Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA

Los Angeles, CA · CCN 054009 · Rates published

13,233 distinct procedures filed
19 distinct payers
139,585 rate rows
2026-03-29 last MRF observed
Data quality

138,511 of 139,585 rate rows are consumer-grade (99.2%)

1,074 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 — reasonRows
percent-of-charges filed in the dollar field — excluded from medians 500
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 456
per-diem day rate — not a per-procedure price 64
placeholder amount (≤ $0.02) — excluded from medians 54
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.uclahealth.org/sites/default/files/cms-hpt/953701255_resnick-neuropsychiatric-hospital-at-ucla_standardcharges.json
Found on page https://www.uclahealth.org/patient-resources/billing-insurance/price-transparency/machine-readable-files
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-18
Content fingerprint 9fe4402ed867de2b… · 59,367,637 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
HCPCS 		Inj, Atidarsagene Autotemcel 4 $2,459,730.00 $4,505,000.00 $4,335,000.00 nat. median
$4,505,000
1.0× median
C9172
HCPCS 		Inj, Beqvez, Per Tx Dose 2 $2,657,245.50 $3,570,000.00 $3,570,000.00 nat. median
$3,570,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 5 $2,012,155.60 $3,685,266.66 $3,570,000.00 nat. median
$3,710,000
1.0× median
60923053847
NDC 		Delandistrogene Moxeparvo-rokl 47 X 10 Ml IV Kit 7 $1,817,011.41 $4,560,000.00 $3,264,000.00 nat. median
$3,327,860
1.0× median
60923055463
NDC 		Delandistrogene Moxeparvo-rokl 63 X 10 Ml IV Kit 7 $1,817,011.41 $4,560,000.00 $3,264,000.00 nat. median
$3,327,860
1.0× median
60923052130
NDC 		Delandistrogene Moxeparvo-rokl 30 X 10 Ml IV Kit 7 $1,817,011.41 $4,560,000.00 $3,264,000.00 nat. median
$3,327,860
1.0× median
60923050918
NDC 		Delandistrogene Moxeparvo-rokl 18 X 10 Ml IV Kit 7 $1,817,011.41 $4,560,000.00 $3,264,000.00 nat. median
$3,327,860
1.0× median
60923051827
NDC 		Delandistrogene Moxeparvo-rokl 27 X 10 Ml IV Kit 7 $1,817,011.41 $4,560,000.00 $3,264,000.00 nat. median
$3,327,860
1.0× median
60923053544
NDC 		Delandistrogene Moxeparvo-rokl 44 X 10 Ml IV Kit 7 $1,817,011.41 $4,560,000.00 $3,264,000.00 nat. median
$3,327,860
1.0× median
60923053241
NDC 		Delandistrogene Moxeparvo-rokl 41 X 10 Ml IV Kit 7 $1,817,011.41 $4,560,000.00 $3,264,000.00 nat. median
$3,327,860
1.0× median
60923051322
NDC 		Delandistrogene Moxeparvo-rokl 22 X 10 Ml IV Kit 7 $1,817,011.41 $4,560,000.00 $3,264,000.00 nat. median
$5
outlier · 628901.7×
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 4 $1,821,357.72 $3,335,820.00 $3,209,940.00 nat. median
$3,335,820
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 5 $1,775,869.41 $3,252,508.07 $3,162,000.00 nat. median
$3,286,000
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 4 $1,736,280.00 $3,180,000.00 $3,060,000.00 nat. median
$3,180,000
1.0× median
71894013006
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 4x8.3ml IV Kit 8 $15,948.00 $4,322,250.00 $3,028,125.00 nat. median
$4,424,250
0.7× median
71894012504
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 3x8.3ml IV Kit 8 $15,948.00 $4,322,250.00 $3,028,125.00 nat. median
$4,424,250
0.7× median
71894014109
NDC 		Onasemnogene Abeparvovec-xioi 9x8.3 Ml IV Kit 8 $15,948.00 $4,322,250.00 $3,028,125.00 nat. median
$4,424,250
0.7× median
71894012404
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 2x8.3ml IV Kit 8 $15,948.00 $4,322,250.00 $3,028,125.00 nat. median
$4,424,250
0.7× median
71894013507
NDC 		Onasemnogene Abeparvovec-xioi 7x8.3 Ml IV Kit 8 $15,948.00 $4,322,250.00 $3,028,125.00 nat. median
$4,424,250
0.7× median
71894012103
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 1x8.3ml IV Kit 8 $15,948.00 $4,322,250.00 $3,028,125.00 nat. median
$4,424,250
0.7× median
71894012705
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 3x8.3ml IV Kit 8 $15,948.00 $4,322,250.00 $3,028,125.00 nat. median
$4,424,250
0.7× median
71894012905
NDC 		Onasemnogene Abeparvovec-xioi 5x8.3 Ml IV Kit 8 $15,948.00 $4,322,250.00 $3,028,125.00 nat. median
$4,424,250
0.7× median
71894013808
NDC 		Onasemnogene Abeparvovec-xioi 8x8.3 Ml IV Kit 8 $15,948.00 $4,322,250.00 $3,028,125.00 nat. median
$4,424,250
0.7× median
71894013909
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 7x8.3ml IV Kit 8 $15,948.00 $4,322,250.00 $3,028,125.00 nat. median
$4,424,250
0.7× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 5 $1,605,223.01 $2,939,968.88 $2,856,000.00 nat. median
$3,006,423
0.9× median
60923052433
NDC 		Delandistrogene Moxeparvo-rokl 33 X 10 Ml IV Kit 4 $15,948.00 $4,560,000.00 $2,606,880.00 nat. median
$3,360,000
0.8× median
60923051120
NDC 		Delandistrogene Moxeparvo-rokl 20 X 10 Ml IV Kit 4 $15,948.00 $4,560,000.00 $2,606,880.00 nat. median
$3,360,000
0.8× median
60923050615
NDC 		Delandistrogene Moxeparvo-rokl 15 X 10 Ml IV Kit 4 $15,948.00 $4,560,000.00 $2,606,880.00 nat. median
$3,360,000
0.8× median
60923051524
NDC 		Delandistrogene Moxeparvo-rokl 24 X 10 Ml IV Kit 4 $15,948.00 $4,560,000.00 $2,606,880.00 nat. median
$3,360,000
0.8× median
60923051423
NDC 		Delandistrogene Moxeparvo-rokl 23 X 10 Ml IV Kit 4 $15,948.00 $4,560,000.00 $2,606,880.00 nat. median
$3,360,000
0.8× median
71894013708
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 7x8.3ml IV Kit 9 $1,413,583.75 $4,322,250.00 $2,500,528.30 nat. median
$4,369,425
0.6× median
71894014009
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 8x8.3ml IV Kit 9 $1,413,583.75 $4,322,250.00 $2,500,528.30 nat. median
$4,369,425
0.6× median
71894012303
NDC 		Onasemnogene Abeparvovec-xioi 3x8.3 Ml IV Kit 9 $1,413,583.75 $4,322,250.00 $2,500,528.30 nat. median
$4,369,425
0.6× median
71894012203
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 2x8.3ml IV Kit 9 $1,413,583.75 $4,322,250.00 $2,500,528.30 nat. median
$4,369,425
0.6× median
71894013206
NDC 		Onasemnogene Abeparvovec-xioi 6x8.3 Ml IV Kit 9 $1,413,583.75 $4,322,250.00 $2,500,528.30 nat. median
$330
outlier · 7579.7×
71894013407
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 6x8.3ml IV Kit 9 $1,413,583.75 $4,322,250.00 $2,500,528.30 nat. median
$4,369,425
0.6× median
71894013608
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 6x8.3ml IV Kit 9 $1,413,583.75 $4,322,250.00 $2,500,528.30 nat. median
$4,369,425
0.6× median
71894013106
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 5x8.3ml IV Kit 9 $1,413,583.75 $4,322,250.00 $2,500,528.30 nat. median
$4,369,425
0.6× median
71894012604
NDC 		Onasemnogene Abeparvovec-xioi 4x8.3 Ml IV Kit 9 $1,413,583.75 $4,322,250.00 $2,500,528.30 nat. median
$4,369,425
0.6× median
71894012805
NDC 		Onasemnogene Abeparvovec-xioi 1x5.5ml & 4x8.3ml IV Kit 9 $1,413,583.75 $4,322,250.00 $2,500,528.30 nat. median
$4,369,425
0.6× median
71894013307
NDC 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 5x8.3ml IV Kit 9 $1,413,583.75 $4,322,250.00 $2,500,528.30 nat. median
$4,369,425
0.6× median
71894012002
NDC 		Onasemnogene Abeparvovec-xioi 2x8.3 Ml IV Kit 9 $1,413,583.75 $4,322,250.00 $2,500,528.30 nat. median
$4,369,425
0.6× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 5 $1,273,272.00 $2,332,000.00 $2,244,000.00 nat. median
$2,448,600
0.9× median
Q2057
HCPCS 		Afamitresgene Autoleucel 4 $420,758.52 $770,620.00 $741,540.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 5 $309,326.09 $575,563.46 $552,054.73 nat. median
$754,974
0.7× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 5 $306,961.88 $562,201.24 $541,977.41 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 5 $304,712.62 $558,081.72 $538,878.68 nat. median
$625,184
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 5 $320,856.67 $587,649.57 $532,496.61 nat. median
$675,122
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 5 $290,576.96 $532,192.24 $513,651.60 nat. median
$634,511
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 5 $267,239.81 $489,450.20 $471,240.00 nat. median
$620,080
0.8× median

Other procedures at this hospital

Browse this hospital's 13,233 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
75833060102 NDC Melphalan Hcl 50 Mg Ia Solr 20 15 $547,500.00 $301,125.00 45% off $15,948.00 $514,650.00 $341,640.00 2026-03-29
64406005801_2 NDC Nusinersen 12 Mg/5ml It Soln 20 15 $426,183.49 $234,400.92 45% off $15,948.00 $400,612.48 $265,938.50 2026-03-29
64406005801 NDC Nusinersen 12 Mg/5ml It Soln|discarded Drug Not Administered 20 15 $426,113.49 $234,362.42 45% off $15,948.00 $400,546.68 $265,894.82 2026-03-29
71336100301 NDC Vutrisiran Sodium 25 Mg/0.5ml Sc Sosy 21 16 $358,053.00 $196,929.15 45% off $2,735.21 $336,569.82 $204,090.21 2026-03-29
69488000301 NDC Lutetium Lu 177 Dotatate 370 Mbq/ml IV Soln 21 16 $159,780.00 $87,879.00 45% off $15,948.00 $150,193.20 $91,074.60 2026-03-29
67979000201 NDC Histrelin Acetate (cpp) 50 Mg Sc Kit 21 16 $135,537.57 $74,545.66 45% off $15,948.00 $127,405.32 $77,256.41 2026-03-29
69488001061 NDC Lutetium Lu 177 Vipivotide Tet 1000 Mbq/ml IV Soln 21 16 $127,500.00 $70,125.00 45% off $141.58 $119,850.00 $72,675.00 2026-03-29
00310453530 NDC Tremelimumab-actl 300 Mg/15ml IV Soln 21 16 $119,340.00 $65,637.00 45% off $78.08 $112,179.60 $68,023.80 2026-03-29
00003712511_2 NDC Nivolumab-relatlimab-rmbw 240-80 Mg/20ml IV Soln 21 16 $118,654.96 $65,260.23 45% off $15,948.00 $111,535.66 $67,633.33 2026-03-29
00003712511 NDC Nivolumab-relatlimab-rmbw 240-80 Mg/20ml IV Soln|discarded Drug Not Administered 21 16 $118,584.96 $65,221.73 45% off $15,948.00 $111,469.86 $67,593.43 2026-03-29
24338005008 NDC Carmustine In Polifeprosan 7.7 Mg Il Wafr 21 16 $117,011.71 $64,356.44 45% off $15,948.00 $109,991.01 $66,696.67 2026-03-29
81481080301 NDC Nogapendekin Alfa Inbakic-pmln 400 Mcg/0.4ml Is Soln 21 16 $107,400.00 $59,070.00 45% off $15,948.00 $100,956.00 $61,218.00 2026-03-29
66658051001 NDC Emapalumab-lzsg 100 Mg/20ml IV Soln 21 16 $101,310.30 $55,720.67 45% off $209.73 $95,231.68 $57,746.87 2026-03-29
50633021011 NDC Glucarpidase 1000 Units IV Solr 21 16 $99,723.00 $54,847.65 45% off $15,948.00 $93,739.62 $56,842.11 2026-03-29
72187040101 NDC Tagraxofusp-erzs 1000 Mcg/ml IV Soln 21 16 $92,738.04 $51,005.92 45% off $15,948.00 $87,173.76 $52,860.68 2026-03-29
00003232822 NDC Ipilimumab 200 Mg/40ml IV Soln 21 16 $81,107.46 $44,609.10 45% off $102.05 $76,241.01 $46,231.25 2026-03-29
00597003510 NDC Spesolimab-sbzo 450 Mg/7.5ml IV Soln 21 16 $76,699.50 $42,184.73 45% off $35.88 $72,097.53 $43,718.72 2026-03-29
57894006103 NDC Ustekinumab 90 Mg/ml Sc Sosy 21 16 $75,651.81 $41,608.50 45% off $15,948.00 $71,112.70 $43,530.35 2026-03-29
72694051501 NDC Calaspargase Pegol-mknl 3750 Unit/5ml IV Soln 21 16 $75,099.36 $41,304.65 45% off $44.81 $70,593.40 $42,806.64 2026-03-29
72493010303 NDC Mitomycin 80 (2 X 40) Mg Ul Solr 21 16 $73,440.00 $40,392.00 45% off $15,948.00 $69,033.60 $42,490.80 2026-03-29
79952011001 NDC Loncastuximab Tesirine-lpyl 10 Mg IV Solr 21 16 $70,500.00 $38,775.00 45% off $15,948.00 $66,270.00 $41,109.00 2026-03-29
79952011001_2 NDC Loncastuximab Tesirine-lpyl 10 Mg IV Solr|discarded Drug Not Administered 21 16 $70,500.00 $38,775.00 45% off $15,948.00 $66,270.00 $41,109.00 2026-03-29
75987008010 NDC Pegloticase 8 Mg/ml IV Soln 21 16 $67,806.00 $37,293.30 45% off $2,057.76 $63,737.64 $38,649.42 2026-03-29
00008010001 NDC Inotuzumab Ozogamicin 0.9 Mg IV Solr 21 16 $67,707.06 $37,238.88 45% off $15,948.00 $63,644.64 $39,796.32 2026-03-29
24338015020 NDC Triptorelin Pamoate ER (cpp) 22.5 Mg IM Srer 21 16 $59,582.28 $32,770.25 45% off $2,055.68 $56,007.34 $33,961.90 2026-03-29
50242015001 NDC Ocrelizumab 300 Mg/10ml IV Soln 21 16 $59,143.14 $32,528.73 45% off $14,785.79 $55,594.55 $35,190.17 2026-03-29
00078073461 NDC Canakinumab 150 Mg/ml Sc Soln 21 16 $58,331.58 $32,082.37 45% off $80.67 $54,831.69 $33,249.00 2026-03-29
24208041601 NDC Fluocinolone Acetonide 0.59 Mg Iz Impl 21 16 $57,075.00 $31,391.25 45% off $185.06 $53,650.50 $32,532.75 2026-03-29
80446040101 NDC Tebentafusp-tebn 100 Mcg/0.5ml IV Soln 21 16 $56,280.00 $30,954.00 45% off $14,070.00 $52,903.20 $33,486.60 2026-03-29
72694095401_3 NDC Pegaspargase Syringe 21 16 $55,874.14 $30,730.78 45% off $15,519.53 $52,521.69 $31,848.26 2026-03-29
72694095401 NDC Pegaspargase 750 Unit/ml Ij Soln 21 16 $55,804.14 $30,692.28 45% off $15,519.53 $52,455.89 $31,808.36 2026-03-29
72694095401_2 NDC Pegaspargase Syringe|discarded Drug Not Administered 21 16 $55,804.14 $30,692.28 45% off $15,519.53 $52,455.89 $31,808.36 2026-03-29
50242014201 NDC Mosunetuzumab-axgb 30 Mg/30ml IV Soln 21 16 $55,081.35 $30,294.74 45% off $357.83 $51,776.47 $31,396.37 2026-03-29
08252000201 NDC Yttrium Y-90 Implant 21 16 $54,000.00 $29,700.00 45% off $13,500.00 $50,760.00 $32,130.00 2026-03-29
11994001601 NDC Samarium Sm 153 Lexidronam 1850 Mbq/ml IV Soln 21 16 $53,733.48 $29,553.41 45% off $1,725.25 $50,509.47 $30,628.08 2026-03-29
66302001401 NDC Dinutuximab 17.5 Mg/5ml IV Soln 21 16 $51,994.38 $28,596.91 45% off $12,998.60 $48,874.72 $30,936.66 2026-03-29
66658050501 NDC Emapalumab-lzsg 50 Mg/10ml IV Soln 21 16 $50,655.15 $27,860.33 45% off $209.73 $47,615.84 $28,873.44 2026-03-29
47783010101_2 NDC Ecallantide 10 Mg/ml Sc Soln 21 16 $49,933.30 $27,463.32 45% off $316.54 $46,937.30 $28,461.98 2026-03-29
47783010101 NDC Ecallantide 10 Mg/ml Sc Soln|discarded Drug Not Administered 21 16 $49,863.30 $27,424.82 45% off $316.54 $46,871.50 $28,422.08 2026-03-29
73475310203 NDC Efgartigimod Alfa-hyalur-qvfc 180-2000 Mg-unit/ml Sc Soln 21 16 $48,265.38 $26,545.96 45% off $18.62 $45,369.46 $27,511.27 2026-03-29
00169720801 NDC Coagulation Factor Viia Recomb 8 Mg IV Solr 21 16 $47,171.40 $25,944.27 45% off $1.43 $44,341.12 $26,887.70 2026-03-29
82705001001 NDC Epcoritamab-bysp 48 Mg/0.8ml Sc Soln 21 16 $45,676.68 $25,122.17 45% off $11,419.17 $42,936.08 $27,177.62 2026-03-29
68403110006 NDC Botulism Immune Globulin Human 100 Mg IV Solr 21 16 $45,300.00 $24,915.00 45% off $11,325.00 $42,582.00 $26,953.50 2026-03-29
55513007701 NDC Tarlatamab-dlle 10 Mg IV Solr 21 16 $45,000.00 $24,750.00 45% off $11,250.00 $42,300.00 $26,775.00 2026-03-29
50242010501 NDC Polatuzumab Vedotin-piiq 140 Mg IV Solr 21 16 $45,000.00 $24,750.00 45% off $11,250.00 $42,300.00 $26,775.00 2026-03-29
73650031614 NDC Teplizumab-mzwv 2 Mg/2ml IV Soln 21 16 $42,804.81 $23,542.65 45% off $10,701.20 $40,236.52 $25,468.86 2026-03-29
00024582411 NDC Cabazitaxel 60 Mg/1.5ml IV Soln 21 16 $42,439.59 $23,341.77 45% off $10,609.90 $39,893.21 $25,251.56 2026-03-29
25357010001 NDC Travoprost 75 Mcg Io Impl 21 16 $41,850.00 $23,017.50 45% off $10,462.50 $39,339.00 $24,900.75 2026-03-29
00069449402 NDC Elranatamab-bcmm 76 Mg/1.9ml Sc Soln 21 16 $40,679.10 $22,373.51 45% off $102.93 $38,238.35 $23,187.09 2026-03-29
42747030401 NDC Burosumab-twza 30 Mg/ml Sc Soln 21 16 $40,063.08 $22,034.69 45% off $271.91 $37,659.30 $22,835.96 2026-03-29
57894006003 NDC Ustekinumab 45 Mg/0.5ml Sc Sosy 21 16 $38,582.25 $21,220.24 45% off $9,645.56 $36,267.32 $22,956.44 2026-03-29
50242024501 NDC Pertuz-trastuz-hyaluron-zzxf 80-40-2000 Mg-mg-u/ml Sc Soln 21 16 $37,954.17 $20,874.79 45% off $9,488.54 $35,676.92 $22,582.73 2026-03-29
04444113707 NDC Indium In-111 Wbc 21 16 $35,284.50 $19,406.48 45% off $8,821.13 $33,167.43 $20,994.28 2026-03-29
51144005001 NDC Brentuximab Vedotin 50 Mg IV Solr 21 16 $35,226.00 $19,374.30 45% off $146.57 $33,112.44 $20,078.82 2026-03-29
00173089803 NDC Dostarlimab-gxly 500 Mg/10ml IV Soln 21 16 $34,689.36 $19,079.15 45% off $135.10 $32,608.00 $19,772.94 2026-03-29
80203034701_3 NDC Sutimlimab-jome (enjaymo) 1 Hour Infusion (straight Drug) 21 16 $34,586.80 $19,022.74 45% off $8,646.70 $32,511.59 $20,579.15 2026-03-29
73077001001_3 NDC Sodium Thiosulfate 125 Mg/ml IV Syringe 21 16 $34,251.27 $18,838.20 45% off $8,562.82 $32,196.19 $20,379.51 2026-03-29
73077001001_2 NDC Sodium Thiosulfate 125 Mg/ml IV Soln 21 16 $34,251.27 $18,838.20 45% off $8,562.82 $32,196.19 $20,379.51 2026-03-29
73077001001 NDC Sodium Thiosulfate 125 Mg/ml IV Intravia 21 16 $34,251.27 $18,838.20 45% off $8,562.82 $32,196.19 $20,379.51 2026-03-29
54092070202 NDC Icatibant Acetate 30 Mg/3ml Sc Sosy 20 15 $33,442.47 $18,393.36 45% off $111.77 $31,435.92 $20,868.10 2026-03-29
04444000058 NDC PET Ids 18-f Lfac 21 16 $33,400.00 $18,370.00 45% off $8,350.00 $31,396.00 $19,873.00 2026-03-29
50242091701 NDC Atezolizumab 1200 Mg/20ml IV Soln 21 16 $32,772.27 $18,024.75 45% off $51.27 $30,805.93 $18,680.19 2026-03-29
61755000801 NDC Cemiplimab-rwlc 350 Mg/7ml IV Soln 21 16 $31,820.28 $17,501.15 45% off $7,955.07 $29,911.06 $18,933.06 2026-03-29
50242012701 NDC Glofitamab-gxbm 10 Mg/10ml IV Soln 21 16 $31,576.65 $17,367.16 45% off $1,552.59 $29,682.05 $17,998.69 2026-03-29
00074377903 NDC Leuprolide Acetate (ped)(3mon) 11.25 Mg IM Kit 21 16 $31,148.43 $17,131.64 45% off $963.07 $29,279.52 $17,754.61 2026-03-29
57894050301 NDC Daratumumab-hyaluronidase-fihj 1800-30000 Mg-ut/15ml Sc Soln 21 16 $29,917.56 $16,454.66 45% off $7,479.39 $28,122.51 $17,800.95 2026-03-29
00008451001 NDC Gemtuzumab Ozogamicin 4.5 Mg IV Solr 21 16 $29,689.68 $16,329.32 45% off $7,422.42 $27,908.30 $17,665.36 2026-03-29
82959011101 NDC Imetelstat Sodium 188 Mg IV Solr 21 16 $29,652.00 $16,308.60 45% off $31.83 $27,872.88 $16,901.64 2026-03-29
00169720501 NDC Coagulation Factor Viia Recomb 5 Mg IV Solr 21 16 $29,482.14 $16,215.18 45% off $1.43 $27,713.21 $16,804.82 2026-03-29
68727074502 NDC Daunorubicin-cytarabine Lipo 44-100 Mg IV Susr 21 16 $29,430.00 $16,186.50 45% off $7,357.50 $27,664.20 $17,510.85 2026-03-29
00074969403 NDC Leuprolide Acetate (ped)(3mon) 30 Mg IM Kit 21 16 $29,027.73 $15,965.25 45% off $963.07 $27,286.07 $16,545.81 2026-03-29
68382039504 NDC Ribavirin 6 G In Solr 21 16 $28,800.00 $15,840.00 45% off $7,200.00 $27,072.00 $17,136.00 2026-03-29
80203034701_2 NDC Sutimlimab-jome (enjaymo) 1 Hour Infusion (straight Drug)|discarded Drug Not Adm… 21 16 $28,764.00 $15,820.20 45% off $7,191.00 $27,038.16 $17,114.58 2026-03-29
44087882201 NDC Interferon Beta-1a 6x8.8 & 6x22 Mcg Sc Sosy 21 16 $28,708.05 $15,789.43 45% off $7,177.01 $26,985.57 $17,081.29 2026-03-29
55292070255 NDC Hemin 350 Mg IV Solr 21 16 $28,165.53 $15,491.04 45% off $19.27 $26,475.60 $16,054.35 2026-03-29
00074501501 NDC Risankizumab-rzaa 600 Mg/10ml IV Soln 21 16 $27,496.29 $15,122.96 45% off $6,874.07 $25,846.51 $16,897.00 2026-03-29
55566980002 NDC Fecal Microbiota Live-jslm 150 Ml Re Susp 21 16 $27,405.00 $15,072.75 45% off $35.28 $25,760.70 $15,620.85 2026-03-29
75987007009 NDC Sodium Phenylbutyrate 3 Gm/tsp Po Powd 21 16 $27,304.90 $15,017.70 45% off $6,826.23 $25,666.61 $16,897.00 2026-03-29
70114034001 NDC Toripalimab-tpzi 240 Mg/6ml IV Soln 21 16 $27,209.61 $14,965.29 45% off $21.95 $25,577.03 $15,509.48 2026-03-29
71879013601 NDC Fluocinolone Acetonide 0.18 Mg Iz Impl 21 16 $26,988.00 $14,843.40 45% off $6,747.00 $25,368.72 $16,897.00 2026-03-29
42747020301 NDC Burosumab-twza 20 Mg/ml Sc Soln 21 16 $26,708.73 $14,689.80 45% off $271.91 $25,106.21 $16,897.00 2026-03-29
68611019002 NDC Fluocinolone Acetonide 0.19 Mg Iz Impl 21 16 $26,700.00 $14,685.00 45% off $277.06 $25,098.00 $15,219.00 2026-03-29
00003232711 NDC Ipilimumab 50 Mg/10ml IV Soln 21 16 $26,109.42 $14,360.18 45% off $6,527.36 $24,542.85 $16,897.00 2026-03-29
64764030020 NDC Vedolizumab 300 Mg IV Solr 21 16 $25,999.74 $14,299.86 45% off $6,499.94 $24,439.76 $16,897.00 2026-03-29
50242008527_3 NDC Alteplase 100 Mg IV Solr (pe) 21 16 $25,679.05 $14,123.48 45% off $6,419.76 $24,138.31 $16,897.00 2026-03-29
64406000801 NDC Natalizumab 300 Mg/15ml IV Conc 21 16 $25,613.16 $14,087.24 45% off $13.38 $24,076.37 $14,599.50 2026-03-29
50242008527 NDC Alteplase 100 Mg IV Solr 21 16 $25,609.05 $14,084.98 45% off $6,402.26 $24,072.51 $16,897.00 2026-03-29
50242008527_2 NDC Alteplase 100 Mg IV Solr (pe)|discarded Drug Not Administered 21 16 $25,609.05 $14,084.98 45% off $6,402.26 $24,072.51 $16,897.00 2026-03-29
00002840001 NDC Teriparatide 600 Mcg/2.4ml Sc Sopn 21 16 $24,089.23 $13,249.08 45% off $6,022.31 $22,643.88 $16,332.50 2026-03-29
57894047001 NDC Talquetamab-tgvs 40 Mg/ml Sc Soln 21 16 $23,561.43 $12,958.79 45% off $40.90 $22,147.74 $13,430.02 2026-03-29
00069252202 NDC Elranatamab-bcmm 44 Mg/1.1ml Sc Soln 21 16 $23,551.05 $12,953.08 45% off $5,887.76 $22,137.99 $15,967.61 2026-03-29
59627033304 NDC Interferon Beta-1a 30 Mcg/0.5ml IM Ajkt 20 15 $22,459.14 $12,352.53 45% off $41.45 $21,111.59 $16,422.50 2026-03-29
58468004001 NDC Agalsidase Beta 35 Mg IV Solr 21 16 $22,364.19 $12,300.30 45% off $5,591.05 $21,022.34 $15,948.00 2026-03-29
50242007001 NDC Obinutuzumab 1000 Mg/40ml IV Soln 21 16 $22,252.98 $12,239.14 45% off $5,563.25 $20,917.80 $15,948.00 2026-03-29
58468005001 NDC Olipudase Alfa-rpcp 20 Mg IV Solr 21 16 $21,854.52 $12,019.99 45% off $5,463.63 $20,543.25 $15,948.00 2026-03-29
51144000301 NDC Tisotumab Vedotin-tftv 40 Mg IV Solr 21 16 $21,369.00 $11,752.95 45% off $5,342.25 $20,086.86 $15,948.00 2026-03-29
00000198888 NDC Tenecteplase 50mg IV And Supply Stroke Kit 21 16 $21,216.72 $11,669.20 45% off $5,304.18 $19,943.72 $15,948.00 2026-03-29
57894007102 NDC Golimumab 100 Mg/ml Sc Soaj 21 16 $20,420.85 $11,231.47 45% off $5,105.21 $19,195.60 $15,948.00 2026-03-29
75987005006 NDC Glycerol Phenylbutyrate 1.1 Gm/ml Po Liqd 21 16 $19,922.00 $10,957.10 45% off $4,980.50 $18,726.68 $15,937.60 2026-03-29
00074012402 NDC Adalimumab 80 Mg/0.8ml Sc Ajkt 21 16 $18,809.51 $10,345.23 45% off $4,702.38 $17,680.94 $15,047.61 2026-03-29
73475304105 NDC Efgartigimod Alfa-fcab 400 Mg/20ml IV Soln 21 16 $18,571.14 $10,214.13 45% off $4,642.79 $17,456.87 $14,856.91 2026-03-29
50242010801 NDC Rituximab-hyaluronidase Human 1400-23400 Mg -ut/11.7ml Sc Soln 21 16 $16,770.27 $9,223.65 45% off $4,192.57 $15,764.05 $13,416.22 2026-03-29
J3391 HCPCS Inj, Atidarsagene Autotemcel 5 4 — — $2,459,730.00 $4,505,000.00 $4,335,000.00 2026-03-29
C9172 HCPCS Inj, Beqvez, Per Tx Dose 3 2 — — $2,657,245.50 $3,570,000.00 $3,570,000.00 2026-03-29
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 7 5 — — $2,012,155.60 $3,685,266.66 $3,570,000.00 2026-03-29
60923051322 NDC Delandistrogene Moxeparvo-rokl 22 X 10 Ml IV Kit 10 7 — — $1,817,011.41 $4,560,000.00 $3,264,000.00 2026-03-29
60923050918 NDC Delandistrogene Moxeparvo-rokl 18 X 10 Ml IV Kit 10 7 — — $1,817,011.41 $4,560,000.00 $3,264,000.00 2026-03-29
60923055463 NDC Delandistrogene Moxeparvo-rokl 63 X 10 Ml IV Kit 10 7 — — $1,817,011.41 $4,560,000.00 $3,264,000.00 2026-03-29
60923052130 NDC Delandistrogene Moxeparvo-rokl 30 X 10 Ml IV Kit 10 7 — — $1,817,011.41 $4,560,000.00 $3,264,000.00 2026-03-29
60923053847 NDC Delandistrogene Moxeparvo-rokl 47 X 10 Ml IV Kit 10 7 — — $1,817,011.41 $4,560,000.00 $3,264,000.00 2026-03-29
60923053544 NDC Delandistrogene Moxeparvo-rokl 44 X 10 Ml IV Kit 10 7 — — $1,817,011.41 $4,560,000.00 $3,264,000.00 2026-03-29
60923051827 NDC Delandistrogene Moxeparvo-rokl 27 X 10 Ml IV Kit 10 7 — — $1,817,011.41 $4,560,000.00 $3,264,000.00 2026-03-29
60923053241 NDC Delandistrogene Moxeparvo-rokl 41 X 10 Ml IV Kit 10 7 — — $1,817,011.41 $4,560,000.00 $3,264,000.00 2026-03-29
J3389 HCPCS Topi Adm Prad Zami Per Treat 5 4 — — $1,821,357.72 $3,335,820.00 $3,209,940.00 2026-03-29
J3394 HCPCS Inj, Lovotibeglogene Autotem 7 5 — — $1,775,869.41 $3,252,508.07 $3,162,000.00 2026-03-29
J3387 HCPCS Inj Elivaldogene Autotemecel 5 4 — — $1,736,280.00 $3,180,000.00 $3,060,000.00 2026-03-29
71894013006 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 4x8.3ml IV Kit 11 8 — $3,506,250.00 $15,948.00 $4,322,250.00 $3,028,125.00 2026-03-29
71894012905 NDC Onasemnogene Abeparvovec-xioi 5x8.3 Ml IV Kit 11 8 — $3,506,250.00 $15,948.00 $4,322,250.00 $3,028,125.00 2026-03-29
71894013808 NDC Onasemnogene Abeparvovec-xioi 8x8.3 Ml IV Kit 11 8 — $3,506,250.00 $15,948.00 $4,322,250.00 $3,028,125.00 2026-03-29
71894012504 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 3x8.3ml IV Kit 11 8 — $3,506,250.00 $15,948.00 $4,322,250.00 $3,028,125.00 2026-03-29
71894012404 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 2x8.3ml IV Kit 11 8 — $3,506,250.00 $15,948.00 $4,322,250.00 $3,028,125.00 2026-03-29
71894013507 NDC Onasemnogene Abeparvovec-xioi 7x8.3 Ml IV Kit 11 8 — $3,506,250.00 $15,948.00 $4,322,250.00 $3,028,125.00 2026-03-29
71894012705 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 3x8.3ml IV Kit 11 8 — $3,506,250.00 $15,948.00 $4,322,250.00 $3,028,125.00 2026-03-29
71894012103 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 1x8.3ml IV Kit 11 8 — $3,506,250.00 $15,948.00 $4,322,250.00 $3,028,125.00 2026-03-29
71894014109 NDC Onasemnogene Abeparvovec-xioi 9x8.3 Ml IV Kit 11 8 — $3,506,250.00 $15,948.00 $4,322,250.00 $3,028,125.00 2026-03-29
71894013909 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 7x8.3ml IV Kit 11 8 — $3,506,250.00 $15,948.00 $4,322,250.00 $3,028,125.00 2026-03-29
J3393 HCPCS Inj, Betibeglogene Autotemce 7 5 — — $1,605,223.01 $2,939,968.88 $2,856,000.00 2026-03-29
60923051524 NDC Delandistrogene Moxeparvo-rokl 24 X 10 Ml IV Kit 6 4 — — $15,948.00 $4,560,000.00 $2,606,880.00 2026-03-29
60923051423 NDC Delandistrogene Moxeparvo-rokl 23 X 10 Ml IV Kit 6 4 — — $15,948.00 $4,560,000.00 $2,606,880.00 2026-03-29
60923052433 NDC Delandistrogene Moxeparvo-rokl 33 X 10 Ml IV Kit 6 4 — — $15,948.00 $4,560,000.00 $2,606,880.00 2026-03-29
60923050615 NDC Delandistrogene Moxeparvo-rokl 15 X 10 Ml IV Kit 6 4 — — $15,948.00 $4,560,000.00 $2,606,880.00 2026-03-29
60923051120 NDC Delandistrogene Moxeparvo-rokl 20 X 10 Ml IV Kit 6 4 — — $15,948.00 $4,560,000.00 $2,606,880.00 2026-03-29
71894012303 NDC Onasemnogene Abeparvovec-xioi 3x8.3 Ml IV Kit 12 9 — $3,506,250.00 $1,413,583.75 $4,322,250.00 $2,500,528.30 2026-03-29
71894013407 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 6x8.3ml IV Kit 12 9 — $3,506,250.00 $1,413,583.75 $4,322,250.00 $2,500,528.30 2026-03-29
71894013206 NDC Onasemnogene Abeparvovec-xioi 6x8.3 Ml IV Kit 12 9 — $3,506,250.00 $1,413,583.75 $4,322,250.00 $2,500,528.30 2026-03-29
71894012604 NDC Onasemnogene Abeparvovec-xioi 4x8.3 Ml IV Kit 12 9 — $3,506,250.00 $1,413,583.75 $4,322,250.00 $2,500,528.30 2026-03-29
71894013106 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 5x8.3ml IV Kit 12 9 — $3,506,250.00 $1,413,583.75 $4,322,250.00 $2,500,528.30 2026-03-29
71894014009 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 8x8.3ml IV Kit 12 9 — $3,506,250.00 $1,413,583.75 $4,322,250.00 $2,500,528.30 2026-03-29
71894012002 NDC Onasemnogene Abeparvovec-xioi 2x8.3 Ml IV Kit 12 9 — $3,506,250.00 $1,413,583.75 $4,322,250.00 $2,500,528.30 2026-03-29
71894013307 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 5x8.3ml IV Kit 12 9 — $3,506,250.00 $1,413,583.75 $4,322,250.00 $2,500,528.30 2026-03-29
71894012203 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 2x8.3ml IV Kit 12 9 — $3,506,250.00 $1,413,583.75 $4,322,250.00 $2,500,528.30 2026-03-29
71894012805 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 4x8.3ml IV Kit 12 9 — $3,506,250.00 $1,413,583.75 $4,322,250.00 $2,500,528.30 2026-03-29
71894013608 NDC Onasemnogene Abeparvovec-xioi 2x5.5ml & 6x8.3ml IV Kit 12 9 — $3,506,250.00 $1,413,583.75 $4,322,250.00 $2,500,528.30 2026-03-29
71894013708 NDC Onasemnogene Abeparvovec-xioi 1x5.5ml & 7x8.3ml IV Kit 12 9 — $3,506,250.00 $1,413,583.75 $4,322,250.00 $2,500,528.30 2026-03-29
J3392 HCPCS Inj, Exagamglogene Autotem 7 5 — — $1,273,272.00 $2,332,000.00 $2,244,000.00 2026-03-29
Q2057 HCPCS Afamitresgene Autoleucel 6 4 — — $420,758.52 $770,620.00 $741,540.00 2026-03-29
Q2042 HCPCS Tisagenlecleucel Car-pos T 7 5 — — $309,326.09 $575,563.46 $552,054.73 2026-03-29
Q2054 HCPCS Lisocabtagene Mara Car Pos T 7 5 — — $306,961.88 $562,201.24 $541,977.41 2026-03-29
Q2055 HCPCS Idecabtagene Vicleucel Car 7 5 — — $304,712.62 $558,081.72 $538,878.68 2026-03-29
Q2056 HCPCS Ciltacabtagene Car-pos T 7 5 — — $320,856.67 $587,649.57 $532,496.61 2026-03-29
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 7 5 — — $290,576.96 $532,192.24 $513,651.60 2026-03-29
Q2053 HCPCS Brexucabtagene Car Pos T 7 5 — — $267,239.81 $489,450.20 $471,240.00 2026-03-29
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 5 4 — — $151,924.50 $278,250.00 $267,750.00 2026-03-29
C9301 HCPCS Obecabtagene Car Pos T 1 1 — — $267,750.00 $267,750.00 $267,750.00 2026-03-29
J3403 HCPCS Revakinagene, Per Implant 5 4 — — $144,690.00 $265,000.00 $255,000.00 2026-03-29
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 5 4 — — $110,111.28 $201,669.02 $197,880.00 2026-03-29
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $67,138.44 $71,167.10 $69,152.77 2026-03-29
J9029 HCPCS Instill Adstiladrin, Tx Dose 7 5 — — $35,094.04 $64,274.79 $61,200.00 2026-03-29
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 7 5 — — $29,704.64 $66,147.00 $54,404.10 2026-03-29
38240 HCPCS Transplt Allo Hct/donor 5 5 — — $35,087.88 $64,263.52 $43,593.81 2026-03-29
64654 HCPCS 1st Opn Implt Bat Modulj Sys 4 4 — — $24,570.27 $45,000.50 $34,785.39 2026-03-29
33276 HCPCS Insj Phrnc Nrv Stim Sys 5 5 — — $24,570.27 $45,000.50 $33,169.87 2026-03-29
0266T HCPCS Implt/rpl Crtd Sns Dev Total 1 1 — — $33,169.87 $33,169.87 $33,169.87 2026-03-29
A9543 HCPCS Y90 Ibritumomab, Rx 5 5 — — $10,890.46 $56,824.54 $31,026.20 2026-03-29
0870T HCPCS Imp Subq Prtl Ascts Pmp Sys 4 4 — — $19,110.27 $35,000.50 $27,055.39 2026-03-29
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 5 5 — — $24,570.27 $45,000.50 $25,798.87 2026-03-29
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 5 5 — — $22,462.08 $45,000.50 $24,570.27 2026-03-29
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 4 4 — — $17,213.23 $31,526.06 $24,369.65 2026-03-29
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 4 4 — — $17,213.23 $31,526.06 $24,369.65 2026-03-29
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 4 4 — — $17,213.23 $31,526.06 $24,369.65 2026-03-29
J9600 HCPCS Porfimer Sodium Injection 7 5 — — $13,228.72 $24,228.42 $23,789.46 2026-03-29
0408T HCPCS Insj/rplc Cardiac Modulj Sys 5 5 — — $17,509.53 $32,068.73 $23,632.59 2026-03-29
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 5 5 — — $17,509.53 $32,068.73 $23,632.59 2026-03-29
33270 HCPCS Ins/rep Subq Defibrillator 5 5 — — $17,509.53 $32,068.73 $23,632.59 2026-03-29
33249 HCPCS Insj/rplcmt Defib W/lead(s) 5 5 — — $17,509.53 $32,068.73 $23,632.59 2026-03-29
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 5 5 — — $17,509.53 $32,068.73 $23,632.59 2026-03-29
33231 HCPCS Insrt Pulse Gen W/mult Leads 5 5 — — $17,509.53 $32,068.73 $23,632.59 2026-03-29
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 5 5 — — $17,509.53 $32,068.73 $23,632.59 2026-03-29
69930 HCPCS Implant Cochlear Device 5 5 — — $18,392.71 $33,686.28 $23,445.54 2026-03-29
63685 HCPCS Ins/rplc Spi Npg/rcvr Pocket 5 5 — — $17,213.23 $31,526.06 $22,462.08 2026-03-29
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 5 5 — — $17,213.23 $31,526.06 $22,462.08 2026-03-29
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 5 5 — — $17,213.23 $31,526.06 $22,462.08 2026-03-29
61886 HCPCS Implant Neurostim Arrays 5 5 — — $17,213.23 $31,526.06 $22,462.08 2026-03-29
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 5 5 — — $17,213.23 $31,526.06 $22,462.08 2026-03-29
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 1 1 — — $22,462.08 $22,462.08 $22,462.08 2026-03-29
22558 HCPCS Arthrd Ant Ntrbd Min Dsc Lum 4 4 — — $15,136.06 $27,721.73 $21,428.90 2026-03-29
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 4 4 — — $15,136.06 $27,721.73 $21,428.90 2026-03-29
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 4 4 — — $15,136.06 $27,721.73 $21,428.90 2026-03-29
0871T HCPCS Rplcmt Subq Prtl Ascites Pmp 4 4 — — $15,015.27 $27,500.50 $21,257.89 2026-03-29
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 5 5 — — $16,000.32 $29,304.62 $20,954.52 2026-03-29
C9760 HCPCS Non-blind Interatrial Shunt 5 5 — — $15,015.27 $27,500.50 $20,270.62 2026-03-29
93656 HCPCS Compre Ep Eval Abltj Atr Fib 5 5 — — $14,580.38 $26,703.99 $18,082.76 2026-03-29
93654 HCPCS Compre Ep Eval Tx Vt 5 5 — — $14,580.38 $26,703.99 $18,082.76 2026-03-29
93653 HCPCS Compre Ep Eval Tx Svt 5 5 — — $14,580.38 $26,703.99 $18,082.76 2026-03-29
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 5 5 — — $15,806.66 $31,526.06 $17,213.23 2026-03-29
61885 HCPCS Insrt/redo Neurostim 1 Array 5 5 — — $15,806.66 $31,526.06 $17,213.23 2026-03-29
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 5 5 — — $12,408.05 $22,725.36 $16,545.09 2026-03-29
0515T HCPCS Insj Wcs Lv Compl Sys 5 5 — — $12,408.05 $22,725.36 $16,545.09 2026-03-29
0409T HCPCS Insj/rplc Car Modulj Pls Gn 5 5 — — $12,408.05 $22,725.36 $16,545.09 2026-03-29
33230 HCPCS Insrt Pulse Gen W/dual Leads 5 5 — — $12,408.05 $22,725.36 $16,545.09 2026-03-29
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 5 5 — — $12,408.05 $22,725.36 $16,545.09 2026-03-29
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 5 5 — — $12,408.05 $22,725.36 $16,545.09 2026-03-29
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 5 5 — — $12,408.05 $22,725.36 $16,545.09 2026-03-29
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 5 5 — — $12,408.05 $22,725.36 $16,545.09 2026-03-29
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 5 5 — — $12,408.05 $22,725.36 $16,545.09 2026-03-29
33240 HCPCS Insrt Pulse Gen W/singl Lead 5 5 — — $12,408.05 $22,725.36 $16,545.09 2026-03-29
64590 HCPCS Ins/rpl Prph Sac/gstr Npg/r 5 5 — — $10,821.89 $19,820.31 $15,806.66 2026-03-29
64580 HCPCS Opn Impltj Nea Neuromuscular 5 5 — — $10,821.89 $19,820.31 $15,806.66 2026-03-29
0817T HCPCS Opn Insj/rplcmt Ins Ptn Subf 5 5 — — $10,821.89 $19,820.31 $15,806.66 2026-03-29
0816T HCPCS Opn Insj/rplcmt Ins Ptn Subq 5 5 — — $10,821.89 $19,820.31 $15,806.66 2026-03-29
0680T HCPCS Insj/rplcmt Pg Only Isdss 5 5 — — $10,821.89 $19,820.31 $15,806.66 2026-03-29
1013T HCPCS Lap Srg Imp/rpl Eso Nea&pg/r 4 4 — — $10,821.89 $19,820.31 $15,321.10 2026-03-29
27702 HCPCS Reconstruct Ankle Joint 5 5 — — $13,555.31 $27,721.73 $15,136.06 2026-03-29
22633 HCPCS Arthrd Cmbn 1ntrspc Lumbar 5 5 — — $13,555.31 $27,721.73 $15,136.06 2026-03-29
22630 HCPCS Arthrd Pst Tq 1ntrspc Lum 5 5 — — $13,555.31 $27,721.73 $15,136.06 2026-03-29
20696 HCPCS App Mltpln Uni Xtrnl Fix 1st 5 5 — — $13,555.31 $27,721.73 $15,136.06 2026-03-29
53444 HCPCS Insert Tandem Cuff 5 5 — — $11,561.57 $21,175.04 $14,836.76 2026-03-29
53447 HCPCS Remove/replace Ur Sphincter 5 5 — — $11,561.57 $21,175.04 $14,836.76 2026-03-29
53445 HCPCS Insert Uro/ves Nck Sphincter 5 5 — — $11,561.57 $21,175.04 $14,836.76 2026-03-29
54405 HCPCS Insert Multi-comp Penis Pros 5 5 — — $11,561.57 $21,175.04 $14,836.76 2026-03-29
54410 HCPCS Remove/replace Penis Prosth 5 5 — — $11,561.57 $21,175.04 $14,836.76 2026-03-29
54411 HCPCS Remov/replc Penis Pros Comp 5 5 — — $11,561.57 $21,175.04 $14,836.76 2026-03-29
54416 HCPCS Remv/repl Penis Contain Pros 5 5 — — $11,561.57 $21,175.04 $14,836.76 2026-03-29
54401 HCPCS Insert Self-contd Prosthesis 5 5 — — $11,561.57 $21,175.04 $14,836.76 2026-03-29
37292 HCPCS Rvsc Evsc Tpvt St Athrc Sf 1 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
37294 HCPCS Rvsc Evsc Tpvt St Athr Cpx 1 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
37277 HCPCS Rvsc Evsc Fpvt St Athr Cpx 1 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
37284 HCPCS Revsc Evasc Tpvt St Sf 1st 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
37273 HCPCS Revsc Evsc Fpvt Athrc Cplx 1 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
0981T HCPCS Tcat Impl Wrls Ivc Snr 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
37275 HCPCS Rvsc Evsc Fpvt St Athrc Sf 1 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
37286 HCPCS Revsc Evasc Tpvt St Cplx 1st 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
37271 HCPCS Revsc Evsc Fpvt Athrc Sf 1st 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
37288 HCPCS Revsc Evsc Tpvt Athrc Sf 1st 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
37290 HCPCS Revsc Evsc Tpvt Athrc Cplx 1 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
61624 HCPCS Tcat Perm Occls/embolj Cns 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
37182 HCPCS Insert Hepatic Shunt (tips) 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
92930 HCPCS Prq Tcat Plmt Ntrac St 2+les 4 4 — — $10,225.86 $18,728.69 $14,477.27 2026-03-29
33221 HCPCS Insert Pulse Gen Mult Leads 5 5 — — $10,744.67 $19,678.89 $14,057.35 2026-03-29
33229 HCPCS Remv&replc Pm Gen Mult Leads 5 5 — — $10,744.67 $19,678.89 $14,057.35 2026-03-29
0803T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Rv 5 5 — — $10,744.67 $19,678.89 $14,057.35 2026-03-29
0823T HCPCS Tcat Ins 1chmbr Ldls Pm Ra 5 5 — — $10,744.67 $19,678.89 $14,057.35 2026-03-29
0796T HCPCS Tcat Ins 2chmbr Ldls Pm Ra 5 5 — — $10,744.67 $19,678.89 $14,057.35 2026-03-29
0801T HCPCS Tcat Rmv&rpl 2chmbr Ldls Pm 5 5 — — $10,744.67 $19,678.89 $14,057.35 2026-03-29
0797T HCPCS Tcat Ins 2chmbr Ldls Pm Rv 5 5 — — $10,744.67 $19,678.89 $14,057.35 2026-03-29
0825T HCPCS Tcat Rmv&rpl1chmb Ldls Pm Ra 5 5 — — $10,744.67 $19,678.89 $14,057.35 2026-03-29
0795T HCPCS Tcat Ins 2chmbr Ldls Pm Cmpl 5 5 — — $10,744.67 $19,678.89 $14,057.35 2026-03-29
0802T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Ra 5 5 — — $10,744.67 $19,678.89 $14,057.35 2026-03-29
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 5 5 — — $10,744.67 $19,678.89 $14,057.35 2026-03-29
0525T HCPCS Insj/rplcmt Compl Iims 5 5 — — $10,744.67 $19,678.89 $14,057.35 2026-03-29
20838 HCPCS Replantation Foot Complete 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
0657T HCPCS Ant Lmbr Vrt Bdy Teth 8+ Seg 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
0656T HCPCS Ant Lmbr Vrt Bdy Teth <7 Seg 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22818 HCPCS Kyphectomy 1-2 Segments 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22804 HCPCS Arthrd Pst Dfrm 13+ Vrt Sgm 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22837 HCPCS Ant Thrc Vrt Body Tethrg 8+ 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22533 HCPCS Arthrd Lat Xtrcvtry Tq Lmbr 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22802 HCPCS Arthrd Pst Dfrm 7-12 Vrt Sgm 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22812 HCPCS Arthrd Ant Dfrm 8+ Vrt Sgm 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22808 HCPCS Arthrd Ant Dfrm 2-3 Vrt Sgm 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
27703 HCPCS Reconstruction Ankle Joint 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
20805 HCPCS Replant Forearm Complete 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22810 HCPCS Arthrd Ant Dfrm 4-7 Vrt Sgm 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22857 HCPCS Tot Disc Arthrp 1ntrspc Lmbr 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22836 HCPCS Ant Thrc Vrt Body Tethrg <7 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
0790T HCPCS Revj Rplcmt/rmvl Vrt Tethrg 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
27290 HCPCS Amputation Of Leg At Hip 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
27280 HCPCS Arthr Si Jt Opn B1grf Instrm 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22861 HCPCS Rev Rplcm Arthrp 1ntrspc Crv 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22556 HCPCS Arthrd Ant Ntrbd Min Dsc Thc 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22800 HCPCS Arthrd Pst Dfrm<6 Vrt Sgm 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22819 HCPCS Kyphectomy 3 Or More 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22586 HCPCS Arthrd Pre-sac Ntrbdy L5-s1 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
20802 HCPCS Replantation Arm Complete 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
20808 HCPCS Replantation Hand Complete 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22610 HCPCS Arthrd Pst Tq 1ntrspc Thrc 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22838 HCPCS Rev Rplc/rmv Thrc Vrt Tethrg 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22600 HCPCS Arthrd Pst Tq 1ntrspc Crv 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
22862 HCPCS Rev Rplcm Rthrp 1ntrspc Lmbr 4 4 — — $9,780.82 $17,913.59 $13,847.20 2026-03-29
24363 HCPCS Replace Elbow Joint 5 5 — — $9,780.82 $17,913.59 $13,555.31 2026-03-29
28705 HCPCS Arthrodesis Pantalar 5 5 — — $9,780.82 $17,913.59 $13,555.31 2026-03-29
22856 HCPCS Tot Disc Arthrp 1ntrspc Crv 5 5 — — $9,780.82 $17,913.59 $13,555.31 2026-03-29
23616 HCPCS Optx Prx Hmrl Fx Fix Rpr Rpl 5 5 — — $9,780.82 $17,913.59 $13,555.31 2026-03-29
27278 HCPCS Arthrd Si Jt Plmt Iartic Dev 5 5 — — $9,780.82 $17,913.59 $13,555.31 2026-03-29
27279 HCPCS Arthrd Si Jt Plmt Tartclr Dv 5 5 — — $9,780.82 $17,913.59 $13,555.31 2026-03-29
C8003 HCPCS Imp Extar Knee Shck Absrb 5 5 — — $9,780.82 $17,913.59 $13,555.31 2026-03-29
22867 HCPCS Insj Stablj Dev W/dcmprn 5 5 — — $9,780.82 $17,913.59 $13,555.31 2026-03-29
25442 HCPCS Arthrp W/prostc Dstl Ulna 5 5 — — $9,780.82 $17,913.59 $13,555.31 2026-03-29
25446 HCPCS Arthrp W/prostc Dst Rds&crps 5 5 — — $9,780.82 $17,913.59 $13,555.31 2026-03-29
22612 HCPCS Arthrd Pst Tq 1ntrspc Lumbar 5 5 — — $9,780.82 $17,913.59 $13,555.31 2026-03-29
C8005 HCPCS Pef Bronch Ablt 3d Nav Ebus 4 4 — — $9,555.27 $17,500.50 $13,527.89 2026-03-29
C9773 HCPCS Revasc Lithotr-stent Tib/per 5 5 — — $10,225.86 $18,728.69 $13,235.90 2026-03-29
C9767 HCPCS Revasc Lithotrip-stent-ather 5 5 — — $10,225.86 $18,728.69 $13,235.90 2026-03-29
C9775 HCPCS Revasc Lith-sten-ath Tib/per 5 5 — — $10,225.86 $18,728.69 $13,235.90 2026-03-29
C9766 HCPCS Revasc Intra Lithotrip-ather 5 5 — — $10,225.86 $18,728.69 $13,235.90 2026-03-29
C9774 HCPCS Revasc Lithotr-ather Tib/per 5 5 — — $10,225.86 $18,728.69 $13,235.90 2026-03-29
0238T HCPCS Trluml Perip Athrc Iliac Art 5 5 — — $10,225.86 $18,728.69 $13,235.90 2026-03-29
93581 HCPCS Transcath Closure Of Vsd 5 5 — — $10,225.86 $18,728.69 $13,235.90 2026-03-29
C9765 HCPCS Revasc Intra Lithotrip-stent 5 5 — — $10,225.86 $18,728.69 $13,235.90 2026-03-29
93580 HCPCS Transcath Closure Of Asd 5 5 — — $10,225.86 $18,728.69 $13,235.90 2026-03-29
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