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

HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER

Englewood, CO · CCN 060034 · Rates published

36,259 distinct procedures filed
33 distinct payers
1,151,320 rate rows
2026-03-01 last MRF observed
Data quality

1,120,290 of 1,151,320 rate rows are consumer-grade (97.3%)

31,030 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 18,385
per-diem day rate — not a per-procedure price 10,851
template filing: same amount across many unrelated codes — excluded 1,691
placeholder amount (≤ $0.02) — excluded from medians 97
exceeds 10× this hospital's gross charge — excluded from medians 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/84-1321373_HCA-HEALTHONE-SWEDISH_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://www.healthonecares.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 1cfcb5d401ea6121… · 608,903,878 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
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,850,948.67 $4,850,948.67 $4,850,948.67 nat. median
$3,006,423
1.6× median
845
OTHER 		Inj, Atidarsagene Autotem 14 $4,459,950.00 $4,730,250.00 $4,505,000.00 nat. median
$9,966
outlier · 452.1×
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 1 $3,847,800.00 $3,847,800.00 $3,847,800.00 nat. median
$2,448,600
1.6× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 3 $3,670,252.89 $4,271,819.03 $3,824,789.85 nat. median
$2,469,189
1.5× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 14 $3,648,414.33 $3,869,530.35 $3,685,267.00 nat. median
$3,746,358
1.0× median
908
OTHER 		Topi Adm Prad Zami Per Tr 14 $3,302,461.80 $3,502,611.00 $3,335,820.00 nat. median
$22,747
outlier · 146.6×
714
OTHER 		Inj Delandistrogene Mox R 14 $3,294,581.40 $3,494,253.00 $3,327,860.00 nat. median
$13,041
outlier · 255.2×
748
OTHER 		Inj, Lovotibeglogene Auto 14 $3,219,982.92 $3,415,133.40 $3,252,508.00 nat. median
$17,963
outlier · 181.1×
906
OTHER 		Inj Elivaldogene Autoteme 14 $3,148,200.00 $3,339,000.00 $3,180,000.00 nat. median
$20,756
outlier · 153.2×
746
OTHER 		Inj, Betibeglogene Autote 14 $2,910,569.31 $3,086,967.45 $2,939,969.00 nat. median
$21,896
outlier · 134.3×
9141
OTHER 		Inj Onase Abepar-xioi Tre 14 $2,563,091.19 $2,718,430.05 $2,588,981.00 nat. median
$2,588,981
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 14 $2,308,680.00 $2,448,600.00 $2,332,000.00 nat. median
$25,250
outlier · 92.4×
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 2 $1,271,523.00 $2,311,860.00 $2,311,860.00 nat. median
$824,563
outlier · 2.8×
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 5 $819,605.32 $1,762,948.71 $1,366,285.25 nat. median
$675,122
outlier · 2.0×
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 5 $765,607.90 $1,686,603.72 $1,307,117.89 nat. median
$674,188
1.9× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 4 $836,958.70 $1,699,593.90 $903,487.86 nat. median
$754,974
1.2× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 4 $782,774.83 $1,674,245.19 $868,284.31 nat. median
$625,184
1.4× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 2 $459,112.50 $834,750.00 $834,750.00 nat. median
$324,450
outlier · 2.6×
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 4 $741,901.04 $1,596,576.72 $825,628.09 nat. median
$634,511
1.3× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 4 $725,845.60 $1,468,350.60 $782,000.18 nat. median
$620,080
1.3× median
2067
OTHER 		Afamitresgene Autoleucel 14 $762,913.80 $809,151.00 $770,620.00 nat. median
$786,032
1.0× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 2 $332,753.88 $605,007.06 $605,007.06 nat. median
$209,753
outlier · 2.9×
9498
OTHER 		Ciltacabtagene Car-pos T 14 $581,773.10 $617,032.08 $587,649.60 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 14 $560,865.99 $594,857.87 $566,531.30 nat. median
$566,531
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 14 $556,579.19 $590,311.26 $562,201.20 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 14 $552,500.98 $585,985.89 $558,081.80 nat. median
$558,082
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 14 $526,870.28 $558,801.81 $532,192.20 nat. median
$532,192
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 14 $484,555.70 $513,922.71 $489,450.20 nat. median
$489,450
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 17 $1,975.00 $616,909.48 $354,035.30 nat. median
$370,174
1.0× median
5834
APR_DRG 		Neonate With Ecmo 2 $261,357.88 $390,081.55 $325,719.71 nat. median
$309,665
1.1× median
891590
CDM 		Kit Pcng Neurx Dps 15 $74,988.74 $444,012.30 $318,208.82 nat. median
$110
outlier · 2897.5×
551981
CDM 		Pump Heart 21fr 85mm 16 $100,547.09 $595,344.60 $297,672.30 nat. median
$62,513
outlier · 4.8×
578762
CDM 		Kit Cath Rt Heart 16 $100,547.09 $595,344.60 $297,672.30 nat. median
$71,486
outlier · 4.2×
581868
CDM 		Stent Eprsth 15cm 8mm 15 $69,253.63 $410,054.40 $293,872.32 nat. median
$64,000
outlier · 4.6×
605996
CDM 		Stent Eprsth 12x37mm 15 $69,253.63 $410,054.40 $293,872.32 nat. median
$387
outlier · 759.5×
607048
CDM 		Stent Eprsth 22fr 31mm 15 $69,253.63 $410,054.40 $293,872.32 nat. median
$270,413
1.1× median
831
OTHER 		Obecbtge Autol Up To 400 14 $275,467.50 $292,162.50 $278,250.00 nat. median
$12,362
outlier · 22.5×
575012
CDM 		Valve Tavr Sz 26mm 15 $64,925.28 $384,426.00 $275,505.30 nat. median
$75,000
outlier · 3.7×
575010
CDM 		Valve Tavr Size 34mm 15 $64,925.28 $384,426.00 $275,505.30 nat. median
$75,000
outlier · 3.7×
575013
CDM 		Valve Tavr Sz 23mm 15 $64,925.28 $384,426.00 $275,505.30 nat. median
$75,000
outlier · 3.7×
575011
CDM 		Valve Tavr Sz 29mm 15 $64,925.28 $384,426.00 $275,505.30 nat. median
$75,000
outlier · 3.7×
5833
APR_DRG 		Neonate With Ecmo 2 $207,000.69 $342,642.39 $274,821.54 nat. median
$244,017
1.1× median
897
OTHER 		Revakinagene, Per Implant 14 $262,350.00 $278,250.00 $265,000.00 nat. median
$9,577
outlier · 27.7×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $214,384.80 $300,544.34 $257,464.57 nat. median
$246,434
1.0× median
585066
CDM 		Valve Tavr 29mm 15 $58,832.51 $348,350.40 $249,651.12 nat. median
$56,472
outlier · 4.4×
585067
CDM 		Valve Tavr 26mm 15 $58,832.51 $348,350.40 $249,651.12 nat. median
$56,472
outlier · 4.4×
585068
CDM 		Valve Tavr 20mm 15 $58,832.51 $348,350.40 $249,651.12 nat. median
$56,472
outlier · 4.4×
584925
CDM 		Valve Tavr 23mm 15 $58,832.51 $348,350.40 $249,651.12 nat. median
$56,472
outlier · 4.4×
561737
CDM 		Bundle Cochlear Implnt 15 $57,026.14 $337,654.80 $241,985.94 nat. median
$241,986
1.0× median
551582
CDM 		Valve Heart Trnscth 20mm 15 $56,236.96 $332,982.00 $238,637.10 nat. median
$65,000
outlier · 3.7×

Other procedures at this hospital

Browse this hospital's 36,259 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
L8614 HCPCS Prc Snd Lf Ns 781 25 $243,405.00 $243,405.00 $1,017.18 $587,497.50 $159,834.50 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 40 19 — — $1,975.00 $400,349.44 $230,079.80 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 33 18 — — $1,975.00 $814,954.03 $174,486.20 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 32 17 — — $1,975.00 $616,909.48 $354,035.30 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 24 17 — — $1,975.00 $325,551.41 $175,510.80 2026-03-01
578762 CDM Kit Cath Rt Heart 35 16 $661,494.00 $661,494.00 $100,547.09 $595,344.60 $297,672.30 2026-03-01
551981 CDM Pump Heart 21fr 85mm 35 16 $661,494.00 $661,494.00 $100,547.09 $595,344.60 $297,672.30 2026-03-01
863779 CDM Set Vntrc 17.4x13.8in 35 16 $403,350.00 $403,350.00 $61,309.20 $363,015.00 $181,507.50 2026-03-01
589193 CDM Kit Lo Prfl Comp Shth 7f 35 16 $403,350.00 $403,350.00 $61,309.20 $363,015.00 $181,507.50 2026-03-01
581224 CDM Cath Vasc Assist Strl 35 16 $403,350.00 $403,350.00 $61,309.20 $363,015.00 $181,507.50 2026-03-01
573195 CDM Kit Cath Rt Heart 35 16 $403,350.00 $403,350.00 $61,309.20 $363,015.00 $181,507.50 2026-03-01
833716 CDM Pump Cath Lv Impella 9fr 35 16 $322,680.00 $322,680.00 $49,047.36 $290,412.00 $145,206.00 2026-03-01
987414 CDM Device Ventric Ast Tandm 35 16 $314,613.00 $314,613.00 $47,821.18 $283,151.70 $141,575.85 2026-03-01
785938 CDM Kit Bld Pmp 15fr 72cm 35 16 $314,613.00 $314,613.00 $47,821.18 $283,151.70 $141,575.85 2026-03-01
891590 CDM Kit Pcng Neurx Dps 22 15 $493,347.00 $493,347.00 $74,988.74 $444,012.30 $318,208.82 2026-03-01
581868 CDM Stent Eprsth 15cm 8mm 22 15 $455,616.00 $455,616.00 $69,253.63 $410,054.40 $293,872.32 2026-03-01
605996 CDM Stent Eprsth 12x37mm 22 15 $455,616.00 $455,616.00 $69,253.63 $410,054.40 $293,872.32 2026-03-01
607048 CDM Stent Eprsth 22fr 31mm 22 15 $455,616.00 $455,616.00 $69,253.63 $410,054.40 $293,872.32 2026-03-01
575013 CDM Valve Tavr Sz 23mm 22 15 $427,140.00 $427,140.00 $64,925.28 $384,426.00 $275,505.30 2026-03-01
575011 CDM Valve Tavr Sz 29mm 22 15 $427,140.00 $427,140.00 $64,925.28 $384,426.00 $275,505.30 2026-03-01
575010 CDM Valve Tavr Size 34mm 22 15 $427,140.00 $427,140.00 $64,925.28 $384,426.00 $275,505.30 2026-03-01
575012 CDM Valve Tavr Sz 26mm 22 15 $427,140.00 $427,140.00 $64,925.28 $384,426.00 $275,505.30 2026-03-01
585066 CDM Valve Tavr 29mm 22 15 $387,056.00 $387,056.00 $58,832.51 $348,350.40 $249,651.12 2026-03-01
585067 CDM Valve Tavr 26mm 22 15 $387,056.00 $387,056.00 $58,832.51 $348,350.40 $249,651.12 2026-03-01
585068 CDM Valve Tavr 20mm 22 15 $387,056.00 $387,056.00 $58,832.51 $348,350.40 $249,651.12 2026-03-01
584925 CDM Valve Tavr 23mm 22 15 $387,056.00 $387,056.00 $58,832.51 $348,350.40 $249,651.12 2026-03-01
561737 CDM Bundle Cochlear Implnt 22 15 $375,172.00 $375,172.00 $57,026.14 $337,654.80 $241,985.94 2026-03-01
871795 CDM Kit Aor Vlv 20fr 29mm 22 15 $369,980.00 $369,980.00 $56,236.96 $332,982.00 $238,637.10 2026-03-01
873687 CDM Kit Aor Vlv 14fr 20mm 22 15 $369,980.00 $369,980.00 $56,236.96 $332,982.00 $238,637.10 2026-03-01
871793 CDM Kit Aor Vlv 18fr 26mm 22 15 $369,980.00 $369,980.00 $56,236.96 $332,982.00 $238,637.10 2026-03-01
551582 CDM Valve Heart Trnscth 20mm 22 15 $369,980.00 $369,980.00 $56,236.96 $332,982.00 $238,637.10 2026-03-01
775845 CDM Valve Heart Trnscth 26mm 22 15 $369,980.00 $369,980.00 $56,236.96 $332,982.00 $238,637.10 2026-03-01
777384 CDM Valve Aor With Intro 23mm 22 15 $369,980.00 $369,980.00 $56,236.96 $332,982.00 $238,637.10 2026-03-01
873686 CDM Kit Aor Vlv 14fr 29mm 22 15 $369,980.00 $369,980.00 $56,236.96 $332,982.00 $238,637.10 2026-03-01
775844 CDM Valve Heart Trnscth 23mm 22 15 $369,980.00 $369,980.00 $56,236.96 $332,982.00 $238,637.10 2026-03-01
873685 CDM Kit Aor Vlv 14fr 26mm 22 15 $369,980.00 $369,980.00 $56,236.96 $332,982.00 $238,637.10 2026-03-01
777390 CDM Valve Aor With Intro 27mm 22 15 $369,980.00 $369,980.00 $56,236.96 $332,982.00 $238,637.10 2026-03-01
777386 CDM Valve Aor With Intro 25mm 22 15 $369,980.00 $369,980.00 $56,236.96 $332,982.00 $238,637.10 2026-03-01
871792 CDM Kit Aor Vlv 16fr 23mm 22 15 $369,980.00 $369,980.00 $56,236.96 $332,982.00 $238,637.10 2026-03-01
589908 CDM Stent Eprsth 28x8mm 20cm 22 15 $364,288.00 $364,288.00 $55,371.78 $327,859.20 $234,965.76 2026-03-01
589130 CDM Stent Eprsth 8x40mm 15cm 22 15 $364,288.00 $364,288.00 $55,371.78 $327,859.20 $234,965.76 2026-03-01
606393 CDM Graft Stent 26x8mm 10cm 22 15 $364,288.00 $364,288.00 $55,371.78 $327,859.20 $234,965.76 2026-03-01
585006 CDM Stent Eprsth 24f 34mm 22 15 $364,288.00 $364,288.00 $55,371.78 $327,859.20 $234,965.76 2026-03-01
598386 CDM Valve Tavr 34mm 22 15 $358,596.00 $358,596.00 $54,506.59 $322,736.40 $231,294.42 2026-03-01
596518 CDM Valve Tavr 26mm 22 15 $358,596.00 $358,596.00 $54,506.59 $322,736.40 $231,294.42 2026-03-01
585556 CDM Implant Crain Cust Xl 22 15 $343,692.00 $343,692.00 $52,241.18 $309,322.80 $221,681.34 2026-03-01
893421 CDM Valve Aortic 34mm 22 15 $341,520.00 $341,520.00 $51,911.04 $307,368.00 $220,280.40 2026-03-01
897594 CDM Valve Aor 29mm Evolutpro 22 15 $341,520.00 $341,520.00 $51,911.04 $307,368.00 $220,280.40 2026-03-01
897593 CDM Valve Aor 26mm Evolutpro 22 15 $341,520.00 $341,520.00 $51,911.04 $307,368.00 $220,280.40 2026-03-01
897592 CDM Valve Aor 23mm Evolutpro 22 15 $341,520.00 $341,520.00 $51,911.04 $307,368.00 $220,280.40 2026-03-01
876574 CDM Valve Transcth Aor 26mm 22 15 $341,520.00 $341,520.00 $51,911.04 $307,368.00 $220,280.40 2026-03-01
876575 CDM Valve Aor 23-26mm Coreva 22 15 $341,520.00 $341,520.00 $51,911.04 $307,368.00 $220,280.40 2026-03-01
876573 CDM Val Evlt Rtm Trnsct Aort 22 15 $341,520.00 $341,520.00 $51,911.04 $307,368.00 $220,280.40 2026-03-01
599964 CDM Ipg Dbs Rchrgbl Battery 22 15 $338,865.00 $338,865.00 $51,507.48 $304,978.50 $218,567.92 2026-03-01
595991 CDM Valve Tavr 29mm 22 15 $330,136.00 $330,136.00 $50,180.67 $297,122.40 $212,937.72 2026-03-01
598801 CDM Valve Tavr 23mm 22 15 $330,136.00 $330,136.00 $50,180.67 $297,122.40 $212,937.72 2026-03-01
C2624 HCPCS Crd Mems Pa Snsr Delsys 22 15 $320,355.00 $320,355.00 $48,693.96 $288,319.50 $206,628.98 2026-03-01
581448 CDM Implant Crnfcl Xl 22 15 $299,561.00 $299,561.00 $45,533.27 $269,604.90 $193,216.85 2026-03-01
776340 CDM Tissue Syn Crani Xl 22 15 $298,676.00 $298,676.00 $45,398.75 $268,808.40 $192,646.02 2026-03-01
580213 CDM Implant Crnfcl Cstm Lg 22 15 $296,795.00 $296,795.00 $45,112.84 $267,115.50 $191,432.77 2026-03-01
569312 CDM Kit Implnt Crnmxf Lg 22 15 $296,795.00 $296,795.00 $45,112.84 $267,115.50 $191,432.77 2026-03-01
C1822 HCPCS Pulse Gen Imp 22 15 $270,522.00 $270,522.00 $41,119.34 $243,469.80 $174,486.69 2026-03-01
481943 CDM Kit Impl Crnl Cstm Lg 22 15 $268,216.00 $268,216.00 $40,768.83 $241,394.40 $172,999.32 2026-03-01
569418 CDM Implant Crnl Custm Large 22 15 $264,824.00 $264,824.00 $40,253.25 $238,341.60 $170,811.48 2026-03-01
842179 CDM Prosthesis Tmj Pt Cstm 22 15 $263,119.00 $263,119.00 $39,994.09 $236,807.10 $169,711.76 2026-03-01
584751 CDM Transcth Aortic Vlv 27mm 22 15 $256,284.00 $256,284.00 $38,955.17 $230,655.60 $165,303.18 2026-03-01
584750 CDM Transcth Aortic Vlv 29mm 22 15 $256,284.00 $256,284.00 $38,955.17 $230,655.60 $165,303.18 2026-03-01
584753 CDM Transcth Aortic Vlv 25mm 22 15 $256,284.00 $256,284.00 $38,955.17 $230,655.60 $165,303.18 2026-03-01
584752 CDM Transcth Aortic Vlv 23mm 22 15 $256,284.00 $256,284.00 $38,955.17 $230,655.60 $165,303.18 2026-03-01
776775 CDM Stent Graft 20cm 45x45mm 22 15 $255,601.00 $255,601.00 $38,851.35 $230,040.90 $164,862.65 2026-03-01
774713 CDM Graft Evas 34x34x10cm 22 15 $255,601.00 $255,601.00 $38,851.35 $230,040.90 $164,862.65 2026-03-01
781732 CDM Stent Eprsth 40x40x20cm 22 15 $255,601.00 $255,601.00 $38,851.35 $230,040.90 $164,862.65 2026-03-01
771873 CDM Stent 20fr 31x31mm 10cm 22 15 $255,601.00 $255,601.00 $38,851.35 $230,040.90 $164,862.65 2026-03-01
775999 CDM Stent 34mmx34mmx15cm 22 15 $250,589.00 $250,589.00 $38,089.53 $225,530.10 $161,629.90 2026-03-01
772933 CDM Stent Graft 10cm 21x21mm 22 15 $250,589.00 $250,589.00 $38,089.53 $225,530.10 $161,629.90 2026-03-01
821803 CDM Kit Implant Crani Lg 22 15 $250,150.00 $250,150.00 $38,022.80 $225,135.00 $161,346.75 2026-03-01
558203 CDM Imp Gen Pc Plus Verc 22 15 $249,165.00 $249,165.00 $37,873.08 $224,248.50 $160,711.42 2026-03-01
C1820 HCPCS Gnrtr Implntble Pls Prdg 220 15 $234,571.50 $234,571.50 $31,851.45 $335,732.40 $157,068.02 2026-03-01
566720 CDM Implant Crani Medium 22 15 $243,356.00 $243,356.00 $36,990.11 $219,020.40 $156,964.62 2026-03-01
122710 CDM Insrt Replac Implnt Icd 29 15 $327,323.23 $327,323.23 $49,753.13 $294,590.91 $156,133.18 2026-03-01
587988 CDM Device Clsr 27mm 22 15 $242,046.00 $242,046.00 $36,790.99 $217,841.40 $156,119.67 2026-03-01
587993 CDM Device Clsr 35mm 22 15 $242,046.00 $242,046.00 $36,790.99 $217,841.40 $156,119.67 2026-03-01
587989 CDM Device Clsr 24mm 22 15 $242,046.00 $242,046.00 $36,790.99 $217,841.40 $156,119.67 2026-03-01
587990 CDM Device Clsr 40mm 22 15 $242,046.00 $242,046.00 $36,790.99 $217,841.40 $156,119.67 2026-03-01
587992 CDM Device Clsr 31mm 22 15 $242,046.00 $242,046.00 $36,790.99 $217,841.40 $156,119.67 2026-03-01
587991 CDM Device Clsr 20mm 22 15 $242,046.00 $242,046.00 $36,790.99 $217,841.40 $156,119.67 2026-03-01
562993 CDM Device 17 Sng Sphr 5 .0 22 15 $234,856.00 $234,856.00 $35,698.11 $211,370.40 $151,482.12 2026-03-01
889842 CDM Device Embl 4x35mm Pline 22 15 $225,787.00 $225,787.00 $34,319.62 $203,208.30 $145,632.61 2026-03-01
564003 CDM Coil Emb Neuro 6x3mm 22 15 $223,113.00 $223,113.00 $33,913.18 $200,801.70 $143,907.89 2026-03-01
566347 CDM Coil Embol Neuro 4x2mm 22 15 $223,113.00 $223,113.00 $33,913.18 $200,801.70 $143,907.89 2026-03-01
566342 CDM Device Endo Sng 5x3mm 22 15 $223,113.00 $223,113.00 $33,913.18 $200,801.70 $143,907.89 2026-03-01
566346 CDM Coil Embl 4.5mm 3mm 22 15 $223,113.00 $223,113.00 $33,913.18 $200,801.70 $143,907.89 2026-03-01
876268 CDM Coil Embz .017 4.5mm 2mm 22 15 $223,113.00 $223,113.00 $33,913.18 $200,801.70 $143,907.89 2026-03-01
565968 CDM Coil Embl 4x3mm 22 15 $223,113.00 $223,113.00 $33,913.18 $200,801.70 $143,907.89 2026-03-01
566343 CDM Coil Emb Neuro 7x4mm 22 15 $223,113.00 $223,113.00 $33,913.18 $200,801.70 $143,907.89 2026-03-01
567117 CDM Coil Embol Neuro 4x2.6mm 22 15 $223,113.00 $223,113.00 $33,913.18 $200,801.70 $143,907.89 2026-03-01
567119 CDM Coil Embl 5.6mm 7mm 22 15 $223,113.00 $223,113.00 $33,913.18 $200,801.70 $143,907.89 2026-03-01
566344 CDM Coil Embol Neuro 7x3mm 22 15 $223,113.00 $223,113.00 $33,913.18 $200,801.70 $143,907.89 2026-03-01
564026 CDM Coil Embl 5mm 2mm 22 15 $223,113.00 $223,113.00 $33,913.18 $200,801.70 $143,907.89 2026-03-01
566345 CDM Coil Emb Neuro 6x4mm 22 15 $223,113.00 $223,113.00 $33,913.18 $200,801.70 $143,907.89 2026-03-01
567118 CDM Coil Emb Neuro 6x4.6mm 22 15 $223,113.00 $223,113.00 $33,913.18 $200,801.70 $143,907.89 2026-03-01
C1882 HCPCS Crt Defib Card 71x51x12 352 15 $220,165.00 $220,165.00 $27,320.63 $214,766.10 $142,805.60 2026-03-01
593124 CDM Stent Vasc 250mm 12mm 22 15 $220,689.00 $220,689.00 $33,544.73 $198,620.10 $142,344.40 2026-03-01
593133 CDM Stent Vasc 250mm 10mm 22 15 $220,689.00 $220,689.00 $33,544.73 $198,620.10 $142,344.40 2026-03-01
593013 CDM Stent Vasc 350mm 14mm 22 15 $220,689.00 $220,689.00 $33,544.73 $198,620.10 $142,344.40 2026-03-01
593019 CDM Stent Vasc 450mm 14mm 22 15 $220,689.00 $220,689.00 $33,544.73 $198,620.10 $142,344.40 2026-03-01
593115 CDM Stent Vasc 350mm 20mm 22 15 $220,689.00 $220,689.00 $33,544.73 $198,620.10 $142,344.40 2026-03-01
593130 CDM Stent Vasc 550mm 40mm 22 15 $220,689.00 $220,689.00 $33,544.73 $198,620.10 $142,344.40 2026-03-01
593024 CDM Device Embl 2.5x14mm 22 15 $220,689.00 $220,689.00 $33,544.73 $198,620.10 $142,344.40 2026-03-01
593113 CDM Stent Vasc 450mm 12mm 22 15 $220,689.00 $220,689.00 $33,544.73 $198,620.10 $142,344.40 2026-03-01
593123 CDM Stent Vasc 300mm 12mm 22 15 $220,689.00 $220,689.00 $33,544.73 $198,620.10 $142,344.40 2026-03-01
780647 CDM Implant Crnl Psi 22 15 $219,978.00 $219,978.00 $33,436.66 $197,980.20 $141,885.81 2026-03-01
C1767 HCPCS Kit Impl Neurostim 660 15 $248,809.50 $248,809.50 $9,803.85 $475,125.30 $138,313.56 2026-03-01
869127 CDM Device Embl 5x30mm 22 15 $214,368.00 $214,368.00 $32,583.94 $192,931.20 $138,267.36 2026-03-01
786486 CDM System Endo Sng Lyr 6mmx 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
786487 CDM System Endo Sng Lyr 6mmx 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
786175 CDM Coil Embl 4mm 9mm 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
786492 CDM System Endo Sng Lyr Sphr 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
786485 CDM Sys Endo Sng Lyr 6x3mm 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
786482 CDM System Endo Sng Lyr 4mmx 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
786484 CDM System Endo Sng Lyr 5mmx 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
786493 CDM System Endo Sng Lyr Sphr 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
786483 CDM System Endo Sng Lyr 5mmx 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
786490 CDM System Endo Sng Lyr 7mmx 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
786494 CDM System Endo Sng Lyr Sphr 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
786488 CDM Coil Emb Endo Sn Ly 7mmx 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
786489 CDM Coil Emb Endo Sn Ly 7mmx 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
786491 CDM System Endo Sng Lyr Sphr 22 15 $212,859.00 $212,859.00 $32,354.57 $191,573.10 $137,294.05 2026-03-01
872224 CDM Coil Embl 30x3.5mm Pipel 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
866999 CDM Device Embl 25x4.25mm Pl 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
866994 CDM Device Embl 25x3.25mm Pl 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
872225 CDM Dev Emb Pipeln 3x35mm 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
872223 CDM Coil Embl 25x3.5mm Pipel 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
872241 CDM Device Emb 20mm 3mm Pip 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
866995 CDM Dev Emb Pipeln 3x30mm 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
867000 CDM Device Embl 25x4.5mm Pl 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
872242 CDM Device Embl 25x3.75mm Pi 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
872251 CDM Device Embl 25mm 3mm 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
865649 CDM Dev Emb Pipeln 5.00x35mm 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
867006 CDM Device Embl 35x4mm Pl 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
867037 CDM Dev Emb Pipeln 2.50x20mm 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
866990 CDM Dev Emb Pipeln 2.75x10mm 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
872253 CDM Device Embl 25mm 4.25mm 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
872244 CDM Device Embl 30x4.25mm Pi 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
866991 CDM Dev Emb Pipeln 2.50x14mm 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
867003 CDM Cath Embl 25x5mm Pipelne 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
867002 CDM Device Embl 25x4mm Pipel 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
867005 CDM Dev Emb Pipeln 4.75x35mm 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
866872 CDM Device Embl 30x5mm Pipel 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
866988 CDM Device Embl 35mm 4.5mm P 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
866989 CDM Dev Emb Pipeln 2.50x10mm 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
897207 CDM Device Embl 35mm 3mm 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
872246 CDM Device Embl 35x3.75mm Pi 22 15 $207,647.00 $207,647.00 $31,562.34 $186,882.30 $133,932.32 2026-03-01
556304 CDM Graft Evas 45x45mm 15cm 22 15 $207,100.00 $207,100.00 $31,479.20 $186,390.00 $133,579.50 2026-03-01
566176 CDM Device Embl 5.0x20mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566239 CDM Device Embl 4.75mm 25mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566232 CDM Device Embl 3.5mm 14mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566068 CDM Device Embl 2.75mm 14mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566183 CDM Device Embl 4.75mm 10mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566237 CDM Device Embl 5mm 35mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
564638 CDM Device Emb 4.25mm 16mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566067 CDM Device Embl 2.75mm 16mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566060 CDM Device Embl 2.5mm 16mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566196 CDM Device Embl 3.25mm 18mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566210 CDM Device Embl 5mm 12mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566182 CDM Device Embl 4.75mm 12mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566238 CDM Device Embl 4.75mm 35mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566177 CDM Device Embl 5mm 18mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566228 CDM Device Embl 3.75x16mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566197 CDM Device Embl 3.25x12mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566247 CDM Device Embl 3.25mm 30mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566216 CDM Device Embl 4.50x16mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566057 CDM Device Embl 2.75mm 18mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566224 CDM Device Embl 4.00x2mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566065 CDM Device Embl 3mm 12mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566053 CDM Device Embl 4mm 12mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566202 CDM Device Embl 4.5mm 30mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566187 CDM Device Embl 4.25mm 18mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566184 CDM Device Embl 4.5mm 12mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566203 CDM Device Embl 4.25mm 25mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566186 CDM Device Embl 4.25mm 20mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566063 CDM Device Embl 3mm 20mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566193 CDM Device Embl 3.75mm 10mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566214 CDM Device Embl 4.5mm 20mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566206 CDM Device Embl 3.75mm 25mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566219 CDM Device Embl 4.25mm 14mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566208 CDM Device Embl 3.25mm 35mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566205 CDM Device Embl 3.75mm 35mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566204 CDM Device Embl 4mm 30mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566189 CDM Device Embl 4mm 16mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566213 CDM Device Embl 4.75mm 18mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566241 CDM Device Embl 4.25mm 30mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566064 CDM Device Embl 3mm 18mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566215 CDM Device Embl 4.5mm 18mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566212 CDM Device Embl 4.75mm 20mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566072 CDM Device Embl 3mm 25mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566209 CDM Device Embl 3.25mm 25mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566243 CDM Device Embl 4mm 25mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566198 CDM Device Embl 3.25mm 10mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566180 CDM Device Embl 4.75mm 16mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566188 CDM Device Embl 4mm 18mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566240 CDM Device Embl 4.25mm 35mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566242 CDM Device Embl 4mm 35mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566175 CDM Device Embl 3.5mm 10mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566055 CDM Device Embl 3mm 14mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566061 CDM Device Embl 2.5mm 14mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566195 CDM Device Embl 3.25mm 20mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566185 CDM Device Embl 4.5mm 10mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566164 CDM Device Embl 4.75x30mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566225 CDM Device Embl 4mm 10mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566248 CDM Device Embl 3mm 35mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566062 CDM Device Embl 3mm 30mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566070 CDM Device Embl 2.5mm 18mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
564639 CDM Device Emb 5mm 14mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566227 CDM Device Embl 3.75mm 18mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566192 CDM Device Embl 3.75mm 12mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566229 CDM Device Embl 3.5mm 18mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566201 CDM Device Embl 4.5mm 35mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566071 CDM Device Embl 2.5mm 12mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566244 CDM Device Embl 3.75mm 30mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566211 CDM Device Embl 5mm 10mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566056 CDM Device Embl 2.75mm 20mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566199 CDM Device Embl 5.0x.0mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566178 CDM Device Embl 5.0x16mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566246 CDM Device Embl 3.5mm 25mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566058 CDM Device Embl 2.75mm 12mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566191 CDM Device Embl 3.75mm 14mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566233 CDM Device Embl 3.50x12mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
566221 CDM Device Embl 4.25mm 10mm 22 15 $204,814.00 $204,814.00 $31,131.73 $184,332.60 $132,105.03 2026-03-01
845 OTHER Inj, Atidarsagene Autotem 20 14 — — $4,459,950.00 $4,730,250.00 $4,505,000.00 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 20 14 — — $3,648,414.33 $3,869,530.35 $3,685,267.00 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 20 14 — — $3,302,461.80 $3,502,611.00 $3,335,820.00 2026-03-01
714 OTHER Inj Delandistrogene Mox R 20 14 — — $3,294,581.40 $3,494,253.00 $3,327,860.00 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 20 14 — — $3,219,982.92 $3,415,133.40 $3,252,508.00 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 20 14 — — $3,148,200.00 $3,339,000.00 $3,180,000.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 20 14 — — $2,910,569.31 $3,086,967.45 $2,939,969.00 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 20 14 — — $2,563,091.19 $2,718,430.05 $2,588,981.00 2026-03-01
824 OTHER Inj, Exagamglogene Autote 20 14 — — $2,308,680.00 $2,448,600.00 $2,332,000.00 2026-03-01
2067 OTHER Afamitresgene Autoleucel 20 14 — — $762,913.80 $809,151.00 $770,620.00 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 20 14 — — $581,773.10 $617,032.08 $587,649.60 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 20 14 — — $560,865.99 $594,857.87 $566,531.30 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 20 14 — — $556,579.19 $590,311.26 $562,201.20 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 20 14 — — $552,500.98 $585,985.89 $558,081.80 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 20 14 — — $526,870.28 $558,801.81 $532,192.20 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 20 14 — — $484,555.70 $513,922.71 $489,450.20 2026-03-01
831 OTHER Obecbtge Autol Up To 400 20 14 — — $275,467.50 $292,162.50 $278,250.00 2026-03-01
897 OTHER Revakinagene, Per Implant 20 14 — — $262,350.00 $278,250.00 $265,000.00 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 20 14 — — $199,652.31 $211,752.45 $201,669.00 2026-03-01
955647 CDM Rmv Icd W Rplc Mult Ld 28 14 $318,467.78 $318,467.78 $48,407.10 $286,621.00 $177,864.26 2026-03-01
124685 CDM Ttvi Perc Aprch 28 14 $317,770.14 $317,770.14 $48,301.06 $285,993.13 $177,474.62 2026-03-01
883402 CDM Ins/repl Subq Imp Icd Sy 28 14 $292,252.88 $292,252.88 $44,422.44 $263,027.59 $163,223.23 2026-03-01
955644 CDM Ins Icd Gen W Mult Lead 28 14 $289,274.83 $289,274.83 $43,969.77 $260,347.35 $161,559.99 2026-03-01
885940 CDM Tavr 28 14 $283,723.34 $283,723.34 $43,125.95 $255,351.01 $158,459.48 2026-03-01
1907 OTHER New Technology - Level 52 20 14 — — $155,885.20 $165,332.79 $157,459.80 2026-03-01
1908 OTHER New Technology - Level 52 20 14 — — $155,885.20 $165,332.79 $157,459.80 2026-03-01
888494 CDM Tmvr Initial 28 14 $257,930.31 $257,930.31 $39,205.41 $232,137.28 $144,054.08 2026-03-01
1906 OTHER New Technology - Level 51 20 14 — — $140,552.28 $149,070.60 $141,972.00 2026-03-01
1905 OTHER New Technology - Level 51 20 14 — — $140,552.28 $149,070.60 $141,972.00 2026-03-01
955646 CDM Rmv Icd W Rplc Dual Ld 28 14 $236,812.72 $236,812.72 $35,995.53 $213,131.45 $132,259.90 2026-03-01
955645 CDM Rmv Icd W Rplc Sgl Ld 28 14 $236,812.72 $236,812.72 $35,995.53 $213,131.45 $132,259.90 2026-03-01
943425 CDM Ins Imp Icd Gen Sng Lead 28 14 $236,812.72 $236,812.72 $35,995.53 $213,131.45 $132,259.90 2026-03-01
C2642 HCPCS Brachytx Strnd Cesium131 57 13 $370,188.00 $370,188.00 $157.48 $602,267.40 $200,755.80 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 9 5 — — $819,605.32 $1,762,948.71 $1,366,285.25 2026-03-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 9 5 — — $765,607.90 $1,686,603.72 $1,307,117.89 2026-03-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 6 4 — — $836,958.70 $1,699,593.90 $903,487.86 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 6 4 — — $782,774.83 $1,674,245.19 $868,284.31 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 6 4 — — $741,901.04 $1,596,576.72 $825,628.09 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 6 4 — — $725,845.60 $1,468,350.60 $782,000.18 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 4 3 — — $3,670,252.89 $4,271,819.03 $3,824,789.85 2026-03-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 6 3 — — $138,148.31 $251,178.75 $194,663.53 2026-03-01
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 3 2 — — $1,271,523.00 $2,311,860.00 $2,311,860.00 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 3 2 — — $459,112.50 $834,750.00 $834,750.00 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 3 2 — — $332,753.88 $605,007.06 $605,007.06 2026-03-01
5834 APR_DRG Neonate With Ecmo 2 2 — — $261,357.88 $390,081.55 $325,719.71 2026-03-01
5833 APR_DRG Neonate With Ecmo 2 2 — — $207,000.69 $342,642.39 $274,821.54 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $214,384.80 $300,544.34 $257,464.57 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 2 2 — — $197,809.14 $267,232.31 $232,520.73 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 2 2 — — $204,977.34 $227,074.08 $216,025.71 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $155,608.67 $241,870.40 $198,739.54 2026-03-01
5832 APR_DRG Neonate With Ecmo 2 2 — — $152,642.84 $235,856.24 $194,249.54 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $144,550.72 $226,153.03 $185,351.88 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $134,845.21 $214,354.80 $174,600.01 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $138,114.37 $205,887.53 $172,000.95 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $135,241.27 $197,085.00 $166,163.14 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $135,018.74 $189,805.36 $162,412.05 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $134,157.73 $184,979.66 $159,568.70 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $129,680.51 $185,485.48 $157,582.99 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $128,796.99 $186,317.79 $157,557.39 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $139,819.17 $175,247.53 $157,533.35 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 2 2 — — $155,337.18 $157,033.95 $156,185.57 2026-03-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $125,754.99 $173,879.40 $149,817.20 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $126,451.75 $164,450.82 $145,451.29 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $89,020.57 $197,085.00 $143,052.79 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $128,449.27 $156,275.14 $142,362.21 2026-03-01
5831 APR_DRG Neonate With Ecmo 2 2 — — $131,911.18 $148,342.61 $140,126.89 2026-03-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 2 — — $77,046.96 $140,085.39 $140,085.39 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $112,390.88 $161,568.68 $136,979.78 2026-03-01
23 APR_DRG Heart And/or Lung Transplant 2 2 — — $122,322.24 $144,998.05 $133,660.14 2026-03-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 1 1 — — $4,850,948.67 $4,850,948.67 $4,850,948.67 2026-03-01
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 1 1 — — $3,847,800.00 $3,847,800.00 $3,847,800.00 2026-03-01
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