Hospital

ASPIRUS EAGLE RIVER HOSPITAL

Eagle River, WI · CCN 521300 · Rates published

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You selected 93306 (HCPCS)

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

135 distinct procedures filed

16 distinct payers

1,452 rate rows

2025-07-01 last MRF observed · ⚠ 15 mo old

Data quality

744 of 1,452 rate rows are consumer-grade (51.2%)

708 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
professional (physician) fee — not the facility price	707
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	1

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 15 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

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

Source MRF file	https://www.aspirus.org/Uploads/Public/Documents/PriceEstimate/TransparencyFY26/390985690_aspirus-eagle-river-hospital_standardcharges.json
Found on page	https://www.aspirus.org/price-estimate
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-09-21
Content fingerprint	6c6558f0ae2110de… · 150,176,975 bytes · first seen 2026-05-09

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
559 MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue With Mcc	2	$39,140.22	$51,673.34	$45,406.78	nat. median $18,115 outlier · 2.5×
602 MS_DRG	Cellulitis With Mcc	1	$39,448.69	$39,448.69	$39,448.69	nat. median $14,036 outlier · 2.8×
948 MS_DRG	Signs And Symptoms Without Mcc	3	$25,070.14	$31,032.24	$28,072.36	nat. median $7,971 outlier · 3.5×
919 MS_DRG	Complications Of Treatment With Mcc	1	$26,522.29	$26,522.29	$26,522.29	nat. median $17,519 1.5× median
896 MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc	1	$26,154.56	$26,154.56	$26,154.56	nat. median $15,491 1.7× median
947 MS_DRG	Signs And Symptoms With Mcc	4	$13,046.74	$44,493.71	$24,958.68	nat. median $12,113 outlier · 2.1×
564 MS_DRG	Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc	1	$23,860.93	$23,860.93	$23,860.93	nat. median $15,007 1.6× median
280 MS_DRG	Acute Myocardial Infarction, Discharged Alive With Mcc	2	$17,549.26	$23,880.38	$20,714.82	nat. median $15,670 1.3× median
563 MS_DRG	Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…	2	$17,664.22	$20,574.22	$19,119.22	nat. median $9,158 outlier · 2.1×
603 MS_DRG	Cellulitis Without Mcc	4	$11,338.08	$23,793.30	$18,836.36	nat. median $8,991 outlier · 2.1×
872 MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc	4	$7,065.69	$28,580.26	$18,355.20	nat. median $10,410 1.8× median
813 MS_DRG	Coagulation Disorders	1	$17,761.53	$17,761.53	$17,761.53	nat. median $14,899 1.2× median
699 MS_DRG	Other Kidney And Urinary Tract Diagnoses With Cc	1	$16,624.33	$16,624.33	$16,624.33	nat. median $10,325 1.6× median
74 MS_DRG	Cranial And Peripheral Nerve Disorders Without Mcc	1	$16,413.63	$16,413.63	$16,413.63	nat. median $10,491 1.6× median
391 MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc	2	$11,657.33	$20,808.09	$16,232.71	nat. median $12,544 1.3× median
84 MS_DRG	Traumatic Stupor And Coma >1 Hour Without Cc/Mcc	1	$16,094.90	$16,094.90	$16,094.90	nat. median $9,909 1.6× median
192 MS_DRG	Chronic Obstructive Pulmonary Disease Without Cc/Mcc	1	$14,992.49	$14,992.49	$14,992.49	nat. median $7,116 outlier · 2.1×
281 MS_DRG	Acute Myocardial Infarction, Discharged Alive With Cc	1	$14,473.61	$14,473.61	$14,473.61	nat. median $9,717 1.5× median
65 MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours	1	$7,043.70	$21,849.98	$14,446.84	nat. median $10,477 1.4× median
243 MS_DRG	Permanent Cardiac Pacemaker Implant With Cc	1	$14,300.56	$14,300.56	$14,300.56	nat. median $21,251 0.7× median
560 MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue With Cc	2	$8,953.62	$17,636.28	$13,294.95	nat. median $11,478 1.2× median
441 MS_DRG	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc	1	$13,227.76	$13,227.76	$13,227.76	nat. median $17,437 0.8× median
729 MS_DRG	Other Male Reproductive System Diagnoses With Cc/Mcc	1	$13,215.43	$13,215.43	$13,215.43	nat. median $10,908 1.2× median
551 MS_DRG	Medical Back Problems With Mcc	1	$13,104.13	$13,104.13	$13,104.13	nat. median $16,106 0.8× median
183 MS_DRG	Major Chest Trauma With Mcc	2	$7,656.33	$16,981.33	$12,318.83	nat. median $15,036 0.8× median
556 MS_DRG	Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc	1	$11,996.73	$11,996.73	$11,996.73	nat. median $8,636 1.4× median
282 MS_DRG	Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc	1	$11,898.17	$11,898.17	$11,898.17	nat. median $7,949 1.5× median
392 MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc	1	$11,338.08	$11,338.08	$11,338.08	nat. median $8,186 1.4× median
308 MS_DRG	Cardiac Arrhythmia And Conduction Disorders With Mcc	2	$5,665.84	$16,158.39	$10,912.11	nat. median $11,997 0.9× median
9132 OTHER	Prothrombin Complex Kcentra	3	$9,971.65	$13,221.28	$10,887.68	nat. median $2 outlier · 4860.6×
536 MS_DRG	Fractures Of Hip And Pelvis Without Mcc	1	$10,595.18	$10,595.18	$10,595.18	nat. median $8,438 1.3× median
880 MS_DRG	Acute Adjustment Reaction And Psychosocial Dysfunction	1	$10,558.62	$10,558.62	$10,558.62	nat. median $8,962 1.2× median
178 MS_DRG	Respiratory Infections And Inflammations With Cc	3	$9,921.76	$11,042.97	$10,373.88	nat. median $10,207 1.0× median
59 MS_DRG	Multiple Sclerosis And Cerebellar Ataxia With Cc	1	$10,359.12	$10,359.12	$10,359.12	nat. median $12,349 0.8× median
342 MS_DRG	Appendectomy Without Complicated Principal Diagnosis With Cc	1	$9,819.42	$9,819.42	$9,819.42	nat. median $9,816 1.0× median
9002 OTHER	Tenecteplase Injection	6	$6,954.25	$16,866.06	$9,681.01	nat. median $187 outlier · 51.8×
57 MS_DRG	Degenerative Nervous System Disorders Without Mcc	1	$9,520.54	$9,520.54	$9,520.54	nat. median $12,550 0.8× median
383 MS_DRG	Uncomplicated Peptic Ulcer With Mcc	1	$9,021.92	$9,021.92	$9,021.92	nat. median $13,199 0.7× median
193 MS_DRG	Simple Pneumonia And Pleurisy With Mcc	3	$7,573.94	$35,665.66	$8,830.88	nat. median $12,877 0.7× median
189 MS_DRG	Pulmonary Edema And Respiratory Failure	4	$5,939.10	$19,950.38	$8,718.92	nat. median $12,282 0.7× median
184 MS_DRG	Major Chest Trauma With Cc	1	$8,655.11	$8,655.11	$8,655.11	nat. median $10,707 0.8× median
641 MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…	2	$7,703.84	$9,382.73	$8,543.28	nat. median $8,119 1.1× median
535 MS_DRG	Fractures Of Hip And Pelvis With Mcc	1	$8,479.23	$8,479.23	$8,479.23	nat. median $12,831 0.7× median
439 MS_DRG	Disorders Of Pancreas Except Malignancy With Cc	2	$7,343.64	$9,200.99	$8,272.32	nat. median $8,941 0.9× median
191 MS_DRG	Chronic Obstructive Pulmonary Disease With Cc	3	$2,374.27	$25,646.06	$8,197.35	nat. median $8,851 0.9× median
698 MS_DRG	Other Kidney And Urinary Tract Diagnoses With Mcc	1	$8,002.37	$8,002.37	$8,002.37	nat. median $15,915 0.5× median
245 MS_DRG	Aicd Generator Procedures	1	$7,967.92	$7,967.92	$7,967.92	nat. median $42,929 outlier · 0.2×
562 MS_DRG	Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…	1	$7,900.67	$7,900.67	$7,900.67	nat. median $13,965 0.6× median
871 MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	4	$4,928.35	$12,038.59	$7,811.05	nat. median $18,659 outlier · 0.4×
552 MS_DRG	Medical Back Problems Without Mcc	2	$7,533.52	$8,025.10	$7,779.31	nat. median $9,833 0.8× median

Other procedures at this hospital

Browse this hospital's 135 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

559	MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue With Mcc	2	2	—	—	$39,140.22	$51,673.34	$45,406.78	2025-07-01
602	MS_DRG	Cellulitis With Mcc	1	1	—	—	$39,448.69	$39,448.69	$39,448.69	2025-07-01
948	MS_DRG	Signs And Symptoms Without Mcc	4	3	—	—	$25,070.14	$31,032.24	$28,072.36	2025-07-01
919	MS_DRG	Complications Of Treatment With Mcc	1	1	—	—	$26,522.29	$26,522.29	$26,522.29	2025-07-01
896	MS_DRG	Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc	1	1	—	—	$26,154.56	$26,154.56	$26,154.56	2025-07-01
947	MS_DRG	Signs And Symptoms With Mcc	4	4	—	—	$13,046.74	$44,493.71	$24,958.68	2025-07-01
564	MS_DRG	Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc	1	1	—	—	$23,860.93	$23,860.93	$23,860.93	2025-07-01
280	MS_DRG	Acute Myocardial Infarction, Discharged Alive With Mcc	2	2	—	—	$17,549.26	$23,880.38	$20,714.82	2025-07-01
563	MS_DRG	Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…	2	2	—	—	$17,664.22	$20,574.22	$19,119.22	2025-07-01
603	MS_DRG	Cellulitis Without Mcc	4	4	—	—	$11,338.08	$23,793.30	$18,836.36	2025-07-01
872	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc	4	4	—	—	$7,065.69	$28,580.26	$18,355.20	2025-07-01
813	MS_DRG	Coagulation Disorders	1	1	—	—	$17,761.53	$17,761.53	$17,761.53	2025-07-01
699	MS_DRG	Other Kidney And Urinary Tract Diagnoses With Cc	1	1	—	—	$16,624.33	$16,624.33	$16,624.33	2025-07-01
74	MS_DRG	Cranial And Peripheral Nerve Disorders Without Mcc	1	1	—	—	$16,413.63	$16,413.63	$16,413.63	2025-07-01
391	MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc	2	2	—	—	$11,657.33	$20,808.09	$16,232.71	2025-07-01
84	MS_DRG	Traumatic Stupor And Coma >1 Hour Without Cc/Mcc	1	1	—	—	$16,094.90	$16,094.90	$16,094.90	2025-07-01
192	MS_DRG	Chronic Obstructive Pulmonary Disease Without Cc/Mcc	1	1	—	—	$14,992.49	$14,992.49	$14,992.49	2025-07-01
281	MS_DRG	Acute Myocardial Infarction, Discharged Alive With Cc	1	1	—	—	$14,473.61	$14,473.61	$14,473.61	2025-07-01
65	MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours	2	1	—	—	$7,043.70	$21,849.98	$14,446.84	2025-07-01
243	MS_DRG	Permanent Cardiac Pacemaker Implant With Cc	1	1	—	—	$14,300.56	$14,300.56	$14,300.56	2025-07-01
560	MS_DRG	Aftercare, Musculoskeletal System And Connective Tissue With Cc	2	2	—	—	$8,953.62	$17,636.28	$13,294.95	2025-07-01
441	MS_DRG	Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc	1	1	—	—	$13,227.76	$13,227.76	$13,227.76	2025-07-01
729	MS_DRG	Other Male Reproductive System Diagnoses With Cc/Mcc	1	1	—	—	$13,215.43	$13,215.43	$13,215.43	2025-07-01
551	MS_DRG	Medical Back Problems With Mcc	1	1	—	—	$13,104.13	$13,104.13	$13,104.13	2025-07-01
183	MS_DRG	Major Chest Trauma With Mcc	2	2	—	—	$7,656.33	$16,981.33	$12,318.83	2025-07-01
556	MS_DRG	Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc	1	1	—	—	$11,996.73	$11,996.73	$11,996.73	2025-07-01
282	MS_DRG	Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc	1	1	—	—	$11,898.17	$11,898.17	$11,898.17	2025-07-01
392	MS_DRG	Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc	1	1	—	—	$11,338.08	$11,338.08	$11,338.08	2025-07-01
308	MS_DRG	Cardiac Arrhythmia And Conduction Disorders With Mcc	2	2	—	—	$5,665.84	$16,158.39	$10,912.11	2025-07-01
9132	OTHER	Prothrombin Complex Kcentra	5	3	—	—	$9,971.65	$13,221.28	$10,887.68	2025-07-01
536	MS_DRG	Fractures Of Hip And Pelvis Without Mcc	1	1	—	—	$10,595.18	$10,595.18	$10,595.18	2025-07-01
880	MS_DRG	Acute Adjustment Reaction And Psychosocial Dysfunction	1	1	—	—	$10,558.62	$10,558.62	$10,558.62	2025-07-01
178	MS_DRG	Respiratory Infections And Inflammations With Cc	3	3	—	—	$9,921.76	$11,042.97	$10,373.88	2025-07-01
59	MS_DRG	Multiple Sclerosis And Cerebellar Ataxia With Cc	1	1	—	—	$10,359.12	$10,359.12	$10,359.12	2025-07-01
342	MS_DRG	Appendectomy Without Complicated Principal Diagnosis With Cc	1	1	—	—	$9,819.42	$9,819.42	$9,819.42	2025-07-01
9002	OTHER	Tenecteplase Injection	9	6	—	—	$6,954.25	$16,866.06	$9,681.01	2025-07-01
57	MS_DRG	Degenerative Nervous System Disorders Without Mcc	1	1	—	—	$9,520.54	$9,520.54	$9,520.54	2025-07-01
383	MS_DRG	Uncomplicated Peptic Ulcer With Mcc	1	1	—	—	$9,021.92	$9,021.92	$9,021.92	2025-07-01
193	MS_DRG	Simple Pneumonia And Pleurisy With Mcc	4	3	—	—	$7,573.94	$35,665.66	$8,830.88	2025-07-01
189	MS_DRG	Pulmonary Edema And Respiratory Failure	4	4	—	—	$5,939.10	$19,950.38	$8,718.92	2025-07-01
184	MS_DRG	Major Chest Trauma With Cc	1	1	—	—	$8,655.11	$8,655.11	$8,655.11	2025-07-01
641	MS_DRG	Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou…	2	2	—	—	$7,703.84	$9,382.73	$8,543.28	2025-07-01
535	MS_DRG	Fractures Of Hip And Pelvis With Mcc	1	1	—	—	$8,479.23	$8,479.23	$8,479.23	2025-07-01
439	MS_DRG	Disorders Of Pancreas Except Malignancy With Cc	2	2	—	—	$7,343.64	$9,200.99	$8,272.32	2025-07-01
191	MS_DRG	Chronic Obstructive Pulmonary Disease With Cc	3	3	—	—	$2,374.27	$25,646.06	$8,197.35	2025-07-01
698	MS_DRG	Other Kidney And Urinary Tract Diagnoses With Mcc	1	1	—	—	$8,002.37	$8,002.37	$8,002.37	2025-07-01
245	MS_DRG	Aicd Generator Procedures	1	1	—	—	$7,967.92	$7,967.92	$7,967.92	2025-07-01
562	MS_DRG	Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit…	1	1	—	—	$7,900.67	$7,900.67	$7,900.67	2025-07-01
871	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	4	4	—	—	$4,928.35	$12,038.59	$7,811.05	2025-07-01
552	MS_DRG	Medical Back Problems Without Mcc	2	2	—	—	$7,533.52	$8,025.10	$7,779.31	2025-07-01
388	MS_DRG	Gastrointestinal Obstruction With Mcc	1	1	—	—	$7,742.43	$7,742.43	$7,742.43	2025-07-01
884	MS_DRG	Organic Disturbances And Intellectual Disability	1	1	—	—	$7,558.72	$7,558.72	$7,558.72	2025-07-01
689	MS_DRG	Kidney And Urinary Tract Infections With Mcc	3	3	—	—	$7,086.43	$9,035.22	$7,341.56	2025-07-01
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	1	1	—	—	$7,266.17	$7,266.17	$7,266.17	2025-07-01
593	MS_DRG	Skin Ulcers With Cc	2	1	—	—	$5,669.04	$8,810.65	$7,239.84	2025-07-01
690	MS_DRG	Kidney And Urinary Tract Infections Without Mcc	4	3	—	—	$3,779.36	$14,826.22	$6,936.12	2025-07-01
177	MS_DRG	Respiratory Infections And Inflammations With Mcc	5	4	—	—	$3,302.56	$8,503.56	$6,846.15	2025-07-01
291	MS_DRG	Heart Failure And Shock With Mcc	6	5	—	—	$5,669.04	$17,209.26	$6,737.76	2025-07-01
71	MS_DRG	Nonspecific Cerebrovascular Disorders With Cc	1	1	—	—	$6,675.97	$6,675.97	$6,675.97	2025-07-01
299	MS_DRG	Peripheral Vascular Disorders With Mcc	1	1	—	—	$6,586.43	$6,586.43	$6,586.43	2025-07-01
5182	OTHER	Level 2 Vascular Procedures	1	1	—	—	$6,568.76	$6,568.76	$6,568.76	2025-07-01
596	MS_DRG	Major Skin Disorders Without Mcc	1	1	—	—	$6,531.01	$6,531.01	$6,531.01	2025-07-01
440	MS_DRG	Disorders Of Pancreas Except Malignancy Without Cc/Mcc	1	1	—	—	$6,355.11	$6,355.11	$6,355.11	2025-07-01
5045	OTHER	Trauma Response With Critical Care	8	5	—	—	$2,746.61	$19,837.48	$6,344.30	2025-07-01
5414	OTHER	Level 4 Gynecologic Procedures	1	1	—	—	$6,323.44	$6,323.44	$6,323.44	2025-07-01
186	MS_DRG	Pleural Effusion With Mcc	1	1	—	—	$6,195.81	$6,195.81	$6,195.81	2025-07-01
433	MS_DRG	Cirrhosis And Alcoholic Hepatitis With Cc	1	1	—	—	$6,124.56	$6,124.56	$6,124.56	2025-07-01
139	MS_DRG	Salivary Gland Procedures	2	2	—	—	$3,964.50	$8,160.46	$6,062.48	2025-07-01
558	MS_DRG	Tendonitis, Myositis And Bursitis Without Mcc	1	1	—	—	$6,044.04	$6,044.04	$6,044.04	2025-07-01
5183	OTHER	Level 3 Vascular Procedures	4	3	—	—	$1,902.25	$17,211.48	$6,017.09	2025-07-01
315	MS_DRG	Other Circulatory System Diagnoses With Cc	1	1	—	—	$5,883.96	$5,883.96	$5,883.96	2025-07-01
69	MS_DRG	Transient Ischemia Without Thrombolytic	3	3	—	—	$3,567.74	$5,898.55	$5,861.76	2025-07-01
5112	OTHER	Level 2 Musculoskeletal Procedures	7	5	—	—	$2,102.82	$14,438.01	$5,782.44	2025-07-01
0944	RC	Gammagard Liquid Injection	1	1	—	—	$5,619.18	$5,619.18	$5,619.18	2025-07-01
543	MS_DRG	Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…	1	1	—	—	$5,477.90	$5,477.90	$5,477.90	2025-07-01
683	MS_DRG	Renal Failure With Cc	2	1	—	—	$1,421.35	$9,309.52	$5,365.43	2025-07-01
684	MS_DRG	Renal Failure Without Cc/Mcc	2	1	—	—	$3,779.36	$6,084.28	$4,931.82	2025-07-01
5301	OTHER	Level 1 Upper Gi Procedures	1	1	—	—	$4,688.48	$4,688.48	$4,688.48	2025-07-01
9133	OTHER	Rabies Ig, Im/sc	3	3	—	—	$283.21	$7,199.03	$4,658.83	2025-07-01
393	MS_DRG	Other Digestive System Diagnoses With Mcc	1	1	—	—	$4,283.45	$4,283.45	$4,283.45	2025-07-01
7043	OTHER	Infliximab Not Biosimil 10mg	1	1	—	—	$4,242.62	$4,242.62	$4,242.62	2025-07-01
639	MS_DRG	Diabetes Without Cc/Mcc	1	1	—	—	$4,223.41	$4,223.41	$4,223.41	2025-07-01
312	MS_DRG	Syncope And Collapse	1	1	—	—	$4,118.10	$4,118.10	$4,118.10	2025-07-01
5041	OTHER	Critical Care	20	8	—	—	$1,352.11	$21,428.32	$4,026.50	2025-07-01
9245	OTHER	Romiplostim Injection	1	1	—	—	$3,847.32	$3,847.32	$3,847.32	2025-07-01
9406	OTHER	Inj, Nyvepria	1	1	—	—	$3,573.08	$3,573.08	$3,573.08	2025-07-01
951	MS_DRG	Other Factors Influencing Health Status	4	4	—	—	$1,925.40	$9,064.77	$3,445.86	2025-07-01
9501	OTHER	Platelet Pheres Leukoreduced	1	1	—	—	$3,347.65	$3,347.65	$3,347.65	2025-07-01
5025	OTHER	Level 5 Type A Ed Visits	33	15	—	—	$905.54	$8,467.21	$2,988.73	2025-07-01
5691	OTHER	Level 1 Drug Administration	4	4	—	—	$2,236.75	$9,991.67	$2,977.44	2025-07-01
5071	OTHER	Level 1 Excision/ Biopsy/ Incision And Drainage	1	1	—	—	$2,751.14	$2,751.14	$2,751.14	2025-07-01
5442	OTHER	Level 2 Nerve Injections	2	2	—	—	$1,366.43	$3,777.61	$2,572.02	2025-07-01
5053	OTHER	Level 3 Skin Procedures	3	2	—	—	$2,125.20	$3,342.89	$2,230.60	2025-07-01
5572	OTHER	Level 2 Imaging With Contrast	25	13	—	—	$575.16	$11,936.80	$2,139.49	2025-07-01
293	MS_DRG	Heart Failure And Shock Without Cc/Mcc	1	1	—	—	$2,118.37	$2,118.37	$2,118.37	2025-07-01
5781	OTHER	Resuscitation And Cardioversion	4	4	—	—	$1,213.13	$3,815.60	$1,953.66	2025-07-01
5024	OTHER	Level 4 Type A Ed Visits	32	13	—	—	$470.39	$6,833.53	$1,890.31	2025-07-01
194	MS_DRG	Simple Pneumonia And Pleurisy With Cc	1	1	—	—	$1,889.68	$1,889.68	$1,889.68	2025-07-01
5181	OTHER	Level 1 Vascular Procedures	2	2	—	—	$1,671.36	$1,720.34	$1,695.85	2025-07-01
5571	OTHER	Level 1 Imaging With Contrast	22	9	—	—	$491.81	$4,056.08	$1,620.06	2025-07-01
5673	OTHER	Level 3 Pathology	2	1	—	—	$396.52	$2,764.07	$1,580.30	2025-07-01
5573	OTHER	Level 3 Imaging With Contrast	12	6	—	—	$965.16	$4,310.58	$1,384.63	2025-07-01
5523	OTHER	Level 3 Imaging Without Contrast	29	12	—	—	$390.34	$8,592.43	$1,328.97	2025-07-01
5312	OTHER	Level 2 Lower Gi Procedures	1	1	—	—	$1,269.45	$1,269.45	$1,269.45	2025-07-01
5072	OTHER	Level 2 Excision/ Biopsy/ Incision And Drainage	4	4	—	—	$723.90	$1,669.80	$1,242.37	2025-07-01
682	MS_DRG	Renal Failure With Mcc	1	1	—	—	$1,190.39	$1,190.39	$1,190.39	2025-07-01
1237	OTHER	Inj Iron Dextran	1	1	—	—	$1,125.48	$1,125.48	$1,125.48	2025-07-01
5111	OTHER	Level 1 Musculoskeletal Procedures	1	1	—	—	$1,069.61	$1,069.61	$1,069.61	2025-07-01
9272	OTHER	Inj, Denosumab	2	2	—	—	$915.22	$961.96	$938.59	2025-07-01
5052	OTHER	Level 2 Skin Procedures	11	6	—	—	$538.81	$2,183.66	$910.73	2025-07-01
5441	OTHER	Level 1 Nerve Injections	5	5	—	—	$608.00	$896.06	$858.68	2025-07-01
9139	OTHER	Rabies Vaccine, IM	2	2	—	—	$532.02	$1,093.97	$813.00	2025-07-01
5524	OTHER	Level 4 Imaging Without Contrast	18	6	—	—	$637.10	$2,160.80	$791.06	2025-07-01
5023	OTHER	Level 3 Type A Ed Visits	37	16	—	—	$287.48	$1,523.08	$703.27	2025-07-01
5051	OTHER	Level 1 Skin Procedures	3	2	—	—	$518.42	$1,350.00	$568.36	2025-07-01
5693	OTHER	Level 3 Drug Administration	12	8	—	—	$238.98	$1,223.07	$480.19	2025-07-01
5022	OTHER	Level 2 Type A Ed Visits	32	16	—	—	$173.24	$677.05	$461.44	2025-07-01
N804	OTHER	Mammography Services	32	14	—	—	$108.10	$571.78	$452.11	2025-07-01
5771	OTHER	Cardiac Rehabilitation	17	7	—	—	$254.43	$1,921.28	$442.85	2025-07-01
N801	OTHER	Therapy Services	29	13	—	—	$103.60	$1,378.63	$435.33	2025-07-01
5522	OTHER	Level 2 Imaging Without Contrast	30	14	—	—	$172.65	$3,355.00	$371.82	2025-07-01
5731	OTHER	Level 1 Minor Procedures	5	2	—	—	$129.09	$962.32	$367.78	2025-07-01
1829	OTHER	Penicillin G Benzathine Inj	1	1	—	—	$347.71	$347.71	$347.71	2025-07-01
5732	OTHER	Level 2 Minor Procedures	4	3	—	—	$193.75	$414.47	$292.45	2025-07-01
9441	OTHER	Inj Ferric Carboxymaltos 1mg	1	1	—	—	$281.25	$281.25	$281.25	2025-07-01
5733	OTHER	Level 3 Minor Procedures	8	6	—	—	$53.63	$524.52	$235.84	2025-07-01
5521	OTHER	Level 1 Imaging Without Contrast	30	13	—	—	$90.83	$391.50	$215.48	2025-07-01
5371	OTHER	Level 1 Urology And Related Services	1	1	—	—	$215.14	$215.14	$215.14	2025-07-01
5021	OTHER	Level 1 Type A Ed Visits	13	6	—	—	$9.41	$262.68	$194.64	2025-07-01
5672	OTHER	Level 2 Pathology	1	1	—	—	$154.02	$154.02	$154.02	2025-07-01
N800	OTHER	Clinical Diagnostic Lab Services	34	14	—	—	$17.71	$450.71	$148.57	2025-07-01
5734	OTHER	Level 4 Minor Procedures	17	10	—	—	$4.29	$1,523.70	$142.79	2025-07-01
5692	OTHER	Level 2 Drug Administration	3	3	—	—	$33.06	$282.26	$115.60	2025-07-01
N905	OTHER	Not Recognized By Opps	1	1	—	—	$65.23	$65.23	$65.23	2025-07-01
N902	OTHER	Packaged Services	18	8	—	—	$4.43	$599.34	$41.97	2025-07-01

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