|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
Q4186
|
HCPCS
|
Epifix, Per Square Centimeter
|
7
|
7
|
$738.75
|
$591.00
20% off
|
$265.95
|
$738.75
|
$701.81
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
J0174
|
HCPCS
|
Injection, Lecanemab-irmb, 1 Mg
|
7
|
7
|
$1,009.00
|
$807.20
|
$363.24
|
$1,009.00
|
$958.55
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
J2598
|
HCPCS
|
Injection, Vasopressin, 1 Unit
|
7
|
7
|
$780.00
|
$624.00
20% off
|
$280.80
|
$780.00
|
$741.00
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
59409
|
HCPCS
|
Vaginal Delivery
|
26
|
13
|
$3,478.50
|
$2,782.80
|
$680.34
|
$4,757.00
|
$1,735.20
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|