Price Transparencybeta Hospital negotiated rates

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

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Hospital

SOUTHERN COOS HOSPITAL & HEALTH CENTER

Bandon, OR · CCN 381304 · Rates published

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You selected 93306 (HCPCS)

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function

This hospital’s price: $1,193 across 22 payers · range $59-$2,010

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSCHBANDONOR&type=CDMWithoutLabel&fileType=CSV · observed 2026-10-09

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

3,406 distinct procedures filed
26 distinct payers
96,986 rate rows
2026-10-09 last MRF observed
Data quality

94,117 of 96,986 rate rows are consumer-grade (97.0%)

2,869 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
template filing: same amount across many unrelated codes — excluded 1,082
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 1,004
per-diem day rate — not a per-procedure price 637
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 63
exceeds 10× this hospital's gross charge — excluded from medians 45
percent-of-charges filed in the dollar field — excluded from medians 22
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 16
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbSCHBANDONOR&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Southern_Coos_V2.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-17
Content fingerprint 6a670f0b1ea3b1a8… · 34,317,560 bytes · first seen 2026-10-10

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
184
MS_DRG 		Major Chest Trauma With Cc 1 $102,485.93 $102,485.93 $102,485.93 nat. median
$7,947
outlier · 12.9×
183
MS_DRG 		Major Chest Trauma With Mcc 1 $91,894.06 $91,894.06 $91,894.06 nat. median
$11,268
outlier · 8.2×
296
MS_DRG 		Cardiac Arrest, Unexplained With Mcc 3 $27,513.34 $69,674.38 $69,674.38 nat. median
$11,574
outlier · 6.0×
155
MS_DRG 		Other Ear, Nose, Mouth And Throat Diagnoses With Cc 3 $25,490.70 $64,249.80 $62,539.00 nat. median
$6,927
outlier · 9.0×
280
MS_DRG 		Acute Myocardial Infarction, Discharged Alive With Mcc 1 $58,010.36 $58,010.36 $58,010.36 nat. median
$11,829
outlier · 4.9×
100
MS_DRG 		Seizures With Mcc 4 $25,078.18 $58,659.04 $57,192.64 nat. median
$13,848
outlier · 4.1×
812
MS_DRG 		Red Blood Cell Disorders Without Mcc 2 $32,256.40 $71,767.24 $52,011.82 nat. median
$6,771
outlier · 7.7×
432
MS_DRG 		Cirrhosis And Alcoholic Hepatitis With Mcc 1 $51,489.89 $51,489.89 $51,489.89 nat. median
$14,126
outlier · 3.6×
867
MS_DRG 		Other Infectious And Parasitic Diseases Diagnoses With Mcc 1 $49,356.28 $49,356.28 $49,356.28 nat. median
$14,941
outlier · 3.3×
637
MS_DRG 		Diabetes With Mcc 1 $48,822.54 $48,822.54 $48,822.54 nat. median
$10,515
outlier · 4.6×
95
MS_DRG 		Bacterial And Tuberculous Infections Of Nervous System With Cc 1 $47,770.07 $47,770.07 $47,770.07 nat. median
$17,673
outlier · 2.7×
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 1 $43,058.22 $43,058.22 $43,058.22 nat. median
$14,442
outlier · 3.0×
443
MS_DRG 		Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without C… 3 $15,460.41 $41,618.23 $41,618.23 nat. median
$5,329
outlier · 7.8×
313
MS_DRG 		Chest Pain 1 $38,927.33 $38,927.33 $38,927.33 nat. median
$5,565
outlier · 7.0×
560
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Cc 4 $17,351.88 $39,809.47 $38,831.87 nat. median
$8,402
outlier · 4.6×
603
MS_DRG 		Cellulitis Without Mcc 4 $16,968.48 $39,383.47 $38,405.87 nat. median
$6,621
outlier · 5.8×
699
MS_DRG 		Other Kidney And Urinary Tract Diagnoses With Cc 1 $37,283.45 $37,283.45 $37,283.45 nat. median
$7,611
outlier · 4.9×
640
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 1 $37,090.04 $37,090.04 $37,090.04 nat. median
$9,697
outlier · 3.8×
565
MS_DRG 		Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 2 $22,259.27 $50,394.52 $36,326.89 nat. median
$7,411
outlier · 4.9×
208
MS_DRG 		Respiratory System Diagnosis With Ventilator Support <=96 Hours 1 $35,221.81 $35,221.81 $35,221.81 nat. median
$19,623
1.8× median
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 1 $33,655.17 $33,655.17 $33,655.17 nat. median
$9,802
outlier · 3.4×
195
MS_DRG 		Simple Pneumonia And Pleurisy Without Cc/mcc 1 $33,563.11 $33,563.11 $33,563.11 nat. median
$4,710
outlier · 7.1×
191
MS_DRG 		Chronic Obstructive Pulmonary Disease With Cc 1 $33,109.39 $33,109.39 $33,109.39 nat. median
$6,349
outlier · 5.2×
299
MS_DRG 		Peripheral Vascular Disorders With Mcc 4 $10,957.27 $32,704.34 $31,726.74 nat. median
$11,794
outlier · 2.7×
442
MS_DRG 		Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 1 $29,915.84 $29,915.84 $29,915.84 nat. median
$7,199
outlier · 4.2×
602
MS_DRG 		Cellulitis With Mcc 1 $29,368.91 $29,368.91 $29,368.91 nat. median
$10,595
outlier · 2.8×
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 1 $28,993.68 $28,993.68 $28,993.68 nat. median
$11,701
outlier · 2.5×
57
MS_DRG 		Degenerative Nervous System Disorders Without Mcc 1 $27,369.73 $27,369.73 $27,369.73 nat. median
$8,924
outlier · 3.1×
683
MS_DRG 		Renal Failure With Cc 2 $16,643.37 $38,044.63 $27,344.00 nat. median
$6,692
outlier · 4.1×
291
MS_DRG 		Heart Failure And Shock With Mcc 1 $26,838.34 $26,838.34 $26,838.34 nat. median
$9,572
outlier · 2.8×
69
MS_DRG 		Transient Ischemia Without Thrombolytic 3 $10,745.02 $27,336.11 $26,602.91 nat. median
$6,174
outlier · 4.3×
439
MS_DRG 		Disorders Of Pancreas Except Malignancy With Cc 3 $10,730.65 $27,320.14 $26,586.94 nat. median
$6,417
outlier · 4.1×
190
MS_DRG 		Chronic Obstructive Pulmonary Disease With Mcc 1 $26,391.36 $26,391.36 $26,391.36 nat. median
$8,303
outlier · 3.2×
189
MS_DRG 		Pulmonary Edema And Respiratory Failure 1 $25,556.26 $25,556.26 $25,556.26 nat. median
$9,470
outlier · 2.7×
866
MS_DRG 		Viral Illness Without Mcc 1 $25,431.11 $25,431.11 $25,431.11 nat. median
$6,363
outlier · 4.0×
536
MS_DRG 		Fractures Of Hip And Pelvis Without Mcc 1 $24,707.30 $24,707.30 $24,707.30 nat. median
$6,111
outlier · 4.0×
176
MS_DRG 		Pulmonary Embolism Without Mcc 1 $24,599.31 $24,599.31 $24,599.31 nat. median
$6,115
outlier · 4.0×
103
MS_DRG 		Headaches Without Mcc 1 $23,657.35 $23,657.35 $23,657.35 nat. median
$6,384
outlier · 3.7×
644
MS_DRG 		Endocrine Disorders With Cc 2 $13,711.05 $30,631.70 $22,171.38 nat. median
$7,727
outlier · 2.9×
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 2 $13,642.01 $30,554.99 $22,098.50 nat. median
$8,710
outlier · 2.5×
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 $21,421.34 $21,421.34 $21,421.34 nat. median
$7,744
outlier · 2.8×
4006268
CDM 		Lupron Depot 45 Mg 6 Month Kit 22 $12,430.58 $22,365.63 $21,070.78 —
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 1 $20,517.66 $20,517.66 $20,517.66 nat. median
$6,156
outlier · 3.3×
292
MS_DRG 		Heart Failure And Shock With Cc 1 $19,791.48 $19,791.48 $19,791.48 nat. median
$6,415
outlier · 3.1×
394
MS_DRG 		Other Digestive System Diagnoses With Cc 1 $19,771.02 $19,771.02 $19,771.02 nat. median
$7,016
outlier · 2.8×
310
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 4 $8,018.00 $19,173.69 $18,684.89 nat. median
$4,383
outlier · 4.3×
389
MS_DRG 		Gastrointestinal Obstruction With Cc 3 $7,970.05 $19,120.42 $18,631.62 nat. median
$5,994
outlier · 3.1×
179
MS_DRG 		Respiratory Infections And Inflammations Without Cc/mcc 1 $18,572.97 $18,572.97 $18,572.97 nat. median
$5,691
outlier · 3.3×
698
MS_DRG 		Other Kidney And Urinary Tract Diagnoses With Mcc 1 $18,494.03 $18,494.03 $18,494.03 nat. median
$12,136
1.5× median
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 1 $18,481.34 $18,481.34 $18,481.34 nat. median
$9,511
1.9× median

Other procedures at this hospital

Browse this hospital's 3,406 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
184 MS_DRG Major Chest Trauma With Cc 1 1 $51,161.93 $51,161.93 $102,485.93 $102,485.93 $102,485.93 2026-10-09
183 MS_DRG Major Chest Trauma With Mcc 1 1 $102,104.51 $102,104.51 $91,894.06 $91,894.06 $91,894.06 2026-10-09
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 3 3 $30,570.38 $30,570.38 $27,513.34 $69,674.38 $69,674.38 2026-10-09
155 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Cc 3 3 $28,323.00 $28,323.00 $25,490.70 $64,249.80 $62,539.00 2026-10-09
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 1 1 $64,455.96 $64,455.96 $58,010.36 $58,010.36 $58,010.36 2026-10-09
100 MS_DRG Seizures With Mcc 4 4 $27,864.64 $27,864.64 $25,078.18 $58,659.04 $57,192.64 2026-10-09
812 MS_DRG Red Blood Cell Disorders Without Mcc 2 2 $35,840.44 $35,840.44 $32,256.40 $71,767.24 $52,011.82 2026-10-09
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 1 1 $57,210.99 $57,210.99 $51,489.89 $51,489.89 $51,489.89 2026-10-09
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 1 1 $54,840.31 $54,840.31 $49,356.28 $49,356.28 $49,356.28 2026-10-09
637 MS_DRG Diabetes With Mcc 1 1 $54,247.27 $54,247.27 $48,822.54 $48,822.54 $48,822.54 2026-10-09
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 1 1 $53,077.85 $53,077.85 $47,770.07 $47,770.07 $47,770.07 2026-10-09
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 1 1 $47,842.47 $47,842.47 $43,058.22 $43,058.22 $43,058.22 2026-10-09
443 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without C… 3 3 $17,178.23 $17,178.23 $15,460.41 $41,618.23 $41,618.23 2026-10-09
313 MS_DRG Chest Pain 1 1 $43,252.59 $43,252.59 $38,927.33 $38,927.33 $38,927.33 2026-10-09
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 4 4 $19,279.87 $19,279.87 $17,351.88 $39,809.47 $38,831.87 2026-10-09
603 MS_DRG Cellulitis Without Mcc 4 4 $18,853.87 $18,853.87 $16,968.48 $39,383.47 $38,405.87 2026-10-09
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 1 1 $41,426.06 $41,426.06 $37,283.45 $37,283.45 $37,283.45 2026-10-09
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 1 1 $41,211.15 $41,211.15 $37,090.04 $37,090.04 $37,090.04 2026-10-09
565 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 2 2 $24,732.52 $24,732.52 $22,259.27 $50,394.52 $36,326.89 2026-10-09
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 1 1 $39,135.34 $39,135.34 $35,221.81 $35,221.81 $35,221.81 2026-10-09
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 1 1 $37,394.63 $37,394.63 $33,655.17 $33,655.17 $33,655.17 2026-10-09
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 1 1 $37,292.34 $37,292.34 $33,563.11 $33,563.11 $33,563.11 2026-10-09
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 1 1 $36,788.22 $36,788.22 $33,109.39 $33,109.39 $33,109.39 2026-10-09
299 MS_DRG Peripheral Vascular Disorders With Mcc 4 4 $12,174.74 $12,174.74 $10,957.27 $32,704.34 $31,726.74 2026-10-09
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 1 1 $33,239.82 $33,239.82 $29,915.84 $29,915.84 $29,915.84 2026-10-09
602 MS_DRG Cellulitis With Mcc 1 1 $32,632.12 $32,632.12 $29,368.91 $29,368.91 $29,368.91 2026-10-09
177 MS_DRG Respiratory Infections And Inflammations With Mcc 1 1 $32,215.20 $32,215.20 $28,993.68 $28,993.68 $28,993.68 2026-10-09
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 1 1 $13,364.20 $13,364.20 $27,369.73 $27,369.73 $27,369.73 2026-10-09
683 MS_DRG Renal Failure With Cc 2 2 $18,492.63 $18,492.63 $16,643.37 $38,044.63 $27,344.00 2026-10-09
291 MS_DRG Heart Failure And Shock With Mcc 1 1 $29,820.37 $29,820.37 $26,838.34 $26,838.34 $26,838.34 2026-10-09
69 MS_DRG Transient Ischemia Without Thrombolytic 3 3 $11,938.91 $11,938.91 $10,745.02 $27,336.11 $26,602.91 2026-10-09
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 3 3 $11,922.94 $11,922.94 $10,730.65 $27,320.14 $26,586.94 2026-10-09
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 1 1 $29,323.73 $29,323.73 $26,391.36 $26,391.36 $26,391.36 2026-10-09
189 MS_DRG Pulmonary Edema And Respiratory Failure 1 1 $28,395.84 $28,395.84 $25,556.26 $25,556.26 $25,556.26 2026-10-09
866 MS_DRG Viral Illness Without Mcc 1 1 $28,256.79 $28,256.79 $25,431.11 $25,431.11 $25,431.11 2026-10-09
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 1 1 $27,452.56 $27,452.56 $24,707.30 $24,707.30 $24,707.30 2026-10-09
176 MS_DRG Pulmonary Embolism Without Mcc 1 1 $27,332.57 $27,332.57 $24,599.31 $24,599.31 $24,599.31 2026-10-09
103 MS_DRG Headaches Without Mcc 1 1 $26,285.94 $26,285.94 $23,657.35 $23,657.35 $23,657.35 2026-10-09
644 MS_DRG Endocrine Disorders With Cc 2 2 $15,234.50 $15,234.50 $13,711.05 $30,631.70 $22,171.38 2026-10-09
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 2 2 $15,157.79 $15,157.79 $13,642.01 $30,554.99 $22,098.50 2026-10-09
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 1 $23,801.49 $23,801.49 $21,421.34 $21,421.34 $21,421.34 2026-10-09
4006268 CDM Lupron Depot 45 Mg 6 Month Kit 22 22 $23,542.77 $23,542.77 $12,430.58 $22,365.63 $21,070.78 2026-10-09
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 1 1 $22,797.40 $22,797.40 $20,517.66 $20,517.66 $20,517.66 2026-10-09
292 MS_DRG Heart Failure And Shock With Cc 1 1 $21,990.54 $21,990.54 $19,791.48 $19,791.48 $19,791.48 2026-10-09
394 MS_DRG Other Digestive System Diagnoses With Cc 1 1 $21,967.81 $21,967.81 $19,771.02 $19,771.02 $19,771.02 2026-10-09
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 4 4 $8,908.89 $8,908.89 $8,018.00 $19,173.69 $18,684.89 2026-10-09
389 MS_DRG Gastrointestinal Obstruction With Cc 3 3 $8,855.62 $8,855.62 $7,970.05 $19,120.42 $18,631.62 2026-10-09
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 1 1 $20,636.63 $20,636.63 $18,572.97 $18,572.97 $18,572.97 2026-10-09
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 1 1 $20,548.92 $20,548.92 $18,494.03 $18,494.03 $18,494.03 2026-10-09
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 1 1 $20,534.82 $20,534.82 $18,481.34 $18,481.34 $18,481.34 2026-10-09
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 1 1 $20,365.70 $20,365.70 $18,329.13 $18,329.13 $18,329.13 2026-10-09
696 MS_DRG Kidney And Urinary Tract Signs And Symptoms Without Mcc 4 4 $8,215.94 $8,215.94 $7,394.35 $18,480.74 $17,991.94 2026-10-09
600 MS_DRG Non-malignant Breast Disorders With Cc/mcc 4 4 $7,993.05 $7,993.05 $7,193.75 $18,257.85 $17,769.05 2026-10-09
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 1 1 $19,079.71 $19,079.71 $17,171.74 $17,171.74 $17,171.74 2026-10-09
723 MS_DRG Malignancy, Male Reproductive System With Cc 4 4 $7,290.57 $7,290.57 $6,561.51 $17,555.37 $17,066.57 2026-10-09
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 1 1 $18,114.91 $18,114.91 $16,303.42 $16,303.42 $16,303.42 2026-10-09
380 MS_DRG Complicated Peptic Ulcer With Mcc 1 1 $17,297.46 $17,297.46 $15,567.71 $15,567.71 $15,567.71 2026-10-09
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 1 1 $16,896.83 $16,896.83 $15,207.15 $15,207.15 $15,207.15 2026-10-09
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 1 $15,548.88 $15,548.88 $13,993.99 $13,993.99 $13,993.99 2026-10-09
552 MS_DRG Medical Back Problems Without Mcc 1 1 $15,370.07 $15,370.07 $13,833.06 $13,833.06 $13,833.06 2026-10-09
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 1 1 $14,968.35 $14,968.35 $13,471.52 $13,471.52 $13,471.52 2026-10-09
436 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Cc 1 1 $14,875.78 $14,875.78 $13,388.20 $13,388.20 $13,388.20 2026-10-09
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 1 1 $14,224.65 $14,224.65 $12,802.19 $12,802.19 $12,802.19 2026-10-09
1000058 CDM Operating Room Services - General Classification 22 22 $13,622.35 $13,622.35 $7,192.60 $12,941.23 $12,192.01 2026-10-09
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 1 1 $13,438.21 $13,438.21 $12,094.39 $12,094.39 $12,094.39 2026-10-09
289 MS_DRG Acute And Subacute Endocarditis With Cc 1 1 $13,131.84 $13,131.84 $11,818.66 $11,818.66 $11,818.66 2026-10-09
7001062 CDM Amniofix 9x20cm 22 22 $13,079.00 $13,079.00 $6,905.71 $12,425.05 $11,705.70 2026-10-09
293 MS_DRG Heart Failure And Shock Without Cc/mcc 1 1 $12,667.55 $12,667.55 $11,400.80 $11,400.80 $11,400.80 2026-10-09
811 MS_DRG Red Blood Cell Disorders With Mcc 1 1 $12,570.93 $12,570.93 $11,313.84 $11,313.84 $11,313.84 2026-10-09
638 MS_DRG Diabetes With Cc 1 1 $12,256.18 $12,256.18 $11,030.56 $11,030.56 $11,030.56 2026-10-09
1000034 CDM Operating Room Services - General Classification 22 22 $11,998.13 $11,998.13 $6,335.01 $11,398.22 $10,738.33 2026-10-09
1000032 CDM Operating Room Services - General Classification 22 22 $11,248.29 $11,248.29 $5,939.10 $10,685.88 $10,067.22 2026-10-09
947 MS_DRG Signs And Symptoms With Mcc 1 1 $10,950.49 $10,950.49 $9,855.44 $9,855.44 $9,855.44 2026-10-09
4000028 CDM Activase 100 Mg Vial 22 22 $10,697.01 $10,697.01 $5,648.02 $10,162.16 $9,573.83 2026-10-09
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 1 1 $10,442.19 $10,442.19 $9,397.97 $9,397.97 $9,397.97 2026-10-09
1000031 CDM Operating Room Services - General Classification 22 22 $10,498.36 $10,498.36 $5,543.13 $9,973.44 $9,396.03 2026-10-09
93 MS_DRG Other Disorders Of Nervous System Without Cc/mcc 1 1 $10,046.53 $10,046.53 $9,041.88 $9,041.88 $9,041.88 2026-10-09
684 MS_DRG Renal Failure Without Cc/mcc 1 1 $9,711.10 $9,711.10 $8,739.99 $8,739.99 $8,739.99 2026-10-09
1000030 CDM Operating Room Services - General Classification 22 22 $9,748.48 $9,748.48 $5,147.20 $9,261.06 $8,724.89 2026-10-09
1000029 CDM Operating Room Services - General Classification 22 22 $8,998.63 $8,998.63 $4,751.28 $8,548.70 $8,053.77 2026-10-09
4004106 CDM Cimzia 2x200 Mg/ml Syringe Kit 22 22 $8,828.55 $8,828.55 $4,661.47 $8,387.12 $7,901.56 2026-10-09
4004092 CDM Fasenra 30 Mg/ml Syringe 22 22 $8,644.68 $8,644.68 $4,564.39 $8,212.45 $7,736.99 2026-10-09
4004488 CDM Fasenra 30 Mg/ml Syringe 22 22 $8,644.68 $8,644.68 $4,564.39 $8,212.45 $7,736.99 2026-10-09
1000027 CDM Operating Room Services - General Classification 22 22 $8,248.75 $8,248.75 $4,355.34 $7,836.31 $7,382.64 2026-10-09
4006011 CDM Ziextenzo 6 Mg/0.6 Ml Syringe 22 22 $8,031.64 $8,031.64 $4,240.71 $7,630.06 $7,188.32 2026-10-09
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 22 22 $8,266.50 $8,266.50 $4,364.71 $9,093.15 $7,109.19 2026-10-09
312 MS_DRG Syncope And Collapse 2 2 $4,618.46 $4,618.46 $4,156.61 $9,506.46 $6,831.53 2026-10-09
1000026 CDM Operating Room Services - General Classification 22 22 $7,498.84 $7,498.84 $3,959.39 $7,123.90 $6,711.47 2026-10-09
96377 HCPCS Application Of On-body Injector For Under Skin Injection 22 22 $7,417.23 $7,417.23 $3,916.30 $7,046.37 $6,378.82 2026-10-09
197 MS_DRG Interstitial Lung Disease With Cc 1 1 $6,936.18 $6,936.18 $6,242.56 $6,242.56 $6,242.56 2026-10-09
81432 HCPCS Test For Detecting Genes Associated With Inherited Breast Cancer-related Disorde… 21 21 $6,799.69 $6,799.69 $3,590.24 $6,459.71 $6,119.72 2026-10-09
1000025 CDM Operating Room Services - General Classification 22 22 $6,748.98 $6,748.98 $3,563.46 $6,411.53 $6,040.34 2026-10-09
315 MS_DRG Other Circulatory System Diagnoses With Cc 1 1 $6,710.32 $6,710.32 $6,039.29 $6,039.29 $6,039.29 2026-10-09
7001079 CDM Amniofill 2000mg 22 22 $6,720.00 $6,720.00 $3,548.16 $6,384.00 $6,014.40 2026-10-09
4000422 CDM Tenecteplase (tnkase) Kit 50mg 22 22 $6,575.75 $6,575.75 $3,472.00 $6,246.96 $5,885.30 2026-10-09
J9312 HCPCS Injection, Rituximab, 10 Mg 22 22 $6,663.18 $6,663.18 $3,518.16 $6,330.02 $5,730.33 2026-10-09
81162 HCPCS Gene Analysis (breast Cancer 1 And 2) Of Full Sequence And Analysis For Duplicat… 21 21 $6,045.87 $6,045.87 $3,192.22 $5,743.58 $5,441.28 2026-10-09
4004868 CDM Privigen 10% Vial 22 22 $6,069.02 $6,069.02 $3,204.44 $5,765.57 $5,431.77 2026-10-09
1000024 CDM Operating Room Services - General Classification 22 22 $5,999.07 $5,999.07 $3,167.51 $5,699.12 $5,369.16 2026-10-09
7001061 CDM Amniofix 6x16cm 22 22 $5,490.00 $5,490.00 $2,898.72 $5,215.50 $4,913.55 2026-10-09
1000023 CDM Operating Room Services - General Classification 22 22 $5,249.22 $5,249.22 $2,771.59 $4,986.76 $4,698.06 2026-10-09
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 1 $5,133.51 $5,133.51 $4,620.16 $4,620.16 $4,620.16 2026-10-09
7001093 CDM Epicord 3 Cm X 5 Cm 22 22 $5,136.00 $5,136.00 $2,711.81 $4,879.20 $4,596.72 2026-10-09
04 CDM Intensive Care Unit - General Classification 14 14 $4,552.46 $4,552.46 $2,868.05 $4,324.84 $4,165.50 2026-10-09
7000434 CDM Shears Curved Laparoscopic Har36 22 22 $4,571.00 $4,571.00 $2,413.49 $4,342.45 $4,091.05 2026-10-09
1000040 CDM Operating Room Services - General Classification 22 22 $4,547.10 $4,547.10 $2,400.87 $4,319.75 $4,069.65 2026-10-09
7000297 CDM Mesh "gore" 26cm X 34cm 22 22 $4,518.00 $4,518.00 $2,385.50 $4,292.10 $4,043.61 2026-10-09
1000022 CDM Operating Room Services - General Classification 22 22 $4,499.31 $4,499.31 $2,375.64 $4,274.34 $4,026.89 2026-10-09
1000039 CDM Operating Room Services - General Classification 22 22 $4,277.10 $4,277.10 $2,258.31 $4,063.25 $3,828.01 2026-10-09
7001078 CDM Amniofill 1000mg 22 22 $4,275.00 $4,275.00 $2,257.20 $4,061.25 $3,826.12 2026-10-09
7000433 CDM Shears Curved Harmonic Ace 45cm With 22 22 $4,241.00 $4,241.00 $2,239.25 $4,028.95 $3,795.69 2026-10-09
1000004 CDM Operating Room Services - General Classification 22 22 $4,219.60 $4,219.60 $2,227.95 $4,008.62 $3,776.54 2026-10-09
7001068 CDM Amniofix Wrap 4x6 Cm 22 22 $4,179.00 $4,179.00 $2,206.51 $3,970.05 $3,740.20 2026-10-09
7001074 CDM Amniocord 3x5 Cm 22 22 $4,076.00 $4,076.00 $2,152.13 $3,872.20 $3,648.02 2026-10-09
7001060 CDM Amniofix 4x6cm 22 22 $4,076.00 $4,076.00 $2,152.13 $3,872.20 $3,648.02 2026-10-09
05 CDM Room & Board - Semi-private (two Beds) - General Classification 14 14 $3,971.66 $3,971.66 $2,502.15 $3,773.08 $3,634.06 2026-10-09
4000133 CDM Digifab 40 Mg Vial 22 22 $4,050.04 $4,050.04 $2,138.42 $3,847.54 $3,624.79 2026-10-09
7001065 CDM Amniofix Surgical 7x6 Cm 22 22 $4,018.00 $4,018.00 $2,121.50 $3,817.10 $3,596.11 2026-10-09
7000435 CDM Shears Harmonic Ace 23mm 22 22 $4,014.00 $4,014.00 $2,119.39 $3,813.30 $3,592.53 2026-10-09
4006103 CDM Actemra 400 Mg/20 Ml Vial 22 22 $3,804.57 $3,804.57 $2,008.81 $3,614.34 $3,405.09 2026-10-09
7001072 CDM Amniofix Injectable 160mg 22 22 $3,791.00 $3,791.00 $2,001.65 $3,601.45 $3,392.94 2026-10-09
1000021 CDM Operating Room Services - General Classification 22 22 $3,749.41 $3,749.41 $1,979.69 $3,561.94 $3,355.72 2026-10-09
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 40 22 $5,563.51 $5,563.51 $64.78 $5,285.33 $3,338.11 2026-10-09
Q4100 HCPCS Skin Substitute, Not Otherwise Specified 44 22 $4,461.50 $4,461.50 $1,881.26 $5,092.00 $3,313.03 2026-10-09
7000238 CDM Filter Greenfield Ivc 12fr 22 22 $3,700.00 $3,700.00 $1,953.60 $3,515.00 $3,311.50 2026-10-09
7000131 CDM Colonic Stent 6cm 22 22 $3,700.00 $3,700.00 $1,953.60 $3,515.00 $3,311.50 2026-10-09
7000296 CDM Mesh "gore" 15cm X 19cm 22 22 $3,700.00 $3,700.00 $1,953.60 $3,515.00 $3,311.50 2026-10-09
7000500 CDM Stent Colonic 4cm Czs 35-4 22 22 $3,700.00 $3,700.00 $1,953.60 $3,515.00 $3,311.50 2026-10-09
7000884 CDM Mesh Composic Ex 7x9 22 22 $3,682.00 $3,682.00 $1,944.10 $3,497.90 $3,295.39 2026-10-09
7001064 CDM Amniofix Surgical 2x12 Cm 22 22 $3,680.00 $3,680.00 $1,943.04 $3,496.00 $3,293.60 2026-10-09
81443 HCPCS Genomic Sequence Analysis Panel For Severe Inherited Conditions With Sequencing … 21 21 $3,655.29 $3,655.29 $1,929.99 $3,472.53 $3,289.76 2026-10-09
1000038 CDM Operating Room Services - General Classification 22 22 $3,666.09 $3,666.09 $1,935.70 $3,482.79 $3,281.15 2026-10-09
07 CDM Room & Board - Private (one Bed) - General Classification 14 14 $3,564.88 $3,564.88 $2,245.87 $3,386.64 $3,261.86 2026-10-09
86341 HCPCS Islet Cell (pancreas) Antibody Measurement 22 22 $3,625.09 $3,625.09 $854.43 $3,443.84 $3,244.45 2026-10-09
94002 HCPCS Initial Hospital Inpatient Or Observation Ventilation Assistance And Management 22 22 $3,557.19 $3,557.19 $1,878.20 $3,379.33 $3,183.68 2026-10-09
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 62 22 $4,881.61 $4,881.61 $80.58 $4,869.41 $3,075.41 2026-10-09
7000403 CDM Protack 5mm Endoscopic 22 22 $3,423.00 $3,423.00 $1,807.34 $3,251.85 $3,063.59 2026-10-09
01 CDM Room & Board - Semi-private (two Beds) - General Classification 14 14 $3,283.93 $3,283.93 $2,068.88 $3,119.73 $3,004.80 2026-10-09
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 40 22 $4,876.44 $4,876.44 $72.74 $4,632.62 $2,925.86 2026-10-09
86711 HCPCS Analysis For Antibody To John Cunningham Virus 22 22 $3,222.25 $3,222.25 $544.24 $3,061.14 $2,883.91 2026-10-09
7000308 CDM Mesh Ventral Hernia 11 X 14 22 22 $3,219.00 $3,219.00 $1,699.63 $3,058.05 $2,881.01 2026-10-09
7000846 CDM Bile Duct Exploration Set 22 22 $3,219.00 $3,219.00 $1,699.63 $3,058.05 $2,881.01 2026-10-09
70553 HCPCS MRI Scan Of Brain Before And After Contrast 40 22 $4,771.56 $4,771.56 $91.36 $4,532.98 $2,862.94 2026-10-09
7000875 CDM Mesh Hernia 18cm X 24cm 22 22 $3,184.00 $3,184.00 $1,681.15 $3,024.80 $2,849.68 2026-10-09
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 40 22 $4,590.60 $4,590.60 $87.54 $4,361.07 $2,754.36 2026-10-09
7000882 CDM Mesh Composix E/x 10x13 22 22 $3,073.00 $3,073.00 $1,622.54 $2,919.35 $2,750.34 2026-10-09
7000306 CDM Mesh Umbilical Hernia Small 22 22 $3,069.00 $3,069.00 $1,620.43 $2,915.55 $2,746.76 2026-10-09
J1561 HCPCS Injection, Immune Globulin, (gamunex-c/gammaked), Non-lyophilized (e.g., Liquid)… 66 22 $3,192.76 $3,192.76 $842.88 $7,024.02 $2,745.77 2026-10-09
1000037 CDM Operating Room Services - General Classification 22 22 $3,055.06 $3,055.06 $1,613.07 $2,902.31 $2,734.28 2026-10-09
71551 HCPCS MRI Scan Of Chest With Contrast 40 22 $4,505.26 $4,505.26 $69.10 $4,280.00 $2,703.16 2026-10-09
1000019 CDM Operating Room Services - General Classification 22 22 $2,999.55 $2,999.55 $1,583.76 $2,849.57 $2,684.60 2026-10-09
99291 HCPCS Critical Care, First 30-74 Minutes 83 22 $4,184.58 $4,184.58 $171.05 $3,976.30 $2,636.29 2026-10-09
Q4186 HCPCS Epifix, Per Square Centimeter 176 22 $3,638.00 $3,638.00 $123.02 $14,203.45 $2,617.25 2026-10-09
7001232 CDM Catheter,picc,sl,4fr,60cm,sher 22 22 $2,898.00 $2,898.00 $1,530.14 $2,753.10 $2,593.71 2026-10-09
7001059 CDM Amniofix 4x4cm 22 22 $2,841.00 $2,841.00 $1,500.05 $2,698.95 $2,542.69 2026-10-09
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 40 22 $4,232.78 $4,232.78 $91.65 $4,021.14 $2,539.67 2026-10-09
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 40 22 $4,197.06 $4,197.06 $86.16 $3,987.21 $2,518.24 2026-10-09
Q4145 HCPCS Epifix, Injectable, 1 Mg 44 22 $3,162.50 $3,162.50 $1,465.20 $3,372.50 $2,497.50 2026-10-09
7001139 CDM Ei-5050 40mg 22 22 $2,775.00 $2,775.00 $1,465.20 $2,636.25 $2,483.62 2026-10-09
7000305 CDM Mesh Umbilical Hernia Medium 22 22 $2,758.00 $2,758.00 $1,456.22 $2,620.10 $2,468.41 2026-10-09
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 40 22 $4,094.92 $4,094.92 $91.65 $3,890.17 $2,456.95 2026-10-09
7000251 CDM Gia 80 4.8 Gun 22 22 $2,739.00 $2,739.00 $1,446.19 $2,602.05 $2,451.40 2026-10-09
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 40 22 $4,066.28 $4,066.28 $88.13 $3,862.97 $2,439.77 2026-10-09
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 40 22 $4,066.28 $4,066.28 $88.13 $3,862.97 $2,439.77 2026-10-09
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 40 22 $4,060.37 $4,060.37 $85.87 $3,857.35 $2,436.22 2026-10-09
71552 HCPCS MRI Scan Of Chest Before And After Contrast 40 22 $4,048.64 $4,048.64 $90.18 $3,846.21 $2,429.18 2026-10-09
84182 HCPCS Protein Measurement, Immunological Probe For Band Identification 22 22 $2,700.47 $2,700.47 $788.81 $2,565.45 $2,416.92 2026-10-09
7001070 CDM Amniofix Injectable 45mg 22 22 $2,684.00 $2,684.00 $1,417.15 $2,549.80 $2,402.18 2026-10-09
7001095 CDM Amniofix Injectable 40 Mg 22 22 $2,684.00 $2,684.00 $1,417.15 $2,549.80 $2,402.18 2026-10-09
7001066 CDM Amniofix Wrap 2x2cm 22 22 $2,684.00 $2,684.00 $1,417.15 $2,549.80 $2,402.18 2026-10-09
7001058 CDM Amniofix 3x3cm 22 22 $2,651.00 $2,651.00 $1,399.73 $2,518.45 $2,372.64 2026-10-09
7001071 CDM Amniofix Injectable 100mg 22 22 $2,651.00 $2,651.00 $1,399.73 $2,518.45 $2,372.64 2026-10-09
Q4133 HCPCS Grafix Prime, Grafixpl Prime, Stravix And Stravixpl, Per Square Centimeter 132 22 $2,910.50 $2,910.50 $1,103.52 $12,920.00 $2,351.25 2026-10-09
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 40 22 $3,914.83 $3,914.83 $91.65 $3,719.09 $2,348.90 2026-10-09
7000478 CDM Stapler Endo Clip Er320 22 22 $2,623.00 $2,623.00 $1,384.94 $2,491.85 $2,347.59 2026-10-09
4004053 CDM Simponi Aria 50 Mg/4 Ml Vial 22 22 $2,611.75 $2,611.75 $1,379.00 $2,481.16 $2,337.52 2026-10-09
7001228 CDM Hvt 2.0 Circuit 22 22 $2,568.00 $2,568.00 $1,355.90 $2,439.60 $2,298.36 2026-10-09
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 40 22 $3,795.95 $3,795.95 $72.45 $3,606.15 $2,277.57 2026-10-09
7000223 CDM Endoclip Applier 5mm El5ml 22 22 $2,533.00 $2,533.00 $1,337.42 $2,406.35 $2,267.03 2026-10-09
1000006 CDM Gastro - Intestinal (gi) Services - General Classification 22 22 $2,528.39 $2,528.39 $1,334.99 $2,401.97 $2,262.91 2026-10-09
73720 HCPCS MRI Scan Of Leg Before And After Contrast 40 22 $3,744.23 $3,744.23 $86.16 $3,557.02 $2,246.54 2026-10-09
7001063 CDM Amniofix Surgical 2x6 Cm 22 22 $2,495.00 $2,495.00 $1,317.36 $2,370.25 $2,233.03 2026-10-09
7000110 CDM Cement Bone Simplex With Tobramysin 22 22 $2,495.00 $2,495.00 $1,317.36 $2,370.25 $2,233.03 2026-10-09
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 40 22 $3,714.59 $3,714.59 $95.00 $3,528.86 $2,228.75 2026-10-09
Q4132 HCPCS Grafix Core And Grafixpl Core, Per Square Centimeter 110 22 $2,565.00 $2,565.00 $1,103.52 $4,377.60 $2,227.50 2026-10-09
Q4105 HCPCS Integra Dermal Regeneration Template (drt) Or Integra Omnigraft Dermal Regenerat… 66 22 $2,590.00 $2,590.00 $1,023.26 $3,700.25 $2,227.40 2026-10-09
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 40 22 $3,701.29 $3,701.29 $72.16 $3,516.23 $2,220.77 2026-10-09
C8929 HCPCS Transthoracic Echocardiography With Contrast, Or Without Contrast Followed By Wi… 22 22 $2,477.01 $2,477.01 $1,307.86 $2,353.16 $2,216.93 2026-10-09
7001086 CDM Epicord 2 Cm X 3 Cm 22 22 $2,461.00 $2,461.00 $1,299.41 $2,337.95 $2,202.60 2026-10-09
7001067 CDM Amniofix Wrap 2x4cm 22 22 $2,461.00 $2,461.00 $1,299.41 $2,337.95 $2,202.60 2026-10-09
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 39 22 $3,660.01 $3,660.01 $71.74 $3,477.01 $2,196.01 2026-10-09
1000036 CDM Operating Room Services - General Classification 22 22 $2,444.06 $2,444.06 $1,290.46 $2,321.86 $2,187.43 2026-10-09
71270 HCPCS CT Scan Of Chest Before And After Contrast 61 22 $3,449.26 $3,449.26 $49.90 $3,434.43 $2,173.03 2026-10-09
7000293 CDM M.r.i. Implanted Port Kit 22 22 $2,405.00 $2,405.00 $1,269.84 $2,284.75 $2,152.47 2026-10-09
73220 HCPCS MRI Scan Of Arm Before And After Contrast 62 22 $2,894.75 $2,894.75 $86.45 $3,400.59 $2,147.74 2026-10-09
7000477 CDM Stapler Cartridge Reload 6r45b 22 22 $2,359.00 $2,359.00 $1,245.55 $2,241.05 $2,111.31 2026-10-09
1000015 CDM Gastro - Intestinal (gi) Services - General Classification 22 22 $2,354.52 $2,354.52 $1,243.19 $2,236.79 $2,107.30 2026-10-09
7000488 CDM Stapler Reload 45mm Wht Tr45w 22 22 $2,336.00 $2,336.00 $1,233.41 $2,219.20 $2,090.72 2026-10-09
7000224 CDM Endoscopic Cut Standrd Et45b 22 22 $2,336.00 $2,336.00 $1,233.41 $2,219.20 $2,090.72 2026-10-09
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 62 22 $3,288.26 $3,288.26 $55.77 $3,280.04 $2,071.60 2026-10-09
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 40 22 $3,441.29 $3,441.29 $69.69 $3,269.23 $2,064.77 2026-10-09
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 40 22 $3,441.29 $3,441.29 $69.69 $3,269.23 $2,064.77 2026-10-09
7000479 CDM Stapler Endo Flex Articng 45mm 22 22 $2,306.00 $2,306.00 $1,217.57 $2,190.70 $2,063.87 2026-10-09
7000304 CDM Mesh Umbilical Hernia Large 22 22 $2,305.00 $2,305.00 $1,217.04 $2,189.75 $2,062.97 2026-10-09
11404 HCPCS Removal Of Noncancer Skin Growth Of Body, Arms, Or Legs, 3.1-4.0 Cm 39 22 $3,421.87 $3,421.87 $130.35 $3,250.78 $2,053.12 2026-10-09
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 40 22 $3,409.82 $3,409.82 $71.45 $3,239.33 $2,045.89 2026-10-09
J1745 HCPCS Injection, Infliximab, Excludes Biosimilar, 10 Mg 22 22 $2,365.30 $2,365.30 $1,248.88 $2,601.83 $2,034.16 2026-10-09
7001073 CDM Amniocord 2x3cm 22 22 $2,271.00 $2,271.00 $1,199.09 $2,157.45 $2,032.55 2026-10-09
7000227 CDM Endoscopic Linear Reload Zr45b 22 22 $2,267.00 $2,267.00 $1,196.98 $2,153.65 $2,028.97 2026-10-09
7000053 CDM Bone Cement Palcros 22 22 $2,266.00 $2,266.00 $1,196.45 $2,152.70 $2,028.07 2026-10-09
26350 HCPCS Repair Of Finger Tendon Of Under Side Of Hand Other Than Upper Most Part Of Palm… 40 22 $3,372.46 $3,372.46 $77.29 $3,203.84 $2,023.48 2026-10-09
1000033 CDM Operating Room Services - General Classification 22 22 $2,249.64 $2,249.64 $1,187.81 $2,137.16 $2,013.43 2026-10-09
7000483 CDM Stapler Pph Hemorrhoid 33mm Pp 22 22 $2,238.00 $2,238.00 $1,181.66 $2,126.10 $2,003.01 2026-10-09
81479 HCPCS Molecular Pathology Procedure 44 22 $3,589.16 $3,589.16 $268.33 $6,336.62 $2,002.31 2026-10-09
7000962 CDM Forceps Grasping 22 22 $2,235.00 $2,235.00 $1,180.08 $2,123.25 $2,000.33 2026-10-09
73722 HCPCS MRI Scan Of Leg Joint With Contrast 40 22 $3,314.24 $3,314.24 $65.37 $3,148.53 $1,988.54 2026-10-09
7000309 CDM Mesh Ventral Hernia 8x12 22 22 $2,220.00 $2,220.00 $1,172.16 $2,109.00 $1,986.90 2026-10-09
7001229 CDM Iovera Smart Tip 190 22 22 $2,218.00 $2,218.00 $1,171.10 $2,107.10 $1,985.11 2026-10-09
7001231 CDM Iovera Smart Tip 309 22 22 $2,218.00 $2,218.00 $1,171.10 $2,107.10 $1,985.11 2026-10-09
7000307 CDM Mesh Ventral Heria 13.8 X 17.8 22 22 $2,214.00 $2,214.00 $1,168.99 $2,103.30 $1,981.53 2026-10-09
71555 HCPCS MRI Scan Of Blood Vessels Of Chest 40 22 $3,292.43 $3,292.43 $71.74 $3,127.81 $1,975.46 2026-10-09
03 CDM Room & Board - Private (one Bed) - General Classification 14 14 $2,157.77 $2,157.77 $1,359.40 $2,049.88 $1,974.36 2026-10-09
71550 HCPCS MRI Scan Of Chest Without Contrast 40 22 $3,263.77 $3,263.77 $57.82 $3,100.58 $1,958.26 2026-10-09
7001077 CDM Amniofill 500mg 22 22 $2,185.00 $2,185.00 $1,153.68 $2,075.75 $1,955.58 2026-10-09
7000388 CDM Patch Hernia Kugel Lg Oval 5.5x7 22 22 $2,185.00 $2,185.00 $1,153.68 $2,075.75 $1,955.58 2026-10-09
70548 HCPCS MRI Scan Of Blood Vessels Of Neck With Contrast 40 22 $3,254.74 $3,254.74 $59.79 $3,092.00 $1,952.84 2026-10-09
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 40 22 $3,254.63 $3,254.63 $71.86 $3,091.90 $1,952.78 2026-10-09
4004289 CDM Prolia 60 Mg/ml Syringe 22 22 $2,179.14 $2,179.14 $1,150.59 $2,070.18 $1,950.33 2026-10-09
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 40 22 $3,247.60 $3,247.60 $69.40 $3,085.22 $1,948.56 2026-10-09
7001081 CDM Needle Tuohy 17 X 5 22 22 $2,175.00 $2,175.00 $1,148.40 $2,066.25 $1,946.62 2026-10-09
Q4110 HCPCS Primatrix, Per Square Centimeter 176 22 $2,378.00 $2,378.00 $1,035.41 $3,800.00 $1,939.51 2026-10-09
70552 HCPCS MRI Scan Of Brain With Contrast 40 22 $3,209.12 $3,209.12 $71.16 $3,048.66 $1,925.47 2026-10-09
7000106 CDM Tray Dual Lumin Picc 5fr 22 22 $2,151.00 $2,151.00 $1,135.73 $2,043.45 $1,925.14 2026-10-09
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 39 22 $3,205.76 $3,205.76 $50.78 $3,045.47 $1,923.46 2026-10-09
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 39 22 $3,205.76 $3,205.76 $50.78 $3,045.47 $1,923.46 2026-10-09
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 39 22 $3,205.76 $3,205.76 $50.49 $3,045.47 $1,923.46 2026-10-09
26356 HCPCS Primary Repair Of Finger Tendon On Underside Of The Hand Without A Graft In Zone… 40 22 $3,163.37 $3,163.37 $184.67 $3,005.20 $1,915.58 2026-10-09
J3489 HCPCS Injection, Zoledronic Acid, 1 Mg 22 22 $2,222.59 $2,222.59 $1,173.53 $2,111.46 $1,911.43 2026-10-09
7000303 CDM Mesh Ultrapro 15x15cm 6x6inch 22 22 $2,131.00 $2,131.00 $1,125.17 $2,024.45 $1,907.24 2026-10-09
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 39 22 $3,176.05 $3,176.05 $48.72 $3,017.25 $1,905.63 2026-10-09
7001076 CDM Amniofill 250mg 22 22 $2,128.00 $2,128.00 $1,123.58 $2,021.60 $1,904.56 2026-10-09
7000109 CDM Cement Bone Colbalt G 22 22 $2,115.00 $2,115.00 $1,116.72 $2,009.25 $1,892.92 2026-10-09
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 64 22 $2,111.09 $2,111.09 $54.59 $3,008.30 $1,889.42 2026-10-09
7000390 CDM Patch Hernia Kugel Sm Oval 3x4.6 22 22 $2,105.00 $2,105.00 $1,111.44 $1,999.75 $1,883.97 2026-10-09
7000918 CDM 5-3 And 5-4 With 2 Reg Boots 22 22 $2,103.00 $2,103.00 $1,110.38 $1,997.85 $1,882.18 2026-10-09
Q4038 HCPCS Cast Supplies, Short Leg Cast, Adult (11 Years +), Fiberglass 22 22 $2,100.00 $2,100.00 $1,108.80 $1,995.00 $1,879.50 2026-10-09
7000440 CDM Six Shtr Multi Ligator #mbl-6 22 22 $2,100.00 $2,100.00 $1,108.80 $1,995.00 $1,879.50 2026-10-09
88374 HCPCS Microscopic Genetic Analysis Of Tissue, Computer-assisted Technology, Initial Pr… 22 22 $2,098.06 $2,098.06 $1,107.78 $1,993.16 $1,877.76 2026-10-09
74182 HCPCS MRI Scan Of Abdomen With Contrast 40 22 $3,119.41 $3,119.41 $68.81 $2,963.44 $1,871.65 2026-10-09
72196 HCPCS MRI Scan Of Pelvis With Contrast 40 22 $3,109.67 $3,109.67 $69.10 $2,954.19 $1,865.80 2026-10-09
7000250 CDM Gia 80 3.8 Gun 22 22 $2,078.00 $2,078.00 $1,097.18 $1,974.10 $1,859.81 2026-10-09
7000252 CDM Gia 80 4.8 Reload 22 22 $2,075.00 $2,075.00 $1,095.60 $1,971.25 $1,857.12 2026-10-09
70545 HCPCS MRI Scan Of Blood Vessels Of Head With Contrast 39 22 $3,084.72 $3,084.72 $47.84 $2,930.48 $1,850.83 2026-10-09
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 40 22 $3,081.38 $3,081.38 $71.45 $2,927.31 $1,848.83 2026-10-09
86362 HCPCS Cell-based Immunofluorescence (cba) Detection Of Myelin Oligodendrocyte Glycopro… 22 22 $2,062.76 $2,062.76 $248.56 $1,959.62 $1,846.17 2026-10-09
86052 HCPCS Cell-based Immunofluorescence (cba) Detection Of Aquaporin-4 (neuromyelitis Opti… 22 22 $2,062.76 $2,062.76 $248.56 $1,959.62 $1,846.17 2026-10-09
7000496 CDM Stapler Surgical Disp 55 3.5 22 22 $2,059.00 $2,059.00 $1,087.15 $1,956.05 $1,842.80 2026-10-09
26910 HCPCS Amputation Of Finger Or Thumb 37 22 $2,922.99 $2,922.99 $637.09 $2,776.84 $1,828.85 2026-10-09
15830 HCPCS Removal Of Extra Skin And Tissue Of Abdomen 15 15 $6,369.70 $6,369.70 $908.45 $5,732.73 $1,823.99 2026-10-09
27503 HCPCS Closed Treatment Of Broken Thigh Bone At Far End With Manipulation 40 22 $2,679.36 $2,679.36 $638.78 $2,789.96 $1,811.75 2026-10-09
7000919 CDM 5-3 And 5-4 With No Boot 22 22 $2,006.00 $2,006.00 $1,059.17 $1,905.70 $1,795.37 2026-10-09
4004052 CDM Injectafer 750 Mg/15 Ml Vial 22 22 $2,005.56 $2,005.56 $1,058.94 $1,905.28 $1,794.97 2026-10-09
7000849 CDM Mesh Circle W Strap 4.3x1.7 22 22 $2,000.00 $2,000.00 $1,056.00 $1,900.00 $1,790.00 2026-10-09
7001057 CDM Amniofix 2x3cm 22 22 $1,996.00 $1,996.00 $1,053.89 $1,896.20 $1,786.42 2026-10-09
7001159 CDM Power Port Cath 8fr Isp MRI Cath Kit 22 22 $1,990.00 $1,990.00 $1,050.72 $1,890.50 $1,781.05 2026-10-09
Q4166 HCPCS Cytal, Per Square Centimeter 110 22 $2,375.00 $2,375.00 $340.56 $3,452.30 $1,777.20 2026-10-09
71260 HCPCS CT Scan Of Chest With Contrast 39 22 $2,960.64 $2,960.64 $46.67 $2,812.61 $1,776.38 2026-10-09
74160 HCPCS CT Scan Of Abdomen With Contrast 39 22 $2,949.80 $2,949.80 $50.78 $2,802.31 $1,769.88 2026-10-09
20100 HCPCS Exploration Of Wound Of Neck 37 22 $2,911.19 $2,911.19 $460.42 $2,765.63 $1,746.71 2026-10-09
84181 HCPCS Protein Measurement 22 22 $1,950.21 $1,950.21 $332.12 $1,852.70 $1,745.44 2026-10-09
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 40 22 $2,894.75 $2,894.75 $86.45 $2,750.01 $1,736.85 2026-10-09
70460 HCPCS CT Scan Head Or Brain With Contrast 40 22 $2,889.44 $2,889.44 $45.20 $2,744.97 $1,733.66 2026-10-09
7000486 CDM Stapler Prem+ Ceea28mm Blue 22 22 $1,935.00 $1,935.00 $1,021.68 $1,838.25 $1,731.83 2026-10-09
7000485 CDM Stapler Prem+ Ceea 31mm Green 22 22 $1,935.00 $1,935.00 $1,021.68 $1,838.25 $1,731.83 2026-10-09
7000484 CDM Stapler Prem +ceea 25mm Grey 22 22 $1,935.00 $1,935.00 $1,021.68 $1,838.25 $1,731.83 2026-10-09
7000842 CDM Forceps Grasping 22 22 $1,934.00 $1,934.00 $1,021.15 $1,837.30 $1,730.93 2026-10-09
06 CDM Room & Board - Semi-private (two Beds) - General Classification 14 14 $1,883.77 $1,883.77 $1,186.78 $1,789.58 $1,723.65 2026-10-09
7000263 CDM Harmonic Scalpel 5mm 22 22 $1,909.00 $1,909.00 $1,007.95 $1,813.55 $1,708.55 2026-10-09
4004051 CDM Xolair 150 Mg/1.2 Ml Powder Vl 22 22 $1,907.98 $1,907.98 $1,007.41 $1,812.58 $1,707.64 2026-10-09
7000389 CDM Patch Hernia Kugel Med Oval 4.34x5.5 22 22 $1,902.00 $1,902.00 $1,004.26 $1,806.90 $1,702.29 2026-10-09
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 39 22 $2,835.26 $2,835.26 $47.84 $2,693.50 $1,701.16 2026-10-09
7001197 CDM Neptune 4 Port Manifold 22 22 $1,900.00 $1,900.00 $1,003.20 $1,805.00 $1,700.50 2026-10-09
70540 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Without Contrast 40 22 $2,811.85 $2,811.85 $53.72 $2,671.26 $1,687.11 2026-10-09
72193 HCPCS CT Scan Of Pelvis With Contrast 40 22 $2,810.96 $2,810.96 $46.37 $2,670.41 $1,686.58 2026-10-09
87483 HCPCS Test For Detecting Nucleic Acid Of Organism Causing Infection Of Central Nervous… 22 22 $1,872.40 $1,872.40 $988.63 $7,803.79 $1,685.16 2026-10-09
7000298 CDM Mesh "gore" 8cm X 12cm 22 22 $1,880.00 $1,880.00 $992.64 $1,786.00 $1,682.60 2026-10-09
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 39 22 $2,800.58 $2,800.58 $50.78 $2,660.55 $1,680.35 2026-10-09
70482 HCPCS CT Scan Of Cranial Cavity Before And After Contrast 61 22 $2,667.22 $2,667.22 $50.49 $2,660.55 $1,680.35 2026-10-09
72132 HCPCS CT Scan Of Lower Spine With Contrast 39 22 $2,800.00 $2,800.00 $48.72 $2,660.00 $1,680.00 2026-10-09
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 40 22 $2,800.00 $2,800.00 $64.20 $2,660.00 $1,680.00 2026-10-09
7000386 CDM Pain Buster W/dual Soaker 400m 22 22 $1,875.00 $1,875.00 $990.00 $1,781.25 $1,678.12 2026-10-09
81513 HCPCS Measurement Of RNA Of Bacteria In Vaginal Fluid Specimen 22 22 $1,863.40 $1,863.40 $983.88 $2,657.77 $1,677.06 2026-10-09
35860 HCPCS Exploration Of Arm Or Leg For Bleeding, Blood Clot, Or Infection After Surgery 39 22 $2,383.16 $2,383.16 $649.74 $2,264.00 $1,671.65 2026-10-09
73702 HCPCS CT Scan Of Leg Before And After Contrast 63 22 $2,650.82 $2,650.82 $48.43 $2,644.19 $1,670.02 2026-10-09
7001069 CDM Amniofix Injectable 20mg 22 22 $1,858.00 $1,858.00 $981.02 $1,765.10 $1,662.91 2026-10-09
70551 HCPCS MRI Scan Of Brain Without Contrast 40 22 $2,756.20 $2,756.20 $58.91 $2,618.39 $1,653.72 2026-10-09
7000481 CDM Stapler Gia 60 4.8 Single Use 22 22 $1,847.00 $1,847.00 $975.22 $1,754.65 $1,653.07 2026-10-09
7001235 CDM Demayo Liner - Sterile Pad 22 22 $1,835.00 $1,835.00 $968.88 $1,743.25 $1,642.33 2026-10-09
1000042 CDM Operating Room Services - General Classification 22 22 $1,833.07 $1,833.07 $967.86 $1,741.42 $1,640.60 2026-10-09
36561 HCPCS Insertion Of Central Venous Tube With Port (5 Years Or Older) 40 22 $2,731.76 $2,731.76 $255.38 $2,595.17 $1,639.06 2026-10-09
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