Does MONTFORT JONES MEMORIAL HOSPITAL publish its standard charges and chargemaster?

Yes. MONTFORT JONES MEMORIAL HOSPITAL publishes a machine-readable file with 33,683 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of A. Browse the negotiated rates by procedure and payer on this page.

How much does MONTFORT JONES MEMORIAL HOSPITAL charge for procedures?

MONTFORT JONES MEMORIAL HOSPITAL (Kosciusko, MS) publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · MS · CCN 250059

MONTFORT JONES MEMORIAL HOSPITAL

Kosciusko, MS, 39090

61 beds29

Compliance grade

100/100

Rates published

33,683

last crawl 2026-05-24

Procedures tracked

194

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All MS hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://www.urmc.rochester.edu/getmedia/636ee711-58e5-4a53-abe8-aac528ae0614/222807681-JONES-MEMORIAL-HOSPITAL-standardcharges.csv · CSV

Procedures & rates

vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	vs nat'l	Neg max
behavioral
Psychoses	MS-DRG	885	6	—	$13,458	$7,239.61	$13,458	1.1×	$13,458
Psychiatric diagnostic evaluation	CPT	90791	15	—	—	$54.82	$159.82	0.90×	$580.19
Psychiatric eval with medical services	CPT	90792	10	—	—	$64.33	$237.3	1.4×	$580.19
Psychotherapy 30 minutes	CPT	90832	15	—	—	$22.71	$74.09	0.50×	$580.19
Psychotherapy 45 minutes	CPT	90834	15	—	—	$29.08	$98.23	0.61×	$580.19
Psychotherapy 60 minutes	CPT	90837	15	—	—	$42.54	$144.89	0.76×	$580.19
Crisis psychotherapy 60 minutes	CPT	90839	15	—	—	$68.47	$141.35	0.89×	$580.19
emergency
ED visit level 1	CPT	99281	15	$336	$168	$6.98	$21.95	0.16×	$275.63
ED visit level 2	CPT	99282	15	$603	$302	$11.97	$48.6	0.20×	$501.9
ED visit level 3	CPT	99283	15	$1,053	$526	$25.95	$75.6	0.19×	$892.3
ED visit level 4	CPT	99284	15	$1,620	$810	$40.54	$135.89	0.20×	$1,363.93
ED visit level 5	CPT	99285	15	$2,331	$1,166	$63.46	$197.35	0.19×	$1,946.64
Critical care, first hour	CPT	99291	15	$3,204	$1,602	$124.83	$268.27	0.25×	$2,700.08
imaging
CT head without contrast	CPT	70450	15	$405	$202	$72.72	$139.77	0.68×	$533.52
CT head with contrast	CPT	70460	15	$678	$339	$87.87	$234.5	1.0×	$644.67
CT head with and without contrast	CPT	70470	15	$678	$339	$131.5	$234.5	0.88×	$964.79
CT neck with contrast	CPT	70491	15	$678	$339	$103.02	$234.5	0.86×	$755.82
MRI brain without contrast	CPT	70551	15	$918	$459	$239.24	$416.89	1.0×	$2,223.01
MRI brain with contrast	CPT	70552	15	$1,359	$680	$303	$505	1.1×	$2,223.01
MRI brain with and without contrast	CPT	70553	15	$1,359	$680	$303	$505	0.86×	$2,223.01
Chest X-ray single view	CPT	71045	17	$336	$168	$6.06	$20.7	0.22×	$284.46
Chest X-ray 2 views	CPT	71046	17	$336	$168	$7.78	$26.6	0.27×	$284.46
Chest X-ray 3 views	CPT	71047	15	$336	$168	$9.09	$35.17	0.37×	$284.46
CT chest without contrast	CPT	71250	15	$405	$202	$84.84	$141.4	0.66×	$622.44
CT chest with contrast	CPT	71260	15	$678	$339	$103.02	$234.5	0.83×	$755.82
CT chest with and without contrast	CPT	71270	15	—	—	$153.92	$256.54	0.88×	$1,129.29
MRI chest without contrast	CPT	71550	15	$918	$459	$239.24	$416.89	0.97×	$2,223.01
MRI chest with contrast	CPT	71551	15	$3,003	$1,502	$303	$1,041.64	1.3×	$2,562.44
MRI chest with and without contrast	CPT	71552	15	$1,359	$680	$303	$505	0.84×	$2,223.01
Lumbosacral spine X-ray	CPT	72100	17	$405	$202	$7.94	$30.91	0.30×	$341.73
CT cervical spine without contrast	CPT	72125	15	$405	$202	$84.84	$141.4	0.70×	$622.44
CT thoracic spine without contrast	CPT	72128	15	$405	$202	$84.84	$141.4	0.71×	$622.44
CT lumbar spine without contrast	CPT	72131	15	$405	$202	$84.84	$141.4	0.70×	$622.44
MRI cervical spine without contrast	CPT	72141	15	$918	$459	$239.24	$417.57	1.1×	$2,223.01
MRI thoracic spine without contrast	CPT	72146	15	$918	$459	$239.24	$416.89	1.1×	$2,223.01
MRI lumbar spine without contrast	CPT	72148	15	$918	$459	$239.24	$417.57	1.1×	$2,223.01
MRI lumbar spine with and without contrast	CPT	72149	15	$1,359	$680	$303	$505	1.1×	$2,223.01
MRI cervical spine with and without contrast	CPT	72156	15	$1,359	$680	$303	$505	0.93×	$2,223.01
MRI lumbar spine with contrast	CPT	72158	15	$1,359	$680	$303	$505	0.92×	$2,223.01
CT pelvis without contrast	CPT	72192	15	$405	$202	$84.84	$141.4	0.71×	$622.44
CT pelvis with contrast	CPT	72193	15	$678	$339	$103.02	$234.5	0.83×	$929.37
Shoulder X-ray	CPT	73030	17	$336	$168	$6.75	$26.83	0.29×	$284.46
Humerus X-ray	CPT	73060	17	$336	$168	$5.99	$22.72	0.25×	$284.46
Hand X-ray 3 views	CPT	73130	17	$336	$168	$6.25	$27.01	0.29×	$284.46
MRI upper extremity joint without contrast	CPT	73221	15	$918	$459	$239.24	$416.89	1.0×	$2,223.01
MRI upper extremity joint with and without contrast	CPT	73223	15	$1,359	$680	$303	$505	0.83×	$2,223.01
Knee X-ray 1-2 views	CPT	73560	17	$336	$168	$5.99	$23.03	0.25×	$284.46
Ankle X-ray 3 views	CPT	73610	17	$336	$168	$6.25	$27.01	0.29×	$284.46
MRI lower extremity joint without contrast	CPT	73721	15	$918	$459	$239.24	$417.57	0.89×	$2,223.01
MRI lower extremity joint with and without contrast	CPT	73723	15	$1,359	$680	$303	$505	0.80×	$2,223.01
CT abdomen without contrast	CPT	74150	15	$405	$202	$84.84	$141.4	0.75×	$622.44
CT abdomen with contrast	CPT	74160	15	$678	$339	$103.02	$234.5	0.82×	$922.3
CT abdomen with and without contrast	CPT	74170	15	$678	$339	$153.92	$256.54	0.77×	$1,129.29
CT abdomen and pelvis without contrast	CPT	74176	15	$918	$459	$41.63	$169.66	0.47×	$779.93
CT abdomen and pelvis with contrast	CPT	74177	15	$1,359	$680	$65.41	$266.58	0.49×	$1,165.93
CT abdomen and pelvis with and without contrast	CPT	74178	15	$1,359	$680	$82.86	$330.28	0.57×	$1,315.54
MRI abdomen without contrast	CPT	74181	15	$918	$459	$239.24	$416.89	1.1×	$2,223.01
MRI abdomen with and without contrast	CPT	74183	15	$1,359	$680	$303	$505	0.89×	$2,223.01
Abdominal ultrasound complete	CPT	76700	17	$405	$202	$28.99	$100.01	0.67×	$408.71
Abdominal ultrasound limited	CPT	76705	17	$405	$202	$20.8	$74.53	0.51×	$341.73
Retroperitoneal ultrasound complete	CPT	76770	17	$405	$202	$26.11	$92.5	0.64×	$385.77
Obstetric ultrasound first trimester	CPT	76801	15	$405	$202	$33.33	$124.99	0.88×	$368.52
Obstetric ultrasound after first trimester	CPT	76805	15	$405	$202	$33.33	$124.99	0.82×	$459.89
Obstetric ultrasound with fetal anatomy	CPT	76811	15	$918	$459	$43.63	$177.84	0.75×	$779.93
Transvaginal ultrasound	CPT	76830	15	$405	$202	$36.36	$130.29	0.88×	$449.3
Pelvic ultrasound complete	CPT	76856	15	$449	$267.74	$33.33	$119.44	0.83×	$382.2
Scrotal ultrasound	CPT	76870	17	$405	$202	$18.18	$75.88	0.58×	$368.11
Diagnostic mammography unilateral	CPT	77065	15	$212	$106	$58.78	$97.14	0.65×	$463.39
Diagnostic mammography bilateral	CPT	77066	15	$272	$136	$58.78	$104.86	0.55×	$590.47
Screening mammography bilateral	CPT	77067	15	$225	$112	$58.78	$97.97	0.62×	$488.52
EKG complete	CPT	93000	17	$201	$119.86	$10.12	$15.15	0.62×	$116.52
EKG tracing only	CPT	93005	17	$225	$112	$4.25	$8.01	0.07×	$192.83
EKG interpretation only	CPT	93010	15	$26	$15.5	$5.87	$8.13	0.45×	$20.03
Transthoracic echocardiogram complete	CPT	93306	17	$2,085	$1,042	$49.86	$186.56	0.31×	$1,786.09
Transthoracic echocardiogram	CPT	93307	15	—	—	$54.54	$204.52	0.83×	$779.93
Stress echocardiogram	CPT	93350	15	$2,085	$1,042	$72.72	$272.7	0.54×	$1,786.09
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	6	—	$15,015	$8,099.47	$15,015	0.97×	$15,015
COPD w MCC	MS-DRG	190	6	—	$10,746	$5,741.21	$10,746	0.96×	$10,746
COPD w CC	MS-DRG	191	6	—	$8,261.59	$4,369.27	$8,261.59	0.94×	$8,261.59
COPD w/o CC/MCC	MS-DRG	192	6	—	$6,375.41	$3,327.49	$6,375.41	0.91×	$6,375.41
Simple pneumonia & pleurisy w CC	MS-DRG	194	6	—	$7,913.45	$4,176.98	$7,913.45	0.93×	$7,913.45
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	6	—	$6,248.72	$3,257.52	$6,248.72	0.94×	$6,248.72
AMI discharged alive w MCC	MS-DRG	280	6	—	$15,404	$8,314.05	$15,404	0.98×	$15,404
AMI discharged alive w CC	MS-DRG	281	6	—	$8,975.71	$4,763.7	$8,975.71	0.93×	$8,975.71
AMI discharged alive w/o CC/MCC	MS-DRG	282	6	—	$7,136.45	$3,747.83	$7,136.45	0.92×	$7,136.45
Heart failure & shock w MCC	MS-DRG	291	6	—	$12,398	$6,653.94	$12,398	0.97×	$12,398
Heart failure & shock w CC	MS-DRG	292	6	—	$8,317.9	$4,400.37	$8,317.9	0.93×	$8,317.9
Heart failure & shock w/o CC/MCC	MS-DRG	293	6	—	$5,662.22	$2,933.58	$5,662.22	0.91×	$5,662.22
Cardiac arrhythmia w MCC	MS-DRG	308	6	—	$11,649	$6,240.33	$11,649	0.96×	$11,649
Cardiac arrhythmia w CC	MS-DRG	309	6	—	$7,254.69	$3,813.13	$7,254.69	0.93×	$7,254.69
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	6	—	$5,663.16	$2,934.1	$5,663.16	0.91×	$5,663.16
GI hemorrhage w CC	MS-DRG	378	6	—	$9,553.77	$5,082.97	$9,553.77	0.95×	$9,553.77
GI hemorrhage w/o CC/MCC	MS-DRG	379	6	—	$6,266.55	$3,267.36	$6,266.55	0.92×	$6,266.55
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	6	—	$7,666.65	$4,040.67	$7,666.65	0.95×	$7,666.65
Fractures of femur w/o MCC	MS-DRG	533	6	—	$15,062	$8,125.39	$15,062	0.99×	$15,062
Kidney/UTI w MCC	MS-DRG	689	6	—	$11,239	$6,013.83	$11,239	0.97×	$11,239
Kidney/UTI w/o MCC	MS-DRG	690	6	—	$7,947.23	$4,195.64	$7,947.23	0.96×	$7,947.23
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	6	—	$18,579	$10,068	$18,579	1.00×	$18,579
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	6	—	$9,953.53	$5,303.76	$9,953.53	0.96×	$9,953.53
Initial hospital care, low complexity	CPT	99221	15	$233	$138.94	$28.49	$79.18	0.85×	$203.44
Initial hospital care, moderate complexity	CPT	99222	15	$315	$187.83	$47.26	$122.58	0.73×	$319.71
Initial hospital care, high complexity	CPT	99223	15	$462	$275.49	$65.86	$166.44	0.74×	$426.74
Hospital discharge, <30 min	CPT	99238	15	$167	$99.58	$29.62	$73.21	0.85×	$198.48
Hospital discharge, >30 min	CPT	99239	15	$245	$146.09	$40.38	$103.49	0.85×	$281.36
lab
Basic metabolic panel (BMP)	CPT	80048	15	$117	$65	$4.97	$8.46	0.26×	$19.19
General health panel	CPT	80050	2	$97	$48	$18.14	$41.03	0.38×	$43.48
Electrolyte panel	CPT	80051	15	$44	$23.26	$4.12	$7.01	0.29×	$15.92
Comprehensive metabolic panel	CPT	80053	15	$69	$40.55	$6.2	$10.56	0.24×	$23.97
Lipid panel	CPT	80061	15	$87	$50.09	$6.1	$12.59	0.33×	$30.39
Renal function panel	CPT	80069	15	$20	$10	$5.09	$8.68	0.32×	$19.71
Hepatic function panel	CPT	80076	15	$44	$23.26	$4.8	$8.17	0.31×	$16.69
Urinalysis non-automated	CPT	81002	17	$23	$13.12	$1.5	$3.15	0.45×	$6.96
Urinalysis automated	CPT	81003	17	$23	$13.71	$1.32	$2.14	0.15×	$5.09
Glucose quantitative	CPT	82947	17	$27	$14.91	$2.3	$3.93	0.22×	$8.92
Hemoglobin A1c	CPT	83036	17	$64	$37.57	$4.08	$9.71	0.36×	$22.04
Thyroid stimulating hormone (TSH)	CPT	84443	17	$108	$63.21	$7.06	$15.09	0.32×	$38.14
Complete blood count with automated differential	CPT	85025	15	$49	$26.83	$3.2	$7.2	0.27×	$15.86
Complete blood count without differential	CPT	85027	15	$49	$28.03	$3.2	$6.08	0.28×	$13.2
Urine culture bacterial	CPT	87086	17	$52	$31.01	$3.39	$8.07	0.35×	$18.16
Urine culture identification	CPT	87088	17	$55	$32.8	$3.4	$8.09	0.36×	$18.2
Tissue exam by pathologist level IV	CPT	88305	17	$204	$102	$8.98	$52.3	0.51×	$175.06
maternity
Fetal non-stress test	CPT	59025	17	$765	$382	$9.09	$37.89	0.20×	$1,512
Routine obstetric care including vaginal delivery	CPT	59400	10	$4,965	$2,960.63	$1,420.74	$2,157.48	0.94×	$5,817.45
Vaginal delivery only	CPT	59409	15	$1,946	$1,160.4	$563.86	$841.8	0.38×	$10,581
Vaginal delivery with postpartum	CPT	59410	10	$2,475	$1,475.84	$730.12	$1,018.97	0.96×	$2,566.95
Routine obstetric care with C-section	CPT	59510	10	$5,496	$3,277.26	$1,420.74	$2,390.18	0.96×	$6,416.42
C-section delivery only	CPT	59514	10	$2,197	$1,310.07	$635.9	$853.05	0.89×	$2,187.94
C-section with postpartum	CPT	59515	10	$2,997	$1,787.11	$735.82	$1,200.71	0.95×	$3,150.23
office
Office visit, new patient, 15-29 min	CPT	99202	15	$258	$153.85	$31.06	$53.12	0.62×	$177.16
Office visit, new patient, 30-44 minutes	CPT	99203	15	$321	$191.41	$45.54	$86.83	0.71×	$274.23
Office visit, new patient, 45-59 min	CPT	99204	15	$451	$268.93	$69.13	$137.07	0.79×	$408.14
Office visit, new patient, 60-74 min	CPT	99205	15	$536	$319.62	$86.68	$177.55	0.80×	$538.85
Office visit, established patient, 5 min	CPT	99211	15	$237	$118	$5.69	$12.56	0.20×	$148.5
Office visit, established patient, 10-19 min	CPT	99212	15	$389	$194	$18.07	$37.08	0.46×	$148.5
Office visit, established patient, 20-29 minutes	CPT	99213	15	$453	$226	$29.93	$64.67	0.56×	$221.41
Office visit, established patient, 30-39 minutes	CPT	99214	15	$543	$272	$44.94	$95.42	0.63×	$313.46
Office visit, established patient, 40-54 min	CPT	99215	15	$629	$314	$60.64	$135.78	0.72×	$439.59
preventive
Upper GI endoscopy diagnostic	CPT	43235	15	$3,564	$1,782	$67.2	$253.68	0.28×	$2,964.71
Upper GI endoscopy with biopsy	CPT	43239	15	$3,564	$1,782	$84	$329.08	0.34×	$2,964.71
Sigmoidoscopy diagnostic	CPT	45330	15	$382	$158.02	$24.7	$158.74	0.19×	$3,039.8
Sigmoidoscopy with biopsy	CPT	45331	15	$614	$138.94	$29.69	$244.5	0.27×	$3,039.8
Colonoscopy diagnostic	CPT	45378	15	$715	$426.35	$85.86	$314.15	0.36×	$3,039.8
Colonoscopy with biopsy	CPT	45380	15	$470	$279.07	$134.4	$395.09	0.33×	$3,911.52
Colonoscopy with polyp removal	CPT	45385	15	$963	$352.41	$122.15	$420.62	0.35×	$3,911.52
surgery
Total shoulder arthroplasty	CPT	23472	15	$69,921	$34,960	$607.5	$1,536.42	0.37×	$45,729
Hip hemiarthroplasty	CPT	27125	15	$2,730	$1,627.9	$449.32	$1,199.41	0.96×	$33,484
Total hip replacement	CPT	27130	15	$3,465	$2,066.18	$579.91	$1,429.94	0.33×	$33,484
Total knee replacement	CPT	27447	15	$3,699	$2,205.71	$623	$1,428.32	0.34×	$33,484
Knee revision arthroplasty single component	CPT	27486	15	$3,227	$1,924.26	$568.34	$1,493.78	0.89×	$41,966
Knee revision arthroplasty all components	CPT	27487	15	$4,224	$2,518.77	$716.69	$1,861.6	0.93×	$57,314
Shoulder arthroscopy with decompression	CPT	29826	12	$4,947	$2,474	$122.11	$180.46	0.55×	$1,368
Shoulder arthroscopy with rotator cuff repair	CPT	29827	15	$27,162	$13,581	$442.28	$1,141.68	0.35×	$23,719
Knee arthroscopy with meniscectomy	CPT	29881	15	$12,336	$6,168	$256.22	$582.6	0.28×	$10,695
ACL reconstruction	CPT	29888	15	$2,383	$1,420.98	$399.19	$1,039.92	0.31×	$23,719
Major small/large bowel procedures w MCC	MS-DRG	329	6	—	$43,484	$23,824	$43,484	1.0×	$43,484
Major small/large bowel procedures w CC	MS-DRG	330	6	—	$22,846	$12,425	$22,846	0.98×	$22,846
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	6	—	$16,143	$8,722.47	$16,143	0.98×	$16,143
CABG single arterial graft	CPT	33533	1	—	—	$1,294.44	$1,294.44	0.69×	$1,294.44
CABG 2 arterial grafts	CPT	33534	1	—	—	$1,532.32	$1,532.32	0.71×	$1,532.32
CABG 3 arterial grafts	CPT	33535	1	—	—	$1,661.52	$1,661.52	0.73×	$1,661.52
CABG 4+ arterial grafts	CPT	33536	1	—	—	$1,789.51	$1,789.51	0.73×	$1,789.51
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	6	—	$16,225	$8,767.56	$16,225	0.98×	$16,225
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	6	—	$13,168	$7,078.94	$13,168	0.97×	$13,168
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	6	—	$32,323	$17,659	$32,323	1.00×	$32,323
Open appendectomy	CPT	44950	15	$1,423	$848.53	$242.82	$661.5	0.58×	$21,161
Laparoscopic appendectomy	CPT	44970	15	$1,361	$807.99	$222.75	$619.73	0.40×	$19,761
Major joint replacement w MCC	MS-DRG	469	6	—	$28,814	$15,721	$28,814	0.97×	$28,814
Major joint replacement w/o MCC	MS-DRG	470	6	—	$18,452	$9,997.49	$18,452	0.98×	$18,452
Laparoscopic cholecystectomy	CPT	47562	15	$1,490	$884.31	$277.43	$676.05	0.38×	$19,761
Lap cholecystectomy with cholangiography	CPT	47563	15	$1,619	$965.41	$285.86	$736.75	0.39×	$19,761
Hip & femur procedures except major joint w MCC	MS-DRG	480	6	—	$27,680	$15,094	$27,680	0.99×	$27,680
Hip & femur procedures except major joint w CC	MS-DRG	481	6	—	$20,006	$10,856	$20,006	0.98×	$20,006
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	6	—	$15,656	$8,453.47	$15,656	0.98×	$15,656
Lap inguinal hernia repair	CPT	49650	15	$987	$588.55	$160.98	$444.99	0.40×	$19,761
Total abdominal hysterectomy	CPT	58150	15	$2,424	$1,445.43	$395.94	$912.56	0.94×	$2,487.84
Vaginal hysterectomy	CPT	58260	15	$2,246	$1,339.29	$332.51	$858.48	0.47×	$16,352
Lap-assisted vaginal hysterectomy	CPT	58550	15	$2,149	$1,281.45	$356.6	$903.73	0.61×	$19,761
Lap-assisted vaginal hysterectomy >250g	CPT	58552	15	$2,388	$1,423.96	$392.54	$1,006.04	0.45×	$34,746
Lap salpingo-oophorectomy	CPT	58661	15	$1,566	$933.81	$260.86	$674.38	0.33×	$19,761
OR procedure for obesity w MCC	MS-DRG	619	6	—	$27,446	$14,965	$27,446	1.0×	$27,446
OR procedure for obesity w CC	MS-DRG	620	6	—	$15,368	$8,294.35	$15,368	0.95×	$15,368
OR procedure for obesity w/o CC/MCC	MS-DRG	621	6	—	$14,506	$7,818.04	$14,506	0.96×	$14,506
Complex cataract surgery	CPT	66982	11	—	—	$551.8	$3,085.36	1.4×	$7,543.7
Cataract surgery with lens implant	CPT	66984	11	—	—	$607.2	$3,085.36	1.4×	$7,543.7
Intravitreal injection	CPT	67028	11	—	—	$230	$454.84	1.3×	$1,512
Vitrectomy mechanical	CPT	67042	11	—	—	$761.61	$5,526.02	2.2×	$13,511
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	6	—	$11,994	$6,430.55	$11,994	0.98×	$11,994
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	6	—	$19,580	$10,620	$19,580	1.0×	$19,580
PCI single major coronary artery	CPT	92920	10	—	—	$284.77	$7,609.12	1.3×	$18,604
PCI with drug-eluting stent	CPT	92928	10	—	—	$316.15	$15,434	1.5×	$37,735
PCI bypass graft	CPT	92937	10	—	—	$513.89	$15,434	1.4×	$37,735
Left heart catheterization	CPT	93452	10	—	—	$741.08	$4,334.18	1.4×	$10,597
Coronary angiography with cath	CPT	93455	10	—	—	$892.38	$4,334.18	1.4×	$10,597
Coronary angiography with bypass cath	CPT	93458	10	—	—	$922.59	$4,334.18	1.4×	$10,597

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 17)

Payer	Codes covered	Median rate
Blue Cross Blue Shield	194	$216.72
UnitedHealthcare	190	$129.08
Medicare	189	$234.5
Aetna	189	$286.5
total senior care 1319	183	$466.41
Humana	183	$466.41
Cigna	149	$244.27
upmc health plan 5138	144	$177.98
Empire BCBS	144	$420.02
mvp 2900	143	$393.46
independent health 5156	142	$148.5
Medicaid	138	$103.02
fidelis 5155	138	$103.82
capital district physicians health plan (cdphp) 5149	83	$277.8
excellus 2201	83	$131.6
univera healthcare 1706	79	$72.72
Molina	79	$136.35

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