Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

SHANDS JACKSONVILLE

Jacksonville, FL · CCN 100001 · Rates published

24,361 distinct procedures filed
47 distinct payers
2,937,738 rate rows
2026-03-31 last MRF observed
Data quality

2,690,344 of 2,937,738 rate rows are consumer-grade (91.6%)

247,394 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 222,404
template filing: same amount across many unrelated codes — excluded 16,430
placeholder amount (≤ $0.02) — excluded from medians 6,428
exceeds 10× this hospital's gross charge — excluded from medians 1,582
percent-of-charges filed in the dollar field — excluded from medians 312
per-diem day rate — not a per-procedure price 238
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://ufhealth.pt.panaceainc.com/MRFDownload/ufhealth/uf-jax
Found on page https://ufhealthjax.org/patients-and-visitors/insurance-billing-finance/procedure-cost#standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-18
Content fingerprint 71c51314cae65f94… · 22,995,138 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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 12 $4,279,750.00 $4,955,500.00 $4,550,050.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 2 $3,965,500.00 $4,686,500.00 $4,326,000.00 nat. median
$3,710,000
1.2× median
J1411
HCPCS 		Hemgenix 19 X 10 Ml IV Supk 15 $3,501,003.33 $4,774,770.00 $3,795,824.66 nat. median
$3,710,000
1.0× median
J3393
HCPCS 		Zynteglo IV Susp 21 $2,792,970.44 $4,926,880.00 $3,489,949.96 nat. median
$3,004,655
1.2× median
J1413
HCPCS 		Elevidys 18.5-19.4 Kg 19 X 10 Ml IV Kit 15 $3,161,466.73 $4,884,710.40 $3,444,334.81 nat. median
$3,325,455
1.0× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 14 $3,169,029.00 $4,169,775.00 $3,369,178.20 nat. median
$3,335,820
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 15 $3,089,882.67 $4,271,800.00 $3,350,083.31 nat. median
$3,286,000
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 14 $3,021,000.00 $3,975,000.00 $3,211,800.00 nat. median
$3,180,000
1.0× median
J3399
HCPCS 		Zolgensma 3.1-3.5 Kg 2x5.5ml & 1x8.3ml IV Kit 27 $11,639.52 $4,968,845.20 $2,891,859.95 nat. median
$2,468,984
1.2× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 17 $2,215,400.00 $4,197,600.00 $2,401,960.00 nat. median
$2,448,600
1.0× median
Q2042
HCPCS 		Kymriah 250000000 Cells IV Susp 44 $27,071.07 $2,235,552.66 $946,916.24 nat. median
$753,246
1.3× median
Q2056
HCPCS 		Carvykti 100000000 Cells IV Susp 44 $27,071.07 $2,133,418.45 $918,492.78 nat. median
$674,867
1.4× median
Q2041
HCPCS 		Yescarta 200000000 Cells IV Susp 44 $27,071.07 $1,774,938.39 $796,155.96 nat. median
$634,303
1.3× median
Q2057
HCPCS 		Afamitresgene Autoleucel 14 $732,089.00 $963,275.00 $778,326.20 nat. median
$824,563
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 23 $27,071.07 $930,106.94 $562,201.24 nat. median
$673,137
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 23 $27,071.07 $947,857.66 $558,081.72 nat. median
$625,184
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 23 $27,071.07 $828,954.72 $489,450.20 nat. median
$619,808
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 22 $184,865.57 $686,606.52 $485,587.74 nat. median
$370,174
1.3× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 22 $119,970.32 $471,809.53 $316,846.43 nat. median
$265,286
1.2× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 14 $264,337.50 $347,812.50 $281,032.50 nat. median
$324,450
0.9× median
J3403
HCPCS 		Revakinagene, Per Implant 14 $251,750.00 $331,250.00 $267,650.00 nat. median
$265,000
1.0× median
5834
APR_DRG 		8 $229,087.21 $532,798.81 $249,913.32 nat. median
$309,665
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 22 $91,401.49 $398,243.56 $242,561.47 nat. median
$206,474
1.2× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 22 $90,865.08 $360,327.83 $241,166.70 nat. median
$202,976
1.2× median
J1823
HCPCS 		Uplizna 100 Mg/10ml IV Soln 44 $470.76 $526,719.51 $221,776.64 nat. median
$798
outlier · 277.8×
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 14 $191,585.57 $252,086.28 $203,685.71 nat. median
$209,753
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 22 $59,297.84 $239,497.93 $158,164.84 nat. median
$133,161
1.2× median
5884
APR_DRG 		8 $140,311.53 $347,591.04 $153,067.13 nat. median
$246,434
0.6× median
J7504
HCPCS 		Atgam 50 Mg/ml IV Soln 39 $4,365.30 $322,806.06 $149,510.17 nat. median
$5,747
outlier · 26.0×
7
MS_DRG 		Lung Transplant 22 $55,439.81 $221,936.74 $147,874.32 nat. median
$122,708
1.2× median
C9293
HCPCS 		Voraxaze 1000 Units IV Solr 44 $426.26 $316,391.33 $143,974.71 nat. median
$21,216
outlier · 6.8×
0114
APR_DRG 		8 $131,167.70 $270,669.66 $143,092.03 nat. median
$197,700
0.7× median
0024
APR_DRG 		8 $131,081.13 $307,823.02 $142,997.59 nat. median
$372,987
outlier · 0.4×
5833
APR_DRG 		8 $130,472.78 $345,163.70 $142,333.94 nat. median
$244,017
0.6× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 22 $51,448.63 $222,482.84 $137,228.67 nat. median
$117,357
1.2× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 22 $48,511.44 $188,027.39 $129,394.31 nat. median
$108,660
1.2× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 $47,181.76 $179,020.09 $125,847.67 nat. median
$98,894
1.3× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 22 $46,552.02 $185,945.60 $124,167.98 nat. median
$102,358
1.2× median
209
MS_DRG 		Complex Aortic Arch Procedures 13 $113,044.46 $139,223.18 $122,564.00 nat. median
$98,047
1.3× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 22 $44,139.25 $181,899.51 $117,732.40 nat. median
$100,136
1.2× median
215
MS_DRG 		Other Heart Assist System Implant 22 $42,625.92 $180,995.98 $113,695.90 nat. median
$99,019
1.1× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 12 $105,927.48 $139,378.26 $112,617.64 nat. median
$111,989
1.0× median
5832
APR_DRG 		8 $100,178.98 $174,387.31 $109,286.16 nat. median
$156,126
0.7× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 $28,318.00 $165,379.23 $108,105.83 nat. median
$93,672
1.2× median
1614
APR_DRG 		8 $97,818.71 $263,803.18 $106,711.32 nat. median
$207,730
0.5× median
6094
APR_DRG 		8 $97,758.63 $228,542.06 $106,645.78 nat. median
$162,982
0.7× median
0113
APR_DRG 		8 $97,616.72 $157,854.43 $106,490.96 nat. median
$128,705
0.8× median
J9029
HCPCS 		Adstiladrin 300000000000 Vp/ml Is Susp 42 $61,061.05 $213,536.25 $105,168.92 nat. median
$69,774
1.5× median
0094
APR_DRG 		8 $95,894.05 $208,544.46 $104,611.69 nat. median
$166,008
0.6× median
J1303
HCPCS 		Ultomiris 300 Mg/3ml IV Soln 44 $213.56 $246,055.66 $103,602.38 nat. median
$4,664
outlier · 22.2×

Other procedures at this hospital

Browse this hospital's 24,361 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
             
0013 APR_DRG — 22 8 — — $37,880.18 $87,197.69 $41,323.84 2026-03-31
0014 APR_DRG — 22 8 — — $72,962.52 $186,396.53 $79,595.47 2026-03-31
0021 APR_DRG — 22 8 — — $45,903.97 $52,132.06 $50,077.06 2026-03-31
0022 APR_DRG — 22 8 — — $54,068.48 $82,767.58 $58,983.79 2026-03-31
0023 APR_DRG — 22 8 — — $71,402.31 $172,840.93 $77,893.43 2026-03-31
0024 APR_DRG — 22 8 — — $131,081.13 $307,823.02 $142,997.59 2026-03-31
0043 APR_DRG — 22 8 — — $50,818.80 $116,081.57 $55,438.69 2026-03-31
0044 APR_DRG — 22 8 — — $73,695.78 $185,120.09 $80,395.39 2026-03-31
0053 APR_DRG — 22 8 — — $37,258.40 $83,409.22 $40,645.52 2026-03-31
0054 APR_DRG — 22 8 — — $51,339.00 $120,748.91 $56,006.18 2026-03-31
0063 APR_DRG — 22 8 — — $36,728.71 $95,257.91 $40,067.69 2026-03-31
0064 APR_DRG — 22 8 — — $47,658.85 $134,089.27 $51,991.48 2026-03-31
0072 APR_DRG — 22 8 — — $34,565.69 $54,050.63 $37,708.02 2026-03-31
0073 APR_DRG — 22 8 — — $49,084.27 $102,436.28 $53,546.47 2026-03-31
0074 APR_DRG — 22 8 — — $77,175.52 $209,594.71 $84,191.47 2026-03-31
0084 APR_DRG — 22 8 — — $34,325.35 $103,884.12 $37,445.83 2026-03-31
0093 APR_DRG — 22 8 — — $64,446.80 $89,875.13 $70,305.60 2026-03-31
0094 APR_DRG — 22 8 — — $95,894.05 $208,544.46 $104,611.69 2026-03-31
0111 APR_DRG — 22 8 — — $24,526.33 $41,694.70 $38,915.05 2026-03-31
0112 APR_DRG — 22 8 — — $77,604.01 $89,185.91 $84,658.92 2026-03-31
0113 APR_DRG — 22 8 — — $97,616.72 $157,854.43 $106,490.96 2026-03-31
0114 APR_DRG — 22 8 — — $131,167.70 $270,669.66 $143,092.03 2026-03-31
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 70 23 — — $7,699.90 $63,239.04 $45,996.81 2026-03-31
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 88 22 — — $119,970.32 $471,809.53 $316,846.43 2026-03-31
10 MS_DRG Pancreas Transplant 88 22 — — $30,719.17 $137,609.34 $81,937.09 2026-03-31
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 90 22 — — $23,349.00 $94,962.41 $62,278.68 2026-03-31
12 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Cc 90 22 — — $18,048.70 $73,578.55 $48,530.56 2026-03-31
134041 CDM Jx Hb Kit Mitral Clip 154 41 $105,000.00 $57,750.00 45% off $16,275.00 $99,750.00 $54,600.00 2026-03-31
14 MS_DRG Allogeneic Bone Marrow Transplant 88 22 — — $51,448.63 $222,482.84 $137,228.67 2026-03-31
140 MS_DRG Major Head And Neck Procedures With Mcc 90 22 — — $18,259.75 $75,655.38 $49,044.43 2026-03-31
142521 CDM Jx Hb Tavr Valve Assy/deliv System 154 41 $108,500.00 $59,675.00 45% off $16,817.50 $103,075.00 $56,420.00 2026-03-31
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 90 22 — — $16,039.19 $60,310.04 $43,637.95 2026-03-31
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 88 22 — — $25,385.05 $105,553.41 $67,709.41 2026-03-31
1604 APR_DRG — 22 8 — — $56,153.23 $153,911.51 $61,258.07 2026-03-31
1611 APR_DRG — 22 8 — — $54,172.07 $61,481.88 $59,096.81 2026-03-31
1612 APR_DRG — 22 8 — — $56,358.39 $94,280.44 $61,481.88 2026-03-31
1613 APR_DRG — 22 8 — — $76,594.44 $178,495.74 $83,557.57 2026-03-31
1614 APR_DRG — 22 8 — — $97,818.71 $263,803.18 $106,711.32 2026-03-31
1624 APR_DRG — 22 8 — — $37,737.10 $105,071.88 $41,167.74 2026-03-31
163 MS_DRG Major Chest Procedures With Mcc 90 22 — — $19,186.59 $81,943.78 $51,301.03 2026-03-31
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 90 22 — — $16,001.09 $69,385.19 $43,545.18 2026-03-31
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 88 22 — — $23,255.68 $105,553.41 $62,029.75 2026-03-31
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 90 22 — — $184,865.57 $686,606.52 $485,587.74 2026-03-31
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 88 22 — — $30,543.22 $136,853.07 $81,467.79 2026-03-31
191637 CDM Jx Hb Graft Endovascular 21x8x10mm 20fr Gore Tag Thoracic Branch 154 41 $112,000.00 $61,600.00 45% off $17,360.00 $106,400.00 $58,240.00 2026-03-31
191641 CDM Jx Hb Graft Endovascular 21x8x10mm 20fr Gore Tag Thoracic Branch 154 41 $112,000.00 $61,600.00 45% off $17,360.00 $106,400.00 $58,240.00 2026-03-31
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 88 22 — — $48,511.44 $188,027.39 $129,394.31 2026-03-31
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 90 22 — — $33,686.33 $139,067.25 $89,851.39 2026-03-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 90 22 — — $27,546.95 $112,690.73 $73,475.84 2026-03-31
209 MS_DRG Complex Aortic Arch Procedures 36 13 — — $113,044.46 $139,223.18 $122,564.00 2026-03-31
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 90 22 — — $22,662.76 $97,136.88 $60,448.26 2026-03-31
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 90 22 — — $46,552.02 $185,945.60 $124,167.98 2026-03-31
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 36 13 — — $59,094.08 $72,779.02 $64,070.42 2026-03-31
215 MS_DRG Other Heart Assist System Implant 90 22 — — $42,625.92 $180,995.98 $113,695.90 2026-03-31
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 96 22 — — $28,318.00 $165,379.23 $108,105.83 2026-03-31
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 96 22 — — $28,148.86 $112,536.83 $74,186.74 2026-03-31
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 90 22 — — $28,148.86 $104,547.27 $75,081.31 2026-03-31
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 96 22 — — $28,318.00 $133,712.19 $85,850.89 2026-03-31
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 90 22 — — $13,602.45 $64,091.36 $37,605.16 2026-03-31
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 96 22 — — $22,829.72 $93,320.82 $60,824.44 2026-03-31
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 96 22 — — $21,577.10 $81,669.08 $57,552.48 2026-03-31
228 MS_DRG Other Cardiothoracic Procedures With Mcc 96 22 — — $21,179.82 $88,134.55 $56,492.83 2026-03-31
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 96 22 — — $13,483.01 $57,073.17 $36,981.38 2026-03-31
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 90 22 — — $24,531.41 $100,079.19 $65,432.52 2026-03-31
231 MS_DRG Coronary Bypass With Ptca With Mcc 96 22 — — $28,318.00 $145,898.43 $93,799.00 2026-03-31
232 MS_DRG Coronary Bypass With Ptca Without Mcc 96 22 — — $25,953.99 $106,758.12 $68,764.98 2026-03-31
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 90 22 — — $32,729.10 $135,017.86 $87,298.17 2026-03-31
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 90 22 — — $23,385.82 $93,709.71 $62,376.88 2026-03-31
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 90 22 — — $25,123.48 $103,043.01 $67,011.72 2026-03-31
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 90 22 — — $17,932.25 $73,717.56 $48,247.05 2026-03-31
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 90 22 — — $21,069.80 $89,021.53 $56,199.37 2026-03-31
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 90 22 — — $16,746.84 $68,580.94 $45,360.89 2026-03-31
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 90 22 — — $13,668.38 $61,801.05 $37,787.43 2026-03-31
245 MS_DRG Aicd Generator Procedures 90 22 — — $19,531.63 $86,537.63 $52,141.13 2026-03-31
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 90 22 — — $19,464.42 $79,678.31 $53,811.10 2026-03-31
252 MS_DRG Other Vascular Procedures With Mcc 90 22 — — $14,933.41 $62,436.50 $40,945.65 2026-03-31
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 90 22 — — $13,451.33 $52,095.40 $37,187.38 2026-03-31
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 90 22 — — $13,310.49 $57,498.10 $37,712.58 2026-03-31
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 90 22 — — $13,925.24 $62,036.04 $38,491.01 2026-03-31
264 MS_DRG Other Circulatory System O.r. Procedures 90 22 — — $14,301.11 $63,507.18 $39,406.15 2026-03-31
265 MS_DRG Aicd Lead Procedures 90 22 — — $15,489.51 $64,700.33 $42,299.62 2026-03-31
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 90 22 — — $26,235.68 $104,807.07 $69,978.30 2026-03-31
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 90 22 — — $20,380.98 $83,524.15 $54,362.10 2026-03-31
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 90 22 — — $29,444.29 $116,007.04 $78,536.61 2026-03-31
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 90 22 — — $18,079.52 $74,521.82 $48,605.61 2026-03-31
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 90 22 — — $22,587.84 $90,611.83 $60,248.43 2026-03-31
271 MS_DRG Other Major Cardiovascular Procedures With Cc 90 22 — — $15,224.52 $62,668.19 $41,654.43 2026-03-31
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 90 22 — — $17,661.27 $70,378.09 $47,587.27 2026-03-31
274 MS_DRG Percutaneous Intracardiac Procedures Without Mcc 90 22 — — $14,091.77 $57,316.43 $38,896.47 2026-03-31
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 90 22 — — $30,525.24 $122,616.46 $81,419.83 2026-03-31
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 90 22 — — $25,714.25 $108,176.32 $68,587.50 2026-03-31
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 90 22 — — $19,771.80 $82,650.40 $52,737.22 2026-03-31
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 90 22 — — $23,828.90 $88,502.58 $63,558.71 2026-03-31
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 90 22 — — $15,439.00 $58,696.57 $42,176.63 2026-03-31
28 MS_DRG Spinal Procedures With Mcc 90 22 — — $25,721.53 $106,274.91 $68,606.92 2026-03-31
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 90 22 — — $14,605.06 $61,216.88 $40,146.20 2026-03-31
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 90 22 — — $90,865.08 $360,327.83 $241,166.70 2026-03-31
3034 APR_DRG — 22 8 — — $37,554.87 $110,543.34 $40,968.95 2026-03-31
31 MS_DRG Ventricular Shunt Procedures With Mcc 90 22 — — $19,181.02 $75,016.61 $51,287.48 2026-03-31
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 90 22 — — $28,624.91 $108,043.94 $76,351.07 2026-03-31
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 90 22 — — $19,105.67 $78,362.71 $51,104.04 2026-03-31
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 90 22 — — $18,525.60 $76,155.14 $49,691.70 2026-03-31
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 90 22 — — $13,489.43 $58,542.67 $37,292.72 2026-03-31
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 90 22 — — $13,743.72 $53,032.04 $37,995.73 2026-03-31
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 90 22 — — $21,351.06 $89,718.22 $56,949.57 2026-03-31
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 90 22 — — $19,677.62 $81,657.49 $52,496.57 2026-03-31
332 MS_DRG Rectal Resection With Mcc 90 22 — — $15,500.22 $63,070.31 $42,325.68 2026-03-31
33276 HCPCS Insj Phrnc Nrv Stim Sys 48 17 — — $43,696.97 $81,307.08 $47,376.72 2026-03-31
335 MS_DRG Peritoneal Adhesiolysis With Mcc 90 22 — — $15,287.02 $65,630.36 $41,806.60 2026-03-31
34 MS_DRG Carotid Artery Stent Procedures With Mcc 90 22 — — $16,570.47 $70,020.64 $44,931.45 2026-03-31
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 90 22 — — $18,805.58 $76,259.40 $50,373.38 2026-03-31
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 36 13 — — $37,287.61 $45,922.64 $40,427.62 2026-03-31
37 MS_DRG Extracranial Procedures With Mcc 90 22 — — $14,093.48 $60,624.46 $38,900.63 2026-03-31
38240 HCPCS Transplt Allo Hct/donor 70 23 — — $2,950.31 $106,858.60 $65,686.31 2026-03-31
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 90 22 — — $59,297.84 $239,497.93 $158,164.84 2026-03-31
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 90 22 — — $16,529.80 $68,091.11 $44,832.44 2026-03-31
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 90 22 — — $17,211.76 $70,409.53 $46,492.84 2026-03-31
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 90 22 — — $23,419.21 $95,505.21 $62,465.94 2026-03-31
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 90 22 — — $15,264.33 $63,609.79 $41,751.36 2026-03-31
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 90 22 — — $14,141.43 $52,522.47 $39,017.37 2026-03-31
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 90 22 — — $15,251.49 $63,651.16 $41,720.09 2026-03-31
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 90 22 — — $14,585.80 $64,076.45 $40,099.29 2026-03-31
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 90 22 — — $17,778.99 $72,977.85 $47,873.91 2026-03-31
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 90 22 — — $47,181.76 $179,020.09 $125,847.67 2026-03-31
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 90 22 — — $30,902.83 $123,207.24 $82,426.96 2026-03-31
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 90 22 — — $24,067.78 $96,752.95 $64,195.88 2026-03-31
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 90 22 — — $38,570.10 $143,692.54 $102,877.83 2026-03-31
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 90 22 — — $24,688.96 $96,196.93 $65,852.73 2026-03-31
4404 APR_DRG — 22 8 — — $36,952.05 $98,192.44 $40,311.32 2026-03-31
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 90 22 — — $28,603.93 $116,620.98 $76,295.12 2026-03-31
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 90 22 — — $18,154.86 $73,244.28 $48,789.06 2026-03-31
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 90 22 — — $22,816.02 $90,894.81 $60,857.05 2026-03-31
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 90 22 — — $13,829.34 $56,737.24 $38,232.43 2026-03-31
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 90 22 — — $35,974.96 $145,820.66 $98,440.80 2026-03-31
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 90 22 — — $25,528.03 $107,783.50 $70,574.48 2026-03-31
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 90 22 — — $17,862.90 $107,783.50 $49,383.56 2026-03-31
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 90 22 — — $23,643.96 $107,221.48 $63,065.42 2026-03-31
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 90 22 — — $24,399.56 $95,046.82 $65,080.82 2026-03-31
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 90 22 — — $13,334.03 $54,463.49 $36,863.10 2026-03-31
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 90 22 — — $22,284.32 $89,976.38 $58,843.21 2026-03-31
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 90 22 — — $15,097.37 $62,350.46 $41,746.27 2026-03-31
471 MS_DRG Cervical Spinal Fusion With Mcc 90 22 — — $20,671.66 $86,049.44 $56,673.75 2026-03-31
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 90 22 — — $18,377.90 $79,883.50 $49,332.11 2026-03-31
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 90 22 — — $14,789.14 $62,578.83 $40,594.39 2026-03-31
4804 APR_DRG — 8 3 — — $41,217.43 $44,964.47 $44,964.47 2026-03-31
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 90 22 — — $13,815.22 $58,943.13 $38,193.37 2026-03-31
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 90 22 — — $15,718.12 $64,435.56 $42,856.21 2026-03-31
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 90 22 — — $15,521.62 $63,929.17 $42,377.79 2026-03-31
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 88 22 — — $44,139.25 $181,899.51 $117,732.40 2026-03-31
500 MS_DRG Soft Tissue Procedures With Mcc 90 22 — — $13,548.51 $58,105.79 $37,456.04 2026-03-31
5104 APR_DRG — 8 3 — — $50,515.89 $55,108.25 $55,108.25 2026-03-31
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 90 22 — — $13,643.12 $56,843.15 $37,717.60 2026-03-31
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 90 22 — — $15,999.38 $64,978.34 $43,541.01 2026-03-31
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 90 22 — — $28,046.54 $107,577.28 $74,808.41 2026-03-31
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 90 22 — — $14,861.06 $63,007.42 $40,769.50 2026-03-31
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 90 22 — — $20,982.04 $94,952.48 $55,965.28 2026-03-31
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 90 22 — — $13,864.02 $59,606.73 $38,328.30 2026-03-31
5831 APR_DRG — 22 8 — — $76,442.96 $98,097.60 $91,557.76 2026-03-31
5832 APR_DRG — 22 8 — — $100,178.98 $174,387.31 $109,286.16 2026-03-31
5833 APR_DRG — 22 8 — — $130,472.78 $345,163.70 $142,333.94 2026-03-31
5834 APR_DRG — 22 8 — — $229,087.21 $532,798.81 $249,913.32 2026-03-31
5881 APR_DRG — 22 8 — — $67,471.81 $74,874.85 $73,605.61 2026-03-31
5882 APR_DRG — 22 8 — — $80,074.17 $130,527.07 $87,353.64 2026-03-31
5883 APR_DRG — 22 8 — — $93,447.20 $226,063.91 $101,942.40 2026-03-31
5884 APR_DRG — 22 8 — — $140,311.53 $347,591.04 $153,067.13 2026-03-31
5891 APR_DRG — 22 8 — — $53,882.24 $71,350.45 $66,593.76 2026-03-31
5892 APR_DRG — 22 8 — — $65,404.58 $86,710.75 $71,350.45 2026-03-31
5893 APR_DRG — 22 8 — — $65,404.58 $128,969.56 $71,350.45 2026-03-31
58980078021 NDC Gattex 5 Mg Sc Kit 154 41 $113,808.63 $62,594.75 45% off $17,640.34 $108,118.20 $56,904.32 2026-03-31
5912 APR_DRG — 22 8 — — $59,517.54 $81,780.13 $64,928.22 2026-03-31
5913 APR_DRG — 22 8 — — $69,391.08 $163,894.87 $75,699.36 2026-03-31
5914 APR_DRG — 22 8 — — $92,009.53 $220,811.66 $100,374.04 2026-03-31
5931 APR_DRG — 22 8 — — $9,987.76 $39,516.14 $36,881.73 2026-03-31
5932 APR_DRG — 22 8 — — $47,597.19 $76,530.20 $51,924.20 2026-03-31
5933 APR_DRG — 22 8 — — $59,176.40 $142,001.03 $64,556.08 2026-03-31
5934 APR_DRG — 22 8 — — $80,894.00 $204,749.00 $88,248.00 2026-03-31
6 MS_DRG Liver Transplant Without Mcc 88 22 — — $19,851.00 $85,915.39 $52,948.47 2026-03-31
6022 APR_DRG — 22 8 — — $33,809.50 $56,751.32 $36,883.09 2026-03-31
6023 APR_DRG — 22 8 — — $42,311.78 $107,848.96 $46,158.30 2026-03-31
6024 APR_DRG — 22 8 — — $60,940.19 $152,042.18 $66,480.20 2026-03-31
6034 APR_DRG — 22 8 — — $44,572.04 $189,385.86 $48,624.05 2026-03-31
6074 APR_DRG — 22 8 — — $47,107.04 $116,521.99 $51,389.50 2026-03-31
6093 APR_DRG — 22 8 — — $33,911.48 $85,332.35 $36,994.34 2026-03-31
6094 APR_DRG — 22 8 — — $97,758.63 $228,542.06 $106,645.78 2026-03-31
6114 APR_DRG — 22 8 — — $39,179.50 $94,438.84 $42,741.28 2026-03-31
6134 APR_DRG — 22 8 — — $38,819.40 $94,882.25 $42,348.43 2026-03-31
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 90 22 — — $14,929.56 $69,628.45 $40,936.27 2026-03-31
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 90 22 — — $15,236.94 $67,592.99 $41,684.66 2026-03-31
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 90 22 — — $15,954.43 $70,963.90 $43,431.57 2026-03-31
6303 APR_DRG — 22 8 — — $47,003.86 $121,072.75 $51,276.94 2026-03-31
6304 APR_DRG — 22 8 — — $85,272.22 $253,555.76 $93,024.24 2026-03-31
6314 APR_DRG — 22 8 — — $94,026.31 $224,371.96 $102,574.15 2026-03-31
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 70 23 — — $13,339.61 $57,496.01 $45,996.81 2026-03-31
64654 HCPCS 1st Opn Implt Bat Modulj Sys 38 14 — — $43,696.97 $57,496.01 $46,456.78 2026-03-31
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 88 22 — — $20,126.69 $81,912.33 $53,683.83 2026-03-31
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 88 22 — — $15,864.53 $63,133.20 $43,212.68 2026-03-31
652 MS_DRG Kidney Transplant 88 22 — — $13,825.49 $56,495.63 $38,221.78 2026-03-31
653 MS_DRG Major Bladder Procedures With Mcc 90 22 — — $22,245.79 $97,919.62 $59,336.08 2026-03-31
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 90 22 — — $13,629.85 $59,583.56 $37,680.91 2026-03-31
665 MS_DRG Prostatectomy With Mcc 90 22 — — $13,361.86 $62,489.46 $36,940.03 2026-03-31
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 90 22 — — $17,987.05 $75,000.06 $48,380.47 2026-03-31
7 MS_DRG Lung Transplant 88 22 — — $55,439.81 $221,936.74 $147,874.32 2026-03-31
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 90 22 — — $15,302.43 $70,829.86 $41,844.12 2026-03-31
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 90 22 — — $15,337.97 $71,546.42 $41,930.64 2026-03-31
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 86 21 — — $25,444.12 $108,550.00 $70,342.51 2026-03-31
791 MS_DRG Prematurity With Major Problems 86 21 — — $17,376.58 $72,853.73 $46,894.13 2026-03-31
793 MS_DRG Full Term Neonate With Major Problems 86 21 — — $17,850.06 $74,683.98 $48,046.94 2026-03-31
799 MS_DRG Splenic Procedures With Mcc 90 22 — — $19,388.22 $84,353.23 $51,791.96 2026-03-31
8 MS_DRG Simultaneous Pancreas/kidney Transplant 88 22 — — $23,993.29 $95,710.40 $63,997.19 2026-03-31
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 90 22 — — $17,055.93 $64,991.59 $46,113.44 2026-03-31
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 90 22 — — $25,107.21 $102,018.65 $66,968.33 2026-03-31
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 90 22 — — $19,627.53 $83,107.14 $52,374.61 2026-03-31
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 90 22 — — $20,025.66 $84,695.77 $53,414.35 2026-03-31
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 90 22 — — $13,527.96 $56,700.82 $37,399.23 2026-03-31
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 90 22 — — $23,502.26 $97,136.88 $62,687.47 2026-03-31
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 90 22 — — $20,567.21 $88,530.04 $54,858.81 2026-03-31
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 90 22 — — $13,848.61 $58,441.73 $38,285.69 2026-03-31
8414 APR_DRG — 22 8 — — $87,012.29 $250,082.16 $94,922.50 2026-03-31
8424 APR_DRG — 22 8 — — $48,714.28 $128,075.75 $53,142.85 2026-03-31
850 MS_DRG Acute Leukemia With Other Procedures 90 22 — — $37,071.32 $158,111.17 $98,880.15 2026-03-31
8513 APR_DRG — 22 8 — — $34,702.11 $49,038.02 $45,768.82 2026-03-31
8514 APR_DRG — 22 8 — — $44,951.52 $130,014.83 $49,038.02 2026-03-31
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 90 22 — — $21,142.15 $88,432.42 $56,392.34 2026-03-31
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 90 22 — — $19,472.98 $80,328.65 $51,998.34 2026-03-31
8634 APR_DRG — 22 8 — — $38,318.96 $97,045.54 $41,802.50 2026-03-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 90 22 — — $29,589.42 $120,787.87 $78,923.70 2026-03-31
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 90 22 — — $16,545.64 $70,697.47 $44,871.00 2026-03-31
901 MS_DRG Wound Debridements For Injuries With Mcc 90 22 — — $17,965.64 $78,986.58 $48,328.35 2026-03-31
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 90 22 — — $15,724.54 $69,563.91 $42,871.84 2026-03-31
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 90 22 — — $16,436.04 $71,592.75 $44,604.17 2026-03-31
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 90 22 — — $91,401.49 $398,243.56 $242,561.47 2026-03-31
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 90 22 — — $30,706.33 $116,194.02 $81,902.84 2026-03-31
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 90 22 — — $13,788.24 $58,299.40 $38,118.81 2026-03-31
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 90 22 — — $16,671.07 $77,272.15 $45,176.40 2026-03-31
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 90 22 — — $15,533.61 $58,193.49 $42,406.97 2026-03-31
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 90 22 — — $15,066.55 $66,049.03 $41,269.81 2026-03-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 90 22 — — $28,815.84 $118,666.36 $76,860.34 2026-03-31
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 90 22 — — $16,109.40 $68,923.48 $43,808.89 2026-03-31
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 90 22 — — $32,620.79 $129,189.50 $87,009.28 2026-03-31
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 90 22 — — $18,039.71 $73,679.50 $48,508.67 2026-03-31
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 90 22 — — $26,205.29 $110,325.96 $69,897.23 2026-03-31
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 90 22 — — $15,462.12 $64,988.27 $42,232.90 2026-03-31
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 90 22 — — $20,085.60 $84,338.34 $52,950.54 2026-03-31
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 90 22 — — $14,676.98 $63,632.96 $38,887.00 2026-03-31
A9513 HCPCS Lutathera 370 Mbq/ml IV Soln 180 44 $241,894.65 $133,042.06 45% off $304.72 $229,799.92 $96,757.86 2026-03-31
A9543 HCPCS Y90 Ibritumomab, Rx 70 23 — — $16,252.21 $71,030.68 $56,824.54 2026-03-31
A9606 HCPCS Xofigo 30 Mcci/ml IV Soln 180 44 $113,853.50 $62,619.43 45% off $163.31 $108,160.83 $45,541.40 2026-03-31
A9607 HCPCS Pluvicto 1000 Mbq/ml IV Soln 180 44 $196,986.10 $108,342.36 45% off $246.34 $187,136.80 $78,794.44 2026-03-31
C1825 HCPCS Jx Hb Barostim Cardiac Stimulator 154 41 $110,250.00 $60,637.50 45% off $17,088.75 $104,737.50 $57,330.00 2026-03-31
C9293 HCPCS Voraxaze 1000 Units IV Solr 180 44 $333,043.51 $183,173.93 45% off $426.26 $316,391.33 $143,974.71 2026-03-31
J0221 HCPCS Lumizyme 50 Mg IV Solr 180 44 $92,422.45 $50,832.35 45% off $197.01 $87,801.33 $36,968.98 2026-03-31
J0567 HCPCS Brineura 2 X 150 Mg/5ml Ve Kit 180 44 $134,523.55 $73,987.95 45% off $115.13 $127,797.37 $58,154.53 2026-03-31
J1299 HCPCS Soliris 300 Mg/30ml IV Soln 170 42 $105,544.25 $58,049.34 45% off $42.77 $100,267.04 $49,605.80 2026-03-31
J1300 HCPCS Soliris 300 Mg/30ml IV Soln 164 43 $105,544.25 $58,049.34 45% off $247.09 $100,267.04 $47,494.91 2026-03-31
J1303 HCPCS Ultomiris 300 Mg/3ml IV Soln 180 44 $259,005.96 $142,453.28 45% off $213.56 $246,055.66 $103,602.38 2026-03-31
J1411 HCPCS Hemgenix 19 X 10 Ml IV Supk 50 15 — — $3,501,003.33 $4,774,770.00 $3,795,824.66 2026-03-31
J1413 HCPCS Elevidys 18.5-19.4 Kg 19 X 10 Ml IV Kit 52 15 — — $3,161,466.73 $4,884,710.40 $3,444,334.81 2026-03-31
J1414 HCPCS Inj, Beqvez, Per Tx Dose 4 2 — — $3,965,500.00 $4,686,500.00 $4,326,000.00 2026-03-31
J1823 HCPCS Uplizna 100 Mg/10ml IV Soln 180 44 $554,441.59 $304,942.87 45% off $470.76 $526,719.51 $221,776.64 2026-03-31
J2329 HCPCS Briumvi 150 Mg/6ml IV Soln 170 42 $127,080.57 $69,894.31 45% off $66.67 $120,726.54 $55,915.45 2026-03-31
J2350 HCPCS Ocrevus 300 Mg/10ml IV Soln 180 44 $159,478.13 $87,712.97 45% off $56.35 $151,504.22 $63,791.25 2026-03-31
J2507 HCPCS Krystexxa 8 Mg/ml IV Soln 180 44 $115,814.39 $63,697.91 45% off $3,580.36 $110,023.67 $46,325.76 2026-03-31
J3357 HCPCS Stelara 45 Mg/0.5ml Sc Soln 164 43 $112,624.75 $61,943.61 45% off $175.90 $106,993.51 $50,681.14 2026-03-31
J3387 HCPCS Inj Elivaldogene Autotemecel 38 14 — — $3,021,000.00 $3,975,000.00 $3,211,800.00 2026-03-31
J3389 HCPCS Topi Adm Prad Zami Per Treat 38 14 — — $3,169,029.00 $4,169,775.00 $3,369,178.20 2026-03-31
J3391 HCPCS Inj, Atidarsagene Autotemcel 34 12 — — $4,279,750.00 $4,955,500.00 $4,550,050.00 2026-03-31
J3392 HCPCS Inj, Exagamglogene Autotem 48 17 — — $2,215,400.00 $4,197,600.00 $2,401,960.00 2026-03-31
J3393 HCPCS Zynteglo IV Susp 84 21 — — $2,792,970.44 $4,926,880.00 $3,489,949.96 2026-03-31
J3394 HCPCS Inj, Lovotibeglogene Autotem 42 15 — — $3,089,882.67 $4,271,800.00 $3,350,083.31 2026-03-31
J3399 HCPCS Zolgensma 3.1-3.5 Kg 2x5.5ml & 1x8.3ml IV Kit 124 27 — — $11,639.52 $4,968,845.20 $2,891,859.95 2026-03-31
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 38 14 — — $191,585.57 $252,086.28 $203,685.71 2026-03-31
J3403 HCPCS Revakinagene, Per Implant 38 14 — — $251,750.00 $331,250.00 $267,650.00 2026-03-31
J7504 HCPCS Atgam 50 Mg/ml IV Soln 158 39 $339,795.85 $186,887.72 45% off $4,365.30 $322,806.06 $149,510.17 2026-03-31
J9021 HCPCS Rylaze 10 Mg/0.5ml IM Soln 180 44 $95,458.51 $52,502.18 45% off $53.36 $90,685.58 $38,183.40 2026-03-31
J9029 HCPCS Adstiladrin 300000000000 Vp/ml Is Susp 170 42 $224,775.00 $123,626.25 45% off $61,061.05 $213,536.25 $105,168.92 2026-03-31
J9042 HCPCS Adcetris 50 Mg IV Solr 180 44 $113,991.36 $62,695.25 45% off $255.03 $108,291.79 $45,596.54 2026-03-31
J9063 HCPCS Elahere 100 Mg/20ml IV Soln 170 42 $87,207.25 $47,963.99 45% off $67.60 $82,846.89 $38,371.19 2026-03-31
J9210 HCPCS Gamifant 10 Mg/2ml IV Soln 400 44 $129,766.17 $71,371.39 45% off $364.92 $389,240.70 $51,906.47 2026-03-31
J9226 HCPCS Supprelin La 50 Mg Sc Kit 180 44 $197,243.43 $108,483.89 45% off $16,732.68 $187,381.26 $80,263.88 2026-03-31
J9228 HCPCS Yervoy 50 Mg/10ml IV Soln 180 44 $140,809.82 $77,445.40 45% off $177.56 $133,769.33 $56,323.93 2026-03-31
J9229 HCPCS Besponsa 0.9 Mg IV Solr 180 44 $116,649.83 $64,157.41 45% off $2,675.92 $110,817.34 $46,659.93 2026-03-31
J9273 HCPCS Tivdak 40 Mg IV Solr 180 44 $92,925.65 $51,109.11 45% off $186.26 $88,279.37 $37,170.26 2026-03-31
J9298 HCPCS Opdualag 240-80 Mg/20ml IV Soln 180 44 $122,315.39 $67,273.46 45% off $191.57 $116,199.62 $48,926.16 2026-03-31
J9347 HCPCS Imjudo 300 Mg/15ml IV Soln 170 42 $164,115.93 $90,263.76 45% off $135.86 $155,910.13 $72,211.01 2026-03-31
J9359 HCPCS Zynlonta 10 Mg IV Solr 180 44 $125,702.57 $69,136.41 45% off $210.16 $119,417.44 $50,281.03 2026-03-31
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 34 12 — — $90,326.98 $118,851.29 $96,031.84 2026-03-31
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 34 12 — — $37,409.52 $49,223.05 $39,772.22 2026-03-31
L7180 HCPCS Electronic Elbow Sequential 34 12 — — $37,992.96 $49,990.74 $40,392.52 2026-03-31
L7181 HCPCS Electronic Elbo Simultaneous 34 12 — — $47,125.18 $62,006.81 $50,101.50 2026-03-31
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 34 12 — — $65,361.62 $86,002.14 $69,489.73 2026-03-31
Q0480 HCPCS Driver Pneumatic Vad, Rep 34 12 — — $105,927.48 $139,378.26 $112,617.64 2026-03-31
Q2041 HCPCS Yescarta 200000000 Cells IV Susp 180 44 $1,868,356.20 $1,027,595.91 45% off $27,071.07 $1,774,938.39 $796,155.96 2026-03-31
Q2042 HCPCS Kymriah 250000000 Cells IV Susp 180 44 $2,353,213.33 $1,294,267.33 45% off $27,071.07 $2,235,552.66 $946,916.24 2026-03-31
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 70 23 — — $16,732.68 $99,027.41 $54,404.10 2026-03-31
Q2053 HCPCS Brexucabtagene Car Pos T 70 23 — — $27,071.07 $828,954.72 $489,450.20 2026-03-31
Q2054 HCPCS Lisocabtagene Mara Car Pos T 70 23 — — $27,071.07 $930,106.94 $562,201.24 2026-03-31
Q2055 HCPCS Idecabtagene Vicleucel Car 70 23 — — $27,071.07 $947,857.66 $558,081.72 2026-03-31
Q2056 HCPCS Carvykti 100000000 Cells IV Susp 180 44 $2,245,703.63 $1,235,137.00 45% off $27,071.07 $2,133,418.45 $918,492.78 2026-03-31
Q2057 HCPCS Afamitresgene Autoleucel 38 14 — — $732,089.00 $963,275.00 $778,326.20 2026-03-31
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 38 14 — — $264,337.50 $347,812.50 $281,032.50 2026-03-31
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