Hospital

Mount Sinai Rehabilitation Hospital Inc

Hartford, CT · CCN 073025 · Rates published

15,509 distinct procedures filed

36 distinct payers

226,540 rate rows

2025-01-01 last MRF observed · ⚠ 21 mo old

Data quality

215,885 of 226,540 rate rows are consumer-grade (95.3%)

10,655 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	8,233
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	1,528
template filing: same amount across many unrelated codes — excluded	646
exceeds 10× this hospital's gross charge — excluded from medians	163
placeholder amount (≤ $0.02) — excluded from medians	73
per-diem day rate — not a per-procedure price	9
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	3

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 21 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

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

Source MRF file	https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/mountsinai-rehabilitationhospital
Found on page	https://www.trinityhealthofne.org/for-patients/billing-and-financial-resources/price-estimates-lists
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-10-15
Content fingerprint	16a786fe0cc80228… · 2,735,844 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
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	11	$1,827,175.00	$3,858,400.00	$3,710,000.00	nat. median $3,685,267 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	11	$1,669,789.09	$3,460,246.28	$3,327,159.88	nat. median $3,325,455 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	9	$3,170,990.00	$3,417,440.00	$3,286,000.00	nat. median $3,248,446 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	9	$2,864,120.00	$3,086,720.00	$2,968,000.00	nat. median $2,968,000 1.0× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	13	$24,278.95	$4,944,477.34	$2,354,513.02	nat. median $2,455,111 1.0× median
'2-4 OTHER	Heart And/or Lung Transplant	1	$755,342.89	$755,342.89	$755,342.89	nat. median $412,192 1.8× median
'002-4 OTHER	Heart And/or Lung Transplant	1	$656,819.90	$656,819.90	$656,819.90	—
'583-4 OTHER	Neonate With Ecmo	1	$586,931.04	$674,970.70	$630,950.87	—
Q2042 HCPCS	Tisagenlecleucel Car-pos T	13	$63,034.11	$1,099,250.38	$523,452.56	nat. median $621,313 0.8× median
'583-3 OTHER	Neonate With Ecmo	1	$479,078.97	$550,940.82	$515,009.89	—
Q2056 HCPCS	Ciltacabtagene Car-pos T	13	$63,034.11	$1,066,142.70	$507,687.00	nat. median $599,737 0.8× median
'588-4 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	1	$471,486.33	$542,209.28	$506,847.81	—
Q2055 HCPCS	Idecabtagene Vicleucel Car	13	$63,034.11	$1,057,254.51	$503,454.53	nat. median $574,037 0.9× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	13	$63,034.11	$1,042,419.44	$496,390.21	nat. median $579,571 0.9× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	13	$63,034.11	$1,027,187.51	$489,136.91	nat. median $562,501 0.9× median
Q2053 HCPCS	Brexucabtagene Car Pos T	13	$63,034.11	$943,824.00	$449,440.00	nat. median $513,770 0.9× median
'161-4 OTHER	Implantable Heart Assist Systems	1	$416,844.14	$479,370.76	$448,107.45	—
'583-2 OTHER	Neonate With Ecmo	1	$354,552.32	$407,735.17	$381,143.74	—
'7-4 OTHER	Allogeneic Bone Marrow Transplant	1	$366,321.28	$366,321.28	$366,321.28	nat. median $242,682 1.5× median
'609-4 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	1	$325,758.73	$374,622.54	$350,190.64	—
'161-3 OTHER	Implantable Heart Assist Systems	1	$319,344.08	$367,245.69	$343,294.89	—
'588-3 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	1	$303,749.57	$349,312.01	$326,530.79	—
'588-2 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	1	$297,429.92	$342,044.41	$319,737.16	—
'007-4 OTHER	Allogeneic Bone Marrow Transplant	1	$318,540.24	$318,540.24	$318,540.24	—
'2-3 OTHER	Heart And/or Lung Transplant	1	$318,160.83	$318,160.83	$318,160.83	nat. median $224,528 1.4× median
'630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	1	$295,934.77	$340,324.99	$318,129.88	—
'4-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	1	$311,399.14	$311,399.14	$311,399.14	nat. median $231,740 1.3× median
'1-4 OTHER	Liver Transplant And/or Intestinal Transplant	1	$307,488.01	$307,488.01	$307,488.01	nat. median $229,434 1.3× median
'583-1 OTHER	Neonate With Ecmo	1	$283,999.93	$326,599.92	$305,299.92	—
'6-4 OTHER	Pancreas Transplant	1	$291,947.72	$291,947.72	$291,947.72	nat. median $149,866 1.9× median
'9-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	1	$287,471.86	$287,471.86	$287,471.86	nat. median $301,544 1.0× median
'841-4 OTHER	Extensive Third Degree Burns With Skin Graft	1	$266,297.89	$306,242.57	$286,270.23	—
'603-4 OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	1	$266,102.04	$306,017.35	$286,059.69	—
'160-4 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	1	$258,031.48	$296,736.20	$277,383.84	—
'002-3 OTHER	Heart And/or Lung Transplant	1	$276,661.59	$276,661.59	$276,661.59	—
'161-2 OTHER	Implantable Heart Assist Systems	1	$256,406.26	$294,867.20	$275,636.73	—
'11-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	$271,696.26	$271,696.26	$271,696.26	—
'004-4 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	1	$270,781.86	$270,781.86	$270,781.86	—
'001-4 OTHER	Liver Transplant And/or Intestinal Transplant	1	$267,380.88	$267,380.88	$267,380.88	—
'161-1 OTHER	Implantable Heart Assist Systems	1	$243,585.73	$280,123.59	$261,854.66	—
'591-4 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	1	$242,435.50	$278,800.83	$260,618.17	—
'006-4 OTHER	Pancreas Transplant	1	$253,867.58	$253,867.58	$253,867.58	—
'009-4 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	1	$249,975.53	$249,975.53	$249,975.53	—
'011-4 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	$236,257.62	$236,257.62	$236,257.62	—
'8-4 OTHER	Autologous Bone Marrow Transplant	1	$235,054.05	$235,054.05	$235,054.05	nat. median $107,938 outlier · 2.2×
'593-4 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	1	$213,431.46	$245,446.18	$229,438.82	—
'2-2 OTHER	Heart And/or Lung Transplant	1	$226,381.34	$226,381.34	$226,381.34	nat. median $170,020 1.3× median
'588-1 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	1	$195,780.57	$225,147.66	$210,464.11	—
'607-4 OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	1	$193,572.20	$222,608.03	$208,090.11	—
'4-3 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	1	$207,123.21	$207,123.21	$207,123.21	nat. median $159,802 1.3× median

Other procedures at this hospital

Browse this hospital's 15,509 published procedures. Use the slice to choose what to show, then sort or filter any column.

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code	Type	Description	Rate rows	Payers	Gross	Cash	Min $	Max $	Avg median	Last observed

J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	12	11	—	—	$1,827,175.00	$3,858,400.00	$3,710,000.00	2025-01-01
J1413	HCPCS	Inj Delandistrogene Mox Rokl	12	11	—	—	$1,669,789.09	$3,460,246.28	$3,327,159.88	2025-01-01
J3394	HCPCS	Inj, Lovotibeglogene Autotem	9	9	—	—	$3,170,990.00	$3,417,440.00	$3,286,000.00	2025-01-01
J3393	HCPCS	Inj, Betibeglogene Autotemce	9	9	—	—	$2,864,120.00	$3,086,720.00	$2,968,000.00	2025-01-01
J3399	HCPCS	Inj Onase Abepar-xioi Treat	15	13	—	—	$24,278.95	$4,944,477.34	$2,354,513.02	2025-01-01
'2-4	OTHER	Heart And/or Lung Transplant	1	1	—	—	$755,342.89	$755,342.89	$755,342.89	2025-01-01
'002-4	OTHER	Heart And/or Lung Transplant	1	1	—	—	$656,819.90	$656,819.90	$656,819.90	2025-01-01
'583-4	OTHER	Neonate With Ecmo	2	1	—	—	$586,931.04	$674,970.70	$630,950.87	2025-01-01
Q2042	HCPCS	Tisagenlecleucel Car-pos T	15	13	—	—	$63,034.11	$1,099,250.38	$523,452.56	2025-01-01
'583-3	OTHER	Neonate With Ecmo	2	1	—	—	$479,078.97	$550,940.82	$515,009.89	2025-01-01
Q2056	HCPCS	Ciltacabtagene Car-pos T	15	13	—	—	$63,034.11	$1,066,142.70	$507,687.00	2025-01-01
'588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	2	1	—	—	$471,486.33	$542,209.28	$506,847.81	2025-01-01
Q2055	HCPCS	Idecabtagene Vicleucel Car	15	13	—	—	$63,034.11	$1,057,254.51	$503,454.53	2025-01-01
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	15	13	—	—	$63,034.11	$1,042,419.44	$496,390.21	2025-01-01
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	15	13	—	—	$63,034.11	$1,027,187.51	$489,136.91	2025-01-01
Q2053	HCPCS	Brexucabtagene Car Pos T	15	13	—	—	$63,034.11	$943,824.00	$449,440.00	2025-01-01
'161-4	OTHER	Implantable Heart Assist Systems	2	1	—	—	$416,844.14	$479,370.76	$448,107.45	2025-01-01
'583-2	OTHER	Neonate With Ecmo	2	1	—	—	$354,552.32	$407,735.17	$381,143.74	2025-01-01
'7-4	OTHER	Allogeneic Bone Marrow Transplant	1	1	—	—	$366,321.28	$366,321.28	$366,321.28	2025-01-01
'609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	2	1	—	—	$325,758.73	$374,622.54	$350,190.64	2025-01-01
'161-3	OTHER	Implantable Heart Assist Systems	2	1	—	—	$319,344.08	$367,245.69	$343,294.89	2025-01-01
'588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	2	1	—	—	$303,749.57	$349,312.01	$326,530.79	2025-01-01
'588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	2	1	—	—	$297,429.92	$342,044.41	$319,737.16	2025-01-01
'007-4	OTHER	Allogeneic Bone Marrow Transplant	1	1	—	—	$318,540.24	$318,540.24	$318,540.24	2025-01-01
'2-3	OTHER	Heart And/or Lung Transplant	1	1	—	—	$318,160.83	$318,160.83	$318,160.83	2025-01-01
'630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	2	1	—	—	$295,934.77	$340,324.99	$318,129.88	2025-01-01
'4-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	1	1	—	—	$311,399.14	$311,399.14	$311,399.14	2025-01-01
'1-4	OTHER	Liver Transplant And/or Intestinal Transplant	1	1	—	—	$307,488.01	$307,488.01	$307,488.01	2025-01-01
'583-1	OTHER	Neonate With Ecmo	2	1	—	—	$283,999.93	$326,599.92	$305,299.92	2025-01-01
'6-4	OTHER	Pancreas Transplant	1	1	—	—	$291,947.72	$291,947.72	$291,947.72	2025-01-01
'9-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	1	1	—	—	$287,471.86	$287,471.86	$287,471.86	2025-01-01
'841-4	OTHER	Extensive Third Degree Burns With Skin Graft	2	1	—	—	$266,297.89	$306,242.57	$286,270.23	2025-01-01
'603-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	2	1	—	—	$266,102.04	$306,017.35	$286,059.69	2025-01-01
'160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	2	1	—	—	$258,031.48	$296,736.20	$277,383.84	2025-01-01
'002-3	OTHER	Heart And/or Lung Transplant	1	1	—	—	$276,661.59	$276,661.59	$276,661.59	2025-01-01
'161-2	OTHER	Implantable Heart Assist Systems	2	1	—	—	$256,406.26	$294,867.20	$275,636.73	2025-01-01
'11-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	1	—	—	$271,696.26	$271,696.26	$271,696.26	2025-01-01
'004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	1	1	—	—	$270,781.86	$270,781.86	$270,781.86	2025-01-01
'001-4	OTHER	Liver Transplant And/or Intestinal Transplant	1	1	—	—	$267,380.88	$267,380.88	$267,380.88	2025-01-01
'161-1	OTHER	Implantable Heart Assist Systems	2	1	—	—	$243,585.73	$280,123.59	$261,854.66	2025-01-01
'591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	2	1	—	—	$242,435.50	$278,800.83	$260,618.17	2025-01-01
'006-4	OTHER	Pancreas Transplant	1	1	—	—	$253,867.58	$253,867.58	$253,867.58	2025-01-01
'009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	1	1	—	—	$249,975.53	$249,975.53	$249,975.53	2025-01-01
'011-4	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	1	—	—	$236,257.62	$236,257.62	$236,257.62	2025-01-01
'8-4	OTHER	Autologous Bone Marrow Transplant	1	1	—	—	$235,054.05	$235,054.05	$235,054.05	2025-01-01
'593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	2	1	—	—	$213,431.46	$245,446.18	$229,438.82	2025-01-01
'2-2	OTHER	Heart And/or Lung Transplant	1	1	—	—	$226,381.34	$226,381.34	$226,381.34	2025-01-01
'588-1	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	2	1	—	—	$195,780.57	$225,147.66	$210,464.11	2025-01-01
'607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$193,572.20	$222,608.03	$208,090.11	2025-01-01
'4-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	1	1	—	—	$207,123.21	$207,123.21	$207,123.21	2025-01-01
'008-4	OTHER	Autologous Bone Marrow Transplant	1	1	—	—	$204,394.83	$204,394.83	$204,394.83	2025-01-01
'5-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	1	1	—	—	$200,948.10	$200,948.10	$200,948.10	2025-01-01
'631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	2	1	—	—	$185,728.18	$213,587.41	$199,657.79	2025-01-01
'002-2	OTHER	Heart And/or Lung Transplant	1	1	—	—	$196,853.34	$196,853.34	$196,853.34	2025-01-01
'6-3	OTHER	Pancreas Transplant	1	1	—	—	$194,201.54	$194,201.54	$194,201.54	2025-01-01
'2-1	OTHER	Heart And/or Lung Transplant	1	1	—	—	$194,070.44	$194,070.44	$194,070.44	2025-01-01
'1-3	OTHER	Liver Transplant And/or Intestinal Transplant	1	1	—	—	$193,085.52	$193,085.52	$193,085.52	2025-01-01
'602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$177,976.23	$204,672.66	$191,324.45	2025-01-01
'609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	2	1	—	—	$175,275.32	$201,566.62	$188,420.97	2025-01-01
'7-3	OTHER	Allogeneic Bone Marrow Transplant	1	1	—	—	$184,933.83	$184,933.83	$184,933.83	2025-01-01
'004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	1	1	—	—	$180,107.14	$180,107.14	$180,107.14	2025-01-01
'11-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	1	—	—	$178,825.95	$178,825.95	$178,825.95	2025-01-01
'593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	2	1	—	—	$166,254.76	$191,192.97	$178,723.86	2025-01-01
'005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	1	1	—	—	$174,737.48	$174,737.48	$174,737.48	2025-01-01
'006-3	OTHER	Pancreas Transplant	1	1	—	—	$168,870.90	$168,870.90	$168,870.90	2025-01-01
'002-1	OTHER	Heart And/or Lung Transplant	1	1	—	—	$168,756.90	$168,756.90	$168,756.90	2025-01-01
'303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	2	1	—	—	$156,409.91	$179,871.40	$168,140.65	2025-01-01
'001-3	OTHER	Liver Transplant And/or Intestinal Transplant	1	1	—	—	$167,900.45	$167,900.45	$167,900.45	2025-01-01
'7-2	OTHER	Allogeneic Bone Marrow Transplant	1	1	—	—	$167,381.67	$167,381.67	$167,381.67	2025-01-01
'6-2	OTHER	Pancreas Transplant	1	1	—	—	$166,998.46	$166,998.46	$166,998.46	2025-01-01
'602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$153,144.85	$176,116.58	$164,630.71	2025-01-01
'591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	2	1	—	—	$152,991.39	$175,940.10	$164,465.74	2025-01-01
'1-2	OTHER	Liver Transplant And/or Intestinal Transplant	1	1	—	—	$162,416.72	$162,416.72	$162,416.72	2025-01-01
'007-3	OTHER	Allogeneic Bone Marrow Transplant	1	1	—	—	$160,812.03	$160,812.03	$160,812.03	2025-01-01
'630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	2	1	—	—	$147,303.12	$169,398.59	$158,350.85	2025-01-01
'842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	2	1	—	—	$145,603.36	$167,443.86	$156,523.61	2025-01-01
'4-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	1	1	—	—	$156,199.59	$156,199.59	$156,199.59	2025-01-01
'011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	1	—	—	$155,500.83	$155,500.83	$155,500.83	2025-01-01
'589-1	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	2	1	—	—	$142,772.38	$164,188.24	$153,480.31	2025-01-01
'91-4	OTHER	Other Major Head And Neck Procedures	1	1	—	—	$153,214.57	$153,214.57	$153,214.57	2025-01-01
'7-1	OTHER	Allogeneic Bone Marrow Transplant	1	1	—	—	$153,029.68	$153,029.68	$153,029.68	2025-01-01
'863-4	OTHER	Neonatal Aftercare	2	1	—	—	$140,299.47	$161,344.39	$150,821.93	2025-01-01
'440-4	OTHER	Kidney Transplant	2	1	—	—	$137,079.72	$157,641.68	$147,360.70	2025-01-01
'007-2	OTHER	Allogeneic Bone Marrow Transplant	1	1	—	—	$145,549.28	$145,549.28	$145,549.28	2025-01-01
'006-2	OTHER	Pancreas Transplant	1	1	—	—	$145,216.05	$145,216.05	$145,216.05	2025-01-01
'001-2	OTHER	Liver Transplant And/or Intestinal Transplant	1	1	—	—	$141,231.93	$141,231.93	$141,231.93	2025-01-01
'602-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$131,202.91	$150,883.35	$141,043.13	2025-01-01
'1-1	OTHER	Liver Transplant And/or Intestinal Transplant	1	1	—	—	$140,494.58	$140,494.58	$140,494.58	2025-01-01
'841-3	OTHER	Extensive Third Degree Burns With Skin Graft	2	1	—	—	$129,019.39	$148,372.30	$138,695.85	2025-01-01
'593-2	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	2	1	—	—	$128,686.16	$147,989.08	$138,337.62	2025-01-01
'611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	2	1	—	—	$128,621.85	$147,915.13	$138,268.49	2025-01-01
'9-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	1	1	—	—	$137,114.58	$137,114.58	$137,114.58	2025-01-01
'613-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	2	1	—	—	$127,439.48	$146,555.40	$136,997.44	2025-01-01
'5-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	1	1	—	—	$136,973.40	$136,973.40	$136,973.40	2025-01-01
'603-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	2	1	—	—	$126,930.87	$145,970.50	$136,450.68	2025-01-01
'004-2	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	1	1	—	—	$135,825.73	$135,825.73	$135,825.73	2025-01-01
'11-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	1	—	—	$135,620.39	$135,620.39	$135,620.39	2025-01-01
'220-4	OTHER	Major Stomach, Esophageal And Duodenal Procedures	2	1	—	—	$125,562.87	$144,397.30	$134,980.08	2025-01-01
'6-1	OTHER	Pancreas Transplant	1	1	—	—	$133,621.96	$133,621.96	$133,621.96	2025-01-01
'091-4	OTHER	Other Major Head And Neck Procedures	1	1	—	—	$133,230.06	$133,230.06	$133,230.06	2025-01-01
'007-1	OTHER	Allogeneic Bone Marrow Transplant	1	1	—	—	$133,069.29	$133,069.29	$133,069.29	2025-01-01
'178-4	OTHER	External Heart Assist Systems	2	1	—	—	$123,621.96	$142,165.25	$132,893.61	2025-01-01
'589-2	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	2	1	—	—	$118,524.15	$136,302.77	$127,413.46	2025-01-01
'167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	2	1	—	—	$117,667.69	$135,317.84	$126,492.76	2025-01-01
'680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	2	1	—	—	$116,846.32	$134,373.27	$125,609.79	2025-01-01
'690-4	OTHER	Acute Leukemia	2	1	—	—	$115,203.56	$132,484.09	$123,843.82	2025-01-01
'001-1	OTHER	Liver Transplant And/or Intestinal Transplant	1	1	—	—	$122,169.20	$122,169.20	$122,169.20	2025-01-01
'608-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	2	1	—	—	$113,176.42	$130,152.88	$121,664.65	2025-01-01
'621-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	2	1	—	—	$112,559.65	$129,443.60	$121,001.62	2025-01-01
'633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	2	1	—	—	$111,288.12	$127,981.34	$119,634.73	2025-01-01
'009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	1	1	—	—	$119,230.07	$119,230.07	$119,230.07	2025-01-01
'005-3	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	1	1	—	—	$119,107.30	$119,107.30	$119,107.30	2025-01-01
'312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	2	1	—	—	$110,095.51	$126,609.84	$118,352.67	2025-01-01
'011-2	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	1	—	—	$117,930.77	$117,930.77	$117,930.77	2025-01-01
'740-4	OTHER	Mental Illness Diagnosis With O.r. Procedure	2	1	—	—	$109,636.59	$126,082.08	$117,859.33	2025-01-01
'162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	2	1	—	—	$108,145.83	$124,367.70	$116,256.76	2025-01-01
'006-1	OTHER	Pancreas Transplant	1	1	—	—	$116,193.01	$116,193.01	$116,193.01	2025-01-01
'8-3	OTHER	Autologous Bone Marrow Transplant	1	1	—	—	$115,881.56	$115,881.56	$115,881.56	2025-01-01
'440-3	OTHER	Kidney Transplant	2	1	—	—	$106,658.00	$122,656.70	$114,657.35	2025-01-01
'910-4	OTHER	Craniotomy For Multiple Significant Trauma	2	1	—	—	$106,431.46	$122,396.18	$114,413.82	2025-01-01
'303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	2	1	—	—	$106,077.77	$121,989.44	$114,033.61	2025-01-01
'92-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	1	1	—	—	$113,689.85	$113,689.85	$113,689.85	2025-01-01
'9-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	1	1	—	—	$112,883.09	$112,883.09	$112,883.09	2025-01-01
'5-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	1	1	—	—	$112,553.66	$112,553.66	$112,553.66	2025-01-01
'183-4	OTHER	Percutaneous Structural Cardiac Procedures	2	1	—	—	$104,012.63	$119,614.52	$111,813.58	2025-01-01
'179-4	OTHER	Defibrillator Implants	2	1	—	—	$103,084.56	$118,547.24	$110,815.90	2025-01-01
'361-4	OTHER	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	2	1	—	—	$102,722.10	$118,130.42	$110,426.26	2025-01-01
'608-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	2	1	—	—	$102,486.79	$117,859.81	$110,173.30	2025-01-01
'614-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	2	1	—	—	$102,412.26	$117,774.10	$110,093.18	2025-01-01
'440-2	OTHER	Kidney Transplant	2	1	—	—	$101,383.34	$116,590.84	$108,987.09	2025-01-01
'4-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	1	1	—	—	$107,761.82	$107,761.82	$107,761.82	2025-01-01
'591-2	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	2	1	—	—	$100,119.12	$115,136.99	$107,628.05	2025-01-01
'163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	2	1	—	—	$98,720.43	$113,528.49	$106,124.46	2025-01-01
'510-4	OTHER	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	2	1	—	—	$98,691.20	$113,494.88	$106,093.04	2025-01-01
'21-4	OTHER	Open Craniotomy Except Trauma	1	1	—	—	$105,346.57	$105,346.57	$105,346.57	2025-01-01
'651-4	OTHER	Other Procedures Of Blood And Blood-forming Organs	2	1	—	—	$97,992.59	$112,691.48	$105,342.04	2025-01-01
'440-1	OTHER	Kidney Transplant	2	1	—	—	$97,980.90	$112,678.04	$105,329.47	2025-01-01
'612-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$97,973.59	$112,669.63	$105,321.61	2025-01-01
'759-4	OTHER	Eating Disorders	2	1	—	—	$96,535.45	$111,015.77	$103,775.61	2025-01-01
'631-3	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	2	1	—	—	$96,010.76	$110,412.37	$103,211.57	2025-01-01
'160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	2	1	—	—	$95,376.45	$109,682.92	$102,529.68	2025-01-01
'589-3	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	2	1	—	—	$94,274.46	$108,415.63	$101,345.05	2025-01-01
'5-1	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	1	1	—	—	$101,178.29	$101,178.29	$101,178.29	2025-01-01
'630-2	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	2	1	—	—	$93,938.31	$108,029.06	$100,983.68	2025-01-01
'008-3	OTHER	Autologous Bone Marrow Transplant	1	1	—	—	$100,766.57	$100,766.57	$100,766.57	2025-01-01
'441-4	OTHER	Major Bladder Procedures	2	1	—	—	$93,543.70	$107,575.26	$100,559.48	2025-01-01
'89-4	OTHER	Major Cranial Or Facial Bone Procedures	1	1	—	—	$100,342.95	$100,342.95	$100,342.95	2025-01-01
'092-4	OTHER	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	1	1	—	—	$98,860.74	$98,860.74	$98,860.74	2025-01-01
'178-3	OTHER	External Heart Assist Systems	2	1	—	—	$91,455.17	$105,173.45	$98,314.31	2025-01-01
'009-2	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	1	1	—	—	$98,159.21	$98,159.21	$98,159.21	2025-01-01
'005-2	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	1	1	—	—	$97,872.75	$97,872.75	$97,872.75	2025-01-01
'120-4	OTHER	Major Respiratory And Chest Procedures	2	1	—	—	$90,125.18	$103,643.96	$96,884.57	2025-01-01
'8-2	OTHER	Autologous Bone Marrow Transplant	1	1	—	—	$96,510.82	$96,510.82	$96,510.82	2025-01-01
'695-4	OTHER	Chemotherapy For Acute Leukemia	2	1	—	—	$88,513.11	$101,790.08	$95,151.60	2025-01-01
'303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	2	1	—	—	$88,431.27	$101,695.96	$95,063.62	2025-01-01
'304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	2	1	—	—	$87,333.66	$100,433.71	$93,883.68	2025-01-01
'004-1	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	1	1	—	—	$93,705.93	$93,705.93	$93,705.93	2025-01-01
'401-4	OTHER	Adrenal Procedures	2	1	—	—	$87,137.82	$100,208.49	$93,673.15	2025-01-01
'26-4	OTHER	Other Nervous System And Related Procedures	1	1	—	—	$93,569.50	$93,569.50	$93,569.50	2025-01-01
'404-4	OTHER	Thyroid, Parathyroid And Thyroglossal Procedures	2	1	—	—	$86,759.28	$99,773.17	$93,266.23	2025-01-01
'9-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	1	1	—	—	$92,641.71	$92,641.71	$92,641.71	2025-01-01
'27-4	OTHER	Other Open Craniotomy	1	1	—	—	$92,337.50	$92,337.50	$92,337.50	2025-01-01
'611-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	2	1	—	—	$85,338.67	$98,139.47	$91,739.07	2025-01-01
'021-4	OTHER	Open Craniotomy Except Trauma	1	1	—	—	$91,605.71	$91,605.71	$91,605.71	2025-01-01
'178-2	OTHER	External Heart Assist Systems	2	1	—	—	$85,207.14	$97,988.21	$91,597.68	2025-01-01
'423-4	OTHER	Inborn Errors Of Metabolism	2	1	—	—	$84,752.60	$97,465.49	$91,109.05	2025-01-01
'950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	2	1	—	—	$84,547.99	$97,230.19	$90,889.09	2025-01-01
'607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$84,205.99	$96,836.89	$90,521.44	2025-01-01
'176-4	OTHER	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	2	1	—	—	$83,888.84	$96,472.17	$90,180.51	2025-01-01
'511-4	OTHER	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	2	1	—	—	$82,992.92	$95,441.86	$89,217.39	2025-01-01
'22-4	OTHER	Ventricular Shunt Procedures	1	1	—	—	$89,019.68	$89,019.68	$89,019.68	2025-01-01
'005-1	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	1	1	—	—	$87,981.12	$87,981.12	$87,981.12	2025-01-01
'792-4	OTHER	Extensive O.r. Procedures For Other Complications Of Treatment	2	1	—	—	$81,250.78	$93,438.40	$87,344.59	2025-01-01
'089-4	OTHER	Major Cranial Or Facial Bone Procedures	1	1	—	—	$87,254.74	$87,254.74	$87,254.74	2025-01-01
'232-4	OTHER	Gastric Fundoplication	2	1	—	—	$81,106.09	$93,272.00	$87,189.04	2025-01-01
'614-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	2	1	—	—	$80,647.17	$92,744.25	$86,695.71	2025-01-01
'681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	2	1	—	—	$80,483.47	$92,555.99	$86,519.73	2025-01-01
'169-4	OTHER	Major Abdominal Vascular Procedures	2	1	—	—	$80,407.47	$92,468.59	$86,438.03	2025-01-01
'260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	2	1	—	—	$80,350.47	$92,403.04	$86,376.76	2025-01-01
'20-4	OTHER	Open Craniotomy For Trauma	1	1	—	—	$85,385.88	$85,385.88	$85,385.88	2025-01-01
'750-4	OTHER	Schizophrenia	2	1	—	—	$79,384.40	$91,292.06	$85,338.23	2025-01-01
'911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	2	1	—	—	$79,323.02	$91,221.47	$85,272.24	2025-01-01
'512-4	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy	2	1	—	—	$78,618.56	$90,411.34	$84,514.95	2025-01-01
'622-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$78,175.72	$89,902.08	$84,038.90	2025-01-01
'165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	2	1	—	—	$78,104.10	$89,819.72	$83,961.91	2025-01-01
'008-2	OTHER	Autologous Bone Marrow Transplant	1	1	—	—	$83,922.45	$83,922.45	$83,922.45	2025-01-01
'612-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$77,903.88	$89,589.46	$83,746.67	2025-01-01
'623-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	2	1	—	—	$77,193.57	$88,772.61	$82,983.09	2025-01-01
'613-3	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	2	1	—	—	$77,031.34	$88,586.04	$82,808.69	2025-01-01
'183-3	OTHER	Percutaneous Structural Cardiac Procedures	2	1	—	—	$77,005.03	$88,555.78	$82,780.40	2025-01-01
'362-4	OTHER	Mastectomy Procedures	2	1	—	—	$76,950.96	$88,493.60	$82,722.28	2025-01-01
'850-4	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	2	1	—	—	$76,948.04	$88,490.25	$82,719.14	2025-01-01
'405-4	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	2	1	—	—	$76,598.73	$88,088.54	$82,343.63	2025-01-01
'29-4	OTHER	Other Percutaneous Intracranial Procedures	1	1	—	—	$82,088.23	$82,088.23	$82,088.23	2025-01-01
'130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	2	1	—	—	$76,059.43	$87,468.34	$81,763.88	2025-01-01
'178-1	OTHER	External Heart Assist Systems	2	1	—	—	$75,998.04	$87,397.75	$81,697.89	2025-01-01
'514-4	OTHER	Female Reproductive System Reconstructive Procedures	2	1	—	—	$75,943.96	$87,335.55	$81,639.76	2025-01-01
'026-4	OTHER	Other Nervous System And Related Procedures	1	1	—	—	$81,364.78	$81,364.78	$81,364.78	2025-01-01
'009-1	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	1	1	—	—	$80,558.01	$80,558.01	$80,558.01	2025-01-01
'027-4	OTHER	Other Open Craniotomy	1	1	—	—	$80,293.48	$80,293.48	$80,293.48	2025-01-01
'179-3	OTHER	Defibrillator Implants	2	1	—	—	$74,682.67	$85,885.07	$80,283.87	2025-01-01
'752-4	OTHER	Disorders Of Personality And Impulse Control	2	1	—	—	$74,326.05	$85,474.96	$79,900.51	2025-01-01
'912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	2	1	—	—	$73,950.44	$85,043.01	$79,496.73	2025-01-01
'230-4	OTHER	Major Small Bowel Procedures	2	1	—	—	$73,649.36	$84,696.76	$79,173.06	2025-01-01
'166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	2	1	—	—	$73,134.91	$84,105.15	$78,620.03	2025-01-01
'483-4	OTHER	Penis, Testes And Scrotal Procedures	2	1	—	—	$72,544.45	$83,426.12	$77,985.29	2025-01-01
'609-2	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	2	1	—	—	$72,402.68	$83,263.08	$77,832.88	2025-01-01
'264-4	OTHER	Other Hepatobiliary, Pancreas And Abdominal Procedures	2	1	—	—	$72,363.22	$83,217.70	$77,790.46	2025-01-01
'480-4	OTHER	Major Male Pelvic Procedures	2	1	—	—	$72,206.84	$83,037.87	$77,622.35	2025-01-01
'022-4	OTHER	Ventricular Shunt Procedures	1	1	—	—	$77,408.42	$77,408.42	$77,408.42	2025-01-01
'625-4	OTHER	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	2	1	—	—	$71,113.61	$81,780.65	$76,447.13	2025-01-01
'162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	2	1	—	—	$70,952.84	$81,595.77	$76,274.30	2025-01-01
'711-4	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	2	1	—	—	$70,881.23	$81,513.41	$76,197.32	2025-01-01
'170-4	OTHER	Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock	2	1	—	—	$70,872.46	$81,503.33	$76,187.90	2025-01-01
'484-4	OTHER	Other Male Reproductive System And Related Procedures	2	1	—	—	$70,131.46	$80,651.18	$75,391.32	2025-01-01
'609-1	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	2	1	—	—	$70,030.62	$80,535.21	$75,282.92	2025-01-01
'23-4	OTHER	Spinal Procedures	1	1	—	—	$74,902.98	$74,902.98	$74,902.98	2025-01-01
'020-4	OTHER	Open Craniotomy For Trauma	1	1	—	—	$74,248.59	$74,248.59	$74,248.59	2025-01-01
'222-4	OTHER	Other Stomach, Esophageal And Duodenal Procedures	2	1	—	—	$68,873.09	$79,204.05	$74,038.57	2025-01-01
'740-3	OTHER	Mental Illness Diagnosis With O.r. Procedure	2	1	—	—	$68,387.86	$78,646.04	$73,516.95	2025-01-01
'181-4	OTHER	Lower Extremity Arterial Procedures	2	1	—	—	$68,064.86	$78,274.59	$73,169.73	2025-01-01
'690-3	OTHER	Acute Leukemia	2	1	—	—	$67,684.86	$77,837.59	$72,761.23	2025-01-01
'73-4	OTHER	Orbit And Eye Procedures	1	1	—	—	$72,686.07	$72,686.07	$72,686.07	2025-01-01
407	LOCAL	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	13	13	—	—	$69,862.83	$152,033.09	$72,396.71	2025-01-01
'309-4	OTHER	Other Significant Hip And Femur Surgery	2	1	—	—	$66,863.49	$76,893.01	$71,878.25	2025-01-01
'261-4	OTHER	Major Biliary Tract Procedures	2	1	—	—	$66,591.64	$76,580.39	$71,586.01	2025-01-01
'029-4	OTHER	Other Percutaneous Intracranial Procedures	1	1	—	—	$71,381.07	$71,381.07	$71,381.07	2025-01-01
'621-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	2	1	—	—	$66,346.10	$76,298.02	$71,322.06	2025-01-01
'317-4	OTHER	Tendon, Muscle And Other Soft Tissue Procedures	2	1	—	—	$66,166.34	$76,091.29	$71,128.82	2025-01-01
'30-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	1	1	—	—	$70,580.08	$70,580.08	$70,580.08	2025-01-01
'607-2	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$65,517.42	$75,345.03	$70,431.23	2025-01-01
'650-4	OTHER	Splenectomy	2	1	—	—	$65,473.57	$75,294.61	$70,384.09	2025-01-01
'445-4	OTHER	Other Bladder Procedures	2	1	—	—	$65,374.19	$75,180.32	$70,277.26	2025-01-01
'519-4	OTHER	Uterine And Adnexa Procedures For Leiomyoma	2	1	—	—	$64,985.42	$74,733.23	$69,859.32	2025-01-01
'91-3	OTHER	Other Major Head And Neck Procedures	1	1	—	—	$69,753.15	$69,753.15	$69,753.15	2025-01-01
'710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	2	1	—	—	$64,270.73	$73,911.34	$69,091.04	2025-01-01
'182-4	OTHER	Other Peripheral Vascular And Related Procedures	2	1	—	—	$63,928.73	$73,518.04	$68,723.38	2025-01-01
'910-3	OTHER	Craniotomy For Multiple Significant Trauma	2	1	—	—	$63,415.74	$72,928.10	$68,171.92	2025-01-01
'98-4	OTHER	Other Ear, Nose, Mouth And Throat Procedures	1	1	—	—	$68,119.45	$68,119.45	$68,119.45	2025-01-01
'518-4	OTHER	Other Female Reproductive System And Related Procedures	2	1	—	—	$63,358.74	$72,862.55	$68,110.65	2025-01-01
'167-3	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	2	1	—	—	$63,291.51	$72,785.24	$68,038.38	2025-01-01
'49-4	OTHER	Bacterial And Tuberculous Infections Of Nervous System	1	1	—	—	$67,484.13	$67,484.13	$67,484.13	2025-01-01
'183-2	OTHER	Percutaneous Structural Cardiac Procedures	2	1	—	—	$62,418.98	$71,781.83	$67,100.40	2025-01-01
'951-4	OTHER	Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis	2	1	—	—	$62,148.59	$71,470.88	$66,809.74	2025-01-01
A9542	HCPCS	Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries	43	25	$97,800.00	$53,790.00 45% off	$3,572.45	$89,477.22	$66,504.00	2025-01-01
'447-4	OTHER	Other Kidney, Urinary Tract And Related Procedures	2	1	—	—	$61,673.60	$70,924.64	$66,299.12	2025-01-01
'403-4	OTHER	Procedures For Obesity	2	1	—	—	$61,514.29	$70,741.43	$66,127.86	2025-01-01
'634-4	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	2	1	—	—	$61,156.21	$70,329.64	$65,742.93	2025-01-01
'50-4	OTHER	Non-bacterial Infections Of Nervous System Except Viral Meningitis	1	1	—	—	$65,423.51	$65,423.51	$65,423.51	2025-01-01
'8-1	OTHER	Autologous Bone Marrow Transplant	1	1	—	—	$65,352.92	$65,352.92	$65,352.92	2025-01-01
'023-4	OTHER	Spinal Procedures	1	1	—	—	$65,133.03	$65,133.03	$65,133.03	2025-01-01
0408T	OTHER	Hc Insertion/replacement Cardiac Modulation System Pulse Generat	60	36	$128,597.00	$70,728.35 45% off	$4,706.00	$124,764.81	$65,062.53	2025-01-01
'229-4	OTHER	Other Digestive System And Abdominal Procedures	2	1	—	—	$60,359.68	$69,413.63	$64,886.65	2025-01-01
'175-4	OTHER	Percutaneous Cardiac Intervention Without Ami	2	1	—	—	$60,330.45	$69,380.02	$64,855.24	2025-01-01
'636-4	OTHER	Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection	2	1	—	—	$60,232.53	$69,267.41	$64,749.97	2025-01-01
'24-4	OTHER	Open Extracranial Vascular Procedures	1	1	—	—	$64,562.97	$64,562.97	$64,562.97	2025-01-01
'43-4	OTHER	Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies	1	1	—	—	$64,531.03	$64,531.03	$64,531.03	2025-01-01
'121-4	OTHER	Other Respiratory And Chest Procedures	2	1	—	—	$60,010.38	$69,011.94	$64,511.16	2025-01-01
'163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	2	1	—	—	$59,929.99	$68,919.49	$64,424.74	2025-01-01
'130-3	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	2	1	—	—	$59,563.15	$68,497.62	$64,030.38	2025-01-01
'183-1	OTHER	Percutaneous Structural Cardiac Procedures	2	1	—	—	$59,416.99	$68,329.54	$63,873.26	2025-01-01
'623-3	OTHER	Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection	2	1	—	—	$59,402.38	$68,312.74	$63,857.56	2025-01-01
1904	LOCAL	Guillain-barr? M <38.50	13	13	—	—	$61,565.17	$133,976.01	$63,798.10	2025-01-01
J9029	HCPCS	Instill Adstiladrin, Tx Dose	14	13	—	—	$31,752.70	$133,348.59	$63,502.37	2025-01-01
'11-1	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	1	—	—	$63,273.83	$63,273.83	$63,273.83	2025-01-01
'073-4	OTHER	Orbit And Eye Procedures	1	1	—	—	$63,205.28	$63,205.28	$63,205.28	2025-01-01
C9098	HCPCS	Ciltacabtagene Car Pos T	1	1	—	—	$63,034.11	$63,034.11	$63,034.11	2025-01-01
C9073	HCPCS	Brexucabtagene Autoleucel Ca	1	1	—	—	$63,034.11	$63,034.11	$63,034.11	2025-01-01
C9076	HCPCS	Lisocabtagene Car Pos T	1	1	—	—	$63,034.11	$63,034.11	$63,034.11	2025-01-01
C9081	HCPCS	Idecabtagene Car Pos T	1	1	—	—	$63,034.11	$63,034.11	$63,034.11	2025-01-01
Q2040	HCPCS	Tisagenlecleucel Car-pos T	1	1	—	—	$63,034.11	$63,034.11	$63,034.11	2025-01-01
'304-3	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	2	1	—	—	$58,604.38	$67,395.04	$62,999.71	2025-01-01
'603-2	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	2	1	—	—	$58,266.77	$67,006.79	$62,636.78	2025-01-01
'313-4	OTHER	Knee And Lower Leg Procedures Except Foot	2	1	—	—	$58,174.70	$66,900.91	$62,537.81	2025-01-01
'952-4	OTHER	Non-extensive O.r. Procedure Unrelated To Principal Diagnosis	2	1	—	—	$58,040.23	$66,746.26	$62,393.24	2025-01-01
'310-4	OTHER	Vertebral And Intervertebral Spinal Procedures Including Disc Procedures	2	1	—	—	$57,879.47	$66,561.39	$62,220.43	2025-01-01
'180-4	OTHER	Other Circulatory System Procedures	2	1	—	—	$57,791.77	$66,460.54	$62,126.15	2025-01-01
'513-4	OTHER	Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma	2	1	—	—	$57,620.78	$66,263.90	$61,942.34	2025-01-01
'444-4	OTHER	Renal Dialysis Access Device Procedures	2	1	—	—	$57,416.16	$66,028.58	$61,722.37	2025-01-01
'89-3	OTHER	Major Cranial Or Facial Bone Procedures	1	1	—	—	$61,517.43	$61,517.43	$61,517.43	2025-01-01
'305-4	OTHER	Amputation Of Lower Limb Except Toes	2	1	—	—	$57,120.93	$65,689.07	$61,405.00	2025-01-01
'030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	1	1	—	—	$61,373.98	$61,373.98	$61,373.98	2025-01-01
'97-4	OTHER	Tonsil And Adenoid Procedures	1	1	—	—	$61,246.83	$61,246.83	$61,246.83	2025-01-01
'325-4	OTHER	Non-elective Or Complex Knee Joint Replacement	2	1	—	—	$56,451.55	$64,919.28	$60,685.42	2025-01-01
'631-2	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	2	1	—	—	$56,423.78	$64,887.35	$60,655.57	2025-01-01
'091-3	OTHER	Other Major Head And Neck Procedures	1	1	—	—	$60,654.91	$60,654.91	$60,654.91	2025-01-01
'160-2	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	2	1	—	—	$56,420.86	$64,883.99	$60,652.43	2025-01-01
'692-4	OTHER	Radiotherapy	2	1	—	—	$56,333.17	$64,783.15	$60,558.16	2025-01-01
'910-2	OTHER	Craniotomy For Multiple Significant Trauma	2	1	—	—	$56,328.78	$64,778.10	$60,553.44	2025-01-01
'131-4	OTHER	Cystic Fibrosis - Pulmonary Disease	2	1	—	—	$55,733.94	$64,094.03	$59,913.99	2025-01-01
'363-4	OTHER	Breast Procedures Except Mastectomy	2	1	—	—	$55,720.79	$64,078.91	$59,899.85	2025-01-01
'381-4	OTHER	Major Skin Disorders	2	1	—	—	$55,466.48	$63,786.45	$59,626.46	2025-01-01
'633-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	2	1	—	—	$55,231.18	$63,515.86	$59,373.52	2025-01-01
'162-2	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	2	1	—	—	$55,155.18	$63,428.46	$59,291.82	2025-01-01
'098-4	OTHER	Other Ear, Nose, Mouth And Throat Procedures	1	1	—	—	$59,234.30	$59,234.30	$59,234.30	2025-01-01
'322-4	OTHER	Shoulder And Elbow Joint Replacement	2	1	—	—	$55,047.02	$63,304.07	$59,175.54	2025-01-01
'793-4	OTHER	Moderately Extensive O.r. Procedures For Other Complications Of Treatment	2	1	—	—	$54,826.33	$63,050.28	$58,938.31	2025-01-01
'612-2	OTHER	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$54,786.87	$63,004.90	$58,895.89	2025-01-01
'303-1	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	2	1	—	—	$54,595.41	$62,784.72	$58,690.07	2025-01-01
'049-4	OTHER	Bacterial And Tuberculous Infections Of Nervous System	1	1	—	—	$58,681.85	$58,681.85	$58,681.85	2025-01-01

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