Hospital

BROOKINGS HEALTH SYSTEM

Brookings, SD · CCN 430008 · Rates published

14,991 distinct procedures filed

21 distinct payers

218,658 rate rows

2026-07-30 last MRF observed

Data quality

216,988 of 218,658 rate rows are consumer-grade (99.2%)

1,670 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
percent-of-charges filed in the dollar field — excluded from medians	839
per-diem day rate — not a per-procedure price	736
exceeds 10× this hospital's gross charge — excluded from medians	95

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

Source MRF file	https://brookingshealthsystem.pg.quadax.revenuemasters.com/cdm-files/466000069_brookings-health-system_standardcharges.csv
Found on page	https://www.brookingshealth.org/why-brookings-health/health-care-value/value-comparisons-price-transparency
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-08-14
Content fingerprint	a5c2fdd859e98a3c… · 39,261,864 bytes · first seen 2026-05-14

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
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	4	$9,092.00	$356,258.10	$315,232.43	nat. median $380,401 0.8× median
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	4	$9,092.00	$231,197.18	$204,573.16	nat. median $226,584 0.9× median
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	4	$9,092.00	$175,107.90	$154,942.97	nat. median $206,020 0.8× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	4	$9,092.00	$155,857.65	$153,953.40	nat. median $2 outlier · 90560.8×
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	4	$9,092.00	$114,274.05	$101,114.57	nat. median $141,447 0.7× median
7 OTHER	Lung Transplant	4	$9,092.00	$106,839.15	$94,535.86	nat. median $145,764 0.6× median
14 OTHER	Allogeneic Bone Marrow Transplant	5	$9,092.00	$342,015.65	$87,730.10	nat. median $114,463 0.8× median
2 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	4	$9,092.00	$93,487.35	$82,721.62	nat. median $108,276 0.8× median
209 OTHER	Complex Aortic Arch Procedures	4	$9,092.00	$93,380.10	$82,626.70	nat. median $6,334 outlier · 13.0×
426 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	4	$9,092.00	$90,924.90	$80,454.26	nat. median $76,314 1.1× median
212 OTHER	Concomitant Aortic And Mitral Valve Procedures	5	$9,092.00	$89,711.33	$79,380.43	nat. median $80,994 1.0× median
5 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	4	$9,092.00	$85,061.63	$75,266.17	nat. median $105,227 0.7× median
215 OTHER	Other Heart Assist System Implant	4	$9,092.00	$82,145.25	$72,685.64	nat. median $76,591 0.9× median
216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	4	$9,092.00	$80,708.10	$71,413.99	nat. median $74,644 1.0× median
429 OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	4	$9,092.00	$74,329.20	$65,769.66	nat. median $63,856 1.0× median
850 OTHER	Acute Leukemia With Other Procedures	4	$9,092.00	$71,440.88	$63,213.94	nat. median $407 outlier · 155.2×
231 OTHER	Coronary Bypass With Ptca With Mcc	5	$9,092.00	$69,546.68	$61,537.88	nat. median $67,378 0.9× median
456 OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	4	$9,092.00	$69,328.05	$61,344.43	nat. median $72,806 0.8× median
20 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	4	$9,092.00	$64,917.60	$57,441.87	nat. median $81,857 0.7× median
219 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	4	$9,092.00	$63,345.98	$56,051.24	nat. median $65,837 0.9× median
233 OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	5	$9,092.00	$63,072.90	$55,809.60	nat. median $61,143 0.9× median
957 OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	4	$9,092.00	$62,864.18	$55,624.91	nat. median $65,173 0.9× median
427 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	4	$9,092.00	$59,553.45	$52,695.44	nat. median $51,025 1.0× median
928 OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	4	$9,092.00	$59,174.78	$52,360.38	nat. median $2 outlier · 28000.2×
19 OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	4	$9,092.00	$54,674.40	$52,082.24	nat. median $71,614 0.7× median
275 OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	4	$9,092.00	$58,825.80	$52,051.59	nat. median $20,809 outlier · 2.5×
870 OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	4	$9,092.00	$57,022.35	$50,455.81	nat. median $4,272 outlier · 11.8×
268 OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	4	$9,092.00	$56,742.68	$50,208.35	nat. median $65,442 0.8× median
955 OTHER	Craniotomy For Multiple Significant Trauma	4	$9,092.00	$55,531.58	$49,136.71	nat. median $62,018 0.8× median
317 OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	4	$9,092.00	$55,163.63	$48,811.14	nat. median $47,264 1.0× median
447 OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	4	$9,092.00	$55,123.20	$48,775.37	nat. median $53,785 0.9× median
217 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	4	$9,092.00	$54,246.23	$47,999.39	nat. median $59,346 0.8× median
218 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	4	$9,092.00	$54,246.23	$47,999.39	nat. median $49,373 1.0× median
573 OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	5	$9,092.00	$54,049.05	$47,824.92	nat. median $50,637 0.9× median
207 OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	4	$9,092.00	$53,086.28	$46,973.01	nat. median $64,908 0.7× median
266 OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	4	$9,092.00	$50,559.30	$44,737.03	nat. median $60,180 0.7× median
969 OTHER	HIV With Extensive O.r. Procedures With Mcc	4	$9,092.00	$50,500.73	$44,685.20	nat. median $256 outlier · 174.8×
232 OTHER	Coronary Bypass With Ptca Without Mcc	5	$9,092.00	$50,016.45	$44,256.70	nat. median $52,973 0.8× median
28 OTHER	Spinal Procedures With Mcc	4	$9,092.00	$49,568.48	$43,860.32	nat. median $60,141 0.7× median
457 OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	4	$9,092.00	$49,195.58	$43,530.35	nat. median $52,802 0.8× median
790 OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	4	$9,092.00	$49,033.88	$43,387.28	nat. median $6,957 outlier · 6.2×
16 OTHER	Autologous Bone Marrow Transplant With Cc/mcc	4	$9,092.00	$48,920.03	$43,286.53	nat. median $52,702 0.8× median
235 OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	4	$9,092.00	$48,415.95	$42,840.51	nat. median $54,997 0.8× median
820 OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	4	$9,092.00	$48,384.60	$42,812.78	nat. median $1,965 outlier · 21.8×
23 OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	5	$9,092.00	$193,171.31	$41,830.92	nat. median $60,080 0.7× median
213 OTHER	Endovascular Abdominal Aorta With Iliac Branch Procedures	5	$9,092.00	$49,299.70	$41,660.11	nat. median $39,164 1.1× median
463 OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective…	5	$8,361.83	$47,020.88	$41,606.08	nat. median $44,745 0.9× median
428 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	4	$9,092.00	$46,381.50	$41,040.33	nat. median $40,290 1.0× median
8 OTHER	Simultaneous Pancreas And Kidney Transplant	4	$9,092.00	$46,237.95	$40,913.32	nat. median $55,478 0.7× median
461 OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	5	$5,360.94	$44,224.95	$40,317.64	nat. median $51,198 0.8× median

Other procedures at this hospital

Browse this hospital's 14,991 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

18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	4	4	—	—	$9,092.00	$356,258.10	$315,232.43	2026-05-14
1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	4	4	—	—	$9,092.00	$231,197.18	$204,573.16	2026-05-14
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	4	4	—	—	$9,092.00	$175,107.90	$154,942.97	2026-05-14
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	4	4	—	—	$9,092.00	$155,857.65	$153,953.40	2026-05-14
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	4	4	—	—	$9,092.00	$114,274.05	$101,114.57	2026-05-14
7	OTHER	Lung Transplant	4	4	—	—	$9,092.00	$106,839.15	$94,535.86	2026-05-14
14	OTHER	Allogeneic Bone Marrow Transplant	5	5	—	—	$9,092.00	$342,015.65	$87,730.10	2026-05-14
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	4	4	—	—	$9,092.00	$93,487.35	$82,721.62	2026-05-14
209	OTHER	Complex Aortic Arch Procedures	4	4	—	—	$9,092.00	$93,380.10	$82,626.70	2026-05-14
426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	4	4	—	—	$9,092.00	$90,924.90	$80,454.26	2026-05-14
212	OTHER	Concomitant Aortic And Mitral Valve Procedures	5	5	—	—	$9,092.00	$89,711.33	$79,380.43	2026-05-14
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	4	4	—	—	$9,092.00	$85,061.63	$75,266.17	2026-05-14
215	OTHER	Other Heart Assist System Implant	4	4	—	—	$9,092.00	$82,145.25	$72,685.64	2026-05-14
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	4	4	—	—	$9,092.00	$80,708.10	$71,413.99	2026-05-14
429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	4	4	—	—	$9,092.00	$74,329.20	$65,769.66	2026-05-14
850	OTHER	Acute Leukemia With Other Procedures	4	4	—	—	$9,092.00	$71,440.88	$63,213.94	2026-05-14
231	OTHER	Coronary Bypass With Ptca With Mcc	5	5	—	—	$9,092.00	$69,546.68	$61,537.88	2026-05-14
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	4	4	—	—	$9,092.00	$69,328.05	$61,344.43	2026-05-14
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	4	4	—	—	$9,092.00	$64,917.60	$57,441.87	2026-05-14
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	4	4	—	—	$9,092.00	$63,345.98	$56,051.24	2026-05-14
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	5	5	—	—	$9,092.00	$63,072.90	$55,809.60	2026-05-14
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	4	4	—	—	$9,092.00	$62,864.18	$55,624.91	2026-05-14
427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	4	4	—	—	$9,092.00	$59,553.45	$52,695.44	2026-05-14
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	4	4	—	—	$9,092.00	$59,174.78	$52,360.38	2026-05-14
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	4	4	—	—	$9,092.00	$54,674.40	$52,082.24	2026-05-14
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	4	4	—	—	$9,092.00	$58,825.80	$52,051.59	2026-05-14
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	4	4	—	—	$9,092.00	$57,022.35	$50,455.81	2026-05-14
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	4	4	—	—	$9,092.00	$56,742.68	$50,208.35	2026-05-14
955	OTHER	Craniotomy For Multiple Significant Trauma	4	4	—	—	$9,092.00	$55,531.58	$49,136.71	2026-05-14
317	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	4	4	—	—	$9,092.00	$55,163.63	$48,811.14	2026-05-14
447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	4	4	—	—	$9,092.00	$55,123.20	$48,775.37	2026-05-14
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	4	4	—	—	$9,092.00	$54,246.23	$47,999.39	2026-05-14
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	4	4	—	—	$9,092.00	$54,246.23	$47,999.39	2026-05-14
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	5	5	—	—	$9,092.00	$54,049.05	$47,824.92	2026-05-14
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	4	4	—	—	$9,092.00	$53,086.28	$46,973.01	2026-05-14
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	4	4	—	—	$9,092.00	$50,559.30	$44,737.03	2026-05-14
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	4	4	—	—	$9,092.00	$50,500.73	$44,685.20	2026-05-14
232	OTHER	Coronary Bypass With Ptca Without Mcc	5	5	—	—	$9,092.00	$50,016.45	$44,256.70	2026-05-14
28	OTHER	Spinal Procedures With Mcc	4	4	—	—	$9,092.00	$49,568.48	$43,860.32	2026-05-14
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	4	4	—	—	$9,092.00	$49,195.58	$43,530.35	2026-05-14
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	4	4	—	—	$9,092.00	$49,033.88	$43,387.28	2026-05-14
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	4	4	—	—	$9,092.00	$48,920.03	$43,286.53	2026-05-14
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	4	4	—	—	$9,092.00	$48,415.95	$42,840.51	2026-05-14
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	4	4	—	—	$9,092.00	$48,384.60	$42,812.78	2026-05-14
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	5	5	—	—	$9,092.00	$193,171.31	$41,830.92	2026-05-14
213	OTHER	Endovascular Abdominal Aorta With Iliac Branch Procedures	5	5	—	—	$9,092.00	$49,299.70	$41,660.11	2026-05-14
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	5	5	—	—	$8,361.83	$47,020.88	$41,606.08	2026-05-14
428	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	4	4	—	—	$9,092.00	$46,381.50	$41,040.33	2026-05-14
8	OTHER	Simultaneous Pancreas And Kidney Transplant	4	4	—	—	$9,092.00	$46,237.95	$40,913.32	2026-05-14
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	5	5	—	—	$5,360.94	$44,224.95	$40,317.64	2026-05-14
834	OTHER	Acute Leukemia With Mcc	4	4	—	—	$9,092.00	$45,291.68	$40,076.01	2026-05-14
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	4	4	—	—	$9,092.00	$45,131.63	$39,934.38	2026-05-14
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	5	5	—	—	$9,092.00	$82,870.27	$39,877.46	2026-05-14
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	5	5	—	—	$9,092.00	$92,413.98	$39,814.68	2026-05-14
17	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	4	4	—	—	$9,092.00	$39,915.98	$39,655.53	2026-05-14
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	4	4	—	—	$9,092.00	$43,995.60	$38,929.20	2026-05-14
10	OTHER	Pancreas Transplant	4	4	—	—	$9,092.00	$52,382.27	$38,854.47	2026-05-14
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	5	5	—	—	$9,092.00	$132,157.65	$38,644.50	2026-05-14
270	OTHER	Other Major Cardiovascular Procedures With Mcc	4	4	—	—	$9,092.00	$43,529.48	$38,516.74	2026-05-14
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	4	4	—	—	$9,092.00	$42,944.55	$37,999.17	2026-05-14
653	OTHER	Major Bladder Procedures With Mcc	4	4	—	—	$9,092.00	$42,870.30	$37,933.48	2026-05-14
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	5	5	—	—	$9,092.00	$41,581.65	$36,793.22	2026-05-14
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	4	4	—	—	$9,092.00	$41,146.05	$36,407.79	2026-05-14
228	OTHER	Other Cardiothoracic Procedures With Mcc	4	4	—	—	$9,092.00	$40,816.05	$36,115.79	2026-05-14
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	4	4	—	—	$9,092.00	$40,743.45	$36,051.55	2026-05-14
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	4	4	—	—	$9,092.00	$40,604.03	$35,928.18	2026-05-14
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	4	4	—	—	$9,092.00	$40,434.90	$35,778.53	2026-05-14
471	OTHER	Cervical Spinal Fusion With Mcc	5	5	—	—	$7,251.44	$39,836.78	$35,249.29	2026-05-14
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	4	4	—	—	$9,092.00	$39,635.48	$35,071.17	2026-05-14
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	4	4	—	—	$9,092.00	$39,276.60	$34,753.63	2026-05-14
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	4	4	—	—	$9,092.00	$38,786.55	$34,320.00	2026-05-14
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	4	4	—	—	$9,092.00	$38,591.85	$34,147.72	2026-05-14
6	OTHER	Liver Transplant Without Mcc	4	4	—	—	$9,092.00	$38,255.25	$33,849.88	2026-05-14
277	OTHER	Cardiac Defibrillator Implant Without Mcc	4	4	—	—	$9,092.00	$38,102.63	$33,714.84	2026-05-14
329	OTHER	Major Small And Large Bowel Procedures With Mcc	4	4	—	—	$9,092.00	$37,921.13	$33,554.23	2026-05-14
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	5	5	—	—	$9,092.00	$37,824.60	$33,468.83	2026-05-14
245	OTHER	Aicd Generator Procedures	4	4	—	—	$9,092.00	$37,639.80	$33,305.32	2026-05-14
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	4	4	—	—	$9,092.00	$37,526.78	$33,205.29	2026-05-14
25	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	4	4	—	—	$9,092.00	$37,510.28	$33,190.70	2026-05-14
799	OTHER	Splenic Procedures With Mcc	4	4	—	—	$9,092.00	$37,363.43	$33,060.77	2026-05-14
163	OTHER	Major Chest Procedures With Mcc	4	4	—	—	$9,092.00	$36,974.85	$32,716.93	2026-05-14
31	OTHER	Ventricular Shunt Procedures With Mcc	4	4	—	—	$9,092.00	$36,964.13	$32,707.44	2026-05-14
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	4	4	—	—	$9,092.00	$36,818.93	$32,578.95	2026-05-14
356	OTHER	Other Digestive System O.r. Procedures With Mcc	4	4	—	—	$9,092.00	$36,240.60	$32,067.24	2026-05-14
323	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	4	4	—	—	$9,092.00	$35,701.05	$31,589.82	2026-05-14
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	5	5	—	—	$9,092.00	$35,416.43	$31,337.97	2026-05-14
140	OTHER	Major Head And Neck Procedures With Mcc	4	4	—	—	$9,092.00	$35,188.73	$31,136.49	2026-05-14
448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	4	4	—	—	$9,092.00	$34,986.60	$30,957.64	2026-05-14
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	4	4	—	—	$9,092.00	$34,841.40	$30,829.15	2026-05-14
12	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	5	5	—	—	$9,092.00	$143,493.26	$30,776.60	2026-05-14
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	4	4	—	—	$9,092.00	$34,764.68	$30,761.27	2026-05-14
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	4	4	—	—	$9,092.00	$34,663.20	$30,671.49	2026-05-14
901	OTHER	Wound Debridements For Injuries With Mcc	4	4	—	—	$9,092.00	$34,621.95	$30,634.98	2026-05-14
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	4	4	—	—	$9,092.00	$34,557.60	$30,578.04	2026-05-14
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	4	4	—	—	$9,092.00	$34,423.95	$30,459.78	2026-05-14
793	OTHER	Full Term Neonate With Major Problems	4	4	—	—	$9,092.00	$34,399.20	$30,437.89	2026-05-14
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	5	5	—	—	$9,092.00	$34,262.25	$30,316.71	2026-05-14
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	5	5	—	—	$9,092.00	$49,190.01	$30,115.95	2026-05-14
791	OTHER	Prematurity With Major Problems	4	4	—	—	$9,092.00	$33,486.75	$29,630.51	2026-05-14
7335594	OTHER	Generator Pulse Proclm +5	14	14	$32,625.00	$16,312.50 50% off	$12,821.63	$32,625.00	$29,362.50	2026-05-14
802	OTHER	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	4	4	—	—	$9,092.00	$32,868.83	$29,083.74	2026-05-14
24	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	5	5	—	—	$9,092.00	$337,503.83	$28,556.70	2026-05-14
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	4	4	—	—	$9,092.00	$31,487.78	$28,427.48	2026-05-14
34	OTHER	Carotid Artery Stent Procedures With Mcc	4	4	—	—	$9,092.00	$31,933.28	$28,255.93	2026-05-14
876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	4	4	—	—	$9,092.00	$31,885.43	$28,213.59	2026-05-14
40	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	4	4	—	—	$9,092.00	$31,854.90	$28,186.58	2026-05-14
907	OTHER	Other O.r. Procedures For Injuries With Mcc	4	4	—	—	$9,092.00	$31,674.23	$28,026.71	2026-05-14
956	OTHER	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	4	4	—	—	$9,092.00	$31,044.75	$27,469.72	2026-05-14
143	OTHER	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	4	4	—	—	$9,092.00	$30,909.45	$27,350.00	2026-05-14
166	OTHER	Other Respiratory System O.r. Procedures With Mcc	4	4	—	—	$9,092.00	$30,836.03	$27,285.04	2026-05-14
518	OTHER	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	4	4	—	—	$9,092.00	$30,832.73	$27,282.12	2026-05-14
628	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	4	4	—	—	$9,092.00	$30,746.10	$27,205.47	2026-05-14
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	4	4	—	—	$9,092.00	$30,572.85	$27,052.17	2026-05-14
904	OTHER	Skin Grafts For Injuries With Cc/mcc	4	4	—	—	$9,092.00	$30,303.08	$26,813.45	2026-05-14
492	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	5	5	—	—	$9,092.00	$30,290.70	$26,802.50	2026-05-14
939	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	4	4	—	—	$9,092.00	$29,935.13	$26,487.88	2026-05-14
495	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	4	4	—	—	$9,092.00	$29,912.03	$26,467.44	2026-05-14
332	OTHER	Rectal Resection With Mcc	4	4	—	—	$9,092.00	$29,870.78	$26,430.95	2026-05-14
265	OTHER	Aicd Lead Procedures	4	4	—	—	$9,092.00	$29,850.15	$26,412.68	2026-05-14
97	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	4	4	—	—	$9,092.00	$29,797.35	$26,365.97	2026-05-14
279	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	4	4	—	—	$9,092.00	$29,752.80	$26,326.55	2026-05-14
739	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	4	4	—	—	$9,092.00	$29,091.98	$26,154.27	2026-05-14
736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	4	4	—	—	$9,092.00	$29,489.63	$26,093.68	2026-05-14
408	OTHER	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	4	4	—	—	$9,092.00	$29,416.20	$26,028.71	2026-05-14
414	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	5	5	—	—	$9,092.00	$33,242.76	$26,006.82	2026-05-14
622	OTHER	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	4	4	—	—	$9,092.00	$29,363.40	$25,981.99	2026-05-14
271	OTHER	Other Major Cardiovascular Procedures With Cc	5	5	—	—	$9,092.00	$29,339.48	$25,960.83	2026-05-14
467	OTHER	Revision Of Hip Or Knee Replacement With Cc	4	4	—	—	$9,092.00	$29,094.45	$25,744.01	2026-05-14
94	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Mcc	5	5	—	—	$9,092.00	$241,955.86	$25,691.46	2026-05-14
252	OTHER	Other Vascular Procedures With Mcc	4	4	—	—	$9,092.00	$28,778.48	$25,464.43	2026-05-14
574	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Cc	5	5	—	—	$9,092.00	$28,639.05	$25,341.06	2026-05-14
477	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	4	4	—	—	$9,092.00	$28,500.45	$25,218.42	2026-05-14
359	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc	4	4	—	—	$9,092.00	$28,368.45	$25,101.61	2026-05-14
987	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	4	4	—	—	$9,092.00	$28,284.30	$25,027.16	2026-05-14
29	OTHER	Spinal Procedures With Cc Or Spinal Neurostimulators	4	4	—	—	$9,092.00	$28,145.70	$24,904.51	2026-05-14
7325185	OTHER	Cntrlr Proclaim Elite 5 W/Pt	14	14	$27,113.00	$13,556.50 50% off	$10,655.41	$27,113.00	$24,401.70	2026-05-14
264	OTHER	Other Circulatory System O.r. Procedures	5	5	—	—	$9,092.00	$54,786.34	$24,386.22	2026-05-14
411	OTHER	Cholecystectomy With C.d.e. With Mcc	5	5	—	—	$9,092.00	$27,252.23	$24,113.94	2026-05-14
37	OTHER	Extracranial Procedures With Mcc	4	4	—	—	$9,092.00	$27,159.83	$24,032.18	2026-05-14
579	OTHER	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	4	4	—	—	$9,092.00	$26,717.63	$23,640.90	2026-05-14
840	OTHER	Lymphoma And Non-acute Leukemia With Mcc	4	4	—	—	$9,092.00	$26,687.93	$23,614.63	2026-05-14
451	OTHER	Single Level Spinal Fusion Except Cervical Without Mcc	5	5	—	—	$8,154.79	$26,650.80	$23,581.77	2026-05-14
652	OTHER	Kidney Transplant	4	4	—	—	$9,092.00	$26,643.38	$23,575.20	2026-05-14
485	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Mcc	4	4	—	—	$9,092.00	$26,623.58	$23,557.68	2026-05-14
929	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	4	4	—	—	$9,092.00	$26,571.60	$23,511.69	2026-05-14
325	OTHER	Coronary Intravascular Lithotripsy Without Intraluminal Device	4	4	—	—	$9,092.00	$26,485.80	$23,435.77	2026-05-14
242	OTHER	Permanent Cardiac Pacemaker Implant With Mcc	5	5	—	—	$9,092.00	$26,340.60	$23,307.29	2026-05-14
515	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	4	4	—	—	$9,092.00	$26,291.93	$23,264.22	2026-05-14
656	OTHER	Kidney And Ureter Procedures For Neoplasm With Mcc	4	4	—	—	$9,092.00	$26,266.35	$23,241.59	2026-05-14
22	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	5	5	—	—	$9,092.00	$152,619.18	$23,194.87	2026-05-14
500	OTHER	Soft Tissue Procedures With Mcc	4	4	—	—	$9,092.00	$26,109.60	$23,102.90	2026-05-14
829	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	4	4	—	—	$9,092.00	$26,070.00	$23,067.85	2026-05-14
229	OTHER	Other Cardiothoracic Procedures Without Mcc	4	4	—	—	$9,092.00	$25,983.38	$22,991.21	2026-05-14
258	OTHER	Cardiac Pacemaker Device Replacement With Mcc	4	4	—	—	$9,092.00	$25,922.33	$22,937.19	2026-05-14
665	OTHER	Prostatectomy With Mcc	4	4	—	—	$9,092.00	$25,749.90	$22,784.62	2026-05-14
464	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	5	5	—	—	$9,092.00	$26,211.92	$22,737.17	2026-05-14
26	OTHER	Craniotomy And Endovascular Intracranial Procedures With Cc	4	4	—	—	$9,092.00	$25,650.90	$22,697.02	2026-05-14
662	OTHER	Minor Bladder Procedures With Mcc	4	4	—	—	$9,092.00	$25,257.38	$22,348.81	2026-05-14
263	OTHER	Vein Ligation And Stripping	5	5	—	—	$9,092.00	$32,054.72	$22,318.88	2026-05-14
469	OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	4	4	—	—	$9,092.00	$25,023.90	$22,142.22	2026-05-14
625	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	4	4	—	—	$9,092.00	$24,915.83	$22,046.59	2026-05-14
498	OTHER	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	4	4	—	—	$9,092.00	$24,888.60	$22,022.49	2026-05-14
173	OTHER	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	4	4	—	—	$9,092.00	$24,555.30	$21,727.59	2026-05-14
7334395	OTHER	Kit Ipg Thk11.6MM 34.9cc Nr	14	14	$24,000.00	$12,000.00 50% off	$9,432.00	$24,000.00	$21,600.00	2026-05-14
472	OTHER	Cervical Spinal Fusion With Cc	5	5	—	—	$7,430.14	$24,305.33	$21,506.39	2026-05-14
959	OTHER	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	4	4	—	—	$9,092.00	$24,288.83	$21,491.79	2026-05-14
570	OTHER	Skin Debridement With Mcc	4	4	—	—	$9,092.00	$24,264.08	$21,469.89	2026-05-14
668	OTHER	Transurethral Procedures With Mcc	4	4	—	—	$9,092.00	$24,090.00	$21,315.86	2026-05-14
480	OTHER	Hip And Femur Procedures Except Major Joint With Mcc	4	4	—	—	$9,092.00	$24,026.48	$21,259.66	2026-05-14
353	OTHER	Hernia Procedures Except Inguinal And Femoral With Mcc	4	4	—	—	$9,092.00	$23,941.50	$21,184.46	2026-05-14
406	OTHER	Pancreas, Liver And Shunt Procedures With Cc	4	4	—	—	$9,092.00	$23,926.65	$21,171.33	2026-05-14
619	OTHER	O.r. Procedures For Obesity With Mcc	4	4	—	—	$9,092.00	$23,821.05	$21,077.89	2026-05-14
974	OTHER	HIV With Major Related Condition With Mcc	5	5	—	—	$9,092.00	$40,560.75	$21,067.66	2026-05-14
13	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	5	5	—	—	$9,092.00	$175,204.15	$21,037.00	2026-05-14
240	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	4	4	—	—	$9,092.00	$23,516.63	$20,808.52	2026-05-14
800	OTHER	Splenic Procedures With Cc	4	4	—	—	$9,092.00	$23,177.55	$20,508.48	2026-05-14
654	OTHER	Major Bladder Procedures With Cc	4	4	—	—	$9,092.00	$23,094.23	$20,434.76	2026-05-14
503	OTHER	Foot Procedures With Mcc	5	5	—	—	$9,092.00	$28,016.15	$20,374.90	2026-05-14
61	OTHER	Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	5	5	—	—	$9,092.00	$88,496.18	$20,126.70	2026-05-14
208	OTHER	Respiratory System Diagnosis With Ventilator Support <=96 Hours	4	4	—	—	$9,092.00	$22,676.78	$20,065.39	2026-05-14
468	OTHER	Revision Of Hip Or Knee Replacement Without Cc/mcc	4	4	—	—	$9,092.00	$22,671.00	$20,060.27	2026-05-14
963	OTHER	Other Multiple Significant Trauma With Mcc	4	4	—	—	$9,092.00	$22,553.85	$19,956.62	2026-05-14
321	OTHER	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	4	4	—	—	$9,092.00	$22,446.60	$19,861.71	2026-05-14
849	OTHER	Radiotherapy	4	4	—	—	$9,092.00	$22,353.38	$19,779.22	2026-05-14
288	OTHER	Acute And Subacute Endocarditis With Mcc	4	4	—	—	$9,092.00	$22,326.15	$19,755.13	2026-05-14
255	OTHER	Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc	4	4	—	—	$9,092.00	$22,253.55	$19,690.89	2026-05-14
462	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	5	5	—	—	$6,645.10	$21,945.00	$19,417.87	2026-05-14
577	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc	4	4	—	—	$9,092.00	$21,868.28	$19,349.99	2026-05-14
970	OTHER	HIV With Extensive O.r. Procedures Without Mcc	4	4	—	—	$9,092.00	$21,758.55	$19,252.89	2026-05-14
253	OTHER	Other Vascular Procedures With Cc	4	4	—	—	$9,092.00	$21,413.70	$18,947.76	2026-05-14
846	OTHER	Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc	4	4	—	—	$9,092.00	$21,388.13	$18,925.12	2026-05-14
96	OTHER	Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc	4	4	—	—	$9,092.00	$21,278.40	$18,828.04	2026-05-14
95	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Cc	4	4	—	—	$9,092.00	$21,278.40	$18,828.04	2026-05-14
749	OTHER	Other Female Reproductive System O.r. Procedures With Cc/mcc	4	4	—	—	$9,092.00	$21,182.70	$18,743.36	2026-05-14
659	OTHER	Kidney And Ureter Procedures For Non-neoplasm With Mcc	4	4	—	—	$9,092.00	$20,962.43	$18,548.45	2026-05-14
493	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc	5	5	—	—	$9,092.00	$29,046.44	$18,513.41	2026-05-14
164	OTHER	Major Chest Procedures With Cc	4	4	—	—	$9,092.00	$20,823.00	$18,425.09	2026-05-14
27	OTHER	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	4	4	—	—	$9,092.00	$20,813.93	$18,417.04	2026-05-14
545	OTHER	Connective Tissue Disorders With Mcc	4	4	—	—	$9,092.00	$20,474.03	$18,116.30	2026-05-14
478	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Cc	4	4	—	—	$9,092.00	$20,288.40	$17,952.05	2026-05-14
783	OTHER	Cesarean Section With Sterilization With Mcc	4	4	—	—	$9,092.00	$20,254.58	$17,922.11	2026-05-14
792	OTHER	Prematurity Without Major Problems	4	4	—	—	$9,092.00	$20,205.90	$17,879.04	2026-05-14
327	OTHER	Stomach, Esophageal And Duodenal Procedures With Cc	4	4	—	—	$9,092.00	$20,164.65	$17,842.54	2026-05-14
473	OTHER	Cervical Spinal Fusion Without Cc/mcc	5	5	—	—	$9,092.00	$20,140.73	$17,821.38	2026-05-14
318	OTHER	Percutaneous Coronary Atherectomy Without Intraluminal Device	4	4	—	—	$9,092.00	$19,983.15	$17,681.95	2026-05-14
330	OTHER	Major Small And Large Bowel Procedures With Cc	4	4	—	—	$9,092.00	$19,776.90	$17,499.46	2026-05-14
397	OTHER	Appendix Procedures With Mcc	4	4	—	—	$9,092.00	$19,757.93	$17,482.66	2026-05-14
35	OTHER	Carotid Artery Stent Procedures With Cc	4	4	—	—	$9,092.00	$19,721.63	$17,450.53	2026-05-14
417	OTHER	Laparoscopic Cholecystectomy Without C.d.e. With Mcc	4	4	—	—	$9,092.00	$19,687.80	$17,420.61	2026-05-14
113	OTHER	Orbital Procedures With Cc/mcc	4	4	—	—	$9,092.00	$19,396.58	$17,162.92	2026-05-14
333	OTHER	Rectal Resection With Cc	4	4	—	—	$9,092.00	$19,323.15	$17,097.94	2026-05-14
674	OTHER	Other Kidney And Urinary Tract Procedures With Cc	4	4	—	—	$9,092.00	$19,293.45	$17,071.66	2026-05-14
709	OTHER	Penis Procedures With Cc/mcc	4	4	—	—	$9,092.00	$19,198.58	$16,987.73	2026-05-14
357	OTHER	Other Digestive System O.r. Procedures With Cc	4	4	—	—	$9,092.00	$19,185.38	$16,976.04	2026-05-14
56	OTHER	Degenerative Nervous System Disorders With Mcc	4	4	—	—	$9,092.00	$19,165.58	$16,958.52	2026-05-14
827	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	4	4	—	—	$9,092.00	$19,067.40	$16,871.64	2026-05-14
347	OTHER	Anal And Stomal Procedures With Mcc	4	4	—	—	$9,092.00	$18,938.70	$16,757.78	2026-05-14
98	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc	4	4	—	—	$9,092.00	$18,932.93	$16,752.66	2026-05-14
82	OTHER	Traumatic Stupor And Coma >1 Hour With Mcc	5	5	—	—	$9,092.00	$64,670.19	$16,684.77	2026-05-14
475	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc	4	4	—	—	$9,092.00	$18,774.53	$16,612.49	2026-05-14
85	OTHER	Traumatic Stupor And Coma <1 Hour With Mcc	4	4	—	—	$9,092.00	$18,743.18	$16,584.76	2026-05-14
7114139	OTHER	Component Femoral	14	14	$18,410.00	$9,205.00 50% off	$7,235.13	$18,410.00	$16,569.00	2026-05-14
7114138	OTHER	Joint Dvc CMpnt Kn 2Xs Lt	14	14	$18,410.00	$9,205.00 50% off	$7,235.13	$18,410.00	$16,569.00	2026-05-14
824	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Cc	5	5	—	—	$9,092.00	$18,908.71	$16,538.77	2026-05-14
821	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Cc	5	5	—	—	$5,873.62	$18,468.45	$16,341.67	2026-05-14
715	OTHER	Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc	4	4	—	—	$9,092.00	$18,457.73	$16,332.18	2026-05-14
407	OTHER	Pancreas, Liver And Shunt Procedures Without Cc/mcc	4	4	—	—	$9,092.00	$18,311.70	$16,202.97	2026-05-14
286	OTHER	Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc	4	4	—	—	$9,092.00	$18,255.60	$16,153.35	2026-05-14
934	OTHER	Full Thickness Burn Without Skin Graft Or Inhalation Injury	4	4	—	—	$9,092.00	$18,237.45	$16,137.28	2026-05-14
808	OTHER	Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…	4	4	—	—	$9,092.00	$18,215.18	$16,117.57	2026-05-14
41	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…	5	5	—	—	$9,092.00	$75,266.37	$16,050.41	2026-05-14
30	OTHER	Spinal Procedures Without Cc/mcc	4	4	—	—	$9,092.00	$18,110.40	$16,024.86	2026-05-14
614	OTHER	Adrenal And Pituitary Procedures With Cc/mcc	4	4	—	—	$9,092.00	$18,082.35	$16,000.04	2026-05-14
141	OTHER	Major Head And Neck Procedures With Cc	4	4	—	—	$9,092.00	$17,994.08	$15,921.93	2026-05-14
629	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc	4	4	—	—	$9,092.00	$17,975.10	$15,905.13	2026-05-14
409	OTHER	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	4	4	—	—	$9,092.00	$17,962.73	$15,894.19	2026-05-14
135	OTHER	Sinus And Mastoid Procedures With Cc/mcc	4	4	—	—	$9,092.00	$17,450.40	$15,840.89	2026-05-14
7325944	OTHER	Kit Pulse Gntr Alpha 16 Thk	14	14	$17,500.00	$8,750.00 50% off	$6,877.50	$17,500.00	$15,750.00	2026-05-14
857	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc	4	4	—	—	$9,092.00	$17,667.38	$15,632.84	2026-05-14
584	OTHER	Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc	5	5	—	—	$9,092.00	$25,413.32	$15,627.00	2026-05-14
374	OTHER	Digestive Malignancy With Mcc	4	4	—	—	$9,092.00	$17,644.28	$15,612.42	2026-05-14
32	OTHER	Ventricular Shunt Procedures With Cc	4	4	—	—	$9,092.00	$17,580.75	$15,556.19	2026-05-14
243	OTHER	Permanent Cardiac Pacemaker Implant With Cc	5	5	—	—	$9,092.00	$20,831.26	$15,555.47	2026-05-14
734	OTHER	Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc	5	5	—	—	$9,092.00	$52,099.71	$15,548.90	2026-05-14
814	OTHER	Reticuloendothelial And Immunity Disorders With Mcc	4	4	—	—	$9,092.00	$17,545.28	$15,524.82	2026-05-14
595	OTHER	Major Skin Disorders With Mcc	4	4	—	—	$9,092.00	$17,495.78	$15,481.01	2026-05-14
522	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc	5	5	—	—	$8,459.19	$17,471.03	$15,459.11	2026-05-14
146	OTHER	Ear, Nose, Mouth And Throat Malignancy With Mcc	4	4	—	—	$9,092.00	$17,468.55	$15,456.92	2026-05-14
655	OTHER	Major Bladder Procedures Without Cc/mcc	4	4	—	—	$9,092.00	$17,461.95	$15,451.07	2026-05-14
336	OTHER	Peritoneal Adhesiolysis With Cc	4	4	—	—	$9,092.00	$17,396.78	$15,393.41	2026-05-14
412	OTHER	Cholecystectomy With C.d.e. With Cc	5	5	—	—	$9,092.00	$17,345.63	$15,348.15	2026-05-14
817	OTHER	Other Antepartum Diagnoses With O.r. Procedures With Mcc	4	4	—	—	$9,092.00	$16,655.57	$15,290.78	2026-05-14
481	OTHER	Hip And Femur Procedures Except Major Joint With Cc	5	5	—	—	$9,092.00	$17,279.63	$15,289.75	2026-05-14
867	OTHER	Other Infectious And Parasitic Diseases Diagnoses With Mcc	4	4	—	—	$9,092.00	$17,268.90	$15,280.26	2026-05-14
486	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Cc	4	4	—	—	$9,092.00	$17,251.58	$15,264.93	2026-05-14
838	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che…	4	4	—	—	$9,092.00	$17,221.05	$15,237.92	2026-05-14
835	OTHER	Acute Leukemia With Cc	4	4	—	—	$9,092.00	$17,207.85	$15,226.24	2026-05-14
314	OTHER	Other Circulatory System Diagnoses With Mcc	4	4	—	—	$9,092.00	$17,202.90	$15,221.86	2026-05-14
711	OTHER	Testes Procedures With Cc/mcc	4	4	—	—	$9,092.00	$17,191.35	$15,211.65	2026-05-14
511	OTHER	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc	5	5	—	—	$6,423.27	$17,155.05	$15,179.52	2026-05-14
516	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc	4	4	—	—	$9,092.00	$17,144.33	$15,170.03	2026-05-14
886	OTHER	Behavioral And Developmental Disorders	4	4	—	—	$9,092.00	$17,121.23	$15,149.59	2026-05-14
415	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Cc	4	4	—	—	$9,092.00	$17,050.28	$15,086.82	2026-05-14
737	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc	4	4	—	—	$9,092.00	$16,999.95	$15,042.29	2026-05-14
935	OTHER	Non-extensive Burns	4	4	—	—	$9,092.00	$16,995.00	$15,037.91	2026-05-14
744	OTHER	D&c, Conization, Laparoscopy And Tubal Interruption With Cc/mcc	4	4	—	—	$9,092.00	$16,905.08	$14,958.33	2026-05-14
7329613	OTHER	Spacer Shldr Inspace Tiss Sys	14	14	$16,500.00	$8,250.00 50% off	$6,484.50	$16,500.00	$14,850.00	2026-05-14
941	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/…	4	4	—	—	$9,092.00	$16,728.53	$14,802.12	2026-05-14
259	OTHER	Cardiac Pacemaker Device Replacement Without Mcc	4	4	—	—	$9,092.00	$16,682.33	$14,761.23	2026-05-14
7114137	OTHER	Comp Fem Xs Kn Lt Repl Lps	14	14	$16,396.00	$8,198.00 50% off	$6,443.63	$16,396.00	$14,756.40	2026-05-14
7217919	OTHER	Cmpnt Fem 2Xs Kn Rt Tpr F	14	14	$16,396.00	$8,198.00 50% off	$6,443.63	$16,396.00	$14,756.40	2026-05-14
499	OTHER	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without…	4	4	—	—	$9,092.00	$16,622.10	$14,707.94	2026-05-14
64	OTHER	Intracranial Hemorrhage Or Cerebral Infarction With Mcc	5	5	—	—	$9,092.00	$203,093.36	$14,680.21	2026-05-14
494	OTHER	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc	5	5	—	—	$9,092.00	$53,019.08	$14,647.35	2026-05-14
707	OTHER	Major Male Pelvic Procedures With Cc/mcc	4	4	—	—	$9,092.00	$16,502.48	$14,602.10	2026-05-14
519	OTHER	Back And Neck Procedures Except Spinal Fusion With Cc	4	4	—	—	$9,092.00	$16,501.65	$14,601.37	2026-05-14
854	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Cc	4	4	—	—	$9,092.00	$16,484.33	$14,586.03	2026-05-14
908	OTHER	Other O.r. Procedures For Injuries With Cc	4	4	—	—	$9,092.00	$16,460.40	$14,564.87	2026-05-14
843	OTHER	Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…	4	4	—	—	$9,092.00	$16,457.10	$14,561.95	2026-05-14
283	OTHER	Acute Myocardial Infarction, Expired With Mcc	4	4	—	—	$9,092.00	$16,341.60	$14,459.75	2026-05-14
539	OTHER	Osteomyelitis With Mcc	4	4	—	—	$9,092.00	$16,250.03	$14,378.73	2026-05-14
432	OTHER	Cirrhosis And Alcoholic Hepatitis With Mcc	5	5	—	—	$9,092.00	$16,237.65	$14,367.77	2026-05-14
883	OTHER	Disorders Of Personality And Impulse Control	4	4	—	—	$9,092.00	$16,221.98	$14,353.90	2026-05-14
906	OTHER	Hand Procedures For Injuries	4	4	—	—	$9,092.00	$14,539.80	$14,339.29	2026-05-14
380	OTHER	Complicated Peptic Ulcer With Mcc	4	4	—	—	$9,092.00	$16,188.15	$14,323.96	2026-05-14
36	OTHER	Carotid Artery Stent Procedures Without Cc/mcc	4	4	—	—	$9,092.00	$16,028.10	$14,182.35	2026-05-14
871	OTHER	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	4	4	—	—	$9,092.00	$16,025.63	$14,180.15	2026-05-14
100	OTHER	Seizures With Mcc	4	4	—	—	$9,092.00	$15,978.60	$14,138.55	2026-05-14
592	OTHER	Skin Ulcers With Mcc	5	5	—	—	$9,092.00	$15,966.23	$14,127.60	2026-05-14
548	OTHER	Septic Arthritis With Mcc	4	4	—	—	$9,092.00	$15,929.93	$14,095.47	2026-05-14
585	OTHER	Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/mcc	4	4	—	—	$9,092.00	$15,915.08	$14,082.34	2026-05-14
470	OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without …	4	4	—	—	$9,092.00	$15,913.43	$14,080.88	2026-05-14
582	OTHER	Mastectomy For Malignancy With Cc/mcc	5	5	—	—	$9,092.00	$15,894.45	$14,064.09	2026-05-14
75	OTHER	Viral Meningitis With Cc/mcc	4	4	—	—	$9,092.00	$15,819.38	$13,997.66	2026-05-14
902	OTHER	Wound Debridements For Injuries With Cc	4	4	—	—	$9,092.00	$15,794.63	$13,975.76	2026-05-14
165	OTHER	Major Chest Procedures Without Cc/mcc	4	4	—	—	$9,092.00	$15,792.15	$13,973.57	2026-05-14
801	OTHER	Splenic Procedures Without Cc/mcc	4	4	—	—	$9,092.00	$15,748.43	$13,934.89	2026-05-14
261	OTHER	Cardiac Pacemaker Revision Except Device Replacement With Cc	5	5	—	—	$9,092.00	$15,596.63	$13,800.56	2026-05-14
717	OTHER	Other Male Reproductive System O.r. Procedures Except Malignancy With Cc/mcc	4	4	—	—	$9,092.00	$15,596.63	$13,800.56	2026-05-14
196	OTHER	Interstitial Lung Disease With Mcc	4	4	—	—	$9,092.00	$15,569.40	$13,776.47	2026-05-14

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