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Hospital

WALLOWA MEMORIAL HOSPITAL

Enterprise, OR · CCN 381306 · Rates published

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You selected 807 (MS_DRG)

This facility hasn’t published a payer-negotiated rate for this exact code. See its full rate list below.

5,396 distinct procedures filed
15 distinct payers
60,241 rate rows
2026-07-17 last MRF observed
Data quality

59,319 of 60,241 rate rows are consumer-grade (98.5%)

922 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 410
per-diem day rate — not a per-procedure price 282
placeholder amount (≤ $0.02) — excluded from medians 99
exceeds 10× this hospital's gross charge — excluded from medians 81
percent-of-charges filed in the dollar field — excluded from medians 36
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 14
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbWCHCENTERPRISEOR&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Wallowa_County_Health.aspx
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-14
Content fingerprint 9427321d3becae8b… · 6,737,660 bytes · first seen 2026-07-17

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
947
MS_DRG 		Signs And Symptoms With Mcc 5 $251,979.23 $265,241.29 $257,284.05 nat. median
$12,594
outlier · 20.4×
439
MS_DRG 		Disorders Of Pancreas Except Malignancy With Cc 5 $200,696.58 $211,259.56 $204,921.77 nat. median
$9,456
outlier · 21.7×
798
MS_DRG 		Vaginal Delivery With Sterilization And/or D&c Without Cc/mcc 5 $185,255.05 $195,005.32 $189,155.16 nat. median
$9,531
outlier · 19.8×
818
MS_DRG 		Other Antepartum Diagnoses With O.r. Procedures With Cc 5 $180,373.77 $189,867.13 $184,171.12 nat. median
$12,579
outlier · 14.6×
378
MS_DRG 		Gastrointestinal Hemorrhage With Cc 5 $169,495.86 $178,416.69 $173,064.19 nat. median
$10,606
outlier · 16.3×
580
MS_DRG 		Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 5 $164,159.27 $172,799.23 $167,615.25 nat. median
$17,681
outlier · 9.5×
440
MS_DRG 		Disorders Of Pancreas Except Malignancy Without Cc/mcc 5 $161,365.31 $169,858.22 $164,762.47 nat. median
$7,284
outlier · 22.6×
698
MS_DRG 		Other Kidney And Urinary Tract Diagnoses With Mcc 5 $154,846.62 $162,996.44 $158,106.55 nat. median
$16,480
outlier · 9.6×
948
MS_DRG 		Signs And Symptoms Without Mcc 5 $149,763.15 $157,645.42 $152,916.06 nat. median
$8,463
outlier · 18.1×
792
MS_DRG 		Prematurity Without Major Problems 5 $147,127.28 $154,870.82 $150,224.70 nat. median
$20,262
outlier · 7.4×
264
MS_DRG 		Other Circulatory System O.r. Procedures 5 $146,258.34 $153,956.15 $149,337.47 nat. median
$32,666
outlier · 4.6×
563
MS_DRG 		Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 5 $144,950.13 $152,579.09 $148,001.71 nat. median
$9,631
outlier · 15.4×
603
MS_DRG 		Cellulitis Without Mcc 5 $139,330.35 $146,663.53 $142,263.62 nat. median
$9,525
outlier · 14.9×
379
MS_DRG 		Gastrointestinal Hemorrhage Without Cc/mcc 5 $138,763.39 $146,066.73 $141,684.72 nat. median
$7,380
outlier · 19.2×
918
MS_DRG 		Poisoning And Toxic Effects Of Drugs Without Mcc 5 $137,479.41 $144,715.17 $140,373.71 nat. median
$8,721
outlier · 16.1×
807
MS_DRG 		Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc 5 $137,325.61 $144,553.28 $140,216.68 nat. median
$7,284
outlier · 19.2×
194
MS_DRG 		Simple Pneumonia And Pleurisy With Cc 5 $137,195.68 $144,416.51 $140,084.01 nat. median
$9,038
outlier · 15.5×
399
MS_DRG 		Appendix Procedures Without Cc/mcc 5 $135,171.94 $142,286.25 $138,017.66 nat. median
$12,315
outlier · 11.2×
639
MS_DRG 		Diabetes Without Cc/mcc 5 $133,329.88 $140,347.24 $136,136.82 nat. median
$7,159
outlier · 19.0×
561
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc 5 $131,004.38 $137,899.35 $133,762.36 nat. median
$9,110
outlier · 14.7×
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 5 $130,582.43 $137,455.19 $133,331.53 nat. median
$10,806
outlier · 12.3×
832
MS_DRG 		Other Antepartum Diagnoses Without O.r. Procedures With Cc 5 $128,269.09 $135,020.09 $130,969.49 nat. median
$7,940
outlier · 16.5×
897
MS_DRG 		Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 5 $126,906.95 $133,586.26 $129,578.67 nat. median
$8,661
outlier · 15.0×
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 5 $126,557.42 $133,218.33 $129,221.78 nat. median
$19,136
outlier · 6.8×
390
MS_DRG 		Gastrointestinal Obstruction Without Cc/mcc 5 $126,500.47 $133,158.39 $129,163.64 nat. median
$6,522
outlier · 19.8×
833
MS_DRG 		Other Antepartum Diagnoses Without O.r. Procedures Without Cc/mcc 5 $125,763.24 $132,382.36 $128,410.89 nat. median
$5,973
outlier · 21.5×
543
MS_DRG 		Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 5 $123,144.18 $129,625.45 $125,736.69 nat. median
$11,162
outlier · 11.3×
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 5 $121,407.72 $127,797.60 $123,963.68 nat. median
$8,588
outlier · 14.4×
638
MS_DRG 		Diabetes With Cc 5 $121,052.45 $127,423.63 $123,600.92 nat. median
$9,750
outlier · 12.7×
195
MS_DRG 		Simple Pneumonia And Pleurisy Without Cc/mcc 5 $120,696.65 $127,049.10 $123,237.63 nat. median
$7,228
outlier · 17.1×
309
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders With Cc 5 $120,541.26 $126,885.54 $123,078.97 nat. median
$8,373
outlier · 14.7×
689
MS_DRG 		Kidney And Urinary Tract Infections With Mcc 5 $117,384.71 $123,562.85 $119,855.96 nat. median
$12,008
outlier · 10.0×
812
MS_DRG 		Red Blood Cell Disorders Without Mcc 5 $117,325.20 $123,500.21 $119,795.20 nat. median
$9,785
outlier · 12.2×
179
MS_DRG 		Respiratory Infections And Inflammations Without Cc/mcc 5 $116,249.53 $122,367.93 $118,696.89 nat. median
$8,650
outlier · 13.7×
281
MS_DRG 		Acute Myocardial Infarction, Discharged Alive With Cc 5 $115,976.47 $122,080.49 $118,418.08 nat. median
$10,300
outlier · 11.5×
432
MS_DRG 		Cirrhosis And Alcoholic Hepatitis With Mcc 5 $114,979.81 $121,031.38 $117,400.44 nat. median
$19,576
outlier · 6.0×
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 5 $114,932.18 $120,981.24 $117,351.80 nat. median
$11,029
outlier · 10.6×
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 5 $114,887.64 $120,934.36 $117,306.32 nat. median
$13,455
outlier · 8.7×
806
MS_DRG 		Vaginal Delivery Without Sterilization Or D&c With Cc 5 $114,184.77 $120,194.50 $116,588.66 nat. median
$7,911
outlier · 14.7×
560
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Cc 5 $113,735.70 $119,721.79 $116,130.14 nat. median
$12,112
outlier · 9.6×
554
MS_DRG 		Bone Diseases And Arthropathies Without Mcc 5 $112,680.42 $118,610.97 $115,052.64 nat. median
$9,200
outlier · 12.5×
371
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 5 $111,511.63 $117,380.66 $113,859.24 nat. median
$17,605
outlier · 6.5×
951
MS_DRG 		Other Factors Influencing Health Status 5 $110,691.62 $116,517.49 $113,021.97 nat. median
$6,472
outlier · 17.5×
690
MS_DRG 		Kidney And Urinary Tract Infections Without Mcc 5 $110,153.13 $115,950.67 $112,472.15 nat. median
$8,869
outlier · 12.7×
795
MS_DRG 		Normal Newborn 5 $110,062.28 $115,855.03 $112,379.38 nat. median
$2,642
outlier · 42.5×
392
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 5 $108,953.90 $114,688.32 $111,247.67 nat. median
$8,659
outlier · 12.8×
949
MS_DRG 		Aftercare With Cc/mcc 5 $107,134.43 $112,773.08 $109,389.89 nat. median
$12,344
outlier · 8.9×
54
MS_DRG 		Nervous System Neoplasms With Mcc 5 $106,109.34 $111,694.04 $108,343.22 nat. median
$15,277
outlier · 7.1×
55
MS_DRG 		Nervous System Neoplasms Without Mcc 5 $104,986.47 $110,512.07 $107,196.71 nat. median
$11,231
outlier · 9.5×
65
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 5 $103,829.01 $109,293.69 $106,014.88 nat. median
$11,101
outlier · 9.6×

Other procedures at this hospital

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Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
947 MS_DRG Signs And Symptoms With Mcc 5 5 $265,241.29 $265,241.29 $251,979.23 $265,241.29 $257,284.05 2026-07-09
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 5 5 $211,259.56 $211,259.56 $200,696.58 $211,259.56 $204,921.77 2026-07-09
798 MS_DRG Vaginal Delivery With Sterilization And/or D&c Without Cc/mcc 5 5 $195,005.32 $195,005.32 $185,255.05 $195,005.32 $189,155.16 2026-07-09
818 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Cc 5 5 $189,867.13 $189,867.13 $180,373.77 $189,867.13 $184,171.12 2026-07-09
378 MS_DRG Gastrointestinal Hemorrhage With Cc 5 5 $178,416.69 $178,416.69 $169,495.86 $178,416.69 $173,064.19 2026-07-09
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 5 5 $172,799.23 $172,799.23 $164,159.27 $172,799.23 $167,615.25 2026-07-09
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 5 5 $169,858.22 $169,858.22 $161,365.31 $169,858.22 $164,762.47 2026-07-09
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 5 5 $162,996.44 $162,996.44 $154,846.62 $162,996.44 $158,106.55 2026-07-09
948 MS_DRG Signs And Symptoms Without Mcc 5 5 $157,645.42 $157,645.42 $149,763.15 $157,645.42 $152,916.06 2026-07-09
792 MS_DRG Prematurity Without Major Problems 5 5 $154,870.82 $154,870.82 $147,127.28 $154,870.82 $150,224.70 2026-07-09
264 MS_DRG Other Circulatory System O.r. Procedures 5 5 $153,956.15 $153,956.15 $146,258.34 $153,956.15 $149,337.47 2026-07-09
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 5 5 $152,579.09 $152,579.09 $144,950.13 $152,579.09 $148,001.71 2026-07-09
603 MS_DRG Cellulitis Without Mcc 5 5 $146,663.53 $146,663.53 $139,330.35 $146,663.53 $142,263.62 2026-07-09
379 MS_DRG Gastrointestinal Hemorrhage Without Cc/mcc 5 5 $146,066.73 $146,066.73 $138,763.39 $146,066.73 $141,684.72 2026-07-09
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 5 5 $144,715.17 $144,715.17 $137,479.41 $144,715.17 $140,373.71 2026-07-09
807 MS_DRG Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc 5 5 $144,553.28 $144,553.28 $137,325.61 $144,553.28 $140,216.68 2026-07-09
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 5 5 $144,416.51 $144,416.51 $137,195.68 $144,416.51 $140,084.01 2026-07-09
399 MS_DRG Appendix Procedures Without Cc/mcc 5 5 $142,286.25 $142,286.25 $135,171.94 $142,286.25 $138,017.66 2026-07-09
639 MS_DRG Diabetes Without Cc/mcc 5 5 $140,347.24 $140,347.24 $133,329.88 $140,347.24 $136,136.82 2026-07-09
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/mcc 5 5 $137,899.35 $137,899.35 $131,004.38 $137,899.35 $133,762.36 2026-07-09
178 MS_DRG Respiratory Infections And Inflammations With Cc 5 5 $137,455.19 $137,455.19 $130,582.43 $137,455.19 $133,331.53 2026-07-09
832 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Cc 5 5 $135,020.09 $135,020.09 $128,269.09 $135,020.09 $130,969.49 2026-07-09
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 5 5 $133,586.26 $133,586.26 $126,906.95 $133,586.26 $129,578.67 2026-07-09
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 5 5 $133,218.33 $133,218.33 $126,557.42 $133,218.33 $129,221.78 2026-07-09
390 MS_DRG Gastrointestinal Obstruction Without Cc/mcc 5 5 $133,158.39 $133,158.39 $126,500.47 $133,158.39 $129,163.64 2026-07-09
833 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures Without Cc/mcc 5 5 $132,382.36 $132,382.36 $125,763.24 $132,382.36 $128,410.89 2026-07-09
543 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 5 5 $129,625.45 $129,625.45 $123,144.18 $129,625.45 $125,736.69 2026-07-09
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 5 5 $127,797.60 $127,797.60 $121,407.72 $127,797.60 $123,963.68 2026-07-09
638 MS_DRG Diabetes With Cc 5 5 $127,423.63 $127,423.63 $121,052.45 $127,423.63 $123,600.92 2026-07-09
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 5 5 $127,049.10 $127,049.10 $120,696.65 $127,049.10 $123,237.63 2026-07-09
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 5 5 $126,885.54 $126,885.54 $120,541.26 $126,885.54 $123,078.97 2026-07-09
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 5 5 $123,562.85 $123,562.85 $117,384.71 $123,562.85 $119,855.96 2026-07-09
812 MS_DRG Red Blood Cell Disorders Without Mcc 5 5 $123,500.21 $123,500.21 $117,325.20 $123,500.21 $119,795.20 2026-07-09
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 5 5 $122,367.93 $122,367.93 $116,249.53 $122,367.93 $118,696.89 2026-07-09
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 5 5 $122,080.49 $122,080.49 $115,976.47 $122,080.49 $118,418.08 2026-07-09
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 5 5 $121,031.38 $121,031.38 $114,979.81 $121,031.38 $117,400.44 2026-07-09
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 5 5 $120,981.24 $120,981.24 $114,932.18 $120,981.24 $117,351.80 2026-07-09
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 5 5 $120,934.36 $120,934.36 $114,887.64 $120,934.36 $117,306.32 2026-07-09
806 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Cc 5 5 $120,194.50 $120,194.50 $114,184.77 $120,194.50 $116,588.66 2026-07-09
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 5 5 $119,721.79 $119,721.79 $113,735.70 $119,721.79 $116,130.14 2026-07-09
554 MS_DRG Bone Diseases And Arthropathies Without Mcc 5 5 $118,610.97 $118,610.97 $112,680.42 $118,610.97 $115,052.64 2026-07-09
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 5 5 $117,380.66 $117,380.66 $111,511.63 $117,380.66 $113,859.24 2026-07-09
951 MS_DRG Other Factors Influencing Health Status 5 5 $116,517.49 $116,517.49 $110,691.62 $116,517.49 $113,021.97 2026-07-09
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 5 5 $115,950.67 $115,950.67 $110,153.13 $115,950.67 $112,472.15 2026-07-09
795 MS_DRG Normal Newborn 5 5 $115,855.03 $115,855.03 $110,062.28 $115,855.03 $112,379.38 2026-07-09
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 5 5 $114,688.32 $114,688.32 $108,953.90 $114,688.32 $111,247.67 2026-07-09
949 MS_DRG Aftercare With Cc/mcc 5 5 $112,773.08 $112,773.08 $107,134.43 $112,773.08 $109,389.89 2026-07-09
54 MS_DRG Nervous System Neoplasms With Mcc 5 5 $111,694.04 $111,694.04 $106,109.34 $111,694.04 $108,343.22 2026-07-09
55 MS_DRG Nervous System Neoplasms Without Mcc 5 5 $110,512.07 $110,512.07 $104,986.47 $110,512.07 $107,196.71 2026-07-09
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 5 5 $109,293.69 $109,293.69 $103,829.01 $109,293.69 $106,014.88 2026-07-09
90 MS_DRG Concussion Without Cc/mcc 5 5 $109,230.39 $109,230.39 $103,768.87 $109,230.39 $105,953.48 2026-07-09
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 5 5 $108,481.27 $108,481.27 $103,057.21 $108,481.27 $105,226.83 2026-07-09
572 MS_DRG Skin Debridement Without Cc/mcc 5 5 $107,601.48 $107,601.48 $102,221.41 $107,601.48 $104,373.44 2026-07-09
881 MS_DRG Depressive Neuroses 5 5 $106,782.17 $106,782.17 $101,443.06 $106,782.17 $103,578.70 2026-07-09
291 MS_DRG Heart Failure And Shock With Mcc 5 5 $106,442.69 $106,442.69 $101,120.56 $106,442.69 $103,249.41 2026-07-09
177 MS_DRG Respiratory Infections And Inflammations With Mcc 5 5 $105,220.14 $105,220.14 $99,959.13 $105,220.14 $102,063.54 2026-07-09
176 MS_DRG Pulmonary Embolism Without Mcc 5 5 $104,631.67 $104,631.67 $99,400.09 $104,631.67 $101,492.72 2026-07-09
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 5 5 $101,729.52 $101,729.52 $96,643.04 $101,729.52 $98,677.63 2026-07-09
788 MS_DRG Cesarean Section Without Sterilization Without Cc/mcc 5 5 $97,461.70 $97,461.70 $92,588.62 $97,461.70 $94,537.85 2026-07-09
998 MS_DRG Principal Diagnosis Invalid As Discharge Diagnosis 5 5 $97,295.78 $97,295.78 $92,430.99 $97,295.78 $94,376.91 2026-07-09
395 MS_DRG Other Digestive System Diagnoses Without Cc/mcc 5 5 $97,246.23 $97,246.23 $92,383.92 $97,246.23 $94,328.84 2026-07-09
884 MS_DRG Organic Disturbances And Intellectual Disability 5 5 $95,370.93 $95,370.93 $90,602.39 $95,370.93 $92,509.80 2026-07-09
203 MS_DRG Bronchitis And Asthma Without Cc/mcc 5 5 $95,247.07 $95,247.07 $90,484.72 $95,247.07 $92,389.66 2026-07-09
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 5 5 $93,852.22 $93,852.22 $89,159.61 $93,852.22 $91,036.65 2026-07-09
811 MS_DRG Red Blood Cell Disorders With Mcc 5 5 $92,935.37 $92,935.37 $88,288.60 $92,935.37 $90,147.31 2026-07-09
684 MS_DRG Renal Failure Without Cc/mcc 5 5 $91,306.28 $91,306.28 $86,740.97 $91,306.28 $88,567.09 2026-07-09
885 MS_DRG Psychoses 5 5 $89,035.06 $89,035.06 $84,583.31 $89,035.06 $86,364.01 2026-07-09
437 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas Without Cc/mcc 5 5 $86,955.55 $86,955.55 $82,607.77 $86,955.55 $84,346.88 2026-07-09
189 MS_DRG Pulmonary Edema And Respiratory Failure 5 5 $86,850.91 $86,850.91 $82,508.36 $86,850.91 $84,245.38 2026-07-09
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 5 5 $86,796.34 $86,796.34 $82,456.52 $86,796.34 $84,192.45 2026-07-09
394 MS_DRG Other Digestive System Diagnoses With Cc 5 5 $83,387.91 $83,387.91 $79,218.51 $83,387.91 $80,886.27 2026-07-09
683 MS_DRG Renal Failure With Cc 5 5 $82,667.17 $82,667.17 $78,533.81 $82,667.17 $80,187.15 2026-07-09
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 5 5 $80,793.37 $80,793.37 $76,753.70 $80,793.37 $78,369.57 2026-07-09
316 MS_DRG Other Circulatory System Diagnoses Without Cc/mcc 5 5 $78,355.16 $78,355.16 $74,437.40 $78,355.16 $76,004.51 2026-07-09
312 MS_DRG Syncope And Collapse 5 5 $77,416.26 $77,416.26 $73,545.45 $77,416.26 $75,093.77 2026-07-09
552 MS_DRG Medical Back Problems Without Mcc 5 5 $72,639.61 $72,639.61 $69,007.63 $72,639.61 $70,460.42 2026-07-09
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 5 5 $66,672.53 $66,672.53 $63,338.90 $66,672.53 $64,672.35 2026-07-09
315 MS_DRG Other Circulatory System Diagnoses With Cc 5 5 $60,701.43 $60,701.43 $57,666.36 $60,701.43 $58,880.39 2026-07-09
914 MS_DRG Traumatic Injury Without Mcc 5 5 $54,045.75 $54,045.75 $51,343.46 $54,045.75 $52,424.38 2026-07-09
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 5 5 $51,143.44 $51,143.44 $48,586.27 $51,143.44 $49,609.14 2026-07-09
682 MS_DRG Renal Failure With Mcc 5 5 $49,501.52 $49,501.52 $47,026.44 $49,501.52 $48,016.47 2026-07-09
388 MS_DRG Gastrointestinal Obstruction With Mcc 5 5 $43,279.74 $43,279.74 $41,115.75 $43,279.74 $41,981.35 2026-07-09
J2350 HCPCS Ocrelizumab 300 Mg/10ml IV Soln 9 8 $33,003.70 $29,703.33 $31,353.52 $32,343.63 $31,353.52 2026-07-17
J9144 HCPCS Daratumumab-hyaluronidase-fihj 1800-30000 Mg-ut/15ml Subq Soln 9 8 $19,871.56 $17,884.40 $18,877.98 $19,474.13 $18,877.98 2026-07-17
J9022 HCPCS Atezolizumab 1200 Mg/20ml IV Soln 18 8 $17,712.51 $15,941.26 $12,284.34 $22,044.25 $17,020.84 2026-07-17
J3380 HCPCS Vedolizumab 300 Mg IV Solr 9 8 $17,866.90 $16,080.21 $16,973.56 $17,509.56 $16,973.56 2026-07-17
J9301 HCPCS Obinutuzumab 1000 Mg/40ml IV Soln 9 8 $16,996.32 $15,296.69 $16,146.50 $16,656.39 $16,146.50 2026-07-17
J9223 HCPCS Lurbinectedin 4 Mg IV Solr 9 8 $16,562.10 $14,905.89 $15,734.00 $16,230.86 $15,734.00 2026-07-17
J9228 HCPCS Ipilimumab 50 Mg/10ml IV Soln 9 8 $16,500.91 $14,850.82 $15,675.86 $16,170.89 $15,675.86 2026-07-17
J2323 HCPCS Natalizumab 300 Mg/15ml IV Conc 9 8 $15,642.92 $14,078.63 $14,860.77 $15,330.06 $14,860.77 2026-07-17
J9042 HCPCS Brentuximab Vedotin 50 Mg IV Solr 9 8 $15,095.59 $13,586.03 $14,340.81 $14,793.68 $14,340.81 2026-07-17
32994 CPT Hc Pr 32994 Ablate Pulm Tumor Perq Crybl 9 8 $15,025.00 $13,522.50 $14,273.75 $14,724.50 $14,273.75 2026-07-17
J0896 HCPCS Luspatercept-aamt 25 Mg Subq Solr 18 8 $13,370.45 $12,033.41 $6,350.98 $19,654.56 $12,802.22 2026-07-17
J9311 HCPCS Rituximab-hyaluronidase Human 1600-26800 Mg -ut/13.4ml Subq Soln 9 8 $12,709.74 $11,438.77 $12,074.25 $12,455.55 $12,074.25 2026-07-17
J9306 HCPCS Pertuzumab 420 Mg/14ml IV Soln 9 8 $12,374.61 $11,137.15 $11,755.88 $12,127.12 $11,755.88 2026-07-17
31298 CPT Hc Pr 31298 Nasal/Sinus Ndsc W/Sins Dilat 9 8 $9,421.00 $8,478.90 $8,949.95 $9,232.58 $8,949.95 2026-07-17
43288 CPT Hc Pr 43288 Esphg Thrsc Moblj 9 8 $9,308.00 $8,377.20 $8,842.60 $9,121.84 $8,842.60 2026-07-17
J9308 HCPCS Ramucirumab 100 Mg/10ml IV Soln 18 8 $9,060.98 $8,154.88 $2,934.55 $14,732.30 $8,654.26 2026-07-17
55874 CPT Hc Pr 55874 Tprnl Plmt Biodegrdabl Matrl W/Img Guidance 9 8 $9,047.00 $8,142.30 $8,594.65 $8,866.06 $8,594.65 2026-07-17
43287 CPT Hc Pr 43287 Esphg Dstl 2/3 W/Laps Moblj 9 8 $8,920.00 $8,028.00 $8,474.00 $8,741.60 $8,474.00 2026-07-17
J0517 HCPCS Benralizumab 30 Mg/ml Subq Sosy 9 8 $8,495.47 $7,645.92 $8,070.70 $8,325.56 $8,070.70 2026-07-17
J1162 HCPCS Digoxin Immune Fab 40 Mg IV Solr 9 8 $8,355.72 $7,520.15 $7,937.93 $8,188.61 $7,937.93 2026-07-17
J9299 HCPCS Nivolumab 100 Mg/10ml IV Soln 27 8 $7,927.33 $7,134.60 $6,292.12 $15,436.72 $7,530.96 2026-07-17
43286 CPT Hc Pr 43286 Esphg Tot W/Laps Moblj 9 8 $7,810.00 $7,029.00 $7,419.50 $7,653.80 $7,419.50 2026-07-17
45388 CPT Hc Pr 45388 Colonoscopy W/Ablation 9 8 $7,571.00 $6,813.90 $7,192.45 $7,419.58 $7,192.45 2026-07-17
J2997 HCPCS Alteplase 100 Mg IV Solr 18 8 $7,126.55 $6,413.89 $514.17 $13,437.62 $6,778.34 2026-07-17
J2353 HCPCS Octreotide Acetate 10 Mg IM Kit 27 8 $7,120.74 $6,408.67 $5,789.07 $10,449.51 $6,764.70 2026-07-17
J2182 HCPCS Mepolizumab 100 Mg/ml Subq Sosy 9 8 $6,993.93 $6,294.54 $6,644.23 $6,854.05 $6,644.23 2026-07-17
J1950 HCPCS Leuprolide Acetate (3 Month) 11.25 Mg IM Kit 9 8 $6,922.29 $6,230.06 $6,576.18 $6,783.84 $6,576.18 2026-07-17
J2506 HCPCS Pegfilgrastim 6 Mg/0.6ml Subq Sosy 9 8 $6,699.84 $6,029.86 $6,364.85 $6,565.84 $6,364.85 2026-07-17
59510 CPT Hc Pr 59510 Total OB/Cesarean Delivery/Pp Car 9 8 $6,645.00 $5,980.50 $6,312.75 $6,512.10 $6,312.75 2026-07-17
36010152 CDM Operating Room Services - General Classification 6 6 $6,624.00 $6,624.00 $6,173.57 $6,624.00 $6,292.80 2026-07-09
J9352 HCPCS Trabectedin 1 Mg IV Solr 9 8 $6,537.28 $5,883.55 $6,210.42 $6,406.53 $6,210.42 2026-07-17
J0565 HCPCS Bezlotoxumab 1000 Mg/40ml IV Soln 9 8 $6,425.75 $5,783.18 $6,104.46 $6,297.24 $6,104.46 2026-07-17
3253621WWM CDM Hc Or Allograft P.l.#0741531 6 6 $6,336.00 $6,336.00 $5,905.15 $6,336.00 $6,019.20 2026-07-09
33927 CPT Hc Pr 33927 Impltj Tot Rplcmt Hrt Sys 9 8 $6,333.00 $5,699.70 $6,016.35 $6,206.34 $6,016.35 2026-07-17
20610001 CDM Intensive Care Unit - Intermediate ICU 5 5 $6,055.00 $6,055.00 $5,752.25 $6,055.00 $5,873.35 2026-07-09
17310001 CDM Nursery - Newborn - Level Iii 5 5 $5,986.00 $5,986.00 $5,686.70 $5,986.00 $5,806.42 2026-07-09
0173 RC — 9 8 $5,986.00 $5,387.40 $5,686.70 $5,866.28 $5,686.70 2026-07-17
59400 CPT Hc Pr 59400 Total OB/Vaginal Delivery/Pp Care 9 8 $5,976.00 $5,378.40 $5,677.20 $5,856.48 $5,677.20 2026-07-17
J9312 HCPCS Rituximab 100 Mg/10ml IV Soln 18 8 $5,880.19 $5,292.18 $1,927.29 $9,537.02 $5,616.61 2026-07-17
36010151 CDM Operating Room Services - General Classification 6 6 $5,908.00 $5,908.00 $5,506.26 $5,908.00 $5,612.60 2026-07-09
J9145 HCPCS Daratumumab 400 Mg/20ml IV Soln 9 8 $5,904.42 $5,313.98 $5,609.20 $5,786.33 $5,609.20 2026-07-17
J9358 HCPCS Fam-trastuzumab Deruxtec-nxki 100 Mg IV Solr 9 8 $5,859.32 $5,273.39 $5,566.35 $5,742.13 $5,566.35 2026-07-17
29999 CPT Hc Pr 29999 Arthroscopy Of Joint 9 8 $5,749.00 $5,174.10 $5,461.55 $5,634.02 $5,461.55 2026-07-17
12010011 CDM Room & Board - Semi-private (two Beds) - General Classification 5 5 $5,620.00 $5,620.00 $5,339.00 $5,620.00 $5,451.40 2026-07-09
Q5115 HCPCS Rituximab-abbs 500 Mg/50ml IV Soln 9 8 $5,292.97 $4,763.67 $5,028.32 $5,187.11 $5,028.32 2026-07-17
Q5119 HCPCS Rituximab-pvvr 500 Mg/50ml IV Soln 9 8 $5,247.24 $4,722.52 $4,984.88 $5,142.30 $4,984.88 2026-07-17
0206 RC — 18 8 $5,153.00 $4,637.70 $4,259.80 $5,705.56 $4,962.61 2026-07-17
36010150 CDM Operating Room Services - General Classification 6 6 $5,192.00 $5,192.00 $4,838.94 $5,192.00 $4,932.40 2026-07-09
J3590 HCPCS Dulaglutide 0.75 Mg/0.5ml Subq Soaj 18 8 $5,025.91 $4,523.32 $712.43 $9,115.85 $4,785.86 2026-07-17
20610002 CDM Intensive Care Unit - Intermediate ICU 5 5 $4,865.00 $4,865.00 $4,621.75 $4,865.00 $4,719.05 2026-07-09
J0897 HCPCS Denosumab 120 Mg/1.7ml Subq Soln 18 8 $4,826.51 $4,343.86 $3,718.30 $5,624.25 $4,643.90 2026-07-17
81162 HCPCS Gene Analysis (breast Cancer 1 And 2) Of Full Sequence And Analysis For Duplicat… 6 6 $4,797.00 $4,797.00 $4,470.80 $4,797.00 $4,557.15 2026-07-09
3253689WWM CDM Hc Or Graft 8 Layer 13x15 6 6 $4,796.00 $4,796.00 $4,469.87 $4,796.00 $4,556.20 2026-07-09
J9177 HCPCS Enfortumab Vedotin-ejfv 20 Mg IV Solr 9 8 $4,770.18 $4,293.16 $4,531.67 $4,674.78 $4,531.67 2026-07-17
58575 CPT Hc Pr 58575 Laps Tot Hyst Resj Mal 9 8 $4,766.00 $4,289.40 $4,527.70 $4,670.68 $4,527.70 2026-07-17
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 6 6 $4,756.00 $4,756.00 $4,432.59 $4,756.00 $4,518.20 2026-07-09
C9482 HCPCS Sotalol Hcl 150 Mg/10ml IV Soln 9 8 $4,717.18 $4,245.46 $4,481.32 $4,622.84 $4,481.32 2026-07-17
3253630WWM CDM Hc Or Allograft Pl 6 6 $4,716.00 $4,716.00 $4,395.31 $4,716.00 $4,480.20 2026-07-09
3253637WWM CDM Hc Or Allograft Btb 17817000 6 6 $4,716.00 $4,716.00 $4,395.31 $4,716.00 $4,480.20 2026-07-09
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 6 6 $4,694.00 $4,694.00 $4,374.81 $4,694.00 $4,459.30 2026-07-09
44180 CPT Hc Pr 44180 Laparoscopy Enterolysis 9 8 $4,646.00 $4,181.40 $4,413.70 $4,553.08 $4,413.70 2026-07-17
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 6 6 $4,638.00 $4,638.00 $4,322.62 $4,638.00 $4,406.10 2026-07-09
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 6 6 $4,638.00 $4,638.00 $4,322.62 $4,638.00 $4,406.10 2026-07-09
70471 HCPCS Computed Tomographic Angiography (cta), Head And Neck, With Contrast Material(s)… 6 6 $4,614.00 $4,614.00 $4,300.25 $4,614.00 $4,383.30 2026-07-09
81162 CPT Gene Analysis (breast Cancer 1, 2) Full Sequence 9 8 $4,612.00 $4,150.80 $4,381.40 $4,519.76 $4,381.40 2026-07-17
70549 CPT MRI Scan Of Blood Vessels Of Neck Before And After Contrast 9 8 $4,573.00 $4,115.70 $4,344.35 $4,481.54 $4,344.35 2026-07-17
A0434 HCPCS Hc Specialty Care Transport 15 14 $4,473.00 $4,025.70 $4,249.35 $4,652.00 $4,338.81 2026-07-17
36010149 CDM Operating Room Services - General Classification 6 6 $4,476.00 $4,476.00 $4,171.63 $4,476.00 $4,252.20 2026-07-09
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 6 6 $4,470.00 $4,470.00 $4,166.04 $4,470.00 $4,246.50 2026-07-09
44141 CPT Hc Pr 44141 Partial Removal Of Colon, With Skin Level Cecostomy Or Colos 9 8 $4,435.00 $3,991.50 $4,213.25 $4,346.30 $4,213.25 2026-07-17
3253696WWM CDM Hc Or Mesh Composite 14x11 6 6 $4,352.00 $4,352.00 $4,056.06 $4,352.00 $4,134.40 2026-07-09
17210001 CDM Nursery - Newborn - Level Ii 5 5 $4,242.00 $4,242.00 $4,029.90 $4,242.00 $4,114.74 2026-07-09
74178 CPT CT Scan Of Abdomen And Pelvis Before And After Contrast 9 8 $4,326.00 $3,893.40 $4,109.70 $4,239.48 $4,109.70 2026-07-17
44144 CPT Hc Pr 44144 Partial Removal Of Colon, With Resection 9 8 $4,311.00 $3,879.90 $4,095.45 $4,224.78 $4,095.45 2026-07-17
3253707WWM CDM Hc Or Mesh Composix 10x14 6 6 $4,309.00 $4,309.00 $4,015.99 $4,309.00 $4,093.55 2026-07-09
72157 CPT MRI Scan Of Middle Spinal Canal Before And After Contrast 9 8 $4,275.00 $3,847.50 $4,061.25 $4,189.50 $4,061.25 2026-07-17
72158 CPT MRI Scan Of Lower Spinal Canal Before And After Contrast 9 8 $4,275.00 $3,847.50 $4,061.25 $4,189.50 $4,061.25 2026-07-17
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 6 6 $4,247.00 $4,247.00 $3,958.20 $4,247.00 $4,034.65 2026-07-09
0172 RC — 9 8 $4,242.00 $3,817.80 $4,029.90 $4,157.16 $4,029.90 2026-07-17
J9035 HCPCS Bevacizumab 100 Mg/4ml IV Soln 18 8 $4,186.73 $3,768.05 $1,649.68 $6,504.22 $4,003.44 2026-07-17
70553 HCPCS MRI Scan Of Brain Before And After Contrast 6 6 $4,191.00 $4,191.00 $3,906.01 $4,191.00 $3,981.45 2026-07-09
70552 HCPCS MRI Scan Of Brain With Contrast 6 6 $4,145.00 $4,145.00 $3,863.14 $4,145.00 $3,937.75 2026-07-09
44143 CPT Hc Pr 44143 Partial Removal Of Colon, Hartmann Procedure 9 8 $4,122.00 $3,709.80 $3,915.90 $4,039.56 $3,915.90 2026-07-17
74177 CPT CT Scan Of Abdomen And Pelvis With Contrast 9 8 $4,120.00 $3,708.00 $3,914.00 $4,037.60 $3,914.00 2026-07-17
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 6 6 $4,120.00 $4,120.00 $3,839.84 $4,120.00 $3,914.00 2026-07-09
21406 CPT Treat Broken Eye Bone 18 8 $4,036.50 $3,632.85 $2,119.45 $5,725.16 $3,868.14 2026-07-17
38573 CPT Hc Pr 38573 Laps Pelvic Lymphadec 9 8 $4,071.00 $3,663.90 $3,867.45 $3,989.58 $3,867.45 2026-07-17
71552 HCPCS MRI Scan Of Chest Before And After Contrast 6 6 $4,018.00 $4,018.00 $3,744.78 $4,018.00 $3,817.10 2026-07-09
3254049WWM CDM Hc Or Tissue #43917000 6 6 $3,996.00 $3,996.00 $3,724.27 $3,996.00 $3,796.20 2026-07-09
70552 CPT MRI Scan Of Brain With Contrast 9 8 $3,985.00 $3,586.50 $3,785.75 $3,905.30 $3,785.75 2026-07-17
72149 CPT MRI Scan Of Lower Spinal Canal With Contrast 9 8 $3,961.00 $3,564.90 $3,762.95 $3,881.78 $3,762.95 2026-07-17
66984 CPT Removal Of Cataract By Inserting Prosthetic Lens 9 8 $3,933.00 $3,539.70 $3,736.35 $3,854.34 $3,736.35 2026-07-17
74174 CPT CT Scan Of Blood Vessels Of Abdomen And Pelvis W/contrast 9 8 $3,914.00 $3,522.60 $3,718.30 $3,835.72 $3,718.30 2026-07-17
J2357 HCPCS Omalizumab 150 Mg/ml Subq Sosy 9 8 $3,914.00 $3,522.60 $3,718.30 $3,835.72 $3,718.30 2026-07-17
J3358 HCPCS Ustekinumab 130 Mg/26ml IV Soln 9 8 $3,914.00 $3,522.60 $3,718.30 $3,835.72 $3,718.30 2026-07-17
Q5103 HCPCS Infliximab-dyyb 100 Mg IV Solr 9 8 $3,914.00 $3,522.60 $3,718.30 $3,835.72 $3,718.30 2026-07-17
J0330 HCPCS Succinylcholine Chloride 20 Mg/ml Injection Soln (narrator Wrapper) 9 8 $3,914.00 $3,522.60 $3,718.30 $3,835.72 $3,718.30 2026-07-17
Q5106 HCPCS Epoetin Alfa-epbx 40000 Unit/ml Injection Soln 9 8 $3,914.00 $3,522.60 $3,718.30 $3,835.72 $3,718.30 2026-07-17
71552 CPT MRI Scan Of Chest Before And After Contrast 9 8 $3,863.00 $3,476.70 $3,669.85 $3,785.74 $3,669.85 2026-07-17
70553 CPT MRI Scan Of Brain Before And After Contrast 9 8 $3,863.00 $3,476.70 $3,669.85 $3,785.74 $3,669.85 2026-07-17
44204 CPT Hc Pr 44204 Laparoscopy Partial Colectomy 9 8 $3,831.00 $3,447.90 $3,639.45 $3,754.38 $3,639.45 2026-07-17
74176 HCPCS CT Scan Of Abdomen And Pelvis Without Contrast 6 6 $3,800.00 $3,800.00 $3,541.60 $3,800.00 $3,610.00 2026-07-09
15730 CPT Hc Pr 15730 Mdfc Flap W/Prsrv Vasc Pedcl 9 8 $3,794.00 $3,414.60 $3,604.30 $3,718.12 $3,604.30 2026-07-17
36010148 CDM Operating Room Services - General Classification 6 6 $3,760.00 $3,760.00 $3,504.32 $3,760.00 $3,572.00 2026-07-09
74182 CPT MRI Scan Of Abdomen With Contrast 9 8 $3,756.00 $3,380.40 $3,568.20 $3,680.88 $3,568.20 2026-07-17
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 6 6 $3,755.00 $3,755.00 $3,499.66 $3,755.00 $3,567.25 2026-07-09
71555 CPT MRI Scan Of Blood Vessels Of Chest 9 8 $3,730.00 $3,357.00 $3,543.50 $3,655.40 $3,543.50 2026-07-17
3253697WWM CDM Hc Or Mesh Composite 12x8 6 6 $3,666.00 $3,666.00 $3,416.71 $3,666.00 $3,482.70 2026-07-09
J0881 HCPCS Darbepoetin Alfa 100 Mcg/0.5ml Injection Sosy 45 8 $3,650.81 $3,285.73 $1,213.06 $5,903.35 $3,468.27 2026-07-17
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 6 6 $3,633.00 $3,633.00 $3,385.96 $3,633.00 $3,451.35 2026-07-09
72142 CPT MRI Scan Of Upper Spinal Canal With Contrast 9 8 $3,628.00 $3,265.20 $3,446.60 $3,555.44 $3,446.60 2026-07-17
72147 CPT MRI Scan Of Middle Spinal Canal With Contrast 9 8 $3,610.00 $3,249.00 $3,429.50 $3,537.80 $3,429.50 2026-07-17
72196 CPT MRI Scan Of Pelvis With Contrast 9 8 $3,592.00 $3,232.80 $3,412.40 $3,520.16 $3,412.40 2026-07-17
45550 CPT Hc Pr 45550 Repair Rectum/Remove Sigmoid 9 8 $3,543.00 $3,188.70 $3,365.85 $3,472.14 $3,365.85 2026-07-17
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 6 6 $3,521.00 $3,521.00 $3,281.57 $3,521.00 $3,344.95 2026-07-09
70544 HCPCS MRI Scan Of Blood Vessels Of Head Without Contrast 6 6 $3,521.00 $3,521.00 $3,281.57 $3,521.00 $3,344.95 2026-07-09
74176 CPT CT Scan Of Abdomen And Pelvis Without Contrast 9 8 $3,502.00 $3,151.80 $3,326.90 $3,431.96 $3,326.90 2026-07-17
J1568 HCPCS Immune Globulin (human) 30 Gm/300ml IV Soln 27 8 $3,443.24 $3,098.92 $1,793.59 $5,061.56 $3,271.08 2026-07-17
20822 CPT Reattachment Of Part Of Cutoff Finger 18 8 $3,383.50 $3,045.15 $2,145.10 $4,418.82 $3,248.20 2026-07-17
36561 CPT Hc Pr 36561 Insert Tunneled Cv Cath W/Port > 5 9 8 $3,409.00 $3,068.10 $3,238.55 $3,340.82 $3,238.55 2026-07-17
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 6 6 $3,409.00 $3,409.00 $3,177.19 $3,409.00 $3,238.55 2026-07-09
73720 HCPCS MRI Scan Of Leg Before And After Contrast 6 6 $3,409.00 $3,409.00 $3,177.19 $3,409.00 $3,238.55 2026-07-09
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 6 6 $3,409.00 $3,409.00 $3,177.19 $3,409.00 $3,238.55 2026-07-09
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 6 6 $3,409.00 $3,409.00 $3,177.19 $3,409.00 $3,238.55 2026-07-09
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 6 6 $3,409.00 $3,409.00 $3,177.19 $3,409.00 $3,238.55 2026-07-09
70547 HCPCS MRI Scan Of Blood Vessels Of Neck Without Contrast 6 6 $3,402.00 $3,402.00 $3,170.66 $3,402.00 $3,231.90 2026-07-09
J9041 HCPCS Bortezomib 3.5 Mg Injection Solr 9 8 $3,388.68 $3,049.81 $3,219.25 $3,320.91 $3,219.25 2026-07-17
73725 HCPCS MRI Scan Of Blood Vessels Of Leg 6 6 $3,354.00 $3,354.00 $3,125.93 $3,354.00 $3,186.30 2026-07-09
70543 CPT MRI Scan Of Bone Of Eye Socket, Face, And/or Neck 9 8 $3,348.00 $3,013.20 $3,180.60 $3,281.04 $3,180.60 2026-07-17
20205 CPT Biopsy Of Muscle 18 8 $3,291.00 $2,961.90 $3,003.90 $3,351.60 $3,173.88 2026-07-17
43840 CPT Hc Pr 43840 Repair Of Stomach Lesion 9 8 $3,340.00 $3,006.00 $3,173.00 $3,273.20 $3,173.00 2026-07-17
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6ml Subq Sosy 9 8 $3,313.64 $2,982.28 $3,147.96 $3,247.37 $3,147.96 2026-07-17
C8929 HCPCS Ultrasound Heart W/color Flow, Rate, Direction And Valve 9 8 $3,300.00 $2,970.00 $3,135.00 $3,234.00 $3,135.00 2026-07-17
J9355 HCPCS Trastuzumab 150 Mg IV Solr 9 8 $3,297.30 $2,967.57 $3,132.44 $3,231.35 $3,132.44 2026-07-17
44140 CPT Hc Pr 44140 Partial Removal Of Colon With Anastomosis 9 8 $3,290.00 $2,961.00 $3,125.50 $3,224.20 $3,125.50 2026-07-17
74185 CPT MRI Scan Of Blood Vessels Of Abdomen 9 8 $3,288.00 $2,959.20 $3,123.60 $3,222.24 $3,123.60 2026-07-17
70547 CPT MRI Scan Of Blood Vessels Of Neck Without Contrast 9 8 $3,271.00 $2,943.90 $3,107.45 $3,205.58 $3,107.45 2026-07-17
3253706WWM CDM Hc Or Mesh Composix 8x10 6 6 $3,271.00 $3,271.00 $3,048.57 $3,271.00 $3,107.45 2026-07-09
74181 HCPCS MRI Scan Of Abdomen Without Contrast 6 6 $3,268.00 $3,268.00 $3,045.78 $3,268.00 $3,104.60 2026-07-09
70544 CPT MRI Scan Of Blood Vessels Of Head Without Contrast 9 8 $3,245.00 $2,920.50 $3,082.75 $3,180.10 $3,082.75 2026-07-17
72156 CPT MRI Scan Of Upper Spinal Canal Before And After Contrast 9 8 $3,245.00 $2,920.50 $3,082.75 $3,180.10 $3,082.75 2026-07-17
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 6 6 $3,241.00 $3,241.00 $3,020.61 $3,241.00 $3,078.95 2026-07-09
73725 CPT MRI Scan Of Blood Vessels Of Leg 9 8 $3,225.00 $2,902.50 $3,063.75 $3,160.50 $3,063.75 2026-07-17
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 6 6 $3,200.00 $3,200.00 $2,982.40 $3,200.00 $3,040.00 2026-07-09
73220 HCPCS MRI Scan Of Arm Before And After Contrast 6 6 $3,186.00 $3,186.00 $2,969.35 $3,186.00 $3,026.70 2026-07-09
27252 CPT Closed Treatment Of Dislocated Hip Under Anesthesia 18 8 $3,128.00 $2,815.20 $2,711.30 $3,333.96 $3,014.41 2026-07-17
27447 CPT Hc Pr 27447 Arthrp Kne Condyle&Platu Medial&Lat Compartments 9 8 $3,158.00 $2,842.20 $3,000.10 $3,094.84 $3,000.10 2026-07-17
73719 CPT MRI Scan Of Leg With Contrast 9 8 $3,144.00 $2,829.60 $2,986.80 $3,081.12 $2,986.80 2026-07-17
73222 CPT MRI Scan Of Arm Joint With Contrast 9 8 $3,144.00 $2,829.60 $2,986.80 $3,081.12 $2,986.80 2026-07-17
73723 CPT MRI Scan Of Leg Joint Before And After Contrast 9 8 $3,142.00 $2,827.80 $2,984.90 $3,079.16 $2,984.90 2026-07-17
74183 CPT MRI Scan Of Abdomen Before And After Contrast 9 8 $3,142.00 $2,827.80 $2,984.90 $3,079.16 $2,984.90 2026-07-17
72197 CPT MRI Scan Of Pelvis Before And After Contrast 9 8 $3,142.00 $2,827.80 $2,984.90 $3,079.16 $2,984.90 2026-07-17
73720 CPT MRI Scan Of Leg Before And After Contrast 9 8 $3,142.00 $2,827.80 $2,984.90 $3,079.16 $2,984.90 2026-07-17
74181 CPT MRI Scan Of Abdomen Without Contrast 9 8 $3,142.00 $2,827.80 $2,984.90 $3,079.16 $2,984.90 2026-07-17
73223 CPT MRI Scan Of Arm Joint Before And After Contrast 9 8 $3,142.00 $2,827.80 $2,984.90 $3,079.16 $2,984.90 2026-07-17
81229 CPT Genome-wide Microarray Analysis 9 8 $3,141.00 $2,826.90 $2,983.95 $3,078.18 $2,983.95 2026-07-17
J7326 HCPCS Hc Pr Rx Hyaluronan Or Derivative (gel-one) Inj 1 Ea 9 8 $3,135.00 $2,821.50 $2,978.25 $3,072.30 $2,978.25 2026-07-17
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 6 6 $3,129.00 $3,129.00 $2,916.23 $3,129.00 $2,972.55 2026-07-09
71270 HCPCS CT Scan Of Chest Before And After Contrast 6 6 $3,105.00 $3,105.00 $2,893.86 $3,105.00 $2,949.75 2026-07-09
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 6 6 $3,102.00 $3,102.00 $2,891.06 $3,102.00 $2,946.90 2026-07-09
J9264 HCPCS Paclitaxel Protein-bound Part 100 Mg IV Susr 9 8 $3,087.12 $2,778.41 $2,932.76 $3,025.38 $2,932.76 2026-07-17
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 6 6 $3,076.00 $3,076.00 $2,866.83 $3,076.00 $2,922.20 2026-07-09
70546 CPT MRI Scan Of Blood Vessels Of Head Before And After Contrast 9 8 $3,076.00 $2,768.40 $2,922.20 $3,014.48 $2,922.20 2026-07-17
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 6 6 $3,076.00 $3,076.00 $2,866.83 $3,076.00 $2,922.20 2026-07-09
58291 CPT Hc Pr 58291 Vaginal Hysterectomy Incl Tubes/Ovary(S) Complex 9 8 $3,063.00 $2,756.70 $2,909.85 $3,001.74 $2,909.85 2026-07-17
73218 HCPCS MRI Scan Of Arm Without Contrast 6 6 $3,054.00 $3,054.00 $2,846.33 $3,054.00 $2,901.30 2026-07-09
12010001 CDM Room & Board - Semi-private (two Beds) - General Classification 5 5 $2,990.00 $2,990.00 $2,840.50 $2,990.00 $2,900.30 2026-07-09
73722 CPT MRI Scan Of Leg Joint With Contrast 9 8 $3,052.00 $2,746.80 $2,899.40 $2,990.96 $2,899.40 2026-07-17
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 6 6 $3,043.00 $3,043.00 $2,836.08 $3,043.00 $2,890.85 2026-07-09
71551 HCPCS MRI Scan Of Chest With Contrast 6 6 $3,042.00 $3,042.00 $2,835.14 $3,042.00 $2,889.90 2026-07-09
49618 CPT Hc Pr 49618 Rpr Aa Hernia Recr > 10 Cm Ncrc8/Strangulated Cdm 9 8 $3,036.00 $2,732.40 $2,884.20 $2,975.28 $2,884.20 2026-07-17
12210001 CDM Room & Board - Semi-private (two Beds) - Obstetrics (ob) 5 5 $2,970.00 $2,970.00 $2,821.50 $2,970.00 $2,880.90 2026-07-09
27245 CPT Hc Pr 27245 Tx Inter/PR/Subtrchntric Fem Fx Imed Implt Screw Cdm 9 8 $3,025.00 $2,722.50 $2,873.75 $2,964.50 $2,873.75 2026-07-17
44120 CPT Hc Pr 44120 Removal Of Small Intestine, Single Resection 9 8 $2,996.00 $2,696.40 $2,846.20 $2,936.08 $2,846.20 2026-07-17
73219 CPT MRI Scan Of Arm With Contrast 9 8 $2,995.00 $2,695.50 $2,845.25 $2,935.10 $2,845.25 2026-07-17
44320 CPT Colostomy/Skin Level Cecostomy 9 8 $2,994.00 $2,694.60 $2,844.30 $2,934.12 $2,844.30 2026-07-17
25606 CPT Place Stabilizing Device For Broken Forearm Bone 18 8 $2,961.50 $2,665.35 $1,593.15 $4,161.08 $2,838.58 2026-07-17
25260 CPT Primary Repair Tendon/muscle Of Palm Side Of Forearm/wrist 18 8 $2,943.50 $2,649.15 $2,657.15 $3,028.20 $2,838.28 2026-07-17
72148 CPT MRI Scan Of Lower Spinal Canal Without Contrast 9 8 $2,987.00 $2,688.30 $2,837.65 $2,927.26 $2,837.65 2026-07-17
36010147 CDM Operating Room Services - General Classification 6 6 $2,984.00 $2,984.00 $2,781.09 $2,984.00 $2,834.80 2026-07-09
58570 CPT Hc Pr 58570 Tlh Uterus 250 G Or Less 9 8 $2,984.00 $2,685.60 $2,834.80 $2,924.32 $2,834.80 2026-07-17
26548 CPT Repair Of Joint Between Finger And Palm 9 8 $2,980.00 $2,682.00 $2,831.00 $2,920.40 $2,831.00 2026-07-17
35840 CPT Hc Pr 35840 Explore Abdominal Vessels 9 8 $2,964.00 $2,667.60 $2,815.80 $2,904.72 $2,815.80 2026-07-17
70551 HCPCS MRI Scan Of Brain Without Contrast 6 6 $2,962.00 $2,962.00 $2,760.58 $2,962.00 $2,813.90 2026-07-09
0122 RC — 9 8 $2,954.00 $2,658.60 $2,806.30 $2,894.92 $2,806.30 2026-07-17
27236 CPT Hc Pr 27236 Optx Fem Fx Prox End Nck Int Fixj/Prostc Rplcmt 9 8 $2,947.00 $2,652.30 $2,799.65 $2,888.06 $2,799.65 2026-07-17
73220 CPT MRI Scan Of Arm Before And After Contrast 9 8 $2,936.00 $2,642.40 $2,789.20 $2,877.28 $2,789.20 2026-07-17
73218 CPT MRI Scan Of Arm Without Contrast 9 8 $2,936.00 $2,642.40 $2,789.20 $2,877.28 $2,789.20 2026-07-17
72198 CPT MRI Scan Of Blood Vessels Of Pelvis 9 8 $2,929.00 $2,636.10 $2,782.55 $2,870.42 $2,782.55 2026-07-17
72159 CPT MRI Scan Of Blood Vessels Of Spinal Canal 9 8 $2,929.00 $2,636.10 $2,782.55 $2,870.42 $2,782.55 2026-07-17
71551 CPT MRI Scan Of Chest With Contrast 9 8 $2,925.00 $2,632.50 $2,778.75 $2,866.50 $2,778.75 2026-07-17
19307 CPT Hc Pr 19307 Mast Mod Rad 9 8 $2,911.00 $2,619.90 $2,765.45 $2,852.78 $2,765.45 2026-07-17
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 6 6 $2,906.00 $2,906.00 $2,708.39 $2,906.00 $2,760.70 2026-07-09
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 6 6 $2,906.00 $2,906.00 $2,708.39 $2,906.00 $2,760.70 2026-07-09
72146 CPT MRI Scan Of Middle Spinal Canal Without Contrast 9 8 $2,884.00 $2,595.60 $2,739.80 $2,826.32 $2,739.80 2026-07-17
44125 CPT Hc Pr 44125 Removal Of Small Intestine, With Enterostomy 9 8 $2,882.00 $2,593.80 $2,737.90 $2,824.36 $2,737.90 2026-07-17
73721 HCPCS MRI Scan Of Leg Joint Without Contrast 6 6 $2,879.00 $2,879.00 $2,683.23 $2,879.00 $2,735.05 2026-07-09
36569 HCPCS Insertion Of Tube For Infusion (5 Years Or Older) 9 6 $2,864.00 $2,864.00 $3.97 $2,864.00 $2,720.80 2026-07-09
71270 CPT CT Scan Of Chest Before And After Contrast 9 8 $2,862.00 $2,575.80 $2,718.90 $2,804.76 $2,718.90 2026-07-17
74175 CPT CT Scan Of Blood Vessels Of Arm With Contrast 9 8 $2,859.00 $2,573.10 $2,716.05 $2,801.82 $2,716.05 2026-07-17
59410 CPT Hc Pr 59410 Vag Delivery W/Postpartum 9 8 $2,852.00 $2,566.80 $2,709.40 $2,794.96 $2,709.40 2026-07-17
73718 HCPCS MRI Scan Of Leg Without Contrast 6 6 $2,850.00 $2,850.00 $2,656.20 $2,850.00 $2,707.50 2026-07-09
70496 CPT CT Scan Of Blood Vessels Of Head With Contrast 9 8 $2,835.00 $2,551.50 $2,693.25 $2,778.30 $2,693.25 2026-07-17
19305 CPT Hc Pr 19305 Mast Radical 9 8 $2,835.00 $2,551.50 $2,693.25 $2,778.30 $2,693.25 2026-07-17
70498 CPT CT Scan Of Blood Vessels Of Neck With Contrast 9 8 $2,835.00 $2,551.50 $2,693.25 $2,778.30 $2,693.25 2026-07-17
81414 CPT Test For Detecting Genes Associated With Heart Disease 9 8 $2,826.00 $2,543.40 $2,684.70 $2,769.48 $2,684.70 2026-07-17
81413 CPT Test For Detecting Genes Associated With Heart Disease 9 8 $2,826.00 $2,543.40 $2,684.70 $2,769.48 $2,684.70 2026-07-17
27552 CPT Closed Treatment Of Dislocated Knee Under Anesthesia 18 8 $2,784.50 $2,506.05 $1,945.60 $3,450.58 $2,675.99 2026-07-17
17110001 CDM Nursery - Newborn - Level I 5 5 $2,749.00 $2,749.00 $2,611.55 $2,749.00 $2,666.53 2026-07-09
71275 CPT CT Blood Vessels Chest With Contrast 9 8 $2,805.00 $2,524.50 $2,664.75 $2,748.90 $2,664.75 2026-07-17
44005 CPT Hc Pr 44005 Freeing Of Bowel Adhesion 18 8 $2,762.50 $2,486.25 $2,544.10 $2,790.06 $2,664.55 2026-07-17
12010009 CDM Room & Board - Semi-private (two Beds) - General Classification 5 5 $2,732.00 $2,732.00 $2,595.40 $2,732.00 $2,650.04 2026-07-09
73206 HCPCS CT Scan Of Blood Vessels Of Arm With Contrast 6 6 $2,786.00 $2,786.00 $2,596.55 $2,786.00 $2,646.70 2026-07-09
58553 CPT Hc Pr 58553 Laparo-vaginal Hysterectomy Complex 9 8 $2,768.00 $2,491.20 $2,629.60 $2,712.64 $2,629.60 2026-07-17
73706 HCPCS CT Scan Of Blood Vessels Of Lower Leg With Contrast 6 6 $2,760.00 $2,760.00 $2,572.32 $2,760.00 $2,622.00 2026-07-09
71550 CPT MRI Scan Of Chest Without Contrast 9 8 $2,754.00 $2,478.60 $2,616.30 $2,698.92 $2,616.30 2026-07-17
72195 HCPCS MRI Scan Of Pelvis Without Contrast 6 6 $2,739.00 $2,739.00 $2,552.75 $2,739.00 $2,602.05 2026-07-09
19303 CPT Hc Pr 19303 Mast Simple Complete 9 8 $2,731.00 $2,457.90 $2,594.45 $2,676.38 $2,594.45 2026-07-17
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