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

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Hospital

PENN HIGHLANDS ELK

Saint Marys, PA · CCN 391315 · Rates published

231 distinct procedures filed
62 distinct payers
7,386 rate rows
2025-08-01 last MRF observed
Data quality

898 of 7,386 rate rows are consumer-grade (12.2%)

6,488 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 5,890
professional (physician) fee — not the facility price 598
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.phhealthcare.org/download/?id=15372
Found on page https://www.phhealthcare.org/patients-visitors/patient-billing-services
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 307cbc1ea27362b3… · 5,460,697 bytes · first seen 2026-05-05

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
0944
OTHER 		Gammagard Liquid Injection 1 $36,845.30 $36,845.30 $36,845.30 nat. median
$149
outlier · 247.0×
264
MS_DRG 		Other Circulatory System O.r. Procedures 1 $22,244.23 $22,244.23 $22,244.23 nat. median
$33,061
0.7× median
9274
OTHER 		Crotalidae Poly Immune Fab 2 $22,048.66 $22,048.66 $22,048.66 nat. median
$1,850
outlier · 11.9×
5115
OTHER 		Level 5 Musculoskeletal Procedures 9 $20,950.51 $20,950.51 $20,950.51 nat. median
$13,542
1.5× median
438
MS_DRG 		Disorders Of Pancreas Except Malignancy With Mcc 1 $16,914.68 $16,914.68 $16,914.68 nat. median
$16,971
1.0× median
623
MS_DRG 		Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 $14,984.06 $14,984.06 $14,984.06 nat. median
$18,744
0.8× median
673
MS_DRG 		Other Kidney And Urinary Tract Procedures With Mcc 1 $14,794.71 $14,794.71 $14,794.71 nat. median
$40,454
outlier · 0.4×
629
MS_DRG 		Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 1 $14,656.93 $14,656.93 $14,656.93 nat. median
$22,198
0.7× median
5464
OTHER 		Level 4 Neurostimulator And Related Procedures 1 $14,509.26 $14,509.26 $14,509.26 nat. median
$20,658
0.7× median
644
MS_DRG 		Endocrine Disorders With Cc 1 $14,379.72 $14,379.72 $14,379.72 nat. median
$11,068
1.3× median
9013
OTHER 		Inj Risankizumab-rzaa?1 Mg 3 $14,332.98 $14,332.98 $14,332.98 nat. median
$15
outlier · 941.1×
9002
OTHER 		Tenecteplase Injection 2 $13,451.22 $13,451.22 $13,451.22 nat. median
$187
outlier · 71.9×
560
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Cc 2 $13,376.13 $13,376.13 $13,376.13 nat. median
$12,148
1.1× median
571
MS_DRG 		Skin Debridement With Cc 2 $12,872.31 $12,872.31 $12,872.31 nat. median
$17,260
0.7× median
57
MS_DRG 		Degenerative Nervous System Disorders Without Mcc 1 $12,840.09 $12,840.09 $12,840.09 nat. median
$13,201
1.0× median
394
MS_DRG 		Other Digestive System Diagnoses With Cc 1 $12,218.99 $12,218.99 $12,218.99 nat. median
$10,259
1.2× median
674
MS_DRG 		Other Kidney And Urinary Tract Procedures With Cc 1 $12,051.36 $12,051.36 $12,051.36 nat. median
$23,466
0.5× median
641
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 7 $11,922.08 $11,922.08 $11,922.08 nat. median
$8,664
1.4× median
617
MS_DRG 		Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 4 $11,850.36 $11,850.36 $11,850.36 nat. median
$19,472
0.6× median
950
MS_DRG 		Aftercare Without Cc/Mcc 2 $11,795.66 $11,795.66 $11,795.66 nat. median
$7,552
1.6× median
917
MS_DRG 		Poisoning And Toxic Effects Of Drugs With Mcc 1 $11,765.25 $11,765.25 $11,765.25 nat. median
$15,271
0.8× median
95
MS_DRG 		Bacterial And Tuberculous Infections Of Nervous System With Cc 1 $11,635.00 $11,635.00 $11,635.00 nat. median
$24,991
outlier · 0.5×
5463
OTHER 		Level 3 Neurostimulator And Related Procedures 1 $11,104.60 $11,104.60 $11,104.60 nat. median
$12,334
0.9× median
694
MS_DRG 		Urinary Stones Without Mcc 1 $11,000.00 $11,000.00 $11,000.00 nat. median
$8,711
1.3× median
809
MS_DRG 		Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 $10,886.23 $10,886.23 $10,886.23 nat. median
$13,226
0.8× median
9186
OTHER 		Inj., Rituximab, 10 Mg 5 $10,661.75 $10,661.75 $10,661.75 nat. median
$78
outlier · 135.8×
390
MS_DRG 		Gastrointestinal Obstruction Without Cc/Mcc 1 $10,553.01 $10,553.01 $10,553.01 nat. median
$6,562
1.6× median
501
MS_DRG 		Soft Tissue Procedures With Cc 1 $10,402.91 $10,402.91 $10,402.91 nat. median
$17,876
0.6× median
9126
OTHER 		Natalizumab Injection 3 $10,235.61 $10,235.61 $10,235.61 nat. median
$25
outlier · 409.4×
190
MS_DRG 		Chronic Obstructive Pulmonary Disease With Mcc 9 $10,166.49 $10,166.49 $10,166.49 nat. median
$11,699
0.9× median
728
MS_DRG 		Inflammation Of The Male Reproductive System Without Mcc 1 $10,104.00 $10,104.00 $10,104.00 nat. median
$9,013
1.1× median
562
MS_DRG 		Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 $10,104.00 $10,104.00 $10,104.00 nat. median
$14,855
0.7× median
348
MS_DRG 		Anal And Stomal Procedures With Cc 1 $10,083.90 $10,083.90 $10,083.90 nat. median
$13,700
0.7× median
920
MS_DRG 		Complications Of Treatment With Cc 1 $10,058.90 $10,058.90 $10,058.90 nat. median
$10,962
0.9× median
553
MS_DRG 		Bone Diseases And Arthropathies With Mcc 1 $10,005.10 $10,005.10 $10,005.10 nat. median
$13,586
0.7× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 8 $9,987.97 $9,987.97 $9,987.97 nat. median
$19,634
0.5× median
56
MS_DRG 		Degenerative Nervous System Disorders With Mcc 1 $9,845.49 $9,845.49 $9,845.49 nat. median
$22,361
outlier · 0.4×
59
MS_DRG 		Multiple Sclerosis And Cerebellar Ataxia With Cc 1 $9,583.90 $9,583.90 $9,583.90 nat. median
$13,000
0.7× median
742
MS_DRG 		Uterine And Adnexa Procedures For Non-malignancy With Cc/Mcc 1 $9,549.29 $9,549.29 $9,549.29 nat. median
$18,899
0.5× median
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 4 $9,388.70 $9,388.70 $9,388.70 nat. median
$20,254
outlier · 0.5×
947
MS_DRG 		Signs And Symptoms With Mcc 5 $9,284.00 $9,284.00 $9,284.00 nat. median
$12,688
0.7× median
867
MS_DRG 		Other Infectious And Parasitic Diseases Diagnoses With Mcc 1 $9,101.50 $9,101.50 $9,101.50 nat. median
$21,263
outlier · 0.4×
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 2 $9,099.84 $9,099.84 $9,099.84 nat. median
$13,245
0.7× median
948
MS_DRG 		Signs And Symptoms Without Mcc 5 $8,974.99 $8,974.99 $8,974.99 nat. median
$8,515
1.1× median
304
MS_DRG 		Hypertension With Mcc 1 $8,922.92 $8,922.92 $8,922.92 nat. median
$12,521
0.7× median
354
MS_DRG 		Hernia Procedures Except Inguinal And Femoral With Cc 1 $8,880.97 $8,880.97 $8,880.97 nat. median
$17,599
0.5× median
399
MS_DRG 		Appendix Procedures Without Cc/Mcc 1 $8,768.15 $8,768.15 $8,768.15 nat. median
$12,332
0.7× median
643
MS_DRG 		Endocrine Disorders With Mcc 1 $8,732.76 $8,732.76 $8,732.76 nat. median
$16,781
0.5× median
92
MS_DRG 		Other Disorders Of Nervous System With Cc 1 $8,420.00 $8,420.00 $8,420.00 nat. median
$11,294
0.7× median
603
MS_DRG 		Cellulitis Without Mcc 3 $8,377.62 $8,377.62 $8,377.62 nat. median
$9,571
0.9× median

Other procedures at this hospital

Browse this hospital's 231 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
             
0944 OTHER Gammagard Liquid Injection 1 1 — — $36,845.30 $36,845.30 $36,845.30 2025-08-01
264 MS_DRG Other Circulatory System O.r. Procedures 1 1 — — $22,244.23 $22,244.23 $22,244.23 2025-08-01
9274 OTHER Crotalidae Poly Immune Fab 2 2 — — $22,048.66 $22,048.66 $22,048.66 2025-08-01
5115 OTHER Level 5 Musculoskeletal Procedures 9 9 — — $20,950.51 $20,950.51 $20,950.51 2025-08-01
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 1 1 — — $16,914.68 $16,914.68 $16,914.68 2025-08-01
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $14,984.06 $14,984.06 $14,984.06 2025-08-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 1 1 — — $14,794.71 $14,794.71 $14,794.71 2025-08-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 1 1 — — $14,656.93 $14,656.93 $14,656.93 2025-08-01
5464 OTHER Level 4 Neurostimulator And Related Procedures 1 1 — — $14,509.26 $14,509.26 $14,509.26 2025-08-01
644 MS_DRG Endocrine Disorders With Cc 1 1 — — $14,379.72 $14,379.72 $14,379.72 2025-08-01
9013 OTHER Inj Risankizumab-rzaa?1 Mg 3 3 — — $14,332.98 $14,332.98 $14,332.98 2025-08-01
9002 OTHER Tenecteplase Injection 2 2 — — $13,451.22 $13,451.22 $13,451.22 2025-08-01
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 2 2 — — $13,376.13 $13,376.13 $13,376.13 2025-08-01
571 MS_DRG Skin Debridement With Cc 2 2 — — $12,872.31 $12,872.31 $12,872.31 2025-08-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 1 1 — — $12,840.09 $12,840.09 $12,840.09 2025-08-01
394 MS_DRG Other Digestive System Diagnoses With Cc 1 1 — — $12,218.99 $12,218.99 $12,218.99 2025-08-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 1 1 — — $12,051.36 $12,051.36 $12,051.36 2025-08-01
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 7 7 — — $11,922.08 $11,922.08 $11,922.08 2025-08-01
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 4 4 — — $11,850.36 $11,850.36 $11,850.36 2025-08-01
950 MS_DRG Aftercare Without Cc/Mcc 2 2 — — $11,795.66 $11,795.66 $11,795.66 2025-08-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 1 1 — — $11,765.25 $11,765.25 $11,765.25 2025-08-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 1 1 — — $11,635.00 $11,635.00 $11,635.00 2025-08-01
5463 OTHER Level 3 Neurostimulator And Related Procedures 1 1 — — $11,104.60 $11,104.60 $11,104.60 2025-08-01
694 MS_DRG Urinary Stones Without Mcc 1 1 — — $11,000.00 $11,000.00 $11,000.00 2025-08-01
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 1 — — $10,886.23 $10,886.23 $10,886.23 2025-08-01
9186 OTHER Inj., Rituximab, 10 Mg 5 5 — — $10,661.75 $10,661.75 $10,661.75 2025-08-01
390 MS_DRG Gastrointestinal Obstruction Without Cc/Mcc 1 1 — — $10,553.01 $10,553.01 $10,553.01 2025-08-01
501 MS_DRG Soft Tissue Procedures With Cc 1 1 — — $10,402.91 $10,402.91 $10,402.91 2025-08-01
9126 OTHER Natalizumab Injection 3 3 — — $10,235.61 $10,235.61 $10,235.61 2025-08-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 9 9 — — $10,166.49 $10,166.49 $10,166.49 2025-08-01
728 MS_DRG Inflammation Of The Male Reproductive System Without Mcc 1 1 — — $10,104.00 $10,104.00 $10,104.00 2025-08-01
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 1 — — $10,104.00 $10,104.00 $10,104.00 2025-08-01
348 MS_DRG Anal And Stomal Procedures With Cc 1 1 — — $10,083.90 $10,083.90 $10,083.90 2025-08-01
920 MS_DRG Complications Of Treatment With Cc 1 1 — — $10,058.90 $10,058.90 $10,058.90 2025-08-01
553 MS_DRG Bone Diseases And Arthropathies With Mcc 1 1 — — $10,005.10 $10,005.10 $10,005.10 2025-08-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 8 8 — — $9,987.97 $9,987.97 $9,987.97 2025-08-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 1 1 — — $9,845.49 $9,845.49 $9,845.49 2025-08-01
59 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Cc 1 1 — — $9,583.90 $9,583.90 $9,583.90 2025-08-01
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/Mcc 1 1 — — $9,549.29 $9,549.29 $9,549.29 2025-08-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 4 4 — — $9,388.70 $9,388.70 $9,388.70 2025-08-01
947 MS_DRG Signs And Symptoms With Mcc 5 5 — — $9,284.00 $9,284.00 $9,284.00 2025-08-01
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 1 1 — — $9,101.50 $9,101.50 $9,101.50 2025-08-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 2 2 — — $9,099.84 $9,099.84 $9,099.84 2025-08-01
948 MS_DRG Signs And Symptoms Without Mcc 5 5 — — $8,974.99 $8,974.99 $8,974.99 2025-08-01
304 MS_DRG Hypertension With Mcc 1 1 — — $8,922.92 $8,922.92 $8,922.92 2025-08-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 1 1 — — $8,880.97 $8,880.97 $8,880.97 2025-08-01
399 MS_DRG Appendix Procedures Without Cc/Mcc 1 1 — — $8,768.15 $8,768.15 $8,768.15 2025-08-01
643 MS_DRG Endocrine Disorders With Mcc 1 1 — — $8,732.76 $8,732.76 $8,732.76 2025-08-01
92 MS_DRG Other Disorders Of Nervous System With Cc 1 1 — — $8,420.00 $8,420.00 $8,420.00 2025-08-01
603 MS_DRG Cellulitis Without Mcc 3 3 — — $8,377.62 $8,377.62 $8,377.62 2025-08-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 2 — — $8,374.39 $8,374.39 $8,374.39 2025-08-01
5415 OTHER Level 5 Gynecologic Procedures 7 7 — — $8,286.09 $8,286.09 $8,286.09 2025-08-01
176 MS_DRG Pulmonary Embolism Without Mcc 1 1 — — $8,226.87 $8,226.87 $8,226.87 2025-08-01
9132 OTHER Prothrombin Complex Kcentra 5 5 — — $8,226.51 $8,226.51 $8,226.51 2025-08-01
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 1 1 — — $8,008.51 $8,008.51 $8,008.51 2025-08-01
204 MS_DRG Respiratory Signs And Symptoms 1 1 — — $7,611.86 $7,611.86 $7,611.86 2025-08-01
682 MS_DRG Renal Failure With Mcc 4 4 — — $7,521.22 $7,521.22 $7,521.22 2025-08-01
566 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/Mcc 1 1 — — $7,255.10 $7,255.10 $7,255.10 2025-08-01
868 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Cc 1 1 — — $7,167.36 $7,167.36 $7,167.36 2025-08-01
74 MS_DRG Cranial And Peripheral Nerve Disorders Without Mcc 1 1 — — $7,054.34 $7,054.34 $7,054.34 2025-08-01
638 MS_DRG Diabetes With Cc 6 6 — — $7,047.35 $7,047.35 $7,047.35 2025-08-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 1 1 — — $6,874.84 $6,874.84 $6,874.84 2025-08-01
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 1 1 — — $6,867.84 $6,867.84 $6,867.84 2025-08-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $6,834.56 $6,834.56 $6,834.56 2025-08-01
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc 2 2 — — $6,810.96 $6,810.96 $6,810.96 2025-08-01
9008 OTHER Inj Tezepelumab-ekko, 1mg 4 4 — — $6,781.14 $6,781.14 $6,781.14 2025-08-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/Mcc 1 1 — — $6,736.00 $6,736.00 $6,736.00 2025-08-01
292 MS_DRG Heart Failure And Shock With Cc 1 1 — — $6,682.50 $6,682.50 $6,682.50 2025-08-01
637 MS_DRG Diabetes With Mcc 2 2 — — $6,479.29 $6,479.29 $6,479.29 2025-08-01
5114 OTHER Level 4 Musculoskeletal Procedures 11 11 — — $6,434.09 $6,434.09 $6,434.09 2025-08-01
865 MS_DRG Viral Illness With Mcc 1 1 — — $6,308.00 $6,308.00 $6,308.00 2025-08-01
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 3 3 — — $6,198.32 $6,198.32 $6,198.32 2025-08-01
683 MS_DRG Renal Failure With Cc 5 5 — — $6,189.23 $6,189.23 $6,189.23 2025-08-01
312 MS_DRG Syncope And Collapse 3 3 — — $6,177.18 $6,177.18 $6,177.18 2025-08-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 1 1 — — $6,159.81 $6,159.81 $6,159.81 2025-08-01
9367 OTHER Inj Ruxience, 10 Mg 1 1 — — $6,070.38 $6,070.38 $6,070.38 2025-08-01
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 1 1 — — $5,923.59 $5,923.59 $5,923.59 2025-08-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 3 3 — — $5,808.41 $5,808.41 $5,808.41 2025-08-01
68 MS_DRG Precerebral Occlusion Without Infarction Without Mcc 1 1 — — $5,775.43 $5,775.43 $5,775.43 2025-08-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 6 6 — — $5,751.12 $5,751.12 $5,751.12 2025-08-01
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/Mcc 4 4 — — $5,657.72 $5,657.72 $5,657.72 2025-08-01
305 MS_DRG Hypertension Without Mcc 1 1 — — $5,581.82 $5,581.82 $5,581.82 2025-08-01
594 MS_DRG Skin Ulcers Without Cc/Mcc 1 1 — — $5,540.04 $5,540.04 $5,540.04 2025-08-01
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 2 2 — — $5,493.51 $5,493.51 $5,493.51 2025-08-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 2 2 — — $5,469.18 $5,469.18 $5,469.18 2025-08-01
5091 OTHER Level 1 Breast/Lymphatic Surgery And Related Procedures 4 4 — — $5,445.13 $5,445.13 $5,445.13 2025-08-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 7 7 — — $5,404.28 $5,404.28 $5,404.28 2025-08-01
5374 OTHER Level 4 Urology And Related Services 3 3 — — $5,273.34 $5,273.34 $5,273.34 2025-08-01
5342 OTHER Level 2 Abdominal/Peritoneal/Biliary And Related Procedures 6 6 — — $5,252.94 $5,252.94 $5,252.94 2025-08-01
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 1 1 — — $5,174.80 $5,174.80 $5,174.80 2025-08-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 1 1 — — $5,156.78 $5,156.78 $5,156.78 2025-08-01
811 MS_DRG Red Blood Cell Disorders With Mcc 2 2 — — $5,027.07 $5,027.07 $5,027.07 2025-08-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 5 5 — — $4,898.78 $4,898.78 $4,898.78 2025-08-01
5302 OTHER Level 2 Upper Gi Procedures 7 7 — — $4,871.94 $4,871.94 $4,871.94 2025-08-01
5113 OTHER Level 3 Musculoskeletal Procedures 11 11 — — $4,796.64 $4,796.64 $4,796.64 2025-08-01
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 2 2 — — $4,782.88 $4,782.88 $4,782.88 2025-08-01
602 MS_DRG Cellulitis With Mcc 1 1 — — $4,721.88 $4,721.88 $4,721.88 2025-08-01
5361 OTHER Level 1 Laparoscopy And Related Services 16 16 — — $4,702.65 $4,702.65 $4,702.65 2025-08-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 6 6 — — $4,689.98 $4,689.98 $4,689.98 2025-08-01
202 MS_DRG Bronchitis And Asthma With Cc/Mcc 3 3 — — $4,506.86 $4,506.86 $4,506.86 2025-08-01
393 MS_DRG Other Digestive System Diagnoses With Mcc 2 2 — — $4,447.00 $4,447.00 $4,447.00 2025-08-01
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 6 6 — — $4,439.90 $4,439.90 $4,439.90 2025-08-01
5341 OTHER Level 1 Abdominal/Peritoneal/Biliary And Related Procedures 10 10 — — $4,371.02 $4,371.02 $4,371.02 2025-08-01
389 MS_DRG Gastrointestinal Obstruction With Cc 4 4 — — $4,312.00 $4,312.00 $4,312.00 2025-08-01
7043 OTHER Infliximab Not Biosimil 10mg 3 3 — — $4,230.17 $4,230.17 $4,230.17 2025-08-01
5184 OTHER Level 4 Vascular Procedures 7 7 — — $4,212.35 $4,212.35 $4,212.35 2025-08-01
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 5 5 — — $4,210.00 $4,210.00 $4,210.00 2025-08-01
9434 OTHER Inj Anifrolumab-fnia 1mg 1 1 — — $4,170.08 $4,170.08 $4,170.08 2025-08-01
9381 OTHER Inj. Avsola, 10 Mg 1 1 — — $4,136.55 $4,136.55 $4,136.55 2025-08-01
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/Mcc 1 1 — — $4,092.36 $4,092.36 $4,092.36 2025-08-01
5594 OTHER Level 4 Nuclear Medicine And Related Services 14 14 — — $4,092.30 $4,092.30 $4,092.30 2025-08-01
9473 OTHER Injection, Mepolizumab, 1mg 4 4 — — $4,075.12 $4,075.12 $4,075.12 2025-08-01
5362 OTHER Level 2 Laparoscopy And Related Services 9 9 — — $4,067.50 $4,067.50 $4,067.50 2025-08-01
5164 OTHER Level 4 ENT Procedures 1 1 — — $3,861.32 $3,861.32 $3,861.32 2025-08-01
9536 OTHER Platelets Pheresis Path Redu 1 1 — — $3,847.59 $3,847.59 $3,847.59 2025-08-01
9512 OTHER Rbc Leukocytes Reduced 2 2 — — $3,827.41 $3,827.41 $3,827.41 2025-08-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 3 3 — — $3,822.66 $3,822.66 $3,822.66 2025-08-01
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 3 3 — — $3,766.91 $3,766.91 $3,766.91 2025-08-01
5781 OTHER Resuscitation And Cardioversion 3 3 — — $3,750.93 $3,750.93 $3,750.93 2025-08-01
1670 OTHER Tetanus Immune Globulin Inj 1 1 — — $3,525.42 $3,525.42 $3,525.42 2025-08-01
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 3 3 — — $3,472.88 $3,472.88 $3,472.88 2025-08-01
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 1 1 — — $3,467.44 $3,467.44 $3,467.44 2025-08-01
639 MS_DRG Diabetes Without Cc/Mcc 1 1 — — $3,457.46 $3,457.46 $3,457.46 2025-08-01
552 MS_DRG Medical Back Problems Without Mcc 3 3 — — $3,200.97 $3,200.97 $3,200.97 2025-08-01
9200 OTHER Inj, Remdesivir, 1 Mg 2 2 — — $3,178.05 $3,178.05 $3,178.05 2025-08-01
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 1 1 — — $3,161.30 $3,161.30 $3,161.30 2025-08-01
864 MS_DRG Fever And Inflammatory Conditions 1 1 — — $3,154.00 $3,154.00 $3,154.00 2025-08-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 1 1 — — $3,146.30 $3,146.30 $3,146.30 2025-08-01
316 MS_DRG Other Circulatory System Diagnoses Without Cc/Mcc 1 1 — — $3,146.30 $3,146.30 $3,146.30 2025-08-01
5112 OTHER Level 2 Musculoskeletal Procedures 9 9 — — $3,053.64 $3,053.64 $3,053.64 2025-08-01
884 MS_DRG Organic Disturbances And Intellectual Disability 1 1 — — $3,050.67 $3,050.67 $3,050.67 2025-08-01
5313 OTHER Level 3 Lower Gi Procedures 12 12 — — $3,032.76 $3,032.76 $3,032.76 2025-08-01
5073 OTHER Level 3 Excision/ Biopsy/ Incision And Drainage 7 7 — — $2,913.70 $2,913.70 $2,913.70 2025-08-01
5491 OTHER Level 1 Intraocular Procedures 17 17 — — $2,872.05 $2,872.05 $2,872.05 2025-08-01
951 MS_DRG Other Factors Influencing Health Status 5 5 — — $2,497.02 $2,497.02 $2,497.02 2025-08-01
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 1 1 — — $2,448.07 $2,448.07 $2,448.07 2025-08-01
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/Mcc 2 2 — — $2,364.15 $2,364.15 $2,364.15 2025-08-01
5414 OTHER Level 4 Gynecologic Procedures 12 12 — — $2,247.03 $2,247.03 $2,247.03 2025-08-01
5431 OTHER Level 1 Nerve Procedures 13 13 — — $2,205.43 $2,205.43 $2,205.43 2025-08-01
5053 OTHER Level 3 Skin Procedures 5 5 — — $2,095.18 $2,095.18 $2,095.18 2025-08-01
5111 OTHER Level 1 Musculoskeletal Procedures 2 2 — — $2,068.75 $2,068.75 $2,068.75 2025-08-01
1214 OTHER Inj Ivig Privigen 500 Mg 2 2 — — $2,043.49 $2,043.49 $2,043.49 2025-08-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 2 2 — — $2,015.00 $2,015.00 $2,015.00 2025-08-01
0763 OTHER Inj, Bupivacaine Liposome 1 1 — — $2,014.17 $2,014.17 $2,014.17 2025-08-01
5573 OTHER Level 3 Imaging With Contrast 16 16 — — $1,952.96 $1,952.96 $1,952.96 2025-08-01
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 1 1 — — $1,944.00 $1,944.00 $1,944.00 2025-08-01
70 MS_DRG Other Cerebrovascular Disorders With Mcc 1 1 — — $1,858.47 $1,858.47 $1,858.47 2025-08-01
299 MS_DRG Peripheral Vascular Disorders With Mcc 1 1 — — $1,829.63 $1,829.63 $1,829.63 2025-08-01
9300 OTHER Omalizumab Injection 7 7 — — $1,737.97 $1,737.97 $1,737.97 2025-08-01
755 MS_DRG Malignancy, Female Reproductive System With Cc 1 1 — — $1,722.96 $1,722.96 $1,722.96 2025-08-01
5241 OTHER Level 1 Blood Product Exchange And Related Services 12 12 — — $1,704.63 $1,704.63 $1,704.63 2025-08-01
5182 OTHER Level 2 Vascular Procedures 3 3 — — $1,699.98 $1,699.98 $1,699.98 2025-08-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 1 1 — — $1,684.00 $1,684.00 $1,684.00 2025-08-01
5593 OTHER Level 3 Nuclear Medicine And Related Services 19 19 — — $1,673.24 $1,673.24 $1,673.24 2025-08-01
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 1 1 — — $1,632.00 $1,632.00 $1,632.00 2025-08-01
5312 OTHER Level 2 Lower Gi Procedures 22 22 — — $1,602.98 $1,602.98 $1,602.98 2025-08-01
5592 OTHER Level 2 Nuclear Medicine And Related Services 17 17 — — $1,550.72 $1,550.72 $1,550.72 2025-08-01
5694 OTHER Level 4 Drug Administration 4 4 — — $1,497.39 $1,497.39 $1,497.39 2025-08-01
5375 OTHER Level 5 Urology And Related Services 2 2 — — $1,422.84 $1,422.84 $1,422.84 2025-08-01
5724 OTHER Level 4 Diagnostic Tests And Related Services 15 15 — — $1,371.73 $1,371.73 $1,371.73 2025-08-01
N811 OTHER Observation, Other 1 1 — — $1,319.50 $1,319.50 $1,319.50 2025-08-01
9357 OTHER Inj. Eptinezumab-jjmr 1 Mg 4 4 — — $1,305.09 $1,305.09 $1,305.09 2025-08-01
5572 OTHER Level 2 Imaging With Contrast 25 25 — — $1,148.12 $1,148.12 $1,148.12 2025-08-01
5771 OTHER Cardiac Rehabilitation 8 8 — — $1,146.15 $1,146.15 $1,146.15 2025-08-01
5503 OTHER Level 3 Extraocular, Repair, And Plastic Eye Procedures 1 1 — — $1,129.49 $1,129.49 $1,129.49 2025-08-01
788 MS_DRG Cesarean Section Without Sterilization Without Cc/Mcc 1 1 — — $1,068.50 $1,068.50 $1,068.50 2025-08-01
5373 OTHER Level 3 Urology And Related Services 1 1 — — $1,009.13 $1,009.13 $1,009.13 2025-08-01
1829 OTHER Penicillin G Benzathine Inj 1 1 — — $955.55 $955.55 $955.55 2025-08-01
5052 OTHER Level 2 Skin Procedures 9 9 — — $951.39 $951.39 $951.39 2025-08-01
5442 OTHER Level 2 Nerve Injections 17 17 — — $857.36 $857.36 $857.36 2025-08-01
5672 OTHER Level 2 Pathology 6 6 — — $842.40 $842.40 $842.40 2025-08-01
N809 OTHER Other Medicine 9 9 — — $803.66 $803.66 $803.66 2025-08-01
5591 OTHER Level 1 Nuclear Medicine And Related Services 18 18 — — $713.94 $713.94 $713.94 2025-08-01
N801 OTHER Therapy Services 29 29 — — $632.29 $632.29 $632.29 2025-08-01
5523 OTHER Level 3 Imaging Without Contrast 26 26 — — $577.13 $577.13 $577.13 2025-08-01
9369 OTHER Inj, Metronidazole, 10 Mg 1 1 — — $546.16 $546.16 $546.16 2025-08-01
5012 OTHER Clinic Visits And Related Services 13 13 — — $532.15 $532.15 $532.15 2025-08-01
5023 OTHER Level 3 Type A Ed Visits 31 31 — — $524.00 $524.00 $524.00 2025-08-01
1822 OTHER Injection, Zarxio 1 1 — — $379.88 $379.88 $379.88 2025-08-01
5441 OTHER Level 1 Nerve Injections 10 10 — — $379.26 $379.26 $379.26 2025-08-01
5021 OTHER Level 1 Type A Ed Visits 4 4 — — $348.72 $348.72 $348.72 2025-08-01
N804 OTHER Mammography Services 26 26 — — $314.32 $314.32 $314.32 2025-08-01
5734 OTHER Level 4 Minor Procedures 22 22 — — $288.88 $288.88 $288.88 2025-08-01
5101 OTHER Level 1 Strapping And Cast Application 7 7 — — $285.19 $285.19 $285.19 2025-08-01
5721 OTHER Level 1 Diagnostic Tests And Related Services 19 19 — — $272.38 $272.38 $272.38 2025-08-01
5411 OTHER Level 1 Gynecologic Procedures 1 1 — — $266.49 $266.49 $266.49 2025-08-01
0764 OTHER Ketorolac Tromethamine Inj 2 2 — — $231.98 $231.98 $231.98 2025-08-01
N907 OTHER Not Billable To Fi 5 5 — — $213.92 $213.92 $213.92 2025-08-01
5481 OTHER Laser Eye Procedures 2 2 — — $198.55 $198.55 $198.55 2025-08-01
N905 OTHER Not Recognized By Opps 3 3 — — $187.40 $187.40 $187.40 2025-08-01
5823 OTHER Level 3 Health And Behavior Services 6 6 — — $142.44 $142.44 $142.44 2025-08-01
9517 OTHER Red Blood Cells Unit 1 1 — — $51.42 $51.42 $51.42 2025-08-01
9466 OTHER Inj., Benralizumab, 1 Mg 1 1 — — $50.45 $50.45 $50.45 2025-08-01
9291 OTHER Inj, Clindamycin Phosp 300mg 1 1 — — $50.35 $50.35 $50.35 2025-08-01
N902 OTHER Packaged Services 3 3 — — $40.50 $40.50 $40.50 2025-08-01
5731 OTHER Level 1 Minor Procedures 1 1 — — $6.05 $6.05 $6.05 2025-08-01
5693 OTHER Level 3 Drug Administration 0 0 — — — — — 2025-08-01
5311 OTHER Level 1 Lower Gi Procedures 0 0 — — — — — 2025-08-01
5301 OTHER Level 1 Upper Gi Procedures 0 0 — — — — — 2025-08-01
9133 OTHER Rabies Ig, Im/sc 0 0 — — — — — 2025-08-01
9139 OTHER Rabies Vaccine, IM 0 0 — — — — — 2025-08-01
5183 OTHER Level 3 Vascular Procedures 0 0 — — — — — 2025-08-01
5692 OTHER Level 2 Drug Administration 0 0 — — — — — 2025-08-01
5072 OTHER Level 2 Excision/ Biopsy/ Incision And Drainage 0 0 — — — — — 2025-08-01
5071 OTHER Level 1 Excision/ Biopsy/ Incision And Drainage 0 0 — — — — — 2025-08-01
9327 OTHER Inj. Romosozumab-aqqg 1 Mg 0 0 — — — — — 2025-08-01
5054 OTHER Level 4 Skin Procedures 0 0 — — — — — 2025-08-01
5051 OTHER Level 1 Skin Procedures 0 0 — — — — — 2025-08-01
5041 OTHER Critical Care 0 0 — — — — — 2025-08-01
5025 OTHER Level 5 Type A Ed Visits 0 0 — — — — — 2025-08-01
5024 OTHER Level 4 Type A Ed Visits 0 0 — — — — — 2025-08-01
9441 OTHER Inj Ferric Carboxymaltos 1mg 0 0 — — — — — 2025-08-01
5022 OTHER Level 2 Type A Ed Visits 0 0 — — — — — 2025-08-01
9494 OTHER Injection, Ocrelizumab 0 0 — — — — — 2025-08-01
5691 OTHER Level 1 Drug Administration 0 0 — — — — — 2025-08-01
1489 OTHER Inj Vedolizumab IV 1 Mg 0 0 — — — — — 2025-08-01
N800 OTHER Clinical Diagnostic Lab Services 0 0 — — — — — 2025-08-01
0790 OTHER Inj, Methylpred Acetate 1 Mg 0 0 — — — — — 2025-08-01
5673 OTHER Level 3 Pathology 0 0 — — — — — 2025-08-01
5571 OTHER Level 1 Imaging With Contrast 0 0 — — — — — 2025-08-01
291 MS_DRG Heart Failure And Shock With Mcc 0 0 — — — — — 2025-08-01
N900 OTHER Non-covered Services 0 0 — — — — — 2025-08-01
5522 OTHER Level 2 Imaging Without Contrast 0 0 — — — — — 2025-08-01
5671 OTHER Level 1 Pathology 0 0 — — — — — 2025-08-01
5732 OTHER Level 2 Minor Procedures 0 0 — — — — — 2025-08-01
5733 OTHER Level 3 Minor Procedures 0 0 — — — — — 2025-08-01
5722 OTHER Level 2 Diagnostic Tests And Related Services 0 0 — — — — — 2025-08-01
5521 OTHER Level 1 Imaging Without Contrast 0 0 — — — — — 2025-08-01
5462 OTHER Level 2 Neurostimulator And Related Procedures 0 0 — — — — — 2025-08-01
5443 OTHER Level 3 Nerve Injections 0 0 — — — — — 2025-08-01
5524 OTHER Level 4 Imaging Without Contrast 0 0 — — — — — 2025-08-01
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