exceeds 10× this hospital's gross charge — excluded from medians 175
exceeds 3× this hospital's gross charge for a DRG stay — excluded 88
percent-of-charges filed in the dollar field — excluded from medians 48
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbWRHIWEATHERFORDOK&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Weatherford.aspx#
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint a7800be429891fc9… · 11,204,070 bytes · first seen 2026-05-08

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
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 7 $9,010.98 $25,030.50 $23,778.98 nat. median
$2,076
outlier · 11.5×
J9043
HCPCS 		Injection, Cabazitaxel, 1 Mg 13 $77.47 $55,999.50 $20,159.82 nat. median
$739
outlier · 27.3×
J0491
HCPCS 		Injection, Anifrolumab-fnia, 1 Mg 7 $7,488.90 $20,802.50 $19,762.38 nat. median
$54
outlier · 366.8×
J2356
HCPCS 		Injection, Tezepelumab-ekko, 1 Mg 7 $6,134.04 $17,039.00 $16,187.05 nat. median
$66
outlier · 244.5×
208
MS_DRG 		Respiratory System Diagnosis With Ventilator Support <=96 Hours 8 $7,674.48 $22,456.88 $16,100.01 nat. median
$26,748
0.6× median
559
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Mcc 11 $12,547.05 $58,475.70 $14,103.58 nat. median
$19,049
0.7× median
314
MS_DRG 		Other Circulatory System Diagnoses With Mcc 12 $8,644.62 $27,190.40 $14,029.23 nat. median
$20,753
0.7× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 11 $9,141.82 $27,972.94 $13,069.14 nat. median
$19,635
0.7× median
J1306
HCPCS 		Injection, Inclisiran, 1 Mg 7 $4,843.44 $13,454.00 $12,781.30 nat. median
$57
outlier · 226.1×
J9228
HCPCS 		Injection, Ipilimumab, 1 Mg 13 $77.47 $34,621.50 $12,463.74 nat. median
$9,906
1.3× median
742
MS_DRG 		Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 10 $8,606.67 $20,280.04 $12,344.53 nat. median
$18,902
0.7× median
913
MS_DRG 		Traumatic Injury With Mcc 12 $10,177.27 $40,866.34 $12,176.14 nat. median
$16,480
0.7× median
J9301
HCPCS 		Injection, Obinutuzumab, 10 Mg 13 $19.63 $33,590.00 $12,092.40 nat. median
$314
outlier · 38.5×
371
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 11 $9,052.01 $20,407.80 $11,929.42 nat. median
$17,809
0.7× median
884
MS_DRG 		Organic Disturbances And Intellectual Disability 12 $6,107.34 $36,439.42 $11,672.76 nat. median
$14,856
0.8× median
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 13 $77.47 $32,359.50 $11,649.42 nat. median
$5,949
2.0× median
580
MS_DRG 		Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 10 $7,907.28 $21,004.74 $11,625.98 nat. median
$17,923
0.6× median
70
MS_DRG 		Other Cerebrovascular Disorders With Mcc 10 $5,888.62 $18,401.03 $11,200.77 nat. median
$17,286
0.6× median
698
MS_DRG 		Other Kidney And Urinary Tract Diagnoses With Mcc 9 $4,893.93 $13,516.45 $11,130.80 nat. median
$16,677
0.7× median
J0180
HCPCS 		Injection, Agalsidase Beta, 1 Mg 13 $77.47 $30,527.50 $10,989.90 nat. median
$1,688
outlier · 6.5×
438
MS_DRG 		Disorders Of Pancreas Except Malignancy With Mcc 11 $8,133.24 $18,898.90 $10,967.99 nat. median
$16,973
0.6× median
J2802
HCPCS 		Injection, Romiplostim, 1 Microgram 7 $3,865.32 $21,473.50 $10,586.56 nat. median
$2,983
outlier · 3.5×
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 10 $7,236.55 $17,272.52 $10,513.85 nat. median
$16,235
0.6× median
564
MS_DRG 		Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 11 $6,177.38 $17,061.41 $10,385.34 nat. median
$15,782
0.7× median
183
MS_DRG 		Major Chest Trauma With Mcc 12 $7,227.30 $17,945.28 $10,293.17 nat. median
$15,869
0.6× median
57
MS_DRG 		Degenerative Nervous System Disorders Without Mcc 12 $6,083.85 $32,066.78 $9,650.92 nat. median
$13,201
0.7× median
J9306
HCPCS 		Injection, Pertuzumab, 1 Mg 13 $8.26 $26,600.00 $9,576.00 nat. median
$87
outlier · 110.5×
602
MS_DRG 		Cellulitis With Mcc 11 $6,718.75 $15,709.63 $9,562.51 nat. median
$14,838
0.6× median
205
MS_DRG 		Other Respiratory System Diagnoses With Mcc 8 $4,398.03 $12,318.97 $9,197.44 nat. median
$18,295
0.5× median
640
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 10 $5,777.19 $14,762.39 $8,985.92 nat. median
$13,400
0.7× median
555
MS_DRG 		Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc 11 $6,474.45 $42,148.94 $8,893.07 nat. median
$13,889
0.6× median
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 11 $5,107.65 $15,466.26 $8,843.28 nat. median
$13,648
0.6× median
291
MS_DRG 		Heart Failure And Shock With Mcc 10 $6,261.87 $14,189.84 $8,637.41 nat. median
$13,522
0.6× median
535
MS_DRG 		Fractures Of Hip And Pelvis With Mcc 10 $6,349.14 $14,169.95 $8,625.30 nat. median
$13,519
0.6× median
947
MS_DRG 		Signs And Symptoms With Mcc 12 $6,258.73 $23,669.59 $8,540.52 nat. median
$12,688
0.7× median
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 11 $6,167.09 $42,260.50 $8,533.12 nat. median
$13,246
0.6× median
743
MS_DRG 		Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc 10 $5,969.70 $17,850.97 $8,347.43 nat. median
$13,187
0.6× median
189
MS_DRG 		Pulmonary Edema And Respiratory Failure 12 $5,563.72 $16,803.04 $8,311.77 nat. median
$13,021
0.6× median
J9271
HCPCS 		Injection, Pembrolizumab, 1 Mg 13 $19.63 $23,001.50 $8,280.54 nat. median
$736
outlier · 11.2×
J0517
HCPCS 		Injection, Benralizumab, 1 Mg 13 $77.47 $22,803.50 $8,209.26 nat. median
$919
outlier · 8.9×
593
MS_DRG 		Skin Ulcers With Cc 8 $3,458.00 $9,692.07 $7,981.43 nat. median
$12,573
0.6× median
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 10 $5,732.74 $12,824.80 $7,806.50 nat. median
$12,152
0.6× median
71
MS_DRG 		Other Cerebrovascular Disorders With Cc 12 $5,561.67 $31,127.90 $7,642.68 nat. median
$11,209
0.7× median
436
MS_DRG 		Malignancy Of Hepatobiliary System Or Pancreas With Cc 12 $4,036.34 $12,502.05 $7,610.04 nat. median
$12,086
0.6× median
560
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Cc 11 $6,770.95 $34,781.27 $7,576.40 nat. median
$12,148
0.6× median
787
MS_DRG 		Cesarean Section Without Sterilization With Cc 10 $3,377.47 $14,849.18 $7,513.83 nat. median
$11,413
0.7× median
J2406
HCPCS 		Injection, Oritavancin (kimyrsa), 10 Mg 13 $17.04 $20,814.00 $7,493.04 nat. median
$63
outlier · 119.1×
190
MS_DRG 		Chronic Obstructive Pulmonary Disease With Mcc 11 $4,832.03 $12,243.41 $7,452.61 nat. median
$11,700
0.6× median
805
MS_DRG 		Vaginal Delivery Without Sterilization Or D&c With Mcc 10 $2,838.86 $11,928.40 $7,260.86 nat. median
$10,237
0.7× median
768
MS_DRG 		Vaginal Delivery With O.r. Procedures Except Sterilization And/or D&c 10 $2,821.51 $19,229.71 $7,209.72 nat. median
$10,536
0.7× median

Other procedures at this hospital

Browse this hospital's 2,731 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
             
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 7 7 $25,030.50 $20,024.40 $9,010.98 $25,030.50 $23,778.98 2026-01-05
J9043 HCPCS Injection, Cabazitaxel, 1 Mg 13 13 $55,999.50 $44,799.60 20% off $77.47 $55,999.50 $20,159.82 2026-01-05
J0491 HCPCS Injection, Anifrolumab-fnia, 1 Mg 7 7 $20,802.50 $16,642.00 20% off $7,488.90 $20,802.50 $19,762.38 2026-01-05
J2356 HCPCS Injection, Tezepelumab-ekko, 1 Mg 7 7 $17,039.00 $13,631.20 $6,134.04 $17,039.00 $16,187.05 2026-01-05
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 8 8 $8,078.40 $6,462.72 $7,674.48 $22,456.88 $16,100.01 2026-01-05
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 11 11 $20,703.70 $16,562.96 20% off $12,547.05 $58,475.70 $14,103.58 2026-01-05
314 MS_DRG Other Circulatory System Diagnoses With Mcc 12 12 $9,099.60 $7,279.68 20% off $8,644.62 $27,190.40 $14,029.23 2026-01-05
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 11 11 $12,466.54 $9,973.23 20% off $9,141.82 $27,972.94 $13,069.14 2026-01-05
J1306 HCPCS Injection, Inclisiran, 1 Mg 7 7 $13,454.00 $10,763.20 $4,843.44 $13,454.00 $12,781.30 2026-01-05
J9228 HCPCS Injection, Ipilimumab, 1 Mg 13 13 $34,621.50 $27,697.20 20% off $77.47 $34,621.50 $12,463.74 2026-01-05
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 10 10 $20,895.49 $16,716.39 20% off $8,606.67 $20,280.04 $12,344.53 2026-01-05
913 MS_DRG Traumatic Injury With Mcc 12 12 $17,606.74 $14,085.39 20% off $10,177.27 $40,866.34 $12,176.14 2026-01-05
J9301 HCPCS Injection, Obinutuzumab, 10 Mg 13 13 $33,590.00 $26,872.00 20% off $19.63 $33,590.00 $12,092.40 2026-01-05
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 11 11 $10,070.20 $8,056.16 20% off $9,052.01 $20,407.80 $11,929.42 2026-01-05
884 MS_DRG Organic Disturbances And Intellectual Disability 12 12 $13,179.82 $10,543.85 20% off $6,107.34 $36,439.42 $11,672.76 2026-01-05
J3101 HCPCS Injection, Tenecteplase, 1 Mg 13 13 $32,359.50 $25,887.60 20% off $77.47 $32,359.50 $11,649.42 2026-01-05
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 10 10 $22,110.25 $17,688.20 $7,907.28 $21,004.74 $11,625.98 2026-01-05
70 MS_DRG Other Cerebrovascular Disorders With Mcc 10 10 $6,198.55 $4,958.84 20% off $5,888.62 $18,401.03 $11,200.77 2026-01-05
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 9 9 $5,151.50 $4,121.20 20% off $4,893.93 $13,516.45 $11,130.80 2026-01-05
J0180 HCPCS Injection, Agalsidase Beta, 1 Mg 13 13 $30,527.50 $24,422.00 20% off $77.47 $30,527.50 $10,989.90 2026-01-05
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 11 11 $8,561.30 $6,849.04 $8,133.24 $18,898.90 $10,967.99 2026-01-05
J2802 HCPCS Injection, Romiplostim, 1 Microgram 14 7 $16,105.25 $12,884.20 $3,865.32 $21,473.50 $10,586.56 2026-01-05
177 MS_DRG Respiratory Infections And Inflammations With Mcc 10 10 $11,144.83 $8,915.86 20% off $7,236.55 $17,272.52 $10,513.85 2026-01-05
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 11 11 $6,502.50 $5,202.00 20% off $6,177.38 $17,061.41 $10,385.34 2026-01-05
183 MS_DRG Major Chest Trauma With Mcc 12 12 $7,607.68 $6,086.14 20% off $7,227.30 $17,945.28 $10,293.17 2026-01-05
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 12 12 $11,391.58 $9,113.26 20% off $6,083.85 $32,066.78 $9,650.92 2026-01-05
J9306 HCPCS Injection, Pertuzumab, 1 Mg 13 13 $26,600.00 $21,280.00 20% off $8.26 $26,600.00 $9,576.00 2026-01-05
602 MS_DRG Cellulitis With Mcc 11 11 $7,127.10 $5,701.68 20% off $6,718.75 $15,709.63 $9,562.51 2026-01-05
205 MS_DRG Other Respiratory System Diagnoses With Mcc 8 8 $4,629.50 $3,703.60 20% off $4,398.03 $12,318.97 $9,197.44 2026-01-05
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 10 10 $10,492.90 $8,394.32 20% off $5,777.19 $14,762.39 $8,985.92 2026-01-05
555 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc 11 11 $16,304.94 $13,043.95 20% off $6,474.45 $42,148.94 $8,893.07 2026-01-05
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 11 11 $7,713.06 $6,170.45 $5,107.65 $15,466.26 $8,843.28 2026-01-05
291 MS_DRG Heart Failure And Shock With Mcc 10 10 $6,591.44 $5,273.16 $6,261.87 $14,189.84 $8,637.41 2026-01-05
535 MS_DRG Fractures Of Hip And Pelvis With Mcc 10 10 $6,683.30 $5,346.64 20% off $6,349.14 $14,169.95 $8,625.30 2026-01-05
947 MS_DRG Signs And Symptoms With Mcc 12 12 $8,163.19 $6,530.55 20% off $6,258.73 $23,669.59 $8,540.52 2026-01-05
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 11 11 $14,428.50 $11,542.80 20% off $6,167.09 $42,260.50 $8,533.12 2026-01-05
743 MS_DRG Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc 10 10 $18,790.50 $15,032.40 20% off $5,969.70 $17,850.97 $8,347.43 2026-01-05
189 MS_DRG Pulmonary Edema And Respiratory Failure 12 12 $6,465.44 $5,172.35 20% off $5,563.72 $16,803.04 $8,311.77 2026-01-05
J9271 HCPCS Injection, Pembrolizumab, 1 Mg 13 13 $23,001.50 $18,401.20 $19.63 $23,001.50 $8,280.54 2026-01-05
J0517 HCPCS Injection, Benralizumab, 1 Mg 13 13 $22,803.50 $18,242.80 20% off $77.47 $22,803.50 $8,209.26 2026-01-05
593 MS_DRG Skin Ulcers With Cc 8 8 $3,640.00 $2,912.00 20% off $3,458.00 $9,692.07 $7,981.43 2026-01-05
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 10 10 $7,896.21 $6,316.96 20% off $5,732.74 $12,824.80 $7,806.50 2026-01-05
71 MS_DRG Other Cerebrovascular Disorders With Cc 12 12 $13,037.10 $10,429.68 20% off $5,561.67 $31,127.90 $7,642.68 2026-01-05
436 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Cc 12 12 $4,248.78 $3,399.02 20% off $4,036.34 $12,502.05 $7,610.04 2026-01-05
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 11 11 $12,913.27 $10,330.62 $6,770.95 $34,781.27 $7,576.40 2026-01-05
787 MS_DRG Cesarean Section Without Sterilization With Cc 10 10 $15,630.72 $12,504.58 $3,377.47 $14,849.18 $7,513.83 2026-01-05
J2406 HCPCS Injection, Oritavancin (kimyrsa), 10 Mg 13 13 $20,814.00 $16,651.20 $17.04 $20,814.00 $7,493.04 2026-01-05
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 11 11 $5,086.35 $4,069.08 20% off $4,832.03 $12,243.41 $7,452.61 2026-01-05
805 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Mcc 10 10 $7,932.25 $6,345.80 20% off $2,838.86 $11,928.40 $7,260.86 2026-01-05
768 MS_DRG Vaginal Delivery With O.r. Procedures Except Sterilization And/or D&c 10 10 $20,241.80 $16,193.44 $2,821.51 $19,229.71 $7,209.72 2026-01-05
784 MS_DRG Cesarean Section With Sterilization With Cc 10 10 $10,065.34 $8,052.27 20% off $3,715.87 $11,717.29 $7,132.35 2026-01-05
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 12 12 $7,641.90 $6,113.52 $4,520.50 $20,563.90 $7,064.55 2026-01-05
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 11 11 $12,323.31 $9,858.65 $4,344.99 $27,829.71 $6,884.76 2026-01-05
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 12 12 $6,305.55 $5,044.44 20% off $5,990.27 $16,643.15 $6,797.30 2026-01-05
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 12 12 $7,235.02 $5,788.02 $5,749.60 $20,157.02 $6,683.91 2026-01-05
540 MS_DRG Osteomyelitis With Cc 7 7 $3,333.69 $2,666.95 20% off $3,167.01 $8,721.51 $6,622.52 2026-01-05
378 MS_DRG Gastrointestinal Hemorrhage With Cc 10 10 $7,753.90 $6,203.12 20% off $5,055.09 $10,839.68 $6,598.15 2026-01-05
178 MS_DRG Respiratory Infections And Inflammations With Cc 11 11 $7,282.50 $5,826.00 20% off $5,013.33 $15,035.70 $6,566.53 2026-01-05
202 MS_DRG Bronchitis And Asthma With Cc/mcc 11 11 $8,961.00 $7,168.80 20% off $2,996.25 $19,298.60 $6,534.23 2026-01-05
552 MS_DRG Medical Back Problems Without Mcc 10 10 $6,666.24 $5,332.99 20% off $4,934.32 $10,625.25 $6,467.63 2026-01-05
788 MS_DRG Cesarean Section Without Sterilization Without Cc/mcc 10 10 $15,626.00 $12,500.80 20% off $2,890.99 $14,844.70 $6,450.81 2026-01-05
785 MS_DRG Cesarean Section With Sterilization Without Cc/mcc 10 10 $15,757.55 $12,606.04 $3,142.48 $14,969.67 $6,444.08 2026-01-05
798 MS_DRG Vaginal Delivery With Sterilization And/or D&c Without Cc/mcc 10 10 $14,470.77 $11,576.62 $3,259.87 $13,747.23 $6,439.37 2026-01-05
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 10 10 $9,154.30 $7,323.44 20% off $4,257.65 $10,401.98 $6,331.72 2026-01-05
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 12 12 $12,391.06 $9,912.85 $4,052.79 $35,650.66 $6,187.14 2026-01-05
812 MS_DRG Red Blood Cell Disorders Without Mcc 10 10 $18,528.44 $14,822.75 20% off $4,368.34 $17,602.02 $6,177.65 2026-01-05
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 12 12 $6,969.40 $5,575.52 $3,537.18 $17,307.00 $6,029.97 2026-01-05
638 MS_DRG Diabetes With Cc 11 11 $11,140.40 $8,912.32 20% off $4,036.78 $24,062.40 $6,029.63 2026-01-05
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 12 12 $4,898.13 $3,918.51 $3,568.50 $12,651.33 $6,009.45 2026-01-05
864 MS_DRG Fever And Inflammatory Conditions 11 11 $10,324.20 $8,259.36 20% off $3,174.02 $23,246.20 $5,972.45 2026-01-05
948 MS_DRG Signs And Symptoms Without Mcc 12 12 $17,125.60 $13,700.48 $4,301.75 $48,138.40 $5,962.93 2026-01-05
J9173 HCPCS Injection, Durvalumab, 10 Mg 13 13 $16,421.00 $13,136.80 20% off $38.73 $16,421.00 $5,911.56 2026-01-05
683 MS_DRG Renal Failure With Cc 11 11 $10,521.30 $8,417.04 $3,940.77 $23,443.30 $5,892.38 2026-01-05
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 13 13 $16,282.50 $13,026.00 20% off $77.47 $16,282.50 $5,861.70 2026-01-05
603 MS_DRG Cellulitis Without Mcc 11 11 $7,396.43 $5,917.14 20% off $3,895.20 $15,149.63 $5,859.42 2026-01-05
869 MS_DRG Other Infectious And Parasitic Diseases Diagnoses Without Cc/mcc 12 12 $7,060.70 $5,648.56 $4,909.42 $17,398.30 $5,746.81 2026-01-05
292 MS_DRG Heart Failure And Shock With Cc 11 11 $9,029.13 $7,223.30 20% off $4,300.83 $19,366.73 $5,712.07 2026-01-05
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 11 11 $8,030.00 $6,424.00 20% off $4,294.48 $18,367.60 $5,671.70 2026-01-05
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 11 11 $4,065.63 $3,252.50 20% off $3,862.34 $9,297.78 $5,659.59 2026-01-05
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 12 12 $8,886.02 $7,108.82 $3,640.81 $21,808.02 $5,624.00 2026-01-05
Q5113 HCPCS Injection, Trastuzumab-pkrb, Biosimilar, (herzuma), 10 Mg 13 13 $15,315.50 $12,252.40 20% off $0.13 $15,315.50 $5,513.58 2026-01-05
Q5120 HCPCS Injection, Pegfilgrastim-bmez (ziextenzo), Biosimilar, 0.5 Mg 13 13 $15,310.00 $12,248.00 20% off $77.47 $15,310.00 $5,511.60 2026-01-05
728 MS_DRG Inflammation Of The Male Reproductive System Without Mcc 10 10 $10,304.00 $8,243.20 $4,525.37 $9,788.80 $5,457.75 2026-01-05
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 11 11 $6,020.00 $4,816.00 20% off $4,884.80 $15,960.00 $5,433.53 2026-01-05
204 MS_DRG Respiratory Signs And Symptoms 12 12 $3,623.00 $2,898.40 20% off $2,852.90 $8,924.19 $5,432.19 2026-01-05
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 11 11 $9,334.05 $7,467.24 $4,158.75 $19,671.65 $5,422.10 2026-01-05
176 MS_DRG Pulmonary Embolism Without Mcc 12 12 $3,884.50 $3,107.60 20% off $3,690.28 $11,637.70 $5,416.04 2026-01-05
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc 11 11 $12,763.52 $10,210.82 $4,301.32 $34,631.52 $5,408.64 2026-01-05
Q5117 HCPCS Injection, Trastuzumab-anns, Biosimilar, (kanjinti), 10 Mg 13 13 $14,852.00 $11,881.60 20% off $38.73 $14,852.00 $5,346.72 2026-01-05
J0565 HCPCS Injection, Bezlotoxumab, 10 Mg 13 13 $14,820.00 $11,856.00 20% off $17.04 $14,820.00 $5,335.20 2026-01-05
J2182 HCPCS Injection, Mepolizumab, 1 Mg 13 13 $14,818.50 $11,854.80 20% off $8.26 $14,818.50 $5,334.66 2026-01-05
389 MS_DRG Gastrointestinal Obstruction With Cc 11 11 $2,884.50 $2,307.60 20% off $2,740.27 $8,053.30 $5,313.77 2026-01-05
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 11 11 $7,068.53 $5,654.83 $3,373.09 $14,821.73 $5,245.15 2026-01-05
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 12 12 $3,405.72 $2,724.58 $3,194.05 $8,601.44 $5,235.73 2026-01-05
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 20 13 $25,112.00 $20,089.60 20% off $77.47 $25,112.00 $5,152.88 2026-01-05
156 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/mcc 12 12 $7,519.60 $6,015.68 20% off $2,507.93 $17,857.20 $5,148.01 2026-01-05
806 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Cc 10 10 $12,192.27 $9,753.81 20% off $2,203.75 $11,582.65 $5,072.91 2026-01-05
443 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without C… 10 10 $5,050.85 $4,040.68 20% off $4,707.58 $7,733.78 $5,050.85 2026-01-05
153 MS_DRG Otitis Media And Uri Without Mcc 9 9 $2,671.50 $2,137.20 20% off $2,237.75 $7,094.84 $4,966.61 2026-01-05
J1437 HCPCS Injection, Ferric Derisomaltose, 10 Mg 13 13 $13,696.00 $10,956.80 20% off $8.26 $13,696.00 $4,930.56 2026-01-05
776 MS_DRG Postpartum And Post Abortion Diagnoses Without O.r. Procedures 12 12 $5,537.60 $4,430.08 20% off $2,704.19 $13,290.80 $4,832.77 2026-01-05
779 MS_DRG Abortion Without D&c 10 10 $3,428.50 $2,742.80 $2,397.60 $7,881.89 $4,797.74 2026-01-05
90375 HCPCS Rabies Immune Globulin For Injection 13 13 $13,270.00 $10,616.00 20% off $33.89 $13,270.00 $4,777.20 2026-01-05
815123_1 CDM Operating Room Services - General Classification 4 4 $10,000.00 $8,000.00 20% off $3,600.00 $9,500.00 $4,770.00 2026-01-05
700 MS_DRG Other Kidney And Urinary Tract Diagnoses Without Cc/mcc 9 9 $2,113.50 $1,690.80 20% off $2,007.83 $5,636.48 $4,641.65 2026-01-05
387 MS_DRG Inflammatory Bowel Disease Without Cc/mcc 12 12 $4,561.95 $3,649.56 20% off $3,703.53 $12,315.15 $4,583.79 2026-01-05
807 MS_DRG Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc 10 10 $10,392.05 $8,313.64 20% off $1,876.77 $9,872.45 $4,536.02 2026-01-05
59412 HCPCS Turning Of Fetus Through External Manipulation 7 7 $4,757.00 $3,805.60 20% off $1,712.52 $4,757.00 $4,519.15 2026-01-05
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 12 12 $4,773.36 $3,818.68 20% off $3,130.84 $12,526.56 $4,381.62 2026-01-05
395 MS_DRG Other Digestive System Diagnoses Without Cc/mcc 10 10 $5,338.50 $4,270.80 $3,781.62 $7,173.40 $4,366.47 2026-01-05
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 11 11 $4,998.17 $3,998.53 20% off $3,735.41 $10,166.97 $4,319.38 2026-01-05
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 11 11 $6,039.67 $4,831.73 20% off $3,184.53 $13,792.87 $4,180.78 2026-01-05
639 MS_DRG Diabetes Without Cc/mcc 10 10 $4,156.75 $3,325.40 20% off $3,160.97 $6,866.12 $4,179.43 2026-01-05
811386_1 CDM Operating Room Services - General Classification 4 4 $8,700.00 $6,960.00 20% off $3,132.00 $8,265.00 $4,149.90 2026-01-05
684 MS_DRG Renal Failure Without Cc/mcc 10 10 $4,522.20 $3,617.76 $2,587.37 $6,635.12 $4,038.82 2026-01-05
Q5107 HCPCS Injection, Bevacizumab-awwb, Biosimilar, (mvasi), 10 Mg 13 13 $10,884.50 $8,707.60 $38.73 $10,884.50 $3,918.42 2026-01-05
36557 HCPCS Insertion Of Tunneled Central Venous Tube For Infusion (younger Than 5 Years) 13 13 $7,838.27 $6,270.62 $2,813.10 $7,838.27 $3,809.40 2026-01-05
293 MS_DRG Heart Failure And Shock Without Cc/mcc 11 11 $6,201.80 $4,961.44 20% off $3,368.93 $13,955.00 $3,808.05 2026-01-05
Q0249 HCPCS Injection, Tocilizumab, For Hospitalized Adults And Pediatric Patients (2 Years … 13 13 $10,358.00 $8,286.40 20% off $3.62 $10,358.00 $3,728.88 2026-01-05
61583 HCPCS Removal Of Facial Bone To Approach Growth Of Brain Within Brain Membrane 13 13 $8,444.00 $6,755.20 20% off $2,685.41 $8,444.00 $3,625.30 2026-01-05
390 MS_DRG Gastrointestinal Obstruction Without Cc/mcc 10 10 $1,586.65 $1,269.32 20% off $1,507.32 $4,444.48 $3,617.34 2026-01-05
951 MS_DRG Other Factors Influencing Health Status 8 8 $1,607.10 $1,285.68 $1,526.75 $4,542.52 $3,590.12 2026-01-05
Q5114 HCPCS Injection, Trastuzumab-dkst, Biosimilar, (ogivri), 10 Mg 20 13 $10,238.00 $8,190.40 20% off $38.73 $10,238.00 $3,576.30 2026-01-05
J9317 HCPCS Injection, Sacituzumab Govitecan-hziy, 2.5 Mg 13 13 $9,802.00 $7,841.60 $19.63 $9,802.00 $3,528.72 2026-01-05
833 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures Without Cc/mcc 10 10 $2,622.31 $2,097.85 $1,819.00 $5,779.61 $3,518.07 2026-01-05
793 MS_DRG Full Term Neonate With Major Problems 3 3 $3,445.00 $2,756.00 20% off $3,272.75 $3,445.00 $3,445.00 2026-01-05
49999 HCPCS Other Procedure On Abdomen 3 3 $3,442.00 $2,753.60 20% off $3,442.00 $3,442.00 $3,442.00 2026-01-05
36810 HCPCS Insertion Of Tube Connecting Artery To Vein For Hemodialysis 13 13 $4,563.88 $3,651.10 20% off $1,643.00 $4,618.47 $3,412.30 2026-01-05
36558 HCPCS Insertion Of Tunneled Central Venous Tube For Infusion (5 Years Or Older) 13 13 $4,563.88 $3,651.10 20% off $1,643.00 $4,618.47 $3,412.30 2026-01-05
36585 HCPCS Replacement Of Peripherally Inserted Central Venous Tube (picc) With Port 13 13 $4,563.88 $3,651.10 20% off $1,643.00 $4,618.47 $3,412.30 2026-01-05
36571 HCPCS Insertion Of Central Venous Tube With Port For Infusion (5 Years Or Older) 13 13 $4,563.88 $3,651.10 20% off $1,643.00 $4,618.47 $3,412.30 2026-01-05
59510 HCPCS Cesarean Delivery With Care Before And After Delivery 13 13 $4,344.00 $3,475.20 20% off $2,305.33 $4,344.00 $3,112.20 2026-01-05
58578 HCPCS Other Procedure On Uterus Using An Endoscope 3 3 $3,000.00 $2,400.00 20% off $3,000.00 $3,000.00 $3,000.00 2026-01-05
61601 HCPCS Removal Of Growth Or Tissue Of Front Of Skull Base Within Membranes Covering Bra… 13 13 $7,041.00 $5,632.80 20% off $2,205.91 $7,041.00 $2,977.98 2026-01-05
C5271 HCPCS Application Of Low Cost Skin Substitute Graft To Trunk, Arms, Legs, Total Wound … 13 13 $3,257.00 $2,605.60 20% off $1,172.52 $4,020.73 $2,970.66 2026-01-05
59871 HCPCS Removal Of Suture Of Cervix Under Anesthesia 13 13 $4,757.00 $3,805.60 20% off $1,712.52 $4,757.00 $2,969.00 2026-01-05
J9145 HCPCS Injection, Daratumumab, 10 Mg 20 13 $3,025.00 $2,420.00 20% off $19.63 $11,471.50 $2,949.38 2026-01-05
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 13 13 $8,141.50 $6,513.20 20% off $77.47 $8,141.50 $2,930.94 2026-01-05
789 MS_DRG Neonates, Died Or Transferred To Another Acute Care Facility 3 3 $2,900.00 $2,320.00 20% off $2,755.00 $2,900.00 $2,900.00 2026-01-05
59400 HCPCS Vaginal Delivery With Care Before And After Delivery 13 13 $3,903.00 $3,122.40 20% off $2,068.67 $3,903.00 $2,792.70 2026-01-05
998 MS_DRG Principal Diagnosis Invalid As Discharge Diagnosis 4 4 $6,374.10 $5,099.28 20% off $2,740.23 $6,055.40 $2,740.23 2026-01-05
J0897 HCPCS Injection, Denosumab, 1 Mg 27 13 $7,314.50 $5,851.60 $8.26 $13,454.00 $2,633.22 2026-01-05
831 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Mcc 6 6 $1,586.70 $1,269.36 20% off $1,507.37 $4,171.10 $2,580.70 2026-01-05
J9075 HCPCS Injection, Cyclophosphamide, Not Otherwise Specified, 5 Mg 7 7 $2,683.50 $2,146.80 $966.06 $2,683.50 $2,549.33 2026-01-05
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 3 3 $2,538.30 $2,030.64 20% off $2,411.39 $2,538.30 $2,538.30 2026-01-05
J1670 HCPCS Injection, Tetanus Immune Globulin, Human, Up To 250 Units 7 7 $2,532.00 $2,025.60 20% off $911.52 $2,532.00 $2,405.40 2026-01-05
794 MS_DRG Neonate With Other Significant Problems 4 4 $3,209.54 $2,567.63 20% off $2,399.58 $3,049.06 $2,399.58 2026-01-05
811385_1 CDM Operating Room Services - General Classification 4 4 $5,000.00 $4,000.00 20% off $1,800.00 $4,750.00 $2,385.00 2026-01-05
J0248 HCPCS Injection, Remdesivir, 1 Mg 7 7 $2,476.00 $1,980.80 20% off $891.36 $2,476.00 $2,352.20 2026-01-05
792 MS_DRG Prematurity Without Major Problems 3 3 $2,334.83 $1,867.87 $2,218.09 $2,334.83 $2,334.83 2026-01-05
36590 HCPCS Removal Of Central Venous Tube With Port Or Pump 13 13 $2,252.49 $1,801.99 20% off $810.90 $4,048.12 $2,252.49 2026-01-05
J9264 HCPCS Injection, Paclitaxel Protein-bound Particles, 1 Mg 13 13 $6,162.50 $4,930.00 20% off $8.26 $6,162.50 $2,218.50 2026-01-05
J1439 HCPCS Injection, Ferric Carboxymaltose, 1 Mg 13 13 $5,982.50 $4,786.00 20% off $0.78 $5,982.50 $2,153.70 2026-01-05
J0129 HCPCS Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere… 13 13 $5,903.50 $4,722.80 $17.04 $5,903.50 $2,125.26 2026-01-05
19083 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, First Growth 13 13 $2,210.00 $1,768.00 20% off $795.60 $3,156.47 $2,099.50 2026-01-05
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 4 4 $2,012.50 $1,610.00 20% off $1,911.88 $5,768.79 $2,012.50 2026-01-05
61548 HCPCS Removal Of Growth Of Pituitary Gland 13 13 $4,747.29 $3,797.83 20% off $1,377.96 $4,747.29 $1,874.76 2026-01-05
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 13 13 $5,126.50 $4,101.20 20% off $3.62 $5,126.50 $1,845.54 2026-01-05
J9299 HCPCS Injection, Nivolumab, 1 Mg 13 13 $5,062.00 $4,049.60 20% off $8.26 $5,062.00 $1,822.32 2026-01-05
10121 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Complex 13 13 $3,735.00 $2,988.00 20% off $1,194.58 $3,735.00 $1,747.98 2026-01-05
ERX154799_1 CDM Infasurf 35 Mg/ml Vial 4 4 $3,644.50 $2,915.60 20% off $1,312.02 $3,462.28 $1,738.43 2026-01-05
59409 HCPCS Vaginal Delivery 26 13 $3,478.50 $2,782.80 $680.34 $4,757.00 $1,735.20 2026-01-05
Q0138 HCPCS Injection, Ferumoxytol, For Treatment Of Iron Deficiency Anemia, 1 Mg (non-esrd … 13 13 $4,655.50 $3,724.40 20% off $0.78 $4,655.50 $1,675.98 2026-01-05
J1745 HCPCS Injection, Infliximab, Excludes Biosimilar, 10 Mg 13 13 $4,554.50 $3,643.60 20% off $38.73 $4,554.50 $1,639.62 2026-01-05
SUP107734_1 CDM Sys Jada 2002 Hemorage Vac Vlv Blu Kt 4 4 $3,418.00 $2,734.40 20% off $1,230.48 $3,247.10 $1,630.38 2026-01-05
J2407 HCPCS Injection, Oritavancin (orbactiv), 10 Mg 13 13 $4,527.50 $3,622.00 20% off $8.26 $4,527.50 $1,629.90 2026-01-05
30420 HCPCS Reshaping Of Bony Cartilage Dividing Nasal Passages 13 13 $425.00 $340.00 20% off $425.00 $2,076.19 $1,581.74 2026-01-05
59515 HCPCS Cesarean Delivery With Care After Delivery 13 13 $3,300.00 $2,640.00 20% off $1,147.08 $3,300.00 $1,548.56 2026-01-05
Q4081 HCPCS Injection, Epoetin Alfa, 100 Units (for Esrd On Dialysis) 13 13 $4,169.50 $3,335.60 20% off $0.78 $4,169.50 $1,501.02 2026-01-05
J0666 HCPCS Injection, Bupivacaine Liposome, 1 Mg 7 7 $1,555.00 $1,244.00 20% off $559.80 $1,555.00 $1,477.25 2026-01-05
81408 HCPCS Molecular Pathology Procedure Level 9 Genetic Analysis 13 13 $3,915.00 $3,132.00 20% off $170.66 $3,915.00 $1,409.40 2026-01-05
P9037 HCPCS Platelets, Pheresis, Leukocytes Reduced, Irradiated, Each Unit 13 13 $1,477.00 $1,181.60 20% off $531.72 $1,975.23 $1,403.15 2026-01-05
45541 HCPCS Suture Of Rectum To Sacrum Through Perineum 23 13 $2,828.00 $2,262.40 $836.18 $4,672.57 $1,378.71 2026-01-05
59614 HCPCS Vaginal Delivery And Care After Delivery After Prior Cesarean Delivery 13 13 $3,000.00 $2,400.00 20% off $999.85 $3,000.00 $1,349.80 2026-01-05
795 MS_DRG Normal Newborn 10 10 $2,316.43 $1,853.14 20% off $925.62 $2,208.39 $1,344.25 2026-01-05
P9053 HCPCS Platelets, Pheresis, Leukocytes Reduced, Cmv-negative, Irradiated, Each Unit 13 13 $1,412.00 $1,129.60 20% off $508.32 $1,975.23 $1,341.40 2026-01-05
811384_1 CDM Operating Room Services - General Classification 4 4 $2,800.00 $2,240.00 20% off $1,008.00 $2,660.00 $1,335.60 2026-01-05
86366 HCPCS Test For Muscle-specific Kinase Antibody 7 7 $1,400.00 $1,120.00 20% off $504.00 $1,400.00 $1,330.00 2026-01-05
J9312 HCPCS Injection, Rituximab, 10 Mg 13 13 $3,664.50 $2,931.60 20% off $38.73 $3,664.50 $1,319.22 2026-01-05
95810 HCPCS Sleep Study In Sleep Lab (6 Years Or Older) 13 13 $2,400.00 $1,920.00 20% off $864.00 $2,400.00 $1,311.12 2026-01-05
95811 HCPCS Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 13 13 $2,500.00 $2,000.00 20% off $900.00 $2,500.00 $1,311.12 2026-01-05
J9395 HCPCS Injection, Fulvestrant, 25 Mg 13 13 $3,545.00 $2,836.00 20% off $77.47 $3,545.00 $1,276.20 2026-01-05
24605 HCPCS Repair Of Dislocated Elbow Under Anesthesia 26 13 $2,026.00 $1,620.80 20% off $443.32 $2,777.00 $1,275.00 2026-01-05
60260 HCPCS Removal Of Remaining Thyroid Tissue From Prior Operation 13 13 $2,664.00 $2,131.20 20% off $916.35 $2,664.00 $1,251.19 2026-01-05
SUP108128_1 CDM Warmer Blood Disp 4 4 $2,610.00 $2,088.00 20% off $939.60 $2,479.50 $1,244.97 2026-01-05
59410 HCPCS Vaginal Delivery With Post Delivery Care 13 13 $2,710.00 $2,168.00 20% off $917.94 $2,710.00 $1,239.22 2026-01-05
J1569 HCPCS Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),… 13 13 $3,405.00 $2,724.00 20% off $17.04 $3,405.00 $1,225.80 2026-01-05
32554 HCPCS Aspiration Of Fluid From Chest Cavity 13 13 $1,561.00 $1,248.80 20% off $561.96 $1,658.36 $1,225.26 2026-01-05
49082 HCPCS Drainage Of Fluid From Abdominal Cavity 13 13 $1,596.00 $1,276.80 20% off $574.56 $1,658.36 $1,225.26 2026-01-05
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 13 13 $2,600.00 $2,080.00 20% off $837.25 $2,600.00 $1,216.80 2026-01-05
58150 HCPCS Removal Of Uterus And Cervix Through Abdomen 13 13 $2,800.00 $2,240.00 20% off $880.48 $2,800.00 $1,195.61 2026-01-05
58552 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, 250.… 13 13 $2,552.00 $2,041.60 20% off $830.79 $2,552.00 $1,165.93 2026-01-05
59320 HCPCS Suture Of Cervix During Pregnancy Through Vagina 26 13 $2,687.00 $2,149.60 20% off $127.92 $4,757.00 $1,164.76 2026-01-05
30465 HCPCS Repair Of Nasal Passage 13 13 $2,700.00 $2,160.00 20% off $860.55 $2,700.00 $1,161.74 2026-01-05
J7297 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System (liletta), 52 Mg 13 13 $3,200.00 $2,560.00 20% off $271.13 $3,200.00 $1,152.00 2026-01-05
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 13 13 $2,350.00 $1,880.00 20% off $846.00 $2,350.00 $1,142.10 2026-01-05
P9035 HCPCS Platelets, Pheresis, Leukocytes Reduced, Each Unit 13 13 $1,140.00 $912.00 20% off $410.40 $1,975.23 $1,140.00 2026-01-05
58180 HCPCS Removal Of Uterus Through Abdomen 13 13 $2,771.00 $2,216.80 $820.13 $2,771.00 $1,138.59 2026-01-05
60500 HCPCS Removal Or Exploration Of Parathyroid Glands 13 13 $2,281.00 $1,824.80 20% off $837.31 $2,281.00 $1,130.37 2026-01-05
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 26 13 $2,136.00 $1,708.80 $386.96 $3,200.00 $1,112.00 2026-01-05
58262 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina, 250.0 G Or Less 13 13 $2,500.00 $2,000.00 20% off $776.21 $2,500.00 $1,098.55 2026-01-05
28435 HCPCS Closed Treatment Of Broken Ankle Joint Bone With Manipulation 13 13 $2,320.59 $1,856.47 20% off $746.50 $2,320.59 $1,086.04 2026-01-05
60225 HCPCS Removal Of Thyroid Lobe On Side Of Neck And Partial Removal Of Thyroid Lobe On O… 13 13 $2,241.00 $1,792.80 20% off $798.28 $2,241.00 $1,077.68 2026-01-05
J7307 HCPCS Etonogestrel (contraceptive) Implant System, Including Implant And Supplies 13 13 $2,945.00 $2,356.00 20% off $271.13 $2,945.00 $1,060.20 2026-01-05
G0379 HCPCS Direct Admission Of Patient For Hospital Observation Care 7 7 $1,115.00 $892.00 20% off $401.40 $1,115.00 $1,059.25 2026-01-05
Q5104 HCPCS Injection, Infliximab-abda, Biosimilar, (renflexis), 10 Mg 13 13 $2,938.50 $2,350.80 $38.73 $2,938.50 $1,057.86 2026-01-05
60240 HCPCS Removal Of Thyroid 13 13 $2,175.00 $1,740.00 20% off $781.30 $2,175.00 $1,054.76 2026-01-05
59612 HCPCS Vaginal Delivery After Previous Cesarean Delivery 13 13 $2,514.00 $2,011.20 20% off $772.23 $2,514.00 $1,050.58 2026-01-05
58550 HCPCS Removal Of Uterus Through Vagina Using An Endoscope, 250.0 G Or Less 13 13 $2,500.00 $2,000.00 20% off $744.88 $2,500.00 $1,045.81 2026-01-05
46040 HCPCS Drainage Of Deep Abscess In Rectum 26 13 $1,988.00 $1,590.40 $402.43 $4,672.57 $1,028.00 2026-01-05
49402 HCPCS Removal Of Foreign Body In Abdominal Cavity 13 13 $2,400.00 $1,920.00 20% off $750.30 $2,400.00 $1,012.91 2026-01-05
49900 HCPCS Suture Of Postsurgical Opening In Abdominal Wall 13 13 $2,303.00 $1,842.40 $746.16 $2,303.00 $1,007.32 2026-01-05
Q5119 HCPCS Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg 13 13 $2,796.00 $2,236.80 $38.73 $2,796.00 $1,006.56 2026-01-05
58260 HCPCS Removal Of Uterus Through Vagina, 250.0 G Or Less 13 13 $2,226.00 $1,780.80 20% off $702.48 $2,226.00 $988.40 2026-01-05
10005 HCPCS Fine Needle Aspiration Biopsy Using Ultrasound Guidance, First Growth 12 12 $1,340.00 $1,072.00 20% off $627.12 $1,340.00 $971.35 2026-01-05
74182 HCPCS MRI Scan Of Abdomen With Contrast 13 13 $1,196.00 $956.80 20% off $430.56 $1,309.53 $967.53 2026-01-05
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 13 13 $1,728.00 $1,382.40 $622.08 $1,728.00 $967.53 2026-01-05
P9055 HCPCS Platelets, Leukocytes Reduced, Cmv-negative, Apheresis/pheresis, Each Unit 13 13 $963.00 $770.40 20% off $346.68 $1,975.23 $963.00 2026-01-05
J0174 HCPCS Injection, Lecanemab-irmb, 1 Mg 7 7 $1,009.00 $807.20 $363.24 $1,009.00 $958.55 2026-01-05
J2785 HCPCS Injection, Regadenoson, 0.1 Mg 7 7 $1,005.50 $804.40 20% off $361.98 $1,005.50 $955.23 2026-01-05
27257 HCPCS Treatment Of Spontaneous Dislocated Hip Under Anesthesia 26 13 $1,838.50 $1,470.80 20% off $308.82 $2,777.00 $949.86 2026-01-05
ERX133412_1 CDM Combivent Respimat 20-100 Mcg 4 4 $1,966.00 $1,572.80 20% off $707.76 $1,867.70 $937.79 2026-01-05
J1611 HCPCS Injection, Glucagon Hydrochloride (fresenius Kabi), Not Therapeutically Equivale… 7 7 $985.50 $788.40 20% off $354.78 $985.50 $936.23 2026-01-05
58700 HCPCS Removal Of Uterine Tubes 13 13 $2,000.00 $1,600.00 20% off $687.81 $2,000.00 $933.02 2026-01-05
57260 HCPCS Plastic Repair Of Vagina And Tissue Separating Vagina, Rectum, And Bladder 13 13 $2,024.00 $1,619.20 20% off $651.61 $2,024.00 $916.80 2026-01-05
J0585 HCPCS Injection, Onabotulinumtoxina, 1 Unit 13 13 $2,519.50 $2,015.60 20% off $8.26 $2,519.50 $907.02 2026-01-05
93 MS_DRG Other Disorders Of Nervous System Without Cc/mcc 3 3 $902.00 $721.60 20% off $856.90 $902.00 $902.00 2026-01-05
J1096 HCPCS Dexamethasone, Lacrimal Ophthalmic Insert, 0.1 Mg 13 13 $2,496.00 $1,996.80 20% off $77.47 $2,496.00 $898.56 2026-01-05
59150 HCPCS Removal Of Ovarian Or Tubal Pregnancy Using An Endoscope 13 13 $2,059.00 $1,647.20 20% off $664.74 $2,059.00 $897.40 2026-01-05
15240 HCPCS Full Thickness Skin Graft To Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Gen… 13 13 $1,200.00 $960.00 20% off $654.21 $1,200.00 $891.86 2026-01-05
26725 HCPCS Closed Treatment Of Broken Finger Or Thumb At Midportion Or Part Near Hand With … 13 13 $1,903.00 $1,522.40 $558.19 $1,903.00 $890.60 2026-01-05
12036 HCPCS Intermediate Repair Of Wound Of Scalp, Underarms, Trunk, Arms, Or Legs, 20.1-30.… 13 13 $887.59 $710.07 20% off $319.53 $1,544.35 $887.59 2026-01-05
59151 HCPCS Removal Of Ovarian Or Tubal Pregnancy With Removal Of Ovary And/or Tube Using An… 13 13 $2,147.00 $1,717.60 20% off $647.67 $2,147.00 $874.35 2026-01-05
Q9968 HCPCS Injection, Non-radioactive, Non-contrast, Visualization Adjunct (e.g., Methylene… 7 7 $914.50 $731.60 20% off $329.22 $914.50 $868.78 2026-01-05
30118 HCPCS Removal Or Destruction Of Growth Of Nose 13 13 $2,000.00 $1,600.00 20% off $590.92 $2,000.00 $866.37 2026-01-05
812556_1 CDM Labor Room/delivery - Labor 4 4 $1,800.00 $1,440.00 20% off $648.00 $1,710.00 $858.60 2026-01-05
81292 HCPCS Gene Analysis (mutL Homolog 1, Colon Cancer, Nonpolyposis Type 2) Full Sequence … 13 13 $1,154.00 $923.20 $415.44 $1,154.00 $849.86 2026-01-05
J7298 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System (mirena), 52 Mg 13 13 $2,348.00 $1,878.40 $271.13 $2,348.00 $845.28 2026-01-05
58662 HCPCS Destruction Or Removal Of Ovary Or Growth Of Pelvis Using An Endoscope 13 13 $2,023.00 $1,618.40 $610.63 $2,023.00 $842.96 2026-01-05
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 13 13 $1,728.00 $1,382.40 $622.08 $1,728.00 $839.81 2026-01-05
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 26 13 $2,188.50 $1,750.80 20% off $507.41 $2,777.00 $831.90 2026-01-05
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 13 13 $1,652.00 $1,321.60 20% off $594.72 $1,652.00 $826.51 2026-01-05
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 13 13 $1,116.00 $892.80 20% off $401.76 $1,118.66 $826.51 2026-01-05
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 13 13 $924.00 $739.20 $332.64 $1,118.66 $826.51 2026-01-05
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 13 13 $1,350.00 $1,080.00 20% off $486.00 $1,350.00 $826.51 2026-01-05
27818 HCPCS Closed Treatment Of 3 Broken Lower Leg Bones At Ankle With Manipulation 26 13 $1,988.50 $1,590.80 20% off $440.33 $2,777.00 $826.00 2026-01-05
25565 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation 26 13 $2,038.50 $1,630.80 20% off $471.01 $2,777.00 $826.00 2026-01-05
24655 HCPCS Closed Treatment Of Broken Forearm Bone On Thumb Side At Elbow With Manipulation 26 13 $1,926.00 $1,540.80 20% off $407.00 $2,777.00 $826.00 2026-01-05
74181 HCPCS MRI Scan Of Abdomen Without Contrast 13 13 $861.00 $688.80 20% off $309.96 $1,309.53 $817.95 2026-01-05
73720 HCPCS MRI Scan Of Leg Before And After Contrast 13 13 $1,610.00 $1,288.00 20% off $579.60 $1,610.00 $811.25 2026-01-05
73718 HCPCS MRI Scan Of Leg Without Contrast 13 13 $1,092.00 $873.60 20% off $393.12 $1,098.00 $811.25 2026-01-05
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 13 13 $1,593.00 $1,274.40 $573.48 $1,593.00 $811.25 2026-01-05
73220 HCPCS MRI Scan Of Arm Before And After Contrast 13 13 $1,313.00 $1,050.40 $472.68 $1,313.00 $811.25 2026-01-05
73218 HCPCS MRI Scan Of Arm Without Contrast 13 13 $1,050.00 $840.00 20% off $378.00 $1,098.00 $811.25 2026-01-05
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 13 13 $1,036.00 $828.80 20% off $372.96 $1,098.00 $811.25 2026-01-05
72196 HCPCS MRI Scan Of Pelvis With Contrast 13 13 $1,188.00 $950.40 20% off $427.68 $1,188.00 $811.25 2026-01-05
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 13 13 $975.00 $780.00 20% off $351.00 $1,098.00 $811.25 2026-01-05
72195 HCPCS MRI Scan Of Pelvis Without Contrast 13 13 $1,274.00 $1,019.20 $458.64 $1,274.00 $811.25 2026-01-05
78227 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System With Use Of Drugs 13 13 $850.00 $680.00 20% off $306.00 $1,290.42 $807.50 2026-01-05
78226 HCPCS Nuclear Medicine Study Of Liver And Bile Duct System 13 13 $850.00 $680.00 20% off $306.00 $1,290.42 $807.50 2026-01-05
36430 HCPCS Transfusion Of Blood Or Blood Products 13 13 $805.00 $644.00 20% off $289.80 $1,975.23 $805.00 2026-01-05
58660 HCPCS Removal Of Scar Tissue Of Ovaries Or Fallopian Tubes Using An Endoscope 13 13 $1,900.00 $1,520.00 20% off $591.65 $1,900.00 $802.91 2026-01-05
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 13 13 $2,200.00 $1,760.00 20% off $389.21 $2,200.00 $792.00 2026-01-05
78264 HCPCS Nuclear Medicine Study Of Stomach To Assess Emptying 13 13 $788.00 $630.40 20% off $283.68 $1,290.42 $785.99 2026-01-05
15120 HCPCS Partial Thickness Self Skin Graft To Face, Scalp, Eyelids, Mouth, Neck, Ears, Ar… 13 13 $2,415.00 $1,932.00 20% off $577.92 $2,415.00 $782.44 2026-01-05
59070 HCPCS Infusion Of Normal Saline Into Fetal Amniotic Sac Using Ultrasound Guidance 13 13 $777.00 $621.60 20% off $279.72 $1,482.98 $777.00 2026-01-05
42145 HCPCS Complex Removal Of Soft Tissue Of Roof Of Mouth 13 13 $2,000.00 $1,600.00 20% off $572.16 $2,000.00 $776.56 2026-01-05
70553 HCPCS MRI Scan Of Brain Before And After Contrast 13 13 $1,656.00 $1,324.80 20% off $533.61 $1,656.00 $775.01 2026-01-05
90620 HCPCS Meningococcal Recombinant Protein And Outer Membrane Vesicle Vaccine, Serogroup … 7 7 $815.00 $652.00 20% off $293.40 $815.00 $774.25 2026-01-05
J9171 HCPCS Injection, Docetaxel, 1 Mg 13 13 $2,145.00 $1,716.00 20% off $0.78 $2,145.00 $772.20 2026-01-05
58661 HCPCS Removal Of Ovaries And/or Tubes Using An Endoscope 13 13 $1,959.00 $1,567.20 20% off $554.77 $1,959.00 $771.81 2026-01-05
30520 HCPCS Reshaping Of Nasal Cartilage 13 13 $1,740.00 $1,392.00 20% off $568.42 $1,740.00 $767.37 2026-01-05
90736 HCPCS Shingles Vaccine For Injection Under Skin 7 7 $806.00 $644.80 20% off $290.16 $806.00 $765.70 2026-01-05
27788 HCPCS Closed Treatment Of Broken Outside Lower Leg Bone At Ankle With Manipulation 13 13 $803.00 $642.40 20% off $289.08 $1,225.58 $762.85 2026-01-05
26742 HCPCS Closed Treatment Of Broken Finger Or Hand At Base Of Finger With Manipulation 26 13 $1,777.50 $1,422.00 20% off $315.04 $2,777.00 $762.25 2026-01-05
90684 HCPCS Pneumococcal Conjugate Vaccine, 21 Valent (pcv21), For Intramuscular Use 7 7 $800.00 $640.00 20% off $288.00 $800.00 $760.00 2026-01-05
J7300 HCPCS Intrauterine Copper Contraceptive 13 13 $2,079.00 $1,663.20 20% off $271.13 $2,079.00 $748.44 2026-01-05
J1442 HCPCS Injection, Filgrastim (g-csf), Excludes Biosimilars, 1 Microgram 13 13 $2,073.00 $1,658.40 $0.78 $2,073.00 $746.28 2026-01-05
14060 HCPCS Repair Of Wound Of Eyelids, Nose, Ears, Or Lips By Transferring Skin, 10.0 Sq Cm… 13 13 $1,900.00 $1,520.00 20% off $540.15 $1,900.00 $745.18 2026-01-05
J2598 HCPCS Injection, Vasopressin, 1 Unit 7 7 $780.00 $624.00 20% off $280.80 $780.00 $741.00 2026-01-05
38792 HCPCS Injection Of Radioactive Material For X-ray Identification Of Lymph Node 7 7 $780.00 $624.00 20% off $280.80 $780.00 $741.00 2026-01-05
13152 HCPCS Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 2.6-7.5 Cm 26 13 $1,163.00 $930.40 20% off $265.01 $1,544.35 $740.31 2026-01-05
27810 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation 13 13 $730.00 $584.00 20% off $262.80 $1,225.58 $730.00 2026-01-05
21336 HCPCS Treatment Of Broken Bone And Tissue Separating Nose Airways 13 13 $1,700.00 $1,360.00 20% off $540.57 $1,700.00 $729.77 2026-01-05
62273 HCPCS Injection Of Blood Or Blood Clot Into Spinal Canal 33 13 $1,500.00 $1,200.00 20% off $97.96 $1,900.03 $729.00 2026-01-05
J9025 HCPCS Injection, Azacitidine, 1 Mg 13 13 $2,007.50 $1,606.00 20% off $0.78 $2,007.50 $722.70 2026-01-05
90671 HCPCS Pneumococcal Conjugate Vaccine, 15 Valent (pcv15), For Intramuscular Use 7 7 $760.00 $608.00 20% off $273.60 $760.00 $722.00 2026-01-05
90677 HCPCS Pneumococcal Conjugate Vaccine, 20 Valent (pcv20), For Intramuscular Use 7 7 $760.00 $608.00 20% off $273.60 $760.00 $722.00 2026-01-05
57250 HCPCS Repair Of Herniated Rectum Into Vaginal Wall 13 13 $1,648.00 $1,318.40 $515.81 $1,648.00 $717.87 2026-01-05
57240 HCPCS Repair Of Bladder Hernia Into Vaginal Wall 13 13 $1,570.00 $1,256.00 20% off $515.67 $1,570.00 $713.74 2026-01-05
20520 HCPCS Removal Of Foreign Body In Muscle Or Tendon 26 13 $1,611.50 $1,289.20 $132.33 $2,821.00 $708.78 2026-01-05
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 20 13 $722.50 $578.00 20% off $38.73 $34,321.50 $704.44 2026-01-05
J0211 HCPCS Injection, Sodium Nitrite 3 Mg And Sodium Thiosulfate 125 Mg (nithiodote) 7 7 $741.00 $592.80 20% off $266.76 $741.00 $703.95 2026-01-05
J7301 HCPCS Levonorgestrel-releasing Intrauterine Contraceptive System (skyla), 13.5 Mg 13 13 $1,955.00 $1,564.00 20% off $271.13 $1,955.00 $703.80 2026-01-05
13151 HCPCS Complicated Repair Of Wound Of Eyelids, Nose, Ears, Or Lip, 1.1-2.5 Cm 26 13 $969.50 $775.60 20% off $221.37 $1,544.35 $703.76 2026-01-05
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 13 13 $1,866.00 $1,492.80 20% off $427.74 $1,866.00 $702.26 2026-01-05
Q4186 HCPCS Epifix, Per Square Centimeter 7 7 $738.75 $591.00 20% off $265.95 $738.75 $701.81 2026-01-05
90675 HCPCS Rabies Vaccine For Injection Into Muscle 20 13 $1,453.00 $1,162.40 $33.89 $1,478.50 $699.05 2026-01-05
24200 HCPCS Removal Of Foreign Body Of Upper Arm Or Elbow Area, Accessed Beneath The Skin 26 13 $1,600.50 $1,280.40 $132.85 $2,821.00 $697.78 2026-01-05
25505 HCPCS Closed Treatment Of Broken Midpart Of Forearm Bone On Thumb Side With Manipulati… 23 13 $1,467.00 $1,173.60 20% off $452.78 $1,467.00 $686.56 2026-01-05
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