Hospital

ST BERNARDS FIVE RIVERS MEDICAL CENTER

Pocahontas, AR · CCN 040779 · Rates published

24,616 distinct procedures filed

10 distinct payers

395,007 rate rows

2026-05-09 last MRF observed

Data quality

391,249 of 395,007 rate rows are consumer-grade (99.0%)

3,758 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
template filing: same amount across many unrelated codes — excluded	1,846
per-diem day rate — not a per-procedure price	1,544
placeholder amount (≤ $0.02) — excluded from medians	275
percent-of-charges filed in the dollar field — excluded from medians	93

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

Source MRF file	https://www.stbernards.info/app/files/public/4589b01b-482d-4b7e-838a-3c633b628526/273970823_five-rivers-medical-center-inc_standardcharges.csv
Found on page	https://www.stbernards.info/cms-hpt.txt
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	93400c4267e6d525… · 51,734,445 bytes · first seen 2026-05-09

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
J3391 OTHER	Inj Atidarsagene Autotemcel	5	$4,505,000.00	$4,730,250.00	$4,730,250.00	nat. median $4,505,000 1.1× median
J1411 OTHER	Inj Hemgenix Per Tx Dose	6	$3,685,266.67	$4,790,846.67	$3,869,530.00	nat. median $3,685,267 1.0× median
J1413 OTHER	Inj Delandistrogene Mox Rokl	9	$3,316,462.59	$4,643,047.63	$3,482,285.72	nat. median $3,327,860 1.0× median
J3394 OTHER	Inj Lovotibeglogene Autotem	7	$3,248,445.72	$4,547,824.01	$3,410,868.01	nat. median $3,286,000 1.0× median
J3393 OTHER	Inj Betibeglogene Autotemce	8	$2,945,740.00	$4,713,184.00	$3,093,027.00	nat. median $2,968,000 1.0× median
J3399 OTHER	Inj Onase Abepar-xioi Treat	8	$2,455,110.61	$3,928,176.98	$2,577,866.14	nat. median $2,472,216 1.0× median
J3392 OTHER	Inj Exagamglogene Autotem	8	$2,332,000.00	$3,731,200.00	$2,448,600.00	nat. median $2,332,000 1.1× median
Q2057 OTHER	Afamitresgene Autoleucel	8	$770,620.00	$1,232,992.00	$809,151.00	nat. median $770,620 1.1× median
Q2042 OTHER	Tisagenlecleucel Car-pos T	8	$591,726.20	$946,761.92	$621,312.51	nat. median $591,726 1.1× median
Q2056 OTHER	Ciltacabtagene Car-pos T	10	$530,100.00	$1,224,531.00	$594,162.40	nat. median $583,076 1.0× median
Q2054 OTHER	Lisocabtagene Mara Car Pos T	10	$467,742.00	$1,080,484.02	$590,665.10	nat. median $562,538 1.1× median
Q2055 OTHER	Idecabtagene Vicleucel Car	10	$478,230.00	$1,104,711.30	$585,183.83	nat. median $558,082 1.0× median
Q2041 OTHER	Axicabtagene Ciloleucel Car+	10	$454,860.00	$1,050,726.60	$559,891.68	nat. median $533,230 1.1× median
Q2053 OTHER	Brexucabtagene Car Pos T	10	$454,860.00	$1,050,726.60	$513,769.84	nat. median $489,720 1.0× median
MS-018 OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	8	$266,828.38	$426,925.41	$299,753.30	nat. median $309,559 1.0× median
Q2058 OTHER	Obecbtge Autol Up To 400 Mil	10	$278,250.00	$691,267.50	$299,250.00	nat. median $281,111 1.1× median
J3403 OTHER	Revakinagene Per Implant	8	$257,500.00	$412,000.00	$270,375.00	nat. median $265,000 1.0× median
J3402 OTHER	Inj. Remestemcel-l-rknd/ Td	8	$205,640.00	$329,024.00	$215,922.00	nat. median $205,640 1.1× median
MS-001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	8	$173,160.88	$277,057.42	$194,527.83	nat. median $224,278 0.9× median
MS-927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	8	$131,925.66	$211,081.05	$148,204.45	nat. median $175,322 0.8× median
MS-003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	8	$131,151.42	$209,842.28	$147,334.67	nat. median $169,886 0.9× median
Q0480 OTHER	Driver Pneumatic Vad Rep	8	$12,999.99	$174,889.68	$114,771.35	nat. median $109,316 1.0× median
MS-004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	8	$85,588.40	$136,941.44	$96,149.46	nat. median $107,587 0.9× median
MS-007 OTHER	Lung Transplant	8	$80,019.84	$128,031.75	$89,893.79	nat. median $95,292 0.9× median
MS-014 OTHER	Allogeneic Bone Marrow Transplant	8	$74,259.12	$118,814.59	$83,422.23	nat. median $91,600 0.9× median
MS-002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	8	$70,019.68	$112,031.49	$78,659.66	nat. median $91,287 0.9× median
MS-209 OTHER	Complex Aortic Arch Procedures	8	$69,939.35	$111,902.96	$78,569.43	nat. median $81,783 1.0× median
MS-426 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	8	$68,100.47	$108,960.75	$76,503.63	nat. median $84,247 0.9× median
MS-212 OTHER	Concomitant Aortic And Mitral Valve?procedures	8	$67,191.53	$107,506.45	$75,482.54	nat. median $87,208 0.9× median
A9543 OTHER	Y90 Ibritumomab Rx	8	$56,824.55	$90,919.28	$73,905.52	nat. median $66,156 1.1× median
MS-005 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	8	$63,709.02	$101,934.44	$71,570.31	nat. median $85,046 0.8× median
L8702 OTHER	Ewhf S/d Uprt Micro Sensor	8	$67,452.66	$107,924.26	$70,825.29	nat. median $68,802 1.0× median
MS-215 OTHER	Other Heart Assist System Implant	8	$61,524.73	$98,439.57	$69,116.49	nat. median $80,736 0.9× median
MS-216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	8	$60,448.34	$96,717.35	$67,907.29	nat. median $76,284 0.9× median
0100T OTHER	Prosth Retina Receive&gen	1	$2,161.72	$132,440.00	$67,300.86	nat. median $10,612 outlier · 6.3×
J9029 OTHER	Instill Adstiladrin Tx Dose	10	$59,756.87	$158,004.00	$66,509.40	nat. median $66,509 1.0× median
MS-429 OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	8	$55,670.71	$89,073.13	$62,540.12	nat. median $69,654 0.9× median
C9150 OTHER	Xe129 Xenon- Diagnostic	2	$59,280.00	$61,651.20	$60,465.60	nat. median $53,040 1.1× median
MS-850 OTHER	Acute Leukemia With Other Procedures	8	$53,507.42	$85,611.88	$60,109.90	nat. median $70,217 0.9× median
MS-231 OTHER	Coronary Bypass With Ptca With Mcc	8	$52,088.72	$83,341.94	$58,516.13	nat. median $64,520 0.9× median
MS-456 OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	8	$51,924.97	$83,079.95	$58,332.18	nat. median $65,528 0.9× median
Q2043 OTHER	Sipuleucel-t Auto Cd54+	10	$52,916.50	$122,237.12	$58,035.94	nat. median $55,946 1.0× median
L7180 OTHER	Electronic Elbow Sequential	8	$49,026.62	$78,442.59	$56,859.39	nat. median $42,587 1.3× median
L7181 OTHER	Electronic Elbo Simultaneous	8	$48,628.26	$77,805.22	$56,397.38	nat. median $48,901 1.2× median
MS-020 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	8	$48,621.65	$77,794.65	$54,621.26	nat. median $64,597 0.8× median
MS-219 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	8	$47,444.55	$75,911.27	$53,298.90	nat. median $59,911 0.9× median
MS-233 OTHER	Coronary Bypass With Cardiac Catheterization With Mcc	8	$47,240.02	$75,584.03	$53,069.13	nat. median $60,330 0.9× median
MS-957 OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	8	$47,083.69	$75,333.90	$52,893.51	nat. median $59,203 0.9× median
MS-427 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	8	$44,604.04	$71,366.46	$50,107.90	nat. median $54,639 0.9× median
MS-010 OTHER	Pancreas Transplant	8	$44,338.96	$70,942.33	$49,810.11	nat. median $55,393 0.9× median

Other procedures at this hospital

Browse this hospital's 24,616 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

J3391	OTHER	Inj Atidarsagene Autotemcel	5	5	—	—	$4,505,000.00	$4,730,250.00	$4,730,250.00	2026-05-09
J1411	OTHER	Inj Hemgenix Per Tx Dose	6	6	—	—	$3,685,266.67	$4,790,846.67	$3,869,530.00	2026-05-09
J1413	OTHER	Inj Delandistrogene Mox Rokl	9	9	—	—	$3,316,462.59	$4,643,047.63	$3,482,285.72	2026-05-09
J3394	OTHER	Inj Lovotibeglogene Autotem	7	7	—	—	$3,248,445.72	$4,547,824.01	$3,410,868.01	2026-05-09
J3393	OTHER	Inj Betibeglogene Autotemce	8	8	—	—	$2,945,740.00	$4,713,184.00	$3,093,027.00	2026-05-09
J3399	OTHER	Inj Onase Abepar-xioi Treat	8	8	—	—	$2,455,110.61	$3,928,176.98	$2,577,866.14	2026-05-09
J3392	OTHER	Inj Exagamglogene Autotem	8	8	—	—	$2,332,000.00	$3,731,200.00	$2,448,600.00	2026-05-09
Q2057	OTHER	Afamitresgene Autoleucel	11	8	—	—	$770,620.00	$1,232,992.00	$809,151.00	2026-05-09
Q2042	OTHER	Tisagenlecleucel Car-pos T	12	8	—	—	$591,726.20	$946,761.92	$621,312.51	2026-05-09
Q2056	OTHER	Ciltacabtagene Car-pos T	18	10	—	—	$530,100.00	$1,224,531.00	$594,162.40	2026-05-09
Q2054	OTHER	Lisocabtagene Mara Car Pos T	17	10	—	—	$467,742.00	$1,080,484.02	$590,665.10	2026-05-09
Q2055	OTHER	Idecabtagene Vicleucel Car	14	10	—	—	$478,230.00	$1,104,711.30	$585,183.83	2026-05-09
Q2041	OTHER	Axicabtagene Ciloleucel Car+	14	10	—	—	$454,860.00	$1,050,726.60	$559,891.68	2026-05-09
Q2053	OTHER	Brexucabtagene Car Pos T	14	10	—	—	$454,860.00	$1,050,726.60	$513,769.84	2026-05-09
MS-018	OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	10	8	—	—	$266,828.38	$426,925.41	$299,753.30	2026-05-09
Q2058	OTHER	Obecbtge Autol Up To 400 Mil	11	10	—	—	$278,250.00	$691,267.50	$299,250.00	2026-05-09
J3403	OTHER	Revakinagene Per Implant	8	8	—	—	$257,500.00	$412,000.00	$270,375.00	2026-05-09
J3402	OTHER	Inj. Remestemcel-l-rknd/ Td	11	8	—	—	$205,640.00	$329,024.00	$215,922.00	2026-05-09
MS-001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	10	8	—	—	$173,160.88	$277,057.42	$194,527.83	2026-05-09
MS-927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	10	8	—	—	$131,925.66	$211,081.05	$148,204.45	2026-05-09
MS-003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	10	8	—	—	$131,151.42	$209,842.28	$147,334.67	2026-05-09
Q0480	OTHER	Driver Pneumatic Vad Rep	10	8	—	—	$12,999.99	$174,889.68	$114,771.35	2026-05-09
MS-004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	10	8	—	—	$85,588.40	$136,941.44	$96,149.46	2026-05-09
MS-007	OTHER	Lung Transplant	10	8	—	—	$80,019.84	$128,031.75	$89,893.79	2026-05-09
MS-014	OTHER	Allogeneic Bone Marrow Transplant	10	8	—	—	$74,259.12	$118,814.59	$83,422.23	2026-05-09
MS-002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	10	8	—	—	$70,019.68	$112,031.49	$78,659.66	2026-05-09
MS-209	OTHER	Complex Aortic Arch Procedures	10	8	—	—	$69,939.35	$111,902.96	$78,569.43	2026-05-09
MS-426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	10	8	—	—	$68,100.47	$108,960.75	$76,503.63	2026-05-09
MS-212	OTHER	Concomitant Aortic And Mitral Valve?procedures	10	8	—	—	$67,191.53	$107,506.45	$75,482.54	2026-05-09
A9543	OTHER	Y90 Ibritumomab Rx	12	8	—	—	$56,824.55	$90,919.28	$73,905.52	2026-05-09
MS-005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	10	8	—	—	$63,709.02	$101,934.44	$71,570.31	2026-05-09
L8702	OTHER	Ewhf S/d Uprt Micro Sensor	8	8	—	—	$67,452.66	$107,924.26	$70,825.29	2026-05-09
MS-215	OTHER	Other Heart Assist System Implant	10	8	—	—	$61,524.73	$98,439.57	$69,116.49	2026-05-09
MS-216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	10	8	—	—	$60,448.34	$96,717.35	$67,907.29	2026-05-09
0100T	OTHER	Prosth Retina Receive&gen	4	1	—	—	$2,161.72	$132,440.00	$67,300.86	2026-05-09
J9029	OTHER	Instill Adstiladrin Tx Dose	19	10	—	—	$59,756.87	$158,004.00	$66,509.40	2026-05-09
MS-429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	10	8	—	—	$55,670.71	$89,073.13	$62,540.12	2026-05-09
C9150	OTHER	Xe129 Xenon- Diagnostic	2	2	—	—	$59,280.00	$61,651.20	$60,465.60	2026-05-09
MS-850	OTHER	Acute Leukemia With Other Procedures	10	8	—	—	$53,507.42	$85,611.88	$60,109.90	2026-05-09
MS-231	OTHER	Coronary Bypass With Ptca With Mcc	10	8	—	—	$52,088.72	$83,341.94	$58,516.13	2026-05-09
MS-456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	10	8	—	—	$51,924.97	$83,079.95	$58,332.18	2026-05-09
Q2043	OTHER	Sipuleucel-t Auto Cd54+	14	10	—	—	$52,916.50	$122,237.12	$58,035.94	2026-05-09
L7180	OTHER	Electronic Elbow Sequential	10	8	—	—	$49,026.62	$78,442.59	$56,859.39	2026-05-09
L7181	OTHER	Electronic Elbo Simultaneous	10	8	—	—	$48,628.26	$77,805.22	$56,397.38	2026-05-09
MS-020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	10	8	—	—	$48,621.65	$77,794.65	$54,621.26	2026-05-09
MS-219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	10	8	—	—	$47,444.55	$75,911.27	$53,298.90	2026-05-09
MS-233	OTHER	Coronary Bypass With Cardiac Catheterization With Mcc	10	8	—	—	$47,240.02	$75,584.03	$53,069.13	2026-05-09
MS-957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	10	8	—	—	$47,083.69	$75,333.90	$52,893.51	2026-05-09
MS-427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	10	8	—	—	$44,604.04	$71,366.46	$50,107.90	2026-05-09
MS-010	OTHER	Pancreas Transplant	10	8	—	—	$44,338.96	$70,942.33	$49,810.11	2026-05-09
MS-928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	10	8	—	—	$44,320.42	$70,912.68	$49,789.28	2026-05-09
MS-019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	10	8	—	—	$44,085.00	$70,536.00	$49,524.81	2026-05-09
MS-275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	10	8	—	—	$44,059.05	$70,494.48	$49,495.65	2026-05-09
MS-870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	10	8	—	—	$42,708.31	$68,333.30	$47,978.25	2026-05-09
MS-268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	10	8	—	—	$42,498.84	$67,998.14	$47,742.93	2026-05-09
J9226	OTHER	Supprelin La Implant	18	10	—	—	$14,834.06	$72,033.04	$46,969.79	2026-05-09
MS-955	OTHER	Craniotomy For Multiple Significant Trauma	10	8	—	—	$41,591.76	$66,546.81	$46,723.91	2026-05-09
MS-317	OTHER	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	10	8	—	—	$41,316.17	$66,105.87	$46,414.32	2026-05-09
MS-447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	10	8	—	—	$41,285.89	$66,057.43	$46,380.31	2026-05-09
MS-217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	10	8	—	—	$40,629.06	$65,006.50	$45,642.43	2026-05-09
MS-218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	10	8	—	—	$40,629.06	$65,006.50	$45,642.43	2026-05-09
MS-573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	10	8	—	—	$40,481.38	$64,770.21	$45,476.52	2026-05-09
L2006	OTHER	Kaf Sng/dbl Swg/stn Mcpr Cus	10	8	—	—	$38,750.60	$62,000.96	$44,941.60	2026-05-09
MS-207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	10	8	—	—	$39,760.29	$63,616.46	$44,666.46	2026-05-09
0266T	OTHER	Implt/rpl Crtd Sns Dev Total	10	8	—	—	$41,466.16	$66,345.86	$43,734.24	2026-05-09
MS-266	OTHER	Endovascular Cardiac Valve Replacement W Mcc	10	8	—	—	$37,867.65	$60,588.24	$42,540.27	2026-05-09
MS-969	OTHER	HIV With Extensive O.r. Procedures With Mcc	10	8	—	—	$37,823.78	$60,518.04	$42,490.99	2026-05-09
MS-232	OTHER	Coronary Bypass With Ptca Without Mcc	10	8	—	—	$37,461.07	$59,937.71	$42,083.53	2026-05-09
33276	OTHER	Insj Phrnc Nrv Stim Sys	18	8	—	—	$417.32	$66,345.86	$41,880.82	2026-05-09
MS-028	OTHER	Spinal Procedures With Mcc	10	8	—	—	$37,125.54	$59,400.87	$41,706.60	2026-05-09
MS-276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	10	8	—	—	$37,115.04	$59,384.06	$41,694.80	2026-05-09
MS-457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	10	8	—	—	$36,846.25	$58,954.00	$41,392.84	2026-05-09
MS-790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome- Neonate	10	8	—	—	$36,725.14	$58,760.23	$41,256.79	2026-05-09
MS-016	OTHER	Autolous Bone Marrow Transplant With Cc/mcc	10	8	—	—	$36,639.87	$58,623.79	$41,161.00	2026-05-09
MS-235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	10	8	—	—	$36,262.33	$58,019.73	$40,736.88	2026-05-09
MS-820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	10	8	—	—	$36,238.85	$57,982.16	$40,710.49	2026-05-09
MS-430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	10	8	—	—	$35,635.16	$57,016.25	$40,032.31	2026-05-09
MS-023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	10	8	—	—	$35,407.77	$56,652.43	$39,776.87	2026-05-09
MS-213	OTHER	Endovascular Abdominal Aorta With Iliac Branch Procedures	10	8	—	—	$35,263.18	$56,421.09	$39,614.43	2026-05-09
MS-463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	10	8	—	—	$35,217.46	$56,347.93	$39,563.07	2026-05-09
MS-428	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	10	8	—	—	$34,738.58	$55,581.73	$39,025.10	2026-05-09
MS-008	OTHER	Simultaneous Pancreas/kidney Transplant	10	8	—	—	$34,631.06	$55,409.70	$38,904.32	2026-05-09
MS-278	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	10	8	—	—	$34,393.79	$55,030.06	$38,637.76	2026-05-09
MS-461	OTHER	Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc	10	8	—	—	$34,126.85	$54,602.97	$38,337.89	2026-05-09
MS-834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	10	8	—	—	$33,922.33	$54,275.73	$38,108.12	2026-05-09
MS-405	OTHER	Pancreas- Liver And Shunt Procedures With Mcc	10	8	—	—	$33,802.46	$54,083.93	$37,973.46	2026-05-09
MS-234	OTHER	Coronary Bypass With Cardiac Catheterization Without Mcc	10	8	—	—	$33,754.26	$54,006.81	$37,919.32	2026-05-09
MS-011	OTHER	Tracheostomy For Facemouth & Neck Diagnoses W Mcc	10	8	—	—	$33,701.12	$53,921.79	$37,859.62	2026-05-09
MS-017	OTHER	Autolous Bone Marrow Transplant Without Cc/mcc	10	8	—	—	$33,566.42	$53,706.26	$37,708.30	2026-05-09
MS-220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	10	8	—	—	$32,951.60	$52,722.56	$37,017.62	2026-05-09
MS-450	OTHER	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	10	8	—	—	$32,931.83	$52,690.92	$36,995.40	2026-05-09
MS-021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	10	8	—	—	$32,710.62	$52,336.99	$36,746.90	2026-05-09
MS-270	OTHER	Other Major Cardiovascular Procedures With Mcc	10	8	—	—	$32,602.48	$52,163.98	$36,625.43	2026-05-09
MS-466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	10	8	—	—	$32,164.39	$51,463.03	$36,133.27	2026-05-09
MS-653	OTHER	Major Bladder Procedures With Mcc	10	8	—	—	$32,108.78	$51,374.05	$36,070.80	2026-05-09
L8701	OTHER	Ewh S/d Uprt Micro Sensor	8	8	—	—	$34,284.44	$54,855.10	$35,998.66	2026-05-09
0620T	OTHER	Evasc Ven Artlz Tibl/prnl Vn	10	8	—	—	$32,251.56	$51,602.50	$35,235.88	2026-05-09
MS-221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	10	8	—	—	$31,143.61	$49,829.78	$34,986.54	2026-05-09
MS-326	OTHER	Stomach- Esophageal And Duodenal Procedures With Mcc	10	8	—	—	$30,817.36	$49,307.77	$34,620.03	2026-05-09
MS-228	OTHER	Other Cardiothoracic Procedures With Mcc	10	8	—	—	$30,570.20	$48,912.32	$34,342.36	2026-05-09
MS-853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	10	8	—	—	$30,515.82	$48,825.32	$34,281.28	2026-05-09
MS-239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	10	8	—	—	$30,411.40	$48,658.23	$34,163.97	2026-05-09
MS-576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	10	8	—	—	$30,284.73	$48,455.56	$34,021.67	2026-05-09
L5856	OTHER	Elec Knee-shin Swing/stance	10	8	—	—	$29,134.51	$46,615.22	$33,789.21	2026-05-09
L6880	OTHER	Elec Hand Ind Art Digits	10	8	—	—	$28,996.90	$46,395.04	$33,629.62	2026-05-09
MS-471	OTHER	Cervical Spinal Fusion With Mcc	10	8	—	—	$29,836.75	$47,738.79	$33,518.41	2026-05-09
MS-837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	10	8	—	—	$29,685.98	$47,497.56	$33,349.04	2026-05-09
MS-267	OTHER	Endovascular Cardiac Valve Replacement Without Mcc	10	8	—	—	$29,417.19	$47,067.50	$33,047.08	2026-05-09
MS-650	OTHER	Kidney Transplant With Hemodialysis With Mcc	10	8	—	—	$29,050.15	$46,480.24	$32,634.75	2026-05-09
MS-981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	10	8	—	—	$28,990.83	$46,385.33	$32,568.12	2026-05-09
MS-826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	10	8	—	—	$28,904.33	$46,246.92	$32,470.94	2026-05-09
0408T	OTHER	Insj/rplc Cardiac Modulj Sys	10	8	—	—	$29,543.46	$47,269.54	$32,277.19	2026-05-09
0571T	OTHER	Insj/rplcmt Icds Ss Eltrd	10	8	—	—	$29,543.46	$47,269.54	$32,277.19	2026-05-09
MS-006	OTHER	Liver Transplant Without Mcc	10	8	—	—	$28,652.22	$45,843.56	$32,187.73	2026-05-09
MS-277	OTHER	Cardiac Defibrillator Implant Without Mcc	10	8	—	—	$28,537.91	$45,660.66	$32,059.31	2026-05-09
MS-329	OTHER	Major Small And Large Bowel Procedures With Mcc	10	8	—	—	$28,401.97	$45,443.15	$31,906.60	2026-05-09
MS-823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	10	8	—	—	$28,329.68	$45,327.48	$31,825.38	2026-05-09
MS-245	OTHER	Aicd Generator Procedures	10	8	—	—	$28,191.27	$45,106.03	$31,669.89	2026-05-09
MS-856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	10	8	—	—	$28,106.61	$44,970.58	$31,574.79	2026-05-09
MS-025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	10	8	—	—	$28,094.26	$44,950.81	$31,560.91	2026-05-09
MS-799	OTHER	Splenic Procedures With Mcc	10	8	—	—	$27,984.27	$44,774.83	$31,437.35	2026-05-09
0915T	OTHER	Insj Perm Ccm-d Sys Pg&eltrd	10	8	—	—	$29,543.46	$47,269.54	$31,159.40	2026-05-09
MS-163	OTHER	Major Chest Procedures With Mcc	10	8	—	—	$27,693.24	$44,309.18	$31,110.41	2026-05-09
MS-031	OTHER	Ventricular Shunt Procedures With Mcc	10	8	—	—	$27,685.20	$44,296.32	$31,101.38	2026-05-09
MS-319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	10	8	—	—	$27,576.45	$44,122.32	$30,979.21	2026-05-09
0268T	OTHER	Implt/rpl Crtd Sns Dev Gen	10	8	—	—	$28,080.19	$44,928.30	$30,678.52	2026-05-09
0674T	OTHER	Laps Insj Nw/rpcmt Prm Isdss	10	8	—	—	$28,080.19	$44,928.30	$30,678.52	2026-05-09
MS-356	OTHER	Other Digestive System O.r. Procedures With Mcc	10	8	—	—	$27,143.30	$43,429.28	$30,492.61	2026-05-09
L6700	OTHER	Ue Add Ext Power Myoel	8	8	—	—	$28,931.56	$46,290.50	$30,378.14	2026-05-09
MS-323	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	10	8	—	—	$26,739.19	$42,782.71	$30,038.64	2026-05-09
6369001580	OTHER	Zynlonta 10mg Vial	6	2	$72,771.87	$65,494.68	$25,259.12	$69,133.28	$29,836.47	2026-05-09
MS-474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	10	8	—	—	$26,526.01	$42,441.62	$29,799.15	2026-05-09
MS-140	OTHER	Major Head And Neck Procedures With Mcc	10	8	—	—	$26,355.47	$42,168.76	$29,607.57	2026-05-09
L8614	OTHER	Cochlear Device	2	1	—	—	$29,492.27	$29,492.27	$29,492.27	2026-05-09
MS-448	OTHER	Multiple Level Spinal Fusion Except Cervical Without Mcc	10	8	—	—	$26,204.09	$41,926.54	$29,437.51	2026-05-09
J9266	OTHER	Pegaspargase Injection	18	10	—	—	$26,815.15	$62,532.92	$29,418.90	2026-05-09
MS-269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	10	8	—	—	$26,095.33	$41,752.54	$29,315.33	2026-05-09
MS-012	OTHER	Tracheostomy For Facemouth & Neck Diagnoses W Cc	10	8	—	—	$26,050.85	$41,681.35	$29,265.35	2026-05-09
MS-958	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Cc	10	8	—	—	$26,037.87	$41,660.59	$29,250.78	2026-05-09
MS-673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	10	8	—	—	$25,961.87	$41,538.99	$29,165.40	2026-05-09
MS-901	OTHER	Wound Debridements For Injuries With Mcc	10	8	—	—	$25,930.97	$41,489.56	$29,130.69	2026-05-09
MS-236	OTHER	Coronary Bypass Without Cardiac Catheterization Without Mcc	10	8	—	—	$25,882.78	$41,412.44	$29,076.54	2026-05-09
MS-458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	10	8	—	—	$25,782.68	$41,252.28	$28,964.10	2026-05-09
MS-793	OTHER	Full Term Neonate With Major Problems	10	8	—	—	$25,764.14	$41,222.62	$28,943.26	2026-05-09
MS-423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	10	8	—	—	$25,661.57	$41,058.51	$28,828.04	2026-05-09
MS-273	OTHER	Percutaneous Intracardiac Procedures W Mcc	10	8	—	—	$25,491.64	$40,786.63	$28,637.15	2026-05-09
33287	OTHER	Rmv&rplcmt Phrnc Nrv Stim Pg	18	8	—	—	$279.99	$44,928.30	$28,360.99	2026-05-09
MS-791	OTHER	Prematurity With Major Problems	10	8	—	—	$25,080.74	$40,129.18	$28,175.54	2026-05-09
MS-402	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	10	8	—	—	$24,842.84	$39,748.55	$27,908.29	2026-05-09
MS-802	OTHER	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	10	8	—	—	$24,617.93	$39,388.68	$27,655.62	2026-05-09
6369001715	OTHER	Jelmyto 80mg Kit	6	2	$66,319.50	$59,687.55	$23,019.50	$63,003.52	$27,191.00	2026-05-09
MS-024	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	10	8	—	—	$24,171.80	$38,674.88	$27,154.44	2026-05-09
MS-933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	10	8	—	—	$24,062.43	$38,499.89	$27,031.58	2026-05-09
L6975	OTHER	Interscap-thor Myoelectronic	10	8	—	—	$23,177.19	$37,083.50	$26,880.10	2026-05-09
MS-034	OTHER	Carotid Artery Stent Procedures With Mcc	10	8	—	—	$23,917.22	$38,267.56	$26,868.46	2026-05-09
MS-876	OTHER	O.r. Procedures With Principal Diagnosis Of Mental Illness	10	8	—	—	$23,851.11	$38,161.77	$26,812.30	2026-05-09
MS-040	OTHER	Peripheral- Cranial Nerve And Other Nervous System Procedures With Mcc	10	8	—	—	$23,858.52	$38,173.63	$26,802.51	2026-05-09
L6970	OTHER	Interscapular-thor Switch CT	10	8	—	—	$23,053.46	$36,885.54	$26,736.61	2026-05-09
MS-907	OTHER	Other O.r. Procedures For Injuries With Mcc	10	8	—	—	$23,723.20	$37,957.12	$26,650.49	2026-05-09
C9760	OTHER	Non-blind Interatrial Shunt	8	8	—	—	$25,340.61	$40,544.98	$26,607.65	2026-05-09
L6965	OTHER	Shldr Disartic Myoelectronic	10	8	—	—	$22,680.77	$36,289.23	$26,304.37	2026-05-09
L5858	OTHER	Stance Phase Only	10	8	—	—	$22,555.79	$36,089.26	$26,159.43	2026-05-09
MS-956	OTHER	Limb Reattachment- Hip And Femur Procedures For Multiple Significant Trauma	10	8	—	—	$23,251.74	$37,202.78	$26,120.86	2026-05-09
MS-143	OTHER	Other Ear- Nose- Mouth And Throat O.r. Procedures With Mcc	10	8	—	—	$23,150.40	$37,040.64	$26,007.01	2026-05-09
MS-166	OTHER	Other Respiratory System O.r. Procedures With Mcc	10	8	—	—	$23,095.41	$36,952.65	$25,945.24	2026-05-09
MS-518	OTHER	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	10	8	—	—	$23,092.94	$36,948.70	$25,942.46	2026-05-09
MS-628	OTHER	Other Endocrine- Nutritional And Metabolic O.r. Procedures With Mcc	10	8	—	—	$23,028.06	$36,844.89	$25,869.57	2026-05-09
MS-651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	10	8	—	—	$22,898.30	$36,637.28	$25,723.80	2026-05-09
MS-904	OTHER	Skin Grafts For Injuries With Cc/mcc	10	8	—	—	$22,696.24	$36,313.99	$25,496.82	2026-05-09
MS-492	OTHER	Lower Extremity And Humerus Procedures Except Hip- Foot And Femur With Mcc	10	8	—	—	$22,686.97	$36,299.16	$25,486.40	2026-05-09
MS-939	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	10	8	—	—	$22,420.66	$35,873.05	$25,187.22	2026-05-09
MS-495	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	10	8	—	—	$22,403.36	$35,845.37	$25,167.78	2026-05-09
MS-332	OTHER	Rectal Resection With Mcc	10	8	—	—	$22,372.46	$35,795.94	$25,133.08	2026-05-09
MS-265	OTHER	Aicd Lead Procedures	10	8	—	—	$22,357.01	$35,771.22	$25,115.72	2026-05-09
MS-097	OTHER	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	10	8	—	—	$22,317.47	$35,707.95	$25,071.30	2026-05-09
MS-279	OTHER	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	10	8	—	—	$22,284.10	$35,654.56	$25,033.82	2026-05-09
MS-739	OTHER	Uterineadnexa Proc For Non-ovarian/adnexal Malig W Mcc	10	8	—	—	$22,138.28	$35,421.24	$24,870.00	2026-05-09
MS-736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	10	8	—	—	$22,086.99	$35,339.18	$24,812.39	2026-05-09
MS-335	OTHER	Peritoneal Adhesiolysis With Mcc	10	8	—	—	$22,064.74	$35,303.59	$24,787.40	2026-05-09
MS-408	OTHER	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	10	8	—	—	$22,032.00	$35,251.19	$24,750.60	2026-05-09
MS-414	OTHER	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	10	8	—	—	$22,013.46	$35,221.53	$24,729.78	2026-05-09
J9600	OTHER	Porfimer Sodium Injection	13	10	—	—	$2,444.76	$38,765.47	$24,712.99	2026-05-09
MS-622	OTHER	Skin Grafts And Wound Debridement For Endocrine- Nutritional And Metabolic Disor…	10	8	—	—	$21,992.45	$35,187.92	$24,706.17	2026-05-09
MS-271	OTHER	Other Major Cardiovascular Procedures With Cc	10	8	—	—	$21,974.53	$35,159.25	$24,686.05	2026-05-09
E0194	OTHER	Air Fluidized Bed	4	1	—	—	$5,772.47	$43,293.51	$24,532.99	2026-05-09
MS-467	OTHER	Revision Of Hip Or Knee Replacement With Cc	10	8	—	—	$21,791.01	$34,865.62	$24,479.89	2026-05-09
MS-094	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Mcc	10	8	—	—	$21,746.52	$34,794.44	$24,429.90	2026-05-09
L5973	OTHER	Ank-foot Sys Dors-plant Flex	10	8	—	—	$20,880.34	$33,408.54	$24,216.31	2026-05-09
MS-252	OTHER	Other Vascular Procedures With Mcc	10	8	—	—	$21,554.36	$34,486.97	$24,214.03	2026-05-09
MS-616	OTHER	Amputation Of Lower Limb For Endocrine- Nutritional And Metabolic Disorders With…	10	8	—	—	$21,548.79	$34,478.07	$24,207.78	2026-05-09
MS-574	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Cc	10	8	—	—	$21,449.93	$34,319.89	$24,096.72	2026-05-09
MS-477	OTHER	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	10	8	—	—	$21,346.12	$34,153.80	$23,980.10	2026-05-09
Q0483	OTHER	Monitor Elec Vad Rep	10	8	—	—	$2,888.84	$36,408.21	$23,892.89	2026-05-09
MS-359	OTHER	Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc	10	8	—	—	$21,247.26	$33,995.61	$23,869.03	2026-05-09
MS-987	OTHER	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	10	8	—	—	$21,184.23	$33,894.77	$23,798.23	2026-05-09
MS-029	OTHER	Spinal Procedures With Cc Or Spinal Neurostimulators	10	8	—	—	$21,080.42	$33,728.68	$23,681.61	2026-05-09
MS-420	OTHER	Hepatobiliary Diagnostic Procedures With Mcc	10	8	—	—	$21,052.62	$33,684.19	$23,650.38	2026-05-09
6366000485	OTHER	Stelara 90mg/1ml Syringe	6	2	$57,642.00	$51,877.80	$20,007.54	$54,759.90	$23,633.22	2026-05-09
MS-264	OTHER	Other Circulatory System O.r. Procedures	10	8	—	—	$20,641.71	$33,026.74	$23,188.77	2026-05-09
MS-411	OTHER	Cholecystectomy With C.d.e. With Mcc	10	8	—	—	$20,411.23	$32,657.97	$22,929.85	2026-05-09
MS-037	OTHER	Extracranial Procedures With Mcc	10	8	—	—	$20,342.03	$32,547.24	$22,852.11	2026-05-09
MS-274	OTHER	Percutaneous Intracardiac Procedures Without Mcc	10	8	—	—	$20,339.56	$32,543.29	$22,849.32	2026-05-09
0956T	OTHER	Prt Crn Ch Cr&tun Elt S-sclp	10	8	—	—	$20,733.31	$33,173.30	$22,651.81	2026-05-09
0960T	OTHER	Rpl S-sclp Eltr Ra Rcvr&tlmt	10	8	—	—	$20,733.31	$33,173.30	$22,651.81	2026-05-09
0515T	OTHER	Insj Wcs Lv Compl Sys	10	8	—	—	$20,683.27	$33,093.23	$22,597.14	2026-05-09
0414T	OTHER	Rmvl & Rpl Car Modulj Pls Gn	10	8	—	—	$20,683.27	$33,093.23	$22,597.14	2026-05-09
0409T	OTHER	Insj/rplc Car Modulj Pls Gn	10	8	—	—	$20,683.27	$33,093.23	$22,597.14	2026-05-09
0614T	OTHER	Rmvl&rplcmt Ss Impl Dfb Pg	10	8	—	—	$20,683.27	$33,093.23	$22,597.14	2026-05-09
MS-260	OTHER	Cardiac Pacemaker Revision Except Device Replacement With Mcc	10	8	—	—	$20,099.19	$32,158.71	$22,579.31	2026-05-09
MS-579	OTHER	Other Skin- Subcutaneous Tissue And Breast Procedures With Mcc	10	8	—	—	$20,010.83	$32,017.33	$22,480.04	2026-05-09
MS-840	OTHER	Lymphoma And Non-acute Leukemia With Mcc	10	8	—	—	$19,988.59	$31,981.74	$22,455.06	2026-05-09
MS-451	OTHER	Single Level Spinal Fusion Except Cervical Without Mcc	10	8	—	—	$19,960.78	$31,937.25	$22,423.82	2026-05-09
MS-652	OTHER	Kidney Transplant	10	8	—	—	$19,955.22	$31,928.35	$22,417.57	2026-05-09
MS-485	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Mcc	10	8	—	—	$19,940.39	$31,904.62	$22,400.90	2026-05-09
MS-929	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	10	8	—	—	$19,901.46	$31,842.34	$22,357.17	2026-05-09
MS-325	OTHER	Coronary Intravascular Lithotripsy Without Intraluminal Device	10	8	—	—	$19,837.20	$31,739.52	$22,284.99	2026-05-09
MS-242	OTHER	Permanent Cardiac Pacemaker Implant With Mcc	10	8	—	—	$19,728.45	$31,565.52	$22,162.81	2026-05-09
6363002855	OTHER	Yervoy (ipilmumab) 200mg/40ml	6	2	$54,000.00	$48,600.00	$18,743.40	$51,300.00	$22,140.00	2026-05-09
MS-515	OTHER	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	10	8	—	—	$19,691.99	$31,507.19	$22,121.86	2026-05-09
MS-656	OTHER	Kidney And Ureter Procedures For Neoplasm With Mcc	10	8	—	—	$19,672.84	$31,476.54	$22,100.34	2026-05-09
MS-022	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	10	8	—	—	$19,633.29	$31,413.27	$22,055.92	2026-05-09
MS-500	OTHER	Soft Tissue Procedures With Mcc	10	8	—	—	$19,555.44	$31,288.70	$21,968.46	2026-05-09
MS-829	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	10	8	—	—	$19,525.78	$31,241.24	$21,935.13	2026-05-09
MS-324	OTHER	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	10	8	—	—	$19,470.16	$31,152.26	$21,872.66	2026-05-09
MS-229	OTHER	Other Cardiothoracic Procedures Without Mcc	10	8	—	—	$19,460.90	$31,137.43	$21,862.24	2026-05-09
0923T	OTHER	Rmvl&rplcmt Perm Ccm-d Pg	10	8	—	—	$20,683.27	$33,093.23	$21,814.58	2026-05-09
0916T	OTHER	Insj Perm Ccm-d Sys Pg Only	10	8	—	—	$20,683.27	$33,093.23	$21,814.58	2026-05-09
MS-258	OTHER	Cardiac Pacemaker Device Replacement With Mcc	10	8	—	—	$19,415.17	$31,064.27	$21,810.88	2026-05-09
MS-665	OTHER	Prostatectomy With Mcc	10	8	—	—	$19,286.03	$30,857.65	$21,665.80	2026-05-09
MS-464	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	10	8	—	—	$19,245.87	$30,793.38	$21,620.68	2026-05-09
0816T	OTHER	Opn Insj/rplcmt Ins Ptn Subq	10	8	—	—	$19,760.14	$31,616.23	$21,588.60	2026-05-09
0680T	OTHER	Insj/rplcmt Pg Only Isdss	10	8	—	—	$19,760.14	$31,616.23	$21,588.60	2026-05-09
0817T	OTHER	Opn Insj/rplcmt Ins Ptn Subf	10	8	—	—	$19,760.14	$31,616.23	$21,588.60	2026-05-09
MS-026	OTHER	Craniotomy And Endovascular Intracranial Procedures With Cc	10	8	—	—	$19,211.88	$30,739.01	$21,582.50	2026-05-09
MS-662	OTHER	Minor Bladder Procedures With Mcc	10	8	—	—	$18,917.14	$30,267.42	$21,251.40	2026-05-09
MS-263	OTHER	Vein Ligation And Stripping	10	8	—	—	$18,891.81	$30,226.89	$21,222.94	2026-05-09
6369001840	OTHER	Rystiggo 840 Mg Vial	3	2	$51,525.78	$46,373.20	$17,884.60	$48,949.49	$21,125.57	2026-05-09
MS-469	OTHER	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	10	8	—	—	$18,742.27	$29,987.64	$21,054.95	2026-05-09
MS-510	OTHER	Shoulderelbow Or Forearm Procexc Major Joint Proc W Mcc	10	8	—	—	$18,663.80	$29,862.08	$20,966.79	2026-05-09
MS-625	OTHER	Thyroid- Parathyroid And Thyroglossal Procedures With Mcc	10	8	—	—	$18,661.33	$29,858.12	$20,964.01	2026-05-09
MS-498	OTHER	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc…	10	8	—	—	$18,640.94	$29,825.50	$20,941.11	2026-05-09
Q0489	OTHER	Pwr Pck Base Combo Vad Rep	10	8	—	—	$2,504.47	$31,563.97	$20,713.85	2026-05-09
MS-173	OTHER	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	10	8	—	—	$18,391.30	$29,426.09	$20,660.67	2026-05-09
Q0481	OTHER	Microprcsr Cu Elec Vad Rep	10	8	—	—	$17,635.28	$28,216.45	$20,452.79	2026-05-09
MS-472	OTHER	Cervical Spinal Fusion With Cc	10	8	—	—	$18,204.08	$29,126.53	$20,450.35	2026-05-09
MS-959	OTHER	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	10	8	—	—	$18,191.72	$29,106.75	$20,436.47	2026-05-09
L5859	OTHER	Knee-shin Pro Flex/ext Cont	10	8	—	—	$17,609.11	$28,174.58	$20,422.44	2026-05-09
MS-570	OTHER	Skin Debridement With Mcc	10	8	—	—	$18,173.18	$29,077.09	$20,415.64	2026-05-09
MS-668	OTHER	Transurethral Procedures With Mcc	10	8	—	—	$18,042.81	$28,868.49	$20,269.18	2026-05-09
MS-480	OTHER	Hip And Femur Procedures Except Major Joint With Mcc	10	8	—	—	$17,995.23	$28,792.36	$20,215.72	2026-05-09
MS-353	OTHER	Hernia Procedures Except Inguinal And Femoral With Mcc	10	8	—	—	$17,931.58	$28,690.53	$20,144.22	2026-05-09
MS-406	OTHER	Pancreas- Liver And Shunt Procedures With Cc	10	8	—	—	$17,920.46	$28,672.74	$20,131.73	2026-05-09
MS-619	OTHER	O.r. Procedures For Obesity With Mcc	10	8	—	—	$17,841.37	$28,546.19	$20,042.88	2026-05-09
MS-974	OTHER	HIV With Major Related Condition With Mcc	10	8	—	—	$17,832.72	$28,532.35	$20,033.16	2026-05-09
MS-013	OTHER	Tracheostomy For Facemouth & Neck Diagnoses Without Cc/mcc	10	8	—	—	$17,806.77	$28,490.83	$20,004.00	2026-05-09
6366000825	OTHER	Ocrevus Sdv 30mg/ml	6	2	$48,750.00	$43,875.00	$16,921.12	$46,312.50	$19,987.50	2026-05-09
MS-521	OTHER	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	10	8	—	—	$17,735.09	$28,376.14	$19,923.49	2026-05-09
E0766	OTHER	Elec Stim Cancer Treatment	2	1	—	—	$19,876.27	$19,876.27	$19,876.27	2026-05-09
MS-240	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	10	8	—	—	$17,613.36	$28,181.38	$19,786.74	2026-05-09
MS-800	OTHER	Splenic Procedures With Cc	10	8	—	—	$17,359.40	$27,775.05	$19,501.44	2026-05-09
MS-654	OTHER	Major Bladder Procedures With Cc	10	8	—	—	$17,297.00	$27,675.19	$19,431.33	2026-05-09
MS-503	OTHER	Foot Procedures With Mcc	10	8	—	—	$17,246.33	$27,594.12	$19,374.41	2026-05-09
L5969	OTHER	Ak/ft Power Asst Incl Motors	2	1	—	—	$19,295.02	$19,295.02	$19,295.02	2026-05-09
6366000935	OTHER	Sipuleucel-t Min 50million	6	2	$47,001.00	$42,300.90	$16,314.05	$44,650.95	$19,270.41	2026-05-09
MS-483	OTHER	Major Joint/limb Reattachment Procedure Of Upper Extremities	10	8	—	—	$17,127.69	$27,404.30	$19,241.14	2026-05-09
0801T	OTHER	Tcat Rmv&rpl 2chmbr Ldls Pm	10	8	—	—	$17,573.31	$28,117.30	$19,199.42	2026-05-09
0796T	OTHER	Tcat Ins 2chmbr Ldls Pm Ra	10	8	—	—	$17,573.31	$28,117.30	$19,199.42	2026-05-09
0525T	OTHER	Insj/rplcmt Compl Iims	10	8	—	—	$17,573.31	$28,117.30	$19,199.42	2026-05-09
0802T	OTHER	Tcat Rmv&rpl2chmb Ldls Pm Ra	10	8	—	—	$17,573.31	$28,117.30	$19,199.42	2026-05-09
0803T	OTHER	Tcat Rmv&rpl2chmb Ldls Pm Rv	10	8	—	—	$17,573.31	$28,117.30	$19,199.42	2026-05-09
0797T	OTHER	Tcat Ins 2chmbr Ldls Pm Rv	10	8	—	—	$17,573.31	$28,117.30	$19,199.42	2026-05-09
0795T	OTHER	Tcat Ins 2chmbr Ldls Pm Cmpl	10	8	—	—	$17,573.31	$28,117.30	$19,199.42	2026-05-09
MS-061	OTHER	Ischemic Stroke- Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…	10	8	—	—	$17,036.24	$27,257.98	$19,138.40	2026-05-09
MS-208	OTHER	Respiratory System Diagnosis With Ventilator Support <=96 Hours	10	8	—	—	$16,984.34	$27,174.94	$19,080.10	2026-05-09
MS-468	OTHER	Revision Of Hip Or Knee Replacement Without Cc/mcc	10	8	—	—	$16,980.01	$27,168.02	$19,075.24	2026-05-09
C2616	OTHER	Brachytx Non-str Yttrium-90	10	8	—	—	$17,485.10	$27,976.16	$19,056.46	2026-05-09
6369001135	OTHER	Hemlibra 150 Mg/ml	6	2	$46,348.72	$41,713.85	$16,087.64	$44,031.28	$19,002.98	2026-05-09
MS-963	OTHER	Other Multiple Significant Trauma With Mcc	10	8	—	—	$16,892.27	$27,027.63	$18,976.67	2026-05-09
MS-321	OTHER	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	10	8	—	—	$16,811.94	$26,899.10	$18,886.43	2026-05-09
MS-849	OTHER	Radiotherapy	10	8	—	—	$16,742.12	$26,787.39	$18,807.99	2026-05-09
MS-288	OTHER	Acute And Subacute Endocarditis With Mcc	10	8	—	—	$16,721.73	$26,754.76	$18,785.08	2026-05-09
MS-255	OTHER	Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc	10	8	—	—	$16,667.35	$26,667.76	$18,724.00	2026-05-09
0823T	OTHER	Tcat Ins 1chmbr Ldls Pm Ra	10	8	—	—	$17,573.31	$28,117.30	$18,721.02	2026-05-09
0825T	OTHER	Tcat Rmv&rpl1chmb Ldls Pm Ra	10	8	—	—	$17,573.31	$28,117.30	$18,721.02	2026-05-09
MS-462	OTHER	Bilateral Or Multiple Major Joint Procs Of Lower Extremity Without Mcc	10	8	—	—	$16,436.25	$26,298.01	$18,464.39	2026-05-09
6369001795	OTHER	Vyvgrt Hytrl 1008mg 11200un Vl	3	2	$44,953.00	$40,457.70	$15,603.19	$42,705.35	$18,430.73	2026-05-09
MS-577	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc	10	8	—	—	$16,378.79	$26,206.06	$18,399.83	2026-05-09
MS-970	OTHER	HIV With Extensive O.r. Procedures Without Mcc	10	8	—	—	$16,296.61	$26,074.57	$18,307.50	2026-05-09
L6955	OTHER	Above Elbow Myoelectronic CT	10	8	—	—	$15,745.30	$25,192.48	$18,260.86	2026-05-09
0238T	OTHER	Trluml Perip Athrc Iliac Art	10	8	—	—	$16,546.40	$26,474.24	$18,077.47	2026-05-09
0645T	OTHER	Tcat Impltj C Sins Rdctj Dev	10	8	—	—	$16,546.40	$26,474.24	$18,077.47	2026-05-09
0793T	OTHER	Prq Tcat Thrm Ablt Nrv P-art	10	8	—	—	$16,546.40	$26,474.24	$18,077.47	2026-05-09
0981T	OTHER	Tcat Impl Wrls Ivc Snr	10	8	—	—	$16,546.40	$26,474.24	$18,077.47	2026-05-09
MS-253	OTHER	Other Vascular Procedures With Cc	10	8	—	—	$16,038.32	$25,661.32	$18,017.35	2026-05-09
L6960	OTHER	Shldr Disartic Switch Contro	10	8	—	—	$15,525.65	$24,841.04	$18,006.11	2026-05-09
MS-846	OTHER	Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc	10	8	—	—	$16,019.17	$25,630.67	$17,995.83	2026-05-09
MS-344	OTHER	Minor Small And Large Bowel Procedures With Mcc	10	8	—	—	$15,959.23	$25,534.77	$17,928.50	2026-05-09
MS-095	OTHER	Bacterial And Tuberculous Infections Of Nervous System With Cc	10	8	—	—	$15,936.99	$25,499.18	$17,903.51	2026-05-09
MS-096	OTHER	Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc	10	8	—	—	$15,936.99	$25,499.18	$17,903.51	2026-05-09
MS-749	OTHER	Other Female Reproductive System O.r. Procedures With Cc/mcc	10	8	—	—	$15,865.31	$25,384.50	$17,822.99	2026-05-09

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