Hospital

Community Behavioral Health Center

Fresno, CA · CCN 054091 · Rates published

18,096 distinct procedures filed

144 distinct payers

2,986,015 rate rows

2025-03-13 last MRF observed · ⚠ 15 mo old

Data quality

2,294,870 of 2,986,015 rate rows are consumer-grade (76.9%)

691,145 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
professional (physician) fee — not the facility price	629,324
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	53,794
placeholder amount (≤ $0.02) — excluded from medians	3,489
per-diem day rate — not a per-procedure price	1,724
exceeds 10× this hospital's gross charge — excluded from medians	1,586
template filing: same amount across many unrelated codes — excluded	1,063
percent-of-charges filed in the dollar field — excluded from medians	165

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 15 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

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

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/8231/941156276-1104906569_fresno-community-hospital-and-medical-center_standardcharges.csv
Found on page	https://www.communitymedical.org/cms-hpt.txt
Discovered via	Discovered by HANK (automated)
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint	9d7f035ca7c40482… · 1,803,395,362 bytes · first seen 2026-05-18

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
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	82	$3,339,000.00	$4,823,000.00	$3,710,000.00	nat. median $3,710,000 1.0× median
J1414 HCPCS	Inj, Beqvez, Per Tx Dose	82	$3,339,000.00	$4,823,000.00	$3,710,000.00	nat. median $3,710,000 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	82	$2,989,603.36	$4,318,315.96	$3,321,781.51	nat. median $3,325,455 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	82	$2,873,700.00	$4,150,900.00	$3,193,000.00	nat. median $3,286,000 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	82	$2,671,200.00	$3,858,400.00	$2,968,000.00	nat. median $3,004,655 1.0× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	83	$2,163,112.88	$4,806,917.50	$2,403,458.75	nat. median $2,468,984 1.0× median
J3392 HCPCS	Inj, Exagamglogene Autotem	83	$2,098,800.00	$4,664,000.00	$2,332,000.00	nat. median $2,448,600 1.0× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	84	$509,061.46	$1,216,091.26	$565,623.84	nat. median $753,246 0.8× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	84	$477,090.02	$1,185,334.43	$551,318.34	nat. median $674,867 0.8× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	119	$83,900.00	$1,135,871.72	$528,312.43	nat. median $625,184 0.8× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	119	$82,060.00	$1,110,444.84	$516,485.97	nat. median $673,137 0.8× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	119	$99,750.00	$1,052,461.87	$489,517.15	nat. median $634,303 0.8× median
Q2053 HCPCS	Brexucabtagene Car Pos T	119	$99,750.00	$1,049,310.75	$488,051.51	nat. median $619,808 0.8× median
Q2040 HCPCS	Pharmacy	1	$487,349.97	$487,349.97	$487,349.97	nat. median $25,594 outlier · 19.0×
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	83	$377,606.27	$902,059.42	$419,562.52	nat. median $370,174 1.1× median
J2326 HCPCS	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	142	$1,066.96	$925,240.53	$407,041.04	nat. median $2,675 outlier · 152.1×
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	86	$71,035.00	$674,085.44	$313,528.11	nat. median $265,286 1.2× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	99	$237,726.86	$567,903.04	$264,140.95	nat. median $206,474 1.3× median
5834 APR_DRG	Neonate With Ecmo - Extreme Severity	37	$248,268.01	$454,330.46	$248,268.01	nat. median $309,665 0.8× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	83	$214,818.20	$513,176.81	$238,686.89	nat. median $202,976 1.2× median
5884 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure - Extreme Severity	37	$203,646.92	$372,673.86	$203,646.92	nat. median $246,434 0.8× median
5833 APR_DRG	Neonate With Ecmo - Major Severity	37	$196,632.90	$359,838.21	$196,632.90	nat. median $244,017 0.8× median
1614 APR_DRG	Implantable Heart Assist Systems - Extreme Severity	37	$194,710.36	$356,319.96	$194,710.36	nat. median $207,730 0.9× median
24 APR_DRG	Heart And/or Lung Transplant - Extreme Severity	37	$187,901.77	$343,860.24	$187,901.77	nat. median $234,729 0.8× median
J9226 HCPCS	Histrelin 50 Mg (65 Mcg/day) Implant Kit	142	$14,962.50	$371,729.52	$163,534.96	nat. median $60,368 outlier · 2.7×
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And…	83	$141,812.95	$338,775.37	$157,569.94	nat. median $133,161 1.2× median
1613 APR_DRG	Implantable Heart Assist Systems - Major Severity	37	$149,168.99	$272,979.25	$149,168.99	nat. median $119,796 1.2× median
6304 APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure - Extreme…	37	$147,814.83	$270,501.14	$147,814.83	nat. median $150,721 1.0× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	83	$131,532.47	$314,216.46	$146,147.19	nat. median $117,357 1.2× median
7 MS_DRG	Lung Transplant	83	$131,202.51	$313,428.23	$145,780.57	nat. median $122,708 1.2× median
5832 APR_DRG	Neonate With Ecmo - Moderate Severity	37	$144,997.80	$265,345.97	$144,997.80	nat. median $156,126 0.9× median
8414 APR_DRG	Extensive Third Degree Burns With Skin Graft - Extreme Severity	37	$5,510.00	$251,278.01	$137,310.39	nat. median $160,267 0.9× median
5934 APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure - Extreme Severity	37	$132,816.77	$243,054.69	$132,816.77	nat. median $151,838 0.9× median
5883 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure - Major Severity	37	$131,197.30	$240,091.06	$131,197.30	nat. median $182,665 0.7× median
5882 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure - Moderate Severity	37	$128,466.87	$235,094.37	$128,466.87	nat. median $145,336 0.9× median
5914 APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure - Extreme Severity	37	$128,256.83	$234,710.00	$128,256.83	nat. median $164,289 0.8× median
114 APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies - Extreme Sever…	37	$128,091.02	$234,406.57	$128,091.02	nat. median $117,173 1.1× median
6094 APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure - Extreme Severity	37	$127,438.81	$233,213.02	$127,438.81	nat. median $162,982 0.8× median
5831 APR_DRG	Neonate With Ecmo - Minor Severity	37	$125,304.39	$229,307.03	$125,304.39	nat. median $144,745 0.9× median
74 APR_DRG	Allogeneic Bone Marrow Transplant - Extreme Severity	37	$123,185.63	$225,429.70	$123,185.63	nat. median $187,061 0.7× median
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	84	$71,035.00	$264,484.72	$123,016.15	nat. median $108,660 1.1× median
6314 APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure - Extreme Severity	37	$122,345.49	$223,892.25	$122,345.49	nat. median $122,924 1.0× median
44 APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure - Extreme Severity	37	$122,015.70	$223,288.73	$122,015.70	nat. median $105,658 1.2× median
212 MS_DRG	Concomitant Aortic And Mitral Valve Procedures	83	$109,456.71	$261,479.93	$121,618.57	nat. median $102,358 1.2× median
14 APR_DRG	Liver Transplant And/or Intestinal Transplant - Extreme Severity	37	$120,118.03	$219,815.99	$120,118.03	nat. median $129,535 0.9× median
1612 APR_DRG	Implantable Heart Assist Systems - Moderate Severity	37	$119,768.90	$219,177.09	$119,768.90	nat. median $85,444 1.4× median
94 APR_DRG	Extracorporeal Membrane Oxygenation (ecmo) - Extreme Severity	37	$119,456.61	$218,605.60	$119,456.61	nat. median $164,834 0.7× median
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	83	$107,012.10	$255,640.01	$118,902.33	nat. median $100,136 1.2× median
215 MS_DRG	Other Heart Assist System Implant	88	$17,504.00	$254,335.84	$118,295.74	nat. median $99,019 1.2× median
C9293 HCPCS	Glucarpidase 1,000 Unit Intravenous Solution	142	$230.85	$268,374.92	$118,066.18	nat. median $21,216 outlier · 5.6×

Other procedures at this hospital

Browse this hospital's 18,096 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

J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	83	82	—	—	$3,339,000.00	$4,823,000.00	$3,710,000.00	2025-03-13
J1414	HCPCS	Inj, Beqvez, Per Tx Dose	83	82	—	—	$3,339,000.00	$4,823,000.00	$3,710,000.00	2025-03-13
J1413	HCPCS	Inj Delandistrogene Mox Rokl	83	82	—	—	$2,989,603.36	$4,318,315.96	$3,321,781.51	2025-03-13
J3394	HCPCS	Inj, Lovotibeglogene Autotem	83	82	—	—	$2,873,700.00	$4,150,900.00	$3,193,000.00	2025-03-13
J3393	HCPCS	Inj, Betibeglogene Autotemce	83	82	—	—	$2,671,200.00	$3,858,400.00	$2,968,000.00	2025-03-13
J3399	HCPCS	Inj Onase Abepar-xioi Treat	86	83	—	—	$2,163,112.88	$4,806,917.50	$2,403,458.75	2025-03-13
J3392	HCPCS	Inj, Exagamglogene Autotem	84	83	—	—	$2,098,800.00	$4,664,000.00	$2,332,000.00	2025-03-13
Q2042	HCPCS	Tisagenlecleucel Car-pos T	85	84	—	—	$509,061.46	$1,216,091.26	$565,623.84	2025-03-13
Q2056	HCPCS	Ciltacabtagene Car-pos T	86	84	—	—	$477,090.02	$1,185,334.43	$551,318.34	2025-03-13
Q2055	HCPCS	Idecabtagene Vicleucel Car	124	119	—	—	$83,900.00	$1,135,871.72	$528,312.43	2025-03-13
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	124	119	—	—	$82,060.00	$1,110,444.84	$516,485.97	2025-03-13
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	124	119	—	—	$99,750.00	$1,052,461.87	$489,517.15	2025-03-13
Q2053	HCPCS	Brexucabtagene Car Pos T	124	119	—	—	$99,750.00	$1,049,310.75	$488,051.51	2025-03-13
Q2040	HCPCS	Pharmacy	2	1	—	—	$487,349.97	$487,349.97	$487,349.97	2025-03-13
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	84	83	—	—	$377,606.27	$902,059.42	$419,562.52	2025-03-13
J2326	HCPCS	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	300	142	$852,441.98	$681,953.58 20% off	$1,066.96	$925,240.53	$407,041.04	2025-03-13
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	88	86	—	—	$71,035.00	$674,085.44	$313,528.11	2025-03-13
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	109	99	—	—	$237,726.86	$567,903.04	$264,140.95	2025-03-13
5834	APR_DRG	Neonate With Ecmo - Extreme Severity	37	37	—	—	$248,268.01	$454,330.46	$248,268.01	2025-03-13
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	84	83	—	—	$214,818.20	$513,176.81	$238,686.89	2025-03-13
5884	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure - Extreme Severity	37	37	—	—	$203,646.92	$372,673.86	$203,646.92	2025-03-13
5833	APR_DRG	Neonate With Ecmo - Major Severity	37	37	—	—	$196,632.90	$359,838.21	$196,632.90	2025-03-13
1614	APR_DRG	Implantable Heart Assist Systems - Extreme Severity	37	37	—	—	$194,710.36	$356,319.96	$194,710.36	2025-03-13
24	APR_DRG	Heart And/or Lung Transplant - Extreme Severity	37	37	—	—	$187,901.77	$343,860.24	$187,901.77	2025-03-13
J9226	HCPCS	Histrelin 50 Mg (65 Mcg/day) Implant Kit	300	142	$342,481.59	$273,985.27 20% off	$14,962.50	$371,729.52	$163,534.96	2025-03-13
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …	84	83	—	—	$141,812.95	$338,775.37	$157,569.94	2025-03-13
1613	APR_DRG	Implantable Heart Assist Systems - Major Severity	37	37	—	—	$149,168.99	$272,979.25	$149,168.99	2025-03-13
6304	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure - Extreme …	37	37	—	—	$147,814.83	$270,501.14	$147,814.83	2025-03-13
14	MS_DRG	Allogeneic Bone Marrow Transplant	84	83	—	—	$131,532.47	$314,216.46	$146,147.19	2025-03-13
7	MS_DRG	Lung Transplant	84	83	—	—	$131,202.51	$313,428.23	$145,780.57	2025-03-13
5832	APR_DRG	Neonate With Ecmo - Moderate Severity	37	37	—	—	$144,997.80	$265,345.97	$144,997.80	2025-03-13
8414	APR_DRG	Extensive Third Degree Burns With Skin Graft - Extreme Severity	37	37	—	—	$5,510.00	$251,278.01	$137,310.39	2025-03-13
5934	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure - Extreme Severity	37	37	—	—	$132,816.77	$243,054.69	$132,816.77	2025-03-13
5883	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure - Major Severity	37	37	—	—	$131,197.30	$240,091.06	$131,197.30	2025-03-13
5882	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure - Moderate Severity	37	37	—	—	$128,466.87	$235,094.37	$128,466.87	2025-03-13
5914	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure - Extreme Severity	37	37	—	—	$128,256.83	$234,710.00	$128,256.83	2025-03-13
114	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies - Extreme Sever…	37	37	—	—	$128,091.02	$234,406.57	$128,091.02	2025-03-13
6094	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure - Extreme Severity	37	37	—	—	$127,438.81	$233,213.02	$127,438.81	2025-03-13
5831	APR_DRG	Neonate With Ecmo - Minor Severity	37	37	—	—	$125,304.39	$229,307.03	$125,304.39	2025-03-13
74	APR_DRG	Allogeneic Bone Marrow Transplant - Extreme Severity	37	37	—	—	$123,185.63	$225,429.70	$123,185.63	2025-03-13
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	86	84	—	—	$71,035.00	$264,484.72	$123,016.15	2025-03-13
6314	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure - Extreme Severity	37	37	—	—	$122,345.49	$223,892.25	$122,345.49	2025-03-13
44	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure - Extreme Severity	37	37	—	—	$122,015.70	$223,288.73	$122,015.70	2025-03-13
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	84	83	—	—	$109,456.71	$261,479.93	$121,618.57	2025-03-13
14	APR_DRG	Liver Transplant And/or Intestinal Transplant - Extreme Severity	37	37	—	—	$120,118.03	$219,815.99	$120,118.03	2025-03-13
1612	APR_DRG	Implantable Heart Assist Systems - Moderate Severity	37	37	—	—	$119,768.90	$219,177.09	$119,768.90	2025-03-13
94	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo) - Extreme Severity	37	37	—	—	$119,456.61	$218,605.60	$119,456.61	2025-03-13
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	84	83	—	—	$107,012.10	$255,640.01	$118,902.33	2025-03-13
215	MS_DRG	Other Heart Assist System Implant	92	88	—	—	$17,504.00	$254,335.84	$118,295.74	2025-03-13
C9293	HCPCS	Glucarpidase 1,000 Unit Intravenous Solution	217	142	$247,259.00	$197,807.20	$230.85	$268,374.92	$118,066.18	2025-03-13
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	84	83	—	—	$105,272.33	$251,483.91	$116,969.26	2025-03-13
23	APR_DRG	Heart And/or Lung Transplant - Major Severity	37	37	—	—	$116,195.56	$212,637.87	$116,195.56	2025-03-13
1611	APR_DRG	Implantable Heart Assist Systems - Minor Severity	37	37	—	—	$113,781.10	$208,219.41	$113,781.10	2025-03-13
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	92	88	—	—	$17,504.00	$231,795.20	$107,811.72	2025-03-13
6034	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition - Ext…	37	37	—	—	$106,762.47	$195,375.32	$106,762.47	2025-03-13
64	APR_DRG	Pancreas Transplant - Extreme Severity	37	37	—	—	$106,078.02	$194,122.78	$106,078.02	2025-03-13
850	MS_DRG	Acute Leukemia With Other Procedures	84	83	—	—	$92,639.19	$221,304.72	$102,932.43	2025-03-13
Q0480	HCPCS	Driver Pneumatic Vad, Rep	85	84	—	—	$89,999.92	$214,999.81	$99,999.91	2025-03-13
6024	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	37	37	—	—	$95,203.26	$174,221.97	$95,203.26	2025-03-13
J9043	HCPCS	Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution	300	142	$199,106.42	$159,285.14	$138.19	$216,110.11	$95,073.32	2025-03-13
231	MS_DRG	Coronary Bypass With Ptca With Mcc	95	89	—	—	$25,191.00	$203,677.33	$94,733.64	2025-03-13
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	84	83	—	—	$85,213.28	$203,565.05	$94,681.42	2025-03-13
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	84	83	—	—	$83,927.48	$200,493.41	$93,252.75	2025-03-13
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	85	84	—	—	$83,895.03	$200,415.91	$93,216.70	2025-03-13
C9098	HCPCS	Outpatient Services	39	38	—	—	$93,000.00	$477,090.00	$93,000.00	2025-03-13
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	84	83	—	—	$81,132.89	$193,817.45	$90,147.65	2025-03-13
10	MS_DRG	Pancreas Transplant	84	83	—	—	$80,252.01	$191,713.14	$89,168.90	2025-03-13
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	84	83	—	—	$79,795.07	$190,621.56	$88,661.19	2025-03-13
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	94	88	—	—	$17,504.00	$187,972.69	$87,429.16	2025-03-13
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	92	88	—	—	$17,504.00	$186,088.11	$86,552.61	2025-03-13
22	APR_DRG	Heart And/or Lung Transplant - Moderate Severity	37	37	—	—	$86,229.85	$157,800.63	$86,229.85	2025-03-13
5933	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure - Major Severity	37	37	—	—	$85,409.98	$156,300.26	$85,409.98	2025-03-13
5881	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure - Minor Severity	37	37	—	—	$84,562.48	$154,749.34	$84,562.48	2025-03-13
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	107	99	—	—	$75,164.76	$179,560.26	$83,516.40	2025-03-13
43	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure - Major Severity	37	37	—	—	$83,498.49	$152,802.24	$83,498.49	2025-03-13
1604	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly - Extreme Severity	37	37	—	—	$82,390.29	$150,774.23	$82,390.29	2025-03-13
54	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure - Extreme Severity	37	37	—	—	$80,410.63	$147,151.45	$80,410.63	2025-03-13
J3357	HCPCS	Ustekinumab 90 Mg/ml Subcutaneous Syringe	300	142	$167,272.10	$133,817.68 20% off	$111.52	$181,557.14	$79,872.43	2025-03-13
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	84	83	—	—	$71,550.29	$170,925.69	$79,500.32	2025-03-13
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	84	83	—	—	$71,193.35	$170,073.00	$79,103.72	2025-03-13
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	84	83	—	—	$70,088.52	$167,433.68	$77,876.13	2025-03-13
1624	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis - Extreme Sever…	37	37	—	—	$77,651.63	$142,102.48	$77,651.63	2025-03-13
955	MS_DRG	Craniotomy For Multiple Significant Trauma	84	83	—	—	$68,806.69	$164,371.54	$76,451.88	2025-03-13
5913	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure - Major Severity	37	37	—	—	$75,138.60	$137,503.64	$75,138.60	2025-03-13
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	84	83	—	—	$67,570.87	$161,419.29	$75,078.74	2025-03-13
6023	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	37	37	—	—	$75,070.43	$137,378.89	$75,070.43	2025-03-13
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	109	99	—	—	$67,312.92	$160,803.08	$74,792.13	2025-03-13
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	92	88	—	—	$17,504.00	$160,533.17	$74,666.59	2025-03-13
63	APR_DRG	Pancreas Transplant - Major Severity	37	37	—	—	$74,588.64	$136,497.21	$74,588.64	2025-03-13
3034	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back - Extreme Severity	37	37	—	—	$74,237.67	$135,854.94	$74,237.67	2025-03-13
21	APR_DRG	Heart And/or Lung Transplant - Minor Severity	37	37	—	—	$73,921.69	$135,276.69	$73,921.69	2025-03-13
6074	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	37	37	—	—	$73,123.93	$133,816.79	$73,123.93	2025-03-13
73	APR_DRG	Allogeneic Bone Marrow Transplant - Major Severity	37	37	—	—	$72,596.09	$132,850.84	$72,596.09	2025-03-13
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	84	83	—	—	$65,196.22	$155,746.52	$72,440.24	2025-03-13
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	92	88	—	—	$17,504.00	$155,524.40	$72,336.93	2025-03-13
6303	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure - Major Se…	37	37	—	—	$71,420.64	$130,699.77	$71,420.64	2025-03-13
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	84	83	—	—	$63,767.44	$152,333.33	$70,852.71	2025-03-13
4404	APR_DRG	Kidney Transplant - Extreme Severity	37	37	—	—	$70,574.97	$129,152.20	$70,574.97	2025-03-13
13	APR_DRG	Liver Transplant And/or Intestinal Transplant - Major Severity	37	37	—	—	$69,443.74	$127,082.04	$69,443.74	2025-03-13
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	84	83	—	—	$62,468.63	$149,230.62	$69,409.59	2025-03-13
8424	APR_DRG	Burns With Skin Graft Except Extensive Third Degree Burns - Extreme Severity	37	37	—	—	$5,510.00	$126,989.32	$69,393.07	2025-03-13
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	84	83	—	—	$62,388.64	$149,039.53	$69,320.71	2025-03-13
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	84	83	—	—	$62,106.68	$148,365.95	$69,007.42	2025-03-13
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	86	84	—	—	$13,205.00	$147,852.43	$68,768.57	2025-03-13
248	MS_DRG	Cardiovascular Surgery/Defib Implant/Pacemaker Imp/Rev/Heart Assist System	8	6	—	—	$17,504.00	$117,724.00	$68,610.50	2025-03-13
247	MS_DRG	Cardiovascular Surgery/Defib Implant/Pacemaker Imp/Rev/Heart Assist System	8	6	—	—	$17,504.00	$117,724.00	$68,610.50	2025-03-13
249	MS_DRG	Cardiovascular Surgery/Defib Implant/Pacemaker Imp/Rev/Heart Assist System	8	6	—	—	$17,504.00	$117,724.00	$68,610.50	2025-03-13
225	MS_DRG	Cardiovascular Surgery/Defib Implant/Pacemaker Imp/Rev/Heart Assist System	8	6	—	—	$17,504.00	$117,724.00	$68,610.50	2025-03-13
227	MS_DRG	Cardiovascular Surgery/Defib Implant/Pacemaker Imp/Rev/Heart Assist System	8	6	—	—	$17,504.00	$117,724.00	$68,610.50	2025-03-13
246	MS_DRG	Cardiovascular Surgery/Defib Implant/Pacemaker Imp/Rev/Heart Assist System	8	6	—	—	$17,504.00	$117,724.00	$68,610.50	2025-03-13
226	MS_DRG	Cardiovascular Surgery/Defib Implant/Pacemaker Imp/Rev/Heart Assist System	8	6	—	—	$17,504.00	$117,724.00	$68,610.50	2025-03-13
223	MS_DRG	Cardiovascular Surgery/Defib Implant/Pacemaker Imp/Rev/Heart Assist System	8	6	—	—	$17,504.00	$117,724.00	$68,610.50	2025-03-13
222	MS_DRG	Cardiovascular Surgery/Defib Implant/Pacemaker Imp/Rev/Heart Assist System	8	6	—	—	$17,504.00	$117,724.00	$68,610.50	2025-03-13
224	MS_DRG	Cardiovascular Surgery/Defib Implant/Pacemaker Imp/Rev/Heart Assist System	8	6	—	—	$17,504.00	$117,724.00	$68,610.50	2025-03-13
38240	CPT	Transplt Allo Hct/donor	133	123	—	—	$205.61	$147,335.67	$68,528.22	2025-03-13
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	95	89	—	—	$25,191.00	$147,183.65	$68,457.51	2025-03-13
28	MS_DRG	Spinal Procedures With Mcc	84	83	—	—	$61,319.80	$146,486.19	$68,133.11	2025-03-13
5932	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure - Moderate Severity	37	37	—	—	$67,695.30	$123,882.40	$67,695.30	2025-03-13
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	84	83	—	—	$60,883.88	$145,444.81	$67,648.75	2025-03-13
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	84	83	—	—	$60,883.88	$145,444.81	$67,648.75	2025-03-13
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	85	84	—	—	$60,707.39	$145,023.22	$67,452.66	2025-03-13
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	86	84	—	—	$46,013.00	$144,367.53	$67,147.69	2025-03-13
J9347	HCPCS	Tremelimumab-actl 20 Mg/ml Intravenous Solution	262	142	$140,285.00	$112,228.00 20% off	$124.59	$152,265.34	$66,986.09	2025-03-13
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	92	88	—	—	$17,504.00	$143,376.25	$66,686.63	2025-03-13
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	84	83	—	—	$59,972.99	$143,268.82	$66,636.66	2025-03-13
1634	APR_DRG	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis - Extreme Se…	37	37	—	—	$66,076.75	$120,920.45	$66,076.75	2025-03-13
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	94	88	—	—	$17,504.00	$141,821.37	$65,963.43	2025-03-13
1784	APR_DRG	External Heart Assist Systems - Extreme Severity	37	37	—	—	$65,636.42	$120,114.65	$65,636.42	2025-03-13
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	84	83	—	—	$58,748.17	$140,342.84	$65,275.74	2025-03-13
62	APR_DRG	Pancreas Transplant - Moderate Severity	37	37	—	—	$64,750.23	$118,492.92	$64,750.23	2025-03-13
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	84	83	—	—	$57,919.29	$138,362.76	$64,354.77	2025-03-13
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	84	83	—	—	$57,576.33	$137,543.46	$63,973.70	2025-03-13
6093	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure - Major Severity	37	37	—	—	$63,490.03	$116,186.75	$63,490.03	2025-03-13
J9029	HCPCS	Instill Adstiladrin, Tx Dose	85	84	—	—	$57,061.84	$136,314.39	$63,402.04	2025-03-13
113	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies - Major Severit…	37	37	—	—	$63,049.69	$115,380.93	$63,049.69	2025-03-13
653	MS_DRG	Major Bladder Procedures With Mcc	84	83	—	—	$56,271.55	$134,426.47	$62,523.94	2025-03-13
84	APR_DRG	Autologous Bone Marrow Transplant - Extreme Severity	37	37	—	—	$62,314.57	$114,035.66	$62,314.57	2025-03-13
834	MS_DRG	Acute Leukemia With Mcc	84	83	—	—	$55,798.61	$133,296.69	$61,998.46	2025-03-13
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	84	83	—	—	$55,798.61	$133,296.69	$61,998.46	2025-03-13
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	84	83	—	—	$55,566.64	$132,742.53	$61,740.71	2025-03-13
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	84	83	—	—	$55,230.70	$131,940.00	$61,367.44	2025-03-13
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	84	83	—	—	$54,936.73	$131,237.74	$61,040.81	2025-03-13
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	84	83	—	—	$54,812.75	$130,941.56	$60,903.05	2025-03-13
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	84	83	—	—	$54,535.81	$130,279.98	$60,595.34	2025-03-13
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	84	83	—	—	$54,484.80	$130,158.14	$60,538.67	2025-03-13
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	84	83	—	—	$54,478.80	$130,143.80	$60,532.00	2025-03-13
1654	APR_DRG	Coronary Bypass With Ami Or Complex Principal Diagnosis - Extreme Severity	37	37	—	—	$60,426.11	$110,579.78	$60,426.11	2025-03-13
J2327	HCPCS	Risankizumab-rzaa 360 Mg/2.4 Ml (150 Mg/ml) Subcut Wearable Injector	285	142	$126,319.16	$101,055.33	$13.57	$137,106.82	$60,317.40	2025-03-13
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	94	88	—	—	$17,504.00	$128,350.01	$59,697.68	2025-03-13
1674	APR_DRG	Other Cardiothoracic And Thoracic Vascular Procedures - Extreme Severity	37	37	—	—	$59,436.75	$108,769.25	$59,436.75	2025-03-13
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	92	88	—	—	$17,504.00	$127,788.69	$59,436.60	2025-03-13
53	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure - Major Severity	37	37	—	—	$59,213.81	$108,361.27	$59,213.81	2025-03-13
12	APR_DRG	Liver Transplant And/or Intestinal Transplant - Moderate Severity	37	37	—	—	$58,202.34	$106,510.28	$58,202.34	2025-03-13
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	84	83	—	—	$52,027.17	$124,287.14	$57,807.97	2025-03-13
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	92	88	—	—	$17,504.00	$123,878.70	$57,618.00	2025-03-13
42	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure - Moderate Severity	37	37	—	—	$57,406.42	$105,053.75	$57,406.42	2025-03-13
6022	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	37	37	—	—	$57,280.22	$104,822.80	$57,280.22	2025-03-13
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	89	86	—	—	$16,673.00	$122,961.49	$57,191.39	2025-03-13
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	86	85	—	—	$19,773.00	$122,588.87	$57,018.08	2025-03-13
3044	APR_DRG	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back - Extreme Severi…	37	37	—	—	$56,980.83	$104,274.92	$56,980.83	2025-03-13
6073	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	37	37	—	—	$56,886.86	$104,102.95	$56,886.86	2025-03-13
A9543	HCPCS	Y90 Ibritumomab, Rx	124	119	—	—	$51,142.10	$122,172.78	$56,824.55	2025-03-13
72	APR_DRG	Allogeneic Bone Marrow Transplant - Moderate Severity	37	37	—	—	$56,785.53	$103,917.52	$56,785.53	2025-03-13
J2350	HCPCS	Ocrelizumab 30 Mg/ml Intravenous Solution	300	142	$118,501.28	$94,801.02 20% off	$52.89	$128,621.29	$56,584.36	2025-03-13
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	84	83	—	—	$50,895.34	$121,583.32	$56,550.38	2025-03-13
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	84	83	—	—	$50,598.36	$120,873.86	$56,220.40	2025-03-13
3033	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back - Major Severity	37	37	—	—	$56,209.78	$102,863.90	$56,209.78	2025-03-13
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	84	83	—	—	$50,559.37	$120,780.72	$56,177.08	2025-03-13
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	84	83	—	—	$50,539.38	$120,732.97	$56,154.87	2025-03-13
1834	APR_DRG	Percutaneous Structural Cardiac Procedures - Extreme Severity	37	37	—	—	$56,009.88	$102,498.08	$56,009.88	2025-03-13
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	84	83	—	—	$50,359.39	$120,302.99	$55,954.88	2025-03-13
6114	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Major Anomaly - Extreme Severity	37	37	—	—	$55,568.63	$101,690.59	$55,568.63	2025-03-13
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	125	119	—	—	$31,806.02	$119,403.48	$55,536.50	2025-03-13
93	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo) - Major Severity	37	37	—	—	$55,056.44	$100,753.29	$55,056.44	2025-03-13
245	MS_DRG	Aicd Generator Procedures	84	83	—	—	$49,394.55	$117,998.08	$54,882.83	2025-03-13
471	MS_DRG	Cervical Spinal Fusion With Mcc	84	83	—	—	$49,099.58	$117,293.44	$54,555.09	2025-03-13
8634	APR_DRG	Neonatal Aftercare - Extreme Severity	37	37	—	—	$54,477.93	$99,694.61	$54,477.93	2025-03-13
1664	APR_DRG	Coronary Bypass Without Ami Or Complex Principal Diagnosis - Extreme Severity	37	37	—	—	$54,468.71	$99,677.74	$54,468.71	2025-03-13
6	MS_DRG	Liver Transplant Without Mcc	84	83	—	—	$49,018.61	$117,100.01	$54,465.12	2025-03-13
9104	APR_DRG	Craniotomy For Multiple Significant Trauma - Extreme Severity	37	37	—	—	$5,510.00	$98,470.71	$53,809.13	2025-03-13
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	84	83	—	—	$48,281.71	$115,339.63	$53,646.34	2025-03-13
J7330	HCPCS	Cultured Chondrocytes Implnt	2	1	—	—	$53,610.57	$53,610.57	$53,610.57	2025-03-13
1794	APR_DRG	Defibrillator Implants - Extreme Severity	37	37	—	—	$53,474.74	$97,858.77	$53,474.74	2025-03-13
799	MS_DRG	Splenic Procedures With Mcc	84	83	—	—	$48,074.73	$114,845.20	$53,416.37	2025-03-13
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	84	83	—	—	$48,065.74	$114,823.72	$53,406.38	2025-03-13
6804	APR_DRG	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms - Extreme …	37	37	—	—	$53,253.65	$97,454.18	$53,253.65	2025-03-13
1623	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis - Major Severit…	37	37	—	—	$53,185.48	$97,329.43	$53,185.48	2025-03-13
6124	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	37	37	—	—	$53,137.58	$97,241.77	$53,137.58	2025-03-13
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	86	84	—	—	$26,342.00	$113,648.59	$52,859.81	2025-03-13
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	84	83	—	—	$47,321.86	$113,046.66	$52,579.84	2025-03-13
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	84	83	—	—	$47,045.90	$112,387.42	$52,273.22	2025-03-13
33276	CPT	Insj Phrnc Nrv Stim Sys	85	84	—	—	$46,927.87	$112,105.47	$52,142.08	2025-03-13
0266T	CPT	Implt/rpl Crtd Sns Dev Total	93	87	—	—	$3,396.00	$112,105.47	$52,142.08	2025-03-13
6134	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection - Ex…	37	37	—	—	$52,134.39	$95,405.93	$52,134.39	2025-03-13
6033	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition - Maj…	37	37	—	—	$51,953.84	$95,075.53	$51,953.84	2025-03-13
163	MS_DRG	Major Chest Procedures With Mcc	84	83	—	—	$46,618.95	$111,367.48	$51,798.83	2025-03-13
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	84	83	—	—	$46,599.97	$111,322.14	$51,777.74	2025-03-13
11	APR_DRG	Liver Transplant And/or Intestinal Transplant - Minor Severity	37	37	—	—	$51,675.64	$94,566.42	$51,675.64	2025-03-13
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	92	88	—	—	$17,504.00	$117,724.00	$51,614.41	2025-03-13
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	84	83	—	—	$46,445.98	$110,954.28	$51,606.64	2025-03-13
1694	APR_DRG	Major Abdominal Vascular Procedures - Extreme Severity	37	37	—	—	$50,980.13	$93,293.64	$50,980.13	2025-03-13
61	APR_DRG	Pancreas Transplant - Minor Severity	37	37	—	—	$50,897.22	$93,141.91	$50,897.22	2025-03-13
9114	APR_DRG	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma - Ext…	37	37	—	—	$5,510.00	$93,028.97	$50,835.50	2025-03-13
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	84	83	—	—	$45,643.10	$109,036.30	$50,714.56	2025-03-13
3124	APR_DRG	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses - E…	37	37	—	—	$50,614.41	$92,624.37	$50,614.41	2025-03-13
71	APR_DRG	Allogeneic Bone Marrow Transplant - Minor Severity	37	37	—	—	$50,562.83	$92,529.98	$50,562.83	2025-03-13
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	84	83	—	—	$45,374.14	$108,393.78	$50,415.71	2025-03-13
8413	APR_DRG	Extensive Third Degree Burns With Skin Graft - Major Severity	37	37	—	—	$5,510.00	$92,216.41	$50,391.48	2025-03-13
914	APR_DRG	Other Major Head And Neck Procedures - Extreme Severity	37	37	—	—	$50,349.11	$92,138.87	$50,349.11	2025-03-13
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	84	83	—	—	$45,250.16	$108,097.59	$50,277.95	2025-03-13
901	MS_DRG	Wound Debridements For Injuries With Mcc	84	83	—	—	$44,832.22	$107,099.20	$49,813.58	2025-03-13
J3245	HCPCS	Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe	300	142	$103,639.82	$82,911.86	$119.86	$112,490.66	$49,488.01	2025-03-13
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	86	84	—	—	$44,455.28	$106,198.73	$49,394.76	2025-03-13
9124	APR_DRG	Musculoskeletal And Other Procedures For Multiple Significant Trauma - Extreme S…	37	37	—	—	$5,510.00	$90,385.64	$49,391.06	2025-03-13
J9118	HCPCS	Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution	179	142	$102,681.49	$82,145.19 20% off	$66.49	$111,450.49	$49,030.41	2025-03-13
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	109	99	—	—	$43,796.38	$104,624.68	$48,662.64	2025-03-13
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	84	83	—	—	$43,707.40	$104,412.13	$48,563.78	2025-03-13
1783	APR_DRG	External Heart Assist Systems - Major Severity	37	37	—	—	$48,557.37	$88,859.99	$48,557.37	2025-03-13
8504	APR_DRG	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	37	37	—	—	$48,359.32	$88,497.56	$48,359.32	2025-03-13
234	APR_DRG	Spinal Procedures - Extreme Severity	37	37	—	—	$48,235.87	$88,271.64	$48,235.87	2025-03-13
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	84	83	—	—	$43,184.48	$103,162.91	$47,982.75	2025-03-13
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	84	83	—	—	$43,121.48	$103,012.41	$47,912.75	2025-03-13
140	MS_DRG	Major Head And Neck Procedures With Mcc	84	83	—	—	$42,819.51	$102,291.04	$47,577.23	2025-03-13
214	APR_DRG	Open Craniotomy Except Trauma - Extreme Severity	37	37	—	—	$47,574.45	$87,061.24	$47,574.45	2025-03-13
4414	APR_DRG	Major Bladder Procedures - Extreme Severity	37	37	—	—	$47,566.16	$87,046.07	$47,566.16	2025-03-13
L7181	HCPCS	Electronic Elbo Simultaneous	85	84	—	—	$42,490.14	$101,504.23	$47,211.27	2025-03-13
31	MS_DRG	Ventricular Shunt Procedures With Mcc	84	83	—	—	$42,433.58	$101,369.10	$47,148.42	2025-03-13
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	84	83	—	—	$42,423.58	$101,345.22	$47,137.31	2025-03-13
6313	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure - Major Severity	37	37	—	—	$46,983.96	$85,980.65	$46,983.96	2025-03-13
2604	APR_DRG	Major Pancreas, Liver And Shunt Procedures - Extreme Severity	37	37	—	—	$46,969.22	$85,953.67	$46,969.22	2025-03-13
793	MS_DRG	Full Term Neonate With Major Problems	84	83	—	—	$42,232.61	$100,889.01	$46,925.12	2025-03-13
J9359	HCPCS	Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution	300	142	$98,237.40	$78,589.92 20% off	$185.67	$106,626.87	$46,908.36	2025-03-13
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	92	88	—	—	$17,504.00	$117,724.00	$46,816.24	2025-03-13
4403	APR_DRG	Kidney Transplant - Major Severity	37	37	—	—	$46,520.60	$85,132.70	$46,520.60	2025-03-13
7404	APR_DRG	Mental Illness Diagnosis With O.r. Procedure - Extreme Severity	37	37	—	—	$46,368.60	$84,854.54	$46,368.60	2025-03-13
6084	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition - Ext…	37	37	—	—	$46,299.51	$84,728.10	$46,299.51	2025-03-13
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	94	88	—	—	$17,504.00	$117,724.00	$46,276.32	2025-03-13
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	107	99	—	—	$41,625.68	$99,439.13	$46,250.76	2025-03-13
J9334	HCPCS	Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11,200 Unit/5.6 Ml Subcut Soln	262	142	$96,745.75	$77,396.60	$29.79	$105,007.84	$46,196.10	2025-03-13
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	84	83	—	—	$41,564.70	$99,293.45	$46,183.00	2025-03-13
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	84	83	—	—	$41,362.72	$98,810.95	$45,958.58	2025-03-13
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	84	83	—	—	$41,201.75	$98,426.40	$45,779.72	2025-03-13
791	MS_DRG	Prematurity With Major Problems	84	83	—	—	$41,126.78	$98,247.30	$45,696.42	2025-03-13
6814	APR_DRG	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms - Extreme…	37	37	—	—	$45,409.63	$83,099.62	$45,409.63	2025-03-13
J9266	HCPCS	Pegaspargase 750 Unit/ml Injection Solution	300	142	$94,908.03	$75,926.42 20% off	$1,284.65	$103,013.18	$45,318.58	2025-03-13
6302	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure - Moderate…	37	37	—	—	$45,313.83	$82,924.31	$45,313.83	2025-03-13
1782	APR_DRG	External Heart Assist Systems - Moderate Severity	37	37	—	—	$45,240.13	$82,789.44	$45,240.13	2025-03-13
G0340	HCPCS	Robt Lin-radsurg Fractx 2-5	15	9	—	—	$6,111.00	$67,772.00	$45,119.00	2025-03-13
G0339	HCPCS	Robot Lin-radsurg Com, First	15	9	—	—	$7,262.00	$67,772.00	$45,119.00	2025-03-13
2204	APR_DRG	Major Stomach, Esophageal And Duodenal Procedures - Extreme Severity	37	37	—	—	$45,063.26	$82,465.77	$45,063.26	2025-03-13
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	84	83	—	—	$40,364.87	$96,427.20	$44,849.86	2025-03-13
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	84	83	—	—	$40,336.88	$96,360.31	$44,818.75	2025-03-13
894	APR_DRG	Major Cranial Or Facial Bone Procedures - Extreme Severity	37	37	—	—	$44,757.42	$81,906.08	$44,757.42	2025-03-13
1653	APR_DRG	Coronary Bypass With Ami Or Complex Principal Diagnosis - Major Severity	37	37	—	—	$44,628.46	$81,670.08	$44,628.46	2025-03-13
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	84	83	—	—	$39,984.92	$95,519.53	$44,427.69	2025-03-13
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	84	83	—	—	$39,903.95	$95,326.10	$44,337.72	2025-03-13
9504	APR_DRG	Extensive O.r. Procedure Unrelated To Principal Diagnosis - Extreme Severity	37	37	—	—	$44,317.09	$81,100.27	$44,317.09	2025-03-13
876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	84	83	—	—	$39,823.96	$95,135.01	$44,248.84	2025-03-13
1603	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly - Major Severity	37	37	—	—	$44,227.73	$80,936.75	$44,227.73	2025-03-13
6083	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition - Maj…	37	37	—	—	$44,095.08	$80,694.00	$44,095.08	2025-03-13
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	84	83	—	—	$39,650.00	$94,719.43	$44,055.55	2025-03-13
6072	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	37	37	—	—	$44,049.02	$80,609.71	$44,049.02	2025-03-13
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	92	88	—	—	$17,504.00	$117,724.00	$44,034.44	2025-03-13
1633	APR_DRG	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis - Major Seve…	37	37	—	—	$43,989.14	$80,500.13	$43,989.14	2025-03-13
204	APR_DRG	Open Craniotomy For Trauma - Extreme Severity	37	37	—	—	$5,510.00	$80,321.45	$43,891.50	2025-03-13
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	92	88	—	—	$17,504.00	$117,724.00	$43,794.48	2025-03-13
1204	APR_DRG	Major Respiratory And Chest Procedures - Extreme Severity	37	37	—	—	$43,688.83	$79,950.56	$43,688.83	2025-03-13
6214	APR_DRG	Neonate Birth Weight 2000-2499 Grams With Major Anomaly - Extreme Severity	37	37	—	—	$43,594.87	$79,778.61	$43,594.87	2025-03-13
616	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	84	83	—	—	$39,178.05	$93,592.02	$43,531.17	2025-03-13
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	84	83	—	—	$39,139.06	$93,498.86	$43,487.84	2025-03-13
L7180	HCPCS	Electronic Elbow Sequential	123	119	—	—	$23,395.06	$93,497.29	$43,487.11	2025-03-13
6904	APR_DRG	Acute Leukemia - Extreme Severity	37	37	—	—	$43,466.82	$79,544.28	$43,466.82	2025-03-13
7594	APR_DRG	Eating Disorders - Extreme Severity	37	37	—	—	$43,388.52	$79,400.99	$43,388.52	2025-03-13
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	84	83	—	—	$39,031.08	$93,240.92	$43,367.87	2025-03-13
52	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure - Moderate Severity	37	37	—	—	$43,342.46	$79,316.70	$43,342.46	2025-03-13
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	84	83	—	—	$38,752.12	$92,574.51	$43,057.91	2025-03-13
3614	APR_DRG	Skin Graft For Skin And Subcutaneous Tissue Diagnoses - Extreme Severity	37	37	—	—	$42,863.44	$78,440.10	$42,863.44	2025-03-13
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	84	83	—	—	$38,545.15	$92,080.07	$42,827.94	2025-03-13
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	84	83	—	—	$38,249.19	$91,373.07	$42,499.10	2025-03-13
622	MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	84	83	—	—	$37,948.24	$90,654.13	$42,164.71	2025-03-13
1814	APR_DRG	Lower Extremity Arterial Procedures - Extreme Severity	37	37	—	—	$42,151.35	$77,136.97	$42,151.35	2025-03-13
1622	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis - Moderate Seve…	37	37	—	—	$42,151.35	$77,136.97	$42,151.35	2025-03-13
274	APR_DRG	Other Open Craniotomy - Extreme Severity	37	37	—	—	$41,933.95	$76,739.13	$41,933.95	2025-03-13
6144	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition…	37	37	—	—	$41,896.18	$76,670.01	$41,896.18	2025-03-13
1304	APR_DRG	Respiratory System Diagnosis With Ventilator Support > 96 Hours - Extreme Severi…	37	37	—	—	$41,460.45	$75,872.62	$41,460.45	2025-03-13
1764	APR_DRG	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices - Ex…	37	37	—	—	$41,409.78	$75,779.90	$41,409.78	2025-03-13
2614	APR_DRG	Major Biliary Tract Procedures - Extreme Severity	37	37	—	—	$41,285.42	$75,552.32	$41,285.42	2025-03-13
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	84	83	—	—	$37,015.36	$88,425.59	$41,128.18	2025-03-13
6954	APR_DRG	Chemotherapy For Acute Leukemia - Extreme Severity	37	37	—	—	$40,908.65	$74,862.83	$40,908.65	2025-03-13
335	MS_DRG	Peritoneal Adhesiolysis With Mcc	84	83	—	—	$36,762.42	$87,821.33	$40,847.13	2025-03-13
3032	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back - Moderate Severity	37	37	—	—	$40,838.64	$74,734.71	$40,838.64	2025-03-13
0620T	CPT	Evasc Ven Artlz Tibl/prnl Vn	95	88	—	—	$3,858.00	$87,193.42	$40,555.08	2025-03-13
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	84	83	—	—	$36,376.47	$86,899.35	$40,418.30	2025-03-13
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	84	83	—	—	$36,374.45	$86,894.51	$40,416.05	2025-03-13
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	84	83	—	—	$36,368.48	$86,880.25	$40,409.42	2025-03-13
2304	APR_DRG	Major Small Bowel Procedures - Extreme Severity	37	37	—	—	$40,389.09	$73,912.03	$40,389.09	2025-03-13
5104	APR_DRG	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	37	37	—	—	$40,374.35	$73,885.06	$40,374.35	2025-03-13
1781	APR_DRG	External Heart Assist Systems - Minor Severity	37	37	—	—	$40,350.40	$73,841.23	$40,350.40	2025-03-13
265	MS_DRG	Aicd Lead Procedures	84	83	—	—	$36,200.51	$86,479.00	$40,222.79	2025-03-13
92	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo) - Moderate Severity	37	37	—	—	$40,156.03	$73,485.53	$40,156.03	2025-03-13

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