Hospital

SAN LUIS VALLEY REGIONAL MEDICAL CENTER

Alamosa, CO · CCN 060008 · Rates published

16,701 distinct procedures filed

29 distinct payers

151,439 rate rows

2026-03-26 last MRF observed

Data quality

117,949 of 151,439 rate rows are consumer-grade (77.9%)

33,490 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	17,641
professional (physician) fee — not the facility price	15,669
percent-of-charges filed in the dollar field — excluded from medians	155
exceeds 10× this hospital's gross charge — excluded from medians	9
placeholder amount (≤ $0.02) — excluded from medians	9
per-diem day rate — not a per-procedure price	7

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

Source MRF file	https://sanluis.pt.panaceainc.com/MRFDownload/sanluis/slvhealth
Found on page	https://www.sanluisvalleyhealth.org/patient-center/price-transparency/
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	883fcc7b688f88d7… · 45,485,537 bytes · first seen 2026-05-08

Top 50 most expensive offerings

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

Code	Description	Payers	Min $	Max $	Avg median	vs national
J3391 HCPCS	Inj, Atidarsagene Autotemcel	3	$4,505,000.00	$4,505,000.00	$4,505,000.00	nat. median $4,505,000 1.0× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	3	$3,672,900.00	$3,685,266.66	$3,685,266.66	nat. median $3,710,000 1.0× median
J1414 HCPCS	Inj, Beqvez, Per Tx Dose	1	$3,605,000.00	$3,605,000.00	$3,605,000.00	nat. median $3,710,000 1.0× median
J3389 HCPCS	Topi Adm Prad Zami Per Treat	3	$3,335,820.00	$3,335,820.00	$3,335,820.00	nat. median $3,335,820 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	3	$3,325,454.76	$3,327,859.72	$3,327,859.72	nat. median $3,325,455 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	3	$3,252,508.07	$3,286,000.00	$3,252,508.07	nat. median $3,286,000 1.0× median
J3387 HCPCS	Inj Elivaldogene Autotemecel	3	$3,180,000.00	$3,180,000.00	$3,180,000.00	nat. median $3,180,000 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	3	$2,939,968.88	$2,968,000.00	$2,939,968.88	nat. median $3,004,655 1.0× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	3	$2,388,614.23	$2,588,981.22	$2,588,981.22	nat. median $2,468,984 1.0× median
J3392 HCPCS	Inj, Exagamglogene Autotem	3	$2,332,000.00	$2,332,000.00	$2,332,000.00	nat. median $2,448,600 1.0× median
Q2057 HCPCS	Afamitresgene Autoleucel	4	$770,620.00	$1,733,895.00	$770,620.00	nat. median $824,563 0.9× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	4	$527,123.43	$1,322,211.53	$587,649.57	nat. median $674,867 0.9× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	4	$529,192.86	$1,274,695.43	$566,531.30	nat. median $753,246 0.8× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	4	$516,726.08	$1,264,952.79	$562,201.24	nat. median $673,137 0.8× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	4	$526,587.59	$1,255,683.87	$558,081.72	nat. median $625,184 0.9× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	4	$489,455.96	$1,197,432.54	$532,192.24	nat. median $634,303 0.8× median
Q2053 HCPCS	Brexucabtagene Car Pos T	4	$460,530.40	$1,101,262.95	$489,450.20	nat. median $619,808 0.8× median
Q2058 HCPCS	Obecbtge Autol Up To 400 Mil	4	$278,250.00	$626,062.50	$278,250.00	nat. median $324,450 0.9× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell Immunotherapy	5	$277,685.70	$577,138.12	$277,685.70	nat. median $370,174 0.8× median
J3403 HCPCS	Revakinagene, Per Implant	4	$265,000.00	$596,250.00	$265,000.00	nat. median $265,000 1.0× median
5834 APR_DRG		1	$253,716.23	$253,716.23	$253,716.23	nat. median $309,665 0.8× median
5884 APR_DRG		1	$228,192.00	$228,192.00	$228,192.00	nat. median $246,434 0.9× median
J3402 HCPCS	Inj. Remestemcel-l-rknd/ Td	4	$201,669.02	$453,755.30	$201,669.02	nat. median $209,753 1.0× median
0024 APR_DRG		1	$198,769.68	$198,769.68	$198,769.68	nat. median $372,987 0.5× median
1614 APR_DRG		1	$198,260.43	$198,260.43	$198,260.43	nat. median $207,730 1.0× median
0034 APR_DRG		1	$187,385.58	$187,385.58	$187,385.58	nat. median $267,508 0.7× median
5833 APR_DRG		1	$182,467.35	$182,467.35	$182,467.35	nat. median $244,017 0.7× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	5	$180,206.85	$374,539.42	$180,206.85	nat. median $265,286 0.7× median
0044 APR_DRG		1	$168,845.58	$168,845.58	$168,845.58	nat. median $195,681 0.9× median
8414 APR_DRG		1	$167,275.56	$167,275.56	$167,275.56	nat. median $160,267 1.0× median
5832 APR_DRG		1	$165,878.87	$165,878.87	$165,878.87	nat. median $156,126 1.1× median
0014 APR_DRG		1	$161,556.13	$161,556.13	$161,556.13	nat. median $190,591 0.8× median
5883 APR_DRG		1	$150,510.43	$150,510.43	$150,510.43	nat. median $182,665 0.8× median
5914 APR_DRG		1	$139,327.87	$139,327.87	$139,327.87	nat. median $164,289 0.8× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	5	$137,293.75	$285,349.43	$137,293.75	nat. median $206,474 0.7× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	5	$136,488.01	$283,674.80	$136,488.01	nat. median $202,976 0.7× median
5934 APR_DRG		1	$128,972.21	$128,972.21	$128,972.21	nat. median $151,838 0.8× median
6094 APR_DRG		1	$125,475.53	$125,475.53	$125,475.53	nat. median $162,982 0.8× median
0064 APR_DRG		1	$124,219.86	$124,219.86	$124,219.86	nat. median $98,565 1.3× median
9104 APR_DRG		1	$123,646.74	$123,646.74	$123,646.74	nat. median $57,769 outlier · 2.1×
0023 APR_DRG		1	$121,808.84	$121,808.84	$121,808.84	nat. median $167,082 0.7× median
5891 APR_DRG		1	$121,613.94	$121,613.94	$121,613.94	nat. median $93,370 1.3× median
0054 APR_DRG		1	$118,907.66	$118,907.66	$118,907.66	nat. median $149,310 0.8× median
6304 APR_DRG		1	$118,036.80	$118,036.80	$118,036.80	nat. median $150,721 0.8× median
5892 APR_DRG		1	$110,559.10	$110,559.10	$110,559.10	nat. median $89,796 1.2× median
6024 APR_DRG		1	$110,306.97	$110,306.97	$110,306.97	nat. median $118,620 0.9× median
5831 APR_DRG		1	$105,049.52	$105,049.52	$105,049.52	nat. median $144,745 0.7× median
9114 APR_DRG		1	$103,389.93	$103,389.93	$103,389.93	nat. median $52,039 2.0× median
6314 APR_DRG		1	$101,451.66	$101,451.66	$101,451.66	nat. median $122,924 0.8× median
4404 APR_DRG		1	$101,014.57	$101,014.57	$101,014.57	nat. median $79,034 1.3× median

Other procedures at this hospital

Browse this hospital's 16,701 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

0011	APR_DRG	—	1	1	—	—	$62,430.90	$62,430.90	$62,430.90	2026-03-26
0012	APR_DRG	—	1	1	—	—	$68,337.76	$68,337.76	$68,337.76	2026-03-26
0013	APR_DRG	—	1	1	—	—	$85,160.11	$85,160.11	$85,160.11	2026-03-26
0014	APR_DRG	—	1	1	—	—	$161,556.13	$161,556.13	$161,556.13	2026-03-26
0021	APR_DRG	—	1	1	—	—	$84,795.19	$84,795.19	$84,795.19	2026-03-26
0022	APR_DRG	—	1	1	—	—	$94,429.29	$94,429.29	$94,429.29	2026-03-26
0023	APR_DRG	—	1	1	—	—	$121,808.84	$121,808.84	$121,808.84	2026-03-26
0024	APR_DRG	—	1	1	—	—	$198,769.68	$198,769.68	$198,769.68	2026-03-26
0031	APR_DRG	—	1	1	—	—	$43,185.92	$43,185.92	$43,185.92	2026-03-26
0032	APR_DRG	—	1	1	—	—	$60,043.11	$60,043.11	$60,043.11	2026-03-26
0033	APR_DRG	—	1	1	—	—	$98,722.17	$98,722.17	$98,722.17	2026-03-26
0034	APR_DRG	—	1	1	—	—	$187,385.58	$187,385.58	$187,385.58	2026-03-26
0041	APR_DRG	—	1	1	—	—	$61,676.99	$61,676.99	$61,676.99	2026-03-26
0042	APR_DRG	—	1	1	—	—	$68,530.17	$68,530.17	$68,530.17	2026-03-26
0043	APR_DRG	—	1	1	—	—	$93,819.68	$93,819.68	$93,819.68	2026-03-26
0044	APR_DRG	—	1	1	—	—	$168,845.58	$168,845.58	$168,845.58	2026-03-26
0051	APR_DRG	—	1	1	—	—	$45,475.84	$45,475.84	$45,475.84	2026-03-26
0052	APR_DRG	—	1	1	—	—	$50,529.27	$50,529.27	$50,529.27	2026-03-26
0053	APR_DRG	—	1	1	—	—	$65,516.20	$65,516.20	$65,516.20	2026-03-26
0054	APR_DRG	—	1	1	—	—	$118,907.66	$118,907.66	$118,907.66	2026-03-26
0061	APR_DRG	—	1	1	—	—	$59,346.43	$59,346.43	$59,346.43	2026-03-26
0062	APR_DRG	—	1	1	—	—	$77,737.14	$77,737.14	$77,737.14	2026-03-26
0063	APR_DRG	—	1	1	—	—	$80,124.11	$80,124.11	$80,124.11	2026-03-26
0064	APR_DRG	—	1	1	—	—	$124,219.86	$124,219.86	$124,219.86	2026-03-26
0204	APR_DRG	—	1	1	—	—	$64,564.90	$64,564.90	$64,564.90	2026-03-26
0213	APR_DRG	—	1	1	—	—	$37,544.46	$37,544.46	$37,544.46	2026-03-26
0214	APR_DRG	—	1	1	—	—	$74,187.39	$74,187.39	$74,187.39	2026-03-26
0224	APR_DRG	—	1	1	—	—	$67,432.91	$67,432.91	$67,432.91	2026-03-26
0233	APR_DRG	—	1	1	—	—	$38,254.41	$38,254.41	$38,254.41	2026-03-26
0234	APR_DRG	—	1	1	—	—	$66,017.15	$66,017.15	$66,017.15	2026-03-26
0244	APR_DRG	—	1	1	—	—	$57,156.85	$57,156.85	$57,156.85	2026-03-26
0264	APR_DRG	—	1	1	—	—	$54,868.59	$54,868.59	$54,868.59	2026-03-26
0266T	HCPCS	Implt/rpl Crtd Sns Dev Total	1	1	—	—	$45,224.60	$45,224.60	$45,224.60	2026-03-26
0494	APR_DRG	—	1	1	—	—	$41,566.14	$41,566.14	$41,566.14	2026-03-26
0504	APR_DRG	—	1	1	—	—	$43,120.39	$43,120.39	$43,120.39	2026-03-26
0620T	HCPCS	Evasc Ven Artlz Tibl/prnl Vn	5	4	—	—	$35,174.80	$104,543.81	$46,463.92	2026-03-26
0704	APR_DRG	—	1	1	—	—	$39,917.33	$39,917.33	$39,917.33	2026-03-26
0870T	HCPCS	Imp Subq Prtl Ascts Pmp Sys	4	4	—	—	$36,138.72	$81,312.11	$36,138.72	2026-03-26
0894	APR_DRG	—	1	1	—	—	$63,070.35	$63,070.35	$63,070.35	2026-03-26
0904	APR_DRG	—	1	1	—	—	$67,643.56	$67,643.56	$67,643.56	2026-03-26
0913	APR_DRG	—	1	1	—	—	$36,051.57	$36,051.57	$36,051.57	2026-03-26
0914	APR_DRG	—	1	1	—	—	$58,679.60	$58,679.60	$58,679.60	2026-03-26
0924	APR_DRG	—	1	1	—	—	$51,207.70	$51,207.70	$51,207.70	2026-03-26
0974	APR_DRG	—	1	1	—	—	$37,893.64	$37,893.64	$37,893.64	2026-03-26
0984	APR_DRG	—	1	1	—	—	$35,951.22	$35,951.22	$35,951.22	2026-03-26
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	5	5	—	—	$180,206.85	$374,539.42	$180,206.85	2026-03-26
10	MS_DRG	Pancreas Transplant	5	5	—	—	$46,143.12	$95,903.23	$46,143.12	2026-03-26
1204	APR_DRG	—	1	1	—	—	$55,864.67	$55,864.67	$55,864.67	2026-03-26
1214	APR_DRG	—	1	1	—	—	$51,840.51	$51,840.51	$51,840.51	2026-03-26
1302	APR_DRG	—	1	1	—	—	$38,187.23	$38,187.23	$38,187.23	2026-03-26
1303	APR_DRG	—	1	1	—	—	$44,156.30	$44,156.30	$44,156.30	2026-03-26
1304	APR_DRG	—	1	1	—	—	$55,789.21	$55,789.21	$55,789.21	2026-03-26
14	MS_DRG	Allogeneic Bone Marrow Transplant	5	5	—	—	$77,280.75	$160,619.23	$77,280.75	2026-03-26
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	5	5	—	—	$38,130.76	$79,250.44	$38,130.76	2026-03-26
1602	APR_DRG	—	1	1	—	—	$36,783.09	$36,783.09	$36,783.09	2026-03-26
1603	APR_DRG	—	1	1	—	—	$48,138.99	$48,138.99	$48,138.99	2026-03-26
1604	APR_DRG	—	1	1	—	—	$97,232.59	$97,232.59	$97,232.59	2026-03-26
1612	APR_DRG	—	1	1	—	—	$37,191.97	$37,191.97	$37,191.97	2026-03-26
1613	APR_DRG	—	1	1	—	—	$65,761.70	$65,761.70	$65,761.70	2026-03-26
1614	APR_DRG	—	1	1	—	—	$198,260.43	$198,260.43	$198,260.43	2026-03-26
1621	APR_DRG	—	1	1	—	—	$38,342.32	$38,342.32	$38,342.32	2026-03-26
1622	APR_DRG	—	1	1	—	—	$44,393.49	$44,393.49	$44,393.49	2026-03-26
1623	APR_DRG	—	1	1	—	—	$52,951.06	$52,951.06	$52,951.06	2026-03-26
1624	APR_DRG	—	1	1	—	—	$95,991.83	$95,991.83	$95,991.83	2026-03-26
1633	APR_DRG	—	1	1	—	—	$39,877.52	$39,877.52	$39,877.52	2026-03-26
1634	APR_DRG	—	1	1	—	—	$89,330.24	$89,330.24	$89,330.24	2026-03-26
1652	APR_DRG	—	1	1	—	—	$36,457.98	$36,457.98	$36,457.98	2026-03-26
1653	APR_DRG	—	1	1	—	—	$42,402.99	$42,402.99	$42,402.99	2026-03-26
1654	APR_DRG	—	1	1	—	—	$53,263.74	$53,263.74	$53,263.74	2026-03-26
1663	APR_DRG	—	1	1	—	—	$36,083.10	$36,083.10	$36,083.10	2026-03-26
1664	APR_DRG	—	1	1	—	—	$63,036.35	$63,036.35	$63,036.35	2026-03-26
1674	APR_DRG	—	1	1	—	—	$73,829.92	$73,829.92	$73,829.92	2026-03-26
1694	APR_DRG	—	1	1	—	—	$67,135.15	$67,135.15	$67,135.15	2026-03-26
1704	APR_DRG	—	1	1	—	—	$44,340.41	$44,340.41	$44,340.41	2026-03-26
1714	APR_DRG	—	1	1	—	—	$40,621.47	$40,621.47	$40,621.47	2026-03-26
1734	APR_DRG	—	1	1	—	—	$47,138.75	$47,138.75	$47,138.75	2026-03-26
1754	APR_DRG	—	1	1	—	—	$41,437.58	$41,437.58	$41,437.58	2026-03-26
1764	APR_DRG	—	1	1	—	—	$47,793.13	$47,793.13	$47,793.13	2026-03-26
1774	APR_DRG	—	1	1	—	—	$43,625.49	$43,625.49	$43,625.49	2026-03-26
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell Immunotherapy	5	5	—	—	$277,685.70	$577,138.12	$277,685.70	2026-03-26
1804	APR_DRG	—	1	1	—	—	$42,840.90	$42,840.90	$42,840.90	2026-03-26
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	5	5	—	—	$45,878.83	$95,353.93	$45,878.83	2026-03-26
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	5	5	—	—	$72,868.80	$151,449.51	$72,868.80	2026-03-26
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	5	5	—	—	$50,600.08	$105,166.51	$50,600.08	2026-03-26
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	5	5	—	—	$41,378.15	$85,999.77	$41,378.15	2026-03-26
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	5	5	—	—	$69,925.57	$145,332.35	$69,925.57	2026-03-26
215	MS_DRG	Other Heart Assist System Implant	5	5	—	—	$64,028.19	$133,075.31	$64,028.19	2026-03-26
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	5	5	—	—	$62,908.00	$130,747.12	$62,908.00	2026-03-26
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	5	5	—	—	$42,282.27	$87,878.88	$42,282.27	2026-03-26
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	5	5	—	—	$42,282.27	$87,878.88	$42,282.27	2026-03-26
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	5	5	—	—	$49,375.08	$102,620.48	$49,375.08	2026-03-26
2204	APR_DRG	—	1	1	—	—	$62,155.54	$62,155.54	$62,155.54	2026-03-26
2214	APR_DRG	—	1	1	—	—	$49,570.50	$49,570.50	$49,570.50	2026-03-26
2224	APR_DRG	—	1	1	—	—	$46,923.11	$46,923.11	$46,923.11	2026-03-26
2234	APR_DRG	—	1	1	—	—	$49,121.80	$49,121.80	$49,121.80	2026-03-26
2244	APR_DRG	—	1	1	—	—	$42,595.40	$42,595.40	$42,595.40	2026-03-26
2274	APR_DRG	—	1	1	—	—	$42,194.80	$42,194.80	$42,194.80	2026-03-26
2294	APR_DRG	—	1	1	—	—	$48,371.22	$48,371.22	$48,371.22	2026-03-26
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	5	5	—	—	$36,848.52	$76,585.46	$36,848.52	2026-03-26
231	MS_DRG	Coronary Bypass With Ptca With Mcc	5	5	—	—	$54,208.22	$112,665.61	$54,208.22	2026-03-26
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	5	5	—	—	$38,985.37	$81,026.65	$38,985.37	2026-03-26
233	MS_DRG	Coronary Bypass With Cardiac Catheterization With Mcc	5	5	—	—	$49,162.23	$102,178.10	$49,162.23	2026-03-26
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	5	5	—	—	$37,737.86	$78,433.84	$37,737.86	2026-03-26
2604	APR_DRG	—	1	1	—	—	$71,128.62	$71,128.62	$71,128.62	2026-03-26
2614	APR_DRG	—	1	1	—	—	$50,836.96	$50,836.96	$50,836.96	2026-03-26
2624	APR_DRG	—	1	1	—	—	$45,528.09	$45,528.09	$45,528.09	2026-03-26
2644	APR_DRG	—	1	1	—	—	$58,126.41	$58,126.41	$58,126.41	2026-03-26
266	MS_DRG	Endovascular Cardiac Valve Replacement W Mcc	5	5	—	—	$39,408.49	$81,906.07	$39,408.49	2026-03-26
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	5	5	—	—	$44,228.13	$91,923.13	$44,228.13	2026-03-26
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	5	5	—	—	$45,851.82	$95,297.80	$45,851.82	2026-03-26
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	5	5	—	—	$38,625.26	$80,278.21	$38,625.26	2026-03-26
28	MS_DRG	Spinal Procedures With Mcc	5	5	—	—	$38,636.19	$80,300.93	$38,636.19	2026-03-26
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	5	5	—	—	$136,488.01	$283,674.80	$136,488.01	2026-03-26
3014	APR_DRG	—	1	1	—	—	$37,100.74	$37,100.74	$37,100.74	2026-03-26
3024	APR_DRG	—	1	1	—	—	$36,139.49	$36,139.49	$36,139.49	2026-03-26
3031	APR_DRG	—	1	1	—	—	$39,777.99	$39,777.99	$39,777.99	2026-03-26
3032	APR_DRG	—	1	1	—	—	$43,235.68	$43,235.68	$43,235.68	2026-03-26
3033	APR_DRG	—	1	1	—	—	$49,811.85	$49,811.85	$49,811.85	2026-03-26
3034	APR_DRG	—	1	1	—	—	$98,790.18	$98,790.18	$98,790.18	2026-03-26
3044	APR_DRG	—	1	1	—	—	$82,629.67	$82,629.67	$82,629.67	2026-03-26
3054	APR_DRG	—	1	1	—	—	$45,010.55	$45,010.55	$45,010.55	2026-03-26
3094	APR_DRG	—	1	1	—	—	$44,149.66	$44,149.66	$44,149.66	2026-03-26
3104	APR_DRG	—	1	1	—	—	$42,736.40	$42,736.40	$42,736.40	2026-03-26
3123	APR_DRG	—	1	1	—	—	$38,588.66	$38,588.66	$38,588.66	2026-03-26
3124	APR_DRG	—	1	1	—	—	$85,588.07	$85,588.07	$85,588.07	2026-03-26
3134	APR_DRG	—	1	1	—	—	$45,189.71	$45,189.71	$45,189.71	2026-03-26
3154	APR_DRG	—	1	1	—	—	$44,303.92	$44,303.92	$44,303.92	2026-03-26
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	4	4	—	—	$42,997.34	$89,365.07	$42,997.34	2026-03-26
3174	APR_DRG	—	1	1	—	—	$47,448.94	$47,448.94	$47,448.94	2026-03-26
3204	APR_DRG	—	1	1	—	—	$42,494.22	$42,494.22	$42,494.22	2026-03-26
3214	APR_DRG	—	1	1	—	—	$67,519.98	$67,519.98	$67,519.98	2026-03-26
33276	HCPCS	Insj Phrnc Nrv Stim Sys	5	4	—	—	$45,224.60	$104,543.81	$46,463.92	2026-03-26
3464	APR_DRG	—	1	1	—	—	$37,636.53	$37,636.53	$37,636.53	2026-03-26
3614	APR_DRG	—	1	1	—	—	$53,124.40	$53,124.40	$53,124.40	2026-03-26
3624	APR_DRG	—	1	1	—	—	$45,845.74	$45,845.74	$45,845.74	2026-03-26
3634	APR_DRG	—	1	1	—	—	$40,332.02	$40,332.02	$40,332.02	2026-03-26
3644	APR_DRG	—	1	1	—	—	$36,382.50	$36,382.50	$36,382.50	2026-03-26
3814	APR_DRG	—	1	1	—	—	$38,334.03	$38,334.03	$38,334.03	2026-03-26
38240	HCPCS	Transplt Allo Hct/donor	6	5	—	—	$220.45	$149,295.08	$66,353.37	2026-03-26
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	5	5	—	—	$89,071.01	$185,123.96	$89,071.01	2026-03-26
4014	APR_DRG	—	1	1	—	—	$71,401.49	$71,401.49	$71,401.49	2026-03-26
4034	APR_DRG	—	1	1	—	—	$62,178.76	$62,178.76	$62,178.76	2026-03-26
4044	APR_DRG	—	1	1	—	—	$42,576.33	$42,576.33	$42,576.33	2026-03-26
4054	APR_DRG	—	1	1	—	—	$53,035.65	$53,035.65	$53,035.65	2026-03-26
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	4	4	—	—	$70,871.50	$147,298.34	$70,871.50	2026-03-26
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	4	4	—	—	$46,418.99	$96,476.59	$46,418.99	2026-03-26
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	4	4	—	—	$36,152.10	$75,138.03	$36,152.10	2026-03-26
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	4	4	—	—	$57,935.96	$120,413.30	$57,935.96	2026-03-26
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	4	4	—	—	$37,085.16	$77,077.29	$37,085.16	2026-03-26
4401	APR_DRG	—	1	1	—	—	$44,095.75	$44,095.75	$44,095.75	2026-03-26
4402	APR_DRG	—	1	1	—	—	$48,856.41	$48,856.41	$48,856.41	2026-03-26
4403	APR_DRG	—	1	1	—	—	$58,222.61	$58,222.61	$58,222.61	2026-03-26
4404	APR_DRG	—	1	1	—	—	$101,014.57	$101,014.57	$101,014.57	2026-03-26
4414	APR_DRG	—	1	1	—	—	$58,312.18	$58,312.18	$58,312.18	2026-03-26
4424	APR_DRG	—	1	1	—	—	$52,158.17	$52,158.17	$52,158.17	2026-03-26
4434	APR_DRG	—	1	1	—	—	$43,835.32	$43,835.32	$43,835.32	2026-03-26
4444	APR_DRG	—	1	1	—	—	$39,498.49	$39,498.49	$39,498.49	2026-03-26
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	4	4	—	—	$42,965.83	$89,299.58	$42,965.83	2026-03-26
4474	APR_DRG	—	1	1	—	—	$50,292.06	$50,292.06	$50,292.06	2026-03-26
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	5	5	—	—	$54,037.81	$112,311.44	$54,037.81	2026-03-26
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	5	5	—	—	$38,345.54	$79,696.83	$38,345.54	2026-03-26
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	5	5	—	—	$36,650.46	$76,173.82	$36,650.46	2026-03-26
4804	APR_DRG	—	1	1	—	—	$44,191.13	$44,191.13	$44,191.13	2026-03-26
4814	APR_DRG	—	1	1	—	—	$44,336.27	$44,336.27	$44,336.27	2026-03-26
4834	APR_DRG	—	1	1	—	—	$48,004.62	$48,004.62	$48,004.62	2026-03-26
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	5	5	—	—	$66,301.36	$137,799.83	$66,301.36	2026-03-26
5104	APR_DRG	—	1	1	—	—	$59,081.86	$59,081.86	$59,081.86	2026-03-26
5114	APR_DRG	—	1	1	—	—	$46,987.80	$46,987.80	$46,987.80	2026-03-26
5124	APR_DRG	—	1	1	—	—	$45,796.81	$45,796.81	$45,796.81	2026-03-26
5134	APR_DRG	—	1	1	—	—	$41,018.74	$41,018.74	$41,018.74	2026-03-26
5144	APR_DRG	—	1	1	—	—	$46,455.34	$46,455.34	$46,455.34	2026-03-26
5184	APR_DRG	—	1	1	—	—	$46,142.66	$46,142.66	$46,142.66	2026-03-26
5194	APR_DRG	—	1	1	—	—	$42,316.72	$42,316.72	$42,316.72	2026-03-26
5424	APR_DRG	—	1	1	—	—	$38,087.71	$38,087.71	$38,087.71	2026-03-26
5464	APR_DRG	—	1	1	—	—	$41,644.92	$41,644.92	$41,644.92	2026-03-26
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	5	5	—	—	$42,128.58	$87,559.46	$42,128.58	2026-03-26
5831	APR_DRG	—	1	1	—	—	$105,049.52	$105,049.52	$105,049.52	2026-03-26
5832	APR_DRG	—	1	1	—	—	$165,878.87	$165,878.87	$165,878.87	2026-03-26
5833	APR_DRG	—	1	1	—	—	$182,467.35	$182,467.35	$182,467.35	2026-03-26
5834	APR_DRG	—	1	1	—	—	$253,716.23	$253,716.23	$253,716.23	2026-03-26
5881	APR_DRG	—	1	1	—	—	$50,986.26	$50,986.26	$50,986.26	2026-03-26
5882	APR_DRG	—	1	1	—	—	$73,761.91	$73,761.91	$73,761.91	2026-03-26
5883	APR_DRG	—	1	1	—	—	$150,510.43	$150,510.43	$150,510.43	2026-03-26
5884	APR_DRG	—	1	1	—	—	$228,192.00	$228,192.00	$228,192.00	2026-03-26
5891	APR_DRG	—	1	1	—	—	$121,613.94	$121,613.94	$121,613.94	2026-03-26
5892	APR_DRG	—	1	1	—	—	$110,559.10	$110,559.10	$110,559.10	2026-03-26
5893	APR_DRG	—	1	1	—	—	$100,508.65	$100,508.65	$100,508.65	2026-03-26
5912	APR_DRG	—	1	1	—	—	$58,635.64	$58,635.64	$58,635.64	2026-03-26
5913	APR_DRG	—	1	1	—	—	$92,981.18	$92,981.18	$92,981.18	2026-03-26
5914	APR_DRG	—	1	1	—	—	$139,327.87	$139,327.87	$139,327.87	2026-03-26
5932	APR_DRG	—	1	1	—	—	$54,676.17	$54,676.17	$54,676.17	2026-03-26
5933	APR_DRG	—	1	1	—	—	$87,207.85	$87,207.85	$87,207.85	2026-03-26
5934	APR_DRG	—	1	1	—	—	$128,972.21	$128,972.21	$128,972.21	2026-03-26
6022	APR_DRG	—	1	1	—	—	$61,831.26	$61,831.26	$61,831.26	2026-03-26
6023	APR_DRG	—	1	1	—	—	$81,722.32	$81,722.32	$81,722.32	2026-03-26
6024	APR_DRG	—	1	1	—	—	$110,306.97	$110,306.97	$110,306.97	2026-03-26
6032	APR_DRG	—	1	1	—	—	$44,788.29	$44,788.29	$44,788.29	2026-03-26
6033	APR_DRG	—	1	1	—	—	$69,078.39	$69,078.39	$69,078.39	2026-03-26
6034	APR_DRG	—	1	1	—	—	$74,514.99	$74,514.99	$74,514.99	2026-03-26
6072	APR_DRG	—	1	1	—	—	$50,012.56	$50,012.56	$50,012.56	2026-03-26
6073	APR_DRG	—	1	1	—	—	$65,176.97	$65,176.97	$65,176.97	2026-03-26
6074	APR_DRG	—	1	1	—	—	$83,740.20	$83,740.20	$83,740.20	2026-03-26
6082	APR_DRG	—	1	1	—	—	$37,965.79	$37,965.79	$37,965.79	2026-03-26
6083	APR_DRG	—	1	1	—	—	$55,488.15	$55,488.15	$55,488.15	2026-03-26
6084	APR_DRG	—	1	1	—	—	$63,640.13	$63,640.13	$63,640.13	2026-03-26
6092	APR_DRG	—	1	1	—	—	$40,684.50	$40,684.50	$40,684.50	2026-03-26
6093	APR_DRG	—	1	1	—	—	$69,128.99	$69,128.99	$69,128.99	2026-03-26
6094	APR_DRG	—	1	1	—	—	$125,475.53	$125,475.53	$125,475.53	2026-03-26
6113	APR_DRG	—	1	1	—	—	$42,714.82	$42,714.82	$42,714.82	2026-03-26
6114	APR_DRG	—	1	1	—	—	$55,232.69	$55,232.69	$55,232.69	2026-03-26
6123	APR_DRG	—	1	1	—	—	$49,294.32	$49,294.32	$49,294.32	2026-03-26
6124	APR_DRG	—	1	1	—	—	$65,612.40	$65,612.40	$65,612.40	2026-03-26
6133	APR_DRG	—	1	1	—	—	$39,602.99	$39,602.99	$39,602.99	2026-03-26
6134	APR_DRG	—	1	1	—	—	$51,425.83	$51,425.83	$51,425.83	2026-03-26
6143	APR_DRG	—	1	1	—	—	$38,339.84	$38,339.84	$38,339.84	2026-03-26
6144	APR_DRG	—	1	1	—	—	$53,505.91	$53,505.91	$53,505.91	2026-03-26
6214	APR_DRG	—	1	1	—	—	$40,127.98	$40,127.98	$40,127.98	2026-03-26
6224	APR_DRG	—	1	1	—	—	$49,714.82	$49,714.82	$49,714.82	2026-03-26
6234	APR_DRG	—	1	1	—	—	$41,002.98	$41,002.98	$41,002.98	2026-03-26
6303	APR_DRG	—	1	1	—	—	$55,030.32	$55,030.32	$55,030.32	2026-03-26
6304	APR_DRG	—	1	1	—	—	$118,036.80	$118,036.80	$118,036.80	2026-03-26
6313	APR_DRG	—	1	1	—	—	$39,475.27	$39,475.27	$39,475.27	2026-03-26
6314	APR_DRG	—	1	1	—	—	$101,451.66	$101,451.66	$101,451.66	2026-03-26
6334	APR_DRG	—	1	1	—	—	$41,841.50	$41,841.50	$41,841.50	2026-03-26
6344	APR_DRG	—	1	1	—	—	$49,431.17	$49,431.17	$49,431.17	2026-03-26
64568	HCPCS	Opn Impltj Crnl Nrv Nea&pg	6	5	—	—	$565.89	$104,543.81	$46,463.92	2026-03-26
64654	HCPCS	1st Opn Implt Bat Modulj Sys	4	4	—	—	$46,463.92	$104,543.81	$46,463.92	2026-03-26
6504	APR_DRG	—	1	1	—	—	$51,538.63	$51,538.63	$51,538.63	2026-03-26
6514	APR_DRG	—	1	1	—	—	$56,565.51	$56,565.51	$56,565.51	2026-03-26
6604	APR_DRG	—	1	1	—	—	$35,893.17	$35,893.17	$35,893.17	2026-03-26
6614	APR_DRG	—	1	1	—	—	$35,924.67	$35,924.67	$35,924.67	2026-03-26
6804	APR_DRG	—	1	1	—	—	$72,295.56	$72,295.56	$72,295.56	2026-03-26
6814	APR_DRG	—	1	1	—	—	$65,488.82	$65,488.82	$65,488.82	2026-03-26
6904	APR_DRG	—	1	1	—	—	$68,246.52	$68,246.52	$68,246.52	2026-03-26
6914	APR_DRG	—	1	1	—	—	$38,213.78	$38,213.78	$38,213.78	2026-03-26
6924	APR_DRG	—	1	1	—	—	$37,913.54	$37,913.54	$37,913.54	2026-03-26
6934	APR_DRG	—	1	1	—	—	$55,383.64	$55,383.64	$55,383.64	2026-03-26
7	MS_DRG	Lung Transplant	5	5	—	—	$83,275.87	$173,079.42	$83,275.87	2026-03-26
7104	APR_DRG	—	1	1	—	—	$50,010.08	$50,010.08	$50,010.08	2026-03-26
7114	APR_DRG	—	1	1	—	—	$56,757.93	$56,757.93	$56,757.93	2026-03-26
7724	APR_DRG	—	1	1	—	—	$49,816.82	$49,816.82	$49,816.82	2026-03-26
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	5	5	—	—	$38,219.50	$79,434.88	$38,219.50	2026-03-26
7914	APR_DRG	—	1	1	—	—	$52,966.82	$52,966.82	$52,966.82	2026-03-26
8	MS_DRG	Simultaneous Pancreas/kidney Transplant	5	5	—	—	$36,040.21	$74,905.48	$36,040.21	2026-03-26
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	5	5	—	—	$37,713.42	$78,383.05	$37,713.42	2026-03-26
8411	APR_DRG	—	1	1	—	—	$41,075.14	$41,075.14	$41,075.14	2026-03-26
8412	APR_DRG	—	1	1	—	—	$41,772.65	$41,772.65	$41,772.65	2026-03-26
8413	APR_DRG	—	1	1	—	—	$56,399.63	$56,399.63	$56,399.63	2026-03-26
8414	APR_DRG	—	1	1	—	—	$167,275.56	$167,275.56	$167,275.56	2026-03-26
8423	APR_DRG	—	1	1	—	—	$37,303.11	$37,303.11	$37,303.11	2026-03-26
8424	APR_DRG	—	1	1	—	—	$92,325.97	$92,325.97	$92,325.97	2026-03-26
8444	APR_DRG	—	1	1	—	—	$55,684.71	$55,684.71	$55,684.71	2026-03-26
850	MS_DRG	Acute Leukemia With Other Procedures	4	4	—	—	$55,684.65	$115,734.22	$55,684.65	2026-03-26
8504	APR_DRG	—	1	1	—	—	$56,840.86	$56,840.86	$56,840.86	2026-03-26
8633	APR_DRG	—	1	1	—	—	$36,421.47	$36,421.47	$36,421.47	2026-03-26
8634	APR_DRG	—	1	1	—	—	$87,015.44	$87,015.44	$87,015.44	2026-03-26
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	5	5	—	—	$44,446.12	$92,376.21	$44,446.12	2026-03-26
8904	APR_DRG	—	1	1	—	—	$37,537.83	$37,537.83	$37,537.83	2026-03-26
9101	APR_DRG	—	1	1	—	—	$38,486.64	$38,486.64	$38,486.64	2026-03-26
9102	APR_DRG	—	1	1	—	—	$42,665.06	$42,665.06	$42,665.06	2026-03-26
9103	APR_DRG	—	1	1	—	—	$60,322.60	$60,322.60	$60,322.60	2026-03-26
9104	APR_DRG	—	1	1	—	—	$123,646.74	$123,646.74	$123,646.74	2026-03-26
9113	APR_DRG	—	1	1	—	—	$38,913.78	$38,913.78	$38,913.78	2026-03-26
9114	APR_DRG	—	1	1	—	—	$103,389.93	$103,389.93	$103,389.93	2026-03-26
9123	APR_DRG	—	1	1	—	—	$47,581.64	$47,581.64	$47,581.64	2026-03-26
9124	APR_DRG	—	1	1	—	—	$100,063.27	$100,063.27	$100,063.27	2026-03-26
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	5	5	—	—	$137,293.75	$285,349.43	$137,293.75	2026-03-26
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	5	5	—	—	$46,123.83	$95,863.14	$46,123.83	2026-03-26
9304	APR_DRG	—	1	1	—	—	$58,049.27	$58,049.27	$58,049.27	2026-03-26
9504	APR_DRG	—	1	1	—	—	$63,893.10	$63,893.10	$63,893.10	2026-03-26
9514	APR_DRG	—	1	1	—	—	$49,061.25	$49,061.25	$49,061.25	2026-03-26
9524	APR_DRG	—	1	1	—	—	$41,993.26	$41,993.26	$41,993.26	2026-03-26
955	MS_DRG	Craniotomy For Multiple Significant Trauma	5	5	—	—	$43,284.14	$89,961.15	$43,284.14	2026-03-26
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	5	5	—	—	$48,999.54	$101,839.96	$48,999.54	2026-03-26
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	5	5	—	—	$39,362.84	$81,811.17	$39,362.84	2026-03-26
A9543	HCPCS	Y90 Ibritumomab, Rx	5	4	—	—	$14,774.74	$127,855.22	$56,824.54	2026-03-26
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	4	3	—	—	$3,672,900.00	$3,685,266.66	$3,685,266.66	2026-03-26
J1413	HCPCS	Inj Delandistrogene Mox Rokl	4	3	—	—	$3,325,454.76	$3,327,859.72	$3,327,859.72	2026-03-26
J1414	HCPCS	Inj, Beqvez, Per Tx Dose	1	1	—	—	$3,605,000.00	$3,605,000.00	$3,605,000.00	2026-03-26
J2350	HCPCS	Ocrevus 300 Mg/10 Ml Vial	25	21	$55,067.20	$30,286.96 45% off	$59.32	$52,313.84	$48,459.14	2026-03-26
J3387	HCPCS	Inj Elivaldogene Autotemecel	3	3	—	—	$3,180,000.00	$3,180,000.00	$3,180,000.00	2026-03-26
J3389	HCPCS	Topi Adm Prad Zami Per Treat	3	3	—	—	$3,335,820.00	$3,335,820.00	$3,335,820.00	2026-03-26
J3391	HCPCS	Inj, Atidarsagene Autotemcel	3	3	—	—	$4,505,000.00	$4,505,000.00	$4,505,000.00	2026-03-26
J3392	HCPCS	Inj, Exagamglogene Autotem	3	3	—	—	$2,332,000.00	$2,332,000.00	$2,332,000.00	2026-03-26
J3393	HCPCS	Inj, Betibeglogene Autotemce	4	3	—	—	$2,939,968.88	$2,968,000.00	$2,939,968.88	2026-03-26
J3394	HCPCS	Inj, Lovotibeglogene Autotem	4	3	—	—	$3,252,508.07	$3,286,000.00	$3,252,508.07	2026-03-26
J3399	HCPCS	Inj Onase Abepar-xioi Treat	4	3	—	—	$2,388,614.23	$2,588,981.22	$2,588,981.22	2026-03-26
J3402	HCPCS	Inj. Remestemcel-l-rknd/ Td	4	4	—	—	$201,669.02	$453,755.30	$201,669.02	2026-03-26
J3403	HCPCS	Revakinagene, Per Implant	4	4	—	—	$265,000.00	$596,250.00	$265,000.00	2026-03-26
J9029	HCPCS	Instill Adstiladrin, Tx Dose	5	4	—	—	$63,354.77	$144,618.28	$64,274.79	2026-03-26
J9226	HCPCS	Supprelin La Implant	5	4	—	—	$43,185.33	$97,166.99	$43,185.33	2026-03-26
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	5	4	—	—	$489,455.96	$1,197,432.54	$532,192.24	2026-03-26
Q2042	HCPCS	Tisagenlecleucel Car-pos T	5	4	—	—	$529,192.86	$1,274,695.43	$566,531.30	2026-03-26
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	5	4	—	—	$54,404.10	$122,409.23	$54,404.10	2026-03-26
Q2053	HCPCS	Brexucabtagene Car Pos T	5	4	—	—	$460,530.40	$1,101,262.95	$489,450.20	2026-03-26
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	5	4	—	—	$516,726.08	$1,264,952.79	$562,201.24	2026-03-26
Q2055	HCPCS	Idecabtagene Vicleucel Car	5	4	—	—	$526,587.59	$1,255,683.87	$558,081.72	2026-03-26
Q2056	HCPCS	Ciltacabtagene Car-pos T	5	4	—	—	$527,123.43	$1,322,211.53	$587,649.57	2026-03-26
Q2057	HCPCS	Afamitresgene Autoleucel	4	4	—	—	$770,620.00	$1,733,895.00	$770,620.00	2026-03-26
Q2058	HCPCS	Obecbtge Autol Up To 400 Mil	4	4	—	—	$278,250.00	$626,062.50	$278,250.00	2026-03-26

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