Hospital

PENN HIGHLANDS BROOKVILLE

Brookville, PA · CCN 391312 · Rates published

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You selected 93306 (HCPCS)

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

183 distinct procedures filed

59 distinct payers

7,101 rate rows

2025-08-01 last MRF observed · ⚠ 14 mo old

Data quality

1,169 of 7,101 rate rows are consumer-grade (16.5%)

5,932 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	5,330
professional (physician) fee — not the facility price	598
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	4

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 14 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://www.phhealthcare.org/download/?id=15368
Found on page	https://www.phhealthcare.org/patients-visitors/patient-billing-services
Discovered via	Discovered by HANK
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-01
Content fingerprint	e4e5cadd51eeb327… · 5,301,569 bytes · first seen 2026-05-18

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
0717 OTHER	Instill Adstiladrin, Tx Dose	1	$105,504.93	$105,504.93	$105,504.93	nat. median $64,134 1.6× median
329 MS_DRG	Major Small And Large Bowel Procedures With Mcc	1	$27,561.18	$27,561.18	$27,561.18	nat. median $42,662 0.6× median
57 MS_DRG	Degenerative Nervous System Disorders Without Mcc	4	$11,440.40	$31,809.60	$20,716.97	nat. median $12,550 1.7× median
885 MS_DRG	Psychoses	5	$7,363.12	$27,355.83	$18,326.00	nat. median $12,315 1.5× median
675 MS_DRG	Other Kidney And Urinary Tract Procedures Without Cc/Mcc	2	$11,705.28	$23,039.50	$17,372.39	nat. median $15,990 1.1× median
91 MS_DRG	Other Disorders Of Nervous System With Mcc	1	$15,592.50	$15,592.50	$15,592.50	nat. median $17,070 0.9× median
41 MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…	1	$15,584.66	$15,584.66	$15,584.66	nat. median $21,312 0.7× median
74 MS_DRG	Cranial And Peripheral Nerve Disorders Without Mcc	1	$15,010.56	$15,010.56	$15,010.56	nat. median $10,491 1.4× median
884 MS_DRG	Organic Disturbances And Intellectual Disability	1	$14,606.43	$14,606.43	$14,606.43	nat. median $14,262 1.0× median
330 MS_DRG	Major Small And Large Bowel Procedures With Cc	2	$4,548.00	$23,047.56	$13,797.78	nat. median $22,965 0.6× median
637 MS_DRG	Diabetes With Mcc	1	$13,550.00	$13,550.00	$13,550.00	nat. median $13,970 1.0× median
882 MS_DRG	Neuroses Except Depressive	1	$13,475.00	$13,475.00	$13,475.00	nat. median $9,336 1.4× median
356 MS_DRG	Other Digestive System O.r. Procedures With Mcc	1	$13,043.02	$13,043.02	$13,043.02	nat. median $40,230 outlier · 0.3×
56 MS_DRG	Degenerative Nervous System Disorders With Mcc	1	$12,974.52	$12,974.52	$12,974.52	nat. median $21,152 0.6× median
385 MS_DRG	Inflammatory Bowel Disease With Mcc	1	$11,300.50	$11,300.50	$11,300.50	nat. median $15,369 0.7× median
5094 OTHER	Level 4 Breast/Lymphatic Surgery And Related Procedures	3	$2,610.85	$20,576.57	$10,534.59	nat. median $16,222 0.6× median
331 MS_DRG	Major Small And Large Bowel Procedures Without Cc/Mcc	2	$9,802.38	$10,793.09	$10,297.74	nat. median $16,542 0.6× median
1489 OTHER	Inj Vedolizumab IV 1 Mg	1	$10,022.69	$10,022.69	$10,022.69	nat. median $22 outlier · 446.6×
881 MS_DRG	Depressive Neuroses	1	$9,937.11	$9,937.11	$9,937.11	nat. median $8,589 1.2× median
206 MS_DRG	Other Respiratory System Diagnoses Without Mcc	1	$9,778.35	$9,778.35	$9,778.35	nat. median $9,496 1.0× median
5378 OTHER	Level 8 Urology And Related Services	1	$9,656.62	$9,656.62	$9,656.62	nat. median $21,237 outlier · 0.5×
71 MS_DRG	Other Cerebrovascular Disorders With Cc	2	$6,325.64	$12,597.39	$9,461.51	nat. median $10,562 0.9× median
388 MS_DRG	Gastrointestinal Obstruction With Mcc	1	$9,328.25	$9,328.25	$9,328.25	nat. median $14,325 0.7× median
948 MS_DRG	Signs And Symptoms Without Mcc	4	$4,625.91	$10,023.75	$9,123.07	nat. median $7,971 1.1× median
372 MS_DRG	Major Gastrointestinal Disorders And Peritoneal Infections With Cc	1	$8,678.90	$8,678.90	$8,678.90	nat. median $10,422 0.8× median
809 MS_DRG	Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…	1	$8,578.94	$8,578.94	$8,578.94	nat. median $12,522 0.7× median
640 MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…	2	$1,260.00	$15,581.02	$8,420.51	nat. median $12,851 0.7× median
377 MS_DRG	Gastrointestinal Hemorrhage With Mcc	1	$8,273.26	$8,273.26	$8,273.26	nat. median $17,311 outlier · 0.5×
5464 OTHER	Level 4 Neurostimulator And Related Procedures	1	$8,120.28	$8,120.28	$8,120.28	nat. median $20,792 outlier · 0.4×
9132 OTHER	Prothrombin Complex Kcentra	4	$4,844.68	$12,327.46	$7,976.59	nat. median $2 outlier · 3561.0×
600 MS_DRG	Non-malignant Breast Disorders With Cc/Mcc	1	$7,883.89	$7,883.89	$7,883.89	nat. median $10,255 0.8× median
189 MS_DRG	Pulmonary Edema And Respiratory Failure	6	$1,954.50	$13,585.16	$7,816.67	nat. median $12,282 0.6× median
391 MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc	1	$7,233.50	$7,233.50	$7,233.50	nat. median $12,544 0.6× median
440 MS_DRG	Disorders Of Pancreas Except Malignancy Without Cc/Mcc	2	$5,254.81	$8,857.44	$7,056.12	nat. median $6,865 1.0× median
696 MS_DRG	Kidney And Urinary Tract Signs And Symptoms Without Mcc	1	$6,898.55	$6,898.55	$6,898.55	nat. median $7,416 0.9× median
378 MS_DRG	Gastrointestinal Hemorrhage With Cc	2	$2,135.00	$11,538.22	$6,836.61	nat. median $10,031 0.7× median
638 MS_DRG	Diabetes With Cc	1	$6,820.64	$6,820.64	$6,820.64	nat. median $9,230 0.7× median
291 MS_DRG	Heart Failure And Shock With Mcc	6	$1,475.00	$12,951.00	$6,548.63	nat. median $12,775 0.5× median
193 MS_DRG	Simple Pneumonia And Pleurisy With Mcc	9	$2,898.90	$7,909.01	$6,446.62	nat. median $12,877 0.5× median
5376 OTHER	Level 6 Urology And Related Services	2	$5,507.22	$7,182.47	$6,344.85	nat. median $9,795 0.6× median
5313 OTHER	Level 3 Lower Gi Procedures	2	$2,823.66	$9,706.72	$6,265.19	nat. median $2,971 outlier · 2.1×
389 MS_DRG	Gastrointestinal Obstruction With Cc	2	$4,811.31	$7,713.64	$6,262.48	nat. median $8,347 0.8× median
5371 OTHER	Level 1 Urology And Related Services	1	$6,045.43	$6,045.43	$6,045.43	nat. median $264 outlier · 22.9×
178 MS_DRG	Respiratory Infections And Inflammations With Cc	1	$5,954.71	$5,954.71	$5,954.71	nat. median $10,207 0.6× median
280 MS_DRG	Acute Myocardial Infarction, Discharged Alive With Mcc	2	$1,652.71	$10,199.13	$5,925.92	nat. median $15,670 outlier · 0.4×
70 MS_DRG	Other Cerebrovascular Disorders With Mcc	2	$5,788.00	$6,048.00	$5,918.00	nat. median $16,327 outlier · 0.4×
390 MS_DRG	Gastrointestinal Obstruction Without Cc/Mcc	1	$5,734.55	$5,734.55	$5,734.55	nat. median $6,125 0.9× median
603 MS_DRG	Cellulitis Without Mcc	5	$1,800.00	$16,785.46	$5,604.80	nat. median $8,991 0.6× median
5114 OTHER	Level 4 Musculoskeletal Procedures	4	$2,338.60	$6,225.27	$5,601.89	nat. median $7,727 0.7× median
194 MS_DRG	Simple Pneumonia And Pleurisy With Cc	2	$1,950.00	$9,229.20	$5,589.60	nat. median $8,522 0.7× median

Other procedures at this hospital

Browse this hospital's 183 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

0717	OTHER	Instill Adstiladrin, Tx Dose	1	1	—	—	$105,504.93	$105,504.93	$105,504.93	2025-08-01
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	1	1	—	—	$27,561.18	$27,561.18	$27,561.18	2025-08-01
57	MS_DRG	Degenerative Nervous System Disorders Without Mcc	4	4	—	—	$11,440.40	$31,809.60	$20,716.97	2025-08-01
885	MS_DRG	Psychoses	5	5	—	—	$7,363.12	$27,355.83	$18,326.00	2025-08-01
675	MS_DRG	Other Kidney And Urinary Tract Procedures Without Cc/Mcc	2	2	—	—	$11,705.28	$23,039.50	$17,372.39	2025-08-01
91	MS_DRG	Other Disorders Of Nervous System With Mcc	1	1	—	—	$15,592.50	$15,592.50	$15,592.50	2025-08-01
41	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…	1	1	—	—	$15,584.66	$15,584.66	$15,584.66	2025-08-01
74	MS_DRG	Cranial And Peripheral Nerve Disorders Without Mcc	1	1	—	—	$15,010.56	$15,010.56	$15,010.56	2025-08-01
884	MS_DRG	Organic Disturbances And Intellectual Disability	1	1	—	—	$14,606.43	$14,606.43	$14,606.43	2025-08-01
330	MS_DRG	Major Small And Large Bowel Procedures With Cc	2	2	—	—	$4,548.00	$23,047.56	$13,797.78	2025-08-01
637	MS_DRG	Diabetes With Mcc	1	1	—	—	$13,550.00	$13,550.00	$13,550.00	2025-08-01
882	MS_DRG	Neuroses Except Depressive	1	1	—	—	$13,475.00	$13,475.00	$13,475.00	2025-08-01
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	1	1	—	—	$13,043.02	$13,043.02	$13,043.02	2025-08-01
56	MS_DRG	Degenerative Nervous System Disorders With Mcc	1	1	—	—	$12,974.52	$12,974.52	$12,974.52	2025-08-01
385	MS_DRG	Inflammatory Bowel Disease With Mcc	1	1	—	—	$11,300.50	$11,300.50	$11,300.50	2025-08-01
5094	OTHER	Level 4 Breast/Lymphatic Surgery And Related Procedures	3	3	—	—	$2,610.85	$20,576.57	$10,534.59	2025-08-01
331	MS_DRG	Major Small And Large Bowel Procedures Without Cc/Mcc	2	2	—	—	$9,802.38	$10,793.09	$10,297.74	2025-08-01
1489	OTHER	Inj Vedolizumab IV 1 Mg	1	1	—	—	$10,022.69	$10,022.69	$10,022.69	2025-08-01
881	MS_DRG	Depressive Neuroses	1	1	—	—	$9,937.11	$9,937.11	$9,937.11	2025-08-01
206	MS_DRG	Other Respiratory System Diagnoses Without Mcc	1	1	—	—	$9,778.35	$9,778.35	$9,778.35	2025-08-01
5378	OTHER	Level 8 Urology And Related Services	1	1	—	—	$9,656.62	$9,656.62	$9,656.62	2025-08-01
71	MS_DRG	Other Cerebrovascular Disorders With Cc	2	2	—	—	$6,325.64	$12,597.39	$9,461.51	2025-08-01
388	MS_DRG	Gastrointestinal Obstruction With Mcc	1	1	—	—	$9,328.25	$9,328.25	$9,328.25	2025-08-01
948	MS_DRG	Signs And Symptoms Without Mcc	4	4	—	—	$4,625.91	$10,023.75	$9,123.07	2025-08-01
372	MS_DRG	Major Gastrointestinal Disorders And Peritoneal Infections With Cc	1	1	—	—	$8,678.90	$8,678.90	$8,678.90	2025-08-01
809	MS_DRG	Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…	1	1	—	—	$8,578.94	$8,578.94	$8,578.94	2025-08-01
640	MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M…	2	2	—	—	$1,260.00	$15,581.02	$8,420.51	2025-08-01
377	MS_DRG	Gastrointestinal Hemorrhage With Mcc	1	1	—	—	$8,273.26	$8,273.26	$8,273.26	2025-08-01
5464	OTHER	Level 4 Neurostimulator And Related Procedures	1	1	—	—	$8,120.28	$8,120.28	$8,120.28	2025-08-01
9132	OTHER	Prothrombin Complex Kcentra	4	4	—	—	$4,844.68	$12,327.46	$7,976.59	2025-08-01
600	MS_DRG	Non-malignant Breast Disorders With Cc/Mcc	1	1	—	—	$7,883.89	$7,883.89	$7,883.89	2025-08-01
189	MS_DRG	Pulmonary Edema And Respiratory Failure	6	6	—	—	$1,954.50	$13,585.16	$7,816.67	2025-08-01
391	MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc	1	1	—	—	$7,233.50	$7,233.50	$7,233.50	2025-08-01
440	MS_DRG	Disorders Of Pancreas Except Malignancy Without Cc/Mcc	2	2	—	—	$5,254.81	$8,857.44	$7,056.12	2025-08-01
696	MS_DRG	Kidney And Urinary Tract Signs And Symptoms Without Mcc	1	1	—	—	$6,898.55	$6,898.55	$6,898.55	2025-08-01
378	MS_DRG	Gastrointestinal Hemorrhage With Cc	2	2	—	—	$2,135.00	$11,538.22	$6,836.61	2025-08-01
638	MS_DRG	Diabetes With Cc	1	1	—	—	$6,820.64	$6,820.64	$6,820.64	2025-08-01
291	MS_DRG	Heart Failure And Shock With Mcc	6	6	—	—	$1,475.00	$12,951.00	$6,548.63	2025-08-01
193	MS_DRG	Simple Pneumonia And Pleurisy With Mcc	9	9	—	—	$2,898.90	$7,909.01	$6,446.62	2025-08-01
5376	OTHER	Level 6 Urology And Related Services	2	2	—	—	$5,507.22	$7,182.47	$6,344.85	2025-08-01
5313	OTHER	Level 3 Lower Gi Procedures	2	2	—	—	$2,823.66	$9,706.72	$6,265.19	2025-08-01
389	MS_DRG	Gastrointestinal Obstruction With Cc	2	2	—	—	$4,811.31	$7,713.64	$6,262.48	2025-08-01
5371	OTHER	Level 1 Urology And Related Services	1	1	—	—	$6,045.43	$6,045.43	$6,045.43	2025-08-01
178	MS_DRG	Respiratory Infections And Inflammations With Cc	1	1	—	—	$5,954.71	$5,954.71	$5,954.71	2025-08-01
280	MS_DRG	Acute Myocardial Infarction, Discharged Alive With Mcc	2	2	—	—	$1,652.71	$10,199.13	$5,925.92	2025-08-01
70	MS_DRG	Other Cerebrovascular Disorders With Mcc	2	2	—	—	$5,788.00	$6,048.00	$5,918.00	2025-08-01
390	MS_DRG	Gastrointestinal Obstruction Without Cc/Mcc	1	1	—	—	$5,734.55	$5,734.55	$5,734.55	2025-08-01
603	MS_DRG	Cellulitis Without Mcc	5	5	—	—	$1,800.00	$16,785.46	$5,604.80	2025-08-01
5114	OTHER	Level 4 Musculoskeletal Procedures	4	4	—	—	$2,338.60	$6,225.27	$5,601.89	2025-08-01
194	MS_DRG	Simple Pneumonia And Pleurisy With Cc	2	2	—	—	$1,950.00	$9,229.20	$5,589.60	2025-08-01
9466	OTHER	Inj., Benralizumab, 1 Mg	2	2	—	—	$4,229.55	$6,287.56	$5,258.56	2025-08-01
392	MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc	4	4	—	—	$1,632.00	$5,420.00	$5,227.41	2025-08-01
683	MS_DRG	Renal Failure With Cc	2	2	—	—	$1,106.00	$9,247.97	$5,176.98	2025-08-01
694	MS_DRG	Urinary Stones Without Mcc	1	1	—	—	$5,052.62	$5,052.62	$5,052.62	2025-08-01
872	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc	8	8	—	—	$1,281.00	$6,151.30	$5,052.27	2025-08-01
947	MS_DRG	Signs And Symptoms With Mcc	4	4	—	—	$3,369.00	$9,594.32	$4,811.16	2025-08-01
9521	OTHER	Platelets Leukoreduced Irrad	1	1	—	—	$4,802.45	$4,802.45	$4,802.45	2025-08-01
0792	OTHER	Inj, Glycopyrrolate, 0.1 Mg	1	1	—	—	$4,598.36	$4,598.36	$4,598.36	2025-08-01
195	MS_DRG	Simple Pneumonia And Pleurisy Without Cc/Mcc	1	1	—	—	$4,554.88	$4,554.88	$4,554.88	2025-08-01
334	MS_DRG	Rectal Resection Without Cc/Mcc	1	1	—	—	$4,536.00	$4,536.00	$4,536.00	2025-08-01
5375	OTHER	Level 5 Urology And Related Services	17	17	—	—	$155.86	$14,468.55	$4,529.66	2025-08-01
308	MS_DRG	Cardiac Arrhythmia And Conduction Disorders With Mcc	3	3	—	—	$1,183.00	$7,233.40	$4,459.22	2025-08-01
641	MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…	4	4	—	—	$1,979.00	$8,206.77	$4,416.39	2025-08-01
7043	OTHER	Infliximab Not Biosimil 10mg	2	2	—	—	$2,822.04	$5,976.78	$4,399.41	2025-08-01
639	MS_DRG	Diabetes Without Cc/Mcc	1	1	—	—	$4,290.90	$4,290.90	$4,290.90	2025-08-01
564	MS_DRG	Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc	1	1	—	—	$4,065.00	$4,065.00	$4,065.00	2025-08-01
309	MS_DRG	Cardiac Arrhythmia And Conduction Disorders With Cc	1	1	—	—	$4,024.13	$4,024.13	$4,024.13	2025-08-01
682	MS_DRG	Renal Failure With Mcc	1	1	—	—	$4,004.00	$4,004.00	$4,004.00	2025-08-01
9512	OTHER	Rbc Leukocytes Reduced	1	1	—	—	$3,947.15	$3,947.15	$3,947.15	2025-08-01
5165	OTHER	Level 5 ENT Procedures	3	3	—	—	$853.60	$5,556.55	$3,929.12	2025-08-01
871	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	8	8	—	—	$1,610.00	$8,171.63	$3,927.89	2025-08-01
5342	OTHER	Level 2 Abdominal/Peritoneal/Biliary And Related Procedures	2	2	—	—	$2,889.36	$4,859.56	$3,874.46	2025-08-01
5041	OTHER	Critical Care	4	4	—	—	$669.27	$12,127.59	$3,593.28	2025-08-01
5054	OTHER	Level 4 Skin Procedures	11	11	—	—	$250.00	$11,866.64	$3,426.89	2025-08-01
177	MS_DRG	Respiratory Infections And Inflammations With Mcc	4	4	—	—	$1,707.48	$31,898.64	$3,399.96	2025-08-01
5341	OTHER	Level 1 Abdominal/Peritoneal/Biliary And Related Procedures	8	8	—	—	$853.60	$6,886.32	$3,378.30	2025-08-01
5055	OTHER	Level 5 Skin Procedures	3	3	—	—	$942.10	$10,649.29	$3,363.84	2025-08-01
439	MS_DRG	Disorders Of Pancreas Except Malignancy With Cc	2	2	—	—	$2,738.20	$3,976.54	$3,357.37	2025-08-01
9473	OTHER	Injection, Mepolizumab, 1mg	4	4	—	—	$13.97	$4,167.74	$3,241.13	2025-08-01
5362	OTHER	Level 2 Laparoscopy And Related Services	2	2	—	—	$2,165.28	$4,288.85	$3,227.07	2025-08-01
690	MS_DRG	Kidney And Urinary Tract Infections Without Mcc	3	3	—	—	$1,516.00	$4,789.76	$3,184.50	2025-08-01
305	MS_DRG	Hypertension Without Mcc	1	1	—	—	$3,008.00	$3,008.00	$3,008.00	2025-08-01
689	MS_DRG	Kidney And Urinary Tract Infections With Mcc	3	3	—	—	$2,893.00	$13,550.00	$3,008.00	2025-08-01
5431	OTHER	Level 1 Nerve Procedures	6	6	—	—	$249.59	$6,287.30	$2,926.09	2025-08-01
5361	OTHER	Level 1 Laparoscopy And Related Services	10	10	—	—	$225.00	$5,196.85	$2,789.82	2025-08-01
5241	OTHER	Level 1 Blood Product Exchange And Related Services	4	4	—	—	$360.02	$4,408.21	$2,784.15	2025-08-01
66	MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc	4	4	—	—	$1,355.00	$10,634.11	$2,741.55	2025-08-01
192	MS_DRG	Chronic Obstructive Pulmonary Disease Without Cc/Mcc	1	1	—	—	$2,710.00	$2,710.00	$2,710.00	2025-08-01
862	MS_DRG	Postoperative And Post-traumatic Infections With Mcc	1	1	—	—	$2,704.00	$2,704.00	$2,704.00	2025-08-01
5374	OTHER	Level 4 Urology And Related Services	12	12	—	—	$491.36	$13,759.43	$2,651.20	2025-08-01
5301	OTHER	Level 1 Upper Gi Procedures	14	14	—	—	$236.27	$7,757.89	$2,640.22	2025-08-01
5503	OTHER	Level 3 Extraocular, Repair, And Plastic Eye Procedures	8	8	—	—	$3.10	$6,795.38	$2,616.75	2025-08-01
281	MS_DRG	Acute Myocardial Infarction, Discharged Alive With Cc	1	1	—	—	$2,584.00	$2,584.00	$2,584.00	2025-08-01
5164	OTHER	Level 4 ENT Procedures	4	4	—	—	$59.08	$5,104.48	$2,576.11	2025-08-01
5183	OTHER	Level 3 Vascular Procedures	3	3	—	—	$853.60	$4,195.89	$2,499.63	2025-08-01
5112	OTHER	Level 2 Musculoskeletal Procedures	13	13	—	—	$496.52	$4,406.85	$2,436.76	2025-08-01
9300	OTHER	Omalizumab Injection	6	6	—	—	$1,603.96	$2,946.21	$2,380.38	2025-08-01
5312	OTHER	Level 2 Lower Gi Procedures	18	18	—	—	$245.00	$10,004.37	$2,362.31	2025-08-01
9327	OTHER	Inj. Romosozumab-aqqg 1 Mg	4	4	—	—	$13.97	$2,635.25	$2,344.02	2025-08-01
5093	OTHER	Level 3 Breast/Lymphatic Surgery And Related Procedures	3	3	—	—	$812.99	$20,112.80	$2,338.60	2025-08-01
5673	OTHER	Level 3 Pathology	7	7	—	—	$67.54	$3,942.58	$2,205.40	2025-08-01
282	MS_DRG	Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc	2	2	—	—	$1,451.40	$2,919.00	$2,185.20	2025-08-01
5092	OTHER	Level 2 Breast/Lymphatic Surgery And Related Procedures	5	5	—	—	$868.57	$10,296.85	$2,090.48	2025-08-01
5182	OTHER	Level 2 Vascular Procedures	2	2	—	—	$1,709.92	$2,390.86	$2,050.39	2025-08-01
5373	OTHER	Level 3 Urology And Related Services	19	19	—	—	$506.98	$10,124.12	$2,048.44	2025-08-01
5593	OTHER	Level 3 Nuclear Medicine And Related Services	17	17	—	—	$179.16	$5,002.14	$1,995.80	2025-08-01
9133	OTHER	Rabies Ig, Im/sc	5	5	—	—	$152.84	$9,761.62	$1,988.00	2025-08-01
5311	OTHER	Level 1 Lower Gi Procedures	20	20	—	—	$487.30	$6,824.04	$1,974.59	2025-08-01
1829	OTHER	Penicillin G Benzathine Inj	2	2	—	—	$1,134.64	$2,692.01	$1,913.33	2025-08-01
5871	OTHER	Dental Procedures	11	11	—	—	$710.60	$7,643.43	$1,874.45	2025-08-01
5073	OTHER	Level 3 Excision/ Biopsy/ Incision And Drainage	8	8	—	—	$225.00	$3,390.21	$1,850.72	2025-08-01
9441	OTHER	Inj Ferric Carboxymaltos 1mg	7	7	—	—	$1,265.85	$2,079.26	$1,792.09	2025-08-01
5071	OTHER	Level 1 Excision/ Biopsy/ Incision And Drainage	7	7	—	—	$150.48	$3,595.48	$1,786.39	2025-08-01
100	MS_DRG	Seizures With Mcc	1	1	—	—	$1,780.50	$1,780.50	$1,780.50	2025-08-01
5573	OTHER	Level 3 Imaging With Contrast	12	12	—	—	$949.94	$4,246.41	$1,721.04	2025-08-01
312	MS_DRG	Syncope And Collapse	1	1	—	—	$1,708.00	$1,708.00	$1,708.00	2025-08-01
5163	OTHER	Level 3 ENT Procedures	5	5	—	—	$853.60	$7,677.32	$1,704.77	2025-08-01
5781	OTHER	Resuscitation And Cardioversion	2	2	—	—	$1,553.75	$1,789.07	$1,671.41	2025-08-01
5414	OTHER	Level 4 Gynecologic Procedures	2	2	—	—	$619.19	$2,681.79	$1,650.49	2025-08-01
184	MS_DRG	Major Chest Trauma With Cc	1	1	—	—	$1,632.00	$1,632.00	$1,632.00	2025-08-01
5025	OTHER	Level 5 Type A Ed Visits	32	32	—	—	$110.00	$6,348.55	$1,547.07	2025-08-01
602	MS_DRG	Cellulitis With Mcc	1	1	—	—	$1,452.50	$1,452.50	$1,452.50	2025-08-01
9173	OTHER	Injection, Fulphila	1	1	—	—	$1,419.77	$1,419.77	$1,419.77	2025-08-01
5113	OTHER	Level 3 Musculoskeletal Procedures	5	5	—	—	$225.00	$6,392.80	$1,417.32	2025-08-01
5072	OTHER	Level 2 Excision/ Biopsy/ Incision And Drainage	13	13	—	—	$129.25	$5,590.73	$1,386.49	2025-08-01
5691	OTHER	Level 1 Drug Administration	18	18	—	—	$14.48	$14,254.89	$1,361.76	2025-08-01
65	MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours	1	1	—	—	$1,355.00	$1,355.00	$1,355.00	2025-08-01
190	MS_DRG	Chronic Obstructive Pulmonary Disease With Mcc	1	1	—	—	$1,355.00	$1,355.00	$1,355.00	2025-08-01
9272	OTHER	Inj, Denosumab	6	6	—	—	$89.10	$1,416.62	$1,341.69	2025-08-01
5694	OTHER	Level 4 Drug Administration	1	1	—	—	$1,317.06	$1,317.06	$1,317.06	2025-08-01
5053	OTHER	Level 3 Skin Procedures	5	5	—	—	$247.12	$2,326.47	$1,301.05	2025-08-01
5491	OTHER	Level 1 Intraocular Procedures	6	6	—	—	$245.00	$2,852.51	$1,288.68	2025-08-01
175	MS_DRG	Pulmonary Embolism With Mcc Or Acute Cor Pulmonale	1	1	—	—	$1,260.00	$1,260.00	$1,260.00	2025-08-01
5024	OTHER	Level 4 Type A Ed Visits	33	33	—	—	$175.40	$3,750.60	$1,211.78	2025-08-01
N811	OTHER	Observation, Other	2	2	—	—	$935.00	$1,319.00	$1,127.00	2025-08-01
9406	OTHER	Inj, Nyvepria	1	1	—	—	$1,083.11	$1,083.11	$1,083.11	2025-08-01
292	MS_DRG	Heart Failure And Shock With Cc	1	1	—	—	$1,046.00	$1,046.00	$1,046.00	2025-08-01
5672	OTHER	Level 2 Pathology	3	3	—	—	$50.00	$1,078.99	$1,015.20	2025-08-01
89	MS_DRG	Concussion With Cc	1	1	—	—	$1,008.00	$1,008.00	$1,008.00	2025-08-01
5572	OTHER	Level 2 Imaging With Contrast	20	20	—	—	$317.65	$2,915.07	$999.24	2025-08-01
5091	OTHER	Level 1 Breast/Lymphatic Surgery And Related Procedures	5	5	—	—	$173.51	$4,713.25	$965.80	2025-08-01
5524	OTHER	Level 4 Imaging Without Contrast	23	23	—	—	$1.00	$3,869.95	$949.94	2025-08-01
5771	OTHER	Cardiac Rehabilitation	11	11	—	—	$241.23	$2,150.68	$884.79	2025-08-01
5415	OTHER	Level 5 Gynecologic Procedures	1	1	—	—	$853.60	$853.60	$853.60	2025-08-01
N905	OTHER	Not Recognized By Opps	3	3	—	—	$11.00	$853.60	$850.60	2025-08-01
5052	OTHER	Level 2 Skin Procedures	8	8	—	—	$158.10	$2,976.06	$823.44	2025-08-01
5592	OTHER	Level 2 Nuclear Medicine And Related Services	15	15	—	—	$384.80	$2,278.40	$804.80	2025-08-01
5372	OTHER	Level 2 Urology And Related Services	15	15	—	—	$5.32	$3,805.68	$786.40	2025-08-01
5591	OTHER	Level 1 Nuclear Medicine And Related Services	19	19	—	—	$108.90	$1,795.68	$721.42	2025-08-01
5571	OTHER	Level 1 Imaging With Contrast	21	21	—	—	$48.72	$2,465.40	$694.12	2025-08-01
5523	OTHER	Level 3 Imaging Without Contrast	24	24	—	—	$205.92	$2,924.14	$578.56	2025-08-01
N801	OTHER	Therapy Services	25	25	—	—	$113.97	$2,665.50	$525.26	2025-08-01
5502	OTHER	Level 2 Extraocular, Repair, And Plastic Eye Procedures	1	1	—	—	$470.97	$470.97	$470.97	2025-08-01
5693	OTHER	Level 3 Drug Administration	11	11	—	—	$38.50	$1,701.66	$461.26	2025-08-01
9139	OTHER	Rabies Vaccine, IM	6	6	—	—	$11.00	$864.71	$452.90	2025-08-01
5722	OTHER	Level 2 Diagnostic Tests And Related Services	21	21	—	—	$48.90	$2,509.50	$447.21	2025-08-01
5023	OTHER	Level 3 Type A Ed Visits	33	33	—	—	$55.39	$2,230.07	$381.64	2025-08-01
N809	OTHER	Other Medicine	6	6	—	—	$152.52	$454.19	$370.28	2025-08-01
5522	OTHER	Level 2 Imaging Without Contrast	33	33	—	—	$63.25	$912.48	$285.05	2025-08-01
5051	OTHER	Level 1 Skin Procedures	8	8	—	—	$64.35	$1,356.96	$284.40	2025-08-01
5442	OTHER	Level 2 Nerve Injections	2	2	—	—	$169.42	$371.35	$270.38	2025-08-01
5734	OTHER	Level 4 Minor Procedures	15	15	—	—	$81.40	$946.84	$218.94	2025-08-01
N804	OTHER	Mammography Services	19	19	—	—	$104.58	$575.13	$214.76	2025-08-01
N903	OTHER	Influenza Vaccines & Pneumococcal Pneumonia Vaccines	2	2	—	—	$69.88	$346.71	$208.29	2025-08-01
5462	OTHER	Level 2 Neurostimulator And Related Procedures	1	1	—	—	$204.86	$204.86	$204.86	2025-08-01
5441	OTHER	Level 1 Nerve Injections	6	6	—	—	$90.20	$403.43	$180.39	2025-08-01
5022	OTHER	Level 2 Type A Ed Visits	23	23	—	—	$38.50	$901.72	$178.09	2025-08-01
5723	OTHER	Level 3 Diagnostic Tests And Related Services	1	1	—	—	$165.68	$165.68	$165.68	2025-08-01
N902	OTHER	Packaged Services	2	2	—	—	$71.46	$220.00	$145.73	2025-08-01
N900	OTHER	Non-covered Services	20	20	—	—	$61.77	$973.32	$142.15	2025-08-01
N907	OTHER	Not Billable To Fi	7	7	—	—	$71.38	$660.88	$129.80	2025-08-01
5521	OTHER	Level 1 Imaging Without Contrast	31	31	—	—	$14.50	$693.68	$125.10	2025-08-01
5823	OTHER	Level 3 Health And Behavior Services	4	4	—	—	$105.30	$687.24	$115.62	2025-08-01
5732	OTHER	Level 2 Minor Procedures	7	7	—	—	$30.24	$2,607.09	$103.50	2025-08-01
5733	OTHER	Level 3 Minor Procedures	23	23	—	—	$10.74	$249.75	$94.88	2025-08-01
5671	OTHER	Level 1 Pathology	9	9	—	—	$9.90	$162.82	$82.55	2025-08-01
5692	OTHER	Level 2 Drug Administration	10	10	—	—	$13.97	$198.00	$73.35	2025-08-01
5791	OTHER	Pulmonary Treatment	1	1	—	—	$72.50	$72.50	$72.50	2025-08-01
N800	OTHER	Clinical Diagnostic Lab Services	45	45	—	—	$3.41	$200.58	$70.02	2025-08-01
5111	OTHER	Level 1 Musculoskeletal Procedures	1	1	—	—	$56.44	$56.44	$56.44	2025-08-01
5012	OTHER	Clinic Visits And Related Services	20	20	—	—	$35.37	$375.51	$41.23	2025-08-01
5721	OTHER	Level 1 Diagnostic Tests And Related Services	4	4	—	—	$9.90	$890.68	$40.22	2025-08-01
5731	OTHER	Level 1 Minor Procedures	10	10	—	—	$3.50	$12.00	$6.05	2025-08-01

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