Hospital

FLOWERS HOSPITAL

Dothan, AL · CCN 010055 · Rates published

7,525 distinct procedures filed

64 distinct payers

648,654 rate rows

2026-05-24 last MRF observed

Data quality

595,486 of 648,654 rate rows are consumer-grade (91.8%)

53,168 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
per-diem day rate — not a per-procedure price	36,998
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	12,714
template filing: same amount across many unrelated codes — excluded	2,266
placeholder amount (≤ $0.02) — excluded from medians	908
exceeds 10× this hospital's gross charge — excluded from medians	282

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

Source MRF file	https://www.flowershospital.com/Uploads/Public/Documents/charge-masters/charge-masters-2024/621762412_flowers-hospital_standardcharges.csv
Found on page	https://www.flowershospital.com/pricing-information
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	f5d9696a579fcccf… · 175,885,528 bytes · first seen 2026-05-08

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code	Description	Payers	Min $	Max $	Avg median	vs national
681 OTHER	Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…	2	$295,454.83	$348,325.69	$321,890.26	nat. median $0
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	25	$2,680.00	$437,249.28	$298,798.75	nat. median $386,529 0.8× median
583-3 OTHER	Neonate With Ecmo	1	$221,000.00	$221,000.00	$221,000.00	nat. median $259,487 0.9× median
583-4 OTHER	Neonate With Ecmo	1	$221,000.00	$221,000.00	$221,000.00	nat. median $309,400 0.7× median
588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	1	$221,000.00	$221,000.00	$221,000.00	nat. median $267,493 0.8× median
011-3 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	$203,108.61	$203,108.61	$203,108.61	nat. median $171,094 1.2× median
631-4 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	1	$195,638.13	$195,638.13	$195,638.13	nat. median $203,379 1.0× median
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	24	$2,680.00	$283,757.19	$194,165.57	nat. median $239,422 0.8× median
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	1	$177,423.74	$177,423.74	$177,423.74	nat. median $210,669 0.8× median
609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	1	$165,000.00	$165,000.00	$165,000.00	nat. median $169,856 1.0× median
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	28	$2,680.00	$255,245.23	$148,102.93	nat. median $146,562 1.0× median
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	28	$2,680.00	$253,747.27	$147,238.05	nat. median $181,005 0.8× median
583-2 OTHER	Neonate With Ecmo	1	$137,155.23	$137,155.23	$137,155.23	nat. median $191,347 0.7× median
588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	1	$132,000.00	$132,000.00	$132,000.00	nat. median $165,000 0.8× median
593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	1	$121,000.00	$121,000.00	$121,000.00	nat. median $151,250 0.8× median
591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	1	$120,000.00	$120,000.00	$120,000.00	nat. median $156,696 0.8× median
002-4 OTHER	Heart And/or Lung Transplant	1	$118,068.03	$118,068.03	$118,068.03	nat. median $216,800 0.5× median
7 OTHER	Lung Transplant	23	$2,680.00	$354,760.81	$117,564.27	nat. median $169,933 0.7× median
588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	1	$109,629.69	$109,629.69	$109,629.69	nat. median $153,523 0.7× median
602-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	1	$100,000.00	$100,000.00	$100,000.00	nat. median $125,000 0.8× median
593-3 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	1	$99,000.00	$99,000.00	$99,000.00	nat. median $112,711 0.9× median
607-4 OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	1	$98,014.40	$98,014.40	$98,014.40	nat. median $100,015 1.0× median
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	28	$2,680.00	$165,593.49	$96,340.95	nat. median $134,983 0.7× median
630-3 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	1	$95,000.00	$95,000.00	$95,000.00	nat. median $95,000 1.0× median
591-3 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	1	$91,000.00	$91,000.00	$91,000.00	nat. median $99,157 0.9× median
161-4 OTHER	Implantable Heart Assist Systems	1	$88,107.75	$88,107.75	$88,107.75	nat. median $202,242 outlier · 0.4×
602-3 OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	1	$88,037.04	$88,037.04	$88,037.04	nat. median $99,067 0.9× median
589-3 OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	1	$87,000.00	$87,000.00	$87,000.00	nat. median $87,000 1.0× median
009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	1	$86,374.15	$86,374.15	$86,374.15	nat. median $150,954 0.6× median
14 OTHER	Allogeneic Bone Marrow Transplant	22	$2,680.00	$121,687.75	$83,684.10	nat. median $100,915 0.8× median
611-4 OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	1	$81,519.79	$81,519.79	$81,519.79	nat. median $93,000 0.9× median
583-1 OTHER	Neonate With Ecmo	1	$80,995.71	$80,995.71	$80,995.71	nat. median $171,226 outlier · 0.5×
603-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	1	$80,000.00	$80,000.00	$80,000.00	nat. median $107,050 0.7× median
591-2 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	1	$80,000.00	$80,000.00	$80,000.00	nat. median $80,000 1.0× median
863-4 OTHER	Neonatal Aftercare	1	$79,729.28	$79,729.28	$79,729.28	nat. median $108,047 0.7× median
2 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	24	$2,680.00	$124,649.12	$78,946.46	nat. median $111,558 0.7× median
841-4 OTHER	Extensive Third Degree Burns With Skin Graft	1	$78,374.13	$78,374.13	$78,374.13	nat. median $151,691 0.5× median
303-4 OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	1	$78,139.45	$78,139.45	$78,139.45	nat. median $108,000 0.7× median
212 OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	27	$2,680.00	$129,999.87	$75,788.15	nat. median $90,581 0.8× median
1110865 OTHER	Bilat Lithotripsy	23	$3,500.00	$99,999.99	$73,999.99	nat. median $22,027 outlier · 3.4×
1210840 OTHER	Cult Chondro Implant	28	$15,000.00	$99,999.99	$72,999.99	nat. median $38,978 1.9× median
1210446 OTHER	Carmust Implnt 7.7mg	25	$14,999.90	$99,999.31	$72,999.50	nat. median $4,878 outlier · 15.0×
5 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	23	$2,680.00	$104,399.42	$71,897.17	nat. median $94,894 0.8× median
609-3 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	1	$70,558.76	$70,558.76	$70,558.76	nat. median $83,785 0.8× median
1410074 OTHER	Lead Aicd End Dul L4	25	$10,000.00	$99,999.99	$69,999.99	nat. median $8,893 outlier · 7.9×
1410093 OTHER	Pmkr Othr Th Sngl L3	25	$10,000.00	$99,999.99	$69,999.99	nat. median $19,653 outlier · 3.6×
1411003 OTHER	Aicd Ohr Thn Sgl/du3	25	$10,000.00	$99,999.99	$69,999.99	nat. median $29,432 outlier · 2.4×
1410064 OTHER	Lead Aicd Endo Sn L4	25	$10,000.00	$99,999.99	$69,999.99	nat. median $6,674 outlier · 10.5×
1410067 OTHER	Pmkr Dual Rate-rs L3	25	$10,000.00	$99,999.99	$69,999.99	nat. median $19,297 outlier · 3.6×
1410049 OTHER	Pmkr Singl Rate-rsl4	25	$10,000.00	$99,999.99	$69,999.99	nat. median $25,000 outlier · 2.8×

Other procedures at this hospital

Browse this hospital's 7,525 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

681	OTHER	Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip…	4	2	—	—	$295,454.83	$348,325.69	$321,890.26	2026-05-24
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	52	25	—	—	$2,680.00	$437,249.28	$298,798.75	2026-05-24
583-3	OTHER	Neonate With Ecmo	2	1	—	—	$221,000.00	$221,000.00	$221,000.00	2026-05-24
583-4	OTHER	Neonate With Ecmo	2	1	—	—	$221,000.00	$221,000.00	$221,000.00	2026-05-24
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	2	1	—	—	$221,000.00	$221,000.00	$221,000.00	2026-05-24
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	1	—	—	$203,108.61	$203,108.61	$203,108.61	2026-05-24
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	2	1	—	—	$195,638.13	$195,638.13	$195,638.13	2026-05-24
1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	50	24	—	—	$2,680.00	$283,757.19	$194,165.57	2026-05-24
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	2	1	—	—	$177,423.74	$177,423.74	$177,423.74	2026-05-24
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	2	1	—	—	$165,000.00	$165,000.00	$165,000.00	2026-05-24
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	58	28	—	—	$2,680.00	$255,245.23	$148,102.93	2026-05-24
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	58	28	—	—	$2,680.00	$253,747.27	$147,238.05	2026-05-24
583-2	OTHER	Neonate With Ecmo	2	1	—	—	$137,155.23	$137,155.23	$137,155.23	2026-05-24
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	2	1	—	—	$132,000.00	$132,000.00	$132,000.00	2026-05-24
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	2	1	—	—	$121,000.00	$121,000.00	$121,000.00	2026-05-24
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	2	1	—	—	$120,000.00	$120,000.00	$120,000.00	2026-05-24
002-4	OTHER	Heart And/or Lung Transplant	2	1	—	—	$118,068.03	$118,068.03	$118,068.03	2026-05-24
7	OTHER	Lung Transplant	48	23	—	—	$2,680.00	$354,760.81	$117,564.27	2026-05-24
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	2	1	—	—	$109,629.69	$109,629.69	$109,629.69	2026-05-24
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$100,000.00	$100,000.00	$100,000.00	2026-05-24
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	2	1	—	—	$99,000.00	$99,000.00	$99,000.00	2026-05-24
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$98,014.40	$98,014.40	$98,014.40	2026-05-24
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	58	28	—	—	$2,680.00	$165,593.49	$96,340.95	2026-05-24
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	2	1	—	—	$95,000.00	$95,000.00	$95,000.00	2026-05-24
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	2	1	—	—	$91,000.00	$91,000.00	$91,000.00	2026-05-24
161-4	OTHER	Implantable Heart Assist Systems	2	1	—	—	$88,107.75	$88,107.75	$88,107.75	2026-05-24
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$88,037.04	$88,037.04	$88,037.04	2026-05-24
589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	2	1	—	—	$87,000.00	$87,000.00	$87,000.00	2026-05-24
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	2	1	—	—	$86,374.15	$86,374.15	$86,374.15	2026-05-24
14	OTHER	Allogeneic Bone Marrow Transplant	46	22	—	—	$2,680.00	$121,687.75	$83,684.10	2026-05-24
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	2	1	—	—	$81,519.79	$81,519.79	$81,519.79	2026-05-24
583-1	OTHER	Neonate With Ecmo	2	1	—	—	$80,995.71	$80,995.71	$80,995.71	2026-05-24
591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	2	1	—	—	$80,000.00	$80,000.00	$80,000.00	2026-05-24
603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	2	1	—	—	$80,000.00	$80,000.00	$80,000.00	2026-05-24
863-4	OTHER	Neonatal Aftercare	2	1	—	—	$79,729.28	$79,729.28	$79,729.28	2026-05-24
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	50	24	—	—	$2,680.00	$124,649.12	$78,946.46	2026-05-24
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	2	1	—	—	$78,374.13	$78,374.13	$78,374.13	2026-05-24
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	2	1	—	—	$78,139.45	$78,139.45	$78,139.45	2026-05-24
212	OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	56	27	—	—	$2,680.00	$129,999.87	$75,788.15	2026-05-24
1110865	OTHER	Bilat Lithotripsy	56	23	$99,999.99	$15,000.00 85% off	$3,500.00	$99,999.99	$73,999.99	2026-05-24
1210840	OTHER	Cult Chondro Implant	66	28	$99,999.99	$15,000.00 85% off	$15,000.00	$99,999.99	$72,999.99	2026-05-24
1210446	OTHER	Carmust Implnt 7.7mg	60	25	$99,999.31	$14,999.90 85% off	$14,999.90	$99,999.31	$72,999.50	2026-05-24
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	48	23	—	—	$2,680.00	$104,399.42	$71,897.17	2026-05-24
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	2	1	—	—	$70,558.76	$70,558.76	$70,558.76	2026-05-24
1413007	OTHER	Aicd Single Chamber3	60	25	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1410067	OTHER	Pmkr Dual Rate-rs L3	60	25	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1410047	OTHER	Pmkr Singl Rate-rsl2	60	25	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1410064	OTHER	Lead Aicd Endo Sn L4	60	25	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1410038	OTHER	Aicd Dual Chamber L4	60	25	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1410074	OTHER	Lead Aicd End Dul L4	60	25	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1410094	OTHER	Pmkr Othr Th Sngl L4	60	25	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1410093	OTHER	Pmkr Othr Th Sngl L3	60	25	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1410049	OTHER	Pmkr Singl Rate-rsl4	60	25	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1410048	OTHER	Pmkr Singl Rate-rsl3	60	25	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1411003	OTHER	Aicd Ohr Thn Sgl/du3	60	25	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1413142	OTHER	Cath Brachy Seed Ad2	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1414906	OTHER	Tavr L1	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1417404	OTHER	Gen Neuro Ext Cntrl	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1417403	OTHER	Gen Neuro Closd Loop	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1414904	OTHER	Watchman Atr App L1	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1414878	OTHER	Prsths Penile Infl 4	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1415232	OTHER	Prsths Urnary Sphc 2	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1418017	OTHER	Impl/insert Noc Lvl7	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1411701	OTHER	Impella Device L2	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1414480	OTHER	Conn Tissue Human 6	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1414905	OTHER	Watchman Atr App L2	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1410730	OTHER	Lead Neurostimulat 7	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1414907	OTHER	Tavr L2	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1418016	OTHER	Impl/insert Noc Lvl6	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1414329	OTHER	Cath-angio Level 5	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1411702	OTHER	Impella Device L3	62	26	$99,999.99	$30,000.00 70% off	$10,000.00	$99,999.99	$69,999.99	2026-05-24
1417227	OTHER	Lead Neurostimulat 4	62	26	$99,999.81	$29,999.94 70% off	$9,999.98	$99,999.81	$69,999.86	2026-05-24
1410039	OTHER	Aicd Dual Chamber L5	60	25	$99,999.61	$29,999.88 70% off	$9,999.96	$99,999.61	$69,999.73	2026-05-24
1414575	OTHER	Genratr Neurostm 2	62	26	$99,999.59	$29,999.88 70% off	$9,999.96	$99,999.59	$69,999.71	2026-05-24
1413006	OTHER	Aicd Single Chamber2	60	25	$99,999.49	$29,999.85 70% off	$9,999.95	$99,999.49	$69,999.64	2026-05-24
1411004	OTHER	Aicd Ohr Thn Sgl/du4	60	25	$99,999.49	$29,999.85 70% off	$9,999.95	$99,999.49	$69,999.64	2026-05-24
1411131	OTHER	Gen Neuro Hf Recarge	62	26	$99,999.24	$29,999.77 70% off	$9,999.92	$99,999.24	$69,999.47	2026-05-24
1413211	OTHER	Patient Progr Neuro2	62	26	$99,999.24	$29,999.77 70% off	$9,999.92	$99,999.24	$69,999.47	2026-05-24
1413125	OTHER	Genrate Neuro Rech 4	62	26	$99,999.24	$29,999.77 70% off	$9,999.92	$99,999.24	$69,999.47	2026-05-24
1414331	OTHER	Cath-angio Level 7	62	26	$99,999.22	$29,999.77 70% off	$9,999.92	$99,999.22	$69,999.45	2026-05-24
1413209	OTHER	Patient Progr Neuro1	62	26	$99,999.15	$29,999.75 70% off	$9,999.92	$99,999.15	$69,999.40	2026-05-24
1418018	OTHER	Impl/insert Noc Lvl8	62	26	$99,999.00	$29,999.70 70% off	$9,999.90	$99,999.00	$69,999.30	2026-05-24
1414579	OTHER	Genratr Neurostm 6	62	26	$99,999.00	$29,999.70 70% off	$9,999.90	$99,999.00	$69,999.30	2026-05-24
1414578	OTHER	Genratr Neurostm 5	62	26	$99,999.00	$29,999.70 70% off	$9,999.90	$99,999.00	$69,999.30	2026-05-24
1418019	OTHER	Impl/insert Noc Lvl9	62	26	$99,999.00	$29,999.70 70% off	$9,999.90	$99,999.00	$69,999.30	2026-05-24
1418038	OTHER	Genrate Neuro Rech 6	62	26	$99,999.00	$29,999.70 70% off	$9,999.90	$99,999.00	$69,999.30	2026-05-24
007-4	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$69,513.90	$69,513.90	$69,513.90	2026-05-24
215	OTHER	Other Heart Assist System Implant	60	29	—	—	$2,680.00	$122,138.00	$69,493.77	2026-05-24
1418037	OTHER	Genrate Neuro Rech 5	62	26	$99,000.00	$29,700.00 70% off	$9,900.00	$99,000.00	$69,300.00	2026-05-24
161-3	OTHER	Implantable Heart Assist Systems	2	1	—	—	$68,990.52	$68,990.52	$68,990.52	2026-05-24
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	60	29	—	—	$2,680.00	$116,953.37	$68,257.74	2026-05-24
1110864	OTHER	Lithotripsy	56	23	$91,727.00	$13,759.05 85% off	$3,500.00	$91,727.00	$67,877.98	2026-05-24
1410015	OTHER	Oth Ster Supp Lvl 15	60	25	$92,884.00	$13,932.60 85% off	$13,932.60	$92,884.00	$67,805.32	2026-05-24
1410017	OTHER	Oth Ster Supp Lvl 17	60	25	$92,728.80	$13,909.32 85% off	$13,909.32	$92,728.80	$67,692.02	2026-05-24
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$67,200.62	$67,200.62	$67,200.62	2026-05-24
1414852	OTHER	Probe Cryoablation 3	62	26	$95,990.00	$28,797.00 70% off	$9,599.00	$95,990.00	$67,193.00	2026-05-24
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	2	1	—	—	$66,379.62	$66,379.62	$66,379.62	2026-05-24
1410014	OTHER	Oth Ster Supp Lvl 14	60	25	$90,177.00	$13,526.55 85% off	$13,526.55	$90,177.00	$65,829.21	2026-05-24
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	2	1	—	—	$65,719.16	$65,719.16	$65,719.16	2026-05-24
593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	2	1	—	—	$65,165.40	$65,165.40	$65,165.40	2026-05-24
002-3	OTHER	Heart And/or Lung Transplant	2	1	—	—	$64,313.84	$64,313.84	$64,313.84	2026-05-24
612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$64,215.88	$64,215.88	$64,215.88	2026-05-24
1410016	OTHER	Oth Ster Supp Lvl 16	60	25	$87,772.35	$13,165.85 85% off	$13,165.85	$87,772.35	$64,073.82	2026-05-24
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	2	1	—	—	$64,047.27	$64,047.27	$64,047.27	2026-05-24
1418034	OTHER	Lead Neurostimulat 6	62	26	$89,999.00	$26,999.70 70% off	$8,999.90	$89,999.00	$62,999.30	2026-05-24
621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	2	1	—	—	$62,975.60	$62,975.60	$62,975.60	2026-05-24
613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	2	1	—	—	$62,000.00	$62,000.00	$62,000.00	2026-05-24
453	OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	54	26	—	—	$2,680.00	$89,726.49	$61,291.35	2026-05-24
1413005	OTHER	Aicd Single Chamber1	60	25	$87,348.00	$26,204.40 70% off	$8,734.80	$87,348.00	$61,143.60	2026-05-24
1211483	OTHER	Surgimnd Col Mtx 0.5	60	25	$82,587.98	$12,388.20 85% off	$12,388.20	$82,587.98	$60,289.23	2026-05-24
8650038	OTHER	Y90 Ibritum Rx-dose	94	41	$99,999.95	$14,999.99 85% off	$14,999.99	$89,999.96	$60,234.02	2026-05-24
231	OTHER	Coronary Bypass With Ptca With Mcc	60	29	—	—	$2,680.00	$100,779.45	$58,919.45	2026-05-24
589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	2	1	—	—	$58,911.54	$58,911.54	$58,911.54	2026-05-24
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	58	28	—	—	$2,680.00	$100,462.65	$58,736.55	2026-05-24
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	2	1	—	—	$58,048.83	$58,048.83	$58,048.83	2026-05-24
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	2	1	—	—	$57,782.49	$57,782.49	$57,782.49	2026-05-24
631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	2	1	—	—	$57,501.25	$57,501.25	$57,501.25	2026-05-24
608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	2	1	—	—	$55,904.01	$55,904.01	$55,904.01	2026-05-24
625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	2	1	—	—	$55,822.59	$55,822.59	$55,822.59	2026-05-24
1418021	OTHER	Impl/insert Noc Lv11	62	26	$79,329.00	$23,798.70 70% off	$7,932.90	$79,329.00	$55,530.30	2026-05-24
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	58	28	—	—	$2,680.00	$97,003.85	$55,046.50	2026-05-24
1413181	OTHER	Lead Neurostimulat 2	62	26	$78,589.21	$23,576.76 70% off	$7,858.92	$78,589.21	$55,012.45	2026-05-24
1061570	OTHER	Ic-prq De Cr Rev Ami	60	25	$76,344.00	$11,451.60 85% off	$6,984.00	$68,709.60	$54,795.90	2026-05-24
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	60	29	—	—	$2,680.00	$91,794.08	$53,731.58	2026-05-24
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	60	29	—	—	$2,680.00	$91,398.37	$53,503.11	2026-05-24
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	58	28	—	—	$2,680.00	$91,095.90	$53,328.48	2026-05-24
603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	2	1	—	—	$52,514.62	$52,514.62	$52,514.62	2026-05-24
754-4	OTHER	Depression Except Major Depressive Disorder	2	1	—	—	$50,828.51	$50,828.51	$50,828.51	2026-05-24
161-1	OTHER	Implantable Heart Assist Systems	2	1	—	—	$50,763.40	$50,763.40	$50,763.40	2026-05-24
161-2	OTHER	Implantable Heart Assist Systems	2	1	—	—	$50,763.40	$50,763.40	$50,763.40	2026-05-24
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	2	1	—	—	$50,578.61	$50,578.61	$50,578.61	2026-05-24
613	OTHER	Neonate, Birth Weight <750 Grams, Died	4	2	—	—	$46,276.44	$54,557.49	$50,416.96	2026-05-24
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	58	28	—	—	$2,680.00	$85,749.63	$50,241.72	2026-05-24
011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	1	—	—	$50,021.00	$50,021.00	$50,021.00	2026-05-24
10	OTHER	Pancreas Transplant	48	23	—	—	$2,680.00	$72,657.86	$50,008.90	2026-05-24
588-1	OTHER	Female Reproductive System Reconstructive Procedures	2	1	—	—	$50,000.00	$50,000.00	$50,000.00	2026-05-24
011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	1	—	—	$50,000.00	$50,000.00	$50,000.00	2026-05-24
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	50	24	—	—	$2,680.00	$72,241.70	$49,964.00	2026-05-24
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	56	27	—	—	$2,680.00	$85,243.93	$49,942.38	2026-05-24
1412785	OTHER	Corneal Tissue Proc	62	26	$70,239.13	$10,535.87 85% off	$3,850.04	$63,215.22	$49,553.71	2026-05-24
1414577	OTHER	Genratr Neurostm 4	62	26	$69,999.00	$20,999.70 70% off	$6,999.90	$69,999.00	$48,999.30	2026-05-24
002-2	OTHER	Heart And/or Lung Transplant	2	1	—	—	$48,700.82	$48,700.82	$48,700.82	2026-05-24
608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	2	1	—	—	$48,256.70	$48,256.70	$48,256.70	2026-05-24
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	60	29	—	—	$2,680.00	$82,225.29	$48,199.17	2026-05-24
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	56	27	—	—	$2,680.00	$69,985.71	$47,729.01	2026-05-24
1414760	OTHER	Mesh Implantable 11	62	26	$68,115.85	$20,434.76 70% off	$6,811.59	$68,115.85	$47,681.10	2026-05-24
318	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	4	2	—	—	$43,438.06	$51,211.18	$47,324.62	2026-05-24
955	OTHER	Craniotomy For Multiple Significant Trauma	58	28	—	—	$2,680.00	$92,594.15	$47,194.30	2026-05-24
1414252	OTHER	Cath Thrmb/embol 4	62	26	$67,281.00	$20,184.30 70% off	$6,728.10	$67,281.00	$47,096.70	2026-05-24
8060110	OTHER	Ic-pr De Cr Stn Ar B	62	26	$66,727.00	$10,009.05 85% off	$5,527.88	$60,054.30	$47,075.90	2026-05-24
8060112	OTHER	Ic-pr De Cr Rv Ch Ea	62	26	$66,727.00	$10,009.05 85% off	$5,527.88	$60,054.30	$47,075.90	2026-05-24
1414757	OTHER	Mesh Implantable 8	62	26	$66,977.18	$20,093.15 70% off	$6,697.72	$66,977.18	$46,884.03	2026-05-24
602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$46,288.65	$46,288.65	$46,288.65	2026-05-24
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	2	1	—	—	$46,242.32	$46,242.32	$46,242.32	2026-05-24
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	60	29	—	—	$2,680.00	$80,902.00	$46,118.20	2026-05-24
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	60	29	—	—	$2,680.00	$80,902.00	$46,118.20	2026-05-24
459	OTHER	Spinal Fusion Except Cervical With Mcc	54	26	—	—	$2,680.00	$67,155.65	$46,056.00	2026-05-24
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	58	28	—	—	$2,680.00	$78,321.99	$45,953.24	2026-05-24
1410066	OTHER	Pmkr Dual Rate-rs L2	60	25	$65,514.00	$19,654.20 70% off	$6,551.40	$65,514.00	$45,859.80	2026-05-24
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	2	1	—	—	$45,773.76	$45,773.76	$45,773.76	2026-05-24
1414103	OTHER	Breast Implant 4	62	26	$64,535.00	$19,360.50 70% off	$6,453.50	$64,535.00	$45,174.50	2026-05-24
623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	2	1	—	—	$44,986.56	$44,986.56	$44,986.56	2026-05-24
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	56	27	—	—	$2,680.00	$65,154.84	$44,484.31	2026-05-24
612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$44,469.23	$44,469.23	$44,469.23	2026-05-24
007-3	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$44,211.42	$44,211.42	$44,211.42	2026-05-24
1414176	OTHER	Cath Hemodial Lt 2	62	26	$63,100.00	$18,930.00 70% off	$6,310.00	$63,100.00	$44,170.00	2026-05-24
1414104	OTHER	Breast Implant 5	62	26	$62,985.60	$18,895.68 70% off	$6,298.56	$62,985.60	$44,089.92	2026-05-24
1410043	OTHER	Lead Lt Vent Cor Lv3	60	25	$62,914.00	$18,874.20 70% off	$6,291.40	$62,914.00	$44,039.80	2026-05-24
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	2	1	—	—	$43,878.16	$43,878.16	$43,878.16	2026-05-24
613-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	2	1	—	—	$43,646.76	$43,646.76	$43,646.76	2026-05-24
1410044	OTHER	Lead Lt Vent Cor Lv4	60	25	$62,336.97	$18,701.09 70% off	$6,233.70	$62,336.97	$43,635.88	2026-05-24
1414102	OTHER	Breast Implant 3	62	26	$61,575.00	$18,472.50 70% off	$6,157.50	$61,575.00	$43,102.50	2026-05-24
002-1	OTHER	Heart And/or Lung Transplant	2	1	—	—	$43,043.59	$43,043.59	$43,043.59	2026-05-24
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	58	28	—	—	$2,680.00	$112,982.63	$43,034.21	2026-05-24
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	58	28	—	—	$2,680.00	$104,862.26	$42,984.51	2026-05-24
454	OTHER	Combined Anterior And Posterior Spinal Fusion With Cc	54	26	—	—	$2,680.00	$61,930.86	$42,932.45	2026-05-24
006-4	OTHER	Pancreas Transplant	2	1	—	—	$42,927.52	$42,927.52	$42,927.52	2026-05-24
232	OTHER	Coronary Bypass With Ptca Without Mcc	60	29	—	—	$2,680.00	$72,478.38	$42,579.35	2026-05-24
28	OTHER	Spinal Procedures With Mcc	58	28	—	—	$2,680.00	$71,829.23	$42,204.53	2026-05-24
276	OTHER	Non-maligant Breast Disorders	56	27	—	—	$2,680.00	$71,808.90	$42,183.88	2026-05-24
8060109	OTHER	Ic-prq De Cor Stnt B	62	26	$59,788.00	$8,968.20 85% off	$5,527.88	$53,809.20	$42,180.43	2026-05-24
1418015	OTHER	Impl/insert Noc Lvl5	62	26	$60,072.00	$18,021.60 70% off	$6,007.20	$60,072.00	$42,050.40	2026-05-24
1414286	OTHER	Cath Trns Arthr Rot2	62	26	$59,960.00	$17,988.00 70% off	$5,996.00	$59,960.00	$41,972.00	2026-05-24
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	58	28	—	—	$2,680.00	$71,288.86	$41,892.53	2026-05-24
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	46	22	—	—	$2,680.00	$60,041.43	$41,643.95	2026-05-24
622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$41,643.23	$41,643.23	$41,643.23	2026-05-24
1414508	OTHER	Drill Bit/blade Lvl9	60	25	$56,631.41	$8,494.71 85% off	$8,494.71	$56,631.41	$41,340.93	2026-05-24
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	60	29	—	—	$2,680.00	$70,159.11	$41,240.26	2026-05-24
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	58	28	—	—	$2,680.00	$70,113.68	$41,214.03	2026-05-24
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	58	28	—	—	$2,680.00	$60,181.17	$40,939.18	2026-05-24
1411002	OTHER	Aicd Ohr Thn Sgl/du2	60	25	$58,447.17	$17,534.15 70% off	$5,844.72	$58,447.17	$40,913.01	2026-05-24
1061560	OTHER	Ic-prq Card Rev 1 Vs	70	30	$58,399.00	$8,759.85 85% off	$569.55	$52,559.10	$40,879.30	2026-05-24
1413047	OTHER	Cath Ep Dig/abl 3d 2	62	26	$58,298.00	$17,489.40 70% off	$5,829.80	$58,298.00	$40,808.60	2026-05-24
1414576	OTHER	Genratr Neurostm 3	62	26	$58,255.26	$17,476.58 70% off	$5,825.53	$58,255.26	$40,778.68	2026-05-24
1417058	OTHER	Tissue Non-human 10	62	26	$57,669.61	$17,300.88 70% off	$5,766.96	$57,669.61	$40,368.73	2026-05-24
213	OTHER	Splenic Procedures Age 0-17	4	2	—	—	$36,994.44	$43,614.50	$40,304.47	2026-05-24
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	58	28	—	—	$2,680.00	$68,505.74	$40,285.66	2026-05-24
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	58	28	—	—	$2,680.00	$68,137.52	$40,073.07	2026-05-24
1413039	OTHER	Cath Bal Dil Nonvas2	62	26	$56,691.00	$17,007.30 70% off	$5,669.10	$56,691.00	$39,683.70	2026-05-24
1414756	OTHER	Mesh Implantable 7	62	26	$56,649.36	$16,994.81 70% off	$5,664.94	$56,649.36	$39,654.55	2026-05-24
8	OTHER	Simultaneous Pancreas And Kidney Transplant	48	23	—	—	$2,680.00	$79,006.71	$39,408.54	2026-05-24
1413192	OTHER	Inf Pump Program Lv6	62	26	$55,940.00	$16,782.00 70% off	$5,594.00	$55,940.00	$39,158.00	2026-05-24
278	OTHER	Cellulitis Age >17 Without Cc	56	27	—	—	$2,680.00	$66,543.92	$39,143.45	2026-05-24
634-4	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	2	1	—	—	$38,849.30	$38,849.30	$38,849.30	2026-05-24
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	60	29	—	—	$2,680.00	$66,027.46	$38,845.19	2026-05-24
1410013	OTHER	Oth Ster Supp Lvl 13	60	25	$53,161.00	$7,974.15 85% off	$7,974.15	$53,161.00	$38,807.53	2026-05-24
8060111	OTHER	Ic-pr De Cr Rv Cab B	62	26	$54,851.12	$8,227.67 85% off	$5,527.88	$49,366.01	$38,697.47	2026-05-24
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	58	28	—	—	$2,680.00	$65,399.83	$38,492.41	2026-05-24
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	60	29	—	—	$2,680.00	$65,306.58	$38,438.56	2026-05-24
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	58	28	—	—	$2,680.00	$65,203.77	$38,379.20	2026-05-24
17	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	46	22	—	—	$2,680.00	$55,005.00	$38,209.31	2026-05-24
1413054	OTHER	Cath Intra Echocard4	62	26	$54,411.00	$16,323.30 70% off	$5,441.10	$54,411.00	$38,087.70	2026-05-24
834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	56	27	—	—	$2,680.00	$55,588.21	$38,058.79	2026-05-24
1414021	OTHER	Anchor/scrw Level 21	62	26	$54,236.90	$16,271.07 70% off	$5,423.69	$54,236.90	$37,965.83	2026-05-24
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	60	29	—	—	$2,680.00	$63,753.62	$37,541.95	2026-05-24
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	58	28	—	—	$2,680.00	$73,764.44	$37,272.73	2026-05-24
1413283	OTHER	Lead Neurostm Tst K2	62	26	$53,195.08	$15,958.52 70% off	$5,319.51	$53,195.08	$37,236.56	2026-05-24
270	OTHER	Other Major Cardiovascular Procedures With Mcc	60	29	—	—	$2,680.00	$63,078.17	$37,151.96	2026-05-24
1413325	OTHER	Cath Bal Dil Nonvas5	62	26	$52,492.00	$15,747.60 70% off	$5,249.20	$52,492.00	$36,744.40	2026-05-24
1413324	OTHER	Cath Bal Dil Nonvas4	62	26	$52,492.00	$15,747.60 70% off	$5,249.20	$52,492.00	$36,744.40	2026-05-24
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	60	29	—	—	$2,680.00	$62,230.56	$36,652.54	2026-05-24
653	OTHER	Major Bladder Procedures With Mcc	58	28	—	—	$2,680.00	$62,122.96	$36,600.46	2026-05-24
614-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	2	1	—	—	$36,398.35	$36,398.35	$36,398.35	2026-05-24
1414755	OTHER	Mesh Implantable 6	62	26	$51,890.00	$15,567.00 70% off	$5,189.00	$51,890.00	$36,323.00	2026-05-24
1414483	OTHER	Conn Tissue Human 9	62	26	$51,630.11	$15,489.03 70% off	$5,163.01	$51,630.11	$36,141.08	2026-05-24
1417034	OTHER	Bone Void Per 0.5cc5	62	26	$51,318.30	$15,395.49 70% off	$5,131.83	$51,318.30	$35,922.81	2026-05-24
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	60	29	—	—	$2,680.00	$60,255.59	$35,522.29	2026-05-24
1414378	OTHER	Catheter Guiding 4	62	26	$50,381.00	$15,114.30 70% off	$5,038.10	$50,381.00	$35,266.70	2026-05-24
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	58	28	—	—	$2,680.00	$59,624.37	$35,157.85	2026-05-24
1417226	OTHER	Lead Neurostimulat 3	62	26	$50,100.63	$15,030.19 70% off	$5,010.06	$50,100.63	$35,070.44	2026-05-24
1414287	OTHER	Cath Trns Arthr Rot3	62	26	$49,890.00	$14,967.00 70% off	$4,989.00	$49,890.00	$34,923.00	2026-05-24
228	OTHER	Other Cardiothoracic Procedures With Mcc	60	29	—	—	$2,680.00	$61,503.29	$34,881.76	2026-05-24
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	58	28	—	—	$2,680.00	$59,040.96	$34,821.02	2026-05-24
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	58	28	—	—	$2,680.00	$58,838.92	$34,704.36	2026-05-24
1414276	OTHER	Cath Trns Arthr Dir2	62	26	$49,432.63	$14,829.79 70% off	$4,943.26	$49,432.63	$34,602.84	2026-05-24
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	58	28	—	—	$2,680.00	$58,593.85	$34,562.85	2026-05-24
1417033	OTHER	Bone Void Per 0.5cc4	62	26	$49,323.00	$14,796.90 70% off	$4,932.30	$49,323.00	$34,526.10	2026-05-24
011-1	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	1	—	—	$34,425.83	$34,425.83	$34,425.83	2026-05-24
483-4	OTHER	Penis, Testes And Scrotal Procedures	2	1	—	—	$34,391.52	$34,391.52	$34,391.52	2026-05-24
1417076	OTHER	Vena Cava Filter 2	62	26	$49,063.71	$14,719.11 70% off	$4,906.37	$49,063.71	$34,344.59	2026-05-24
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	2	1	—	—	$34,119.63	$34,119.63	$34,119.63	2026-05-24
471	OTHER	Cervical Spinal Fusion With Mcc	60	29	—	—	$2,680.00	$57,727.11	$34,051.88	2026-05-24
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	2	1	—	—	$33,990.74	$33,990.74	$33,990.74	2026-05-24
623-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	2	1	—	—	$33,834.71	$33,834.71	$33,834.71	2026-05-24
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	58	28	—	—	$2,680.00	$56,915.36	$33,593.76	2026-05-24
005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	2	1	—	—	$33,559.57	$33,559.57	$33,559.57	2026-05-24
232-4	OTHER	Gastric Fundoplication	2	1	—	—	$33,454.73	$33,454.73	$33,454.73	2026-05-24
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	56	27	—	—	$2,680.00	$48,646.14	$33,396.08	2026-05-24
589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	2	1	—	—	$33,354.00	$33,354.00	$33,354.00	2026-05-24
1414708	OTHER	Joint Device Implt 9	62	26	$47,590.00	$14,277.00 70% off	$4,759.00	$47,590.00	$33,313.00	2026-05-24
440-4	OTHER	Kidney Transplant	2	1	—	—	$33,283.63	$33,283.63	$33,283.63	2026-05-24
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	50	24	—	—	$2,680.00	$47,604.22	$33,162.29	2026-05-24
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	58	28	—	—	$2,680.00	$56,090.47	$33,117.49	2026-05-24
317	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	4	2	—	—	$30,369.67	$35,804.24	$33,086.96	2026-05-24
006-3	OTHER	Pancreas Transplant	2	1	—	—	$33,082.46	$33,082.46	$33,082.46	2026-05-24
607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$33,026.75	$33,026.75	$33,026.75	2026-05-24
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	58	28	—	—	$2,680.00	$55,923.10	$33,020.85	2026-05-24
6	OTHER	Liver Transplant Without Mcc	48	23	—	—	$2,680.00	$81,890.76	$32,728.42	2026-05-24
1414330	OTHER	Cath-angio Level 6	62	26	$46,750.00	$14,025.00 70% off	$4,675.00	$46,750.00	$32,725.00	2026-05-24
277	OTHER	Cellulitis Age >17 W Cc	56	27	—	—	$2,680.00	$55,214.17	$32,600.69	2026-05-24
455	OTHER	Combined Anterior And Posterior Spinal Fusion Without Cc/mcc	54	26	—	—	$2,680.00	$59,179.00	$32,522.50	2026-05-24
329	OTHER	Major Small And Large Bowel Procedures With Mcc	58	28	—	—	$2,680.00	$54,951.16	$32,459.69	2026-05-24
1413072	OTHER	Cath Bal Tis Dis Lv3	62	26	$46,321.04	$13,896.31 70% off	$4,632.10	$46,321.04	$32,424.73	2026-05-24
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	58	28	—	—	$2,680.00	$54,811.28	$32,378.94	2026-05-24
245	OTHER	Aicd Generator Procedures	60	29	—	—	$2,680.00	$54,543.49	$32,213.39	2026-05-24
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	58	28	—	—	$2,680.00	$54,379.71	$32,129.75	2026-05-24
25	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	58	28	—	—	$2,680.00	$54,355.80	$32,115.95	2026-05-24
1414278	OTHER	Cath Trns Arthr Dir4	62	26	$45,770.95	$13,731.29 70% off	$4,577.10	$45,770.95	$32,039.66	2026-05-24
799	OTHER	Splenectomy With Mcc	58	28	—	—	$2,680.00	$54,143.00	$31,993.08	2026-05-24
163	OTHER	Major Chest Procedures With Mcc	58	28	—	—	$2,680.00	$56,068.25	$31,667.98	2026-05-24
31	OTHER	Ventricular Shunt Procedures With Mcc	58	28	—	—	$2,680.00	$53,564.38	$31,659.02	2026-05-24
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	56	27	—	—	$2,680.00	$53,353.97	$31,526.47	2026-05-24
1414482	OTHER	Conn Tissue Human 8	62	26	$44,500.48	$13,350.14 70% off	$4,450.05	$44,500.48	$31,150.34	2026-05-24
1418014	OTHER	Impl/insert Noc Lvl4	62	26	$44,498.00	$13,349.40 70% off	$4,449.80	$44,498.00	$31,148.60	2026-05-24
007-2	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$31,134.17	$31,134.17	$31,134.17	2026-05-24
356	OTHER	Other Digestive System O.r. Procedures With Mcc	58	28	—	—	$2,680.00	$52,515.92	$31,053.66	2026-05-24
1413124	OTHER	Evnt Rcrdr Crdc Lvl1	62	26	$44,217.00	$13,265.10 70% off	$4,421.70	$44,217.00	$30,951.90	2026-05-24
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	2	1	—	—	$30,917.70	$30,917.70	$30,917.70	2026-05-24
1417057	OTHER	Tissue Non-human 9	62	26	$43,722.07	$13,116.62 70% off	$4,372.21	$43,722.07	$30,605.44	2026-05-24
323	OTHER	Urinary Stones W Cc, &/or Esw Lithotripsy	56	27	—	—	$2,680.00	$51,734.07	$30,591.01	2026-05-24
1411006	OTHER	Bone Grow Stim Impl2	62	26	$43,418.97	$13,025.69 70% off	$4,341.90	$43,418.97	$30,393.28	2026-05-24
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	58	28	—	—	$2,680.00	$51,321.62	$30,364.11	2026-05-24
609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	2	1	—	—	$30,294.81	$30,294.81	$30,294.81	2026-05-24
140	OTHER	Major Head And Neck Procedures With Mcc	56	27	—	—	$2,680.00	$50,991.66	$30,162.28	2026-05-24
1414151	OTHER	Cath Abltn Nocrd Ed2	62	26	$42,853.01	$12,855.90 70% off	$4,285.30	$42,853.01	$29,997.11	2026-05-24
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	60	29	—	—	$2,680.00	$50,488.36	$29,871.63	2026-05-24
12	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	58	28	—	—	$2,680.00	$50,402.28	$29,833.31	2026-05-24
958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	58	28	—	—	$2,680.00	$50,377.17	$29,818.82	2026-05-24
1413182	OTHER	Lead Neurostm Tst K1	62	26	$42,556.07	$12,766.82 70% off	$4,255.61	$42,556.07	$29,789.24	2026-05-24
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	2	1	—	—	$29,743.10	$29,743.10	$29,743.10	2026-05-24
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	58	28	—	—	$2,680.00	$50,230.13	$29,733.93	2026-05-24
901	OTHER	Wound Debridements For Injuries With Mcc	58	28	—	—	$2,680.00	$50,170.35	$29,699.41	2026-05-24
236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	60	29	—	—	$2,680.00	$50,077.10	$29,645.57	2026-05-24
1418036	OTHER	Genrate Neuro Rech 3	62	26	$42,327.52	$12,698.26 70% off	$4,232.75	$42,327.52	$29,629.26	2026-05-24
1411011	OTHER	Cath Ep Not Cool-tp6	62	26	$42,250.00	$12,675.00 70% off	$4,225.00	$42,250.00	$29,575.00	2026-05-24
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	60	29	—	—	$2,680.00	$51,337.00	$29,533.76	2026-05-24
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	58	28	—	—	$2,680.00	$49,649.11	$29,399.15	2026-05-24
630-2	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	2	1	—	—	$29,328.79	$29,328.79	$29,328.79	2026-05-24
004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	2	1	—	—	$29,251.04	$29,251.04	$29,251.04	2026-05-24
273	OTHER	Percutaneous And Other Intracardiac Procedures With Mcc	58	28	—	—	$2,680.00	$49,320.35	$29,208.65	2026-05-24

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