Cedar-Sinai Marina Del Rey Hospital — Pricing
777 procedures published in this hospital's Machine-Readable File (MRF) — 0 with a comparable price, 777 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 777
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 777 procedures
Procedures with negotiated rates only
These 777 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 |
|---|---|---|---|
| 429 | COMBINED ANTERIOR/POSTERIOR SPINAL FUSION WITH CC | $5,197 – $237,099 · median $86,533 | 27 plans |
| 430 | Combined Anterior and Posterior Cervical Spinal Fusion withoutMCC | $5,197 – $152,199 · median $55,547 | 27 plans |
| 456 | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE OR MALIGNANCY OR INFECTION OR EXTENSIVE FUSIONS WITH MCC | $9,077 – $221,227 · median $80,740 | 23 plans |
| 457 | Spinal Fusion & Kyphoplasty | $9,077 – $157,331 · median $57,420 | 23 plans |
| 458 | Spinal Fusion Except Cervical w/ Spinal Curvature or Malignancy or Infection or Extensive Fusions w/o CC/MCC, Case Rate | $9,077 – $110,449 · median $40,310 | 23 plans |
| 471 | CERVICAL SPINAL FUSION WITH MCC | $9,077 – $127,629 · median $46,580 | 23 plans |
| 472 | Cervical Spinal Fusion w CC | $9,077 – $78,335 · median $28,590 | 23 plans |
| 473 | Cervical Spinal Fusion w/o CC/MCC | $9,077 – $65,118 · median $23,766 | 23 plans |
| 518 | Back & Neck Procedures Except Spinal Fusion w MCC or Disc Device/Neurostimulator | $9,077 – $99,052 · median $36,150 | 23 plans |
| 519 | BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC | $9,077 – $53,568 · median $19,550 | 23 plans |
| 520 | BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC | $9,077 – $40,312 · median $14,712 | 23 plans |
| 030 | Medical/Surgical | $5,197 – $58,674 · median $21,414 | 21 plans |
| 461 | BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC | $9,077 – $145,808 · median $53,215 | 21 plans |
| 462 | Bilateral or Multiple Major Joint Procedures of Lower Extremity w/o MCC | $9,077 – $70,844 · median $25,856 | 21 plans |
| 463 | Medical/Surgical | $5,197 – $150,429 · median $22,024 | 21 plans |
| 464 | Medical/Surgical | $5,197 – $82,750 · median $22,024 | 21 plans |
| 465 | Medical/Surgical | $5,197 – $48,947 · median $17,864 | 21 plans |
| 466 | Revision of Hip or Knee Replacement w MCC | $9,077 – $137,492 · median $50,180 | 21 plans |
| 467 | REVISION OF HIP OR KNEE REPLACEMENT WITH CC | $9,077 – $93,535 · median $34,137 | 21 plans |
| 468 | Revision of Hip or Knee Replacement w/o CC/MCC | $9,077 – $73,148 · median $26,696 | 21 plans |
| 469 | Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity w/ MCC or Total Ankle Replacement | $9,077 – $80,616 · median $29,422 | 21 plans |
| 470 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | $9,077 – $51,701 · median $18,869 | 21 plans |
| 480 | Hip & Femur Procedures Except Major Joint w/ MCC | $5,197 – $77,450 · median $22,024 | 21 plans |
| 481 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | $5,197 – $56,037 · median $20,452 | 21 plans |
| 482 | Hip & Femur Procedures Except Major Joint w/o CC/MCC | $5,197 – $43,901 · median $16,022 | 21 plans |
| 483 | MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES | $5,197 – $73,774 · median $22,024 | 21 plans |
| 485 | KNEE PROCEDURES WITH PDX OF INFECTION WITH MCC | $5,197 – $85,693 · median $22,024 | 21 plans |
| 486 | Knee Procedures w/ PDX of Infection w/ CC | $5,197 – $55,948 · median $20,419 | 21 plans |
| 487 | Knee Procedures w/ PDX of Infection w/o CC/MCC | $5,197 – $42,205 · median $15,403 | 21 plans |
| 488 | Knee Procedures w/o PDX of Infection w/ CC/MCC | $5,197 – $47,512 · median $17,340 | 21 plans |
| 489 | KNEE PROCEDURES WITHOUT PDX OF INFECTION WITHOUT CC/MCC | $5,197 – $30,438 · median $11,109 | 21 plans |
| 474 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC | $5,197 – $113,599 · median $41,460 | 19 plans |
| 475 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC | $5,197 – $60,782 · median $22,183 | 19 plans |
| 476 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC | $5,197 – $32,098 · median $11,715 | 19 plans |
| 477 | BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $5,197 – $91,650 · median $33,449 | 19 plans |
| 478 | BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | $5,197 – $65,587 · median $23,937 | 19 plans |
| 479 | BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | $5,197 – $49,869 · median $18,200 | 19 plans |
| 493 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | $9,077 – $67,600 · median $24,672 | 19 plans |
| 494 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC | $9,077 – $53,733 · median $19,611 | 19 plans |
| 499 | LOCAL EXCISION AND REMOVAL INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC | $5,197 – $53,951 · median $19,690 | 19 plans |
| 500 | Medical/Surgical | $5,197 – $84,062 · median $30,679 | 19 plans |
| 501 | Medical/Surgical | $5,197 – $46,967 · median $17,141 | 19 plans |
| 502 | Medical/Surgical | $5,197 – $36,436 · median $13,298 | 19 plans |
| 503 | FOOT PROCEDURES WITH MCC | $5,197 – $74,277 · median $27,108 | 19 plans |
| 028 | Medical/Surgical | $5,197 – $158,515 · median $57,852 | 18 plans |
| 029 | Medical/Surgical | $5,197 – $90,524 · median $33,038 | 18 plans |
| 619 | Bariatric Surgery | $12,130 – $76,798 · median $28,029 | 18 plans |
| 620 | Bariatric Surgery | $12,130 – $43,097 · median $17,560 | 18 plans |
| 621 | Bariatric Surgery/lap Band Surgery | $12,130 – $40,875 · median $16,564 | 18 plans |
| 140 | MAJOR HEAD AND NECK PROCEDURES WITH CC/MCC OR MAJOR DEVICE | $5,197 – $112,877 · median $41,196 | 17 plans |
| 142 | MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC | $5,197 – $42,995 · median $15,692 | 17 plans |
| 163 | MAJOR CHEST PROCEDURES WITH MCC | $5,197 – $118,545 · median $43,265 | 17 plans |
| 164 | MAJOR CHEST PROCEDURES WITH CC | $5,197 – $67,283 · median $24,556 | 17 plans |
| 165 | MAJOR CHEST PROCEDURES WITHOUT CC/MCC | $5,197 – $51,317 · median $18,729 | 17 plans |
| 166 | Medical/Surgical | $5,197 – $99,062 · median $36,154 | 17 plans |
| 167 | Medical/Surgical | $5,197 – $48,415 · median $17,670 | 17 plans |
| 168 | Medical/Surgical | $5,197 – $36,973 · median $13,494 | 17 plans |
| 288 | ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC | $5,197 – $72,054 · median $26,297 | 17 plans |
| 326 | Medical/Surgical | $5,197 – $131,784 · median $48,096 | 17 plans |
| 327 | Medical/Surgical | $5,197 – $65,194 · median $23,793 | 17 plans |
| 328 | Medical/Surgical | $5,197 – $43,150 · median $15,748 | 17 plans |
| 329 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | $5,197 – $121,549 · median $44,361 | 17 plans |
| 330 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | $5,197 – $63,963 · median $23,344 | 17 plans |
| 331 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | $5,197 – $45,260 · median $16,518 | 17 plans |
| 334 | Medical/Surgical | $5,197 – $44,082 · median $16,088 | 17 plans |
| 335 | Medical/Surgical | $5,197 – $94,695 · median $34,560 | 17 plans |
| 417 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC | $5,197 – $63,680 · median $23,241 | 17 plans |
| 418 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | $5,197 – $45,488 · median $16,601 | 17 plans |
| 419 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC | $5,197 – $36,957 · median $13,488 | 17 plans |
| 652 | KIDNEY TRANSPLANT | $5,197 – $85,756 · median $31,298 | 17 plans |
| 653 | MAJOR BLADDER PROCEDURES WITH MCC | $5,197 – $137,256 · median $50,094 | 17 plans |
| 654 | MAJOR BLADDER PROCEDURES WITH CC | $5,197 – $74,492 · median $27,187 | 17 plans |
| 655 | MAJOR BLADDER PROCEDURES WITHOUT CC/MCC | $5,197 – $56,616 · median $20,663 | 17 plans |
| 656 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC | $5,197 – $84,559 · median $30,861 | 17 plans |
| 657 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC | $5,197 – $49,112 · median $17,924 | 17 plans |
| 658 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC | $5,197 – $41,828 · median $15,266 | 17 plans |
| 659 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC | $5,197 – $67,726 · median $24,717 | 17 plans |
| 660 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | $5,197 – $35,803 · median $13,067 | 17 plans |
| 661 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | $5,197 – $28,306 · median $10,331 | 17 plans |
| 662 | Medical/Surgical | $5,197 – $81,357 · median $29,692 | 17 plans |
| 663 | MINOR BLADDER PROCEDURES WITH CC | $5,197 – $41,000 · median $14,964 | 17 plans |
| 664 | MINOR BLADDER PROCEDURES WITHOUT CC/MCC | $5,197 – $28,608 · median $10,441 | 17 plans |
| 665 | Medical/Surgical | $5,197 – $82,920 · median $30,263 | 17 plans |
| 666 | Medical/Surgical | $5,197 – $46,999 · median $17,153 | 17 plans |
| 667 | Medical/Surgical | $5,197 – $30,160 · median $11,007 | 17 plans |
| 668 | Medical/Surgical | $5,197 – $77,652 · median $28,340 | 17 plans |
| 669 | Medical/Surgical | $5,197 – $41,833 · median $15,267 | 17 plans |
| 670 | Medical/Surgical | $5,197 – $26,785 · median $9,776 | 17 plans |
| 671 | Medical/Surgical | $5,197 – $48,195 · median $17,590 | 17 plans |
| 672 | Medical/Surgical | $5,197 – $29,461 · median $10,752 | 17 plans |
| 673 | Medical/Surgical | $5,197 – $111,209 · median $40,587 | 17 plans |
| 674 | Medical/Surgical | $5,197 – $62,429 · median $22,784 | 17 plans |
| 675 | Medical/Surgical | $5,197 – $44,174 · median $16,122 | 17 plans |
| 707 | MAJOR MALE PELVIC PROCEDURES WITH CC/MCC | $5,197 – $53,571 · median $19,551 | 17 plans |
| 708 | MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC | $5,197 – $41,367 · median $15,097 | 17 plans |
| 734 | Medical/Surgical | $5,197 – $56,967 · median $20,791 | 17 plans |
| 735 | Medical/Surgical | $5,197 – $36,426 · median $13,294 | 17 plans |
| 736 | Medical/Surgical | $5,197 – $94,789 · median $34,595 | 17 plans |
| 737 | Medical/Surgical | $5,197 – $55,150 · median $20,128 | 17 plans |
| 738 | Medical/Surgical | $5,197 – $39,647 · median $14,470 | 17 plans |
| 739 | Medical/Surgical | $5,197 – $95,006 · median $34,674 | 17 plans |
| 740 | Medical/Surgical | $5,197 – $48,578 · median $17,729 | 17 plans |
| 741 | Medical/Surgical | $5,197 – $38,536 · median $14,064 | 17 plans |
| 742 | Medical/Surgical | $5,197 – $49,238 · median $17,970 | 17 plans |
| 743 | Medical/Surgical | $5,197 – $33,682 · median $12,293 | 17 plans |
| 744 | D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC | $5,197 – $54,849 · median $20,018 | 17 plans |
| 745 | D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC | $5,197 – $30,980 · median $11,306 | 17 plans |
| 746 | Medical/Surgical | $5,197 – $46,679 · median $17,036 | 17 plans |
| 747 | Medical/Surgical | $5,197 – $23,706 · median $9,368 | 17 plans |
| 748 | FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES | $5,197 – $37,520 · median $13,694 | 17 plans |
| 749 | Medical/Surgical | $5,197 – $68,425 · median $24,973 | 17 plans |
| 750 | Medical/Surgical | $5,197 – $39,838 · median $14,539 | 17 plans |
| 492 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC | $9,077 – $97,332 · median $35,522 | 16 plans |
| 495 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC | $5,197 – $96,130 · median $35,084 | 16 plans |
| 496 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC | $5,197 – $48,428 · median $17,675 | 16 plans |
| 497 | LOCAL EXCISION AND REMOVAL INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC | $5,197 – $32,834 · median $11,983 | 16 plans |
| 498 | LOCAL EXCISION AND REMOVAL INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC | $5,197 – $80,187 · median $29,265 | 16 plans |
| 504 | FOOT PROCEDURES WITH CC | $5,197 – $50,138 · median $18,299 | 16 plans |
| 505 | FOOT PROCEDURES WITHOUT CC/MCC | $5,197 – $48,138 · median $17,569 | 16 plans |
| 506 | Medical/Surgical | $5,197 – $36,523 · median $13,329 | 16 plans |
| 507 | MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC | $5,197 – $48,494 · median $17,699 | 16 plans |
| 508 | MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC | $5,197 – $40,848 · median $14,908 | 16 plans |
| 510 | Medical/Surgical | $5,197 – $80,283 · median $29,301 | 16 plans |
| 511 | Medical/Surgical | $5,197 – $55,642 · median $20,307 | 16 plans |
| 512 | Medical/Surgical | $5,197 – $44,540 · median $16,256 | 16 plans |
| 513 | HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC | $5,197 – $42,417 · median $15,481 | 16 plans |
| 514 | HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC | $5,197 – $27,963 · median $10,206 | 16 plans |
| 515 | Medical/Surgical | $5,197 – $84,640 · median $30,891 | 16 plans |
| 516 | Medical/Surgical | $5,197 – $55,608 · median $20,295 | 16 plans |
| 517 | Medical/Surgical | $5,197 – $41,432 · median $15,121 | 16 plans |
| 768 | Obstetrics (Mother Only) - Vaginal Delivery | $4,362 – $29,254 · median $10,677 | 16 plans |
| 783 | CESAREAN SECTION WITH STERILIZATION WITH MCC | $4,362 – $65,479 · median $23,898 | 16 plans |
| 784 | CESAREAN SECTION WITH STERILIZATION WITH CC | $4,362 – $30,479 · median $10,567 | 16 plans |
| 785 | C-SECTION W/O COMP & VAGINAL W/COMP | $9,589 – $30,479 · median $11,031 | 16 plans |
| 786 | CESAREAN SECTION WITHOUT STERILIZATION WITH MCC | $4,362 – $44,386 · median $16,199 | 16 plans |
| 787 | CESAREAN SECTION WITHOUT STERILIZATION WITH CC | $4,362 – $30,479 · median $11,109 | 16 plans |
| 788 | C-SECTION W/O COMP & VAGINAL W/COMP | $9,599 – $30,479 · median $11,037 | 16 plans |
| 796 | Obstetrics (Mother Only) - Vaginal Delivery | $4,362 – $31,752 · median $11,588 | 16 plans |
| 797 | Obstetrics (Mother Only) - Vaginal Delivery | $4,362 – $27,390 · median $9,996 | 16 plans |
| 798 | Obstetrics (Mother Only) - Vaginal Delivery | $4,362 – $26,256 · median $9,583 | 16 plans |
| 805 | C-SECTION W/O COMP & VAGINAL W/COMP | $10,456 – $29,453 · median $11,260 | 16 plans |
| 806 | C-SECTION W/O COMP & VAGINAL W/COMP | $7,642 – $21,145 · median $9,713 | 16 plans |
| 807 | Obstetrics (Mother Only) - Vaginal Delivery | $6,879 – $21,145 · median $8,685 | 16 plans |
| 987 | NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | $5,197 – $90,964 · median $33,198 | 16 plans |
| 988 | Non-Extensive O.R. Procedure Unrelated to Principal Diagnosis w/ CC | $5,197 – $44,231 · median $16,143 | 16 plans |
| 989 | NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC | $5,197 – $32,595 · median $11,896 | 16 plans |
| 880 | ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION | $2,814 – $26,337 · median $9,612 | 15 plans |
| 881 | DEPRESSIVE NEUROSES | $2,814 – $25,832 · median $9,428 | 15 plans |
| 882 | NEUROSES EXCEPT DEPRESSIVE | $2,814 – $29,312 · median $10,698 | 15 plans |
| 883 | DISORDERS OF PERSONALITY AND IMPULSE CONTROL | $2,814 – $52,681 · median $19,227 | 15 plans |
| 884 | Medical/Surgical | $2,814 – $43,323 · median $15,811 | 15 plans |
| 885 | Medical/Surgical | $2,814 – $37,769 · median $13,784 | 15 plans |
| 886 | BEHAVIORAL AND DEVELOPMENTAL DISORDERS | $2,814 – $55,535 · median $20,268 | 15 plans |
| 887 | Medical/Surgical | $2,814 – $29,236 · median $10,670 | 15 plans |
| 894 | ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA | $2,814 – $17,349 · median $6,332 | 15 plans |
| 895 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY | $2,814 – $38,261 · median $13,964 | 15 plans |
| 896 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC | $2,814 – $46,889 · median $17,113 | 15 plans |
| 897 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | $2,814 – $24,311 · median $8,873 | 15 plans |
| 001 | HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC | $5,197 – $734,962 · median $268,234 | 14 plans |
| 002 | HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC | $5,197 – $297,903 · median $108,724 | 14 plans |
| 003 | ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PDX EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURE | $5,197 – $556,947 · median $203,265 | 14 plans |
| 004 | Medical/Surgical | $5,197 – $363,875 · median $132,801 | 14 plans |
| 005 | LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT | $5,197 – $271,162 · median $98,964 | 14 plans |
| 006 | LIVER TRANSPLANT WITHOUT MCC | $5,197 – $122,609 · median $44,748 | 14 plans |
| 007 | LUNG TRANSPLANT | $5,197 – $340,278 · median $124,189 | 14 plans |
| 008 | Medical/Surgical | $5,197 – $147,944 · median $53,994 | 14 plans |
| 010 | Medical/Surgical | $5,197 – $189,081 · median $69,008 | 14 plans |
| 011 | Medical/Surgical | $5,197 – $144,004 · median $52,556 | 14 plans |
| 012 | Medical/Surgical | $5,197 – $111,586 · median $40,725 | 14 plans |
| 013 | Medical/Surgical | $5,197 – $76,652 · median $27,975 | 14 plans |
| 014 | ALLOGENEIC BONE MARROW TRANSPLANT | $5,197 – $315,867 · median $115,280 | 14 plans |
| 016 | AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC OR T-CELL IMMUNOTHERAPY | $5,197 – $156,457 · median $57,101 | 14 plans |
| 017 | AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC | $5,197 – $143,433 · median $52,348 | 14 plans |
| 020 | INTRACRANIAL VASCULAR PROCEDURES WITH PDX HEMORRHAGE WITH MCC | $5,197 – $207,229 · median $75,631 | 14 plans |
| 021 | INTRACRANIAL VASCULAR PROCEDURES WITH PDX HEMORRHAGE WITH CC | $5,197 – $139,806 · median $51,024 | 14 plans |
| 022 | INTRACRANIAL VASCULAR PROCEDURES WITH PDX HEMORRHAGE WITHOUT CC/MCC | $5,197 – $84,392 · median $30,800 | 14 plans |
| 023 | CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PDX WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR | $5,197 – $151,236 · median $55,195 | 14 plans |
| 024 | CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PDX WITHOUT MCC | $5,197 – $103,623 · median $37,819 | 14 plans |
| 025 | CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC | $5,197 – $120,245 · median $43,885 | 14 plans |
| 026 | CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC | $5,197 – $82,606 · median $30,148 | 14 plans |
| 027 | CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC | $5,197 – $67,254 · median $24,545 | 14 plans |
| 031 | Medical/Surgical | $5,197 – $118,511 · median $43,252 | 14 plans |
| 032 | Medical/Surgical | $5,197 – $56,993 · median $20,800 | 14 plans |
| 033 | Medical/Surgical | $5,197 – $44,737 · median $16,327 | 14 plans |
| 034 | CAROTID ARTERY STENT PROCEDURE WITH MCC | $5,197 – $102,545 · median $37,425 | 14 plans |
| 035 | CAROTID ARTERY STENT PROCEDURE WITH CC | $5,197 – $63,788 · median $23,280 | 14 plans |
| 036 | CAROTID ARTERY STENT PROCEDURE WITHOUT CC/MCC | $5,197 – $52,065 · median $19,002 | 14 plans |
| 037 | EXTRACRANIAL PROCEDURES WITH MCC | $5,197 – $87,395 · median $31,896 | 14 plans |
| 038 | EXTRACRANIAL PROCEDURES WITH CC | $5,197 – $43,681 · median $15,942 | 14 plans |
| 039 | EXTRACRANIAL PROCEDURES WITHOUT CC/MCC | $5,197 – $31,975 · median $11,670 | 14 plans |
| 040 | Medical/Surgical | $5,197 – $102,296 · median $37,334 | 14 plans |
| 041 | Medical/Surgical | $5,197 – $58,766 · median $21,447 | 14 plans |
| 042 | Medical/Surgical | $5,197 – $46,433 · median $16,946 | 14 plans |
| 052 | Medical/Surgical | $5,197 – $48,622 · median $17,745 | 14 plans |
| 053 | Medical/Surgical | $5,197 – $26,835 · median $9,794 | 14 plans |
| 054 | NERVOUS SYSTEM NEOPLASMS WITH MCC | $5,197 – $41,176 · median $15,028 | 14 plans |
| 055 | NERVOUS SYSTEM NEOPLASMS WITHOUT MCC | $5,197 – $27,893 · median $10,180 | 14 plans |
| 056 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | $5,197 – $62,023 · median $22,636 | 14 plans |
| 057 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | $5,197 – $35,119 · median $12,817 | 14 plans |
| 058 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC | $5,197 – $45,957 · median $16,773 | 14 plans |
| 059 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC | $5,197 – $33,687 · median $12,295 | 14 plans |
| 060 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC | $5,197 – $25,280 · median $9,226 | 14 plans |
| 061 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC | $5,197 – $73,387 · median $26,783 | 14 plans |
| 062 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC | $5,197 – $47,206 · median $17,228 | 14 plans |
| 063 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC | $5,197 – $37,952 · median $13,851 | 14 plans |
| 064 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | $5,197 – $53,851 · median $19,654 | 14 plans |
| 065 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | $5,197 – $27,649 · median $10,091 | 14 plans |
| 066 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | $5,197 – $19,116 · median $6,977 | 14 plans |
| 067 | NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC | $5,197 – $39,652 · median $14,471 | 14 plans |
| 068 | NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC | $5,197 – $23,829 · median $8,697 | 14 plans |
| 069 | Medical/Surgical | $5,197 – $22,111 · median $8,070 | 14 plans |
| 070 | NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC | $5,197 – $44,786 · median $16,345 | 14 plans |
| 071 | NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | $5,197 – $28,060 · median $10,241 | 14 plans |
| 072 | NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC | $5,197 – $20,996 · median $7,663 | 14 plans |
| 073 | CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC | $5,197 – $43,202 · median $15,767 | 14 plans |
| 074 | CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | $5,197 – $28,186 · median $10,287 | 14 plans |
| 075 | Medical/Surgical | $5,197 – $51,403 · median $18,760 | 14 plans |
| 076 | Medical/Surgical | $5,197 – $22,803 · median $8,322 | 14 plans |
| 080 | Medical/Surgical | $5,197 – $48,588 · median $17,733 | 14 plans |
| 081 | NONTRAUMATIC STUPOR AND COMA WITHOUT MCC | $5,197 – $24,646 · median $8,995 | 14 plans |
| 082 | Medical/Surgical | $5,197 – $61,041 · median $22,278 | 14 plans |
| 083 | Medical/Surgical | $5,197 – $37,743 · median $13,775 | 14 plans |
| 084 | Medical/Surgical | $5,197 – $26,222 · median $9,570 | 14 plans |
| 085 | Medical/Surgical | $5,197 – $60,682 · median $22,147 | 14 plans |
| 086 | Medical/Surgical | $5,197 – $35,305 · median $12,885 | 14 plans |
| 087 | Medical/Surgical | $5,197 – $25,146 · median $9,177 | 14 plans |
| 088 | CONCUSSION WITH MCC | $5,197 – $36,591 · median $13,354 | 14 plans |
| 089 | CONCUSSION WITH CC | $5,197 – $29,961 · median $10,935 | 14 plans |
| 090 | CONCUSSION WITHOUT CC/MCC | $5,197 – $22,750 · median $8,303 | 14 plans |
| 091 | Medical/Surgical | $5,197 – $47,180 · median $17,219 | 14 plans |
| 092 | Medical/Surgical | $5,197 – $27,982 · median $10,212 | 14 plans |
| 093 | Medical/Surgical | $5,197 – $22,046 · median $8,046 | 14 plans |
| 094 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC | $5,197 – $93,346 · median $34,068 | 14 plans |
| 095 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC | $5,197 – $68,729 · median $25,083 | 14 plans |
| 096 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC | $5,197 – $68,729 · median $25,083 | 14 plans |
| 097 | NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC | $5,197 – $95,766 · median $34,951 | 14 plans |
| 098 | NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC | $5,197 – $61,285 · median $22,367 | 14 plans |
| 099 | Medical/Surgical | $5,197 – $36,868 · median $13,456 | 14 plans |
| 100 | Medical/Surgical | $5,197 – $51,908 · median $18,945 | 14 plans |
| 101 | Medical/Surgical | $5,197 – $24,829 · median $9,062 | 14 plans |
| 102 | HEADACHES WITH MCC | $5,197 – $30,545 · median $11,148 | 14 plans |
| 103 | HEADACHES WITHOUT MCC | $5,197 – $23,093 · median $8,428 | 14 plans |
| 113 | Medical/Surgical | $5,197 – $62,756 · median $22,904 | 14 plans |
| 114 | Medical/Surgical | $5,197 – $36,622 · median $13,366 | 14 plans |
| 115 | EXTRAOCULAR PROCEDURES EXCEPT ORBIT | $5,197 – $41,385 · median $15,104 | 14 plans |
| 116 | INTRAOCULAR PROCEDURES WITH CC/MCC | $5,197 – $48,538 · median $17,715 | 14 plans |
| 117 | INTRAOCULAR PROCEDURES WITHOUT CC/MCC | $5,197 – $29,602 · median $10,804 | 14 plans |
| 121 | ACUTE MAJOR EYE INFECTIONS WITH CC/MCC | $5,197 – $31,655 · median $11,553 | 14 plans |
| 122 | ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC | $5,197 – $21,771 · median $7,946 | 14 plans |
| 123 | NEUROLOGICAL EYE DISORDERS | $5,197 – $22,106 · median $8,068 | 14 plans |
| 124 | Medical/Surgical | $5,197 – $35,839 · median $13,080 | 14 plans |
| 125 | Medical/Surgical | $5,197 – $21,300 · median $7,774 | 14 plans |
| 135 | Medical/Surgical | $5,197 – $58,014 · median $21,173 | 14 plans |
| 136 | Medical/Surgical | $5,197 – $27,780 · median $10,139 | 14 plans |
| 137 | MOUTH PROCEDURES WITH CC/MCC | $5,197 – $40,293 · median $14,706 | 14 plans |
| 138 | MOUTH PROCEDURES WITHOUT CC/MCC | $5,197 – $24,400 · median $8,905 | 14 plans |
| 139 | Medical/Surgical | $5,197 – $33,551 · median $12,245 | 14 plans |
| 143 | Medical/Surgical | $5,197 – $99,295 · median $36,239 | 14 plans |
| 145 | Medical/Surgical | $5,197 – $32,676 · median $11,926 | 14 plans |
| 146 | EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC | $5,197 – $56,637 · median $20,670 | 14 plans |
| 147 | EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC | $5,197 – $34,488 · median $12,587 | 14 plans |
| 148 | EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC | $5,197 – $22,067 · median $8,054 | 14 plans |
| 149 | DYSEQUILIBRIUM | $5,197 – $20,876 · median $7,619 | 14 plans |
| 150 | EPISTAXIS WITH MCC | $5,197 – $36,059 · median $13,160 | 14 plans |
| 151 | EPISTAXIS WITHOUT MCC | $5,197 – $20,415 · median $7,451 | 14 plans |
| 152 | Medical/Surgical | $5,197 – $32,150 · median $11,734 | 14 plans |
| 153 | Medical/Surgical | $5,197 – $20,525 · median $7,491 | 14 plans |
| 154 | Medical/Surgical | $5,197 – $42,134 · median $15,377 | 14 plans |
| 155 | Medical/Surgical | $5,197 – $25,193 · median $9,195 | 14 plans |
| 156 | Medical/Surgical | $5,197 – $19,291 · median $7,041 | 14 plans |
| 157 | DENTAL AND ORAL DISEASES WITH MCC | $5,197 – $46,148 · median $16,842 | 14 plans |
| 158 | DENTAL AND ORAL DISEASES WITH CC | $5,197 – $25,018 · median $9,131 | 14 plans |
| 159 | DENTAL AND ORAL DISEASES WITHOUT CC/MCC | $5,197 – $19,747 · median $7,207 | 14 plans |
| 175 | Medical/Surgical | $5,197 – $37,162 · median $13,563 | 14 plans |
| 176 | Medical/Surgical | $5,197 – $22,274 · median $8,129 | 14 plans |
| 177 | Medical/Surgical | $5,197 – $42,113 · median $15,370 | 14 plans |
| 178 | Medical/Surgical | $5,197 – $26,751 · median $9,763 | 14 plans |
| 179 | Medical/Surgical | $5,197 – $20,965 · median $7,651 | 14 plans |
| 180 | Medical/Surgical | $5,197 – $47,436 · median $17,312 | 14 plans |
| 181 | Medical/Surgical | $5,197 – $29,239 · median $10,671 | 14 plans |
| 182 | Medical/Surgical | $5,197 – $20,933 · median $7,640 | 14 plans |
| 183 | MAJOR CHEST TRAUMA WITH MCC | $5,197 – $41,254 · median $15,056 | 14 plans |
| 184 | MAJOR CHEST TRAUMA WITH CC | $5,197 – $29,058 · median $10,605 | 14 plans |
| 185 | MAJOR CHEST TRAUMA WITHOUT CC/MCC | $5,197 – $21,789 · median $7,952 | 14 plans |
| 186 | Medical/Surgical | $5,197 – $42,003 · median $15,330 | 14 plans |
| 187 | Medical/Surgical | $5,197 – $27,094 · median $9,888 | 14 plans |
| 188 | Medical/Surgical | $5,197 – $19,975 · median $7,290 | 14 plans |
| 189 | Medical/Surgical | $5,197 – $33,543 · median $12,242 | 14 plans |
| 190 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | $5,197 – $30,199 · median $11,022 | 14 plans |
| 191 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | $5,197 – $23,269 · median $8,492 | 14 plans |
| 192 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC | $5,197 – $18,006 · median $6,571 | 14 plans |
| 193 | Medical/Surgical | $5,197 – $35,612 · median $12,997 | 14 plans |
| 194 | Medical/Surgical | $5,197 – $22,297 · median $8,138 | 14 plans |
| 195 | Medical/Surgical | $5,197 – $17,652 · median $6,442 | 14 plans |
| 196 | INTERSTITIAL LUNG DISEASE WITH MCC | $5,197 – $50,610 · median $18,471 | 14 plans |
| 197 | INTERSTITIAL LUNG DISEASE WITH CC | $5,197 – $26,047 · median $9,506 | 14 plans |
| 198 | INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC | $5,197 – $19,949 · median $7,281 | 14 plans |
| 199 | Medical/Surgical | $5,197 – $47,386 · median $17,294 | 14 plans |
| 200 | Medical/Surgical | $5,197 – $29,980 · median $10,941 | 14 plans |
| 201 | Medical/Surgical | $5,197 – $19,920 · median $7,270 | 14 plans |
| 202 | BRONCHITIS AND ASTHMA WITH CC/MCC | $5,197 – $26,625 · median $9,717 | 14 plans |
| 203 | BRONCHITIS AND ASTHMA WITHOUT CC/MCC | $5,197 – $18,739 · median $6,839 | 14 plans |
| 204 | Medical/Surgical | $5,197 – $22,337 · median $8,152 | 14 plans |
| 205 | Medical/Surgical | $5,197 – $49,138 · median $17,934 | 14 plans |
| 206 | Medical/Surgical | $5,197 – $25,837 · median $9,430 | 14 plans |
| 207 | Medical/Surgical | $5,197 – $169,679 · median $61,927 | 14 plans |
| 208 | Medical/Surgical | $5,197 – $73,167 · median $26,703 | 14 plans |
| 215 | Medical/Surgical | $5,197 – $261,906 · median $95,586 | 14 plans |
| 216 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC | $5,197 – $257,345 · median $93,921 | 14 plans |
| 217 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC | $5,197 – $173,361 · median $63,270 | 14 plans |
| 218 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC | $5,197 – $173,361 · median $63,270 | 14 plans |
| 219 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC | $5,197 – $202,241 · median $73,811 | 14 plans |
| 220 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC | $5,197 – $140,828 · median $51,397 | 14 plans |
| 221 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC | $5,197 – $133,166 · median $48,601 | 14 plans |
| 228 | Medical/Surgical | $5,197 – $130,737 · median $47,714 | 14 plans |
| 229 | Medical/Surgical | $5,197 – $83,661 · median $30,533 | 14 plans |
| 231 | CORONARY BYPASS WITH PTCA WITH MCC | $5,197 – $221,921 · median $80,993 | 14 plans |
| 232 | CORONARY BYPASS WITH PTCA WITHOUT MCC | $5,197 – $159,936 · median $58,371 | 14 plans |
| 233 | CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITH MCC | $5,197 – $201,375 · median $73,494 | 14 plans |
| 234 | CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITHOUT MCC | $5,197 – $144,229 · median $52,638 | 14 plans |
| 235 | CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC | $5,197 – $154,857 · median $56,517 | 14 plans |
| 236 | CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC | $5,197 – $110,874 · median $40,465 | 14 plans |
| 239 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC | $5,197 – $130,064 · median $47,468 | 14 plans |
| 240 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC | $5,197 – $75,832 · median $27,676 | 14 plans |
| 241 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC | $5,197 – $37,444 · median $13,666 | 14 plans |
| 242 | Medical/Surgical | $5,197 – $84,795 · median $30,947 | 14 plans |
| 243 | Medical/Surgical | $5,197 – $56,990 · median $20,799 | 14 plans |
| 244 | Medical/Surgical | $5,197 – $48,523 · median $17,709 | 14 plans |
| 245 | AICD GENERATOR PROCEDURES | $5,197 – $120,656 · median $44,035 | 14 plans |
| 250 | Medical/Surgical | $5,197 – $58,342 · median $21,293 | 14 plans |
| 251 | Medical/Surgical | $5,197 – $40,327 · median $14,718 | 14 plans |
| 252 | Medical/Surgical | $5,197 – $92,532 · median $33,771 | 14 plans |
| 253 | Medical/Surgical | $5,197 – $69,158 · median $25,240 | 14 plans |
| 254 | Medical/Surgical | $5,197 – $47,847 · median $17,462 | 14 plans |
| 255 | Medical/Surgical | $5,197 – $71,823 · median $26,213 | 14 plans |
| 256 | Medical/Surgical | $5,197 – $45,653 · median $16,662 | 14 plans |
| 257 | Medical/Surgical | $5,197 – $29,794 · median $10,874 | 14 plans |
| 258 | CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC | $5,197 – $83,467 · median $30,463 | 14 plans |
| 259 | CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC | $5,197 – $54,142 · median $19,760 | 14 plans |
| 260 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC | $5,197 – $86,366 · median $31,520 | 14 plans |
| 261 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC | $5,197 – $50,696 · median $18,502 | 14 plans |
| 262 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC | $5,197 – $43,873 · median $16,012 | 14 plans |
| 263 | Medical/Surgical | $5,197 – $81,250 · median $29,653 | 14 plans |
| 264 | Medical/Surgical | $5,197 – $88,665 · median $32,359 | 14 plans |
| 265 | AICD LEAD PROCEDURES | $5,197 – $95,933 · median $35,012 | 14 plans |
| 266 | ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC | $5,197 – $161,659 · median $59,000 | 14 plans |
| 267 | ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC | $5,197 – $125,851 · median $45,931 | 14 plans |
| 268 | AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC | $5,197 – $181,284 · median $66,162 | 14 plans |
| 269 | AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC | $5,197 – $111,774 · median $40,794 | 14 plans |
| 270 | Medical/Surgical | $5,197 – $139,348 · median $50,857 | 14 plans |
| 271 | Medical/Surgical | $5,197 – $94,313 · median $34,421 | 14 plans |
| 272 | Medical/Surgical | $5,197 – $68,043 · median $24,833 | 14 plans |
| 273 | Medical/Surgical | $5,197 – $109,216 · median $39,860 | 14 plans |
| 274 | Medical/Surgical | $5,197 – $87,384 · median $31,892 | 14 plans |
| 275 | CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC | $5,197 – $187,895 · median $68,575 | 14 plans |
| 276 | CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR | $5,197 – $158,470 · median $57,836 | 14 plans |
| 277 | CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC | $5,197 – $122,125 · median $44,571 | 14 plans |
| 280 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | $5,197 – $43,197 · median $15,765 | 14 plans |
| 281 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | $5,197 – $25,261 · median $9,219 | 14 plans |
| 282 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | $5,197 – $20,129 · median $7,346 | 14 plans |
| 283 | ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC | $5,197 – $53,060 · median $19,365 | 14 plans |
| 284 | ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC | $5,197 – $19,320 · median $7,051 | 14 plans |
| 285 | ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC | $5,197 – $16,877 · median $6,160 | 14 plans |
| 286 | CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITH MCC | $5,197 – $59,135 · median $21,582 | 14 plans |
| 287 | CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATETERIZATION WITHOUT MCC | $5,197 – $29,215 · median $10,662 | 14 plans |
| 289 | ACUTE AND SUBACUTE ENDOCARDITIS WITH CC | $5,197 – $45,889 · median $16,748 | 14 plans |
| 290 | ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC | $5,197 – $25,539 · median $9,321 | 14 plans |
| 291 | HEART FAILURE AND SHOCK WITH MCC | $5,197 – $34,810 · median $12,705 | 14 plans |
| 292 | HEART FAILURE AND SHOCK WITH CC | $5,197 – $23,426 · median $8,550 | 14 plans |
| 293 | HEART FAILURE AND SHOCK WITHOUT CC/MCC | $5,197 – $16,016 · median $5,845 | 14 plans |
| 296 | CARDIAC ARREST, UNEXPLAINED WITH MCC | $5,197 – $42,092 · median $15,362 | 14 plans |
| 297 | CARDIAC ARREST, UNEXPLAINED WITH CC | $5,197 – $17,796 · median $6,495 | 14 plans |
| 298 | CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC | $4,785 – $13,112 · median $4,991 | 14 plans |
| 299 | Medical/Surgical | $5,197 – $43,946 · median $16,039 | 14 plans |
| 300 | Medical/Surgical | $5,197 – $29,147 · median $10,638 | 14 plans |
| 301 | Medical/Surgical | $5,197 – $20,040 · median $7,314 | 14 plans |
| 302 | ATHEROSCLEROSIS WITH MCC | $5,197 – $32,527 · median $11,871 | 14 plans |
| 303 | ATHEROSCLEROSIS WITHOUT MCC | $5,197 – $18,823 · median $6,870 | 14 plans |
| 304 | HYPERTENSION WITH MCC | $5,197 – $32,354 · median $11,808 | 14 plans |
| 305 | HYPERTENSION WITHOUT MCC | $5,197 – $20,967 · median $7,652 | 14 plans |
| 306 | CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC | $5,197 – $42,456 · median $15,495 | 14 plans |
| 307 | CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC | $5,197 – $25,107 · median $9,163 | 14 plans |
| 308 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | $5,197 – $32,721 · median $11,942 | 14 plans |
| 309 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | $5,197 – $20,459 · median $7,467 | 14 plans |
| 310 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | $5,197 – $16,018 · median $5,846 | 14 plans |
| 311 | ANGINA PECTORIS | $5,197 – $19,574 · median $7,144 | 14 plans |
| 312 | Medical/Surgical | $5,197 – $24,018 · median $8,766 | 14 plans |
| 313 | CHEST PAIN | $5,197 – $20,048 · median $7,317 | 14 plans |
| 314 | Medical/Surgical | $5,197 – $55,794 · median $20,363 | 14 plans |
| 315 | Medical/Surgical | $5,197 – $26,419 · median $9,642 | 14 plans |
| 316 | Medical/Surgical | $5,197 – $19,056 · median $6,955 | 14 plans |
| 319 | Medical/Surgical | $5,197 – $118,051 · median $43,084 | 14 plans |
| 320 | Medical/Surgical | $5,197 – $64,175 · median $23,422 | 14 plans |
| 332 | Medical/Surgical | $5,197 – $95,999 · median $35,036 | 14 plans |
| 333 | Medical/Surgical | $5,197 – $62,523 · median $22,819 | 14 plans |
| 336 | Medical/Surgical | $5,197 – $56,409 · median $20,587 | 14 plans |
| 337 | Medical/Surgical | $5,197 – $41,388 · median $15,105 | 14 plans |
| 344 | Medical/Surgical | $5,197 – $68,823 · median $25,118 | 14 plans |
| 345 | MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | $5,197 – $40,594 · median $14,815 | 14 plans |
| 346 | Medical/Surgical | $5,197 – $32,255 · median $11,772 | 14 plans |
| 347 | ANAL AND STOMAL PROCEDURES WITH MCC | $5,197 – $61,303 · median $22,373 | 14 plans |
| 348 | ANAL AND STOMAL PROCEDURES WITH CC | $5,197 – $35,465 · median $12,943 | 14 plans |
| 349 | ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC | $5,197 – $23,991 · median $8,756 | 14 plans |
| 350 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC | $5,197 – $66,443 · median $24,249 | 14 plans |
| 351 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC | $5,197 – $41,113 · median $15,005 | 14 plans |
| 352 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC | $5,197 – $31,773 · median $11,596 | 14 plans |
| 353 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC | $5,197 – $77,181 · median $28,168 | 14 plans |
| 354 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC | $5,197 – $45,247 · median $16,514 | 14 plans |
| 355 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC | $5,197 – $36,413 · median $13,289 | 14 plans |
| 356 | Medical/Surgical | $5,197 – $116,215 · median $42,414 | 14 plans |
| 357 | Medical/Surgical | $5,197 – $62,086 · median $22,659 | 14 plans |
| 358 | Medical/Surgical | $5,197 – $37,798 · median $13,795 | 14 plans |
| 368 | MAJOR ESOPHAGEAL DISORDERS WITH MCC | $5,197 – $42,878 · median $15,649 | 14 plans |
| 369 | MAJOR ESOPHAGEAL DISORDERS WITH CC | $5,197 – $27,385 · median $9,994 | 14 plans |
| 370 | MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC | $5,197 – $19,545 · median $7,133 | 14 plans |
| 371 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC | $5,197 – $47,622 · median $17,380 | 14 plans |
| 372 | Medical/Surgical | $5,197 – $27,929 · median $10,193 | 14 plans |
| 373 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC | $5,197 – $20,242 · median $7,388 | 14 plans |
| 374 | DIGESTIVE MALIGNANCY WITH MCC | $5,197 – $57,195 · median $20,874 | 14 plans |
| 375 | DIGESTIVE MALIGNANCY WITH CC | $5,197 – $32,868 · median $11,995 | 14 plans |
| 376 | DIGESTIVE MALIGNANCY WITHOUT CC/MCC | $5,197 – $25,397 · median $9,269 | 14 plans |
| 377 | G.I. HEMORRHAGE WITH MCC | $5,197 – $49,059 · median $17,905 | 14 plans |
| 378 | G.I. HEMORRHAGE WITH CC | $5,197 – $26,874 · median $9,808 | 14 plans |
| 379 | G.I. HEMORRHAGE WITHOUT CC/MCC | $5,197 – $17,702 · median $6,461 | 14 plans |
| 380 | COMPLICATED PEPTIC ULCER WITH MCC | $5,197 – $52,573 · median $19,187 | 14 plans |
| 381 | COMPLICATED PEPTIC ULCER WITH CC | $5,197 – $29,566 · median $10,790 | 14 plans |
| 382 | COMPLICATED PEPTIC ULCER WITHOUT CC/MCC | $5,197 – $22,159 · median $8,087 | 14 plans |
| 383 | Medical/Surgical | $5,197 – $37,348 · median $13,631 | 14 plans |
| 384 | Medical/Surgical | $5,197 – $23,578 · median $8,605 | 14 plans |
| 385 | INFLAMMATORY BOWEL DISEASE WITH MCC | $5,197 – $42,626 · median $15,557 | 14 plans |
| 386 | INFLAMMATORY BOWEL DISEASE WITH CC | $5,197 – $26,759 · median $9,766 | 14 plans |
| 387 | INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC | $5,197 – $19,035 · median $6,947 | 14 plans |
| 388 | G.I. OBSTRUCTION WITH MCC | $5,197 – $39,864 · median $14,549 | 14 plans |
| 389 | G.I. OBSTRUCTION WITH CC | $5,197 – $21,876 · median $7,984 | 14 plans |
| 390 | G.I. OBSTRUCTION WITHOUT CC/MCC | $5,197 – $15,440 · median $5,635 | 14 plans |
| 391 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | $5,197 – $34,405 · median $12,556 | 14 plans |
| 392 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | $5,197 – $21,609 · median $7,886 | 14 plans |
| 393 | Medical/Surgical | $5,197 – $43,071 · median $15,719 | 14 plans |
| 394 | Medical/Surgical | $5,197 – $25,696 · median $9,378 | 14 plans |
| 395 | Medical/Surgical | $5,197 – $18,189 · median $6,638 | 14 plans |
| 397 | APPENDIX PROCEDURES WITH MCC | $5,197 – $63,903 · median $23,322 | 14 plans |
| 398 | APPENDIX PROCEDURES WITH CC | $5,197 – $40,827 · median $14,901 | 14 plans |
| 399 | APPENDIX PROCEDURES WITHOUT CC/MCC | $5,197 – $31,168 · median $11,375 | 14 plans |
| 405 | Medical/Surgical | $5,197 – $144,433 · median $52,713 | 14 plans |
| 406 | Medical/Surgical | $5,197 – $77,134 · median $28,151 | 14 plans |
| 407 | Medical/Surgical | $5,197 – $59,313 · median $21,647 | 14 plans |
| 408 | BILIARY TRACT PROCEDURE EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC | $5,197 – $94,556 · median $34,510 | 14 plans |
| 409 | BILIARY TRACT PROCEDURE EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC | $5,197 – $58,205 · median $21,243 | 14 plans |
| 410 | BILIARY TRACT PROCEDURE EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC | $5,197 – $42,768 · median $15,609 | 14 plans |
| 411 | CHOLECYSTECTOMY WITH C.D.E. WITH MCC | $5,197 – $87,688 · median $32,003 | 14 plans |
| 412 | CHOLECYSTECTOMY WITH C.D.E. WITH CC | $5,197 – $56,247 · median $20,528 | 14 plans |
| 413 | CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC | $5,197 – $44,674 · median $16,304 | 14 plans |
| 414 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC | $5,197 – $94,478 · median $34,481 | 14 plans |
| 415 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC | $5,197 – $55,310 · median $20,186 | 14 plans |
| 416 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC | $5,197 – $36,892 · median $13,464 | 14 plans |
| 420 | HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC | $5,197 – $90,406 · median $32,995 | 14 plans |
| 421 | HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC | $5,197 – $46,690 · median $17,040 | 14 plans |
| 422 | HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC | $5,197 – $37,840 · median $13,810 | 14 plans |
| 423 | Medical/Surgical | $5,197 – $109,936 · median $40,123 | 14 plans |
| 424 | Medical/Surgical | $5,197 – $58,483 · median $21,344 | 14 plans |
| 425 | Medical/Surgical | $5,197 – $40,479 · median $14,773 | 14 plans |
| 432 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | $5,197 – $52,730 · median $19,245 | 14 plans |
| 433 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC | $5,197 – $28,851 · median $10,530 | 14 plans |
| 434 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC | $5,197 – $19,852 · median $7,245 | 14 plans |
| 435 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | $5,197 – $49,287 · median $17,988 | 14 plans |
| 436 | Medical/Surgical | $5,197 – $30,812 · median $11,245 | 14 plans |
| 437 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC | $5,197 – $23,538 · median $8,591 | 14 plans |
| 438 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC | $5,197 – $43,880 · median $16,015 | 14 plans |
| 439 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | $5,197 – $23,222 · median $8,475 | 14 plans |
| 440 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC | $5,197 – $17,466 · median $6,375 | 14 plans |
| 441 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | $5,197 – $48,188 · median $17,587 | 14 plans |
| 442 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC | $5,197 – $26,471 · median $9,661 | 14 plans |
| 443 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC | $5,197 – $19,517 · median $7,123 | 14 plans |
| 444 | DISORDERS OF THE BILIARY TRACT WITH MCC | $5,197 – $44,946 · median $16,404 | 14 plans |
| 445 | DISORDERS OF THE BILIARY TRACT WITH CC | $5,197 – $29,851 · median $10,895 | 14 plans |
| 446 | DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC | $5,197 – $22,858 · median $8,342 | 14 plans |
| 533 | FRACTURES OF FEMUR WITH MCC | $5,197 – $42,244 · median $15,417 | 14 plans |
| 534 | FRACTURES OF FEMUR WITHOUT MCC | $5,197 – $22,303 · median $8,140 | 14 plans |
| 535 | FRACTURES OF HIP AND PELVIS WITH MCC | $5,197 – $34,763 · median $12,687 | 14 plans |
| 536 | FRACTURES OF HIP AND PELVIS WITHOUT MCC | $5,197 – $22,342 · median $8,154 | 14 plans |
| 537 | Medical/Surgical | $5,197 – $26,183 · median $9,556 | 14 plans |
| 538 | Medical/Surgical | $5,197 – $20,056 · median $7,320 | 14 plans |
| 539 | Medical/Surgical | $5,197 – $52,770 · median $19,259 | 14 plans |
| 540 | Medical/Surgical | $5,197 – $35,138 · median $12,824 | 14 plans |
| 541 | Medical/Surgical | $5,197 – $21,813 · median $7,961 | 14 plans |
| 542 | Medical/Surgical | $5,197 – $47,449 · median $17,317 | 14 plans |
| 543 | Medical/Surgical | $5,197 – $28,113 · median $10,260 | 14 plans |
| 544 | Medical/Surgical | $5,197 – $20,954 · median $7,647 | 14 plans |
| 545 | CONNECTIVE TISSUE DISORDERS WITH MCC | $5,197 – $66,176 · median $24,152 | 14 plans |
| 546 | CONNECTIVE TISSUE DISORDERS WITH CC | $5,197 – $31,396 · median $11,458 | 14 plans |
| 547 | CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC | $5,197 – $23,091 · median $8,427 | 14 plans |
| 548 | Medical/Surgical | $5,197 – $51,754 · median $18,888 | 14 plans |
| 549 | Medical/Surgical | $5,197 – $32,805 · median $11,973 | 14 plans |
| 550 | Medical/Surgical | $5,197 – $24,083 · median $8,789 | 14 plans |
| 551 | Medical/Surgical | $5,197 – $45,082 · median $16,453 | 14 plans |
| 552 | MEDICAL BACK PROBLEMS WITHOUT MCC | $5,197 – $26,366 · median $9,623 | 14 plans |
| 553 | BONE DISEASES AND ARTHROPATHIES WITH MCC | $5,197 – $35,138 · median $12,824 | 14 plans |
| 554 | BONE DISEASES AND ARTHROPATHIES WITHOUT MCC | $5,197 – $22,931 · median $8,369 | 14 plans |
| 555 | Medical/Surgical | $5,197 – $35,805 · median $13,068 | 14 plans |
| 556 | Medical/Surgical | $5,197 – $22,944 · median $8,374 | 14 plans |
| 557 | Medical/Surgical | $5,197 – $40,128 · median $14,645 | 14 plans |
| 558 | Medical/Surgical | $5,197 – $24,583 · median $8,972 | 14 plans |
| 559 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $5,197 – $50,026 · median $18,258 | 14 plans |
| 560 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | $5,197 – $30,681 · median $11,198 | 14 plans |
| 561 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | $5,197 – $22,245 · median $8,119 | 14 plans |
| 562 | FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC | $5,197 – $38,502 · median $14,052 | 14 plans |
| 563 | FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | $5,197 – $24,643 · median $8,994 | 14 plans |
| 564 | Medical/Surgical | $5,197 – $41,613 · median $15,187 | 14 plans |
| 565 | Medical/Surgical | $5,197 – $26,709 · median $9,748 | 14 plans |
| 566 | Medical/Surgical | $5,197 – $20,815 · median $7,597 | 14 plans |
| 570 | Medical/Surgical | $5,197 – $78,204 · median $28,542 | 14 plans |
| 571 | Medical/Surgical | $5,197 – $45,433 · median $16,581 | 14 plans |
| 572 | Medical/Surgical | $5,197 – $31,210 · median $11,391 | 14 plans |
| 573 | Medical/Surgical | $5,197 – $172,735 · median $63,042 | 14 plans |
| 574 | Medical/Surgical | $5,197 – $92,090 · median $33,609 | 14 plans |
| 575 | Medical/Surgical | $5,197 – $48,248 · median $17,609 | 14 plans |
| 576 | Medical/Surgical | $5,197 – $129,527 · median $47,273 | 14 plans |
| 577 | Medical/Surgical | $5,197 – $70,601 · median $25,767 | 14 plans |
| 578 | Medical/Surgical | $5,197 – $43,257 · median $15,787 | 14 plans |
| 579 | Medical/Surgical | $5,197 – $85,991 · median $31,384 | 14 plans |
| 580 | Medical/Surgical | $5,197 – $46,441 · median $16,949 | 14 plans |
| 581 | Medical/Surgical | $5,197 – $38,981 · median $14,227 | 14 plans |
| 582 | Medical/Surgical | $5,197 – $51,641 · median $18,847 | 14 plans |
| 583 | MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC | $5,197 – $46,347 · median $16,915 | 14 plans |
| 584 | BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC | $5,197 – $57,247 · median $20,893 | 14 plans |
| 585 | BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC | $5,197 – $51,707 · median $18,871 | 14 plans |
| 592 | Medical/Surgical | $5,197 – $51,869 · median $18,930 | 14 plans |
| 593 | Medical/Surgical | $5,197 – $32,258 · median $11,773 | 14 plans |
| 594 | Medical/Surgical | $5,197 – $23,892 · median $8,720 | 14 plans |
| 595 | MAJOR SKIN DISORDERS WITH MCC | $5,197 – $56,723 · median $20,702 | 14 plans |
| 596 | MAJOR SKIN DISORDERS WITHOUT MCC | $5,197 – $29,540 · median $10,781 | 14 plans |
| 597 | MALIGNANT BREAST DISORDERS WITH MCC | $5,197 – $44,847 · median $16,367 | 14 plans |
| 598 | MALIGNANT BREAST DISORDERS WITH CC | $5,197 – $30,817 · median $11,247 | 14 plans |
| 599 | MALIGNANT BREAST DISORDERS WITHOUT CC/MCC | $5,197 – $21,342 · median $7,789 | 14 plans |
| 600 | Medical/Surgical | $5,197 – $28,469 · median $10,390 | 14 plans |
| 601 | NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC | $5,197 – $17,037 · median $6,218 | 14 plans |
| 602 | CELLULITIS WITH MCC | $5,197 – $38,411 · median $14,018 | 14 plans |
| 603 | CELLULITIS WITHOUT MCC | $5,197 – $23,999 · median $8,759 | 14 plans |
| 604 | Medical/Surgical | $5,197 – $39,741 · median $14,504 | 14 plans |
| 605 | Medical/Surgical | $5,197 – $25,180 · median $9,190 | 14 plans |
| 606 | Medical/Surgical | $5,197 – $40,817 · median $14,897 | 14 plans |
| 607 | MINOR SKIN DISORDERS WITHOUT MCC | $5,197 – $24,929 · median $9,098 | 14 plans |
| 614 | ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC | $5,197 – $58,585 · median $21,381 | 14 plans |
| 615 | ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC | $5,197 – $37,835 · median $13,808 | 14 plans |
| 616 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC | $5,197 – $92,509 · median $33,762 | 14 plans |
| 617 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | $5,197 – $50,167 · median $18,309 | 14 plans |
| 618 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC | $5,197 – $38,332 · median $13,990 | 14 plans |
| 622 | Medical/Surgical | $5,197 – $94,388 · median $34,448 | 14 plans |
| 623 | Medical/Surgical | $5,197 – $48,167 · median $17,579 | 14 plans |
| 624 | Medical/Surgical | $5,197 – $33,975 · median $12,400 | 14 plans |
| 625 | Medical/Surgical | $5,197 – $80,273 · median $29,297 | 14 plans |
| 626 | Medical/Surgical | $5,197 – $40,456 · median $14,765 | 14 plans |
| 627 | Medical/Surgical | $5,197 – $35,976 · median $13,130 | 14 plans |
| 628 | Medical/Surgical | $5,197 – $98,777 · median $36,050 | 14 plans |
| 629 | Medical/Surgical | $5,197 – $58,245 · median $21,257 | 14 plans |
| 630 | Medical/Surgical | $5,197 – $39,411 · median $14,384 | 14 plans |
| 637 | DIABETES WITH MCC | $5,197 – $38,814 · median $14,166 | 14 plans |
| 638 | DIABETES WITH CC | $5,197 – $24,662 · median $9,001 | 14 plans |
| 639 | DIABETES WITHOUT CC/MCC | $5,197 – $17,461 · median $6,373 | 14 plans |
| 640 | Medical/Surgical | $5,197 – $36,167 · median $13,200 | 14 plans |
| 641 | Medical/Surgical | $5,197 – $21,572 · median $7,873 | 14 plans |
| 642 | INBORN AND OTHER DISORDERS OF METABOLISM | $5,197 – $38,432 · median $14,026 | 14 plans |
| 643 | ENDOCRINE DISORDERS WITH MCC | $5,197 – $44,297 · median $16,167 | 14 plans |
| 644 | ENDOCRINE DISORDERS WITH CC | $5,197 – $28,034 · median $10,231 | 14 plans |
| 645 | ENDOCRINE DISORDERS WITHOUT CC/MCC | $5,197 – $21,313 · median $7,778 | 14 plans |
| 682 | Medical/Surgical | $5,197 – $39,974 · median $14,589 | 14 plans |
| 683 | Medical/Surgical | $5,197 – $24,128 · median $8,806 | 14 plans |
| 684 | Medical/Surgical | $5,197 – $16,914 · median $6,173 | 14 plans |
| 686 | KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC | $5,197 – $48,423 · median $17,673 | 14 plans |
| 687 | KIDNEY AND URINARY TRACT NEOPLASMS WITH CC | $5,197 – $28,631 · median $10,449 | 14 plans |
| 688 | KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC | $5,197 – $21,889 · median $7,989 | 14 plans |
| 689 | KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | $5,197 – $31,577 · median $11,524 | 14 plans |
| 690 | KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | $5,197 – $22,392 · median $8,172 | 14 plans |
| 693 | Medical/Surgical | $5,197 – $36,400 · median $13,285 | 14 plans |
| 694 | Medical/Surgical | $5,197 – $21,664 · median $7,906 | 14 plans |
| 695 | KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC | $5,197 – $31,145 · median $11,367 | 14 plans |
| 696 | KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC | $5,197 – $19,236 · median $7,021 | 14 plans |
| 697 | Medical/Surgical | $5,197 – $29,417 · median $10,736 | 14 plans |
| 698 | Medical/Surgical | $5,197 – $44,514 · median $16,246 | 14 plans |
| 699 | Medical/Surgical | $5,197 – $27,772 · median $10,136 | 14 plans |
| 700 | Medical/Surgical | $5,197 – $19,260 · median $7,029 | 14 plans |
| 709 | Medical/Surgical | $5,197 – $62,128 · median $22,674 | 14 plans |
| 710 | Medical/Surgical | $5,197 – $37,884 · median $13,826 | 14 plans |
| 711 | Medical/Surgical | $5,197 – $55,757 · median $20,349 | 14 plans |
| 712 | Medical/Surgical | $5,197 – $29,990 · median $10,945 | 14 plans |
| 713 | Medical/Surgical | $5,197 – $40,560 · median $14,803 | 14 plans |
| 714 | Medical/Surgical | $5,197 – $28,882 · median $10,541 | 14 plans |
| 715 | Medical/Surgical | $5,197 – $59,776 · median $21,816 | 14 plans |
| 716 | Medical/Surgical | $5,197 – $39,712 · median $14,493 | 14 plans |
| 717 | Medical/Surgical | $5,197 – $50,696 · median $18,502 | 14 plans |
| 718 | Medical/Surgical | $5,197 – $36,363 · median $13,271 | 14 plans |
| 722 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC | $5,197 – $48,580 · median $17,730 | 14 plans |
| 723 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC | $5,197 – $31,116 · median $11,356 | 14 plans |
| 724 | Medical/Surgical | $5,197 – $18,365 · median $6,702 | 14 plans |
| 725 | BENIGN PROSTATIC HYPERTROPHY WITH MCC | $5,197 – $31,836 · median $11,619 | 14 plans |
| 726 | BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC | $5,197 – $20,100 · median $7,336 | 14 plans |
| 727 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC | $5,197 – $40,024 · median $14,607 | 14 plans |
| 728 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC | $5,197 – $22,436 · median $8,188 | 14 plans |
| 729 | Medical/Surgical | $5,197 – $28,916 · median $10,553 | 14 plans |
| 730 | Medical/Surgical | $5,197 – $18,791 · median $6,858 | 14 plans |
| 754 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC | $5,197 – $49,418 · median $18,036 | 14 plans |
| 755 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC | $5,197 – $29,678 · median $10,832 | 14 plans |
| 756 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | $5,197 – $26,345 · median $9,615 | 14 plans |
| 757 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC | $5,197 – $38,688 · median $14,120 | 14 plans |
| 758 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC | $5,197 – $26,830 · median $9,792 | 14 plans |
| 759 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | $5,197 – $18,571 · median $6,778 | 14 plans |
| 760 | MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC | $5,197 – $27,576 · median $10,064 | 14 plans |
| 761 | MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC | $5,197 – $16,134 · median $5,888 | 14 plans |
| 769 | Medical/Surgical | $5,197 – $45,441 · median $16,584 | 14 plans |
| 770 | ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY | $5,197 – $27,450 · median $10,018 | 14 plans |
| 776 | Medical/Surgical | $5,197 – $18,338 · median $6,693 | 14 plans |
| 779 | ABORTION WITHOUT D&C | $5,197 – $23,224 · median $8,476 | 14 plans |
| 789 | NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY | $5,197 – $48,384 · median $17,658 | 14 plans |
| 790 | EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE | $5,197 – $156,818 · median $57,233 | 14 plans |
| 791 | Medical/Surgical | $5,197 – $107,475 · median $39,224 | 14 plans |
| 792 | Medical/Surgical | $5,197 – $65,325 · median $23,841 | 14 plans |
| 793 | FULL TERM NEONATE WITH MAJOR PROBLEMS | $5,197 – $110,371 · median $40,281 | 14 plans |
| 794 | NEONATE WITH OTHER SIGNIFICANT PROBLEMS | $5,197 – $39,840 · median $14,540 | 14 plans |
| 795 | NORMAL NEWBORN | $2,346 – $9,368 · median $2,383 | 14 plans |
| 799 | Medical/Surgical | $5,197 – $119,779 · median $43,715 | 14 plans |
| 800 | Medical/Surgical | $5,197 – $74,756 · median $27,283 | 14 plans |
| 801 | Medical/Surgical | $5,197 – $51,178 · median $18,678 | 14 plans |
| 802 | Medical/Surgical | $5,197 – $105,514 · median $38,509 | 14 plans |
| 803 | Medical/Surgical | $5,197 – $49,869 · median $18,200 | 14 plans |
| 804 | Medical/Surgical | $5,197 – $36,701 · median $13,394 | 14 plans |
| 808 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC | $5,197 – $59,007 · median $21,535 | 14 plans |
| 809 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC | $5,197 – $34,342 · median $12,533 | 14 plans |
| 810 | Medical/Surgical | $5,197 – $28,600 · median $10,438 | 14 plans |
| 811 | Medical/Surgical | $5,197 – $37,966 · median $13,856 | 14 plans |
| 812 | Medical/Surgical | $5,197 – $25,238 · median $9,211 | 14 plans |
| 813 | COAGULATION DISORDERS | $5,197 – $41,134 · median $15,012 | 14 plans |
| 814 | Medical/Surgical | $5,197 – $56,881 · median $20,759 | 14 plans |
| 815 | Medical/Surgical | $5,197 – $27,746 · median $10,126 | 14 plans |
| 816 | Medical/Surgical | $5,197 – $17,744 · median $6,476 | 14 plans |
| 817 | False Labor | $828 – $60,936 · median $22,240 | 14 plans |
| 818 | False Labor | $828 – $31,548 · median $11,514 | 14 plans |
| 819 | False Labor | $828 – $23,711 · median $8,654 | 14 plans |
| 820 | LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURE WITH MCC | $5,197 – $154,757 · median $56,481 | 14 plans |
| 821 | LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURE WITH CC | $5,197 – $59,810 · median $21,829 | 14 plans |
| 822 | LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURE WITHOUT CC/MCC | $5,197 – $32,721 · median $11,942 | 14 plans |
| 823 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURE WITH MCC | $5,197 – $121,242 · median $44,249 | 14 plans |
| 824 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURE WITH CC | $5,197 – $60,517 · median $22,087 | 14 plans |
| 825 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURE WITHOUT CC/MCC | $5,197 – $36,528 · median $13,331 | 14 plans |
| 826 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURE WITH MCC | $5,197 – $123,677 · median $45,138 | 14 plans |
| 827 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURE WITH CC | $5,197 – $61,711 · median $22,522 | 14 plans |
| 828 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURE WITHOUT CC/MCC | $5,197 – $45,807 · median $16,718 | 14 plans |
| 829 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURE WITH CC/MCC | $5,197 – $83,936 · median $30,634 | 14 plans |
| 830 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURE WITHOUT CC/MCC | $5,197 – $40,602 · median $14,818 | 14 plans |
| 834 | ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURE WITH MCC | $5,197 – $144,941 · median $52,898 | 14 plans |
| 835 | ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURE WITH CC | $5,197 – $55,810 · median $20,368 | 14 plans |
| 836 | ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURE WITHOUT CC/MCC | $5,197 – $33,127 · median $12,090 | 14 plans |
| 837 | CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SDX OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC | $5,197 – $126,990 · median $46,347 | 14 plans |
| 838 | CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SDX WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT | $5,197 – $55,852 · median $20,384 | 14 plans |
| 839 | CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SDX WITHOUT CC/MCC | $5,197 – $39,002 · median $14,234 | 14 plans |
| 840 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC | $5,197 – $85,897 · median $31,349 | 14 plans |
| 841 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC | $5,197 – $43,912 · median $16,026 | 14 plans |
| 842 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC | $5,197 – $27,652 · median $10,092 | 14 plans |
| 843 | Medical/Surgical | $5,197 – $53,427 · median $19,499 | 14 plans |
| 844 | Medical/Surgical | $5,197 – $33,072 · median $12,070 | 14 plans |
| 845 | Medical/Surgical | $5,197 – $23,494 · median $8,574 | 14 plans |
| 846 | CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC | $5,197 – $69,077 · median $25,211 | 14 plans |
| 847 | CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC | $5,197 – $35,449 · median $12,938 | 14 plans |
| 848 | CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC | $5,197 – $23,436 · median $8,553 | 14 plans |
| 849 | Medical/Surgical | $5,197 – $72,140 · median $26,329 | 14 plans |
| 853 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH MCC | $5,197 – $130,506 · median $47,630 | 14 plans |
| 854 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITH CC | $5,197 – $53,513 · median $19,530 | 14 plans |
| 855 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURE WITHOUT CC/MCC | $5,197 – $40,398 · median $14,744 | 14 plans |
| 856 | Medical/Surgical | $5,197 – $120,297 · median $43,904 | 14 plans |
| 857 | Medical/Surgical | $5,197 – $57,268 · median $20,901 | 14 plans |
| 858 | Medical/Surgical | $5,197 – $37,667 · median $13,747 | 14 plans |
| 862 | Medical/Surgical | $5,197 – $48,947 · median $17,864 | 14 plans |
| 863 | Medical/Surgical | $5,197 – $27,325 · median $9,972 | 14 plans |
| 864 | FEVER AND INFLAMMATORY CONDITIONS | $5,197 – $24,439 · median $8,919 | 14 plans |
| 865 | Medical/Surgical | $5,197 – $40,427 · median $14,754 | 14 plans |
| 866 | Medical/Surgical | $5,197 – $23,965 · median $8,746 | 14 plans |
| 867 | Medical/Surgical | $5,197 – $56,003 · median $20,439 | 14 plans |
| 868 | Medical/Surgical | $5,197 – $28,194 · median $10,290 | 14 plans |
| 869 | Medical/Surgical | $5,197 – $20,302 · median $7,410 | 14 plans |
| 870 | Medical/Surgical | $5,197 – $182,172 · median $66,486 | 14 plans |
| 871 | Medical/Surgical | $5,197 – $52,058 · median $18,999 | 14 plans |
| 872 | Medical/Surgical | $5,197 – $27,990 · median $10,215 | 14 plans |
| 876 | O.R. PROCEDURE WITH PRINCIPAL DIAGNOSES OF MENTAL ILLNESS | $5,197 – $102,393 · median $37,370 | 14 plans |
| 901 | Medical/Surgical | $5,197 – $111,078 · median $40,539 | 14 plans |
| 902 | Medical/Surgical | $5,197 – $51,324 · median $18,732 | 14 plans |
| 903 | Medical/Surgical | $5,197 – $31,820 · median $11,613 | 14 plans |
| 904 | Medical/Surgical | $5,197 – $97,371 · median $35,537 | 14 plans |
| 905 | Medical/Surgical | $5,197 – $40,037 · median $14,612 | 14 plans |
| 906 | HAND PROCEDURES FOR INJURIES | $5,197 – $52,628 · median $19,207 | 14 plans |
| 907 | Medical/Surgical | $5,197 – $101,723 · median $37,125 | 14 plans |
| 908 | Medical/Surgical | $5,197 – $53,437 · median $19,503 | 14 plans |
| 909 | Medical/Surgical | $5,197 – $35,567 · median $12,981 | 14 plans |
| 913 | Medical/Surgical | $5,197 – $43,996 · median $16,057 | 14 plans |
| 914 | Medical/Surgical | $5,197 – $24,381 · median $8,898 | 14 plans |
| 915 | ALLERGIC REACTIONS WITH MCC | $5,197 – $45,226 · median $16,506 | 14 plans |
| 916 | ALLERGIC REACTIONS WITHOUT MCC | $5,197 – $18,642 · median $6,804 | 14 plans |
| 917 | Medical/Surgical | $5,197 – $42,262 · median $15,424 | 14 plans |
| 918 | Medical/Surgical | $5,197 – $23,638 · median $8,627 | 14 plans |
| 919 | COMPLICATIONS OF TREATMENT WITH MCC | $5,197 – $49,133 · median $17,932 | 14 plans |
| 920 | COMPLICATIONS OF TREATMENT WITH CC | $5,197 – $27,440 · median $10,015 | 14 plans |
| 921 | COMPLICATIONS OF TREATMENT WITHOUT CC/MCC | $5,197 – $19,221 · median $7,015 | 14 plans |
| 922 | Medical/Surgical | $5,197 – $47,001 · median $17,154 | 14 plans |
| 923 | Medical/Surgical | $5,197 – $27,843 · median $10,162 | 14 plans |
| 927 | EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT | $5,197 – $560,228 · median $204,463 | 14 plans |
| 928 | FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC | $5,197 – $189,003 · median $68,979 | 14 plans |
| 929 | FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC | $5,197 – $85,528 · median $31,215 | 14 plans |
| 933 | EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT | $5,197 – $103,160 · median $37,650 | 14 plans |
| 934 | FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY | $5,197 – $59,077 · median $21,561 | 14 plans |
| 935 | Medical/Surgical | $5,197 – $55,134 · median $20,122 | 14 plans |
| 939 | O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC | $5,197 – $96,203 · median $35,111 | 14 plans |
| 940 | O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC | $5,197 – $62,384 · median $22,768 | 14 plans |
| 941 | Medical/Surgical | $5,197 – $54,288 · median $19,813 | 14 plans |
| 945 | Medical/Surgical | $5,197 – $41,744 · median $15,235 | 14 plans |
| 946 | Medical/Surgical | $5,197 – $31,223 · median $11,395 | 14 plans |
| 947 | Medical/Surgical | $5,197 – $34,433 · median $12,567 | 14 plans |
| 948 | Medical/Surgical | $5,197 – $22,156 · median $8,086 | 14 plans |
| 949 | AFTERCARE WITH CC/MCC | $5,197 – $32,347 · median $11,805 | 14 plans |
| 950 | AFTERCARE WITHOUT CC/MCC | $5,197 – $17,631 · median $6,435 | 14 plans |
| 951 | Medical/Surgical | $5,197 – $15,754 · median $5,750 | 14 plans |
| 955 | CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA | $5,197 – $177,440 · median $64,759 | 14 plans |
| 956 | LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA | $5,197 – $99,725 · median $36,396 | 14 plans |
| 957 | Medical/Surgical | $5,197 – $200,712 · median $73,253 | 14 plans |
| 958 | Medical/Surgical | $5,197 – $111,531 · median $40,705 | 14 plans |
| 959 | Medical/Surgical | $5,197 – $78,283 · median $28,570 | 14 plans |
| 963 | Medical/Surgical | $5,197 – $72,777 · median $26,561 | 14 plans |
| 964 | Medical/Surgical | $5,197 – $41,325 · median $15,082 | 14 plans |
| 965 | Medical/Surgical | $5,197 – $25,822 · median $9,424 | 14 plans |
| 969 | HIV WITH EXTENSIVE O.R. PROCEDURE WITH MCC | $5,197 – $161,473 · median $58,932 | 14 plans |
| 970 | HIV WITH EXTENSIVE O.R. PROCEDURE WITHOUT MCC | $5,197 – $70,252 · median $25,640 | 14 plans |
| 974 | HIV WITH MAJOR RELATED CONDITION WITH MCC | $5,197 – $76,762 · median $28,015 | 14 plans |
| 975 | HIV WITH MAJOR RELATED CONDITION WITH CC | $5,197 – $35,104 · median $12,812 | 14 plans |
| 976 | HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC | $5,197 – $24,832 · median $9,063 | 14 plans |
| 977 | HIV WITH OR WITHOUT OTHER RELATED CONDITION | $5,197 – $35,174 · median $12,837 | 14 plans |
| 981 | EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | $5,197 – $124,044 · median $45,272 | 14 plans |
| 982 | EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC | $5,197 – $65,568 · median $23,930 | 14 plans |
| 983 | EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC | $5,197 – $46,075 · median $16,816 | 14 plans |
| 453 | COMBINED ANTERIOR/POSTERIOR SPINAL FUSION WITH MCC | $5,197 – $28,352 · median $14,165 | 13 plans |
| 459 | Medical/Surgical | $5,197 – $28,352 · median $14,165 | 13 plans |
| 460 | Medical/Surgical | $5,197 – $28,352 · median $14,165 | 13 plans |
| 831 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURE WITH MCC | $11,928 – $32,682 · median $11,928 | 10 plans |
| 832 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURE WITH CC | $7,332 – $20,090 · median $7,332 | 10 plans |
| 833 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURE WITHOUT CC/MCC | $5,433 – $14,887 · median $5,433 | 10 plans |
| 509 | ARTHROSCOPY | $5,197 – $9,368 · median $9,223 | 6 plans |
| 077 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 078 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 079 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 131 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 132 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 222 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 223 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 227 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 246 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 247 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 248 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 249 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 294 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 295 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 341 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 342 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 343 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 402 | Single Level Combined Anterior and Posterior Spinal Fusion Except Cervical | $58,476 – $105,020 · median $105,020 | 4 plans |
| 426 | Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with MCC or Custom-Made Anatomically Designed Interbody Fusion Device | $156,576 – $281,202 · median $281,202 | 4 plans |
| 427 | Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with CC | $106,164 – $190,666 · median $190,666 | 4 plans |
| 428 | Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without CC/MCC | $82,270 – $147,753 · median $147,753 | 4 plans |
| 447 | Multiple Level Anterior and Posterior Spinal Fusion Except Cervical with MCC or Custom-Made Anatomically Designed Interbody Fusion Device | $100,217 – $179,981 · median $179,981 | 4 plans |
| 448 | Multiple Level Anterior and Posterior Spinal Fusion Except Cervical without MCC | $61,036 – $109,618 · median $109,618 | 4 plans |
| 450 | Single Level Spinal Fusion Except Cervical with MCC or Custom-Made Anatomically Designed Interbody Fusion Device | $76,979 – $138,249 · median $138,249 | 4 plans |
| 451 | Single Level Spinal Fusion Except Cervical without MCC | $46,127 – $82,841 · median $82,841 | 4 plans |
| 521 | Hip Replacement with Principal Diagnosis of Hip Fracture w MCC | $33,411 – $59,357 · median $59,357 | 4 plans |
| 522 | Hip Replacement with Principal Diagnosis of Hip Fracture w/o MCC | $28,495 – $50,621 · median $50,621 | 4 plans |
| 998 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 999 | Medical/Surgical | $5,197 – $9,368 · median $9,368 | 4 plans |
| 765 | OTHER COMPLICATED DELIVERY | $4,362 – $4,915 · median $4,639 | 2 plans |
| 766 | C-SECTION W/O COMP & VAGINAL W/COMP | $10,456 – $11,775 · median $11,116 | 2 plans |
| 767 | OTHER COMPLICATED DELIVERY | $4,362 – $4,915 · median $4,639 | 2 plans |
| 774 | C-SECTION W/O COMP & VAGINAL W/COMP | $10,456 – $11,775 · median $11,116 | 2 plans |
| 775 | NORMAL VAGINAL DELIVERY | $10,456 – $11,775 · median $11,116 | 2 plans |
| 777 | OTHER COMPLICATED DELIVERY | $4,362 – $4,915 · median $4,639 | 2 plans |
No procedures match that keyword.