Price Transparency Hospital negotiated rates

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

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Hospital

FLAGLER HOSPITAL

Saint Augustine, FL · CCN 100090 · Rates published

25,120 distinct procedures filed
13 distinct payers
375,238 rate rows
2026-03-31 last MRF observed
Data quality

277,442 of 375,238 rate rows are consumer-grade (73.9%)

97,796 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 84,103
template filing: same amount across many unrelated codes — excluded 12,482
placeholder amount (≤ $0.02) — excluded from medians 471
exceeds 10× this hospital's gross charge — excluded from medians 431
per-diem day rate — not a per-procedure price 275
percent-of-charges filed in the dollar field — excluded from medians 34
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://ufhealth.pt.panaceainc.com/MRFDownload/ufhealth/uf-stjohns
Found on page https://ufhealth.org/billing-insurance-and-costs/price-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint aa6aebf89a62b003… · 5,367,213 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 5 $4,505,000.00 $4,730,250.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J3393
HCPCS 		Zynteglo IV Susp 6 $2,939,968.88 $4,889,505.60 $3,971,146.66 nat. median
$3,006,423
1.3× median
J1411
HCPCS 		Hemgenix 19 X 10 Ml IV Supk 5 $3,685,266.66 $4,970,035.52 $3,777,398.33 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Elevidys 18.5-19.4 Kg 19 X 10 Ml IV Kit 5 $3,316,462.59 $4,641,753.60 $3,405,072.72 nat. median
$3,325,455
1.0× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 4 $3,335,820.00 $4,403,282.40 $3,335,820.00 nat. median
$3,335,820
1.0× median
J3399
HCPCS 		Zolgensma 3.1-3.5 Kg 2x5.5ml & 1x8.3ml IV Kit 8 $16,140.83 $4,825,022.42 $3,262,116.34 nat. median
$2,469,189
1.3× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 5 $3,248,445.72 $4,293,310.65 $3,252,508.07 nat. median
$3,286,000
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 4 $3,180,000.00 $4,197,600.00 $3,180,000.00 nat. median
$3,180,000
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 5 $2,332,000.00 $3,078,240.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 5 $770,620.00 $1,017,218.40 $770,620.00 nat. median
$824,563
0.9× median
Q2056
HCPCS 		Carvykti 100000000 Cells IV Susp 9 $38,738.61 $1,886,391.05 $758,067.95 nat. median
$675,122
1.1× median
Q2042
HCPCS 		Kymriah 250000000 Cells IV Susp 9 $38,738.61 $1,976,699.20 $730,825.38 nat. median
$754,974
1.0× median
Q2041
HCPCS 		Yescarta 200000000 Cells IV Susp 9 $38,738.61 $1,569,419.21 $674,387.76 nat. median
$634,511
1.1× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 7 $38,738.61 $742,105.64 $562,201.24 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 7 $38,738.61 $736,667.87 $558,081.72 nat. median
$625,184
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 7 $38,738.61 $646,074.26 $489,450.20 nat. median
$620,080
0.8× median
5834
APR_DRG 		3 $488,372.19 $512,790.80 $488,372.19 nat. median
$309,665
1.6× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 8 $270,780.34 $686,770.61 $354,928.07 nat. median
$370,174
1.0× median
5884
APR_DRG 		3 $299,118.62 $314,074.55 $299,118.62 nat. median
$246,434
1.2× median
0114
APR_DRG 		3 $279,625.64 $293,606.92 $279,625.64 nat. median
$197,700
1.4× median
0024
APR_DRG 		3 $279,441.09 $293,413.14 $279,441.09 nat. median
$372,987
0.7× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 5 $278,250.00 $367,290.00 $278,250.00 nat. median
$324,450
0.9× median
5833
APR_DRG 		3 $278,144.20 $292,051.41 $278,144.20 nat. median
$244,017
1.1× median
J3403
HCPCS 		Revakinagene, Per Implant 5 $257,500.00 $349,800.00 $265,000.00 nat. median
$265,000
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 8 $175,725.55 $445,686.50 $230,334.04 nat. median
$265,286
0.9× median
5832
APR_DRG 		3 $213,563.34 $224,241.51 $213,563.34 nat. median
$156,126
1.4× median
1614
APR_DRG 		3 $208,531.67 $218,958.25 $208,531.67 nat. median
$207,730
1.0× median
6094
APR_DRG 		3 $208,403.58 $218,823.76 $208,403.58 nat. median
$162,982
1.3× median
0113
APR_DRG 		3 $208,101.06 $218,506.11 $208,101.06 nat. median
$128,705
1.6× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 5 $201,669.02 $266,203.11 $205,640.00 nat. median
$209,753
1.0× median
0094
APR_DRG 		3 $204,428.64 $214,650.07 $204,428.64 nat. median
$166,008
1.2× median
6314
APR_DRG 		3 $200,446.95 $210,469.30 $200,446.95 nat. median
$122,924
1.6× median
5883
APR_DRG 		3 $199,212.42 $209,173.04 $199,212.42 nat. median
$182,736
1.1× median
5914
APR_DRG 		3 $196,147.57 $205,954.95 $196,147.57 nat. median
$164,279
1.2× median
5831
APR_DRG 		3 $191,699.04 $201,283.99 $191,699.04 nat. median
$145,122
1.3× median
8414
APR_DRG 		3 $185,494.35 $194,769.07 $185,494.35 nat. median
$160,267
1.2× median
6304
APR_DRG 		3 $181,784.85 $190,874.09 $181,784.85 nat. median
$150,721
1.2× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 8 $133,879.59 $339,554.08 $175,484.03 nat. median
$206,368
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 8 $133,093.89 $337,561.34 $174,454.16 nat. median
$202,986
0.9× median
5934
APR_DRG 		3 $172,451.27 $181,073.83 $172,451.27 nat. median
$151,838
1.1× median
5882
APR_DRG 		3 $170,703.54 $179,238.72 $170,703.54 nat. median
$145,336
1.2× median
0112
APR_DRG 		3 $165,437.60 $173,709.48 $165,437.60 nat. median
$93,442
1.8× median
0074
APR_DRG 		3 $164,524.13 $172,750.34 $164,524.13 nat. median
$178,275
0.9× median
1613
APR_DRG 		3 $163,285.39 $171,449.66 $163,285.39 nat. median
$119,796
1.4× median
0044
APR_DRG 		3 $157,105.98 $164,961.28 $157,105.98 nat. median
$195,681
0.8× median
0014
APR_DRG 		3 $155,542.80 $163,319.94 $155,542.80 nat. median
$190,591
0.8× median
0023
APR_DRG 		3 $152,216.72 $159,827.56 $152,216.72 nat. median
$167,082
0.9× median
5913
APR_DRG 		3 $147,929.14 $155,325.60 $147,929.14 nat. median
$102,636
1.4× median
5881
APR_DRG 		3 $146,317.92 $153,633.82 $146,317.92 nat. median
$124,573
1.2× median
5892
APR_DRG 		3 $139,430.66 $146,402.19 $139,430.66 nat. median
$89,790
1.6× median

Other procedures at this hospital

Browse this hospital's 25,120 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
             
5834 APR_DRG — 3 3 — — $488,372.19 $512,790.80 $488,372.19 2026-03-31
5884 APR_DRG — 3 3 — — $299,118.62 $314,074.55 $299,118.62 2026-03-31
0114 APR_DRG — 3 3 — — $279,625.64 $293,606.92 $279,625.64 2026-03-31
0024 APR_DRG — 3 3 — — $279,441.09 $293,413.14 $279,441.09 2026-03-31
5833 APR_DRG — 3 3 — — $278,144.20 $292,051.41 $278,144.20 2026-03-31
5832 APR_DRG — 3 3 — — $213,563.34 $224,241.51 $213,563.34 2026-03-31
1614 APR_DRG — 3 3 — — $208,531.67 $218,958.25 $208,531.67 2026-03-31
6094 APR_DRG — 3 3 — — $208,403.58 $218,823.76 $208,403.58 2026-03-31
0113 APR_DRG — 3 3 — — $208,101.06 $218,506.11 $208,101.06 2026-03-31
0094 APR_DRG — 3 3 — — $204,428.64 $214,650.07 $204,428.64 2026-03-31
6314 APR_DRG — 3 3 — — $200,446.95 $210,469.30 $200,446.95 2026-03-31
5883 APR_DRG — 3 3 — — $199,212.42 $209,173.04 $199,212.42 2026-03-31
5914 APR_DRG — 3 3 — — $196,147.57 $205,954.95 $196,147.57 2026-03-31
5831 APR_DRG — 3 3 — — $191,699.04 $201,283.99 $191,699.04 2026-03-31
8414 APR_DRG — 3 3 — — $185,494.35 $194,769.07 $185,494.35 2026-03-31
6304 APR_DRG — 3 3 — — $181,784.85 $190,874.09 $181,784.85 2026-03-31
5934 APR_DRG — 3 3 — — $172,451.27 $181,073.83 $172,451.27 2026-03-31
5882 APR_DRG — 3 3 — — $170,703.54 $179,238.72 $170,703.54 2026-03-31
0112 APR_DRG — 3 3 — — $165,437.60 $173,709.48 $165,437.60 2026-03-31
0074 APR_DRG — 3 3 — — $164,524.13 $172,750.34 $164,524.13 2026-03-31
1613 APR_DRG — 3 3 — — $163,285.39 $171,449.66 $163,285.39 2026-03-31
0044 APR_DRG — 3 3 — — $157,105.98 $164,961.28 $157,105.98 2026-03-31
0014 APR_DRG — 3 3 — — $155,542.80 $163,319.94 $155,542.80 2026-03-31
0023 APR_DRG — 3 3 — — $152,216.72 $159,827.56 $152,216.72 2026-03-31
5913 APR_DRG — 3 3 — — $147,929.14 $155,325.60 $147,929.14 2026-03-31
5881 APR_DRG — 3 3 — — $146,317.92 $153,633.82 $146,317.92 2026-03-31
5893 APR_DRG — 3 3 — — $139,430.66 $146,402.19 $139,430.66 2026-03-31
5892 APR_DRG — 3 3 — — $139,430.66 $146,402.19 $139,430.66 2026-03-31
5891 APR_DRG — 3 3 — — $139,430.66 $146,402.19 $139,430.66 2026-03-31
0093 APR_DRG — 3 3 — — $137,388.83 $144,258.27 $137,388.83 2026-03-31
6024 APR_DRG — 3 3 — — $129,913.38 $136,409.05 $129,913.38 2026-03-31
5912 APR_DRG — 3 3 — — $126,880.55 $133,224.58 $126,880.55 2026-03-31
5933 APR_DRG — 3 3 — — $126,153.32 $132,460.99 $126,153.32 2026-03-31
1612 APR_DRG — 3 3 — — $120,145.81 $126,153.10 $120,145.81 2026-03-31
1611 APR_DRG — 3 3 — — $120,145.81 $126,153.10 $120,145.81 2026-03-31
1604 APR_DRG — 3 3 — — $119,708.46 $125,693.88 $119,708.46 2026-03-31
0022 APR_DRG — 3 3 — — $115,264.14 $121,027.35 $115,264.14 2026-03-31
Q0480 HCPCS Driver Pneumatic Vad, Rep 3 3 — — $109,316.28 $111,502.61 $111,502.61 2026-03-31
0054 APR_DRG — 3 3 — — $109,445.40 $114,917.67 $109,445.40 2026-03-31
0043 APR_DRG — 3 3 — — $108,336.43 $113,753.25 $108,336.43 2026-03-31
0073 APR_DRG — 3 3 — — $104,638.72 $109,870.66 $104,638.72 2026-03-31
8424 APR_DRG — 3 3 — — $103,849.97 $109,042.47 $103,849.97 2026-03-31
0021 APR_DRG — 3 3 — — $101,874.72 $106,968.46 $101,874.72 2026-03-31
0064 APR_DRG — 3 3 — — $101,600.00 $106,680.00 $101,600.00 2026-03-31
5932 APR_DRG — 3 3 — — $101,468.54 $106,541.97 $101,468.54 2026-03-31
6074 APR_DRG — 3 3 — — $100,423.61 $105,444.79 $100,423.61 2026-03-31
6303 APR_DRG — 3 3 — — $100,203.67 $105,213.85 $100,203.67 2026-03-31
8514 APR_DRG — 3 3 — — $95,828.45 $100,619.87 $95,828.45 2026-03-31
8513 APR_DRG — 3 3 — — $95,828.45 $100,619.87 $95,828.45 2026-03-31
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 3 3 — — $93,216.70 $95,081.03 $95,081.03 2026-03-31
6034 APR_DRG — 3 3 — — $95,019.48 $99,770.45 $95,019.48 2026-03-31
6023 APR_DRG — 3 3 — — $90,201.00 $94,711.05 $90,201.00 2026-03-31
6114 APR_DRG — 3 3 — — $83,523.57 $87,699.75 $83,523.57 2026-03-31
6134 APR_DRG — 3 3 — — $82,755.88 $86,893.67 $82,755.88 2026-03-31
8634 APR_DRG — 3 3 — — $81,689.04 $85,773.49 $81,689.04 2026-03-31
0111 APR_DRG — 3 3 — — $81,478.37 $85,552.29 $81,478.37 2026-03-31
0013 APR_DRG — 3 3 — — $80,753.66 $84,791.34 $80,753.66 2026-03-31
1624 APR_DRG — 3 3 — — $80,448.61 $84,471.04 $80,448.61 2026-03-31
3034 APR_DRG — 3 3 — — $80,060.13 $84,063.14 $80,060.13 2026-03-31
0053 APR_DRG — 3 3 — — $79,428.12 $83,399.53 $79,428.12 2026-03-31
4404 APR_DRG — 3 3 — — $78,775.04 $82,713.79 $78,775.04 2026-03-31
0063 APR_DRG — 3 3 — — $78,298.92 $82,213.87 $78,298.92 2026-03-31
5931 APR_DRG — 3 3 — — $77,221.13 $81,082.19 $77,221.13 2026-03-31
0072 APR_DRG — 3 3 — — $73,687.75 $77,372.14 $73,687.75 2026-03-31
0084 APR_DRG — 3 3 — — $73,175.39 $76,834.16 $73,175.39 2026-03-31
6093 APR_DRG — 3 3 — — $72,293.10 $75,907.76 $72,293.10 2026-03-31
6022 APR_DRG — 3 3 — — $72,075.69 $75,679.47 $72,075.69 2026-03-31
1634 APR_DRG — 3 3 — — $70,395.38 $73,915.15 $70,395.38 2026-03-31
0042 APR_DRG — 3 3 — — $69,230.79 $72,692.33 $69,230.79 2026-03-31
2994 APR_DRG — 3 3 — — $68,975.45 $72,424.22 $68,975.45 2026-03-31
0092 APR_DRG — 3 3 — — $68,955.23 $72,402.99 $68,955.23 2026-03-31
6073 APR_DRG — 3 3 — — $68,852.42 $72,295.04 $68,852.42 2026-03-31
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 3 3 — — $67,452.66 $68,801.71 $68,801.71 2026-03-31
5484 APR_DRG — 3 3 — — $68,622.96 $72,054.11 $68,622.96 2026-03-31
0062 APR_DRG — 3 3 — — $67,503.28 $70,878.44 $67,503.28 2026-03-31
1784 APR_DRG — 3 3 — — $66,940.37 $70,287.39 $66,940.37 2026-03-31
5474 APR_DRG — 3 3 — — $66,808.92 $70,149.37 $66,808.92 2026-03-31
6124 APR_DRG — 3 3 — — $65,794.32 $69,084.04 $65,794.32 2026-03-31
6334 APR_DRG — 3 3 — — $65,621.57 $68,902.65 $65,621.57 2026-03-31
0071 APR_DRG — 3 3 — — $65,046.86 $68,299.20 $65,046.86 2026-03-31
6214 APR_DRG — 3 3 — — $64,523.55 $67,749.73 $64,523.55 2026-03-31
1654 APR_DRG — 3 3 — — $63,243.51 $66,405.69 $63,243.51 2026-03-31
0012 APR_DRG — 3 3 — — $62,407.57 $65,527.95 $62,407.57 2026-03-31
1674 APR_DRG — 3 3 — — $61,966.84 $65,065.18 $61,966.84 2026-03-31
8413 APR_DRG — 3 3 — — $60,325.29 $63,341.55 $60,325.29 2026-03-31
1834 APR_DRG — 3 3 — — $60,247.76 $63,260.15 $60,247.76 2026-03-31
9104 APR_DRG — 3 3 — — $60,069.96 $63,073.46 $60,069.96 2026-03-31
5394 APR_DRG — 3 3 — — $59,421.33 $62,392.40 $59,421.33 2026-03-31
6313 APR_DRG — 3 3 — — $58,914.64 $61,860.37 $58,914.64 2026-03-31
1623 APR_DRG — 3 3 — — $58,848.06 $61,790.46 $58,848.06 2026-03-31
6804 APR_DRG — 3 3 — — $58,388.80 $61,308.24 $58,388.80 2026-03-31
6084 APR_DRG — 3 3 — — $57,278.14 $60,142.05 $57,278.14 2026-03-31
6254 APR_DRG — 3 3 — — $57,194.72 $60,054.46 $57,194.72 2026-03-31
9114 APR_DRG — 3 3 — — $57,135.73 $59,992.52 $57,135.73 2026-03-31
3044 APR_DRG — 3 3 — — $56,461.58 $59,284.66 $56,461.58 2026-03-31
1664 APR_DRG — 3 3 — — $56,380.68 $59,199.71 $56,380.68 2026-03-31
1794 APR_DRG — 3 3 — — $55,645.86 $58,428.15 $55,645.86 2026-03-31
3033 APR_DRG — 3 3 — — $55,561.59 $58,339.67 $55,561.59 2026-03-31
1603 APR_DRG — 3 3 — — $55,484.91 $58,259.16 $55,484.91 2026-03-31
0914 APR_DRG — 3 3 — — $55,321.43 $58,087.50 $55,321.43 2026-03-31
6144 APR_DRG — 3 3 — — $55,217.78 $57,978.67 $55,217.78 2026-03-31
0011 APR_DRG — 3 3 — — $54,826.77 $57,568.11 $54,826.77 2026-03-31
8504 APR_DRG — 3 3 — — $54,471.16 $57,194.72 $54,471.16 2026-03-31
0214 APR_DRG — 3 3 — — $54,394.47 $57,114.19 $54,394.47 2026-03-31
1783 APR_DRG — 3 3 — — $54,013.58 $56,714.26 $54,013.58 2026-03-31
2993 APR_DRG — 3 3 — — $53,936.05 $56,632.85 $53,936.05 2026-03-31
6033 APR_DRG — 3 3 — — $53,805.44 $56,495.71 $53,805.44 2026-03-31
6021 APR_DRG — 3 3 — — $53,691.67 $56,376.25 $53,691.67 2026-03-31
4403 APR_DRG — 3 3 — — $53,557.69 $56,235.57 $53,557.69 2026-03-31
9124 APR_DRG — 3 3 — — $53,123.71 $55,779.90 $53,123.71 2026-03-31
0052 APR_DRG — 3 3 — — $52,961.91 $55,610.01 $52,961.91 2026-03-31
3004 APR_DRG — 3 3 — — $52,620.62 $55,251.65 $52,620.62 2026-03-31
6904 APR_DRG — 3 3 — — $52,191.70 $54,801.29 $52,191.70 2026-03-31
5424 APR_DRG — 3 3 — — $51,623.54 $54,204.72 $51,623.54 2026-03-31
5404 APR_DRG — 3 3 — — $51,613.58 $54,194.26 $51,613.58 2026-03-31
0083 APR_DRG — 3 3 — — $51,504.06 $54,079.26 $51,504.06 2026-03-31
6072 APR_DRG — 3 3 — — $51,425.69 $53,996.97 $51,425.69 2026-03-31
2604 APR_DRG — 3 3 — — $50,751.55 $53,289.13 $50,751.55 2026-03-31
1633 APR_DRG — 3 3 — — $50,607.45 $53,137.82 $50,607.45 2026-03-31
0091 APR_DRG — 3 3 — — $50,494.53 $53,019.26 $50,494.53 2026-03-31
1694 APR_DRG — 3 3 — — $50,267.85 $52,781.24 $50,267.85 2026-03-31
L7181 HCPCS Electronic Elbo Simultaneous 3 3 — — $48,632.79 $49,605.45 $49,605.45 2026-03-31
0234 APR_DRG — 3 3 — — $49,596.23 $52,076.04 $49,596.23 2026-03-31
7404 APR_DRG — 3 3 — — $49,461.40 $51,934.47 $49,461.40 2026-03-31
6083 APR_DRG — 3 3 — — $49,442.86 $51,915.00 $49,442.86 2026-03-31
1204 APR_DRG — 3 3 — — $48,928.82 $51,375.26 $48,928.82 2026-03-31
6814 APR_DRG — 3 3 — — $48,848.76 $51,291.20 $48,848.76 2026-03-31
3124 APR_DRG — 3 3 — — $48,756.91 $51,194.76 $48,756.91 2026-03-31
1304 APR_DRG — 3 3 — — $48,353.27 $50,770.93 $48,353.27 2026-03-31
2204 APR_DRG — 3 3 — — $48,194.00 $50,603.70 $48,194.00 2026-03-31
6954 APR_DRG — 3 3 — — $48,036.42 $50,438.24 $48,036.42 2026-03-31
0041 APR_DRG — 3 3 — — $47,897.37 $50,292.24 $47,897.37 2026-03-31
0204 APR_DRG — 3 3 — — $47,519.85 $49,895.84 $47,519.85 2026-03-31
0894 APR_DRG — 3 3 — — $47,491.20 $49,865.76 $47,491.20 2026-03-31
3614 APR_DRG — 3 3 — — $47,438.11 $49,810.02 $47,438.11 2026-03-31
4284 APR_DRG — 3 3 — — $47,381.65 $49,750.73 $47,381.65 2026-03-31
2614 APR_DRG — 3 3 — — $47,190.36 $49,549.88 $47,190.36 2026-03-31
5434 APR_DRG — 3 3 — — $47,185.01 $49,544.26 $47,185.01 2026-03-31
9504 APR_DRG — 3 3 — — $47,183.62 $49,542.80 $47,183.62 2026-03-31
6092 APR_DRG — 3 3 — — $47,171.82 $49,530.41 $47,171.82 2026-03-31
1653 APR_DRG — 3 3 — — $46,997.39 $49,347.26 $46,997.39 2026-03-31
0061 APR_DRG — 3 3 — — $46,886.15 $49,230.46 $46,886.15 2026-03-31
6234 APR_DRG — 3 3 — — $46,092.34 $48,396.96 $46,092.34 2026-03-31
0274 APR_DRG — 3 3 — — $45,779.71 $48,068.70 $45,779.71 2026-03-31
6302 APR_DRG — 3 3 — — $45,667.63 $47,951.01 $45,667.63 2026-03-31
4402 APR_DRG — 3 3 — — $45,642.35 $47,924.47 $45,642.35 2026-03-31
6123 APR_DRG — 3 3 — — $45,562.29 $47,840.40 $45,562.29 2026-03-31
0924 APR_DRG — 3 3 — — $45,271.57 $47,535.15 $45,271.57 2026-03-31
4014 APR_DRG — 3 3 — — $44,901.63 $47,146.71 $44,901.63 2026-03-31
5204 APR_DRG — 3 3 — — $44,736.46 $46,973.28 $44,736.46 2026-03-31
6133 APR_DRG — 3 3 — — $44,719.61 $46,955.59 $44,719.61 2026-03-31
6113 APR_DRG — 3 3 — — $44,543.49 $46,770.66 $44,543.49 2026-03-31
1622 APR_DRG — 3 3 — — $44,489.55 $46,714.03 $44,489.55 2026-03-31
4414 APR_DRG — 3 3 — — $44,284.78 $46,499.02 $44,284.78 2026-03-31
1782 APR_DRG — 3 3 — — $43,978.89 $46,177.83 $43,978.89 2026-03-31
6032 APR_DRG — 3 3 — — $43,901.36 $46,096.43 $43,901.36 2026-03-31
1833 APR_DRG — 3 3 — — $43,779.17 $45,968.13 $43,779.17 2026-03-31
6404 APR_DRG — 3 3 — — $43,073.05 $45,226.70 $43,073.05 2026-03-31
5114 APR_DRG — 3 3 — — $42,853.06 $44,995.71 $42,853.06 2026-03-31
4401 APR_DRG — 3 3 — — $42,713.17 $44,848.83 $42,713.17 2026-03-31
6224 APR_DRG — 3 3 — — $42,666.83 $44,800.17 $42,666.83 2026-03-31
3214 APR_DRG — 3 3 — — $42,532.84 $44,659.48 $42,532.84 2026-03-31
0224 APR_DRG — 3 3 — — $42,505.03 $44,630.28 $42,505.03 2026-03-31
7924 APR_DRG — 3 3 — — $42,378.63 $44,497.56 $42,378.63 2026-03-31
1793 APR_DRG — 3 3 — — $42,376.94 $44,495.79 $42,376.94 2026-03-31
8423 APR_DRG — 3 3 — — $41,948.02 $44,045.42 $41,948.02 2026-03-31
6514 APR_DRG — 3 3 — — $41,940.43 $44,037.45 $41,940.43 2026-03-31
8633 APR_DRG — 3 3 — — $41,788.75 $43,878.19 $41,788.75 2026-03-31
3043 APR_DRG — 3 3 — — $41,623.58 $43,704.76 $41,623.58 2026-03-31
1602 APR_DRG — 3 3 — — $41,569.65 $43,648.13 $41,569.65 2026-03-31
0304 APR_DRG — 3 3 — — $41,493.81 $43,568.50 $41,493.81 2026-03-31
1704 APR_DRG — 3 3 — — $41,461.79 $43,534.88 $41,461.79 2026-03-31
1814 APR_DRG — 3 3 — — $41,369.93 $43,438.43 $41,369.93 2026-03-31
1663 APR_DRG — 3 3 — — $41,364.04 $43,432.24 $41,364.04 2026-03-31
1214 APR_DRG — 3 3 — — $41,012.64 $43,063.27 $41,012.64 2026-03-31
5124 APR_DRG — 3 3 — — $40,996.63 $43,046.46 $40,996.63 2026-03-31
2304 APR_DRG — 3 3 — — $40,766.57 $42,804.90 $40,766.57 2026-03-31
0082 APR_DRG — 3 3 — — $40,425.28 $42,446.54 $40,425.28 2026-03-31
3032 APR_DRG — 3 3 — — $40,409.27 $42,429.73 $40,409.27 2026-03-31
5414 APR_DRG — 3 3 — — $40,366.92 $42,385.27 $40,366.92 2026-03-31
4054 APR_DRG — 3 3 — — $40,309.84 $42,325.33 $40,309.84 2026-03-31
J3389 HCPCS Topi Adm Prad Zami Per Treat 5 4 — — $3,335,820.00 $4,403,282.40 $3,335,820.00 2026-03-31
J3387 HCPCS Inj Elivaldogene Autotemecel 5 4 — — $3,180,000.00 $4,197,600.00 $3,180,000.00 2026-03-31
152180 CDM Uf Hb Ad Bilateral Lung Transplant Import W/xvivo 11 4 $241,300.00 $132,715.00 45% off $43,434.00 $202,692.00 $95,554.80 2026-03-31
152176 CDM Uf Hb Ad Bilateral Lung Transplant Local 11 4 $238,400.00 $131,120.00 45% off $42,912.00 $200,256.00 $94,406.40 2026-03-31
179472 CDM Uf Hb Ad Bilat Lung Transplant Import 11 4 $229,600.00 $126,280.00 45% off $41,328.00 $192,864.00 $90,921.60 2026-03-31
179471 CDM Uf Hb Ad Single Lung Transplant Import 11 4 $227,500.00 $125,125.00 45% off $40,950.00 $191,100.00 $90,090.00 2026-03-31
142406 CDM Uf Hb Ad Bilat Lung Transplant Local 11 4 $226,700.00 $124,685.00 45% off $40,806.00 $190,428.00 $89,773.20 2026-03-31
142404 CDM Uf Hb Ad Single Lung Transplant Local 11 4 $224,600.00 $123,530.00 45% off $40,428.00 $188,664.00 $88,941.60 2026-03-31
179467 CDM Uf Ad Liver Transplant-dd Import 11 4 $205,900.00 $113,245.00 45% off $37,062.00 $172,956.00 $81,536.40 2026-03-31
142390 CDM Uf Ad Liver Transplant - Dd 11 4 $190,100.00 $104,555.00 45% off $34,218.00 $159,684.00 $75,279.60 2026-03-31
152174 CDM Uf Hb Ad Single Lung Transplant Local With 11 4 $178,374.00 $98,105.70 45% off $32,107.32 $149,834.16 $70,636.10 2026-03-31
179463 CDM Uf Hb Ped Double Lung Transplant-dd Impo 11 4 $178,054.00 $97,929.70 45% off $32,049.72 $149,565.36 $70,509.38 2026-03-31
152178 CDM Uf Hb Ad Single Lung Transplant Import W 11 4 $170,314.00 $93,672.70 45% off $30,656.52 $143,063.76 $67,444.34 2026-03-31
179470 CDM Uf Hb Ad Heart Transplant Import 11 4 $154,700.00 $85,085.00 45% off $27,846.00 $129,948.00 $61,261.20 2026-03-31
179460 CDM Uf Hb Ped Heart Transplant-dd Import 11 4 $153,700.00 $84,535.00 45% off $27,666.00 $129,108.00 $60,865.20 2026-03-31
142400 CDM Uf Hb Ped Heart Transplant-dd Local 11 4 $153,700.00 $84,535.00 45% off $27,666.00 $129,108.00 $60,865.20 2026-03-31
179464 CDM Uf Hb Pancreas Transplant-dd Import 11 4 $141,010.00 $77,555.50 45% off $25,381.80 $118,448.40 $55,839.96 2026-03-31
142388 CDM Uf Hb Pancreas Transplant-dd Local 11 4 $141,010.00 $77,555.50 45% off $25,381.80 $118,448.40 $55,839.96 2026-03-31
64654 HCPCS 1st Opn Implt Bat Modulj Sys 5 4 — — $45,996.81 $60,715.79 $45,996.81 2026-03-31
58980078021 NDC Gattex 5 Mg Sc Kit 11 4 $113,808.63 $62,594.75 45% off $20,485.55 $95,599.25 $45,068.22 2026-03-31
179468 CDM Uf Hb Kidney Transplant-dd Import 11 4 $103,304.00 $56,817.20 45% off $18,594.72 $86,775.36 $40,908.38 2026-03-31
J3391 HCPCS Inj, Atidarsagene Autotemcel 5 5 — — $4,505,000.00 $4,730,250.00 $4,505,000.00 2026-03-31
J1411 HCPCS Hemgenix 19 X 10 Ml IV Supk 8 5 — — $3,685,266.66 $4,970,035.52 $3,777,398.33 2026-03-31
J1413 HCPCS Elevidys 18.5-19.4 Kg 19 X 10 Ml IV Kit 8 5 — — $3,316,462.59 $4,641,753.60 $3,405,072.72 2026-03-31
J3394 HCPCS Inj, Lovotibeglogene Autotem 7 5 — — $3,248,445.72 $4,293,310.65 $3,252,508.07 2026-03-31
J3392 HCPCS Inj, Exagamglogene Autotem 7 5 — — $2,332,000.00 $3,078,240.00 $2,332,000.00 2026-03-31
Q2057 HCPCS Afamitresgene Autoleucel 7 5 — — $770,620.00 $1,017,218.40 $770,620.00 2026-03-31
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 7 5 — — $278,250.00 $367,290.00 $278,250.00 2026-03-31
J3403 HCPCS Revakinagene, Per Implant 7 5 — — $257,500.00 $349,800.00 $265,000.00 2026-03-31
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 7 5 — — $201,669.02 $266,203.11 $205,640.00 2026-03-31
209 MS_DRG Complex Aortic Arch Procedures 7 5 — — $85,403.78 $148,630.56 $85,403.78 2026-03-31
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 7 5 — — $43,307.47 $74,939.02 $43,307.47 2026-03-31
J3393 HCPCS Zynteglo IV Susp 14 6 — — $2,939,968.88 $4,889,505.60 $3,971,146.66 2026-03-31
J1300 HCPCS Soliris 300 Mg/30ml IV Soln 13 6 $105,544.25 $58,049.34 45% off $18,997.97 $88,657.17 $41,795.52 2026-03-31
0424T HCPCS Uf Hb Insert/rplc Nstim Sleep Apnea Sys, Complete 13 6 $111,765.00 $61,470.75 45% off $18,498.40 $93,882.60 $40,570.70 2026-03-31
Q2054 HCPCS Lisocabtagene Mara Car Pos T 10 7 — — $38,738.61 $742,105.64 $562,201.24 2026-03-31
Q2055 HCPCS Idecabtagene Vicleucel Car 10 7 — — $38,738.61 $736,667.87 $558,081.72 2026-03-31
Q2053 HCPCS Brexucabtagene Car Pos T 10 7 — — $38,738.61 $646,074.26 $489,450.20 2026-03-31
J7504 HCPCS Atgam 50 Mg/ml IV Soln 15 7 $339,795.85 $186,887.72 45% off $5,135.09 $285,428.51 $123,345.89 2026-03-31
J9029 HCPCS Adstiladrin 300000000000 Vp/ml Is Susp 16 7 $224,775.00 $123,626.25 45% off $63,342.28 $188,811.00 $86,926.81 2026-03-31
J9347 HCPCS Imjudo 300 Mg/15ml IV Soln 16 7 $164,115.93 $90,263.76 45% off $140.90 $137,857.38 $62,282.00 2026-03-31
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 10 7 — — $23,203.67 $71,813.41 $54,404.10 2026-03-31
J2329 HCPCS Briumvi 150 Mg/6ml IV Soln 16 7 $127,080.57 $69,894.31 45% off $70.18 $106,747.68 $48,227.08 2026-03-31
J3399 HCPCS Zolgensma 3.1-3.5 Kg 2x5.5ml & 1x8.3ml IV Kit 17 8 — — $16,140.83 $4,825,022.42 $3,262,116.34 2026-03-31
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 15 8 — — $270,780.34 $686,770.61 $354,928.07 2026-03-31
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 15 8 — — $175,725.55 $445,686.50 $230,334.04 2026-03-31
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 15 8 — — $133,879.59 $339,554.08 $175,484.03 2026-03-31
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 15 8 — — $133,093.89 $337,561.34 $174,454.16 2026-03-31
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 15 8 — — $86,856.03 $220,289.90 $113,847.43 2026-03-31
7 MS_DRG Lung Transplant 15 8 — — $81,205.01 $205,957.39 $106,440.28 2026-03-31
14 MS_DRG Allogeneic Bone Marrow Transplant 15 8 — — $75,358.96 $191,130.28 $98,777.52 2026-03-31
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 8 — — $71,056.73 $180,218.68 $93,138.33 2026-03-31
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 8 — — $69,109.10 $175,278.96 $90,585.45 2026-03-31
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 15 8 — — $68,186.70 $172,939.51 $89,376.40 2026-03-31
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 15 8 — — $64,652.61 $163,976.13 $84,744.06 2026-03-31
215 MS_DRG Other Heart Assist System Implant 15 8 — — $62,435.97 $158,354.14 $81,838.57 2026-03-31
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 8 — — $61,343.63 $155,583.69 $80,406.79 2026-03-31
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 15 8 — — $56,495.24 $143,286.88 $74,051.70 2026-03-31
850 MS_DRG Acute Leukemia With Other Procedures 15 8 — — $54,299.91 $137,718.96 $71,174.16 2026-03-31
231 MS_DRG Coronary Bypass With Ptca With Mcc 15 8 — — $52,860.19 $134,067.44 $69,287.03 2026-03-31
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 8 — — $52,694.02 $133,645.99 $69,069.23 2026-03-31
C9293 HCPCS Voraxaze 1000 Units IV Solr 16 8 $333,043.51 $183,173.93 45% off $448.69 $279,756.55 $68,921.33 2026-03-31
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 15 8 — — $49,341.78 $125,143.82 $64,675.24 2026-03-31
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 8 — — $48,147.24 $122,114.15 $63,109.48 2026-03-31
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 15 8 — — $47,939.69 $121,587.73 $62,837.43 2026-03-31
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 15 8 — — $47,781.04 $121,185.37 $62,629.48 2026-03-31
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 8 — — $45,264.66 $114,803.17 $59,331.12 2026-03-31
10 MS_DRG Pancreas Transplant 15 8 — — $44,995.66 $114,120.90 $58,978.51 2026-03-31
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 15 8 — — $44,976.85 $114,073.19 $58,953.86 2026-03-31
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 15 8 — — $44,737.94 $113,467.25 $58,640.70 2026-03-31
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 15 8 — — $44,711.60 $113,400.46 $58,606.18 2026-03-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 15 8 — — $43,340.86 $109,923.88 $56,809.47 2026-03-31
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 15 8 — — $43,128.28 $109,384.75 $56,530.84 2026-03-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 15 8 — — $42,207.77 $107,050.07 $55,324.26 2026-03-31
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 15 8 — — $41,928.10 $106,340.76 $54,957.68 2026-03-31
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 15 8 — — $41,897.37 $106,262.83 $54,917.41 2026-03-31
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 8 — — $41,230.81 $104,572.26 $54,043.71 2026-03-31
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 8 — — $41,230.81 $104,572.26 $54,043.71 2026-03-31
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 15 8 — — $41,080.95 $104,192.16 $53,847.27 2026-03-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 15 8 — — $40,349.17 $102,336.18 $52,888.09 2026-03-31
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 15 8 — — $38,428.50 $97,464.85 $50,370.55 2026-03-31
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 15 8 — — $38,383.98 $97,351.93 $50,312.19 2026-03-31
232 MS_DRG Coronary Bypass With Ptca Without Mcc 15 8 — — $38,015.90 $96,418.38 $49,829.72 2026-03-31
28 MS_DRG Spinal Procedures With Mcc 15 8 — — $37,675.41 $95,554.80 $49,383.42 2026-03-31
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 15 8 — — $37,664.75 $95,527.77 $49,369.45 2026-03-31
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 8 — — $37,391.98 $94,835.95 $49,011.91 2026-03-31
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 15 8 — — $37,269.07 $94,524.24 $48,850.82 2026-03-31
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 15 8 — — $37,182.54 $94,304.76 $48,737.39 2026-03-31
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 15 8 — — $36,799.41 $93,333.04 $48,235.20 2026-03-31
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 15 8 — — $36,775.58 $93,272.61 $48,203.96 2026-03-31
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 15 8 — — $36,162.95 $91,718.80 $47,400.95 2026-03-31
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 15 8 — — $35,932.19 $91,133.55 $47,098.48 2026-03-31
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 15 8 — — $35,739.06 $90,643.71 $46,845.33 2026-03-31
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 8 — — $35,253.09 $89,411.16 $46,208.34 2026-03-31
8 MS_DRG Simultaneous Pancreas/kidney Transplant 15 8 — — $35,143.98 $89,134.44 $46,065.33 2026-03-31
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 15 8 — — $34,903.19 $88,523.73 $45,749.71 2026-03-31
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 15 8 — — $34,632.30 $87,836.69 $45,394.64 2026-03-31
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 15 8 — — $34,424.75 $87,310.27 $45,122.59 2026-03-31
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 15 8 — — $34,303.10 $87,001.74 $44,963.13 2026-03-31
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 15 8 — — $34,254.19 $86,877.69 $44,899.02 2026-03-31
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 15 8 — — $34,200.26 $86,740.92 $44,828.34 2026-03-31
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 15 8 — — $34,063.56 $86,394.21 $44,649.16 2026-03-31
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 8 — — $33,439.64 $84,811.78 $43,831.35 2026-03-31
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 15 8 — — $33,419.58 $84,760.89 $43,805.05 2026-03-31
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 15 8 — — $33,195.09 $84,191.54 $43,510.80 2026-03-31
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 15 8 — — $33,085.36 $83,913.22 $43,366.96 2026-03-31
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 15 8 — — $32,640.77 $82,785.64 $42,784.22 2026-03-31
653 MS_DRG Major Bladder Procedures With Mcc 15 8 — — $32,584.34 $82,642.51 $42,710.25 2026-03-31
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 8 — — $31,604.88 $80,158.33 $41,426.41 2026-03-31
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 15 8 — — $31,273.79 $79,318.61 $40,992.44 2026-03-31
J3357 HCPCS Stelara 45 Mg/0.5ml Sc Soln 15 8 $112,624.75 $61,943.61 45% off $149.40 $94,604.79 $40,882.78 2026-03-31
228 MS_DRG Other Cardiothoracic Procedures With Mcc 15 8 — — $31,022.97 $78,682.46 $40,663.67 2026-03-31
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 15 8 — — $30,967.79 $78,542.51 $40,591.34 2026-03-31
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 15 8 — — $30,861.82 $78,273.73 $40,452.44 2026-03-31
Q2056 HCPCS Carvykti 100000000 Cells IV Susp 18 9 $2,245,703.63 $1,235,137.00 45% off $38,738.61 $1,886,391.05 $758,067.95 2026-03-31
Q2042 HCPCS Kymriah 250000000 Cells IV Susp 18 9 $2,353,213.33 $1,294,267.33 45% off $38,738.61 $1,976,699.20 $730,825.38 2026-03-31
Q2041 HCPCS Yescarta 200000000 Cells IV Susp 18 9 $1,868,356.20 $1,027,595.91 45% off $38,738.61 $1,569,419.21 $674,387.76 2026-03-31
A9543 HCPCS Uf Hb Zevalin Y90 Ibritumomab 18 9 $146,051.00 $80,328.05 45% off $32,931.04 $122,682.84 $57,836.20 2026-03-31
J9226 HCPCS Supprelin La 50 Mg Sc Kit 18 9 $197,243.43 $108,483.89 45% off $23,203.67 $165,684.48 $55,709.08 2026-03-31
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