Hospital

MEDICAL CITY ARLINGTON

Arlington, TX · CCN 450675 · Rates published

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You selected 93350 (CPT)

ECHO STRESS

This hospital’s price: $3,818 across 30 payers · range $668-$9,546

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1682201_MEDICAL-CITY-ARLINGTON_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D · observed 2026-03-01

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

36,482 distinct procedures filed

35 distinct payers

1,270,294 rate rows

2026-07-17 last MRF observed

Data quality

1,248,171 of 1,270,294 rate rows are consumer-grade (98.3%)

22,123 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	21,982
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	102
template filing: same amount across many unrelated codes — excluded	39

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

Source MRF file	https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1682201_MEDICAL-CITY-ARLINGTON_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page	https://www.medicalcityhealthcare.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered via	Discovered by HANK
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-11
Content fingerprint	91d94283bcbcbe5d… · 1,080,954,109 bytes · first seen 2026-05-06

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
422506 CDM	Kit Pmp Rt Hrt 22f 170cm	1	$719,643.75	$719,643.75	$719,643.75	nat. median $113,773 outlier · 6.3×
254667 CDM	Cath Vasc Assist Strl	1	$719,643.75	$719,643.75	$719,643.75	nat. median $1,645 outlier · 437.5×
J7330 HCPCS	Algrf Maci Fnl 1 Membran	31	$69,999.93	$999,999.00	$449,999.55	nat. median $75,000 outlier · 6.0×
217160 CDM	Kit Pt Replacement R16	1	$404,852.25	$404,852.25	$404,852.25	nat. median $252,874 1.6× median
879378 CDM	Hndl Pwr Drv + Reldsx	34	$85,458.94	$1,220,842.00	$389,448.60	nat. median $20,534 outlier · 19.0×
866357 CDM	Set Pump 21fr 5.0	34	$69,654.48	$995,064.00	$317,425.42	nat. median $123,510 outlier · 2.6×
265596 CDM	Kit Lo Prfl Comp Shth 7f	34	$67,166.75	$959,525.00	$306,088.47	nat. median $121,036 outlier · 2.5×
862710 CDM	Set Vntrc 17.4x13.8in	34	$67,166.75	$959,525.00	$306,088.47	nat. median $122,775 outlier · 2.5×
234048 CDM	Device Embl 4mm 30mm	1	$272,100.00	$272,100.00	$272,100.00	nat. median $122,510 outlier · 2.2×
245978 CDM	Stent Eprsth 24f 34mm	23	$97,956.00	$725,600.00	$270,648.80	nat. median $233,406 1.2× median
751731 CDM	Set Pump Asst 2.5in	34	$53,733.40	$767,620.00	$244,870.78	nat. median $110,094 outlier · 2.2×
231698 CDM	Device Embl 4.25mm 14mm	1	$244,635.00	$244,635.00	$244,635.00	nat. median $85,641 outlier · 2.9×
273458 CDM	Device Embl 4.25mm 18mm	1	$244,635.00	$244,635.00	$244,635.00	nat. median $0
254326 CDM	Device Embl 4.5mm 12mm	1	$244,635.00	$244,635.00	$244,635.00	nat. median $122,510 2.0× median
218838 CDM	Stent Aaa Xcldr 12cm	1	$201,337.50	$201,337.50	$201,337.50	nat. median $3,150 outlier · 63.9×
224576 CDM	Retriever Endo 3mm 20mm	1	$197,141.25	$197,141.25	$197,141.25	nat. median $2,350 outlier · 83.9×
273097 CDM	Stent Vasc 500mm 30mm	21	$47,447.50	$351,463.00	$157,103.96	nat. median $3,876 outlier · 40.5×
273096 CDM	Stent Vasc 325mm 20mm	21	$47,447.50	$351,463.00	$157,103.96	nat. median $23,052 outlier · 6.8×
483550 CDM	Stnt Thorac 26x26mm 10cm	23	$55,433.29	$410,617.00	$153,160.14	nat. median $7,724 outlier · 19.8×
229026 CDM	Occluder Cardiac Lt 28mm	23	$55,100.25	$408,150.00	$152,239.95	nat. median $137,955 1.1× median
229029 CDM	Occluder Cardiac Lt 22mm	23	$55,100.25	$408,150.00	$152,239.95	nat. median $133,086 1.1× median
229030 CDM	Occluder Cardiac Lt 20mm	23	$55,100.25	$408,150.00	$152,239.95	nat. median $130,200 1.2× median
229031 CDM	Occluder Cardiac Lt 18mm	23	$55,100.25	$408,150.00	$152,239.95	nat. median $124,641 1.2× median
229023 CDM	Occluder Cardiac Lt 34mm	23	$55,100.25	$408,150.00	$152,239.95	nat. median $124,641 1.2× median
229025 CDM	Occluder Cardiac Lt 31mm	23	$55,100.25	$408,150.00	$152,239.95	nat. median $120,404 1.3× median
229036 CDM	Occluder Cardiac Lt 16mm	23	$55,100.25	$408,150.00	$152,239.95	nat. median $128,808 1.2× median
229028 CDM	Occluder Cardiac Lt 25mm	23	$55,100.25	$408,150.00	$152,239.95	nat. median $124,641 1.2× median
279176 CDM	Stent Graft 15cm 40x34mm	23	$54,953.37	$407,062.00	$151,834.13	nat. median $151,834 1.0× median
459729 CDM	Stent Eprsth 37x37x15cm	23	$54,953.37	$407,062.00	$151,834.13	nat. median $90,099 1.7× median
473093 CDM	Stent Eprsth 37x37x10cm	23	$54,953.37	$407,062.00	$151,834.13	nat. median $125,946 1.2× median
422236 CDM	Generator Nrstm 7 Ipg	23	$54,639.63	$404,738.00	$150,967.27	nat. median $122,530 1.2× median
473614 CDM	Stent Eprsth 40x40x20cm	23	$54,346.28	$402,565.00	$150,156.74	nat. median $154,200 1.0× median
473595 CDM	Stent Thor 20f 26x21x10	23	$53,875.80	$399,080.00	$148,856.84	nat. median $146,778 1.0× median
205115 CDM	Stnt Thorac 28x28mm 10cm	23	$53,875.80	$399,080.00	$148,856.84	nat. median $139,800 1.1× median
442639 CDM	Kit Impl Crnl Cstm Lg	23	$54,780.57	$405,782.00	$146,690.20	nat. median $326 outlier · 449.7×
33262 CPT	Rmvl + Rplc Icd Sgl	24	$33,653.62	$249,286.06	$144,585.91	nat. median $23,311 outlier · 6.2×
266357 CDM	Coil Emb 7x5mm	23	$48,387.51	$358,426.00	$133,692.90	nat. median $333 outlier · 401.8×
268181 CDM	Coil Embz .017 4.5mm 2mm	23	$47,968.61	$355,323.00	$132,535.48	nat. median $1,966 outlier · 67.4×
251695 CDM	Coil Embl 4.5mm 3mm	23	$47,968.61	$355,323.00	$132,535.48	nat. median $49,745 outlier · 2.7×
251670 CDM	Coil Embl 4x3mm	23	$47,968.61	$355,323.00	$132,535.48	nat. median $6,606 outlier · 20.1×
240704 CDM	Coil Emb Neuro 6x3mm	23	$47,968.61	$355,323.00	$132,535.48	nat. median $87,093 1.5× median
268184 CDM	Coil Embl 6mm 2mm	23	$47,968.61	$355,323.00	$132,535.48	nat. median $258 outlier · 514.1×
235425 CDM	Coil Embl 5mm 2mm	23	$47,968.61	$355,323.00	$132,535.48	nat. median $750 outlier · 176.8×
245542 CDM	Coil Embol Neuro 7x3mm	23	$47,968.61	$355,323.00	$132,535.48	nat. median $119,033 1.1× median
275189 CDM	Stent Vasc 325mm 16mm	23	$47,447.50	$351,463.00	$131,095.70	nat. median $120,903 1.1× median
33264 CPT	Rmvl + Rplc Icd Mltp	24	$30,104.41	$222,995.63	$129,337.47	nat. median $31,574 outlier · 4.1×
33263 CPT	Rmvl + Rplc Icd Dual	24	$30,104.41	$222,995.63	$129,337.47	nat. median $23,376 outlier · 5.5×
259679 CDM	Coil Emb 3mm 8mm	23	$43,475.67	$322,042.00	$120,121.67	nat. median $2,142 outlier · 56.1×
232314 CDM	Device Embl 3mm 12mm	23	$44,034.30	$326,180.00	$117,914.07	nat. median $54 outlier · 2183.6×
272762 CDM	Device Embl 4.5mm 10mm	23	$44,034.30	$326,180.00	$117,914.07	nat. median $333 outlier · 354.1×

Other procedures at this hospital

Browse this hospital's 36,482 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

422506	CDM	Kit Pmp Rt Hrt 22f 170cm	1	1	$959,525.00	$959,525.00	$719,643.75	$719,643.75	$719,643.75	2026-03-01
254667	CDM	Cath Vasc Assist Strl	1	1	$959,525.00	$959,525.00	$719,643.75	$719,643.75	$719,643.75	2026-03-01
J7330	HCPCS	Algrf Maci Fnl 1 Membran	44	31	$999,999.00	$999,999.00	$69,999.93	$999,999.00	$449,999.55	2026-07-17
217160	CDM	Kit Pt Replacement R16	1	1	$539,803.00	$539,803.00	$404,852.25	$404,852.25	$404,852.25	2026-03-01
879378	CDM	Hndl Pwr Drv + Reldsx	63	34	$1,220,842.00	$1,220,842.00	$85,458.94	$1,220,842.00	$389,448.60	2026-03-01
866357	CDM	Set Pump 21fr 5.0	63	34	$995,064.00	$995,064.00	$69,654.48	$995,064.00	$317,425.42	2026-03-01
265596	CDM	Kit Lo Prfl Comp Shth 7f	63	34	$959,525.00	$959,525.00	$67,166.75	$959,525.00	$306,088.47	2026-03-01
862710	CDM	Set Vntrc 17.4x13.8in	63	34	$959,525.00	$959,525.00	$67,166.75	$959,525.00	$306,088.47	2026-03-01
234048	CDM	Device Embl 4mm 30mm	1	1	$362,800.00	$362,800.00	$272,100.00	$272,100.00	$272,100.00	2026-03-01
245978	CDM	Stent Eprsth 24f 34mm	41	23	$725,600.00	$725,600.00	$97,956.00	$725,600.00	$270,648.80	2026-03-01
751731	CDM	Set Pump Asst 2.5in	63	34	$767,620.00	$767,620.00	$53,733.40	$767,620.00	$244,870.78	2026-03-01
254326	CDM	Device Embl 4.5mm 12mm	1	1	$326,180.00	$326,180.00	$244,635.00	$244,635.00	$244,635.00	2026-03-01
231698	CDM	Device Embl 4.25mm 14mm	1	1	$326,180.00	$326,180.00	$244,635.00	$244,635.00	$244,635.00	2026-03-01
273458	CDM	Device Embl 4.25mm 18mm	1	1	$326,180.00	$326,180.00	$244,635.00	$244,635.00	$244,635.00	2026-03-01
218838	CDM	Stent Aaa Xcldr 12cm	1	1	$268,450.00	$268,450.00	$201,337.50	$201,337.50	$201,337.50	2026-03-01
224576	CDM	Retriever Endo 3mm 20mm	1	1	$262,855.00	$262,855.00	$197,141.25	$197,141.25	$197,141.25	2026-03-01
273097	CDM	Stent Vasc 500mm 30mm	36	21	$351,463.00	$351,463.00	$47,447.50	$351,463.00	$157,103.96	2026-03-01
273096	CDM	Stent Vasc 325mm 20mm	36	21	$351,463.00	$351,463.00	$47,447.50	$351,463.00	$157,103.96	2026-03-01
483550	CDM	Stnt Thorac 26x26mm 10cm	41	23	$410,617.00	$410,617.00	$55,433.29	$410,617.00	$153,160.14	2026-03-01
229025	CDM	Occluder Cardiac Lt 31mm	41	23	$408,150.00	$408,150.00	$55,100.25	$408,150.00	$152,239.95	2026-03-01
229031	CDM	Occluder Cardiac Lt 18mm	41	23	$408,150.00	$408,150.00	$55,100.25	$408,150.00	$152,239.95	2026-03-01
229029	CDM	Occluder Cardiac Lt 22mm	41	23	$408,150.00	$408,150.00	$55,100.25	$408,150.00	$152,239.95	2026-03-01
229036	CDM	Occluder Cardiac Lt 16mm	41	23	$408,150.00	$408,150.00	$55,100.25	$408,150.00	$152,239.95	2026-03-01
229030	CDM	Occluder Cardiac Lt 20mm	41	23	$408,150.00	$408,150.00	$55,100.25	$408,150.00	$152,239.95	2026-03-01
229023	CDM	Occluder Cardiac Lt 34mm	41	23	$408,150.00	$408,150.00	$55,100.25	$408,150.00	$152,239.95	2026-03-01
229028	CDM	Occluder Cardiac Lt 25mm	41	23	$408,150.00	$408,150.00	$55,100.25	$408,150.00	$152,239.95	2026-03-01
229026	CDM	Occluder Cardiac Lt 28mm	41	23	$408,150.00	$408,150.00	$55,100.25	$408,150.00	$152,239.95	2026-03-01
279176	CDM	Stent Graft 15cm 40x34mm	41	23	$407,062.00	$407,062.00	$54,953.37	$407,062.00	$151,834.13	2026-03-01
459729	CDM	Stent Eprsth 37x37x15cm	41	23	$407,062.00	$407,062.00	$54,953.37	$407,062.00	$151,834.13	2026-03-01
473093	CDM	Stent Eprsth 37x37x10cm	41	23	$407,062.00	$407,062.00	$54,953.37	$407,062.00	$151,834.13	2026-03-01
422236	CDM	Generator Nrstm 7 Ipg	41	23	$404,738.00	$404,738.00	$54,639.63	$404,738.00	$150,967.27	2026-03-01
473614	CDM	Stent Eprsth 40x40x20cm	41	23	$402,565.00	$402,565.00	$54,346.28	$402,565.00	$150,156.74	2026-03-01
473595	CDM	Stent Thor 20f 26x21x10	41	23	$399,080.00	$399,080.00	$53,875.80	$399,080.00	$148,856.84	2026-03-01
205115	CDM	Stnt Thorac 28x28mm 10cm	41	23	$399,080.00	$399,080.00	$53,875.80	$399,080.00	$148,856.84	2026-03-01
442639	CDM	Kit Impl Crnl Cstm Lg	40	23	$405,782.00	$405,782.00	$54,780.57	$405,782.00	$146,690.20	2026-03-01
33262	CPT	Rmvl + Rplc Icd Sgl	27	24	$249,286.06	$249,286.06	$33,653.62	$249,286.06	$144,585.91	2026-07-17
266357	CDM	Coil Emb 7x5mm	41	23	$358,426.00	$358,426.00	$48,387.51	$358,426.00	$133,692.90	2026-03-01
235425	CDM	Coil Embl 5mm 2mm	41	23	$355,323.00	$355,323.00	$47,968.61	$355,323.00	$132,535.48	2026-03-01
251695	CDM	Coil Embl 4.5mm 3mm	41	23	$355,323.00	$355,323.00	$47,968.61	$355,323.00	$132,535.48	2026-03-01
268181	CDM	Coil Embz .017 4.5mm 2mm	41	23	$355,323.00	$355,323.00	$47,968.61	$355,323.00	$132,535.48	2026-03-01
245542	CDM	Coil Embol Neuro 7x3mm	41	23	$355,323.00	$355,323.00	$47,968.61	$355,323.00	$132,535.48	2026-03-01
251670	CDM	Coil Embl 4x3mm	41	23	$355,323.00	$355,323.00	$47,968.61	$355,323.00	$132,535.48	2026-03-01
268184	CDM	Coil Embl 6mm 2mm	41	23	$355,323.00	$355,323.00	$47,968.61	$355,323.00	$132,535.48	2026-03-01
240704	CDM	Coil Emb Neuro 6x3mm	41	23	$355,323.00	$355,323.00	$47,968.61	$355,323.00	$132,535.48	2026-03-01
275189	CDM	Stent Vasc 325mm 16mm	41	23	$351,463.00	$351,463.00	$47,447.50	$351,463.00	$131,095.70	2026-03-01
33264	CPT	Rmvl + Rplc Icd Mltp	27	24	$222,995.63	$222,995.63	$30,104.41	$222,995.63	$129,337.47	2026-07-17
33263	CPT	Rmvl + Rplc Icd Dual	27	24	$222,995.63	$222,995.63	$30,104.41	$222,995.63	$129,337.47	2026-07-17
259679	CDM	Coil Emb 3mm 8mm	41	23	$322,042.00	$322,042.00	$43,475.67	$322,042.00	$120,121.67	2026-03-01
286047	CDM	Device Embl 3.25mm 10mm	40	23	$326,180.00	$326,180.00	$44,034.30	$326,180.00	$117,914.07	2026-03-01
250130	CDM	Device Embl 3.75x16mm	40	23	$326,180.00	$326,180.00	$44,034.30	$326,180.00	$117,914.07	2026-03-01
232314	CDM	Device Embl 3mm 12mm	40	23	$326,180.00	$326,180.00	$44,034.30	$326,180.00	$117,914.07	2026-03-01
272762	CDM	Device Embl 4.5mm 10mm	40	23	$326,180.00	$326,180.00	$44,034.30	$326,180.00	$117,914.07	2026-03-01
234142	CDM	Device Embl 3.5mm 14mm	40	23	$326,180.00	$326,180.00	$44,034.30	$326,180.00	$117,914.07	2026-03-01
875508	CDM	Set Tubing Prfsn Crct	63	34	$362,500.00	$362,500.00	$25,375.00	$362,500.00	$115,637.50	2026-03-01
278510	CDM	Implant Spn Cerv Sys 4mm	1	1	$152,388.00	$152,388.00	$114,291.00	$114,291.00	$114,291.00	2026-03-01
640233	CDM	Valve Aor 25mm Mstr Hmdn	1	1	$144,866.00	$144,866.00	$108,649.50	$108,649.50	$108,649.50	2026-03-01
652278	CDM	Valve Aor 21mm Mstr Hmdn	1	1	$144,866.00	$144,866.00	$108,649.50	$108,649.50	$108,649.50	2026-03-01
571059	CDM	Valve Aortic 29mm	1	1	$144,866.00	$144,866.00	$108,649.50	$108,649.50	$108,649.50	2026-03-01
881298	CDM	System Retr 17cm	63	34	$339,458.00	$339,458.00	$23,762.06	$339,458.00	$108,287.10	2026-03-01
423054	CDM	Valve Aortic 23mm	1	1	$141,968.00	$141,968.00	$106,476.00	$106,476.00	$106,476.00	2026-03-01
422655	CDM	Valve Aortic 25mm	1	1	$141,968.00	$141,968.00	$106,476.00	$106,476.00	$106,476.00	2026-03-01
880854	CDM	Crt-d Amplia Dtmb1qq	41	23	$281,280.00	$281,280.00	$37,972.80	$281,280.00	$104,917.44	2026-03-01
753378	CDM	Device Ex Fix 160mm	1	1	$139,416.00	$139,416.00	$104,562.00	$104,562.00	$104,562.00	2026-03-01
216652	CDM	Graft Endo Aaa 32x14mm	41	23	$277,954.00	$277,954.00	$37,523.79	$277,954.00	$103,676.84	2026-03-01
231788	CDM	Graft Endo Aaa 23x12mm	41	23	$275,162.00	$275,162.00	$37,146.87	$275,162.00	$102,635.43	2026-03-01
216719	CDM	Graft Endo Aaa 26x12mm	41	23	$275,162.00	$275,162.00	$37,146.87	$275,162.00	$102,635.43	2026-03-01
216750	CDM	Graft Endo Aaa 36x14mm	41	23	$275,162.00	$275,162.00	$37,146.87	$275,162.00	$102,635.43	2026-03-01
211853	CDM	Graft Endo Aaa 28.5x12mm	41	23	$275,162.00	$275,162.00	$37,146.87	$275,162.00	$102,635.43	2026-03-01
242042	CDM	Stent Grft 23x12mm 12cm	41	23	$268,450.00	$268,450.00	$36,240.75	$268,450.00	$100,131.85	2026-03-01
C1820	HCPCS	Nrstm Impl 1.9inx.6in	540	21	$244,742.00	$244,742.00	$2,407.18	$599,273.00	$95,694.15	2026-03-01
270066	CDM	Pump Pain Infn 148gm	41	23	$255,881.00	$255,881.00	$34,543.93	$255,881.00	$95,443.61	2026-03-01
33229	CPT	Rmvl + Rplc Ppm Mltp	27	24	$155,766.36	$155,766.36	$21,028.46	$155,766.36	$90,344.49	2026-07-17
481259	CDM	Spacer Sm 12x14 7d	1	1	$120,355.00	$120,355.00	$90,266.25	$90,266.25	$90,266.25	2026-03-01
422734	CDM	Graft Evas 10cm 12mm	41	23	$241,356.00	$241,356.00	$32,583.06	$241,356.00	$90,025.79	2026-03-01
C1882	HCPCS	Crt-d Hf-t Df4	1,080	21	$194,810.00	$194,810.00	$16,569.63	$634,822.00	$89,824.35	2026-03-01
399561	CDM	Valve Mitral 19mm	1	1	$118,790.00	$118,790.00	$89,092.50	$89,092.50	$89,092.50	2026-03-01
856437	CDM	Graft Evas 16cm 25.5mm	41	23	$238,088.00	$238,088.00	$32,141.88	$238,088.00	$88,806.82	2026-03-01
738989	CDM	Graft Evas 14cm 28.5mm	41	23	$238,088.00	$238,088.00	$32,141.88	$238,088.00	$88,806.82	2026-03-01
864007	CDM	Graft Evas 14cm 26mm	41	23	$238,088.00	$238,088.00	$32,141.88	$238,088.00	$88,806.82	2026-03-01
742786	CDM	Graft Evas 12cm 23x14.5m	41	23	$238,088.00	$238,088.00	$32,141.88	$238,088.00	$88,806.82	2026-03-01
749679	CDM	Graft Evas 14cm 23x14.5m	41	23	$238,088.00	$238,088.00	$32,141.88	$238,088.00	$88,806.82	2026-03-01
747478	CDM	Graft Evas 18cm 26mm	41	23	$238,088.00	$238,088.00	$32,141.88	$238,088.00	$88,806.82	2026-03-01
866964	CDM	Valve Aortic 21mm	1	1	$118,210.00	$118,210.00	$88,657.50	$88,657.50	$88,657.50	2026-03-01
865610	CDM	System Cath Trvo Provu18	63	34	$276,171.00	$276,171.00	$19,331.97	$276,171.00	$88,098.55	2026-03-01
857807	CDM	Graft Evas 35x14.5m 14cm	41	23	$235,478.00	$235,478.00	$31,789.53	$235,478.00	$87,833.29	2026-03-01
871572	CDM	Graft Evas 14.5mm 16cm	41	23	$235,478.00	$235,478.00	$31,789.53	$235,478.00	$87,833.29	2026-03-01
861960	CDM	Graft Evas 35x14.5m 16cm	41	23	$235,478.00	$235,478.00	$31,789.53	$235,478.00	$87,833.29	2026-03-01
876247	CDM	Graft Evas 23x12mm 12cm	41	23	$235,478.00	$235,478.00	$31,789.53	$235,478.00	$87,833.29	2026-03-01
871623	CDM	Graft Evas 23x14.5m 12cm	41	23	$233,440.00	$233,440.00	$31,514.40	$233,440.00	$87,073.12	2026-03-01
870599	CDM	Graft Evas 14.5mm 12cm	41	23	$233,440.00	$233,440.00	$31,514.40	$233,440.00	$87,073.12	2026-03-01
436531	CDM	Graft Evas 28.5x12m 12cm	41	23	$233,440.00	$233,440.00	$31,514.40	$233,440.00	$87,073.12	2026-03-01
423117	CDM	Graft Evas 10cm 14.5mm	41	23	$233,440.00	$233,440.00	$31,514.40	$233,440.00	$87,073.12	2026-03-01
870016	CDM	Graft Evas 23x14.5m 16cm	41	23	$233,440.00	$233,440.00	$31,514.40	$233,440.00	$87,073.12	2026-03-01
426570	CDM	Graft Evas 26x12mm 12cm	41	23	$233,440.00	$233,440.00	$31,514.40	$233,440.00	$87,073.12	2026-03-01
858902	CDM	Graft Evas 31x14.5m 13cm	41	23	$233,440.00	$233,440.00	$31,514.40	$233,440.00	$87,073.12	2026-03-01
876981	CDM	Graft Evas 26x14.5m 14cm	41	23	$233,440.00	$233,440.00	$31,514.40	$233,440.00	$87,073.12	2026-03-01
754009	CDM	Graft Evas 12cm 26mm	41	23	$232,306.00	$232,306.00	$31,361.31	$232,306.00	$86,650.14	2026-03-01
857329	CDM	Graft Evas 12cm 28.5mm	41	23	$232,306.00	$232,306.00	$31,361.31	$232,306.00	$86,650.14	2026-03-01
870014	CDM	Graft Evas 16cm 23mm 12m	41	23	$228,616.00	$228,616.00	$30,863.16	$228,616.00	$85,273.77	2026-03-01
444727	CDM	Occluder Cv 35x18mm	41	23	$228,616.00	$228,616.00	$30,863.16	$228,616.00	$85,273.77	2026-03-01
870461	CDM	Graft Evas 26x14.5m 16cm	41	23	$228,616.00	$228,616.00	$30,863.16	$228,616.00	$85,273.77	2026-03-01
875911	CDM	Graft Evas 23x14.5m14cm	41	23	$228,616.00	$228,616.00	$30,863.16	$228,616.00	$85,273.77	2026-03-01
859730	CDM	Graft Evas 17cm 31x14.5	41	23	$228,616.00	$228,616.00	$30,863.16	$228,616.00	$85,273.77	2026-03-01
873698	CDM	Graft Evas 14.5mm 14cm	41	23	$228,616.00	$228,616.00	$30,863.16	$228,616.00	$85,273.77	2026-03-01
280708	CDM	Kit Bone Tamp	1	1	$113,558.00	$113,558.00	$85,168.50	$85,168.50	$85,168.50	2026-03-01
716742	CDM	Spacer Spnl Peek Cpstn	1	1	$113,442.00	$113,442.00	$85,081.50	$85,081.50	$85,081.50	2026-03-01
93653	CPT	Ep Repos Ele Svt Sgl	33	24	$154,614.05	$154,614.05	$20,872.90	$154,614.05	$85,037.73	2026-07-17
861162	CDM	Graft Ostchnd Tochlr Lt	41	23	$227,607.00	$227,607.00	$30,726.94	$227,607.00	$84,897.41	2026-03-01
224577	CDM	Retriever Endo 6x25mm	63	34	$265,808.00	$265,808.00	$18,606.56	$265,808.00	$84,792.75	2026-03-01
873077	CDM	Graft Evas 26x12mm 18cm	41	23	$226,637.00	$226,637.00	$30,595.99	$226,637.00	$84,535.60	2026-03-01
451518	CDM	Occluder Cv 25x18mm	41	23	$226,637.00	$226,637.00	$30,595.99	$226,637.00	$84,535.60	2026-03-01
856438	CDM	Graft Evas 14cm 26mm	41	23	$226,637.00	$226,637.00	$30,595.99	$226,637.00	$84,535.60	2026-03-01
737806	CDM	Graft Evas 15cm 31mm	41	23	$226,637.00	$226,637.00	$30,595.99	$226,637.00	$84,535.60	2026-03-01
859347	CDM	Graft Evas 16cm 26mm	41	23	$226,637.00	$226,637.00	$30,595.99	$226,637.00	$84,535.60	2026-03-01
857566	CDM	Graft Evas 31x14.5m 15cm	41	23	$226,637.00	$226,637.00	$30,595.99	$226,637.00	$84,535.60	2026-03-01
857849	CDM	Graft Evas 35x14.5m 18cm	41	23	$226,637.00	$226,637.00	$30,595.99	$226,637.00	$84,535.60	2026-03-01
870031	CDM	Graft Evs 18cm 26x14.5mm	41	23	$226,637.00	$226,637.00	$30,595.99	$226,637.00	$84,535.60	2026-03-01
633855	CDM	Model Antm Skl Adlt	63	34	$264,133.00	$264,133.00	$18,489.31	$264,133.00	$84,258.43	2026-03-01
260025	CDM	Spacer Spn 16x22x16mm	1	1	$111,536.00	$111,536.00	$83,652.00	$83,652.00	$83,652.00	2026-03-01
652862	CDM	dcdefibril Crd Venkat	1	1	$111,150.00	$111,150.00	$83,362.50	$83,362.50	$83,362.50	2026-03-01
747118	CDM	Graft Bn Fem Hemi Cndyl	41	23	$222,411.00	$222,411.00	$30,025.49	$222,411.00	$82,959.30	2026-03-01
255279	CDM	Spacer Spn Lng 11mm	1	1	$109,299.00	$109,299.00	$81,974.25	$81,974.25	$81,974.25	2026-03-01
563181	CDM	Cnla Vntrc Art 42f	41	23	$217,728.00	$217,728.00	$29,393.28	$217,728.00	$81,212.54	2026-03-01
248232	CDM	Mcath Rtr 2.5mm 20.5mm	63	34	$249,477.00	$249,477.00	$17,463.39	$249,477.00	$79,583.16	2026-03-01
247345	CDM	Mcath Rtr 23mm	63	34	$249,477.00	$249,477.00	$17,463.39	$249,477.00	$79,583.16	2026-03-01
244561	CDM	Retrvr Revac .021in 32mm	63	34	$249,477.00	$249,477.00	$17,463.39	$249,477.00	$79,583.16	2026-03-01
274995	CDM	Solution Embolic 6ml	63	34	$247,558.00	$247,558.00	$17,329.06	$247,558.00	$78,971.00	2026-03-01
634520	CDM	Impl Pulsar Ci Ear 100 H	41	23	$210,504.00	$210,504.00	$28,418.04	$210,504.00	$78,517.99	2026-03-01
437101	CDM	Dvc Revasc 4mm 180cm	63	34	$245,639.00	$245,639.00	$17,194.73	$245,639.00	$78,358.84	2026-03-01
475579	CDM	Dvc Revasc 4x40mm 200cm	63	34	$245,639.00	$245,639.00	$17,194.73	$245,639.00	$78,358.84	2026-03-01
464968	CDM	Dvc Revasc 6x40mm 200cm	63	34	$245,639.00	$245,639.00	$17,194.73	$245,639.00	$78,358.84	2026-03-01
108814	CDM	Dvc Revasc 3x20mm 200c	63	34	$245,639.00	$245,639.00	$17,194.73	$245,639.00	$78,358.84	2026-03-01
866966	CDM	Valve Aortic 25mm	1	1	$104,303.00	$104,303.00	$78,227.25	$78,227.25	$78,227.25	2026-03-01
C1772	HCPCS	Pump Inf Isomd Cnst Flow	144	21	$202,426.50	$202,426.50	$5,604.26	$379,972.00	$77,875.88	2026-03-01
871141	CDM	Graft Bn Ost Trchlea Rt	41	23	$207,757.00	$207,757.00	$28,047.19	$207,757.00	$77,493.36	2026-03-01
872070	CDM	Disc Intvrtb 15x15mm	1	1	$102,994.00	$102,994.00	$77,245.50	$77,245.50	$77,245.50	2026-03-01
568703	CDM	Spacer Spnl 10mm	1	1	$101,964.00	$101,964.00	$76,473.00	$76,473.00	$76,473.00	2026-03-01
254449	CDM	Spacer Spnl 12x15mm	1	1	$101,396.00	$101,396.00	$76,047.00	$76,047.00	$76,047.00	2026-03-01
711633	CDM	Graft Bn Rt Dis Fem Medl	41	23	$200,585.00	$200,585.00	$27,078.97	$200,585.00	$74,818.20	2026-03-01
C1767	HCPCS	Kit Impl Neurostim	720	21	$171,024.50	$171,024.50	$7,302.96	$631,638.00	$73,832.11	2026-03-01
93656	CPT	Com Ep Repo Cth Tx Afib	33	24	$134,003.47	$134,003.47	$18,090.47	$134,003.47	$73,701.91	2026-07-17
717974	CDM	Graft Evas 13cm 31mm	41	23	$195,459.00	$195,459.00	$26,386.97	$195,459.00	$72,906.21	2026-03-01
747440	CDM	Graft Nrv 4-5mm 70mm	41	23	$194,911.00	$194,911.00	$26,312.99	$194,911.00	$72,701.80	2026-03-01
C9610	HCPCS	Cath Blndil 2mm 30mm	57	31	$216,853.00	$216,853.00	$15,179.71	$216,853.00	$72,645.76	2026-03-01
33241	CPT	Remove Icd Gen	27	24	$124,643.95	$124,643.95	$16,826.93	$124,643.95	$72,293.49	2026-07-17
224617	CDM	Spacer Spnl 40x18x7-14mm	1	1	$95,204.00	$95,204.00	$71,403.00	$71,403.00	$71,403.00	2026-03-01
462692	CDM	Cage Spn 10d 10x22x55mm	1	1	$95,204.00	$95,204.00	$71,403.00	$71,403.00	$71,403.00	2026-03-01
219643	CDM	Spacer Spn 3d 7x18x40mm	1	1	$95,204.00	$95,204.00	$71,403.00	$71,403.00	$71,403.00	2026-03-01
245713	CDM	Spcr Spn 10d 10x18x40mm	1	1	$95,204.00	$95,204.00	$71,403.00	$71,403.00	$71,403.00	2026-03-01
716417	CDM	Disk Intvrtb 5mm Prodisc	1	1	$95,204.00	$95,204.00	$71,403.00	$71,403.00	$71,403.00	2026-03-01
461954	CDM	Spacer Spn 18x45x7-14mm	1	1	$95,204.00	$95,204.00	$71,403.00	$71,403.00	$71,403.00	2026-03-01
455194	CDM	Spacer Spnl 22x10x14mm	1	1	$95,204.00	$95,204.00	$71,403.00	$71,403.00	$71,403.00	2026-03-01
212144	CDM	Cage Cohr 8x22x55mm 10d	1	1	$95,204.00	$95,204.00	$71,403.00	$71,403.00	$71,403.00	2026-03-01
473592	CDM	Cage Spn 10d 10x22x50mm	1	1	$95,204.00	$95,204.00	$71,403.00	$71,403.00	$71,403.00	2026-03-01
473805	CDM	Spacer Spn 15d 34x13mm	1	1	$95,204.00	$95,204.00	$71,403.00	$71,403.00	$71,403.00	2026-03-01
477830	CDM	Spacer Spn 26x34x13mm	1	1	$95,204.00	$95,204.00	$71,403.00	$71,403.00	$71,403.00	2026-03-01
232962	CDM	Spacer Spn 45x18x10mm	1	1	$95,204.00	$95,204.00	$71,403.00	$71,403.00	$71,403.00	2026-03-01
388243	CDM	Valve Shnt Chpv Csf Prgm	1	1	$95,151.00	$95,151.00	$71,363.25	$71,363.25	$71,363.25	2026-03-01
588632	CDM	Graft Evas 18cm 28.5mm	41	23	$189,790.00	$189,790.00	$25,621.65	$189,790.00	$70,791.67	2026-03-01
747441	CDM	Graft Nrv 3-4mm 70mm	41	23	$188,322.00	$188,322.00	$25,423.47	$188,322.00	$70,244.11	2026-03-01
866222	CDM	dcs-icd Sbq Sq-rx 1010	41	23	$187,842.00	$187,842.00	$25,358.67	$187,842.00	$70,065.07	2026-03-01
207401	CDM	Spacer Spn 31x10x8-12mm	1	1	$92,484.00	$92,484.00	$69,363.00	$69,363.00	$69,363.00	2026-03-01
204336	CDM	Spacer Spn Sm 12d	1	1	$92,484.00	$92,484.00	$69,363.00	$69,363.00	$69,363.00	2026-03-01
434542	CDM	Spacer Spn 10mm 22mm	1	1	$92,484.00	$92,484.00	$69,363.00	$69,363.00	$69,363.00	2026-03-01
483526	CDM	Spacer Spn 30x10x8-15mm	1	1	$92,484.00	$92,484.00	$69,363.00	$69,363.00	$69,363.00	2026-03-01
442486	CDM	Spacer Spnl 22x10x8-14mm	1	1	$92,484.00	$92,484.00	$69,363.00	$69,363.00	$69,363.00	2026-03-01
203761	CDM	Spacer Spn 26x10x10mm	1	1	$92,484.00	$92,484.00	$69,363.00	$69,363.00	$69,363.00	2026-03-01
876476	CDM	Handpiece Lsr Slgrp3 Dlv	63	34	$217,122.00	$217,122.00	$15,198.54	$217,122.00	$69,261.92	2026-03-01
61635	CPT	Plc Stnt Intracranial	28	25	$122,580.73	$122,580.73	$16,548.40	$122,580.73	$69,258.11	2026-07-17
714876	CDM	Plate Lg Black Widow	1	1	$92,152.00	$92,152.00	$69,114.00	$69,114.00	$69,114.00	2026-03-01
588622	CDM	Graft Evas 16cm 28.5mm	41	23	$185,142.00	$185,142.00	$24,994.17	$185,142.00	$69,057.97	2026-03-01
158329	CDM	Graft Evas 14cm 26mm	41	23	$185,142.00	$185,142.00	$24,994.17	$185,142.00	$69,057.97	2026-03-01
216855	CDM	Kit Bn Harvest 520mm	1	1	$92,000.00	$92,000.00	$69,000.00	$69,000.00	$69,000.00	2026-03-01
61645	CPT	Icrnl Thrmbctomy/lysis	28	25	$120,774.31	$120,774.31	$16,304.53	$120,774.31	$68,237.49	2026-07-17
93654	CPT	Ep Repos Ele Vt 3d Map	33	24	$123,422.63	$123,422.63	$16,662.06	$123,422.63	$67,882.45	2026-07-17
473569	CDM	Implant Collagen Medium	1	1	$90,071.00	$90,071.00	$67,553.25	$67,553.25	$67,553.25	2026-03-01
439401	CDM	System Nvg S7 Fsn ENT Lf	63	34	$207,949.00	$207,949.00	$14,556.43	$207,949.00	$66,335.73	2026-03-01
862618	CDM	Graft Nrv 2-3mm 70mm	41	23	$177,804.00	$177,804.00	$24,003.54	$177,804.00	$66,320.89	2026-03-01
852729	CDM	Spacer Spnl 55x18x12mm	1	1	$88,404.00	$88,404.00	$66,303.00	$66,303.00	$66,303.00	2026-03-01
224515	CDM	Spacer Spnl 55x18x14mm	1	1	$88,404.00	$88,404.00	$66,303.00	$66,303.00	$66,303.00	2026-03-01
C1722	HCPCS	Ccd Lxos Vrt 347640	1,368	21	$136,867.50	$136,867.50	$9,993.38	$356,773.00	$66,210.38	2026-03-01
250869	CDM	Clamp Esurg Isltr Lng	63	34	$207,258.00	$207,258.00	$14,508.06	$207,258.00	$66,115.30	2026-03-01
563258	CDM	dcicd Entrst Dr D153a	1	1	$87,973.00	$87,973.00	$65,979.75	$65,979.75	$65,979.75	2026-03-01
274540	CDM	Stent Graft 15x6mm	41	23	$176,865.00	$176,865.00	$23,876.78	$176,865.00	$65,970.64	2026-03-01
874760	CDM	System Abl Cbr Fsn 150	63	34	$201,385.00	$201,385.00	$14,096.95	$201,385.00	$64,241.82	2026-03-01
879387	CDM	Graft Nrv 1-2mm 70mm	41	23	$171,797.00	$171,797.00	$23,192.60	$171,797.00	$64,080.28	2026-03-01
461245	CDM	Cath Vasc .071 132cm	1	1	$85,398.00	$85,398.00	$64,048.50	$64,048.50	$64,048.50	2026-03-01
33340	CPT	Lt At Appen Clos Wtchman	28	25	$111,774.91	$111,774.91	$15,089.61	$111,774.91	$63,152.82	2026-07-17
445228	CDM	Matrix Tiss Amn 3x8cm	41	23	$167,751.00	$167,751.00	$22,646.38	$167,751.00	$62,571.12	2026-03-01
C1721	HCPCS	Icd Defib Card 7.68cm	1,656	21	$141,468.50	$141,468.50	$853.88	$256,182.00	$62,408.14	2026-03-01
263722	CDM	Protector Nrv Ha+2cm 4cm	1	1	$82,938.00	$82,938.00	$62,203.50	$62,203.50	$62,203.50	2026-03-01
877723	CDM	Endplate Spnl 33-46x20mm	41	23	$165,357.00	$165,357.00	$22,323.19	$165,357.00	$61,678.16	2026-03-01
744053	CDM	Spacer Spnl 27x10x7 0d	1	1	$81,603.00	$81,603.00	$61,202.25	$61,202.25	$61,202.25	2026-03-01
240995	CDM	Spacer Spn 20x14x11.9	1	1	$81,603.00	$81,603.00	$61,202.25	$61,202.25	$61,202.25	2026-03-01
172455	CDM	Cage Sp 45x18x10mm Clyde	1	1	$81,603.00	$81,603.00	$61,202.25	$61,202.25	$61,202.25	2026-03-01
863211	CDM	Graft Bn Rt Hum Hd Algrf	41	23	$162,651.00	$162,651.00	$21,957.88	$162,651.00	$60,668.82	2026-03-01
719641	CDM	Cath Iab Vasc Impela 2.5	63	34	$189,000.00	$189,000.00	$13,230.00	$189,000.00	$60,291.00	2026-03-01
588512	CDM	Graft Evas 14cm 23mm	41	23	$161,446.00	$161,446.00	$21,795.21	$161,446.00	$60,219.36	2026-03-01
C1761	HCPCS	Cath Ivl 2.5x12mm	58	32	$180,391.00	$180,391.00	$12,627.37	$180,391.00	$58,987.86	2026-03-01
37229	CPT	Rvs O Or P Peronl W/ath	41	26	$128,447.46	$128,447.46	$17,340.41	$128,447.46	$57,801.36	2026-07-17
711991	CDM	Combo Valve	41	23	$152,880.00	$152,880.00	$20,638.80	$152,880.00	$57,024.24	2026-03-01
317287	CDM	Matrix Tiss Amn 3x6cm	41	23	$152,445.00	$152,445.00	$20,580.08	$152,445.00	$56,861.99	2026-03-01
469488	CDM	Kit Bln Fx Kyph 11g 15mm	1	1	$75,204.00	$75,204.00	$56,403.00	$56,403.00	$56,403.00	2026-03-01
450452	CDM	Implant Pyramesh 10x14 O	1	1	$75,073.00	$75,073.00	$56,304.75	$56,304.75	$56,304.75	2026-03-01
463202	CDM	Bandage Triangle W Pin	63	34	$176,212.00	$176,212.00	$12,334.84	$176,212.00	$56,211.63	2026-03-01
871312	CDM	Stent Eprsth 6mm 5cm	41	23	$150,699.00	$150,699.00	$20,344.37	$150,699.00	$56,210.73	2026-03-01
509530	CDM	Pin Exfix Stablck Wrist	63	34	$175,171.00	$175,171.00	$12,261.97	$175,171.00	$55,879.55	2026-03-01
93580	CPT	Per Cl Con Int Com W/imp	39	26	$110,912.31	$110,912.31	$7,763.86	$110,912.31	$55,456.15	2026-07-17
61630	CPT	Pta Intracranial Perc	28	25	$98,064.59	$98,064.59	$13,238.72	$98,064.59	$55,406.49	2026-07-17
851272	CDM	Pump Contrl Urn Ab Sys	41	23	$148,435.00	$148,435.00	$20,038.72	$148,435.00	$55,366.25	2026-03-01
878193	CDM	Spacer Spnl 22mmx16mm	1	1	$73,443.00	$73,443.00	$55,082.25	$55,082.25	$55,082.25	2026-03-01
875066	CDM	Spacer Spnl 22mmx16mm	1	1	$73,443.00	$73,443.00	$55,082.25	$55,082.25	$55,082.25	2026-03-01
875067	CDM	Spacer Spnl 22mmx15mm	1	1	$73,443.00	$73,443.00	$55,082.25	$55,082.25	$55,082.25	2026-03-01
873897	CDM	Spacer Spnl 22mmx13mm	1	1	$73,443.00	$73,443.00	$55,082.25	$55,082.25	$55,082.25	2026-03-01
33880	CPT	Evas Rpr Dt Aorta W Lsao	28	25	$97,211.19	$97,211.19	$13,123.51	$97,211.19	$54,924.32	2026-07-17
33881	CPT	Endovas Taa Rpr Without Scl	28	25	$97,211.19	$97,211.19	$13,123.51	$97,211.19	$54,924.32	2026-07-17
334357	CDM	Cage Intrafix Thd 14x23	1	1	$72,578.00	$72,578.00	$54,433.50	$54,433.50	$54,433.50	2026-03-01
475078	CDM	Kit Bln10ga 10mm	1	1	$72,226.00	$72,226.00	$54,169.50	$54,169.50	$54,169.50	2026-03-01
881339	CDM	Graft Nrv 3-4mm 50mm	41	23	$145,170.00	$145,170.00	$19,597.95	$145,170.00	$54,148.41	2026-03-01
267601	CDM	Valve Msc Aor 21mm W/h	41	23	$145,120.00	$145,120.00	$19,591.20	$145,120.00	$54,129.76	2026-03-01
718835	CDM	Valve Aortic 19mm	41	23	$144,866.00	$144,866.00	$19,556.91	$144,866.00	$54,035.02	2026-03-01
589332	CDM	Spacer Spn Tlif 17mm	41	23	$143,849.00	$143,849.00	$19,419.62	$143,849.00	$53,655.68	2026-03-01
278605	CDM	Spacer Spn 16d 15x72x13	41	23	$143,560.00	$143,560.00	$19,380.60	$143,560.00	$53,547.88	2026-03-01
879380	CDM	Dissector Shaft 18cm	1	1	$71,005.00	$71,005.00	$53,253.75	$53,253.75	$53,253.75	2026-03-01
715751	CDM	Spacer Peek 12d D30mmxw3	1	1	$70,811.00	$70,811.00	$53,108.25	$53,108.25	$53,108.25	2026-03-01
268962	CDM	Matrix Dbm Lrg 11cc	41	23	$141,293.00	$141,293.00	$19,074.56	$141,293.00	$52,702.29	2026-03-01
484317	CDM	Sheath Coil Emb 17 3.5	63	34	$165,039.00	$165,039.00	$11,552.73	$165,039.00	$52,647.44	2026-03-01
710067	CDM	Valve Aor 27mm Mstr Hmdn	40	23	$144,866.00	$144,866.00	$19,556.91	$144,866.00	$52,369.06	2026-03-01
717793	CDM	Valve Aortic 25mm	40	23	$144,866.00	$144,866.00	$19,556.91	$144,866.00	$52,369.06	2026-03-01
218198	CDM	Spacer Spn 20mm 41mm	40	23	$144,800.00	$144,800.00	$19,548.00	$144,800.00	$52,345.20	2026-03-01
750416	CDM	Valve Aor11cm 34x26x23.4	40	23	$144,721.00	$144,721.00	$19,537.33	$144,721.00	$52,316.64	2026-03-01
423344	CDM	Stem Fem Tprlc 133 Mp	1	1	$68,695.00	$68,695.00	$51,521.25	$51,521.25	$51,521.25	2026-03-01
732226	CDM	Stent Bifurcated 34x16mm	1	1	$68,229.00	$68,229.00	$51,171.75	$51,171.75	$51,171.75	2026-03-01
717719	CDM	Spacr Spn 26x12 Pk Cpstn	1	1	$68,003.00	$68,003.00	$51,002.25	$51,002.25	$51,002.25	2026-03-01
252762	CDM	Screw Disc 1.5x4mm	41	23	$136,530.00	$136,530.00	$18,431.55	$136,530.00	$50,925.69	2026-03-01
425695	CDM	System Advisa MRI Meee	41	23	$135,868.00	$135,868.00	$18,342.18	$135,868.00	$50,678.76	2026-03-01
525158	CDM	Valve Crd Od24 Pa	1	1	$67,503.00	$67,503.00	$50,627.25	$50,627.25	$50,627.25	2026-03-01
865102	CDM	Graft Nrv 2-3mm 50mm	41	23	$135,338.00	$135,338.00	$18,270.63	$135,338.00	$50,481.07	2026-03-01
272768	CDM	System Cath Dlvry .70in	63	34	$157,363.00	$157,363.00	$11,015.41	$157,363.00	$50,198.80	2026-03-01
877513	CDM	Sealant Evicel Fibrn 5ml	63	34	$157,191.00	$157,191.00	$11,003.37	$157,191.00	$50,143.93	2026-03-01
719743	CDM	Xentmatrix Graft 19x35cm	40	23	$137,953.00	$137,953.00	$18,623.65	$137,953.00	$49,870.01	2026-03-01
33207	CPT	Ppm Vent	27	24	$85,429.63	$85,429.63	$11,533.00	$85,429.63	$49,549.19	2026-07-17
33228	CPT	Rmvl + Rplc Ppm Dual	27	24	$85,429.63	$85,429.63	$11,533.00	$85,429.63	$49,549.19	2026-07-17
737494	CDM	Valve Aortic 31mm	40	23	$135,855.00	$135,855.00	$18,340.42	$135,855.00	$49,111.58	2026-03-01
706856	CDM	Prosth Penl Resv 65ml	1	1	$65,281.00	$65,281.00	$48,960.75	$48,960.75	$48,960.75	2026-03-01
546987	CDM	Spacer Spnl 30mm	1	1	$64,990.00	$64,990.00	$48,742.50	$48,742.50	$48,742.50	2026-03-01
711624	CDM	Cage Peek Corp 12x32mm	1	1	$64,680.00	$64,680.00	$48,510.00	$48,510.00	$48,510.00	2026-03-01
232242	CDM	Spacer Spn 0d 23x37x21mm	40	23	$133,597.00	$133,597.00	$18,035.60	$133,597.00	$48,295.32	2026-03-01
876477	CDM	Spacer Spnl 22mmx14mm Cp	1	1	$64,292.00	$64,292.00	$48,219.00	$48,219.00	$48,219.00	2026-03-01
235663	CDM	Spacer Spnl 22mmx10mm	1	1	$64,292.00	$64,292.00	$48,219.00	$48,219.00	$48,219.00	2026-03-01
240751	CDM	Spacer Spn 24mmx12mm	1	1	$64,292.00	$64,292.00	$48,219.00	$48,219.00	$48,219.00	2026-03-01
205177	CDM	Spacer Spnl 22mmx11mm	1	1	$64,292.00	$64,292.00	$48,219.00	$48,219.00	$48,219.00	2026-03-01
484239	CDM	Spacer Spn Cpstn 22x13mm	1	1	$64,292.00	$64,292.00	$48,219.00	$48,219.00	$48,219.00	2026-03-01
879277	CDM	Spacer Spn 20x31x20mm	40	23	$133,063.00	$133,063.00	$17,963.51	$133,063.00	$48,102.28	2026-03-01
737493	CDM	Valve Aortic 29mm	40	23	$132,175.00	$132,175.00	$17,843.63	$132,175.00	$47,781.26	2026-03-01
718720	CDM	Spacer Spn 14x24x11mm	1	1	$63,650.00	$63,650.00	$47,737.50	$47,737.50	$47,737.50	2026-03-01
266253	CDM	Tube Exfx Assbly 25mm	1	1	$63,600.00	$63,600.00	$47,700.00	$47,700.00	$47,700.00	2026-03-01
37182	CPT	Tips Insertion	28	25	$84,324.00	$84,324.00	$11,383.74	$84,324.00	$47,643.06	2026-07-17
850936	CDM	Spacer Spn Mdln 39x11x8	1	1	$63,504.00	$63,504.00	$47,628.00	$47,628.00	$47,628.00	2026-03-01
850942	CDM	Spcr Spnl Stalif 15x12	1	1	$63,504.00	$63,504.00	$47,628.00	$47,628.00	$47,628.00	2026-03-01
850961	CDM	Spacer Spn Mdln 42x13x12	1	1	$63,504.00	$63,504.00	$47,628.00	$47,628.00	$47,628.00	2026-03-01
205041	CDM	Capsule Endo Cf Dev	1	1	$63,252.00	$63,252.00	$47,439.00	$47,439.00	$47,439.00	2026-03-01
243953	CDM	Graft Bn Lg 8cc 1x2in	41	23	$126,447.00	$126,447.00	$17,070.35	$126,447.00	$47,164.73	2026-03-01
0238T	CPT	Atherectomy Iliac	38	26	$91,299.30	$91,299.30	$6,390.95	$91,299.30	$46,882.19	2026-07-17
221446	CDM	Graft Evas 14.5mm 10cm	41	23	$125,425.00	$125,425.00	$16,932.38	$125,425.00	$46,783.53	2026-03-01
469942	CDM	Graft Evas 14.5mm 14cm	41	23	$125,425.00	$125,425.00	$16,932.38	$125,425.00	$46,783.53	2026-03-01
869102	CDM	Graft Evas 16mm 11.5cm	41	23	$125,425.00	$125,425.00	$16,932.38	$125,425.00	$46,783.53	2026-03-01
869095	CDM	Graft Evas 23mm 12cm	41	23	$125,425.00	$125,425.00	$16,932.38	$125,425.00	$46,783.53	2026-03-01
858903	CDM	Graft Evas 18mm 13.5cm	41	23	$125,425.00	$125,425.00	$16,932.38	$125,425.00	$46,783.53	2026-03-01
871693	CDM	Kit Nrstm Prcsn Chrg	1	1	$61,410.00	$61,410.00	$46,057.50	$46,057.50	$46,057.50	2026-03-01
248812	CDM	Sheath Rtvr Clot 26fr	63	34	$143,929.00	$143,929.00	$10,075.03	$143,929.00	$45,913.35	2026-03-01
284035	CDM	Fixator Exfix 40mm	63	34	$143,929.00	$143,929.00	$10,075.03	$143,929.00	$45,913.35	2026-03-01
752071	CDM	dcicd Ellipse Dr Df4	41	23	$122,936.00	$122,936.00	$16,596.36	$122,936.00	$45,855.13	2026-03-01
707428	CDM	Custom Elbow Rpl Cus-4xx	41	23	$122,493.00	$122,493.00	$16,536.56	$122,493.00	$45,689.89	2026-03-01
J9042	HCPCS	Brentuximab 50 Mg Inj	37	25	$91,374.84	$91,374.84	$6,396.24	$91,374.84	$45,687.42	2026-07-17
438486	CDM	Graft Evas 12mm 14cm	41	23	$122,353.00	$122,353.00	$16,517.65	$122,353.00	$45,637.67	2026-03-01
859733	CDM	Graft Evas 27mm 14cm	41	23	$122,353.00	$122,353.00	$16,517.65	$122,353.00	$45,637.67	2026-03-01
859081	CDM	Graft Evas 20mm 13.5cm	41	23	$122,353.00	$122,353.00	$16,517.65	$122,353.00	$45,637.67	2026-03-01
869106	CDM	Graft Evas 27mm 12cm	41	23	$122,353.00	$122,353.00	$16,517.65	$122,353.00	$45,637.67	2026-03-01
752722	CDM	Stem Fem Sz7 114mm	1	1	$60,335.00	$60,335.00	$45,251.25	$45,251.25	$45,251.25	2026-03-01
866172	CDM	Ring Exfx 210mm	1	1	$59,884.00	$59,884.00	$44,913.00	$44,913.00	$44,913.00	2026-03-01
477569	CDM	Spacer Sm 12x14 7d	41	23	$120,355.00	$120,355.00	$16,247.92	$120,355.00	$44,892.42	2026-03-01
273369	CDM	Dressing Wnd Clgn 1000mg	1	1	$59,491.00	$59,491.00	$44,618.25	$44,618.25	$44,618.25	2026-03-01
240852	CDM	Kit Bngf Infs 18x26 8ml	41	23	$119,208.00	$119,208.00	$16,093.08	$119,208.00	$44,464.58	2026-03-01
746190	CDM	Graft Evas 10cm 23mm	41	23	$118,790.00	$118,790.00	$16,036.65	$118,790.00	$44,308.67	2026-03-01
582086	CDM	Graft Evas 10cm 14.5mm	41	23	$118,790.00	$118,790.00	$16,036.65	$118,790.00	$44,308.67	2026-03-01
749698	CDM	Graft Evas 10cm 27mm	41	23	$118,790.00	$118,790.00	$16,036.65	$118,790.00	$44,308.67	2026-03-01
753117	CDM	Graft Evas 14cm 27mm	41	23	$118,790.00	$118,790.00	$16,036.65	$118,790.00	$44,308.67	2026-03-01
C1886	HCPCS	Probe Osteocool 10mm 17g	116	32	$133,566.50	$133,566.50	$8,207.15	$149,888.00	$44,216.96	2026-03-01
721386	CDM	System Embl Plug Lq 1gm	63	34	$138,034.00	$138,034.00	$9,662.38	$138,034.00	$44,032.85	2026-03-01
713394	CDM	Cage Spacer 14mm 13 Deg	1	1	$58,644.00	$58,644.00	$43,983.00	$43,983.00	$43,983.00	2026-03-01
869673	CDM	Spacer Spnl 14x25mm	1	1	$58,345.00	$58,345.00	$43,758.75	$43,758.75	$43,758.75	2026-03-01
482752	CDM	Impl Spn 0d 12x17mm	40	23	$120,814.00	$120,814.00	$16,309.89	$120,814.00	$43,674.26	2026-03-01
C2621	HCPCS	Crt-p 8 Bdpl Hr-t	396	21	$121,288.00	$121,288.00	$6,200.41	$164,932.00	$43,542.05	2026-03-01
267116	CDM	Protector Nrv Ha+4cm 8cm	41	23	$116,333.00	$116,333.00	$15,704.95	$116,333.00	$43,392.21	2026-03-01
L8614	HCPCS	Coclr Uni Pedi Impl	108	21	$130,625.00	$130,625.00	$7,646.94	$140,728.00	$43,121.19	2026-07-17
399601	CDM	Valve Mitral 27mm	40	23	$118,790.00	$118,790.00	$16,036.65	$118,790.00	$42,942.58	2026-03-01
721385	CDM	Particles Embl Kit Lq Sy	41	23	$115,000.00	$115,000.00	$15,525.00	$115,000.00	$42,895.00	2026-03-01
709810	CDM	Pump 505 & Cnla Set 32f	62	34	$136,080.00	$136,080.00	$9,525.60	$136,080.00	$42,790.35	2026-03-01
748844	CDM	Coils 360 Soft 4mmx15cm	41	23	$114,043.00	$114,043.00	$15,395.81	$114,043.00	$42,538.04	2026-03-01

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