Methodist Hospital Stone Oak — Pricing

779 procedures published in this hospital's Machine-Readable File (MRF) — 0 with a comparable price, 779 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 779
Lowest published price —
Average published price —
Highest published price —

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.

Showing all 779 procedures

Procedures with negotiated rates only

These 779 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
796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC $1,900 – $12,540 · median $7,694 17 plans
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $1,900 – $12,540 · median $7,694 17 plans
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $1,900 – $12,540 · median $7,694 17 plans
783 CESAREAN SECTION WITH STERILIZATION WITH MCC Relapse During Zone 3 $3,200 – $15,294 · median $10,993 16 plans
784 CESAREAN SECTION WITH STERILIZATION WITH CC Trauma $3,200 – $15,294 · median $10,993 16 plans
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC Other Inpatient Outside Transplant Zone 4 $3,200 – $15,294 · median $10,993 16 plans
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC Relapse During Zone 3 $3,200 – $15,294 · median $10,993 16 plans
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC $3,200 – $15,294 · median $10,993 16 plans
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC Non Transplant Related Services $1,900 – $12,540 · median $8,089 16 plans
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $1,900 – $12,540 · median $8,089 16 plans
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $1,900 – $12,540 · median $8,089 16 plans
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C Other Inpatient Outside Transplant Zone 4 $1,900 – $12,540 · median $7,694 15 plans
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $3,200 – $15,294 · median $10,792 14 plans
619 O.R. PROCEDURES FOR OBESITY WITH MCC $16,592 – $50,020 · median $27,974 12 plans
620 O.R. PROCEDURES FOR OBESITY WITH CC $16,592 – $50,020 · median $26,486 12 plans
621 O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC $16,592 – $50,020 · median $26,486 12 plans
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $137,695 – $398,948 · median $247,305 8 plans
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $137,695 – $368,935 · median $197,211 8 plans
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC Pediatric $4,700 – $33,973 · median $10,069 8 plans
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $121,322 – $282,848 · median $167,783 7 plans
006 LIVER TRANSPLANT WITHOUT MCC $66,012 – $282,848 · median $167,783 7 plans
010 PANCREAS TRANSPLANT Trauma $59,204 – $148,526 · median $91,095 7 plans
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Pediatric $58,541 – $147,229 · median $79,313 7 plans
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Other Inpatient Outside Transplant Zone 4 $58,541 – $140,502 · median $79,313 7 plans
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA Pediatric $58,541 – $140,502 · median $79,313 7 plans
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER Other Inpatient Outside Transplant Zone 4 $42,769 – $109,308 · median $79,313 7 plans
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER Non Transplant Related Services $42,769 – $108,452 · median $75,918 7 plans
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER Relapse During Zone 3 $42,769 – $102,360 · median $71,939 7 plans
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC Trauma $38,166 – $102,722 · median $71,939 7 plans
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $38,166 – $100,709 · median $71,939 7 plans
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC Other Inpatient Outside Transplant Zone 4 $39,684 – $108,837 · median $72,234 7 plans
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC Trauma $39,684 – $80,722 · median $75,032 7 plans
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC Non Transplant Related Services $38,165 – $83,545 · median $71,939 7 plans
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $38,165 – $80,722 · median $65,069 7 plans
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC Other Inpatient Outside Transplant Zone 4 $17,866 – $36,367 · median $32,986 7 plans
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC Non Transplant Related Services $17,866 – $36,367 · median $32,986 7 plans
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC Other Inpatient Outside Transplant Zone 4 $4,700 – $24,082 · median $10,103 7 plans
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,700 – $19,444 · median $10,103 7 plans
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC Kidney $4,142 – $223,662 · median $100,939 7 plans
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $4,142 – $223,662 · median $100,939 7 plans
652 KIDNEY TRANSPLANT $45,975 – $223,662 · median $100,939 7 plans
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $4,142 – $31,873 · median $25,859 7 plans
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC Pediatric $4,142 – $29,469 · median $14,568 7 plans
215 OTHER HEART ASSIST SYSTEM IMPLANT Other Inpatient Outside Transplant Zone 4 $4,142 – $269,009 · median $104,644 6 plans
231 CORONARY BYPASS WITH PTCA WITH MCC Pediatric $71,352 – $120,008 · median $80,018 6 plans
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $71,352 – $117,290 · median $80,018 6 plans
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $63,435 · median $25,173 6 plans
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC Trauma $4,142 – $47,831 · median $23,203 6 plans
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $47,242 · median $23,203 6 plans
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC Pediatric $4,142 – $97,914 · median $40,495 6 plans
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC Trauma $4,142 – $65,444 · median $40,495 6 plans
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $78,371 · median $40,386 6 plans
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC Non Transplant Related Services $4,142 – $52,681 · median $40,386 6 plans
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $43,422 · median $36,847 6 plans
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $4,142 – $135,977 · median $61,067 6 plans
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR Trauma $4,142 – $125,055 · median $59,228 6 plans
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC Relapse During Zone 3 $4,142 – $119,032 · median $56,733 6 plans
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC Non Transplant Related Services $4,142 – $31,501 · median $13,289 6 plans
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC Relapse During Zone 3 $4,142 – $16,380 · median $12,992 6 plans
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ A Trauma $4,142 – $52,557 · median $29,055 6 plans
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $43,072 · median $22,238 6 plans
693 URINARY STONES WITH MCC $4,142 – $19,140 · median $8,068 6 plans
694 URINARY STONES WITHOUT MCC $4,142 – $13,342 · median $8,068 6 plans
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC Pediatric $4,142 – $29,469 · median $16,098 6 plans
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC Trauma $4,142 – $31,873 · median $27,152 6 plans
209 COMPLEX AORTIC ARCH PROCEDURES Other Inpatient Outside Transplant Zone 4 — 5 plans
212 CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES $4,142 – $154,804 · median $58,541 5 plans
213 ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES Other Inpatient Outside Transplant Zone 4 $4,142 – $84,163 · median $43,837 5 plans
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC $4,142 – $58,731 · median $29,151 5 plans
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC Non Transplant Related Services $4,142 – $46,861 · median $29,151 5 plans
318 PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE Trauma $4,142 – $50,375 · median $33,983 5 plans
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC Pediatric $4,142 – $61,605 · median $17,866 5 plans
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC Relapse During Zone 3 $4,142 – $44,858 · median $17,866 5 plans
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE Relapse During Zone 3 $4,142 – $45,703 · median $17,866 5 plans
359 PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $52,557 · median $40,110 5 plans
360 PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC Non Transplant Related Services $4,142 – $50,210 · median $34,370 5 plans
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $30,323 · median $7,039 5 plans
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $19,155 · median $7,039 5 plans
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS $4,142 – $183,645 · median $139,755 4 plans
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $4,142 – $55,711 · median $47,638 4 plans
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHE Other Inpatient Outside Transplant Zone 4 $4,142 – $55,711 · median $35,454 4 plans
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC $4,142 – $55,711 · median $31,908 4 plans
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $4,142 – $21,851 · median $12,293 4 plans
116 INTRAOCULAR PROCEDURES WITH CC/MCC Trauma $4,142 – $25,740 · median $12,293 4 plans
117 INTRAOCULAR PROCEDURES WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $15,445 · median $12,293 4 plans
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT Relapse During Zone 3 $4,142 – $18,836 · median $6,387 4 plans
125 OTHER DISORDERS OF THE EYE WITHOUT MCC Non Transplant Related Services $4,142 – $10,930 · median $6,387 4 plans
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC Non Transplant Related Services $4,142 – $25,859 · median $14,846 4 plans
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC Pediatric $4,142 – $22,573 · median $13,079 4 plans
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC Non Transplant Related Services $4,142 – $22,573 · median $9,459 4 plans
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC Pediatric $4,142 – $22,573 · median $8,197 4 plans
252 OTHER VASCULAR PROCEDURES WITH MCC Pediatric $4,142 – $51,779 · median $37,089 4 plans
253 OTHER VASCULAR PROCEDURES WITH CC Non Transplant Related Services $4,142 – $37,732 · median $30,735 4 plans
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC Trauma $4,142 – $35,264 · median $24,942 4 plans
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC Trauma $4,142 – $38,400 · median $18,673 4 plans
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $4,142 – $27,243 · median $17,137 4 plans
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $27,243 · median $12,826 4 plans
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $44,731 · median $26,068 4 plans
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $4,142 – $28,787 · median $25,915 4 plans
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC Relapse During Zone 3 $4,142 – $46,307 · median $26,339 4 plans
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC Trauma $4,142 – $32,749 · median $23,421 4 plans
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC Pediatric $4,142 – $32,749 · median $21,566 4 plans
263 VEIN LIGATION AND STRIPPING Pediatric $4,142 – $43,525 · median $20,644 4 plans
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $4,142 – $47,557 · median $39,216 4 plans
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC Non Transplant Related Services $4,142 – $22,836 · median $16,633 4 plans
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC Non Transplant Related Services $4,142 – $20,413 · median $12,764 4 plans
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC Pediatric $4,142 – $18,521 · median $11,369 4 plans
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC Pediatric $4,142 – $28,199 · median $16,029 4 plans
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $4,142 – $19,477 · median $10,622 4 plans
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC $4,142 – $19,477 · median $9,958 4 plans
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $4,142 – $71,001 · median $16,450 4 plans
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $34,796 · median $16,450 4 plans
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $4,142 – $22,810 · median $16,450 4 plans
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $4,142 – $41,313 · median $9,106 4 plans
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $23,951 · median $9,106 4 plans
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $19,147 · median $9,106 4 plans
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC Other Inpatient Outside Transplant Zone 4 $10,035 – $62,536 · median $10,584 4 plans
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC Pediatric $10,035 – $33,106 · median $10,584 4 plans
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Non Transplant Related Services $10,035 – $19,901 · median $10,584 4 plans
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $12,570 · median $9,272 4 plans
402 SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL Trauma $4,142 – $73,323 · median $58,267 4 plans
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC Relapse During Zone 3 $10,035 – $50,717 · median $10,584 4 plans
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $10,035 – $29,422 · median $10,584 4 plans
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC Non Transplant Related Services $10,035 – $19,408 · median $10,584 4 plans
426 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT Pediatric $4,142 – $158,781 · median $115,110 4 plans
427 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT Relapse During Zone 3 $4,142 – $107,659 · median $88,043 4 plans
428 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT Trauma $4,142 – $83,428 · median $76,679 4 plans
429 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC Non Transplant Related Services — 4 plans
430 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC Relapse During Zone 3 $4,142 – $82,919 · median $77,712 4 plans
447 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALL Relapse During Zone 3 — 4 plans
448 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $4,142 – $78,560 · median $61,134 4 plans
450 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY Other Inpatient Outside Transplant Zone 4 $4,142 – $78,560 · median $76,967 4 plans
451 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $78,560 · median $46,382 4 plans
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX $4,142 – $119,631 · median $84,251 4 plans
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX Other Inpatient Outside Transplant Zone 4 $4,142 – $95,179 · median $79,107 4 plans
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX Pediatric $4,142 – $73,323 · median $65,657 4 plans
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC Pediatric $4,142 – $74,104 · median $39,721 4 plans
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC Non Transplant Related Services $4,142 – $50,205 · median $39,832 4 plans
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC Non Transplant Related Services $4,142 – $47,889 · median $35,447 4 plans
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC Trauma $4,142 – $43,181 · median $35,861 4 plans
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT Other Inpatient Outside Transplant Zone 4 $4,142 – $31,774 · median $28,021 4 plans
471 CERVICAL SPINAL FUSION WITH MCC Non Transplant Related Services $4,142 – $68,741 · median $34,651 4 plans
472 CERVICAL SPINAL FUSION WITH CC Pediatric $4,142 – $41,941 · median $35,283 4 plans
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $36,661 · median $33,697 4 plans
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $4,142 – $39,461 · median $20,410 4 plans
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC Relapse During Zone 3 $4,142 – $45,369 · median $39,564 4 plans
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC Relapse During Zone 3 $4,142 – $32,680 · median $21,281 4 plans
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MC Non Transplant Related Services $4,142 – $37,121 · median $17,428 4 plans
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROST Trauma $4,142 – $53,204 · median $29,923 4 plans
535 FRACTURES OF HIP AND PELVIS WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $38,250 · median $12,848 4 plans
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $38,250 · median $9,471 4 plans
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $38,250 · median $9,675 4 plans
548 SEPTIC ARTHRITIS WITH MCC Non Transplant Related Services $4,142 – $38,250 · median $17,467 4 plans
549 SEPTIC ARTHRITIS WITH CC Non Transplant Related Services $4,142 – $38,250 · median $12,316 4 plans
550 SEPTIC ARTHRITIS WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $38,250 · median $9,945 4 plans
551 MEDICAL BACK PROBLEMS WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $23,861 · median $14,254 4 plans
552 MEDICAL BACK PROBLEMS WITHOUT MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $14,482 · median $12,560 4 plans
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $4,142 – $18,817 · median $10,213 4 plans
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $4,142 – $12,979 · median $9,635 4 plans
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC Non Transplant Related Services $4,142 – $21,168 · median $10,213 4 plans
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $4,142 – $12,979 · median $10,081 4 plans
603 CELLULITIS WITHOUT MCC $4,142 – $12,570 · median $9,922 4 plans
683 RENAL FAILURE WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $12,570 · median $9,957 4 plans
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC Trauma $4,142 – $22,573 · median $11,982 4 plans
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC Pediatric $4,142 – $12,570 · median $9,485 4 plans
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC Trauma $4,142 – $26,120 · median $13,243 4 plans
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Pediatric $4,142 – $17,663 · median $10,937 4 plans
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC Relapse During Zone 3 — 4 plans
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC Trauma — 4 plans
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA Other Inpatient Outside Transplant Zone 4 $4,142 – $95,824 · median $52,316 4 plans
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA Trauma $4,142 – $141,983 · median $86,556 4 plans
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC Pediatric $4,142 – $169,487 · median $125,587 4 plans
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC Relapse During Zone 3 $4,142 – $164,549 · median $99,265 4 plans
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $164,549 · median $88,868 4 plans
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC Trauma $4,142 – $38,918 · median $27,948 4 plans
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC Non Transplant Related Services $4,142 – $30,346 · median $23,434 4 plans
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $4,142 – $29,462 · median $19,097 4 plans
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $77,645 · median $10,103 3 plans
012 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC Trauma $4,142 – $60,019 · median $10,103 3 plans
013 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC Non Transplant Related Services $4,142 – $41,025 · median $10,103 3 plans
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $4,142 – $117,753 · median $112,020 3 plans
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC Trauma $4,142 – $120,107 · median $75,363 3 plans
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/ Other Inpatient Outside Transplant Zone 4 $4,142 – $115,466 · median $45,233 3 plans
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WI Trauma $4,142 – $88,576 · median $81,577 3 plans
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WI Relapse During Zone 3 $4,142 – $84,929 · median $55,690 3 plans
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $64,727 · median $54,812 3 plans
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $51,733 · median $44,263 3 plans
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $50,221 · median $35,916 3 plans
028 SPINAL PROCEDURES WITH MCC Pediatric $4,142 – $85,534 · median $28,501 3 plans
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $4,142 – $48,568 · median $30,736 3 plans
030 SPINAL PROCEDURES WITHOUT CC/MCC Pediatric $4,142 – $31,251 · median $27,940 3 plans
031 VENTRICULAR SHUNT PROCEDURES WITH MCC Pediatric $4,142 – $63,784 · median $28,477 3 plans
032 VENTRICULAR SHUNT PROCEDURES WITH CC Trauma $4,142 – $30,337 · median $28,477 3 plans
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC $4,142 – $27,920 · median $23,673 3 plans
034 CAROTID ARTERY STENT PROCEDURES WITH MCC Pediatric $4,142 – $55,103 · median $10,609 3 plans
035 CAROTID ARTERY STENT PROCEDURES WITH CC Trauma $4,142 – $34,031 · median $10,609 3 plans
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $27,658 · median $10,609 3 plans
037 EXTRACRANIAL PROCEDURES WITH MCC $4,142 – $46,866 · median $12,026 3 plans
038 EXTRACRANIAL PROCEDURES WITH CC Pediatric $4,142 – $23,099 · median $10,428 3 plans
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $16,734 · median $12,126 3 plans
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC Relapse During Zone 3 $4,142 – $25,786 · median $7,446 3 plans
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $13,940 · median $7,446 3 plans
054 NERVOUS SYSTEM NEOPLASMS WITH MCC Pediatric $4,142 – $21,737 · median $7,446 3 plans
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $4,142 – $14,515 · median $7,446 3 plans
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC Non Transplant Related Services $4,142 – $33,072 · median $7,446 3 plans
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC Non Transplant Related Services $4,142 – $18,444 · median $7,446 3 plans
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC Pediatric $4,142 – $24,336 · median $7,446 3 plans
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC Non Transplant Related Services $4,142 – $17,665 · median $7,446 3 plans
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $13,094 · median $7,446 3 plans
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A Pediatric $4,142 – $39,250 · median $7,446 3 plans
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A Non Transplant Related Services $4,142 – $25,016 · median $7,446 3 plans
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A Trauma $4,142 – $19,985 · median $7,446 3 plans
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $28,629 · median $7,446 3 plans
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS Pediatric $4,142 – $14,383 · median $7,446 3 plans
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC Trauma $4,142 – $9,743 · median $7,446 3 plans
067 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $20,908 · median $7,446 3 plans
068 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC Trauma $4,142 – $12,306 · median $7,446 3 plans
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC Relapse During Zone 3 $4,142 – $11,372 · median $7,446 3 plans
070 OTHER CEREBROVASCULAR DISORDERS WITH MCC $4,142 – $23,700 · median $7,446 3 plans
071 OTHER CEREBROVASCULAR DISORDERS WITH CC Relapse During Zone 3 $4,142 – $14,606 · median $7,446 3 plans
072 OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $4,142 – $10,765 · median $7,446 3 plans
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC Non Transplant Related Services $4,142 – $22,839 · median $7,446 3 plans
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC Relapse During Zone 3 $4,142 – $14,674 · median $7,446 3 plans
075 VIRAL MENINGITIS WITH CC/MCC Pediatric $4,142 – $27,298 · median $7,446 3 plans
076 VIRAL MENINGITIS WITHOUT CC/MCC Non Transplant Related Services $4,142 – $11,748 · median $7,446 3 plans
080 NONTRAUMATIC STUPOR AND COMA WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $25,767 · median $7,446 3 plans
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC Trauma $4,142 – $12,750 · median $7,446 3 plans
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $4,142 – $32,538 · median $26,098 3 plans
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $4,142 – $25,653 · median $19,871 3 plans
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC Pediatric $4,142 – $22,269 · median $13,607 3 plans
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC Pediatric $4,142 – $32,343 · median $22,540 3 plans
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC Trauma $4,142 – $22,264 · median $18,545 3 plans
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC Non Transplant Related Services $4,142 – $21,884 · median $13,022 3 plans
088 CONCUSSION WITH MCC Trauma $4,142 – $19,244 · median $7,446 3 plans
089 CONCUSSION WITH CC Non Transplant Related Services $4,142 – $15,640 · median $7,446 3 plans
090 CONCUSSION WITHOUT CC/MCC $4,142 – $11,719 · median $7,446 3 plans
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC Non Transplant Related Services $4,142 – $25,001 · median $7,446 3 plans
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC Trauma $4,142 – $14,563 · median $7,446 3 plans
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC Non Transplant Related Services $4,142 – $11,336 · median $7,446 3 plans
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC Non Transplant Related Services $4,142 – $50,102 · median $7,446 3 plans
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC Relapse During Zone 3 $4,142 – $36,717 · median $7,446 3 plans
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC Non Transplant Related Services $4,142 – $36,717 · median $7,446 3 plans
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC Trauma $4,142 – $51,418 · median $7,446 3 plans
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC Pediatric $4,142 – $32,670 · median $7,446 3 plans
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $19,395 · median $7,446 3 plans
100 SEIZURES WITH MCC Trauma $4,142 – $27,572 · median $7,446 3 plans
101 SEIZURES WITHOUT MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $12,849 · median $7,446 3 plans
102 HEADACHES WITH MCC Trauma $4,142 – $15,957 · median $7,446 3 plans
103 HEADACHES WITHOUT MCC Trauma $4,142 – $11,906 · median $7,446 3 plans
113 ORBITAL PROCEDURES WITH CC/MCC Trauma $4,142 – $33,470 · median $10,103 3 plans
114 ORBITAL PROCEDURES WITHOUT CC/MCC Trauma $4,142 – $19,261 · median $10,103 3 plans
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $4,142 – $16,561 · median $7,446 3 plans
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $11,187 · median $7,446 3 plans
123 NEUROLOGICAL EYE DISORDERS Pediatric $4,142 – $11,369 · median $7,446 3 plans
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC Pediatric $4,142 – $30,892 · median $10,103 3 plans
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC Non Transplant Related Services $4,142 – $14,454 · median $10,103 3 plans
137 MOUTH PROCEDURES WITH CC/MCC Trauma $4,142 – $21,257 · median $10,103 3 plans
138 MOUTH PROCEDURES WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $12,616 · median $10,103 3 plans
139 SALIVARY GLAND PROCEDURES Trauma $4,142 – $17,591 · median $10,103 3 plans
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $60,721 · median $10,103 3 plans
141 MAJOR HEAD AND NECK PROCEDURES WITH CC Relapse During Zone 3 $4,142 – $31,050 · median $10,103 3 plans
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC Non Transplant Related Services $4,142 – $22,726 · median $10,103 3 plans
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC Non Transplant Related Services $4,142 – $53,337 · median $10,103 3 plans
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $4,142 – $24,670 · median $10,103 3 plans
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC Trauma $4,142 – $17,116 · median $10,103 3 plans
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC Non Transplant Related Services $4,142 – $30,143 · median $7,446 3 plans
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC Relapse During Zone 3 $4,142 – $18,101 · median $7,446 3 plans
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC Trauma $4,142 – $11,348 · median $7,446 3 plans
149 DYSEQUILIBRIUM Pediatric $4,142 – $10,700 · median $7,446 3 plans
150 EPISTAXIS WITH MCC Non Transplant Related Services $4,142 – $18,955 · median $7,446 3 plans
151 EPISTAXIS WITHOUT MCC Trauma $4,142 – $10,449 · median $7,446 3 plans
152 OTITIS MEDIA AND URI WITH MCC Pediatric $4,142 – $16,830 · median $7,446 3 plans
153 OTITIS MEDIA AND URI WITHOUT MCC $4,142 – $10,509 · median $7,446 3 plans
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $4,142 – $22,258 · median $7,446 3 plans
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC Non Transplant Related Services $4,142 – $13,047 · median $7,446 3 plans
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $9,839 · median $7,446 3 plans
157 DENTAL AND ORAL DISEASES WITH MCC Pediatric $4,142 – $24,440 · median $7,446 3 plans
158 DENTAL AND ORAL DISEASES WITH CC Non Transplant Related Services $4,142 – $12,952 · median $7,446 3 plans
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC Trauma $4,142 – $10,086 · median $7,446 3 plans
163 MAJOR CHEST PROCEDURES WITH MCC Trauma $4,142 – $63,803 · median $10,103 3 plans
164 MAJOR CHEST PROCEDURES WITH CC Pediatric $4,142 – $35,932 · median $10,103 3 plans
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC Pediatric $4,142 – $27,251 · median $10,103 3 plans
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC Trauma $4,142 – $53,210 · median $10,103 3 plans
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC Non Transplant Related Services $4,142 – $25,673 · median $10,103 3 plans
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $4,142 – $19,452 · median $10,103 3 plans
173 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY Other Inpatient Outside Transplant Zone 4 $4,142 – $42,372 · median $10,103 3 plans
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE Relapse During Zone 3 $4,142 – $19,555 · median $7,446 3 plans
176 PULMONARY EMBOLISM WITHOUT MCC Non Transplant Related Services $4,142 – $11,460 · median $7,446 3 plans
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC Pediatric $4,142 – $13,894 · median $7,446 3 plans
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC Trauma $4,142 – $10,748 · median $7,446 3 plans
180 RESPIRATORY NEOPLASMS WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $25,141 · median $7,446 3 plans
181 RESPIRATORY NEOPLASMS WITH CC Pediatric $4,142 – $15,247 · median $7,446 3 plans
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC Non Transplant Related Services $4,142 – $10,731 · median $7,446 3 plans
183 MAJOR CHEST TRAUMA WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $21,780 · median $7,446 3 plans
184 MAJOR CHEST TRAUMA WITH CC Trauma $4,142 – $15,149 · median $7,446 3 plans
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $11,197 · median $7,446 3 plans
186 PLEURAL EFFUSION WITH MCC Relapse During Zone 3 $4,142 – $22,187 · median $7,446 3 plans
187 PLEURAL EFFUSION WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $14,081 · median $7,446 3 plans
188 PLEURAL EFFUSION WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $10,210 · median $7,446 3 plans
189 PULMONARY EDEMA AND RESPIRATORY FAILURE Trauma $4,142 – $17,587 · median $7,446 3 plans
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC Relapse During Zone 3 $4,142 – $15,769 · median $7,446 3 plans
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $12,001 · median $7,446 3 plans
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC Trauma $4,142 – $9,140 · median $7,446 3 plans
196 INTERSTITIAL LUNG DISEASE WITH MCC Trauma $4,142 – $26,866 · median $7,446 3 plans
197 INTERSTITIAL LUNG DISEASE WITH CC Relapse During Zone 3 $4,142 – $13,511 · median $7,446 3 plans
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $10,196 · median $7,446 3 plans
199 PNEUMOTHORAX WITH MCC Non Transplant Related Services $4,142 – $25,114 · median $7,446 3 plans
200 PNEUMOTHORAX WITH CC Non Transplant Related Services $4,142 – $15,650 · median $7,446 3 plans
201 PNEUMOTHORAX WITHOUT CC/MCC Trauma $4,142 – $10,180 · median $7,446 3 plans
202 BRONCHITIS AND ASTHMA WITH CC/MCC Trauma $4,142 – $13,826 · median $7,446 3 plans
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $4,142 – $9,538 · median $7,446 3 plans
204 RESPIRATORY SIGNS AND SYMPTOMS Non Transplant Related Services $4,142 – $11,494 · median $7,446 3 plans
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC Trauma $4,142 – $26,066 · median $7,446 3 plans
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC Trauma $4,142 – $13,398 · median $7,446 3 plans
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS Other Inpatient Outside Transplant Zone 4 $4,142 – $91,604 · median $7,446 3 plans
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS Relapse During Zone 3 $4,142 – $39,130 · median $7,446 3 plans
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $70,065 · median $10,103 3 plans
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC Non Transplant Related Services $4,142 – $40,580 · median $10,103 3 plans
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC Pediatric $4,142 – $19,708 · median $10,103 3 plans
245 AICD GENERATOR PROCEDURES $4,142 – $66,382 · median $64,950 3 plans
265 AICD LEAD PROCEDURES Trauma $4,142 – $51,509 · median $47,741 3 plans
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC Trauma $4,142 – $152,395 · median $87,244 3 plans
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC Trauma $4,142 – $119,210 · median $67,775 3 plans
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES Other Inpatient Outside Transplant Zone 4 $4,142 – $79,240 · median $51,779 3 plans
279 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES Pediatric $4,142 – $51,341 · median $36,325 3 plans
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $4,142 – $38,525 · median $15,030 3 plans
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC Non Transplant Related Services $4,142 – $24,299 · median $15,030 3 plans
290 ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC $4,142 – $15,030 · median $13,235 3 plans
291 HEART FAILURE AND SHOCK WITH MCC $4,142 – $18,276 · median $17,122 3 plans
292 HEART FAILURE AND SHOCK WITH CC Pediatric $4,142 – $13,737 · median $12,086 3 plans
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC Trauma $4,142 – $13,206 · median $8,058 3 plans
296 CARDIAC ARREST, UNEXPLAINED WITH MCC Trauma $4,142 – $22,235 · median $7,446 3 plans
297 CARDIAC ARREST, UNEXPLAINED WITH CC Non Transplant Related Services $4,142 – $9,026 · median $7,446 3 plans
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC Non Transplant Related Services $4,142 – $7,446 · median $6,479 3 plans
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $4,142 – $23,243 · median $12,298 3 plans
300 PERIPHERAL VASCULAR DISORDERS WITH CC $4,142 – $15,197 · median $10,613 3 plans
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC Trauma $4,142 – $10,246 · median $10,218 3 plans
302 ATHEROSCLEROSIS WITH MCC Non Transplant Related Services $4,142 – $17,035 · median $7,446 3 plans
303 ATHEROSCLEROSIS WITHOUT MCC Non Transplant Related Services $4,142 – $9,584 · median $7,446 3 plans
304 HYPERTENSION WITH MCC Non Transplant Related Services $4,142 – $16,941 · median $7,446 3 plans
305 HYPERTENSION WITHOUT MCC Trauma $4,142 – $10,750 · median $7,446 3 plans
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $22,433 · median $7,446 3 plans
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC Relapse During Zone 3 $4,142 – $13,000 · median $7,446 3 plans
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $4,142 – $17,140 · median $7,446 3 plans
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC Relapse During Zone 3 $4,142 – $10,473 · median $7,446 3 plans
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC Pediatric $4,142 – $8,059 · median $7,446 3 plans
311 ANGINA PECTORIS $4,142 – $9,992 · median $7,446 3 plans
312 SYNCOPE AND COLLAPSE Pediatric $4,142 – $12,408 · median $7,446 3 plans
313 CHEST PAIN Trauma $4,142 – $10,250 · median $9,484 3 plans
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC Trauma $4,142 – $29,685 · median $7,446 3 plans
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC Trauma $4,142 – $13,714 · median $7,446 3 plans
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC Trauma $4,142 – $9,710 · median $7,446 3 plans
317 CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION Other Inpatient Outside Transplant Zone 4 $4,142 – $95,189 · median $83,160 3 plans
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $77,848 · median $63,534 3 plans
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC Trauma $4,142 – $44,568 · median $34,242 3 plans
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric $4,142 – $65,436 · median $10,103 3 plans
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Non Transplant Related Services $4,142 – $34,127 · median $10,103 3 plans
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Trauma $4,142 – $23,958 · median $10,103 3 plans
332 RECTAL RESECTION WITH MCC Pediatric $4,142 – $51,544 · median $10,103 3 plans
333 RECTAL RESECTION WITH CC Trauma $4,142 – $33,344 · median $10,103 3 plans
334 RECTAL RESECTION WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $23,317 · median $10,103 3 plans
335 PERITONEAL ADHESIOLYSIS WITH MCC $4,142 – $50,835 · median $10,103 3 plans
336 PERITONEAL ADHESIOLYSIS WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $30,019 · median $10,103 3 plans
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC Trauma $4,142 – $21,852 · median $10,103 3 plans
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $36,769 · median $10,103 3 plans
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC Relapse During Zone 3 $4,142 – $21,421 · median $10,103 3 plans
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $16,887 · median $10,103 3 plans
347 ANAL AND STOMAL PROCEDURES WITH MCC Pediatric $4,142 – $32,680 · median $10,103 3 plans
348 ANAL AND STOMAL PROCEDURES WITH CC Pediatric $4,142 – $18,632 · median $10,103 3 plans
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $12,394 · median $10,103 3 plans
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC Trauma $4,142 – $35,475 · median $10,103 3 plans
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $21,703 · median $10,103 3 plans
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC $4,142 – $16,625 · median $10,103 3 plans
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC Pediatric $4,142 – $22,662 · median $7,446 3 plans
369 MAJOR ESOPHAGEAL DISORDERS WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $14,239 · median $7,446 3 plans
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $9,977 · median $7,446 3 plans
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC Pediatric $4,142 – $25,242 · median $7,446 3 plans
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $14,535 · median $7,446 3 plans
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC Trauma $4,142 – $10,355 · median $7,446 3 plans
374 DIGESTIVE MALIGNANCY WITH MCC Trauma $4,142 – $30,447 · median $7,446 3 plans
375 DIGESTIVE MALIGNANCY WITH CC Pediatric $4,142 – $17,220 · median $7,446 3 plans
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC Non Transplant Related Services $4,142 – $13,158 · median $7,446 3 plans
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $4,142 – $26,023 · median $7,446 3 plans
378 GASTROINTESTINAL HEMORRHAGE WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $13,961 · median $7,446 3 plans
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC Trauma $4,142 – $8,974 · median $7,446 3 plans
380 COMPLICATED PEPTIC ULCER WITH MCC Non Transplant Related Services $4,142 – $27,934 · median $7,446 3 plans
381 COMPLICATED PEPTIC ULCER WITH CC Non Transplant Related Services $4,142 – $15,425 · median $7,446 3 plans
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC Pediatric $4,142 – $11,397 · median $7,446 3 plans
383 UNCOMPLICATED PEPTIC ULCER WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $19,656 · median $7,446 3 plans
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $4,142 – $12,169 · median $7,446 3 plans
385 INFLAMMATORY BOWEL DISEASE WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $22,526 · median $7,446 3 plans
386 INFLAMMATORY BOWEL DISEASE WITH CC Relapse During Zone 3 $4,142 – $13,899 · median $7,446 3 plans
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC Non Transplant Related Services $4,142 – $9,699 · median $7,446 3 plans
388 GASTROINTESTINAL OBSTRUCTION WITH MCC Pediatric $4,142 – $21,024 · median $7,446 3 plans
389 GASTROINTESTINAL OBSTRUCTION WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $11,244 · median $7,446 3 plans
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $7,744 · median $7,446 3 plans
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC Trauma $4,142 – $18,056 · median $7,446 3 plans
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC Trauma $4,142 – $22,768 · median $7,446 3 plans
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $13,321 · median $7,446 3 plans
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Non Transplant Related Services $4,142 – $9,239 · median $7,446 3 plans
397 APPENDIX PROCEDURES WITH MCC Relapse During Zone 3 $4,142 – $34,094 · median $10,103 3 plans
398 APPENDIX PROCEDURES WITH CC Relapse During Zone 3 $4,142 – $21,548 · median $10,103 3 plans
399 APPENDIX PROCEDURES WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $16,296 · median $10,103 3 plans
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC Relapse During Zone 3 $8,108 – $77,878 · median $10,103 3 plans
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC Relapse During Zone 3 $8,108 – $41,287 · median $10,103 3 plans
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC Non Transplant Related Services $8,108 – $31,598 · median $10,103 3 plans
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH Relapse During Zone 3 $4,142 – $50,760 · median $10,103 3 plans
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH Trauma $4,142 – $30,996 · median $10,103 3 plans
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH Other Inpatient Outside Transplant Zone 4 $4,142 – $22,603 · median $10,103 3 plans
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC Relapse During Zone 3 $4,142 – $47,026 · median $10,103 3 plans
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $4,142 – $29,931 · median $10,103 3 plans
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $23,639 · median $10,103 3 plans
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $4,142 – $48,503 · median $10,103 3 plans
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $4,142 – $24,735 · median $10,103 3 plans
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC $4,142 – $19,923 · median $10,103 3 plans
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC Relapse During Zone 3 $4,142 – $59,122 · median $10,103 3 plans
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC Non Transplant Related Services $4,142 – $31,147 · median $10,103 3 plans
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC Trauma $4,142 – $21,358 · median $10,103 3 plans
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC Relapse During Zone 3 $4,142 – $28,019 · median $7,446 3 plans
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC Trauma $4,142 – $15,036 · median $7,446 3 plans
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC Non Transplant Related Services $4,142 – $10,143 · median $7,446 3 plans
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC Pediatric $4,142 – $26,147 · median $7,446 3 plans
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC Non Transplant Related Services $4,142 – $16,102 · median $7,446 3 plans
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $12,148 · median $7,446 3 plans
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC Pediatric $4,142 – $23,208 · median $7,446 3 plans
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $4,142 – $11,975 · median $7,446 3 plans
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $4,142 – $8,846 · median $7,446 3 plans
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC Trauma $4,142 – $25,549 · median $7,446 3 plans
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC Relapse During Zone 3 $4,142 – $13,742 · median $7,446 3 plans
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT C Trauma $4,142 – $9,961 · median $7,446 3 plans
444 DISORDERS OF THE BILIARY TRACT WITH MCC Non Transplant Related Services $4,142 – $23,787 · median $7,446 3 plans
445 DISORDERS OF THE BILIARY TRACT WITH CC Trauma $4,142 – $15,580 · median $7,446 3 plans
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC Non Transplant Related Services $4,142 – $11,777 · median $7,446 3 plans
461 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC Pediatric $4,142 – $82,962 · median $78,625 3 plans
462 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC $4,142 – $80,538 · median $37,868 3 plans
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE $4,142 – $81,138 · median $33,871 3 plans
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE Trauma $4,142 – $44,341 · median $35,345 3 plans
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE $4,142 – $33,361 · median $25,962 3 plans
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $61,114 · median $10,103 3 plans
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC Non Transplant Related Services $4,142 – $32,397 · median $10,103 3 plans
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC Other Inpatient Outside Transplant Zone 4 $4,142 – $16,801 · median $10,103 3 plans
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Non Transplant Related Services $4,142 – $49,180 · median $10,103 3 plans
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $35,009 · median $10,103 3 plans
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Non Transplant Related Services $4,142 – $26,463 · median $10,103 3 plans
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $4,142 – $41,460 · median $25,008 3 plans
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC Non Transplant Related Services $4,142 – $29,817 · median $23,899 3 plans
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC Trauma $4,142 – $23,899 · median $23,219 3 plans
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC Pediatric $4,142 – $45,941 · median $14,264 3 plans
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $4,142 – $33,177 · median $29,769 3 plans
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Non Transplant Related Services $4,142 – $22,296 · median $15,826 3 plans
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC Relapse During Zone 3 $4,142 – $25,182 · median $15,254 3 plans
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $15,899 · median $15,065 3 plans
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC Pediatric $4,142 – $52,269 · median $23,978 3 plans
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC Pediatric $4,142 – $36,104 · median $28,335 3 plans
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $28,565 · median $26,275 3 plans
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT Other Inpatient Outside Transplant Zone 4 $4,142 – $51,615 · median $19,870 3 plans
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT Pediatric $4,142 – $25,680 · median $16,749 3 plans
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT Trauma $4,142 – $17,201 · median $16,749 3 plans
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC Relapse During Zone 3 $4,142 – $42,947 · median $10,103 3 plans
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT Relapse During Zone 3 $4,142 – $28,683 · median $10,103 3 plans
500 SOFT TISSUE PROCEDURES WITH MCC Pediatric $4,142 – $45,054 · median $10,103 3 plans
501 SOFT TISSUE PROCEDURES WITH CC Relapse During Zone 3 $4,142 – $24,886 · median $10,103 3 plans
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $19,160 · median $10,103 3 plans
503 FOOT PROCEDURES WITH MCC Non Transplant Related Services $4,142 – $39,734 · median $14,371 3 plans
504 FOOT PROCEDURES WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $26,610 · median $13,723 3 plans
505 FOOT PROCEDURES WITHOUT CC/MCC $4,142 – $25,522 · median $15,092 3 plans
506 MAJOR THUMB OR JOINT PROCEDURES Pediatric $4,142 – $19,207 · median $10,103 3 plans
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC $4,142 – $25,716 · median $21,110 3 plans
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $21,559 · median $21,110 3 plans
510 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $43,000 · median $21,110 3 plans
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC $4,142 – $29,602 · median $10,766 3 plans
512 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/ Trauma $4,142 – $23,566 · median $12,011 3 plans
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC Non Transplant Related Services $4,142 – $22,412 · median $10,103 3 plans
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $14,553 · median $10,103 3 plans
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC Trauma $4,142 – $28,475 · median $14,369 3 plans
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $21,267 · median $18,065 3 plans
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $4,142 – $40,860 · median $29,057 3 plans
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC Non Transplant Related Services $4,142 – $30,148 · median $26,478 3 plans
533 FRACTURES OF FEMUR WITH MCC Relapse During Zone 3 $4,142 – $22,318 · median $7,446 3 plans
534 FRACTURES OF FEMUR WITHOUT MCC $4,142 – $11,476 · median $7,446 3 plans
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC Relapse During Zone 3 $4,142 – $13,585 · median $7,446 3 plans
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC $4,142 – $10,254 · median $7,446 3 plans
539 OSTEOMYELITIS WITH MCC Trauma $4,142 – $28,041 · median $7,446 3 plans
540 OSTEOMYELITIS WITH CC Relapse During Zone 3 $4,142 – $18,454 · median $7,446 3 plans
541 OSTEOMYELITIS WITHOUT CC/MCC Non Transplant Related Services $4,142 – $11,209 · median $7,446 3 plans
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH Other Inpatient Outside Transplant Zone 4 $4,142 – $25,148 · median $7,446 3 plans
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH Pediatric $4,142 – $14,635 · median $7,446 3 plans
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH $4,142 – $10,742 · median $7,446 3 plans
545 CONNECTIVE TISSUE DISORDERS WITH MCC Non Transplant Related Services $4,142 – $35,329 · median $7,446 3 plans
546 CONNECTIVE TISSUE DISORDERS WITH CC $4,142 – $16,420 · median $7,446 3 plans
553 BONE DISEASES AND ARTHROPATHIES WITH MCC Pediatric $4,142 – $18,454 · median $7,446 3 plans
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC Relapse During Zone 3 $4,142 – $11,817 · median $7,446 3 plans
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Trauma $4,142 – $26,549 · median $7,446 3 plans
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Trauma $4,142 – $16,031 · median $7,446 3 plans
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Non Transplant Related Services $4,142 – $11,444 · median $7,446 3 plans
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT Relapse During Zone 3 $4,142 – $20,283 · median $7,446 3 plans
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT Pediatric $4,142 – $12,748 · median $7,446 3 plans
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC Pediatric $4,142 – $21,975 · median $7,446 3 plans
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC Non Transplant Related Services $4,142 – $13,872 · median $7,446 3 plans
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $10,667 · median $7,446 3 plans
570 SKIN DEBRIDEMENT WITH MCC Pediatric $4,142 – $41,870 · median $10,103 3 plans
571 SKIN DEBRIDEMENT WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $24,052 · median $10,103 3 plans
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $4,142 – $16,319 · median $10,103 3 plans
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC Relapse During Zone 3 $4,142 – $93,266 · median $10,103 3 plans
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC Non Transplant Related Services $4,142 – $49,419 · median $10,103 3 plans
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $25,582 · median $10,103 3 plans
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC Relapse During Zone 3 $4,142 – $69,773 · median $10,103 3 plans
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC Non Transplant Related Services $4,142 – $37,735 · median $10,103 3 plans
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $22,869 · median $10,103 3 plans
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $46,103 · median $10,103 3 plans
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $4,142 – $24,600 · median $10,103 3 plans
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $4,142 – $20,544 · median $10,103 3 plans
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC Trauma $4,142 – $27,427 · median $10,103 3 plans
583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC Pediatric $4,142 – $24,549 · median $10,103 3 plans
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC Trauma $4,142 – $30,475 · median $10,103 3 plans
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC $4,142 – $27,463 · median $10,103 3 plans
592 SKIN ULCERS WITH MCC Non Transplant Related Services $4,142 – $27,551 · median $7,446 3 plans
593 SKIN ULCERS WITH CC Relapse During Zone 3 $4,142 – $16,888 · median $7,446 3 plans
594 SKIN ULCERS WITHOUT CC/MCC Non Transplant Related Services $4,142 – $12,340 · median $7,446 3 plans
595 MAJOR SKIN DISORDERS WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $30,190 · median $7,446 3 plans
596 MAJOR SKIN DISORDERS WITHOUT MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $15,410 · median $7,446 3 plans
597 MALIGNANT BREAST DISORDERS WITH MCC Relapse During Zone 3 $4,142 – $23,733 · median $7,446 3 plans
598 MALIGNANT BREAST DISORDERS WITH CC Trauma $4,142 – $16,105 · median $7,446 3 plans
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Non Transplant Related Services $4,142 – $10,953 · median $7,446 3 plans
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC Trauma $4,142 – $14,828 · median $7,446 3 plans
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $8,613 · median $7,446 3 plans
602 CELLULITIS WITH MCC $4,142 – $20,234 · median $7,446 3 plans
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC Non Transplant Related Services $4,142 – $20,957 · median $8,708 3 plans
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $13,040 · median $9,242 3 plans
606 MINOR SKIN DISORDERS WITH MCC Relapse During Zone 3 $4,142 – $21,542 · median $7,446 3 plans
607 MINOR SKIN DISORDERS WITHOUT MCC Pediatric $4,142 – $12,904 · median $7,446 3 plans
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC Trauma $4,142 – $31,202 · median $10,103 3 plans
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC Pediatric $4,142 – $19,920 · median $10,103 3 plans
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH $4,142 – $49,647 · median $10,103 3 plans
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH Non Transplant Related Services $4,142 – $26,626 · median $10,103 3 plans
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH Pediatric $4,142 – $20,191 · median $10,103 3 plans
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR Relapse During Zone 3 $4,142 – $50,669 · median $10,103 3 plans
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR Other Inpatient Outside Transplant Zone 4 $4,142 – $25,538 · median $10,103 3 plans
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR Non Transplant Related Services $4,142 – $17,822 · median $10,103 3 plans
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC Trauma $4,142 – $42,994 · median $10,103 3 plans
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $4,142 – $21,345 · median $10,103 3 plans
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $18,910 · median $10,103 3 plans
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC Trauma $4,142 – $53,055 · median $10,103 3 plans
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC Relapse During Zone 3 $4,142 – $31,017 · median $10,103 3 plans
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC Pediatric $4,142 – $20,777 · median $10,103 3 plans
637 DIABETES WITH MCC $4,142 – $20,453 · median $7,446 3 plans
638 DIABETES WITH CC Pediatric $4,142 – $12,758 · median $7,446 3 plans
639 DIABETES WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $8,843 · median $7,446 3 plans
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH M Relapse During Zone 3 $4,142 – $19,014 · median $7,446 3 plans
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOU Non Transplant Related Services $4,142 – $11,078 · median $7,446 3 plans
642 INBORN AND OTHER DISORDERS OF METABOLISM Non Transplant Related Services $4,142 – $20,245 · median $7,446 3 plans
643 ENDOCRINE DISORDERS WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $23,434 · median $7,446 3 plans
644 ENDOCRINE DISORDERS WITH CC Relapse During Zone 3 $4,142 – $14,592 · median $7,446 3 plans
645 ENDOCRINE DISORDERS WITHOUT CC/MCC Pediatric $4,142 – $10,938 · median $7,446 3 plans
653 MAJOR BLADDER PROCEDURES WITH MCC Trauma $4,142 – $73,976 · median $10,103 3 plans
654 MAJOR BLADDER PROCEDURES WITH CC Trauma $4,142 – $39,851 · median $10,103 3 plans
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC Non Transplant Related Services $4,142 – $30,132 · median $10,103 3 plans
662 MINOR BLADDER PROCEDURES WITH MCC Pediatric $4,142 – $43,584 · median $10,103 3 plans
663 MINOR BLADDER PROCEDURES WITH CC Relapse During Zone 3 $4,142 – $21,642 · median $10,103 3 plans
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $14,904 · median $10,103 3 plans
665 PROSTATECTOMY WITH MCC Pediatric $4,142 – $44,433 · median $10,103 3 plans
666 PROSTATECTOMY WITH CC Non Transplant Related Services $4,142 – $24,903 · median $10,103 3 plans
667 PROSTATECTOMY WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $15,748 · median $10,103 3 plans
668 TRANSURETHRAL PROCEDURES WITH MCC $4,142 – $41,569 · median $10,103 3 plans
669 TRANSURETHRAL PROCEDURES WITH CC $4,142 – $22,094 · median $10,103 3 plans
670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC Non Transplant Related Services $4,142 – $13,913 · median $10,103 3 plans
671 URETHRAL PROCEDURES WITH CC/MCC $4,142 – $25,554 · median $10,103 3 plans
672 URETHRAL PROCEDURES WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $15,368 · median $10,103 3 plans
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC Relapse During Zone 3 $4,142 – $59,814 · median $10,103 3 plans
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $33,292 · median $10,103 3 plans
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC Pediatric $4,142 – $23,367 · median $10,103 3 plans
682 RENAL FAILURE WITH MCC Non Transplant Related Services $4,142 – $21,084 · median $7,446 3 plans
684 RENAL FAILURE WITHOUT CC/MCC Trauma $4,142 – $8,546 · median $7,446 3 plans
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC Non Transplant Related Services $4,142 – $25,677 · median $7,446 3 plans
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC Non Transplant Related Services $4,142 – $14,916 · median $7,446 3 plans
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $4,142 – $11,251 · median $7,446 3 plans
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC Non Transplant Related Services $4,142 – $16,283 · median $7,446 3 plans
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $9,809 · median $7,446 3 plans
697 URETHRAL STRICTURE Non Transplant Related Services $4,142 – $15,344 · median $7,446 3 plans
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC Trauma $4,142 – $14,450 · median $7,446 3 plans
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $9,821 · median $7,446 3 plans
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC Non Transplant Related Services $4,142 – $28,476 · median $20,628 3 plans
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC $4,142 – $21,841 · median $15,622 3 plans
709 PENIS PROCEDURES WITH CC/MCC Pediatric $4,142 – $33,129 · median $10,103 3 plans
710 PENIS PROCEDURES WITHOUT CC/MCC Non Transplant Related Services $4,142 – $19,947 · median $10,103 3 plans
711 TESTES PROCEDURES WITH CC/MCC Pediatric $4,142 – $29,665 · median $10,103 3 plans
712 TESTES PROCEDURES WITHOUT CC/MCC Non Transplant Related Services $4,142 – $15,655 · median $10,103 3 plans
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC Trauma $4,142 – $21,402 · median $10,103 3 plans
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $15,053 · median $10,103 3 plans
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC $4,142 – $31,850 · median $10,103 3 plans
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $20,941 · median $10,103 3 plans
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC Pediatric $4,142 – $26,913 · median $10,103 3 plans
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC $4,142 – $19,120 · median $10,103 3 plans
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC Relapse During Zone 3 $4,142 – $25,763 · median $7,446 3 plans
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC Pediatric $4,142 – $16,267 · median $7,446 3 plans
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $4,142 – $9,335 · median $7,446 3 plans
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC Pediatric $4,142 – $16,659 · median $7,446 3 plans
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC Non Transplant Related Services $4,142 – $10,278 · median $7,446 3 plans
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric $4,142 – $21,111 · median $7,446 3 plans
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC Relapse During Zone 3 $4,142 – $11,548 · median $7,446 3 plans
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC $4,142 – $15,072 · median $7,446 3 plans
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric $4,142 – $9,567 · median $7,446 3 plans
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC Trauma $4,142 – $50,887 · median $10,103 3 plans
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $29,335 · median $10,103 3 plans
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC Trauma $4,142 – $20,906 · median $10,103 3 plans
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MC $4,142 – $51,005 · median $35,804 3 plans
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $4,142 – $25,761 · median $18,898 3 plans
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT $4,142 – $20,302 · median $18,082 3 plans
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $24,729 · median $10,103 3 plans
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC $4,142 – $12,239 · median $10,103 3 plans
748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES $4,142 – $19,750 · median $11,999 3 plans
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $36,552 · median $10,103 3 plans
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $21,009 · median $10,103 3 plans
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric $4,142 – $26,218 · median $7,446 3 plans
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $4,142 – $15,486 · median $7,446 3 plans
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $13,674 · median $7,446 3 plans
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $4,142 – $20,385 · median $7,446 3 plans
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC Trauma $4,142 – $13,937 · median $7,446 3 plans
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Non Transplant Related Services $4,142 – $9,447 · median $7,446 3 plans
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC Non Transplant Related Services $4,142 – $14,343 · median $7,446 3 plans
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $8,122 · median $7,446 3 plans
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES Trauma $4,142 – $24,056 · median $10,103 3 plans
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY Non Transplant Related Services $4,142 – $14,274 · median $10,103 3 plans
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES Non Transplant Related Services $4,142 – $9,320 · median $7,446 3 plans
779 ABORTION WITHOUT D&C Pediatric $4,142 – $11,977 · median $7,446 3 plans
799 SPLENIC PROCEDURES WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $64,473 · median $10,103 3 plans
800 SPLENIC PROCEDURES WITH CC $4,142 – $39,995 · median $10,103 3 plans
801 SPLENIC PROCEDURES WITHOUT CC/MCC Trauma $4,142 – $27,175 · median $10,103 3 plans
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC Relapse During Zone 3 $4,142 – $56,718 · median $10,103 3 plans
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC Relapse During Zone 3 $4,142 – $26,463 · median $10,103 3 plans
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC Non Transplant Related Services $4,142 – $19,304 · median $10,103 3 plans
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO Other Inpatient Outside Transplant Zone 4 $4,142 – $31,432 · median $7,446 3 plans
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO Trauma $4,142 – $18,021 · median $7,446 3 plans
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO Non Transplant Related Services $4,142 – $14,899 · median $7,446 3 plans
811 RED BLOOD CELL DISORDERS WITH MCC $4,142 – $19,992 · median $7,446 3 plans
812 RED BLOOD CELL DISORDERS WITHOUT MCC Pediatric $4,142 – $13,072 · median $7,446 3 plans
813 COAGULATION DISORDERS Relapse During Zone 3 $4,142 – $21,714 · median $7,446 3 plans
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC Trauma $4,142 – $30,276 · median $7,446 3 plans
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC Pediatric $4,142 – $14,435 · median $7,446 3 plans
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC Trauma $4,142 – $8,997 · median $7,446 3 plans
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC Trauma $4,142 – $83,491 · median $10,103 3 plans
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $4,142 – $31,869 · median $10,103 3 plans
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC Trauma $4,142 – $17,140 · median $10,103 3 plans
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $65,269 · median $10,103 3 plans
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $32,253 · median $10,103 3 plans
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC Non Transplant Related Services $4,142 – $19,210 · median $10,103 3 plans
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. Relapse During Zone 3 $4,142 – $66,593 · median $10,103 3 plans
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. Other Inpatient Outside Transplant Zone 4 $4,142 – $32,902 · median $10,103 3 plans
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. Pediatric $4,142 – $24,255 · median $10,103 3 plans
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE Relapse During Zone 3 $4,142 – $44,986 · median $10,103 3 plans
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE $4,142 – $21,425 · median $10,103 3 plans
834 ACUTE LEUKEMIA WITH MCC Trauma $4,142 – $78,154 · median $7,446 3 plans
835 ACUTE LEUKEMIA WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $29,693 · median $7,446 3 plans
836 ACUTE LEUKEMIA WITHOUT CC/MCC Non Transplant Related Services $4,142 – $17,361 · median $7,446 3 plans
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOT Other Inpatient Outside Transplant Zone 4 $4,142 – $68,394 · median $7,446 3 plans
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHE Pediatric $4,142 – $29,716 · median $7,446 3 plans
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric $4,142 – $20,555 · median $7,446 3 plans
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC Non Transplant Related Services $4,142 – $46,052 · median $7,446 3 plans
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC Pediatric $4,142 – $23,225 · median $7,446 3 plans
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $4,142 – $14,384 · median $7,446 3 plans
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES Trauma $4,142 – $28,398 · median $7,446 3 plans
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES $4,142 – $17,331 · median $7,446 3 plans
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES Trauma $4,142 – $12,123 · median $7,446 3 plans
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC Pediatric $4,142 – $36,907 · median $7,446 3 plans
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC Relapse During Zone 3 $4,142 – $18,624 · median $7,446 3 plans
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $4,142 – $12,092 · median $7,446 3 plans
849 RADIOTHERAPY $4,142 – $38,572 · median $7,446 3 plans
850 ACUTE LEUKEMIA WITH OTHER PROCEDURES Other Inpatient Outside Transplant Zone 4 — 3 plans
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC Trauma $4,142 – $70,306 · median $10,103 3 plans
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC Trauma $4,142 – $21,314 · median $10,103 3 plans
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $64,755 · median $10,103 3 plans
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC Pediatric $4,142 – $30,486 · median $10,103 3 plans
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC Non Transplant Related Services $4,142 – $19,829 · median $10,103 3 plans
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC Non Transplant Related Services $4,142 – $25,962 · median $7,446 3 plans
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC Trauma $4,142 – $14,206 · median $7,446 3 plans
864 FEVER AND INFLAMMATORY CONDITIONS Trauma $4,142 – $12,637 · median $7,446 3 plans
865 VIRAL ILLNESS WITH MCC $4,142 – $21,330 · median $7,446 3 plans
866 VIRAL ILLNESS WITHOUT MCC Trauma $4,142 – $12,380 · median $7,446 3 plans
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC Non Transplant Related Services $4,142 – $29,799 · median $7,446 3 plans
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $4,142 – $14,679 · median $7,446 3 plans
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC Non Transplant Related Services $4,142 – $10,388 · median $7,446 3 plans
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $4,142 – $98,396 · median $7,446 3 plans
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $2,613 – $13,669 · median $7,446 3 plans
881 DEPRESSIVE NEUROSES $2,613 – $13,395 · median $7,446 3 plans
882 NEUROSES EXCEPT DEPRESSIVE $2,613 – $15,287 · median $7,446 3 plans
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $2,613 – $27,992 · median $7,446 3 plans
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY Trauma $2,613 – $22,904 · median $7,446 3 plans
885 PSYCHOSES Trauma $2,613 – $19,885 · median $7,446 3 plans
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS Trauma $2,613 – $29,544 · median $7,446 3 plans
887 OTHER MENTAL DISORDER DIAGNOSES Trauma $2,613 – $15,245 · median $7,446 3 plans
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA Diagnostic Testing $2,613 – $8,782 · median $7,446 3 plans
895 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY Diagnostic Testing $2,613 – $20,152 · median $7,446 3 plans
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC Diagnostic Testing $2,613 – $24,843 · median $7,446 3 plans
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC Diagnostic Testing $2,613 – $12,568 · median $7,446 3 plans
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $4,142 – $59,743 · median $10,103 3 plans
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $4,142 – $27,255 · median $10,103 3 plans
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC Pediatric $4,142 – $16,650 · median $10,103 3 plans
904 SKIN GRAFTS FOR INJURIES WITH CC/MCC Relapse During Zone 3 $4,142 – $52,290 · median $10,103 3 plans
905 SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC Relapse During Zone 3 $4,142 – $21,118 · median $10,103 3 plans
906 HAND PROCEDURES FOR INJURIES Pediatric $4,142 – $27,964 · median $10,103 3 plans
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $54,656 · median $10,103 3 plans
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC Trauma $4,142 – $28,404 · median $10,103 3 plans
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $18,688 · median $10,103 3 plans
913 TRAUMATIC INJURY WITH MCC $4,142 – $23,270 · median $7,446 3 plans
914 TRAUMATIC INJURY WITHOUT MCC Pediatric $4,142 – $12,606 · median $7,446 3 plans
915 ALLERGIC REACTIONS WITH MCC $4,142 – $23,939 · median $7,446 3 plans
916 ALLERGIC REACTIONS WITHOUT MCC Relapse During Zone 3 $4,142 – $9,485 · median $7,446 3 plans
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $4,142 – $22,328 · median $7,446 3 plans
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $4,142 – $12,202 · median $7,446 3 plans
919 COMPLICATIONS OF TREATMENT WITH MCC Non Transplant Related Services $4,142 – $26,063 · median $7,446 3 plans
920 COMPLICATIONS OF TREATMENT WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $14,269 · median $7,446 3 plans
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC Non Transplant Related Services $4,142 – $9,800 · median $7,446 3 plans
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC Relapse During Zone 3 $4,142 – $24,904 · median $7,446 3 plans
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC Trauma $4,142 – $14,488 · median $7,446 3 plans
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC Pediatric $4,142 – $51,655 · median $10,103 3 plans
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC Relapse During Zone 3 $4,142 – $33,268 · median $10,103 3 plans
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/ Relapse During Zone 3 $4,142 – $28,866 · median $10,103 3 plans
947 SIGNS AND SYMPTOMS WITH MCC Non Transplant Related Services $4,142 – $18,071 · median $7,446 3 plans
948 SIGNS AND SYMPTOMS WITHOUT MCC Non Transplant Related Services $4,142 – $11,396 · median $7,446 3 plans
949 AFTERCARE WITH CC/MCC Relapse During Zone 3 $4,142 – $16,937 · median $7,446 3 plans
950 AFTERCARE WITHOUT CC/MCC Trauma $4,142 – $8,936 · median $7,446 3 plans
951 OTHER FACTORS INFLUENCING HEALTH STATUS Other Inpatient Outside Transplant Zone 4 $4,142 – $7,915 · median $7,446 3 plans
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC Pediatric $4,142 – $87,143 · median $10,103 3 plans
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $4,142 – $37,546 · median $10,103 3 plans
974 HIV WITH MAJOR RELATED CONDITION WITH MCC Pediatric $4,142 – $41,085 · median $7,446 3 plans
975 HIV WITH MAJOR RELATED CONDITION WITH CC Other Inpatient Outside Transplant Zone 4 $4,142 – $18,436 · median $7,446 3 plans
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $4,142 – $12,851 · median $7,446 3 plans
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION Trauma $4,142 – $18,474 · median $7,446 3 plans
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Trauma $4,142 – $66,792 · median $10,103 3 plans
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Relapse During Zone 3 $4,142 – $34,999 · median $10,103 3 plans
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $4,142 – $24,401 · median $10,103 3 plans
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Trauma $4,142 – $48,807 · median $10,103 3 plans
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC Pediatric $4,142 – $23,398 · median $10,103 3 plans
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $4,142 – $17,072 · median $10,103 3 plans
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH Other Inpatient Outside Transplant Zone 4 $4,142 – $302,162 · median $153,152 2 plans
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NEC Relapse During Zone 3 $4,142 – $197,189 · median $100,665 2 plans
007 LUNG TRANSPLANT Non Transplant Related Services — 2 plans
008 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT $79,787 – $110,982 · median $95,385 2 plans
014 ALLOGENEIC BONE MARROW TRANSPLANT $55,029 – $171,087 · median $113,058 2 plans
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC $55,029 – $84,415 · median $69,722 2 plans
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC $55,029 – $77,334 · median $66,182 2 plans
018 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES Trauma — 2 plans
246 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ AR $32,986 – $36,367 · median $34,677 2 plans
247 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC $32,986 – $36,367 · median $34,677 2 plans
248 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITH MCC OR 4 $32,986 – $36,367 · median $34,677 2 plans
249 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITHOUT MCC $32,986 – $36,367 · median $34,677 2 plans
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC Pediatric $10,103 – $45,325 · median $27,714 2 plans
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC Other Inpatient Outside Transplant Zone 4 $10,103 – $26,052 · median $18,077 2 plans
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC Other Inpatient Outside Transplant Zone 4 $18,162 – $22,091 · median $20,127 2 plans
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC Relapse During Zone 3 $36,172 – $38,419 · median $37,296 2 plans
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC Non Transplant Related Services $18,816 – $22,840 · median $20,828 2 plans
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC Pediatric $14,740 – $15,358 · median $15,049 2 plans
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY Trauma $5,225 – $24,655 · median $14,940 2 plans
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE Trauma $6,270 – $68,108 · median $37,189 2 plans
791 PREMATURITY WITH MAJOR PROBLEMS $6,270 – $24,655 · median $15,463 2 plans
792 PREMATURITY WITHOUT MAJOR PROBLEMS Non Transplant Related Services $5,225 – $11,738 · median $8,482 2 plans
793 FULL TERM NEONATE WITH MAJOR PROBLEMS Non Transplant Related Services $6,270 – $11,738 · median $9,004 2 plans
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS Trauma $3,287 – $5,225 · median $4,256 2 plans
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC Pediatric $4,142 – $32,481 · median $18,311 2 plans
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $4,142 – $16,502 · median $10,322 2 plans
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric $4,142 – $12,242 · median $8,192 2 plans
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC Relapse During Zone 3 $4,142 – $17,119 · median $10,630 2 plans
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC Relapse During Zone 3 $4,142 – $10,273 · median $7,207 2 plans
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $4,142 – $7,444 · median $5,793 2 plans
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $10,103 – $55,021 · median $32,562 2 plans
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT Trauma $4,142 – $303,946 · median $154,044 2 plans
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC $4,142 – $102,111 · median $53,126 2 plans
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC $4,142 – $45,851 · median $24,997 2 plans
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $4,142 – $55,438 · median $29,790 2 plans
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY Other Inpatient Outside Transplant Zone 4 $4,142 – $31,470 · median $17,806 2 plans
935 NON-EXTENSIVE BURNS Pediatric $4,142 – $29,326 · median $16,734 2 plans
945 REHABILITATION WITH CC/MCC $2,613 – $22,046 · median $12,329 2 plans
946 REHABILITATION WITHOUT CC/MCC $2,613 – $16,326 · median $9,469 2 plans
453 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC $73,323 – $73,323 · median $73,323 1 plans
454 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC $73,323 – $73,323 · median $73,323 1 plans
455 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC $73,323 – $73,323 · median $73,323 1 plans
459 SPINAL FUSION EXCEPT CERVICAL WITH MCC Pediatric $78,560 – $78,560 · median $78,560 1 plans
460 SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric $78,560 – $78,560 · median $78,560 1 plans
795 NORMAL NEWBORN Non Transplant Related Services $1,254 – $1,254 · median $1,254 1 plans
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