Hospital

HENRICO DOCTORS' HOSPITAL

Richmond, VA · CCN 490118 · Rates published

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You selected 93306 (CPT)

ECHO2D COMP W CF DOP

This hospital’s price: $2,856 across 13 payers · range $1,201-$7,561

Source: https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1113733_HENRICO-DOCTORS-HOSPITAL---FOREST_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.

13,515 distinct procedures filed

37 distinct payers

241,783 rate rows

2026-07-17 last MRF observed

Data quality

237,915 of 241,783 rate rows are consumer-grade (98.4%)

3,868 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	3,335
template filing: same amount across many unrelated codes — excluded	346
per-diem day rate — not a per-procedure price	149
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	20
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	18

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

Source MRF file	https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1113733_PARHAM-DOCTORS-HOSPITAL_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page	https://www.hcavirginia.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered via	CMS hospital list
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-10-11

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
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	1	$214,493.02	$214,493.02	$214,493.02	nat. median $190,557 1.1× median
77145 CDM	Tavr/tavi Perc Fem Aprch	12	$53,739.83	$375,803.00	$169,111.35	nat. median $217,918 0.8× median
83096 CDM	Tmvr Perc Initial Device	12	$53,739.83	$375,803.00	$169,111.35	nat. median $5,995 outlier · 28.2×
118585 CDM	Ttvr - Initial Device	12	$53,739.83	$375,803.00	$169,111.35	nat. median $56,370 outlier · 3.0×
66661 CDM	Ins Icd Lead/generator	11	$36,009.90	$240,066.00	$150,041.25	nat. median $81,962 1.8× median
J9999 HCPCS	Carmustine 7.7mg Implant	13	$56,112.77	$392,397.00	$133,414.98	nat. median $2,702 outlier · 49.4×
76843 CDM	Rem/replace Icd Gen Dual	11	$30,598.05	$203,987.00	$127,491.88	nat. median $229 outlier · 556.5×
76844 CDM	Rem/replace Icd Gen Mult	11	$30,598.05	$203,987.00	$127,491.88	nat. median $97,576 1.3× median
66659 CDM	Ins Icd Gen Only Sgl Ld	11	$26,423.25	$176,155.00	$110,096.88	nat. median $65,600 1.7× median
427 MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	$79,744.00	$109,689.00	$105,439.00	nat. median $63,648 1.7× median
7 MS_DRG	Lung Transplant	1	$104,404.33	$104,404.33	$104,404.33	nat. median $117,894 0.9× median
84398 CDM	Ins/repl Sq Icd With Elec	11	$24,465.90	$163,106.00	$101,941.25	nat. median $100,063 1.0× median
428 MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	2	$45,664.95	$109,689.00	$101,189.00	nat. median $50,590 outlier · 2.0×
33157 CDM	Kidney Acq-living Donor	14	$42,862.25	$299,736.00	$98,912.88	nat. median $1,149 outlier · 86.1×
33151 CDM	Kidney Acq-cadav Donor	14	$42,862.25	$299,736.00	$98,912.88	nat. median $24,738 outlier · 4.0×
1624 APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	6	$96,640.64	$101,472.67	$96,916.07	nat. median $80,771 1.2× median
21 MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	2	$43,034.26	$103,441.00	$95,424.00	nat. median $51,590 1.8× median
234 MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	1	$71,924.00	$98,932.00	$95,098.00	nat. median $51,613 1.8× median
209 MS_DRG	Complex Aortic Arch Procedures	1	$91,327.81	$91,327.81	$91,327.81	nat. median $92,655 1.0× median
J2350 HCPCS	Ocrelizumab 300 Mg Inj	7	$28,062.11	$121,422.60	$87,694.10	nat. median $414 outlier · 211.6×
233 MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	3	$61,881.96	$98,932.00	$86,676.10	nat. median $71,758 1.2× median
88556 CDM	Ins/repl Ccm System	12	$27,524.07	$192,476.00	$86,614.20	nat. median $68,553 1.3× median
215 MS_DRG	Other Heart Assist System Implant	1	$80,412.26	$80,412.26	$80,412.26	nat. median $93,917 0.9× median
74727 CDM	Revsc Fem/pop W Stnt/ath	12	$25,466.73	$178,089.00	$80,140.05	nat. median $53,706 1.5× median
74731 CDM	Revsc Tib/per St/ath Ini	12	$25,380.64	$177,487.00	$79,869.15	nat. median $60,419 1.3× median
116049 CDM	Revsc Tib/per Ivl St/ath	12	$25,373.21	$177,435.00	$79,845.75	nat. median $37,712 outlier · 2.1×
116048 CDM	Revsc Tib/per Ivl/ath	12	$25,373.21	$177,435.00	$79,845.75	nat. median $27,235 outlier · 2.9×
116047 CDM	Revsc Tib/per Ivl/stnt	12	$25,373.21	$177,435.00	$79,845.75	nat. median $26,006 outlier · 3.1×
126092 CDM	Revsc Low Ext Ivl St/ath	12	$25,373.21	$177,435.00	$79,845.75	nat. median $27,589 outlier · 2.9×
116046 CDM	Revsc Tib/per Ivl Angio	12	$23,363.63	$163,382.00	$73,521.90	nat. median $4,896 outlier · 15.0×
113647 CDM	Revsc Low Extr Ivl/ather	12	$23,363.63	$163,382.00	$73,521.90	nat. median $5,442 outlier · 13.5×
126094 CDM	Revsc Low Extr Ivl/stnt	12	$23,363.63	$163,382.00	$73,521.90	nat. median $38,174 1.9× median
74713 CDM	Revsc Iliac W Stnt Init	12	$23,363.63	$163,382.00	$73,521.90	nat. median $20,421 outlier · 3.6×
74672 CDM	Revsc Iliac W Stnt Init	12	$23,363.63	$163,382.00	$73,521.90	nat. median $20,421 outlier · 3.6×
74725 CDM	Revsc Fem/pop W Stnt	12	$23,336.46	$163,192.00	$73,436.40	nat. median $31,367 outlier · 2.3×
74730 CDM	Revsc Tib/per Stnt Init	12	$23,245.08	$162,553.00	$73,148.85	nat. median $25,751 outlier · 2.8×
74681 CDM	Revsc Tib/per Stnt Init	12	$23,245.08	$162,553.00	$73,148.85	nat. median $35,944 outlier · 2.0×
451 MS_DRG	Single Level Spinal Fusion Except Cervical Without Mcc	1	$54,145.00	$74,478.00	$71,592.00	nat. median $30,029 outlier · 2.4×
450 MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically	1	$53,165.00	$73,128.00	$70,294.00	nat. median $48,243 1.5× median
123099 CDM	Imp Wrls P-art Pres Snsr	12	$22,127.96	$154,741.00	$69,633.45	nat. median $127 outlier · 550.3×
448 MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	2	$34,593.90	$74,478.00	$68,706.00	nat. median $39,085 1.8× median
231 MS_DRG	Coronary Bypass With Ptca With Mcc	1	$68,171.75	$68,171.75	$68,171.75	nat. median $77,043 0.9× median
447 MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	2	$53,165.00	$73,128.00	$67,460.00	nat. median $60,543 1.1× median
235 MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	3	$47,641.58	$74,512.00	$66,112.51	nat. median $55,491 1.2× median
457 MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	3	$48,399.04	$73,128.00	$65,722.02	nat. median $55,188 1.2× median
A2028 HCPCS	Micromatrix Flex 750mg	9	$14,699.70	$97,998.00	$63,698.70	nat. median $1,437 outlier · 44.3×
93656 CPT	Com Ep Repo Cth Tx Afib	7	$20,208.86	$87,442.20	$63,152.70	nat. median $27,253 outlier · 2.3×
74722 CDM	Revsc Iliac W Stnt Addl	12	$19,504.91	$136,398.00	$61,379.10	nat. median $12,239 outlier · 5.0×
93653 CPT	Ep Repos Ele Svt Sgl	7	$19,635.41	$84,960.90	$61,360.65	nat. median $26,640 outlier · 2.3×
J9228 HCPCS	Ipilimumab 200 Mg Inj	7	$13,417.87	$232,098.30	$58,058.10	nat. median $8,966 outlier · 6.5×

Other procedures at this hospital

Browse this hospital's 13,515 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

3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	1	1	—	—	$214,493.02	$214,493.02	$214,493.02	2026-03-01
83096	CDM	Tmvr Perc Initial Device	17	12	$375,803.00	$375,803.00	$53,739.83	$375,803.00	$169,111.35	2026-03-01
77145	CDM	Tavr/tavi Perc Fem Aprch	17	12	$375,803.00	$375,803.00	$53,739.83	$375,803.00	$169,111.35	2026-03-01
118585	CDM	Ttvr - Initial Device	17	12	$375,803.00	$375,803.00	$53,739.83	$375,803.00	$169,111.35	2026-03-01
66661	CDM	Ins Icd Lead/generator	14	11	$240,066.00	$240,066.00	$36,009.90	$240,066.00	$150,041.25	2026-03-01
J9999	HCPCS	Carmustine 7.7mg Implant	20	13	$392,397.00	$392,397.00	$56,112.77	$392,397.00	$133,414.98	2026-03-01
76844	CDM	Rem/replace Icd Gen Mult	14	11	$203,987.00	$203,987.00	$30,598.05	$203,987.00	$127,491.88	2026-03-01
76843	CDM	Rem/replace Icd Gen Dual	14	11	$203,987.00	$203,987.00	$30,598.05	$203,987.00	$127,491.88	2026-03-01
66659	CDM	Ins Icd Gen Only Sgl Ld	14	11	$176,155.00	$176,155.00	$26,423.25	$176,155.00	$110,096.88	2026-03-01
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	4	1	—	—	$79,744.00	$109,689.00	$105,439.00	2026-03-01
7	MS_DRG	Lung Transplant	1	1	—	—	$104,404.33	$104,404.33	$104,404.33	2026-03-01
84398	CDM	Ins/repl Sq Icd With Elec	14	11	$163,106.00	$163,106.00	$24,465.90	$163,106.00	$101,941.25	2026-03-01
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	5	2	—	—	$45,664.95	$109,689.00	$101,189.00	2026-03-01
33151	CDM	Kidney Acq-cadav Donor	21	14	$299,736.00	$299,736.00	$42,862.25	$299,736.00	$98,912.88	2026-03-01
33157	CDM	Kidney Acq-living Donor	21	14	$299,736.00	$299,736.00	$42,862.25	$299,736.00	$98,912.88	2026-03-01
1624	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	6	6	—	—	$96,640.64	$101,472.67	$96,916.07	2026-03-01
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	5	2	—	—	$43,034.26	$103,441.00	$95,424.00	2026-03-01
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	4	1	—	—	$71,924.00	$98,932.00	$95,098.00	2026-03-01
209	MS_DRG	Complex Aortic Arch Procedures	1	1	—	—	$91,327.81	$91,327.81	$91,327.81	2026-03-01
J2350	HCPCS	Ocrelizumab 300 Mg Inj	10	7	$134,914.00	$134,914.00	$28,062.11	$121,422.60	$87,694.10	2026-03-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	6	3	—	—	$61,881.96	$98,932.00	$86,676.10	2026-03-01
88556	CDM	Ins/repl Ccm System	17	12	$192,476.00	$192,476.00	$27,524.07	$192,476.00	$86,614.20	2026-03-01
215	MS_DRG	Other Heart Assist System Implant	1	1	—	—	$80,412.26	$80,412.26	$80,412.26	2026-03-01
74727	CDM	Revsc Fem/pop W Stnt/ath	17	12	$178,089.00	$178,089.00	$25,466.73	$178,089.00	$80,140.05	2026-03-01
74731	CDM	Revsc Tib/per St/ath Ini	17	12	$177,487.00	$177,487.00	$25,380.64	$177,487.00	$79,869.15	2026-03-01
116049	CDM	Revsc Tib/per Ivl St/ath	17	12	$177,435.00	$177,435.00	$25,373.21	$177,435.00	$79,845.75	2026-03-01
116048	CDM	Revsc Tib/per Ivl/ath	17	12	$177,435.00	$177,435.00	$25,373.21	$177,435.00	$79,845.75	2026-03-01
116047	CDM	Revsc Tib/per Ivl/stnt	17	12	$177,435.00	$177,435.00	$25,373.21	$177,435.00	$79,845.75	2026-03-01
126092	CDM	Revsc Low Ext Ivl St/ath	17	12	$177,435.00	$177,435.00	$25,373.21	$177,435.00	$79,845.75	2026-03-01
74713	CDM	Revsc Iliac W Stnt Init	17	12	$163,382.00	$163,382.00	$23,363.63	$163,382.00	$73,521.90	2026-03-01
126094	CDM	Revsc Low Extr Ivl/stnt	17	12	$163,382.00	$163,382.00	$23,363.63	$163,382.00	$73,521.90	2026-03-01
74672	CDM	Revsc Iliac W Stnt Init	17	12	$163,382.00	$163,382.00	$23,363.63	$163,382.00	$73,521.90	2026-03-01
116046	CDM	Revsc Tib/per Ivl Angio	17	12	$163,382.00	$163,382.00	$23,363.63	$163,382.00	$73,521.90	2026-03-01
113647	CDM	Revsc Low Extr Ivl/ather	17	12	$163,382.00	$163,382.00	$23,363.63	$163,382.00	$73,521.90	2026-03-01
74725	CDM	Revsc Fem/pop W Stnt	17	12	$163,192.00	$163,192.00	$23,336.46	$163,192.00	$73,436.40	2026-03-01
74681	CDM	Revsc Tib/per Stnt Init	17	12	$162,553.00	$162,553.00	$23,245.08	$162,553.00	$73,148.85	2026-03-01
74730	CDM	Revsc Tib/per Stnt Init	17	12	$162,553.00	$162,553.00	$23,245.08	$162,553.00	$73,148.85	2026-03-01
451	MS_DRG	Single Level Spinal Fusion Except Cervical Without Mcc	4	1	—	—	$54,145.00	$74,478.00	$71,592.00	2026-03-01
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically	4	1	—	—	$53,165.00	$73,128.00	$70,294.00	2026-03-01
123099	CDM	Imp Wrls P-art Pres Snsr	17	12	$154,741.00	$154,741.00	$22,127.96	$154,741.00	$69,633.45	2026-03-01
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	5	2	—	—	$34,593.90	$74,478.00	$68,706.00	2026-03-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	1	1	—	—	$68,171.75	$68,171.75	$68,171.75	2026-03-01
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	5	2	—	—	$53,165.00	$73,128.00	$67,460.00	2026-03-01
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	6	3	—	—	$47,641.58	$74,512.00	$66,112.51	2026-03-01
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	6	3	—	—	$48,399.04	$73,128.00	$65,722.02	2026-03-01
A2028	HCPCS	Micromatrix Flex 750mg	12	9	$97,998.00	$97,998.00	$14,699.70	$97,998.00	$63,698.70	2026-03-01
93656	CPT	Com Ep Repo Cth Tx Afib	10	7	$97,158.00	$97,158.00	$20,208.86	$87,442.20	$63,152.70	2026-03-01
74722	CDM	Revsc Iliac W Stnt Addl	17	12	$136,398.00	$136,398.00	$19,504.91	$136,398.00	$61,379.10	2026-03-01
93653	CPT	Ep Repos Ele Svt Sgl	10	7	$94,401.00	$94,401.00	$19,635.41	$84,960.90	$61,360.65	2026-03-01
J9228	HCPCS	Ipilimumab 200 Mg Inj	20	7	$161,198.00	$161,198.00	$13,417.87	$232,098.30	$58,058.10	2026-03-01
C9610	HCPCS	Cath Blndil 2.50mm 12mm	16	12	$143,760.00	$143,760.00	$23,231.62	$129,384.00	$57,504.00	2026-03-01
57289	CDM	Per Cl Con Int Com W/imp	14	11	$91,918.00	$91,918.00	$13,787.70	$91,918.00	$57,448.75	2026-03-01
85331	CDM	Ins/repl Ldls Ppm Vent	14	11	$91,062.00	$91,062.00	$13,659.30	$91,062.00	$56,913.75	2026-03-01
82159	CDM	Transcth Stnt Plc Ia	17	12	$123,984.00	$123,984.00	$17,729.71	$123,984.00	$55,792.80	2026-03-01
82161	CDM	Transcth Stnt Plc Ia	17	12	$123,984.00	$123,984.00	$17,729.71	$123,984.00	$55,792.80	2026-03-01
82165	CDM	Transcth Stnt Plc In Vn	17	12	$123,984.00	$123,984.00	$17,729.71	$123,984.00	$55,792.80	2026-03-01
485646	CDM	Kit Vlv Aor 18fr 26mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
474489	CDM	Graft Evas 14.5mm 18cm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
469508	CDM	Kit Aor Vlv 14fr 20mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
584750	CDM	Transcth Aortic Vlv 29mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
561944	CDM	Graft Hmeral Head Left	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
389364	CDM	Graft Bn Lg 8cc 1x2in	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
447928	CDM	Valve Aortic 21mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
477174	CDM	Valve Tavr 26mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
556229	CDM	Graft Bn Dist Tib Lt	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
469504	CDM	Kit Aor Vlv 14fr 23mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
447932	CDM	Valve Aortic 27/29mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
447927	CDM	Valve Aortic 19mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
469507	CDM	Kit Aor Vlv 14fr 29mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
482335	CDM	Graft Evas 12mm 10cm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
487214	CDM	Valve Tavr 23mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
367401	CDM	Graft Bn Lgii 8cc 3x4in	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
548860	CDM	Algrf Cartliage	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
485942	CDM	Kit Vlv Aor 18fr 23mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
556648	CDM	Graft Hemi Cndyl L/l Fem	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
514794	CDM	Valve Aortic 29mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
482337	CDM	Graft Evas 12mm 14cm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
478864	CDM	Graft Nrv 4-5mm 70mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
477175	CDM	Valve Tavr 29mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
396983	CDM	Graft Bn Mdl Lt	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
494096	CDM	Valve Aortic 25mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
595991	CDM	Valve Tavr 29mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
416061	CDM	Valve Mtral 29mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
487216	CDM	Valve Tavr 26mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
566274	CDM	Occluder Cardiac Lt 25mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
607103	CDM	Valve Tavr 26mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
596518	CDM	Valve Tavr 26mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
477173	CDM	Valve Tavr 23mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
458871	CDM	Graft Hum Prox Lt W/cuff	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
367402	CDM	Graft Bn Med 5.6cc 1x2in	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
545488	CDM	Valve Aor Tavr 26mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
408514	CDM	Graft Bn Lt Meniscs Medi	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
566272	CDM	Occluder Cardiac Lt 31mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
402571	CDM	Valve Aortic 27mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
402566	CDM	Valve Aortic 19mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
585007	CDM	Stent Eprsth 8x12mm 6cm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
456456	CDM	Graft Evas 35x14.5m 18cm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
405617	CDM	Valve Aortic 29mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
405607	CDM	Valve Aortic 25mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
478917	CDM	Graft Evas 20mm 11.5cm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
405606	CDM	Valve Aortic 23mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
551581	CDM	Valve Heart Trnscth 23mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
566275	CDM	Occluder Cardiac Lt 22mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
402568	CDM	Valve Aortic 21mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
551582	CDM	Valve Heart Trnscth 20mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
447931	CDM	Valve Aortic 25mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
415174	CDM	Graft Nrv 2-3mm 30mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
566278	CDM	Occluder Cardiac Lt 16mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
551580	CDM	Valve Heart Trnscth 26mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
578285	CDM	Stent Graft 15x6mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
484908	CDM	Graft Nrv 3-4mm 70mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
584753	CDM	Transcth Aortic Vlv 25mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
776775	CDM	Stent Graft 20cm 45x45mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
359443	CDM	Vlv Mtrl Ts Prmt Trxfx29	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
584752	CDM	Transcth Aortic Vlv 23mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
777083	CDM	Valve Aor Tavr 23mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
438515	CDM	Graft Bn Tndn Ptla 8cm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
402900	CDM	Valve Aortic 23mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
566271	CDM	Occluder Cardiac Lt 34mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
777081	CDM	Valve Aor Tavr 34mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
469506	CDM	Kit Aor Vlv 14fr 26mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
402572	CDM	Valve Aortic 29mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
487218	CDM	Valve Tavr 34mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
584751	CDM	Transcth Aortic Vlv 27mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
416052	CDM	Valve Mitral 25mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
584862	CDM	Graft Bn Hum Hd Lt	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
402569	CDM	Valve Aortic 25mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
826589	CDM	Graft Kn Bn Rt	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
549505	CDM	Graft St Tis Mnscs Rt	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
777080	CDM	Valve Aor Tavr 29mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
771691	CDM	Valve Aortic 27mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
487217	CDM	Valve Tavr 29mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
416060	CDM	Valve Mitral 27mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
566273	CDM	Occluder Cardiac Lt 28mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
566277	CDM	Occluder Cardiac Lt 18mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
416063	CDM	Valve Mitral 33mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
581868	CDM	Stent Eprsth 15cm 8mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
783815	CDM	Graft Bn Lt Ankl Fsh	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
607107	CDM	Valve Tavr 29mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
607102	CDM	Valve Tavr 20mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
473529	CDM	Graft Nrv 1-2mm 30mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
447930	CDM	Valve Aortic 23mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
610996	CDM	Stent Eprsth 8x8mm 6cm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
598386	CDM	Valve Tavr 34mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
566276	CDM	Occluder Cardiac Lt 20mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
585006	CDM	Stent Eprsth 24f 34mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
598801	CDM	Valve Tavr 23mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
611245	CDM	Graft Bn Mops Tibia Dist	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
485939	CDM	Kit Vlv Aor 18fr 20mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
492573	CDM	Valve Aortic 27mm	12	8	$143,760.00	$143,760.00	$20,557.68	$143,760.00	$55,347.60	2026-03-01
C1817	HCPCS	Occluder Cv 30mm	24	8	$141,164.00	$141,164.00	$19,815.22	$143,760.00	$54,179.40	2026-03-01
575552	CDM	Allograft St Tis 11mm	12	8	$140,547.00	$140,547.00	$20,098.22	$140,547.00	$54,110.60	2026-03-01
461162	CDM	Graft Bone Matrix 15ml	12	8	$139,699.00	$139,699.00	$19,976.96	$139,699.00	$53,784.12	2026-03-01
463209	CDM	Kit Aor Vlv 16fr 23mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
473877	CDM	Enplatee Spnl 18x6mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
562600	CDM	Cage Alif 14mm X-lg	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
468328	CDM	Spacer Spn 9d 29x40x14mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
463975	CDM	Spacer Spnl 24x30x11mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
573292	CDM	Spacer Spnl32x25x12-10.2	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
492627	CDM	Spacer Spn 32x13.5-8mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
474445	CDM	Spacer Spn 30x12x8-15mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
491920	CDM	Spacer Spn32x25x12-6.7mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
465017	CDM	Spacer Spn 8d 37x27x12	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
466788	CDM	Spacer Spn 31x10x9-13mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
458865	CDM	Spacer Spn 12x18x12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
546374	CDM	Spacr Spn 36x28x10.5-6.4	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
583375	CDM	Stent Eprsth 8x40mm 15cm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
457272	CDM	Cage Spnl Roi-a 14d Alif	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
482826	CDM	Spacer Spn 10mm 368-12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
492920	CDM	Cage Spn 12d 11x33mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
463043	CDM	Disc Intvrtb 15x5x13mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
476009	CDM	Sys Reflux Mgmt Bead 16	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
494493	CDM	Cage Spn 12d 36x13mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
565469	CDM	Cage Spn 12d Xlg 15mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
484422	CDM	Cage Spn 8d 15mm 33mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
476008	CDM	Sys Reflux Mgmt Bead 15	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
560753	CDM	Spacer Spn 45x22x7-14mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
546659	CDM	Cage Spn 12d 21x32x12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
465259	CDM	Spacer Spnl 22x10x10-15m	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
466969	CDM	Spacer Spnl 55x18x10mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
560361	CDM	Sys Valve Aor 26mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
565490	CDM	Cage Spn 40x14mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
476006	CDM	System Gs Impl Anrflx	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
456943	CDM	Cage Spn Pk Roi 30x27x12	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
567295	CDM	Cage Spnl Long 7mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
493683	CDM	Cage Spn 10d 10x22x50mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
492709	CDM	Spacer Spnl 36x31x15-7mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
559742	CDM	Spacer Spn 36x28x12-5.9	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
573558	CDM	Implant Cust Cranial Lge	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
540281	CDM	Spacer Spn 32x25x12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
479586	CDM	Spacer Spn 31x10x8-12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
559287	CDM	Cage Spnl 16mm 36mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
480781	CDM	Spacer Spn 23x10mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
475644	CDM	Cage Spnl 36mmx15mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
491202	CDM	Spacer Spnl 14x27mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
581993	CDM	Spacer Spn 36x31x12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
533079	CDM	Occluder Cv 8x6mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
483893	CDM	Cage Spnl 12d 36mm 15mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
533080	CDM	Occluder Cv 10x8mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
468442	CDM	Spacer Spn 10mm 22mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
492921	CDM	Cage Spn 3d 33x13x8mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
462912	CDM	Cage Spn Roi 30x27x14 6d	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
464754	CDM	Spacer Spn 30x24x13mm Ch	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
491346	CDM	Cage Spn 50mm 22mm 12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
479092	CDM	Spacer Spnl 28mmx8mm Ele	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
497083	CDM	Cage Spn 19x36mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
577484	CDM	Cage Spn 8d 33x15mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
485922	CDM	Spacer Spn 15d27x10x10mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
534296	CDM	Spacer Spn 32x28x10.5-8.	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
C1815	HCPCS	Cuff Urth Sphncr Ab 4cm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
492970	CDM	Spacer Spn Med 14d 17mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
540290	CDM	Cage Spn 50x22x8mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
495658	CDM	System Spn 33x13x12mm 3d	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
455249	CDM	Cage Spnl 36x27x14mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
488813	CDM	Cage Spnl 32x10mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
476071	CDM	Disc Intvrt 7x16x17.8mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
495948	CDM	Spacer Spnl 28mmx10mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
473999	CDM	Graft Evas 23x14.5m 18cm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
456779	CDM	Cage Spn Pk Roi 30x27x10	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
485433	CDM	Cage Spn 22x10x8mm 8d	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
581228	CDM	Spacer Spn 6dg 10.5mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
456742	CDM	Cage Spn Roi 30x27x12 6d	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
583625	CDM	Spacer Spn 36mm 28mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
585433	CDM	Spacer 9x26x9.5-14mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
544759	CDM	Kit Impl Uni Tmj Cstm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
C1767	HCPCS	Ipg Nrstm Mr 4.95x5.55cm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
C1822	HCPCS	System Imp Ipg Neuro	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
469356	CDM	Spacer Spn 12x12x21mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
479306	CDM	Spacer Spn 8mm 23mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
447633	CDM	Spacer 10 X 26 Mm 12-17	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
447329	CDM	Spacer Spnl 22mmx8-12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
463976	CDM	Spcr Spnl 36x28x15mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
461846	CDM	Cage Spnl 50x21x12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
490407	CDM	Spacer Spn 6d 8x22x50mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
478029	CDM	Cage Spn 6d 18x10x50mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
459595	CDM	Cage Spnl 36x27x14mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
490408	CDM	Spacer Spn 10d 15mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
554282	CDM	Cage Spn Interbdy 12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
567634	CDM	Spacer Tissue Shldr Med	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
471413	CDM	Cage Spn Midlineii-ti 39	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
C2616	HCPCS	Brachytx Ns Yttrium 90	10	7	$138,568.00	$138,568.00	$19,815.22	$124,711.20	$53,348.68	2026-03-01
463583	CDM	Disc Spn Mobi-c 15x15x5	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
C1820	HCPCS	Device Neurostimulator	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
514806	CDM	Cage Intbdy Spn 15d 12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
472832	CDM	Spacer Spn 9d 29x40x16mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
474377	CDM	Applier Int Clip 86cm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
552534	CDM	Cage Spnl 36mm 11mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
441643	CDM	Spacer Spnl 33-53x12 12m	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
442260	CDM	Spacer Spn 12mm 25-37mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
475685	CDM	Cage Spn 33mmx13mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
459377	CDM	Graft Evas 31x14.5m 15cm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
481744	CDM	Spacer X-lor 28x11mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
493784	CDM	Cage Spn 10d 12x18x55mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
514792	CDM	Valve Aortic 21mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
555460	CDM	Cage Spnl 3d 33x15x12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
572182	CDM	Cage Spn 28x9x8-11mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
479398	CDM	Spacer Spnl 28x9mm Elev	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
473729	CDM	Disc Intvrt 6x18x17.8mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
468590	CDM	Spacer Spn 10d 16x10x8mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
577046	CDM	Spacer Spn 32x25x12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
515224	CDM	Kit Fastener Endo	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
478949	CDM	Spacer Spn 9x10x28mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
C1821	HCPCS	Implnt Spn 8mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
471949	CDM	Disc Intvrt 7x18x17.8mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
555898	CDM	Cage Spn 7d 36x13mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
490406	CDM	Spacr Spnl 36x7.4-13.5mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
391149	CDM	Pump Contrl Urn Ab Sys	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
460162	CDM	Spacer Spn 12x19x12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
480813	CDM	Spacer Spnl 23x8mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
580744	CDM	Cage Spn 3d 36x17x12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
438218	CDM	Spacer Spn 4d 26x10x8mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
468313	CDM	Spacer Spn 9d 25x35x14mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
481299	CDM	Spacer Spnl 23mmx9mm Ele	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
463510	CDM	Cage Spnl 30x27x16mm Roi	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
514584	CDM	Spacer Spn 6.5mm 24mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
550429	CDM	Cage Spn Szc 13mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
479655	CDM	Spacer Spn 26x10x8-12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
485283	CDM	Cage Spnl 36x10mm Endosk	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
514585	CDM	Spacer Spn 8.5x10x24mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
489829	CDM	Cage Spn 55x18x10mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
479895	CDM	Spacer Spn 36x10x10-14mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
569065	CDM	Cage Spnl Long 9mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
580901	CDM	Impl Spn Disc Med 5mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
487245	CDM	Spacer Spn 10x31x9-13mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
494050	CDM	Spacer Spnl 28x33x11-14m	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
556067	CDM	Component Seg Tpr Kn 5cm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
568489	CDM	Cage Spn Short 9mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
486688	CDM	Cage Spn 12d 36x11mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
476134	CDM	Cage Spn 12d 39mmx15mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
490152	CDM	Cage Spnl 55x18x8mm Clyd	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
463210	CDM	Kit Aor Vlv 18fr 26mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
463508	CDM	Cage Spnl 30x27x16mm Roi	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
494255	CDM	Cage Spn 10d 60x22x12mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
464177	CDM	Spcr Spnl 36x28x15mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
525172	CDM	Spacer Spn 60x22x7mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
475749	CDM	Cage 13mm Lrg Endoskelet	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
489594	CDM	Cage Spnl 45x21x14mm Cgr	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
476010	CDM	Sys Reflux Mgmt Bead 17	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
490155	CDM	Disc Spn Cerv 6mm 14mm	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01
480993	CDM	Cage Endoskltn Tas 36x12	12	8	$138,568.00	$138,568.00	$19,815.22	$138,568.00	$53,348.68	2026-03-01

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