Sheridan Memorial Hospital Association — Pricing
170 procedures published in this hospital's Machine-Readable File (MRF) — 154 with a comparable price, 16 with per-payer negotiated rates only. Prices shown are pre-insurance; actual cost depends on your plan, Medicare/Medicaid coverage, or cash-pay discounts.
Procedures published 170
Lowest published price $1,581
Average published price $37,144
Highest published price $296,892
Gross charges are the hospital's listed price — almost no one pays this amount. Your actual cost depends on your insurance plan. Use the cash price (when shown) as a guide for what uninsured patients are charged, and contact the hospital or your insurer for a personalized cost estimate.
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Find your insurer's rate
Choose your insurance company to add its median negotiated rate for each procedure as a column in the table below.
Rates come from the hospital's own published price file and are medians across that insurer's plans. Your specific plan, network tier, and benefit design can differ — confirm with your insurer.
Showing all 170 procedures
Published charges
Showing all 154 procedures with a comparable published price (gross, cash, or insurance-negotiated median), sorted highest to lowest. Green = this hospital prices below the median; amber = above.
| DRG | Description | Published price | Cash price | vs. MT median | vs. National median | ||
|---|---|---|---|---|---|---|---|
| 742 | UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC | $296,892 | $237,514 | $42,055 | +606% | $40,552 | +632% |
| 472 | CERVICAL SPINAL FUSION WITH CC | $210,825 | $168,660 | $64,633 | +226% | $59,537 | +254% |
| 454 | COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC | $177,951 | $142,361 | $144,603 | +23% | $69,101 | +158% |
| 455 | COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC | $158,341 | $126,672 | $136,710 | +16% | $56,836 | +179% |
| 460 | SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | $132,364 | $105,891 | $62,179 | +113% | $51,625 | +156% |
| 517 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC | $127,702 | $102,161 | $39,906 | +220% | $33,393 | +282% |
| 270 | OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC | $110,878 | $88,702 | $110,878 | +0% | $99,423 | +12% |
| 853 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | $93,241 | $74,593 | $50,839 | +83% | $93,172 | +0% |
| 056 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | $89,620 | $71,696 | $40,085 | +124% | $39,973 | +124% |
| 813 | COAGULATION DISORDERS | $88,472 | $70,777 | $43,313 | +104% | $33,296 | +166% |
| 551 | MEDICAL BACK PROBLEMS WITH MCC | $84,684 | $67,747 | $14,087 | +501% | $34,017 | +149% |
| 602 | CELLULITIS WITH MCC | $82,568 | $66,055 | $22,252 | +271% | $30,598 | +170% |
| 355 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC | $82,351 | $65,881 | $32,561 | +153% | $32,841 | +151% |
| 074 | CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | $80,131 | $64,105 | $7,793 | +928% | $23,141 | +246% |
| 661 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | $77,084 | $61,668 | $27,989 | +175% | $25,970 | +197% |
| 908 | OTHER O.R. PROCEDURES FOR INJURIES WITH CC | $76,906 | $61,525 | $30,701 | +151% | $42,914 | +79% |
| 329 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | $76,140 | $60,912 | $42,071 | +81% | $88,050 | −14% |
| 483 | MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | $72,795 | $58,236 | $80,953 | −10% | $58,707 | +24% |
| 467 | REVISION OF HIP OR KNEE REPLACEMENT WITH CC | $72,783 | $58,227 | $48,938 | +49% | $70,847 | +3% |
| 843 | OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC | $68,084 | $54,467 | $34,120 | +100% | $36,431 | +87% |
| 896 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC | $67,619 | $54,095 | $22,416 | +202% | $31,159 | +117% |
| 644 | ENDOCRINE DISORDERS WITH CC | $65,953 | $52,763 | $22,639 | +191% | $23,198 | +184% |
| 208 | RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | $64,358 | $51,486 | $46,723 | +38% | $52,405 | +23% |
| 544 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC | $62,318 | $49,854 | $13,001 | +379% | $16,776 | +271% |
| 432 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | $61,245 | $48,996 | $18,838 | +225% | $40,213 | +52% |
| 071 | OTHER CEREBROVASCULAR DISORDERS WITH CC | $60,366 | $48,293 | $9,230 | +554% | $23,488 | +157% |
| 657 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC | $59,370 | $47,496 | $57,476 | +3% | $43,298 | +37% |
| 251 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC | $58,329 | $46,663 | $58,329 | +0% | $46,295 | +26% |
| 884 | ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | $54,608 | $43,687 | $18,761 | +191% | $26,682 | +105% |
| 555 | SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $53,049 | $42,439 | $33,646 | +58% | $24,127 | +120% |
| 469 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT | $53,008 | $42,406 | $53,008 | +0% | $65,788 | −19% |
| 195 | SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC | $52,454 | $41,963 | $7,089 | +640% | $13,824 | +279% |
| 561 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | $51,923 | $41,539 | $16,572 | +213% | $18,150 | +186% |
| 470 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | $49,344 | $39,475 | $42,798 | +15% | $50,607 | −2% |
| 480 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | $48,688 | $38,950 | $47,396 | +3% | $65,653 | −26% |
| 521 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC | $48,348 | $38,678 | $50,269 | −4% | $70,467 | −31% |
| 559 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $48,146 | $38,517 | $15,618 | +208% | $33,047 | +46% |
| 536 | FRACTURES OF HIP AND PELVIS WITHOUT MCC | $47,865 | $38,292 | $6,876 | +596% | $18,002 | +166% |
| 659 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC | $47,528 | $38,022 | $47,528 | +0% | $52,178 | −9% |
| 330 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | $47,158 | $37,726 | $47,158 | +0% | $59,500 | −21% |
| 658 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC | $46,547 | $37,238 | $40,283 | +16% | $36,253 | +28% |
| 494 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC | $45,916 | $36,733 | $35,507 | +29% | $47,711 | −4% |
| 478 | BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | $43,442 | $34,753 | $31,355 | — | $50,139 | −13% |
| 391 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | $41,932 | $33,545 | $13,378 | +213% | $28,050 | +49% |
| 331 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | $41,298 | $33,038 | $35,950 | +15% | $44,117 | −6% |
| 560 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | $41,144 | $32,915 | $15,453 | +166% | $25,279 | +63% |
| 983 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC | $40,705 | $32,564 | $22,075 | +84% | $34,607 | +18% |
| 039 | EXTRACRANIAL PROCEDURES WITHOUT CC/MCC | $40,591 | $32,473 | $31,640 | +28% | $26,618 | +52% |
| 707 | MAJOR MALE PELVIC PROCEDURES WITH CC/MCC | $40,175 | $32,140 | $40,175 | +0% | $43,080 | −7% |
| 863 | POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC | $38,536 | $30,828 | $10,118 | +281% | $20,957 | +84% |
| 243 | PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | $38,168 | $30,535 | $38,168 | +0% | $50,011 | −24% |
| 282 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | $36,466 | $29,173 | $14,125 | +158% | $19,227 | +90% |
| 786 | CESAREAN SECTION WITHOUT STERILIZATION WITH MCC | $36,107 | $28,886 | $22,307 | +62% | $27,152 | +33% |
| 482 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | $35,138 | $28,111 | $28,839 | +22% | $41,955 | −16% |
| 070 | OTHER CEREBROVASCULAR DISORDERS WITH MCC | $34,994 | $27,995 | $13,189 | +165% | $31,951 | +10% |
| 064 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | $34,732 | $27,786 | $18,509 | +88% | $39,106 | −11% |
| 254 | OTHER VASCULAR PROCEDURES WITHOUT CC/MCC | $34,194 | $27,355 | $34,194 | +0% | $38,836 | −12% |
| 072 | OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC | $33,085 | $26,468 | $33,085 | +0% | $19,037 | +74% |
| 383 | UNCOMPLICATED PEPTIC ULCER WITH MCC | $32,835 | $26,268 | $26,801 | +23% | $27,426 | +20% |
| 299 | PERIPHERAL VASCULAR DISORDERS WITH MCC | $31,677 | $25,342 | $21,669 | +46% | $27,316 | +16% |
| 244 | PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC | $31,586 | $25,268 | $31,586 | +0% | $41,591 | −24% |
| 549 | SEPTIC ARTHRITIS WITH CC | $30,837 | $24,670 | $23,044 | +34% | $24,056 | +28% |
| 308 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | $30,345 | $24,276 | $17,588 | +73% | $26,770 | +13% |
| 548 | SEPTIC ARTHRITIS WITH MCC | $30,032 | $24,026 | $30,032 | +0% | $31,346 | −4% |
| 708 | MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC | $29,697 | $23,758 | $21,761 | — | $36,988 | −20% |
| 696 | KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC | $29,217 | $23,374 | $13,852 | +111% | $14,689 | +99% |
| 682 | RENAL FAILURE WITH MCC | $29,054 | $23,243 | $14,892 | +95% | $29,064 | −0% |
| 949 | AFTERCARE WITH CC/MCC | $28,771 | $23,017 | $20,965 | +37% | $23,953 | +20% |
| 287 | CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | $28,667 | $22,933 | $28,667 | +0% | $32,021 | −10% |
| 638 | DIABETES WITH CC | $28,070 | $22,456 | $13,743 | +104% | $19,661 | +43% |
| 854 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | $26,739 | $21,391 | $28,959 | −8% | $43,943 | −39% |
| 093 | OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC | $26,452 | $21,162 | $11,209 | +136% | $17,620 | +50% |
| 617 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | $26,309 | $21,047 | $25,039 | +5% | $42,881 | −39% |
| 281 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | $25,188 | $20,150 | $17,222 | +46% | $20,463 | +23% |
| 743 | UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC | $25,051 | $20,041 | $23,759 | +5% | $30,784 | −19% |
| 768 | VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C | $24,872 | $19,898 | $14,868 | +67% | $16,846 | +48% |
| 375 | DIGESTIVE MALIGNANCY WITH CC | $24,173 | $19,338 | $24,173 | +0% | $27,277 | −11% |
| 788 | CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC | $24,150 | $19,320 | $19,466 | +24% | $20,084 | +20% |
| 917 | POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | $23,681 | $18,945 | $23,081 | +3% | $30,235 | −22% |
| 066 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | $23,630 | $18,904 | $12,779 | +85% | $20,781 | +14% |
| 377 | GASTROINTESTINAL HEMORRHAGE WITH MCC | $23,410 | $18,728 | $17,493 | +34% | $37,842 | −38% |
| 179 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC | $23,348 | $18,678 | $6,308 | +270% | $14,648 | +59% |
| 787 | CESAREAN SECTION WITHOUT STERILIZATION WITH CC | $23,265 | $18,612 | $18,367 | +27% | $23,571 | −1% |
| 698 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | $22,757 | $18,206 | $12,851 | +77% | $32,496 | −30% |
| 378 | GASTROINTESTINAL HEMORRHAGE WITH CC | $22,670 | $18,136 | $9,048 | +151% | $22,098 | +3% |
| 092 | OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | $21,506 | $17,205 | $11,836 | +82% | $24,914 | −14% |
| 945 | REHABILITATION WITH CC/MCC | $21,284 | $17,027 | $16,910 | — | $23,834 | −11% |
| 785 | CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC | $21,010 | $16,808 | $19,916 | +5% | $19,846 | +6% |
| 292 | HEART FAILURE AND SHOCK WITH CC | $20,779 | $16,623 | $15,309 | +36% | $16,371 | +27% |
| 808 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC | $20,043 | $16,034 | $23,852 | −16% | $39,181 | −49% |
| 065 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | $19,963 | $15,971 | $15,048 | +33% | $23,940 | −17% |
| 689 | KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | $19,864 | $15,891 | $10,188 | +95% | $23,617 | −16% |
| 872 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | $19,789 | $15,831 | $14,252 | +39% | $22,888 | −14% |
| 784 | CESAREAN SECTION WITH STERILIZATION WITH CC | $19,128 | $15,303 | $20,455 | −6% | $23,283 | −18% |
| 832 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC | $18,979 | $15,183 | $12,528 | +51% | $12,895 | +47% |
| 315 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | $18,966 | $15,173 | $21,092 | −10% | $21,363 | −11% |
| 639 | DIABETES WITHOUT CC/MCC | $18,432 | $14,746 | $6,073 | +204% | $13,910 | +33% |
| 637 | DIABETES WITH MCC | $18,088 | $14,470 | $24,134 | −25% | $30,100 | −40% |
| 392 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | $17,936 | $14,349 | $8,669 | +107% | $17,322 | +4% |
| 552 | MEDICAL BACK PROBLEMS WITHOUT MCC | $17,754 | $14,203 | $11,652 | +52% | $21,396 | −17% |
| 660 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | $17,703 | $14,162 | $20,128 | −12% | $31,264 | −43% |
| 372 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | $17,547 | $14,037 | $11,299 | +55% | $22,850 | −23% |
| 189 | PULMONARY EDEMA AND RESPIRATORY FAILURE | $17,540 | $14,032 | $17,540 | +0% | $26,580 | −34% |
| 603 | CELLULITIS WITHOUT MCC | $17,397 | $13,918 | $11,801 | +47% | $18,530 | −6% |
| 194 | SIMPLE PNEUMONIA AND PLEURISY WITH CC | $17,167 | $13,733 | $10,376 | +65% | $18,204 | −6% |
| 690 | KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | $17,019 | $13,615 | $5,574 | +205% | $17,674 | −4% |
| 433 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC | $16,529 | $13,223 | $16,529 | +0% | $23,749 | −30% |
| 389 | GASTROINTESTINAL OBSTRUCTION WITH CC | $15,921 | $12,737 | $7,890 | +102% | $17,578 | −9% |
| 293 | HEART FAILURE AND SHOCK WITHOUT CC/MCC | $15,785 | $12,628 | $9,104 | +73% | $12,999 | +21% |
| 812 | RED BLOOD CELL DISORDERS WITHOUT MCC | $15,756 | $12,605 | $8,187 | +92% | $20,488 | −23% |
| 982 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC | $15,567 | $12,454 | $20,244 | −23% | $51,985 | −70% |
| 580 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC | $15,417 | $12,334 | $18,658 | −17% | $38,101 | −60% |
| 310 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | $15,362 | $12,290 | $10,700 | +44% | $13,384 | +15% |
| 683 | RENAL FAILURE WITH CC | $15,280 | $12,224 | $15,280 | +0% | $19,130 | −20% |
| 793 | FULL TERM NEONATE WITH MAJOR PROBLEMS | $15,154 | $12,123 | $5,005 | +203% | $18,649 | −19% |
| 439 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | $14,924 | $11,939 | $9,693 | +54% | $19,096 | −22% |
| 894 | ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA | $14,515 | $11,612 | $6,662 | +118% | $12,324 | +18% |
| 687 | KIDNEY AND URINARY TRACT NEOPLASMS WITH CC | $13,992 | $11,194 | $13,992 | +0% | $20,232 | −31% |
| 640 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | $13,701 | $10,961 | $12,721 | +8% | $25,463 | −46% |
| 202 | BRONCHITIS AND ASTHMA WITH CC/MCC | $13,611 | $10,889 | $7,230 | +88% | $17,724 | −23% |
| 805 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC | $13,294 | $10,635 | $14,648 | −9% | $15,370 | −14% |
| 312 | SYNCOPE AND COLLAPSE | $13,232 | $10,586 | $13,232 | +0% | $19,342 | −32% |
| 918 | POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC | $13,172 | $10,537 | $13,172 | +0% | $15,452 | −15% |
| 809 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC | $13,138 | $10,511 | $13,138 | +0% | $22,458 | −41% |
| 309 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | $13,102 | $10,482 | $5,241 | +150% | $17,303 | −24% |
| 125 | OTHER DISORDERS OF THE EYE WITHOUT MCC | $13,010 | $10,408 | $13,010 | +0% | $17,298 | −25% |
| 390 | GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | $12,873 | $10,299 | $6,120 | +110% | $13,361 | −4% |
| 394 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | $12,677 | $10,142 | $9,421 | +35% | $20,181 | −37% |
| 522 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | $12,280 | $9,824 | $40,998 | −70% | $58,280 | −79% |
| 641 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | $12,169 | $9,735 | $8,886 | +37% | $17,038 | −29% |
| 806 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC | $12,164 | $9,731 | $11,077 | +10% | $13,275 | −8% |
| 807 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC | $11,747 | $9,397 | $11,747 | +0% | $12,078 | −3% |
| 186 | PLEURAL EFFUSION WITH MCC | $11,636 | $9,309 | $12,286 | −5% | $33,834 | −66% |
| 897 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | $11,481 | $9,185 | $5,130 | +124% | $16,699 | −31% |
| 180 | RESPIRATORY NEOPLASMS WITH MCC | $11,346 | $9,076 | $19,207 | −41% | $36,658 | −69% |
| 798 | VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC | $11,041 | $8,832 | $10,787 | +2% | $18,452 | −40% |
| 300 | PERIPHERAL VASCULAR DISORDERS WITH CC | $10,606 | $8,485 | $13,350 | −21% | $20,422 | −48% |
| 539 | OSTEOMYELITIS WITH MCC | $10,493 | $8,395 | $17,220 | −39% | $37,609 | −72% |
| 601 | NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC | $10,373 | $8,298 | $10,373 | +0% | $10,975 | −5% |
| 191 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | $10,105 | $8,084 | $8,187 | +23% | $18,807 | −46% |
| 791 | PREMATURITY WITH MAJOR PROBLEMS | $8,822 | $7,057 | $12,802 | −31% | $42,679 | −79% |
| 203 | BRONCHITIS AND ASTHMA WITHOUT CC/MCC | $8,789 | $7,031 | $6,827 | +29% | $12,252 | −28% |
| 177 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | $8,011 | $6,409 | $18,255 | −56% | $33,707 | −76% |
| 792 | PREMATURITY WITHOUT MAJOR PROBLEMS | $7,376 | $5,901 | $7,196 | +2% | $12,229 | −40% |
| 176 | PULMONARY EMBOLISM WITHOUT MCC | $7,155 | $5,724 | $10,776 | −34% | $18,081 | −60% |
| 379 | GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC | $6,946 | $5,557 | $7,462 | −7% | $15,038 | −54% |
| 885 | PSYCHOSES | $6,568 | $5,255 | $7,144 | −8% | $21,729 | −70% |
| 440 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC | $6,356 | $5,085 | $5,707 | +11% | $15,183 | −58% |
| 789 | NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY | $4,827 | $3,862 | $4,951 | −3% | $16,351 | −70% |
| 054 | NERVOUS SYSTEM NEOPLASMS WITH MCC | $3,962 | $3,170 | $10,378 | −62% | $30,502 | −87% |
| 193 | SIMPLE PNEUMONIA AND PLEURISY WITH MCC | $3,807 | $3,045 | $16,189 | −76% | $27,275 | −86% |
| 794 | NEONATE WITH OTHER SIGNIFICANT PROBLEMS | $3,121 | $2,497 | $4,110 | −24% | $8,445 | −63% |
| 291 | HEART FAILURE AND SHOCK WITH MCC | $2,309 | $1,847 | $16,739 | −86% | $26,776 | −91% |
| 880 | ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION | $1,581 | $1,265 | $6,812 | −77% | $17,733 | −91% |
Procedures with negotiated rates only
These 16 procedures have published per-payer insurance agreements but no single comparable dollar amount in the MRF — typically because the agreement is expressed as a percentage of charge, a fee schedule reference, or a contract algorithm. The number of payers indicates how many insurance plans have a negotiated rate on file.
| DRG | Description | Insurance rate range | Payers |
|---|---|---|---|
| 178 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | — | 16 plans |
| 181 | RESPIRATORY NEOPLASMS WITH CC | — | 16 plans |
| 057 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | $9,538 – $9,538 · median $9,538 | 1 plans |
| 101 | SEIZURES WITHOUT MCC | $6,645 – $6,645 · median $6,645 | 1 plans |
| 175 | PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | $10,112 – $10,112 · median $10,112 | 1 plans |
| 190 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | $8,155 – $8,155 · median $8,155 | 1 plans |
| 246 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS | $22,052 – $22,052 · median $22,052 | 1 plans |
| 247 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | $14,057 – $14,057 · median $14,057 | 1 plans |
| 280 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | $11,809 – $11,809 · median $11,809 | 1 plans |
| 481 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | $15,419 – $15,419 · median $15,419 | 1 plans |
| 486 | KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC | $15,394 – $15,394 · median $15,394 | 1 plans |
| 795 | NORMAL NEWBORN | $1,471 – $1,471 · median $1,471 | 1 plans |
| 811 | RED BLOOD CELL DISORDERS WITH MCC | $10,338 – $10,338 · median $10,338 | 1 plans |
| 871 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | $14,300 – $14,300 · median $14,300 | 1 plans |
| 881 | DEPRESSIVE NEUROSES | $6,927 – $6,927 · median $6,927 | 1 plans |
| 951 | OTHER FACTORS INFLUENCING HEALTH STATUS | $4,093 – $4,093 · median $4,093 | 1 plans |
No procedures match that keyword.