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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

LAWRENCE & MEMORIAL HOSPITAL

New London, CT · CCN 070007 · Rates published

22,444 distinct procedures filed
20 distinct payers
551,876 rate rows
2026-01-01 last MRF observed
Data quality

466,380 of 551,876 rate rows are consumer-grade (84.5%)

85,496 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
placeholder amount (≤ $0.02) — excluded from medians 77,507
template filing: same amount across many unrelated codes — excluded 7,959
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 30
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.lmhospital.org/-/media/Files/YNHHS/sc/060646704-LawrenceMemorialHospitalstandardcharges011025.ashx
Found on page https://www.lmhospital.org/patients-visitors/patients/billing-insurance/Pricing
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-08-05
Content fingerprint a7b4bad724fd787f… · 102,660,002 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
51167-290-09
OTHER 		Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 11 $424,926.85 $4,833,305.04 $3,300,000.00 nat. median
$3,300,000
1.0× median
51167-290-01
OTHER 		Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 11 $424,926.85 $4,833,305.04 $3,300,000.00 nat. median
$3,300,000
1.0× median
60923-520-29
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-503-12
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-514-23
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-534-43
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-521-30
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-510-19
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-524-33
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-536-45
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-540-49
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-532-41
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-512-21
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-559-68
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-561-70
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-502-11
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-537-46
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-509-18
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-519-28
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-518-27
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-526-35
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.63 $4,272,000.01 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-530-39
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-523-32
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-544-53
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-527-36
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-535-44
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-517-26
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-507-16
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-525-34
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-545-54
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-547-56
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-513-22
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-506-15
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-533-42
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-522-31
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-515-24
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-538-47
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-541-50
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-528-37
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-516-25
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-529-38
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-501-10
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-504-13
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-531-40
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-511-20
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-505-14
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-539-48
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-508-17
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-542-51
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median
60923-543-52
OTHER 		Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 $185,422.62 $4,272,000.00 $1,971,415.94 nat. median
$1,971,416
1.0× median

Other procedures at this hospital

Browse this hospital's 22,444 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
             
481 OTHER Hip And Femur Procedures Except Major Joint With Cc 20 20 $74,692.86 $26,889.43 64% off $3,847.15 $74,692.86 $42,128.19 2026-01-01
62 OTHER Ischemic Stroke Precerebral Occlusion Or Transient Ischemia With Thrombolytic Ag… 20 20 $75,005.71 $27,002.06 64% off $3,863.27 $75,005.71 $42,304.65 2026-01-01
940 OTHER O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 20 20 $76,305.72 $27,470.06 64% off $3,930.23 $76,305.72 $43,037.88 2026-01-01
564 OTHER Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 20 20 $76,434.00 $27,516.24 64% off $3,936.83 $76,434.00 $43,110.23 2026-01-01
737 OTHER Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 20 20 $76,714.92 $27,617.37 64% off $3,951.30 $76,714.92 $43,268.68 2026-01-01
322 OTHER Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 20 20 $76,946.79 $27,700.85 64% off $3,963.25 $76,946.79 $43,399.46 2026-01-01
71104-991-08 OTHER Antihemophil Rfviii Fc-vwf-xten,bdd-ehtl 4,000 (+/-) Unit IV Solution 20 20 $102,800.00 $37,008.00 64% off $3,971.13 $91,492.00 $42,221.15 2026-01-01
71104-984-01 OTHER Antihemophil Rfviii Fc-vwf-xten,bdd-ehtl 4,000 (+/-) Unit IV Solution 20 20 $102,800.00 $37,008.00 64% off $3,971.13 $91,492.00 $42,221.15 2026-01-01
796 OTHER Vaginal Delivery With Sterilization And-or Dandc With Mcc 20 20 $77,731.82 $27,983.46 64% off $4,003.68 $77,731.82 $43,842.23 2026-01-01
486 OTHER Knee Procedures With Principal Diagnosis Of Infection With Cc 20 20 $79,764.99 $28,715.40 64% off $4,108.40 $79,764.99 $44,988.97 2026-01-01
0006-5331-01 OTHER Belzutifan 40 Mg Tablet 20 20 $106,443.00 $38,319.48 64% off $4,111.86 $94,734.27 $43,717.38 2026-01-01
735 OTHER Pelvic Evisceration Radical Hysterectomy And Radical Vulvectomy Without Cc-mcc 20 20 $80,087.61 $28,831.54 64% off $4,125.02 $80,087.61 $45,170.94 2026-01-01
0074-1050-01 OTHER Risankizumab-rzaa 150 Mg/ml Subcutaneous Syringe 20 20 $108,000.35 $38,880.13 64% off $4,172.02 $96,120.31 $44,357.00 2026-01-01
142 OTHER Major Head And Neck Procedures Without Cc-mcc 20 20 $81,129.76 $29,206.71 64% off $4,178.70 $81,129.76 $45,758.73 2026-01-01
32 OTHER Ventricular Shunt Procedures With Cc 20 20 $81,310.29 $29,271.70 64% off $4,187.99 $81,310.29 $45,860.55 2026-01-01
95 OTHER Bacterial And Tuberculous Infections Of Nervous System With Cc 20 20 $81,529.55 $29,350.64 64% off $4,199.29 $81,529.55 $45,984.21 2026-01-01
584 OTHER Breast Biopsy Local Excision And Other Breast Procedures With Cc-mcc 20 20 $81,578.74 $29,368.35 64% off $4,201.82 $81,578.74 $46,011.96 2026-01-01
478 OTHER Biopsies Of Musculoskeletal System And Connective Tissue With Cc 20 20 $81,746.51 $29,428.75 64% off $4,210.46 $81,746.51 $46,106.59 2026-01-01
909 OTHER Other O.r. Procedures For Injuries Without Cc-mcc 20 20 $81,974.35 $29,510.77 64% off $4,222.20 $81,974.35 $46,235.10 2026-01-01
621 OTHER O.r. Procedures For Obesity Without Cc-mcc 20 20 $82,142.46 $29,571.29 64% off $4,230.86 $82,142.46 $46,329.91 2026-01-01
617 OTHER Amputation Of Lower Limb For Endocrine Nutritional And Metabolic Disorders With … 20 20 $82,496.70 $29,698.81 64% off $4,249.10 $82,496.70 $46,529.71 2026-01-01
243 OTHER Permanent Cardiac Pacemaker Implant With Cc 20 20 $82,798.66 $29,807.52 64% off $4,264.65 $82,798.66 $46,700.02 2026-01-01
570 OTHER Skin Debridement With Mcc 20 20 $82,834.81 $29,820.53 64% off $4,266.52 $82,834.81 $46,720.41 2026-01-01
198 OTHER Interstitial Lung Disease Without Cc-mcc 20 20 $83,199.55 $29,951.84 64% off $4,285.30 $83,199.55 $46,926.13 2026-01-01
331 OTHER Major Small And Large Bowel Procedures Without Cc-mcc 20 20 $83,227.05 $29,961.74 64% off $4,286.72 $83,227.05 $46,941.64 2026-01-01
0008-0100-01 OTHER Inotuzumab Ozogamicin 0.9 Mg IV Soln 20 20 $111,434.55 $40,116.44 64% off $4,304.68 $99,176.75 $45,767.47 2026-01-01
516 OTHER Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 20 20 $83,887.51 $30,199.50 64% off $4,320.74 $83,887.51 $47,314.15 2026-01-01
27 OTHER Craniotomy And Endovascular Intracranial Procedures Without Cc-mcc 20 20 $83,975.59 $30,231.21 64% off $4,325.27 $83,975.59 $47,363.83 2026-01-01
470 OTHER Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 20 20 $84,638.23 $30,469.76 64% off $4,359.40 $84,638.23 $47,737.57 2026-01-01
515 OTHER Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 20 20 $84,876.70 $30,555.61 64% off $4,371.69 $84,876.70 $47,872.07 2026-01-01
72493-101-40 OTHER Mitomycin 40 Mg X 2 Intra-pyelocalyceal Kit 20 20 $113,300.00 $40,788.00 64% off $4,376.75 $100,837.00 $46,533.63 2026-01-01
253 OTHER Other Vascular Procedures With Cc 20 20 $85,170.23 $30,661.28 64% off $4,386.80 $85,170.23 $48,037.63 2026-01-01
72893-007-04 OTHER Kit For Yttrium-90-ibritumomab 3.2 Mg/2 Ml Intravenous 20 20 $114,000.01 $41,040.00 64% off $4,403.79 $101,460.01 $46,821.13 2026-01-01
99999-2227-29 OTHER Kit For Yttrium-90-ibritumomab 3.2 Mg/2 Ml Intravenous 20 20 $114,000.00 $41,040.00 64% off $4,403.79 $101,460.00 $46,821.13 2026-01-01
271 OTHER Other Major Cardiovascular Procedures With Cc 20 20 $85,948.30 $30,941.39 64% off $4,426.88 $85,948.30 $48,476.47 2026-01-01
63 OTHER Ischemic Stroke Precerebral Occlusion Or Transient Ischemia With Thrombolytic Ag… 20 20 $85,959.12 $30,945.28 64% off $4,427.44 $85,959.12 $48,482.58 2026-01-01
157 OTHER Dental And Oral Diseases With Mcc 20 20 $86,120.86 $31,003.51 64% off $4,435.77 $86,120.86 $48,573.81 2026-01-01
827 OTHER Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 20 20 $86,224.16 $31,040.70 64% off $4,441.09 $86,224.16 $48,632.07 2026-01-01
713 OTHER Transurethral Prostatectomy With Cc-mcc 20 20 $86,403.71 $31,105.34 64% off $4,450.34 $86,403.71 $48,733.34 2026-01-01
494 OTHER Lower Extremity And Humerus Procedures Except Hip Foot And Femur Without Cc-mcc 20 20 $86,498.13 $31,139.33 64% off $4,455.20 $86,498.13 $48,786.59 2026-01-01
164 OTHER Major Chest Procedures With Cc 20 20 $86,581.04 $31,169.18 64% off $4,459.47 $86,581.04 $48,833.35 2026-01-01
519 OTHER Back And Neck Procedures Except Spinal Fusion With Cc 20 20 $86,688.75 $31,207.95 64% off $4,465.02 $86,688.75 $48,894.10 2026-01-01
72493-103-03 OTHER Mitomycin 40 Mg X 2 Intra-pyelocalyceal Kit 20 20 $116,135.00 $41,808.60 64% off $4,486.26 $103,360.15 $47,698.00 2026-01-01
76128-155-75 OTHER Porfimer 75 Mg Intravenous Solution 20 20 $116,615.00 $41,981.40 64% off $4,504.80 $103,787.35 $47,895.14 2026-01-01
94 OTHER Bacterial And Tuberculous Infections Of Nervous System With Mcc 20 20 $87,779.05 $31,600.46 64% off $4,521.18 $87,779.05 $49,509.06 2026-01-01
336 OTHER Peritoneal Adhesiolysis With Cc 20 20 $87,893.83 $31,641.78 64% off $4,527.09 $87,893.83 $49,573.79 2026-01-01
620 OTHER O.r. Procedures For Obesity With Cc 20 20 $87,936.69 $31,657.21 64% off $4,529.30 $87,936.69 $49,597.97 2026-01-01
25682-028-01 OTHER Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 20 20 $117,406.63 $42,266.39 64% off $4,535.38 $104,491.90 $48,220.27 2026-01-01
418 OTHER Laparoscopic Cholecystectomy Without C.d.e. With Cc 20 20 $88,313.20 $31,792.75 64% off $4,548.69 $88,313.20 $49,810.32 2026-01-01
62935-154-50 OTHER Leuprolide 45 Mg (pediatric 6 Month) Subcutaneous Syringe 20 20 $119,098.95 $42,875.62 64% off $4,600.76 $105,998.07 $48,915.32 2026-01-01
62935-153-50 OTHER Leuprolide 45 Mg (pediatric 6 Month) Subcutaneous Syringe 20 20 $119,098.95 $42,875.62 64% off $4,600.76 $105,998.07 $48,915.32 2026-01-01
324 OTHER Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 20 20 $89,408.94 $32,187.22 64% off $4,605.13 $89,408.94 $50,428.35 2026-01-01
658 OTHER Kidney And Ureter Procedures For Neoplasm Without Cc-mcc 20 20 $89,452.44 $32,202.88 64% off $4,607.37 $89,452.44 $50,452.88 2026-01-01
502 OTHER Soft Tissue Procedures Without Cc-mcc 20 20 $89,648.87 $32,273.59 64% off $4,617.48 $89,648.87 $50,563.67 2026-01-01
520 OTHER Back And Neck Procedures Except Spinal Fusion Without Cc-mcc 20 20 $90,893.33 $32,721.60 64% off $4,681.58 $90,893.33 $51,265.57 2026-01-01
61 OTHER Ischemic Stroke Precerebral Occlusion Or Transient Ischemia With Thrombolytic Ag… 20 20 $92,048.64 $33,137.51 64% off $4,741.09 $92,048.64 $51,917.18 2026-01-01
358 OTHER Other Digestive System O.r. Procedures Without Cc-mcc 20 20 $92,247.50 $33,209.10 64% off $4,751.33 $92,247.50 $52,029.35 2026-01-01
252 OTHER Other Vascular Procedures With Mcc 20 20 $92,685.70 $33,366.85 64% off $4,773.90 $92,685.70 $52,276.50 2026-01-01
956 OTHER Limb Reattachment Hip And Femur Procedures For Multiple Significant Trauma 20 20 $93,104.11 $33,517.48 64% off $4,795.45 $93,104.11 $52,512.49 2026-01-01
707 OTHER Major Male Pelvic Procedures With Cc-mcc 20 20 $93,523.90 $33,668.60 64% off $4,817.07 $93,523.90 $52,749.26 2026-01-01
522 OTHER Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 20 20 $93,811.67 $33,772.20 64% off $4,831.89 $93,811.67 $52,911.57 2026-01-01
614 OTHER Adrenal And Pituitary Procedures With Cc-mcc 20 20 $95,120.62 $34,243.42 64% off $4,899.31 $95,120.62 $53,649.84 2026-01-01
542 OTHER Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 20 20 $95,671.78 $34,441.84 64% off $4,927.70 $95,671.78 $53,960.70 2026-01-01
72694-954-01 OTHER Pegaspargase 750 Unit/ml Injection Solution 20 20 $127,691.25 $45,968.85 64% off $4,932.68 $113,645.21 $52,444.29 2026-01-01
615 OTHER Adrenal And Pituitary Procedures Without Cc-mcc 20 20 $96,587.51 $34,771.50 64% off $4,974.87 $96,587.51 $54,477.19 2026-01-01
72694-515-01 OTHER Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution 20 20 $128,920.50 $46,411.38 64% off $4,980.16 $114,739.25 $52,949.15 2026-01-01
62935-163-60 OTHER Leuprolide 45 Mg (pediatric 6 Month) Subcutaneous Syringe 20 20 $129,047.80 $46,457.21 64% off $4,985.08 $114,852.54 $53,001.43 2026-01-01
982 OTHER Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 20 20 $97,514.47 $35,105.21 64% off $5,022.61 $97,514.47 $55,000.02 2026-01-01
69488-010-61 OTHER Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln 20 20 $130,050.00 $46,818.00 64% off $5,023.79 $115,744.50 $53,413.05 2026-01-01
73 OTHER Cranial And Peripheral Nerve Disorders With Mcc 20 20 $97,705.34 $35,173.92 64% off $5,032.44 $97,705.34 $55,107.67 2026-01-01
0597-0035-10 OTHER Spesolimab-sbzo 60 Mg/ml Intravenous Solution 20 20 $130,389.15 $46,940.09 64% off $5,036.90 $116,046.34 $53,552.35 2026-01-01
511 OTHER Shoulder Elbow Or Forearm Procedures Except Major Joint Procedures With Cc 20 20 $98,616.96 $35,502.10 64% off $5,079.40 $98,616.96 $55,621.84 2026-01-01
239 OTHER Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 20 20 $99,537.27 $35,833.42 64% off $5,126.80 $99,537.27 $56,140.91 2026-01-01
242 OTHER Permanent Cardiac Pacemaker Implant With Mcc 20 20 $100,291.24 $36,104.85 64% off $5,165.63 $100,291.24 $56,566.17 2026-01-01
821 OTHER Lymphoma And Leukemia With Major O.r. Procedures With Cc 20 20 $100,703.84 $36,253.38 64% off $5,186.88 $100,703.84 $56,798.89 2026-01-01
330 OTHER Major Small And Large Bowel Procedures With Cc 20 20 $101,027.77 $36,370.00 64% off $5,203.57 $101,027.77 $56,981.58 2026-01-01
789 OTHER Neonates Died Or Transferred To Another Acute Care Facility 20 20 $101,185.16 $36,426.66 64% off $5,211.67 $101,185.16 $57,070.35 2026-01-01
57894-061-03 OTHER Ustekinumab 90 Mg/ml Subcutaneous Syringe 20 20 $134,968.20 $48,588.55 64% off $5,213.78 $120,121.70 $55,433.01 2026-01-01
79952-110-01 OTHER Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution 20 20 $135,116.30 $48,641.87 64% off $5,219.50 $120,253.51 $55,493.84 2026-01-01
657 OTHER Kidney And Ureter Procedures For Neoplasm With Cc 20 20 $101,974.78 $36,710.92 64% off $5,252.35 $101,974.78 $57,515.71 2026-01-01
493 OTHER Lower Extremity And Humerus Procedures Except Hip Foot And Femur With Cc 20 20 $102,475.19 $36,891.07 64% off $5,278.12 $102,475.19 $57,797.96 2026-01-01
69488-003-01 OTHER Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution 20 20 $137,000.00 $49,320.00 64% off $5,292.27 $121,930.00 $56,267.50 2026-01-01
69488-003-70 OTHER Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution 20 20 $137,000.00 $49,320.00 64% off $5,292.27 $121,930.00 $56,267.50 2026-01-01
622 OTHER Skin Grafts And Wound Debridement For Endocrine Nutritional And Metabolic Disord… 20 20 $104,370.71 $37,573.46 64% off $5,375.75 $104,370.71 $58,867.07 2026-01-01
75987-080-10 OTHER Pegloticase 8 Mg/ml Intravenous Solution 20 20 $139,802.80 $50,329.01 64% off $5,400.54 $124,424.49 $57,418.63 2026-01-01
0006-5087-01 OTHER Sotatercept-csrk 45 Mg Subcutaneous 1 Syringe Kit 20 20 $140,000.00 $50,400.00 64% off $5,408.16 $124,600.00 $57,499.63 2026-01-01
0006-5088-01 OTHER Sotatercept-csrk 60 Mg Subcutaneous 1 Syringe Kit 20 20 $140,000.00 $50,400.00 64% off $5,408.16 $124,600.00 $57,499.63 2026-01-01
166 OTHER Other Respiratory System O.r. Procedures With Mcc 20 20 $105,189.03 $37,868.05 64% off $5,417.90 $105,189.03 $59,328.62 2026-01-01
987 OTHER Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 20 20 $105,420.23 $37,951.28 64% off $5,429.81 $105,420.23 $59,459.01 2026-01-01
907 OTHER Other O.r. Procedures For Injuries With Mcc 20 20 $105,677.97 $38,044.07 64% off $5,443.08 $105,677.97 $59,604.39 2026-01-01
417 OTHER Laparoscopic Cholecystectomy Without C.d.e. With Mcc 20 20 $106,387.36 $38,299.45 64% off $5,479.62 $106,387.36 $60,004.50 2026-01-01
334 OTHER Rectal Resection Without Cc-mcc 20 20 $108,281.92 $38,981.49 64% off $5,577.20 $108,281.92 $61,073.06 2026-01-01
654 OTHER Major Bladder Procedures With Cc 20 20 $109,216.16 $39,317.82 64% off $5,625.32 $109,216.16 $61,599.99 2026-01-01
468 OTHER Revision Of Hip Or Knee Replacement Without Cc-mcc 20 20 $109,347.30 $39,365.03 64% off $5,632.08 $109,347.30 $61,673.96 2026-01-01
327 OTHER Stomach Esophageal And Duodenal Procedures With Cc 20 20 $109,388.13 $39,379.73 64% off $5,634.18 $109,388.13 $61,696.99 2026-01-01
58468-0200-1 OTHER Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 20 20 $147,248.70 $53,009.53 64% off $5,688.18 $131,051.34 $60,476.76 2026-01-01
492 OTHER Lower Extremity And Humerus Procedures Except Hip Foot And Femur With Mcc 20 20 $111,200.67 $40,032.24 64% off $5,727.54 $111,200.67 $62,719.29 2026-01-01
659 OTHER Kidney And Ureter Procedures For Non-neoplasm With Mcc 20 20 $112,150.90 $40,374.32 64% off $5,776.48 $112,150.90 $63,255.24 2026-01-01
24 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 20 20 $112,638.04 $40,549.69 64% off $5,801.57 $112,638.04 $63,530.00 2026-01-01
521 OTHER Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 20 20 $114,248.74 $41,129.54 64% off $5,884.53 $114,248.74 $64,438.46 2026-01-01
335 OTHER Peritoneal Adhesiolysis With Mcc 20 20 $115,113.17 $41,440.74 64% off $5,929.06 $115,113.17 $64,926.02 2026-01-01
981 OTHER Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 20 20 $116,511.13 $41,944.01 64% off $6,001.06 $116,511.13 $65,714.49 2026-01-01
273 OTHER Percutaneous And Other Intracardiac Procedures With Mcc 20 20 $116,650.61 $41,994.22 64% off $6,008.24 $116,650.61 $65,793.17 2026-01-01
469 OTHER Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 20 20 $117,375.56 $42,255.20 64% off $6,045.58 $117,375.56 $66,202.05 2026-01-01
824 OTHER Lymphoma And Non-acute Leukemia With Other Procedures With Cc 20 20 $118,997.26 $42,839.01 64% off $6,129.11 $118,997.26 $67,116.72 2026-01-01
488 OTHER Knee Procedures Without Principal Diagnosis Of Infection With Cc-mcc 20 20 $119,767.20 $43,116.19 64% off $6,168.77 $119,767.20 $67,550.98 2026-01-01
72187-0401-1 OTHER Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution 20 20 $160,745.95 $57,868.54 64% off $6,209.57 $143,063.90 $66,020.24 2026-01-01
473 OTHER Cervical Spinal Fusion Without Cc-mcc 20 20 $122,720.70 $44,179.45 64% off $6,320.89 $122,720.70 $69,216.81 2026-01-01
472 OTHER Cervical Spinal Fusion With Cc 20 20 $123,091.63 $44,312.99 64% off $6,340.00 $123,091.63 $69,426.02 2026-01-01
846 OTHER Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 20 20 $123,788.36 $44,563.81 64% off $6,375.88 $123,788.36 $69,818.99 2026-01-01
480 OTHER Hip And Femur Procedures Except Major Joint With Mcc 20 20 $125,212.53 $45,076.51 64% off $6,449.24 $125,212.53 $70,622.25 2026-01-01
274 OTHER Percutaneous And Other Intracardiac Procedures Without Mcc 20 20 $125,736.47 $45,265.13 64% off $6,476.22 $125,736.47 $70,917.76 2026-01-01
483 OTHER Major Joint Or Limb Reattachment Procedures Of Upper Extremities 20 20 $125,886.04 $45,318.97 64% off $6,483.93 $125,886.04 $71,002.12 2026-01-01
430 OTHER Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 20 20 $126,065.08 $45,383.43 64% off $6,493.15 $126,065.08 $71,103.11 2026-01-01
40 OTHER Peripheral Cranial Nerve And Other Nervous System Procedures With Mcc 20 20 $126,958.69 $45,705.13 64% off $6,539.17 $126,958.69 $71,607.11 2026-01-01
33945 OTHER Hc Heart Transplant 20 20 $170,000.00 $61,200.00 64% off $6,567.05 $151,300.00 $69,820.98 2026-01-01
518 OTHER Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 20 20 $129,032.13 $46,451.57 64% off $6,645.97 $129,032.13 $72,776.57 2026-01-01
593 OTHER Skin Ulcers With Cc 20 20 $129,618.84 $46,662.78 64% off $6,676.19 $129,618.84 $73,107.49 2026-01-01
823 OTHER Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 20 20 $129,750.88 $46,710.32 64% off $6,682.99 $129,750.88 $73,181.96 2026-01-01
0003-2328-22 OTHER Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution 20 20 $174,062.40 $62,662.46 64% off $6,723.98 $154,915.54 $71,489.46 2026-01-01
466 OTHER Revision Of Hip Or Knee Replacement With Mcc 20 20 $131,002.88 $47,161.04 64% off $6,747.48 $131,002.88 $73,888.11 2026-01-01
856 OTHER Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 20 20 $131,715.11 $47,417.44 64% off $6,784.16 $131,715.11 $74,289.83 2026-01-01
321 OTHER Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 20 20 $131,781.83 $47,441.46 64% off $6,787.60 $131,781.83 $74,327.46 2026-01-01
337 OTHER Peritoneal Adhesiolysis Without Cc-mcc 20 20 $132,625.97 $47,745.35 64% off $6,831.08 $132,625.97 $74,803.57 2026-01-01
577 OTHER Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 20 20 $133,237.87 $47,965.63 64% off $6,862.59 $133,237.87 $75,148.69 2026-01-01
673 OTHER Other Kidney And Urinary Tract Procedures With Mcc 20 20 $133,554.09 $48,079.47 64% off $6,878.88 $133,554.09 $75,327.05 2026-01-01
820 OTHER Lymphoma And Leukemia With Major O.r. Procedures With Mcc 20 20 $134,307.83 $48,350.82 64% off $6,917.70 $134,307.83 $75,752.17 2026-01-01
47135 OTHER Hc Split Liver Trnspl Cadavr 20 20 $180,000.00 $64,800.00 64% off $6,953.35 $160,200.00 $73,928.10 2026-01-01
47133 OTHER Hc Liver Transplant Cadaverc 20 20 $180,000.00 $64,800.00 64% off $6,953.35 $160,200.00 $73,928.10 2026-01-01
277 OTHER Cardiac Defibrillator Implant Without Mcc 20 20 $136,724.78 $49,220.92 64% off $7,042.19 $136,724.78 $77,115.38 2026-01-01
462 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 20 20 $140,263.92 $50,495.01 64% off $7,224.48 $140,263.92 $79,111.52 2026-01-01
448 OTHER Multiple Level Spinal Fusion Except Cervical Without Mcc 20 20 $141,412.89 $50,908.64 64% off $7,283.66 $141,412.89 $79,759.57 2026-01-01
91 OTHER Other Disorders Of Nervous System With Mcc 20 20 $142,376.24 $51,255.45 64% off $7,333.28 $142,376.24 $80,302.91 2026-01-01
414 OTHER Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 20 20 $143,340.69 $51,602.65 64% off $7,382.95 $143,340.69 $80,846.88 2026-01-01
329 OTHER Major Small And Large Bowel Procedures With Mcc 20 20 $143,545.80 $51,676.49 64% off $7,393.52 $143,545.80 $80,962.57 2026-01-01
26 OTHER Craniotomy And Endovascular Intracranial Procedures With Cc 20 20 $145,346.63 $52,324.79 64% off $7,486.27 $145,346.63 $81,978.27 2026-01-01
25 OTHER Craniotomy And Endovascular Intracranial Procedures With Mcc 20 20 $145,446.29 $52,360.66 64% off $7,491.40 $145,446.29 $82,034.48 2026-01-01
50242-554-01 OTHER Ocrelizumab 920 Mg-hyaluronidase-ocsq 23,000 Unit/23 Ml Subcut Soln 20 20 $197,144.96 $70,972.19 64% off $7,615.65 $175,459.01 $80,969.73 2026-01-01
356 OTHER Other Digestive System O.r. Procedures With Mcc 20 20 $148,528.98 $53,470.43 64% off $7,650.18 $148,528.98 $83,773.17 2026-01-01
0310-4535-30 OTHER Tremelimumab-actl 20 Mg/ml Intravenous Solution 20 20 $198,900.00 $71,604.00 64% off $7,683.45 $177,021.00 $81,690.54 2026-01-01
464 OTHER Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 20 20 $149,980.30 $53,992.91 64% off $7,724.93 $149,980.30 $84,591.74 2026-01-01
28 OTHER Spinal Procedures With Mcc 20 20 $153,767.16 $55,356.18 64% off $7,919.98 $153,767.16 $86,727.60 2026-01-01
50633-210-11 OTHER Glucarpidase 1,000 Unit Intravenous Solution 20 20 $205,870.00 $74,113.20 64% off $7,952.70 $183,224.30 $84,553.21 2026-01-01
500 OTHER Soft Tissue Procedures With Mcc 20 20 $154,406.04 $55,586.17 64% off $7,952.89 $154,406.04 $87,087.95 2026-01-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 20 20 $154,425.77 $55,593.28 64% off $7,953.90 $154,425.77 $87,099.08 2026-01-01
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 20 20 $158,390.61 $57,020.62 64% off $8,158.12 $158,390.61 $89,335.32 2026-01-01
23 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 20 20 $158,661.89 $57,118.28 64% off $8,172.09 $158,661.89 $89,488.32 2026-01-01
799 OTHER Splenic Procedures With Mcc 20 20 $158,816.20 $57,173.83 64% off $8,180.04 $158,816.20 $89,575.36 2026-01-01
71336-1001-1 OTHER Givosiran 189 Mg/ml Subcutaneous Solution 20 20 $213,080.00 $76,708.80 64% off $8,231.22 $189,641.20 $87,514.44 2026-01-01
504 OTHER Foot Procedures With Cc 20 20 $160,042.70 $57,615.37 64% off $8,243.21 $160,042.70 $90,267.13 2026-01-01
717 OTHER Other Male Reproductive System O.r. Procedures Except Malignancy With Cc-mcc 20 20 $161,576.30 $58,167.47 64% off $8,322.20 $161,576.30 $91,132.11 2026-01-01
73372-0116-1 OTHER Afamelanotide 16 Mg Subcutaneous Implant 20 20 $216,855.00 $78,067.80 64% off $8,377.05 $193,000.95 $89,064.88 2026-01-01
467 OTHER Revision Of Hip Or Knee Replacement With Cc 20 20 $163,173.45 $58,742.44 64% off $8,404.46 $163,173.45 $92,032.93 2026-01-01
61755-010-01 OTHER Evinacumab-dgnb 150 Mg/ml Intravenous Solution 20 20 $219,348.50 $78,965.46 64% off $8,473.37 $195,220.17 $90,088.99 2026-01-01
63004-8710-1 OTHER Corticotropin 80 Unit/ml Injection Gel 20 20 $219,920.00 $79,171.20 64% off $8,495.45 $195,728.80 $90,323.71 2026-01-01
790 OTHER Extreme Immaturity Or Respiratory Distress Syndrome Neonate 20 20 $165,742.99 $59,667.48 64% off $8,536.81 $165,742.99 $93,482.20 2026-01-01
571 OTHER Skin Debridement With Cc 20 20 $168,698.75 $60,731.55 64% off $8,689.05 $168,698.75 $95,149.31 2026-01-01
853 OTHER Infectious And Parasitic Diseases With O.r. Procedures With Mcc 20 20 $169,757.55 $61,112.72 64% off $8,743.59 $169,757.55 $95,746.49 2026-01-01
0187-0010-50 OTHER Sodium Benzoate 10 %-sodium Phenylacetate 10 % Intravenous Solution 20 20 $228,303.50 $82,189.26 64% off $8,819.30 $203,190.12 $93,766.91 2026-01-01
75987-150-01 OTHER Inebilizumab-cdon 10 Mg/ml Intravenous Solution 20 20 $228,492.15 $82,257.17 64% off $8,826.59 $203,358.01 $93,844.39 2026-01-01
471 OTHER Cervical Spinal Fusion With Mcc 20 20 $173,430.71 $62,435.06 64% off $8,932.78 $173,430.71 $97,818.22 2026-01-01
580 OTHER Other Skin Subcutaneous Tissue And Breast Procedures With Cc 20 20 $173,941.14 $62,618.81 64% off $8,959.07 $173,941.14 $98,106.11 2026-01-01
71879-001-01 OTHER Dexamethasone (pf) 9 % Intraocular Suspension 20 20 $235,025.00 $84,609.00 64% off $9,078.95 $209,172.25 $96,527.51 2026-01-01
67979-002-01 OTHER Histrelin 50 Mg (65 Mcg/day) Implant Kit 20 20 $243,836.85 $87,781.27 64% off $9,419.35 $217,014.80 $100,146.64 2026-01-01
20 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 20 20 $190,238.44 $68,485.84 64% off $9,798.48 $190,238.44 $107,298.10 2026-01-01
69866-1030-5 OTHER Autol Chondrocyte-collag,porc 500,000 Cell/cm2 (3 X 5 Cm)implant Sheet 20 20 $260,000.00 $93,600.00 64% off $10,043.73 $231,400.00 $106,785.03 2026-01-01
276 OTHER Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 20 20 $196,988.11 $70,915.72 64% off $10,146.13 $196,988.11 $111,105.04 2026-01-01
802 OTHER Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 20 20 $197,417.86 $71,070.43 64% off $10,168.27 $197,417.86 $111,347.43 2026-01-01
585 OTHER Breast Biopsy Local Excision And Other Breast Procedures Without Cc-mcc 20 20 $199,870.55 $71,953.40 64% off $10,294.60 $199,870.55 $112,730.80 2026-01-01
326 OTHER Stomach Esophageal And Duodenal Procedures With Mcc 20 20 $201,908.82 $72,687.17 64% off $10,399.58 $201,908.82 $113,880.42 2026-01-01
163 OTHER Major Chest Procedures With Mcc 20 20 $203,859.88 $73,389.56 64% off $10,500.07 $203,859.88 $114,980.85 2026-01-01
451 OTHER Single Level Spinal Fusion Except Cervical Without Mcc 20 20 $208,570.76 $75,085.47 64% off $10,742.71 $208,570.76 $117,637.88 2026-01-01
402 OTHER Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 20 20 $211,754.91 $76,231.77 64% off $10,906.72 $211,754.91 $119,433.80 2026-01-01
870 OTHER Septicemia Or Severe Sepsis With Mv Greater Than 96 Hours 20 20 $213,637.35 $76,909.44 64% off $11,003.67 $213,637.35 $120,495.53 2026-01-01
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 20 20 $215,298.37 $77,507.41 64% off $11,089.23 $215,298.37 $121,432.38 2026-01-01
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 20 20 $218,471.69 $78,649.81 64% off $11,252.67 $218,471.69 $123,222.19 2026-01-01
71336-1003-1 OTHER Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe 20 20 $298,377.50 $107,415.90 64% off $11,526.24 $265,555.98 $122,547.12 2026-01-01
344 OTHER Minor Small And Large Bowel Procedures With Mcc 20 20 $229,511.56 $82,624.16 64% off $11,821.30 $229,511.56 $129,448.89 2026-01-01
450 OTHER Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 20 20 $233,656.23 $84,116.24 64% off $12,034.77 $233,656.23 $131,786.56 2026-01-01
581 OTHER Other Skin Subcutaneous Tissue And Breast Procedures Without Cc-mcc 20 20 $238,995.45 $86,038.36 64% off $12,309.78 $238,995.45 $134,797.98 2026-01-01
583 OTHER Mastectomy For Malignancy Without Cc-mcc 20 20 $252,755.83 $90,992.10 64% off $13,018.52 $252,755.83 $142,559.10 2026-01-01
578 OTHER Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc-mcc 20 20 $253,817.39 $91,374.26 64% off $13,073.20 $253,817.39 $143,157.84 2026-01-01
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 20 20 $259,580.27 $93,448.90 64% off $13,370.02 $259,580.27 $146,408.21 2026-01-01
207 OTHER Respiratory System Diagnosis With Ventilator Support Greater Than 96 Hours 20 20 $259,835.97 $93,540.95 64% off $13,383.19 $259,835.97 $146,552.43 2026-01-01
30237-8900-6 OTHER Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 20 20 $354,080.00 $127,468.80 64% off $13,678.01 $315,131.20 $145,424.79 2026-01-01
64406-058-01 OTHER Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 20 20 $355,094.63 $127,834.07 64% off $13,717.20 $316,034.22 $145,841.50 2026-01-01
582 OTHER Mastectomy For Malignancy With Cc-mcc 20 20 $279,029.38 $100,450.58 64% off $14,371.78 $279,029.38 $157,377.89 2026-01-01
955 OTHER Craniotomy For Multiple Significant Trauma 20 20 $291,743.07 $105,027.51 64% off $15,026.61 $291,743.07 $164,548.64 2026-01-01
457 OTHER Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 20 20 $304,984.62 $109,794.46 64% off $15,708.63 $304,984.62 $172,017.13 2026-01-01
428 OTHER Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 20 $310,346.86 $111,724.87 64% off $15,984.82 $310,346.86 $175,041.54 2026-01-01
427 OTHER Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 20 $346,200.99 $124,632.36 64% off $17,831.54 $346,200.99 $195,263.95 2026-01-01
3 OTHER Ecmo Or Tracheostomy With Mv Greater Than 96 Hours Or Principal Diagnosis Except… 20 20 $356,269.92 $128,257.17 64% off $18,350.15 $356,269.92 $200,943.02 2026-01-01
426 OTHER Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 20 $381,965.73 $137,507.66 64% off $19,673.65 $381,965.73 $215,435.95 2026-01-01
456 OTHER Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 20 20 $398,313.85 $143,392.99 64% off $20,515.68 $398,313.85 $224,656.60 2026-01-01
834 OTHER Acute Leukemia With Mcc 20 20 $425,625.87 $153,225.31 64% off $21,922.42 $425,625.87 $240,061.10 2026-01-01
463 OTHER Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 20 20 $455,664.89 $164,039.36 64% off $23,469.62 $455,664.89 $257,003.67 2026-01-01
4 OTHER Tracheostomy With Mv Greater Than 96 Hours Or Principal Diagnosis Except Face Mo… 20 20 $475,617.16 $171,222.18 64% off $24,497.29 $475,617.16 $268,257.14 2026-01-01
71287-219-02 OTHER Brexucabtagene Autoleucel (tecartus) Infusion - Mcl 20 20 $2,120,000.00 $763,200.00 64% off $81,894.99 $1,886,800.00 $870,708.70 2026-01-01
71287-119-02 OTHER Axicabtagene Ciloleucel (yescarta) Infusion - Fl And Lbcl 20 20 $2,120,000.00 $763,200.00 64% off $81,894.99 $1,886,800.00 $870,708.70 2026-01-01
71287-119-01 OTHER Axicabtagene Ciloleucel (yescarta) Infusion - Fl And Lbcl 20 20 $2,120,000.00 $763,200.00 64% off $81,894.99 $1,886,800.00 $870,708.70 2026-01-01
71287-220-02 OTHER Brexucabtagene Autoleucel (tecartus) Infusion - B-all 20 20 $2,120,000.00 $763,200.00 64% off $81,894.99 $1,886,800.00 $870,708.70 2026-01-01
71287-220-01 OTHER Brexucabtagene Autoleucel (tecartus) Infusion - B-all 20 20 $2,310,000.00 $831,600.00 64% off $89,234.64 $2,055,900.00 $948,743.92 2026-01-01
71287-219-01 OTHER Brexucabtagene Autoleucel (tecartus) Infusion - Mcl 20 20 $2,310,000.00 $831,600.00 64% off $89,234.64 $2,055,900.00 $948,743.92 2026-01-01
57894-111-01 OTHER Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension 20 20 $2,610,277.50 $939,699.90 64% off $100,834.27 $2,323,146.98 $1,072,071.39 2026-01-01
57894-111-02 OTHER Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension 20 20 $2,610,277.50 $939,699.90 64% off $100,834.27 $2,323,146.98 $1,072,071.39 2026-01-01
83047-410-04 OTHER Obecabtagene Autoleucel (aucatzyl) - B-all Infusion (drops Charge) 20 20 $2,625,000.00 $945,000.00 64% off $101,403.00 $2,336,250.00 $1,078,118.09 2026-01-01
59572-515-01 OTHER Idecabtagene Vicleucel (abecma) Infusion - Mm 20 20 $2,641,562.15 $950,962.37 64% off $102,042.79 $2,350,990.31 $1,084,920.35 2026-01-01
59572-515-03 OTHER Idecabtagene Vicleucel (abecma) Infusion - Mm 20 20 $2,641,562.15 $950,962.37 64% off $102,042.79 $2,350,990.31 $1,084,920.35 2026-01-01
59572-515-02 OTHER Idecabtagene Vicleucel (abecma) Infusion - Mm 20 20 $2,641,562.15 $950,962.37 64% off $102,042.79 $2,350,990.31 $1,084,920.35 2026-01-01
73153-901-08 OTHER Lisocabtagene Maraleucel (breyanzi) Cd8 Injection - Lbcl 20 20 $2,656,752.00 $956,430.72 64% off $102,629.57 $2,364,509.28 $1,091,159.00 2026-01-01
0078-0958-19 OTHER Tisagenlecleucel (kymriah) Infusion - Fl And Lbcl 20 20 $2,719,137.50 $978,889.50 64% off $105,039.50 $2,420,032.38 $1,116,781.46 2026-01-01
0078-0846-19 OTHER Tisagenlecleucel (kymriah) Infusion- B All 20 20 $2,719,137.50 $978,889.50 64% off $105,039.50 $2,420,032.38 $1,116,781.46 2026-01-01
73776-001-11 OTHER Lifileucel 7.5 X 10exp9 To 72 X 10exp9 Cell Intravenous Suspension 20 20 $2,810,000.00 $1,011,600.00 64% off $108,549.49 $2,500,900.00 $1,154,099.75 2026-01-01
71894-126-04 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-124-04 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-132-06 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-139-09 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-134-07 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-122-03 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-127-05 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-130-06 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-121-03 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-133-07 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-141-09 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-136-08 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-125-04 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-123-03 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-138-08 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-135-07 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-137-08 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-120-02 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-128-05 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-129-05 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-140-09 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
71894-131-06 OTHER Onasemnogene Abeparvovec-xioi 2 X 10exp13 Vg/ml IV Suspension,kit 20 20 $3,483,066.54 $1,253,903.95 64% off $134,549.86 $3,099,929.22 $1,430,536.02 2026-01-01
60923-541-50 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-504-13 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-501-10 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-517-26 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-523-32 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-551-60 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-505-14 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-515-24 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-557-66 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-513-22 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-547-56 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-555-64 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-549-58 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-548-57 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-543-52 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-539-48 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-560-69 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-552-61 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-525-34 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-527-36 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-545-54 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-533-42 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-558-67 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-556-65 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-522-31 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-554-63 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-530-39 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-507-16 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-542-51 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-506-15 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-531-40 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-528-37 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-535-44 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-546-55 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-538-47 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-550-59 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-544-53 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-529-38 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-553-62 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-508-17 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-516-25 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-511-20 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.00 $1,728,000.00 64% off $185,422.62 $4,272,000.00 $1,971,415.94 2026-01-01
60923-537-46 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-561-70 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-520-29 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-521-30 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-510-19 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-532-41 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-559-68 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-514-23 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-536-45 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-512-21 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-509-18 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-534-43 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-502-11 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-526-35 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-503-12 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-524-33 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-540-49 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-519-28 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
60923-518-27 OTHER Delandistrogene Moxeparvovec-rokl 1.33x10exp13 Vg/ml Intravenous Susp 20 20 $4,800,000.01 $1,728,000.00 64% off $185,422.63 $4,272,000.01 $1,971,415.94 2026-01-01
51167-290-09 OTHER Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 11 11 — $3,960,000.00 $424,926.85 $4,833,305.04 $3,300,000.00 2026-01-01
51167-290-01 OTHER Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 11 11 — $3,960,000.00 $424,926.85 $4,833,305.04 $3,300,000.00 2026-01-01
73554-3111-1 OTHER Betibeglogene Autotemcel 2 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 6 6 — — $540,815.99 $4,200,000.00 $1,772,003.26 2026-01-01
73554-1111-1 OTHER Lovotibeglogene Autotemcel 1.7 X 10exp6 To 20 X 10exp6 Cell/ml IV Susp 6 6 — — $598,760.56 $4,650,000.00 $1,961,860.75 2026-01-01
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