|
3
|
OTHER
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
18
|
11
|
$840,730.86
|
$210,182.72
75% off
|
$147,969.06
|
$615,965.62
|
$381,967.34
|
2026-05-08
|
|
4
|
OTHER
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
18
|
11
|
$550,845.82
|
$137,711.46
75% off
|
$152,996.86
|
$406,110.33
|
$279,553.59
|
2026-05-08
|
|
588-4
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
10
|
6
|
—
|
—
|
$221,000.00
|
$247,520.00
|
$232,050.00
|
2026-05-08
|
|
583-4
|
OTHER
|
Neonate With Ecmo
|
10
|
6
|
—
|
—
|
$221,000.00
|
$247,520.00
|
$232,050.00
|
2026-05-08
|
|
583-3
|
OTHER
|
Neonate With Ecmo
|
10
|
6
|
—
|
—
|
$221,000.00
|
$247,520.00
|
$232,050.00
|
2026-05-08
|
|
011-3
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
6
|
—
|
—
|
$204,995.11
|
$229,594.52
|
$215,244.87
|
2026-05-08
|
|
631-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
10
|
6
|
—
|
—
|
$197,455.24
|
$221,149.87
|
$207,328.00
|
2026-05-08
|
|
215
|
OTHER
|
Other Heart Assist System Implant
|
18
|
11
|
$243,908.71
|
$60,977.18
75% off
|
$73,593.16
|
$304,505.15
|
$189,049.15
|
2026-05-08
|
|
630-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
10
|
6
|
—
|
—
|
$179,071.67
|
$200,560.27
|
$188,025.25
|
2026-05-08
|
|
609-4
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
10
|
6
|
—
|
—
|
$165,000.00
|
$184,800.00
|
$173,250.00
|
2026-05-08
|
|
216
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
18
|
11
|
$301,358.64
|
$75,339.66
75% off
|
$67,116.31
|
$277,382.27
|
$172,249.29
|
2026-05-08
|
|
583-2
|
OTHER
|
Neonate With Ecmo
|
10
|
6
|
—
|
—
|
$138,429.14
|
$155,040.64
|
$145,350.60
|
2026-05-08
|
|
588-3
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
10
|
6
|
—
|
—
|
$132,000.00
|
$147,840.00
|
$138,600.00
|
2026-05-08
|
|
207
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support >96 Hours
|
18
|
11
|
$226,176.87
|
$56,544.22
75% off
|
$73,193.23
|
$185,873.79
|
$129,533.51
|
2026-05-08
|
|
593-4
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
10
|
6
|
—
|
—
|
$121,000.00
|
$135,520.00
|
$127,050.00
|
2026-05-08
|
|
275
|
OTHER
|
Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc
|
18
|
11
|
$239,194.64
|
$59,798.66
75% off
|
$49,380.92
|
$203,112.65
|
$126,246.79
|
2026-05-08
|
|
591-4
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
10
|
6
|
—
|
—
|
$120,000.00
|
$134,400.00
|
$126,000.00
|
2026-05-08
|
|
002-4
|
OTHER
|
Heart And/or Lung Transplant
|
10
|
6
|
—
|
—
|
$119,164.66
|
$133,464.42
|
$125,122.89
|
2026-05-08
|
|
870
|
OTHER
|
Septicemia Or Severe Sepsis With Mv >96 Hours
|
18
|
11
|
$303,734.94
|
$75,933.73
75% off
|
$48,622.53
|
$199,936.77
|
$124,279.65
|
2026-05-08
|
|
588-2
|
OTHER
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
10
|
6
|
—
|
—
|
$110,647.94
|
$123,925.69
|
$116,180.34
|
2026-05-08
|
|
276
|
OTHER
|
Non-maligant Breast Disorders
|
18
|
11
|
$194,087.06
|
$48,521.76
75% off
|
$43,392.04
|
$178,033.25
|
$110,712.65
|
2026-05-08
|
|
28
|
OTHER
|
Spinal Procedures With Mcc
|
18
|
11
|
$433,038.48
|
$108,259.62
75% off
|
$42,603.43
|
$174,730.91
|
$108,667.17
|
2026-05-08
|
|
218
|
OTHER
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
18
|
11
|
$310,144.03
|
$77,536.01
75% off
|
$41,709.85
|
$170,988.83
|
$106,349.34
|
2026-05-08
|
|
602-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$100,000.00
|
$112,000.00
|
$105,000.00
|
2026-05-08
|
|
593-3
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
10
|
6
|
—
|
—
|
$99,000.00
|
$110,880.00
|
$103,950.00
|
2026-05-08
|
|
607-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$98,924.77
|
$110,795.74
|
$103,871.01
|
2026-05-08
|
|
630-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
10
|
6
|
—
|
—
|
$95,000.00
|
$106,400.00
|
$99,750.00
|
2026-05-08
|
|
834
|
OTHER
|
Acute Leukemia Without Major O.r. Procedures With Mcc
|
18
|
11
|
$82,862.73
|
$20,715.68
75% off
|
$38,813.54
|
$158,860.13
|
$98,836.84
|
2026-05-08
|
|
405
|
OTHER
|
Pancreas, Liver And Shunt Procedures With Mcc
|
18
|
11
|
$47,692.63
|
$11,923.16
75% off
|
$38,136.83
|
$156,026.27
|
$97,081.55
|
2026-05-08
|
|
463
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
18
|
11
|
$110,256.75
|
$27,564.19
75% off
|
$37,946.72
|
$155,230.14
|
$96,588.43
|
2026-05-08
|
|
591-3
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
10
|
6
|
—
|
—
|
$91,000.00
|
$101,920.00
|
$95,550.00
|
2026-05-08
|
|
161-4
|
OTHER
|
Implantable Heart Assist Systems
|
10
|
6
|
—
|
—
|
$88,926.10
|
$99,597.23
|
$93,372.41
|
2026-05-08
|
|
602-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$88,854.73
|
$99,517.30
|
$93,297.47
|
2026-05-08
|
|
326
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Mcc
|
18
|
11
|
$131,436.90
|
$32,859.23
75% off
|
$40,021.16
|
$145,975.54
|
$92,998.35
|
2026-05-08
|
|
163
|
OTHER
|
Major Chest Procedures With Mcc
|
18
|
11
|
$457,466.21
|
$114,366.55
75% off
|
$53,293.55
|
$132,473.01
|
$92,883.28
|
2026-05-08
|
|
270
|
OTHER
|
Other Major Cardiovascular Procedures With Mcc
|
18
|
11
|
$159,688.60
|
$39,922.15
75% off
|
$36,107.36
|
$147,527.55
|
$91,817.46
|
2026-05-08
|
|
009-4
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
10
|
6
|
—
|
—
|
$87,176.41
|
$97,637.58
|
$91,535.23
|
2026-05-08
|
|
589-3
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
10
|
6
|
—
|
—
|
$87,000.00
|
$97,440.00
|
$91,350.00
|
2026-05-08
|
|
466
|
OTHER
|
Revision Of Hip Or Knee Replacement With Mcc
|
18
|
11
|
$133,494.82
|
$33,373.71
75% off
|
$35,843.81
|
$146,423.90
|
$91,133.85
|
2026-05-08
|
|
471
|
OTHER
|
Cervical Spinal Fusion With Mcc
|
18
|
11
|
$255,753.91
|
$63,938.48
75% off
|
$41,167.39
|
$139,603.66
|
$90,385.52
|
2026-05-08
|
|
239
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc
|
18
|
11
|
$89,296.29
|
$22,324.07
75% off
|
$35,447.80
|
$144,765.54
|
$90,106.67
|
2026-05-08
|
|
853
|
OTHER
|
Infectious And Parasitic Diseases With O.r. Procedures With Mcc
|
18
|
11
|
$182,658.55
|
$45,664.64
75% off
|
$35,203.47
|
$143,742.36
|
$89,472.91
|
2026-05-08
|
|
228
|
OTHER
|
Other Cardiothoracic Procedures With Mcc
|
18
|
11
|
$283,048.35
|
$70,762.09
75% off
|
$35,079.92
|
$143,225.03
|
$89,152.48
|
2026-05-08
|
|
245
|
OTHER
|
Aicd Generator Procedures
|
18
|
11
|
$74,831.30
|
$18,707.83
75% off
|
$34,417.62
|
$140,451.52
|
$87,434.57
|
2026-05-08
|
|
611-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
10
|
6
|
—
|
—
|
$82,276.96
|
$92,150.20
|
$86,390.81
|
2026-05-08
|
|
583-1
|
OTHER
|
Neonate With Ecmo
|
10
|
6
|
—
|
—
|
$81,748.00
|
$91,557.76
|
$85,835.40
|
2026-05-08
|
|
356080097
|
OTHER
|
Icd Bi-v D C1882 (25001-30000)
|
30
|
16
|
$148,800.00
|
$37,200.00
75% off
|
$74.35
|
$166,656.00
|
$85,560.00
|
2026-05-08
|
|
799
|
OTHER
|
Splenectomy With Mcc
|
18
|
11
|
$164,014.37
|
$41,003.59
75% off
|
$33,511.66
|
$136,657.71
|
$85,084.68
|
2026-05-08
|
|
981
|
OTHER
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
18
|
11
|
$180,574.22
|
$45,143.55
75% off
|
$33,505.49
|
$136,631.84
|
$85,068.66
|
2026-05-08
|
|
863-4
|
OTHER
|
Neonatal Aftercare
|
10
|
6
|
—
|
—
|
$80,469.81
|
$90,126.19
|
$84,493.30
|
2026-05-08
|
|
591-2
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
10
|
6
|
—
|
—
|
$80,000.00
|
$89,600.00
|
$84,000.00
|
2026-05-08
|
|
603-4
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
10
|
6
|
—
|
—
|
$80,000.00
|
$89,600.00
|
$84,000.00
|
2026-05-08
|
|
823
|
OTHER
|
Lymphoma And Non-acute Leukemia With Other Procedures With Mcc
|
18
|
11
|
$173,639.82
|
$43,409.96
75% off
|
$32,994.86
|
$134,493.51
|
$83,744.18
|
2026-05-08
|
|
277
|
OTHER
|
Cellulitis Age >17 W Cc
|
18
|
11
|
$179,311.32
|
$44,827.83
75% off
|
$32,805.45
|
$133,700.26
|
$83,252.85
|
2026-05-08
|
|
841-4
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
10
|
6
|
—
|
—
|
$79,102.08
|
$88,594.33
|
$83,057.18
|
2026-05-08
|
|
303-4
|
OTHER
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
10
|
6
|
—
|
—
|
$78,865.22
|
$88,329.05
|
$82,808.48
|
2026-05-08
|
|
329
|
OTHER
|
Major Small And Large Bowel Procedures With Mcc
|
18
|
11
|
$194,282.72
|
$48,570.68
75% off
|
$32,393.65
|
$131,975.80
|
$82,184.73
|
2026-05-08
|
|
856
|
OTHER
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc
|
18
|
11
|
$214,901.02
|
$53,725.25
75% off
|
$31,842.52
|
$129,667.90
|
$80,755.21
|
2026-05-08
|
|
901
|
OTHER
|
Wound Debridements For Injuries With Mcc
|
18
|
11
|
$106,703.09
|
$26,675.77
75% off
|
$31,285.91
|
$127,337.00
|
$79,311.46
|
2026-05-08
|
|
356
|
OTHER
|
Other Digestive System O.r. Procedures With Mcc
|
18
|
11
|
$100,497.67
|
$25,124.42
75% off
|
$30,154.84
|
$122,600.48
|
$76,377.66
|
2026-05-08
|
|
323
|
OTHER
|
Urinary Stones W Cc, &/or Esw Lithotripsy
|
18
|
11
|
$157,679.94
|
$39,419.98
75% off
|
$30,111.61
|
$122,419.42
|
$76,265.51
|
2026-05-08
|
|
673
|
OTHER
|
Other Kidney And Urinary Tract Procedures With Mcc
|
18
|
11
|
$209,387.01
|
$52,346.75
75% off
|
$29,632.54
|
$120,413.29
|
$75,022.91
|
2026-05-08
|
|
609-3
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
10
|
6
|
—
|
—
|
$71,214.11
|
$79,759.80
|
$74,774.82
|
2026-05-08
|
|
356080419
|
OTHER
|
Cardiac Ipg (25000-26000)
|
30
|
16
|
$128,960.00
|
$32,240.00
75% off
|
$74.35
|
$144,435.20
|
$74,152.00
|
2026-05-08
|
|
007-4
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
10
|
6
|
—
|
—
|
$70,159.56
|
$78,578.71
|
$73,667.54
|
2026-05-08
|
|
958
|
OTHER
|
Other O.r. Procedures For Multiple Significant Trauma With Cc
|
18
|
11
|
$133,222.25
|
$33,305.56
75% off
|
$29,084.85
|
$118,119.76
|
$73,602.30
|
2026-05-08
|
|
161-3
|
OTHER
|
Implantable Heart Assist Systems
|
10
|
6
|
—
|
—
|
$69,631.31
|
$77,987.07
|
$73,112.88
|
2026-05-08
|
|
423
|
OTHER
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc
|
18
|
11
|
$57,555.96
|
$14,388.99
75% off
|
$28,793.86
|
$116,901.14
|
$72,847.50
|
2026-05-08
|
|
907
|
OTHER
|
Other O.r. Procedures For Injuries With Mcc
|
18
|
11
|
$200,330.11
|
$50,082.53
75% off
|
$28,219.41
|
$114,495.52
|
$71,357.46
|
2026-05-08
|
|
356080096
|
OTHER
|
Icd Bi-v D C1882 (19501-25000)
|
30
|
16
|
$124,000.00
|
$31,000.00
75% off
|
$74.35
|
$138,880.00
|
$71,300.00
|
2026-05-08
|
|
356080063
|
OTHER
|
Impella 2.5 Catheter System
|
30
|
16
|
$124,000.00
|
$31,000.00
75% off
|
$74.35
|
$138,880.00
|
$71,300.00
|
2026-05-08
|
|
607-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$67,824.78
|
$75,963.75
|
$71,216.02
|
2026-05-08
|
|
628
|
OTHER
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc
|
18
|
11
|
$122,586.87
|
$30,646.72
75% off
|
$27,958.59
|
$113,403.36
|
$70,680.98
|
2026-05-08
|
|
876
|
OTHER
|
O.r. Procedures With Principal Diagnosis Of Mental Illness
|
18
|
11
|
$68,937.02
|
$17,234.26
75% off
|
$27,848.09
|
$112,940.63
|
$70,394.36
|
2026-05-08
|
|
004-4
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
10
|
6
|
—
|
—
|
$66,996.16
|
$75,035.70
|
$70,345.97
|
2026-05-08
|
|
001-4
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
10
|
6
|
—
|
—
|
$66,329.56
|
$74,289.11
|
$69,646.04
|
2026-05-08
|
|
616
|
OTHER
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
18
|
11
|
$149,537.02
|
$37,384.25
75% off
|
$27,404.73
|
$111,083.97
|
$69,244.35
|
2026-05-08
|
|
593-2
|
OTHER
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
10
|
6
|
—
|
—
|
$65,770.67
|
$73,663.15
|
$69,059.20
|
2026-05-08
|
|
166
|
OTHER
|
Other Respiratory System O.r. Procedures With Mcc
|
18
|
11
|
$115,666.15
|
$28,916.54
75% off
|
$27,303.83
|
$110,661.47
|
$68,982.65
|
2026-05-08
|
|
956
|
OTHER
|
Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma
|
18
|
11
|
$139,185.14
|
$34,796.28
75% off
|
$27,112.36
|
$109,859.60
|
$68,485.98
|
2026-05-08
|
|
002-3
|
OTHER
|
Heart And/or Lung Transplant
|
10
|
6
|
—
|
—
|
$64,911.19
|
$72,700.53
|
$68,156.75
|
2026-05-08
|
|
570
|
OTHER
|
Skin Debridement With Mcc
|
18
|
11
|
$64,643.82
|
$16,160.96
75% off
|
$48,069.88
|
$86,516.16
|
$68,153.89
|
2026-05-08
|
|
612-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$64,812.32
|
$72,589.80
|
$68,052.94
|
2026-05-08
|
|
633-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
10
|
6
|
—
|
—
|
$64,642.15
|
$72,399.21
|
$67,874.26
|
2026-05-08
|
|
40
|
OTHER
|
Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc
|
18
|
11
|
$59,455.32
|
$14,863.83
75% off
|
$26,767.14
|
$108,413.93
|
$67,590.54
|
2026-05-08
|
|
621-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
10
|
6
|
—
|
—
|
$63,560.52
|
$71,187.78
|
$66,738.55
|
2026-05-08
|
|
94
|
OTHER
|
Bacterial And Tuberculous Infections Of Nervous System With Mcc
|
18
|
11
|
$63,455.95
|
$15,863.99
75% off
|
$25,920.20
|
$104,867.29
|
$65,393.75
|
2026-05-08
|
|
613-4
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
10
|
6
|
—
|
—
|
$62,000.00
|
$69,440.00
|
$65,100.00
|
2026-05-08
|
|
335
|
OTHER
|
Peritoneal Adhesiolysis With Mcc
|
18
|
11
|
$173,879.87
|
$43,469.97
75% off
|
$25,746.58
|
$104,140.14
|
$64,943.36
|
2026-05-08
|
|
518
|
OTHER
|
Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…
|
18
|
11
|
$186,708.53
|
$46,677.13
75% off
|
$25,476.16
|
$103,007.74
|
$64,241.95
|
2026-05-08
|
|
492
|
OTHER
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc
|
18
|
11
|
$170,409.39
|
$42,602.35
75% off
|
$25,251.03
|
$102,065.04
|
$63,658.04
|
2026-05-08
|
|
420
|
OTHER
|
Hepatobiliary Diagnostic Procedures With Mcc
|
18
|
11
|
$94,697.75
|
$23,674.44
75% off
|
$25,102.10
|
$101,441.36
|
$63,271.73
|
2026-05-08
|
|
495
|
OTHER
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
18
|
11
|
$166,333.46
|
$41,583.37
75% off
|
$25,041.01
|
$101,185.56
|
$63,113.29
|
2026-05-08
|
|
987
|
OTHER
|
Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc
|
18
|
11
|
$82,142.24
|
$20,535.56
75% off
|
$24,918.17
|
$100,671.10
|
$62,794.64
|
2026-05-08
|
|
408
|
OTHER
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
18
|
11
|
$97,076.36
|
$24,269.09
75% off
|
$24,908.56
|
$100,630.86
|
$62,769.71
|
2026-05-08
|
|
264
|
OTHER
|
Other Circulatory System O.r. Procedures
|
18
|
11
|
$95,736.03
|
$23,934.01
75% off
|
$24,866.01
|
$100,452.67
|
$62,659.34
|
2026-05-08
|
|
589-1
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
10
|
6
|
—
|
—
|
$59,458.71
|
$66,593.76
|
$62,431.65
|
2026-05-08
|
|
574
|
OTHER
|
Skin Graft For Skin Ulcer Or Cellulitis With Cc
|
18
|
11
|
$115,496.10
|
$28,874.03
75% off
|
$24,658.73
|
$99,584.69
|
$62,121.71
|
2026-05-08
|
|
271
|
OTHER
|
Other Major Cardiovascular Procedures With Cc
|
18
|
11
|
$125,799.32
|
$31,449.83
75% off
|
$24,518.04
|
$98,995.50
|
$61,756.77
|
2026-05-08
|
|
477
|
OTHER
|
Biopsies Of Musculoskeletal System And Connective Tissue With Mcc
|
18
|
11
|
$116,811.40
|
$29,202.85
75% off
|
$24,480.97
|
$98,840.30
|
$61,660.64
|
2026-05-08
|
|
665
|
OTHER
|
Prostatectomy With Mcc
|
18
|
11
|
$189,769.98
|
$47,442.50
75% off
|
$24,443.92
|
$98,685.10
|
$61,564.51
|
2026-05-08
|
|
009-3
|
OTHER
|
Extracorporeal Membrane Oxygenation (ecmo)
|
10
|
6
|
—
|
—
|
$58,588.00
|
$65,618.56
|
$61,517.40
|
2026-05-08
|
|
467
|
OTHER
|
Revision Of Hip Or Knee Replacement With Cc
|
18
|
11
|
$112,045.87
|
$28,011.47
75% off
|
$24,386.25
|
$98,443.67
|
$61,414.96
|
2026-05-08
|
|
420073659
|
OTHER
|
Nurostm Gen Nonrchg(20000-21500)
|
30
|
16
|
$106,640.00
|
$26,660.00
75% off
|
$74.35
|
$119,436.80
|
$61,318.00
|
2026-05-08
|
|
260
|
OTHER
|
Cardiac Pacemaker Revision Except Device Replacement With Mcc
|
18
|
11
|
$161,537.65
|
$40,384.41
75% off
|
$24,255.85
|
$97,897.59
|
$61,076.72
|
2026-05-08
|
|
631-3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
10
|
6
|
—
|
—
|
$58,035.32
|
$64,999.56
|
$60,937.09
|
2026-05-08
|
|
242
|
OTHER
|
Permanent Cardiac Pacemaker Implant With Mcc
|
18
|
11
|
$153,787.92
|
$38,446.98
75% off
|
$24,158.41
|
$97,489.47
|
$60,823.94
|
2026-05-08
|
|
29
|
OTHER
|
Spinal Procedures With Cc Or Spinal Neurostimulators
|
18
|
11
|
$216,542.66
|
$54,135.66
75% off
|
$23,916.13
|
$96,474.91
|
$60,195.52
|
2026-05-08
|
|
37
|
OTHER
|
Extracranial Procedures With Mcc
|
18
|
11
|
$156,985.22
|
$39,246.31
75% off
|
$23,670.43
|
$95,445.99
|
$59,558.21
|
2026-05-08
|
|
608-4
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
10
|
6
|
—
|
—
|
$56,423.25
|
$63,194.04
|
$59,244.41
|
2026-05-08
|
|
625-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
10
|
6
|
—
|
—
|
$56,341.07
|
$63,102.00
|
$59,158.12
|
2026-05-08
|
|
841-3
|
OTHER
|
Extensive Third Degree Burns With Skin Graft
|
10
|
6
|
—
|
—
|
$56,069.07
|
$62,797.36
|
$58,872.52
|
2026-05-08
|
|
469
|
OTHER
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…
|
18
|
11
|
$226,776.92
|
$56,694.23
75% off
|
$23,312.16
|
$93,945.71
|
$58,628.93
|
2026-05-08
|
|
579
|
OTHER
|
Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc
|
18
|
11
|
$147,557.67
|
$36,889.42
75% off
|
$23,248.33
|
$93,678.42
|
$58,463.38
|
2026-05-08
|
|
485
|
OTHER
|
Knee Procedures With Principal Diagnosis Of Infection With Mcc
|
18
|
11
|
$139,757.69
|
$34,939.42
75% off
|
$22,973.12
|
$92,525.90
|
$57,749.51
|
2026-05-08
|
|
324
|
OTHER
|
Urinary Stones Without Cc
|
18
|
11
|
$114,142.14
|
$28,535.54
75% off
|
$22,807.03
|
$91,830.37
|
$57,318.70
|
2026-05-08
|
|
840
|
OTHER
|
Lymphoma And Non-acute Leukemia With Mcc
|
18
|
11
|
$68,679.13
|
$17,169.78
75% off
|
$22,765.16
|
$91,655.05
|
$57,210.11
|
2026-05-08
|
|
500
|
OTHER
|
Soft Tissue Procedures With Mcc
|
18
|
11
|
$117,232.59
|
$29,308.15
75% off
|
$22,625.84
|
$91,071.61
|
$56,848.72
|
2026-05-08
|
|
662
|
OTHER
|
Minor Bladder Procedures With Mcc
|
18
|
11
|
$158,320.96
|
$39,580.24
75% off
|
$22,288.85
|
$89,660.42
|
$55,974.64
|
2026-05-08
|
|
229
|
OTHER
|
Other Cardiothoracic Procedures Without Mcc
|
18
|
11
|
$167,949.81
|
$41,987.45
75% off
|
$22,197.57
|
$89,278.17
|
$55,737.87
|
2026-05-08
|
|
603-3
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
10
|
6
|
—
|
—
|
$53,002.38
|
$59,362.67
|
$55,652.50
|
2026-05-08
|
|
356080095
|
OTHER
|
Icd Bi-v D C1882 (18501-19500
|
30
|
16
|
$96,720.00
|
$24,180.00
75% off
|
$74.35
|
$108,326.40
|
$55,614.00
|
2026-05-08
|
|
515
|
OTHER
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc
|
18
|
11
|
$126,724.58
|
$31,681.15
75% off
|
$22,102.16
|
$88,878.67
|
$55,490.42
|
2026-05-08
|
|
420071529
|
OTHER
|
Mesh Cl (18500-19000)
|
30
|
16
|
$94,240.00
|
$23,560.00
75% off
|
$74.35
|
$105,548.80
|
$54,188.00
|
2026-05-08
|
|
161-2
|
OTHER
|
Implantable Heart Assist Systems
|
10
|
6
|
—
|
—
|
$51,234.90
|
$57,383.09
|
$53,796.65
|
2026-05-08
|
|
161-1
|
OTHER
|
Implantable Heart Assist Systems
|
10
|
6
|
—
|
—
|
$51,234.90
|
$57,383.09
|
$53,796.65
|
2026-05-08
|
|
160-4
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
10
|
6
|
—
|
—
|
$51,048.39
|
$57,174.20
|
$53,600.81
|
2026-05-08
|
|
974
|
OTHER
|
HIV With Major Related Condition With Mcc
|
18
|
11
|
$84,332.97
|
$21,083.24
75% off
|
$21,373.30
|
$85,826.37
|
$53,599.83
|
2026-05-08
|
|
464
|
OTHER
|
Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …
|
18
|
11
|
$140,614.42
|
$35,153.61
75% off
|
$21,115.23
|
$84,745.71
|
$52,930.47
|
2026-05-08
|
|
480
|
OTHER
|
Hip And Femur Procedures Except Major Joint With Mcc
|
18
|
11
|
$114,072.32
|
$28,518.08
75% off
|
$21,063.07
|
$84,527.28
|
$52,795.18
|
2026-05-08
|
|
420079983
|
OTHER
|
Nurostm Gen Nonrchg (17001-18500)
|
30
|
16
|
$91,760.00
|
$22,940.00
75% off
|
$74.35
|
$102,771.20
|
$52,762.00
|
2026-05-08
|
|
356080094
|
OTHER
|
Icd Bi-v D C1882 (17500-18500)
|
30
|
16
|
$91,760.00
|
$22,940.00
75% off
|
$74.35
|
$102,771.20
|
$52,762.00
|
2026-05-08
|
|
420079773
|
OTHER
|
Nurostim Gen Rechg(17501-18500)
|
30
|
16
|
$91,760.00
|
$22,940.00
75% off
|
$74.35
|
$102,771.20
|
$52,762.00
|
2026-05-08
|
|
420077411
|
OTHER
|
Generator Pulse Vns Therapy
|
30
|
16
|
$91,755.04
|
$22,938.76
75% off
|
$74.35
|
$102,765.64
|
$52,759.14
|
2026-05-08
|
|
353
|
OTHER
|
Hernia Procedures Except Inguinal And Femoral With Mcc
|
18
|
11
|
$117,636.46
|
$29,409.12
75% off
|
$21,008.16
|
$84,297.35
|
$52,652.75
|
2026-05-08
|
|
011-4
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
6
|
—
|
—
|
$50,021.00
|
$56,023.52
|
$52,522.05
|
2026-05-08
|
|
011-2
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
6
|
—
|
—
|
$50,000.00
|
$56,000.00
|
$52,500.00
|
2026-05-08
|
|
588-1
|
OTHER
|
Female Reproductive System Reconstructive Procedures
|
10
|
6
|
—
|
—
|
$50,000.00
|
$56,000.00
|
$52,500.00
|
2026-05-08
|
|
668
|
OTHER
|
Transurethral Procedures With Mcc
|
18
|
11
|
$92,294.17
|
$23,073.54
75% off
|
$20,893.55
|
$83,817.38
|
$52,355.46
|
2026-05-08
|
|
521
|
OTHER
|
Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc
|
18
|
11
|
$143,258.53
|
$35,814.63
75% off
|
$20,882.56
|
$83,771.39
|
$52,326.97
|
2026-05-08
|
|
240
|
OTHER
|
Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc
|
18
|
11
|
$115,787.88
|
$28,946.97
75% off
|
$20,865.41
|
$83,699.54
|
$52,282.47
|
2026-05-08
|
|
472
|
OTHER
|
Cervical Spinal Fusion With Cc
|
18
|
11
|
$195,718.23
|
$48,929.56
75% off
|
$20,762.45
|
$83,268.43
|
$52,015.44
|
2026-05-08
|
|
002-2
|
OTHER
|
Heart And/or Lung Transplant
|
10
|
6
|
—
|
—
|
$49,153.16
|
$55,051.54
|
$51,610.82
|
2026-05-08
|
|
754-4
|
OTHER
|
Depression Except Major Depressive Disorder
|
10
|
6
|
—
|
—
|
$48,950.28
|
$54,824.31
|
$51,397.79
|
2026-05-08
|
|
325
|
OTHER
|
Coronary Intravascular Lithotripsy Without Intraluminal Device
|
18
|
11
|
$78,764.84
|
$19,691.21
75% off
|
$20,521.55
|
$82,259.62
|
$51,390.58
|
2026-05-08
|
|
510
|
OTHER
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc
|
18
|
11
|
$91,321.55
|
$22,830.39
75% off
|
$20,494.10
|
$82,144.65
|
$51,319.38
|
2026-05-08
|
|
608-3
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
10
|
6
|
—
|
—
|
$48,704.91
|
$54,549.50
|
$51,140.16
|
2026-05-08
|
|
321
|
OTHER
|
Kidney & Urinary Tract Infections Age >17 Without Cc
|
18
|
11
|
$134,699.37
|
$33,674.84
75% off
|
$20,416.55
|
$81,819.88
|
$51,118.21
|
2026-05-08
|
|
420080072
|
OTHER
|
Mesh Cl (16501-17500)
|
30
|
16
|
$86,800.00
|
$21,700.00
75% off
|
$74.35
|
$97,216.00
|
$49,910.00
|
2026-05-08
|
|
420079772
|
OTHER
|
Nurostim Gen Rechg (17001-17500)
|
30
|
16
|
$86,800.00
|
$21,700.00
75% off
|
$74.35
|
$97,216.00
|
$49,910.00
|
2026-05-08
|
|
602-2
|
OTHER
|
Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$46,718.58
|
$52,324.81
|
$49,054.51
|
2026-05-08
|
|
005-4
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
10
|
6
|
—
|
—
|
$46,671.82
|
$52,272.44
|
$49,005.41
|
2026-05-08
|
|
61
|
OTHER
|
Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A…
|
18
|
11
|
$88,215.73
|
$22,053.93
75% off
|
$19,432.35
|
$77,698.42
|
$48,565.39
|
2026-05-08
|
|
004-3
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
10
|
6
|
—
|
—
|
$46,198.91
|
$51,742.78
|
$48,508.86
|
2026-05-08
|
|
420079771
|
OTHER
|
Nurostim Gen Rechg (16501-17000)
|
30
|
16
|
$84,320.00
|
$21,080.00
75% off
|
$74.35
|
$94,438.40
|
$48,484.00
|
2026-05-08
|
|
420071875
|
OTHER
|
Penile Implant (16000-17000)
|
30
|
16
|
$84,320.00
|
$21,080.00
75% off
|
$74.35
|
$94,438.40
|
$48,484.00
|
2026-05-08
|
|
356080093
|
OTHER
|
Icd Single Rr C1722 (15001-17000)
|
30
|
16
|
$84,320.00
|
$21,080.00
75% off
|
$74.35
|
$94,438.40
|
$48,484.00
|
2026-05-08
|
|
356080088
|
OTHER
|
Icd Dual C1721 (16001-17000)
|
30
|
16
|
$84,320.00
|
$21,080.00
75% off
|
$74.35
|
$94,438.40
|
$48,484.00
|
2026-05-08
|
|
344
|
OTHER
|
Minor Small And Large Bowel Procedures With Mcc
|
18
|
11
|
$101,839.37
|
$25,459.84
75% off
|
$19,371.27
|
$77,442.62
|
$48,406.94
|
2026-05-08
|
|
208
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support <=96 Hours
|
18
|
11
|
$95,444.70
|
$23,861.18
75% off
|
$19,297.83
|
$77,135.10
|
$48,216.46
|
2026-05-08
|
|
623-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
10
|
6
|
—
|
—
|
$45,404.40
|
$50,852.93
|
$47,674.62
|
2026-05-08
|
|
503
|
OTHER
|
Foot Procedures With Mcc
|
18
|
11
|
$72,309.34
|
$18,077.34
75% off
|
$19,042.52
|
$76,065.93
|
$47,554.22
|
2026-05-08
|
|
468
|
OTHER
|
Revision Of Hip Or Knee Replacement Without Cc/mcc
|
18
|
11
|
$128,234.21
|
$32,058.55
75% off
|
$18,882.60
|
$75,396.27
|
$47,139.43
|
2026-05-08
|
|
612-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$44,882.27
|
$50,268.14
|
$47,126.38
|
2026-05-08
|
|
420079685
|
OTHER
|
Nurostim Gen Rechg (16001-16500)
|
30
|
16
|
$81,840.00
|
$20,460.00
75% off
|
$74.35
|
$91,660.80
|
$47,058.00
|
2026-05-08
|
|
255
|
OTHER
|
Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc
|
18
|
11
|
$111,477.31
|
$27,869.33
75% off
|
$18,835.93
|
$75,200.83
|
$47,018.38
|
2026-05-08
|
|
007-3
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
10
|
6
|
—
|
—
|
$44,622.06
|
$49,976.71
|
$46,853.16
|
2026-05-08
|
|
842-4
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
10
|
6
|
—
|
—
|
$44,285.71
|
$49,600.00
|
$46,500.00
|
2026-05-08
|
|
659
|
OTHER
|
Kidney And Ureter Procedures For Non-neoplasm With Mcc
|
18
|
11
|
$109,015.93
|
$27,253.98
75% off
|
$18,614.94
|
$74,275.37
|
$46,445.15
|
2026-05-08
|
|
613-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
10
|
6
|
—
|
—
|
$44,052.16
|
$49,338.42
|
$46,254.77
|
2026-05-08
|
|
253
|
OTHER
|
Other Vascular Procedures With Cc
|
18
|
11
|
$65,914.30
|
$16,478.58
75% off
|
$18,400.12
|
$73,375.77
|
$45,887.94
|
2026-05-08
|
|
483
|
OTHER
|
Major Joint Or Limb Reattachment Procedures Of Upper Extremities
|
18
|
11
|
$145,125.32
|
$36,281.33
75% off
|
$18,367.17
|
$73,237.82
|
$45,802.50
|
2026-05-08
|
|
356080087
|
OTHER
|
Icd Dual C1721 (15001-16000)
|
30
|
16
|
$79,360.00
|
$19,840.00
75% off
|
$74.35
|
$88,883.20
|
$45,632.00
|
2026-05-08
|
|
420080169
|
OTHER
|
Urinary Sphincter (14000-16000)
|
30
|
16
|
$79,360.00
|
$19,840.00
75% off
|
$74.35
|
$88,883.20
|
$45,632.00
|
2026-05-08
|
|
420079684
|
OTHER
|
Nurostim Gen Rechg (15501-16000)
|
30
|
16
|
$79,360.00
|
$19,840.00
75% off
|
$74.35
|
$88,883.20
|
$45,632.00
|
2026-05-08
|
|
002-1
|
OTHER
|
Heart And/or Lung Transplant
|
10
|
6
|
—
|
—
|
$43,443.38
|
$48,656.59
|
$45,615.55
|
2026-05-08
|
|
006-4
|
OTHER
|
Pancreas Transplant
|
10
|
6
|
—
|
—
|
$43,326.23
|
$48,525.38
|
$45,492.54
|
2026-05-08
|
|
545
|
OTHER
|
Connective Tissue Disorders With Mcc
|
18
|
11
|
$63,563.84
|
$15,890.96
75% off
|
$18,220.99
|
$72,625.63
|
$45,423.31
|
2026-05-08
|
|
356014932
|
OTHER
|
Subcutaneous Icd Implantation
|
15
|
11
|
$141,414.50
|
$35,353.63
75% off
|
$74.35
|
$134,343.77
|
$45,111.23
|
2026-05-08
|
|
56
|
OTHER
|
Degenerative Nervous System Disorders With Mcc
|
18
|
11
|
$65,607.43
|
$16,401.86
75% off
|
$18,064.50
|
$71,970.34
|
$45,017.42
|
2026-05-08
|
|
272
|
OTHER
|
Other Major Cardiovascular Procedures Without Cc/mcc
|
18
|
11
|
$118,955.90
|
$29,738.98
75% off
|
$18,051.46
|
$71,915.73
|
$44,983.60
|
2026-05-08
|
|
397
|
OTHER
|
Coagulation Disorders
|
18
|
11
|
$115,790.06
|
$28,947.51
75% off
|
$17,884.01
|
$71,214.45
|
$44,549.23
|
2026-05-08
|
|
347
|
OTHER
|
Anal And Stomal Procedures With Mcc
|
18
|
11
|
$69,552.27
|
$17,388.07
75% off
|
$21,022.00
|
$68,024.20
|
$44,523.10
|
2026-05-08
|
|
420079778
|
OTHER
|
Nurostim Gen Rechg (15001-15500)
|
30
|
16
|
$76,880.00
|
$19,220.00
75% off
|
$74.35
|
$86,105.60
|
$44,206.00
|
2026-05-08
|
|
622-4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$42,030.02
|
$47,073.62
|
$44,131.52
|
2026-05-08
|
|
982
|
OTHER
|
Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc
|
18
|
11
|
$125,773.73
|
$31,443.43
75% off
|
$17,681.53
|
$70,366.59
|
$44,024.06
|
2026-05-08
|
|
327
|
OTHER
|
Stomach, Esophageal And Duodenal Procedures With Cc
|
18
|
11
|
$107,017.12
|
$26,754.28
75% off
|
$17,542.89
|
$69,786.02
|
$43,664.46
|
2026-05-08
|
|
350
|
OTHER
|
Inguinal And Femoral Hernia Procedures With Mcc
|
18
|
11
|
$105,034.67
|
$26,258.67
75% off
|
$17,478.38
|
$69,515.86
|
$43,497.12
|
2026-05-08
|
|
493
|
OTHER
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc
|
18
|
11
|
$104,840.55
|
$26,210.14
75% off
|
$17,356.92
|
$69,007.14
|
$43,182.03
|
2026-05-08
|
|
96
|
OTHER
|
Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc
|
18
|
11
|
$23,208.64
|
$5,802.16
75% off
|
$17,330.82
|
$68,897.93
|
$43,114.38
|
2026-05-08
|
|
95
|
OTHER
|
Bacterial And Tuberculous Infections Of Nervous System With Cc
|
18
|
11
|
$101,417.90
|
$25,354.48
75% off
|
$17,330.82
|
$68,897.93
|
$43,114.38
|
2026-05-08
|
|
420088629
|
OTHER
|
Penile Implant Cl 19 (14001-15000
|
30
|
16
|
$74,400.00
|
$18,600.00
75% off
|
$74.35
|
$83,328.00
|
$42,780.00
|
2026-05-08
|
|
420079683
|
OTHER
|
Nurostim Gen Rechg (14501-15000)
|
30
|
16
|
$74,400.00
|
$18,600.00
75% off
|
$74.35
|
$83,328.00
|
$42,780.00
|
2026-05-08
|
|
420079708
|
OTHER
|
Nurostm Gen Nonrchg (14501-15000)
|
30
|
16
|
$74,400.00
|
$18,600.00
75% off
|
$74.35
|
$83,328.00
|
$42,780.00
|
2026-05-08
|
|
356080092
|
OTHER
|
Icd Single Rr C1722 (14001-15000)
|
30
|
16
|
$74,400.00
|
$18,600.00
75% off
|
$74.35
|
$83,328.00
|
$42,780.00
|
2026-05-08
|
|
420080190
|
OTHER
|
Mesh (14001-15000)
|
30
|
16
|
$74,400.00
|
$18,600.00
75% off
|
$74.35
|
$83,328.00
|
$42,780.00
|
2026-05-08
|
|
356080086
|
OTHER
|
Icd Dual C1721 (14001-15000)
|
30
|
16
|
$74,400.00
|
$18,600.00
75% off
|
$74.35
|
$83,328.00
|
$42,780.00
|
2026-05-08
|
|
417
|
OTHER
|
Laparoscopic Cholecystectomy Without C.d.e. With Mcc
|
18
|
11
|
$124,195.89
|
$31,048.97
75% off
|
$17,188.75
|
$68,302.99
|
$42,745.87
|
2026-05-08
|
|
473
|
OTHER
|
Cervical Spinal Fusion Without Cc/mcc
|
18
|
11
|
$188,579.77
|
$47,144.94
75% off
|
$17,126.29
|
$68,041.44
|
$42,583.86
|
2026-05-08
|
|
330
|
OTHER
|
Major Small And Large Bowel Procedures With Cc
|
18
|
11
|
$138,216.04
|
$34,554.01
75% off
|
$17,100.91
|
$67,935.10
|
$42,518.00
|
2026-05-08
|
|
420087013
|
OTHER
|
Joint/joint Dev Cl 63 14500-15000
|
30
|
16
|
$73,804.80
|
$18,451.20
75% off
|
$74.35
|
$82,661.38
|
$42,437.76
|
2026-05-08
|
|
478
|
OTHER
|
Biopsies Of Musculoskeletal System And Connective Tissue With Cc
|
18
|
11
|
$113,025.06
|
$28,256.26
75% off
|
$16,928.63
|
$67,213.70
|
$42,071.17
|
2026-05-08
|
|
82
|
OTHER
|
Traumatic Stupor And Coma >1 Hour With Mcc
|
18
|
11
|
$22,583.74
|
$5,645.94
75% off
|
$16,802.36
|
$66,684.87
|
$41,743.61
|
2026-05-08
|
|
250
|
OTHER
|
Percutaneous Cardiovascular Procedures Without Coronary Artery Stent With Mcc
|
18
|
11
|
$88,785.91
|
$22,196.48
75% off
|
$16,750.18
|
$66,466.44
|
$41,608.31
|
2026-05-08
|
|
674
|
OTHER
|
Other Kidney And Urinary Tract Procedures With Cc
|
18
|
11
|
$127,168.97
|
$31,792.24
75% off
|
$16,721.37
|
$66,345.72
|
$41,533.54
|
2026-05-08
|
|
420087012
|
OTHER
|
Joint/joint Dev Cl 62 14000-14500
|
30
|
16
|
$71,920.00
|
$17,980.00
75% off
|
$74.35
|
$80,550.40
|
$41,354.00
|
2026-05-08
|
|
420079682
|
OTHER
|
Nurostim Gen Rechg (14001-14500)
|
30
|
16
|
$71,920.00
|
$17,980.00
75% off
|
$74.35
|
$80,550.40
|
$41,354.00
|
2026-05-08
|
|
146
|
OTHER
|
Ear, Nose, Mouth And Throat Malignancy With Mcc
|
18
|
11
|
$61,296.20
|
$15,324.05
75% off
|
$16,623.20
|
$65,934.73
|
$41,278.96
|
2026-05-08
|
|
808
|
OTHER
|
Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…
|
18
|
11
|
$63,824.48
|
$15,956.12
75% off
|
$16,597.14
|
$65,825.51
|
$41,211.32
|
2026-05-08
|
|
634-4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…
|
10
|
6
|
—
|
—
|
$39,210.14
|
$43,915.36
|
$41,170.65
|
2026-05-08
|
|
424
|
OTHER
|
Other Hepatobiliary Or Pancreas O.r. Procedures With Cc
|
18
|
11
|
$33,041.44
|
$8,260.36
75% off
|
$16,549.10
|
$65,624.33
|
$41,086.71
|
2026-05-08
|
|
85
|
OTHER
|
Traumatic Stupor And Coma <1 Hour With Mcc
|
18
|
11
|
$37,924.85
|
$9,481.21
75% off
|
$16,430.37
|
$65,127.11
|
$40,778.74
|
2026-05-08
|
|
715
|
OTHER
|
Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc
|
18
|
11
|
$202,122.05
|
$50,530.51
75% off
|
$16,377.50
|
$64,905.80
|
$40,641.65
|
2026-05-08
|
|
243
|
OTHER
|
Permanent Cardiac Pacemaker Implant With Cc
|
18
|
11
|
$94,798.18
|
$23,699.54
75% off
|
$16,339.77
|
$64,747.72
|
$40,543.75
|
2026-05-08
|
|
357
|
OTHER
|
Other Digestive System O.r. Procedures With Cc
|
18
|
11
|
$78,491.83
|
$19,622.96
75% off
|
$16,334.28
|
$64,724.73
|
$40,529.50
|
2026-05-08
|
|
629
|
OTHER
|
Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc
|
18
|
11
|
$96,981.23
|
$24,245.31
75% off
|
$16,314.37
|
$64,641.38
|
$40,477.88
|
2026-05-08
|
|
30
|
OTHER
|
Spinal Procedures Without Cc/mcc
|
18
|
11
|
$104,922.93
|
$26,230.73
75% off
|
$16,151.72
|
$63,960.22
|
$40,055.97
|
2026-05-08
|
|
356080085
|
OTHER
|
Icd Dual C1721 (13001-14000)
|
30
|
16
|
$69,440.00
|
$17,360.00
75% off
|
$74.35
|
$77,772.80
|
$39,928.00
|
2026-05-08
|
|
420080071
|
OTHER
|
Mesh Cl (13001-14000)
|
30
|
16
|
$69,440.00
|
$17,360.00
75% off
|
$74.35
|
$77,772.80
|
$39,928.00
|
2026-05-08
|
|
420088636
|
OTHER
|
Penile Implant Cl 18 (13001-14000
|
30
|
16
|
$69,440.00
|
$17,360.00
75% off
|
$74.35
|
$77,772.80
|
$39,928.00
|
2026-05-08
|
|
356072022
|
OTHER
|
Icd Bi-v D C1882 (13000-14000)
|
30
|
16
|
$69,440.00
|
$17,360.00
75% off
|
$74.35
|
$77,772.80
|
$39,928.00
|
2026-05-08
|
|
420079681
|
OTHER
|
Nurostim Gen Rechg (13500-14000)
|
30
|
16
|
$69,440.00
|
$17,360.00
75% off
|
$74.35
|
$77,772.80
|
$39,928.00
|
2026-05-08
|
|
356080091
|
OTHER
|
Icd Single Rr C1722 (13001-14000)
|
30
|
16
|
$69,440.00
|
$17,360.00
75% off
|
$74.35
|
$77,772.80
|
$39,928.00
|
2026-05-08
|
|
286
|
OTHER
|
Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc
|
18
|
11
|
$62,948.53
|
$15,737.13
75% off
|
$16,068.65
|
$63,612.46
|
$39,840.56
|
2026-05-08
|
|
420087011
|
OTHER
|
Joint/joint Dev Cl 61 13500-14000
|
30
|
16
|
$68,324.00
|
$17,081.00
75% off
|
$74.35
|
$76,522.88
|
$39,286.30
|
2026-05-08
|
|
857
|
OTHER
|
Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc
|
18
|
11
|
$83,638.95
|
$20,909.74
75% off
|
$15,832.56
|
$62,623.76
|
$39,228.16
|
2026-05-08
|
|
98
|
OTHER
|
Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc
|
18
|
11
|
$31,232.94
|
$7,808.24
75% off
|
$15,766.68
|
$62,347.85
|
$39,057.26
|
2026-05-08
|
|
356076123
|
OTHER
|
Pm Single C1786 (13000-14000)
|
30
|
16
|
$67,872.00
|
$16,968.00
75% off
|
$74.35
|
$76,016.64
|
$39,026.40
|
2026-05-08
|
|
475
|
OTHER
|
Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc
|
18
|
11
|
$94,891.03
|
$23,722.76
75% off
|
$15,684.32
|
$62,002.96
|
$38,843.64
|
2026-05-08
|
|
314
|
OTHER
|
Other Circulatory System Diagnoses With Mcc
|
18
|
11
|
$89,531.64
|
$22,382.91
75% off
|
$15,658.24
|
$61,893.74
|
$38,775.99
|
2026-05-08
|
|
934
|
OTHER
|
Full Thickness Burn Without Skin Graft Or Inhalation Injury
|
18
|
11
|
$117,802.40
|
$29,450.60
75% off
|
$15,605.40
|
$61,672.44
|
$38,638.92
|
2026-05-08
|
|
867
|
OTHER
|
Other Infectious And Parasitic Diseases Diagnoses With Mcc
|
18
|
11
|
$90,271.04
|
$22,567.76
75% off
|
$15,595.09
|
$61,629.33
|
$38,612.21
|
2026-05-08
|
|
614-3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
10
|
6
|
—
|
—
|
$36,736.42
|
$41,144.79
|
$38,573.24
|
2026-05-08
|
|
420087010
|
OTHER
|
Joint/joint Dev Cl 60 13000-13500
|
30
|
16
|
$66,960.00
|
$16,740.00
75% off
|
$74.35
|
$74,995.20
|
$38,502.00
|
2026-05-08
|
|
420079698
|
OTHER
|
Nurostm Gen Nonrchg (12501-13500)
|
30
|
16
|
$66,960.00
|
$16,740.00
75% off
|
$74.35
|
$74,995.20
|
$38,502.00
|
2026-05-08
|
|
835
|
OTHER
|
Acute Leukemia Without Major O.r. Procedures With Cc
|
18
|
11
|
$59,814.94
|
$14,953.73
75% off
|
$15,537.43
|
$61,387.90
|
$38,462.67
|
2026-05-08
|
|
486
|
OTHER
|
Knee Procedures With Principal Diagnosis Of Infection With Cc
|
18
|
11
|
$94,630.86
|
$23,657.72
75% off
|
$15,434.49
|
$60,956.79
|
$38,195.64
|
2026-05-08
|
|
336
|
OTHER
|
Peritoneal Adhesiolysis With Cc
|
18
|
11
|
$137,683.47
|
$34,420.87
75% off
|
$15,375.48
|
$60,709.61
|
$38,042.54
|
2026-05-08
|
|
374
|
OTHER
|
Digestive Malignancy With Mcc
|
18
|
11
|
$57,178.81
|
$14,294.70
75% off
|
$15,369.29
|
$60,683.75
|
$38,026.52
|
2026-05-08
|
|
522
|
OTHER
|
Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc
|
18
|
11
|
$115,108.54
|
$28,777.14
75% off
|
$15,346.64
|
$60,588.90
|
$37,967.77
|
2026-05-08
|
|
409
|
OTHER
|
Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…
|
18
|
11
|
$55,176.78
|
$13,794.20
75% off
|
$15,267.03
|
$60,255.51
|
$37,761.27
|
2026-05-08
|
|
814
|
OTHER
|
Reticuloendothelial And Immunity Disorders With Mcc
|
18
|
11
|
$106,055.83
|
$26,513.96
75% off
|
$15,225.85
|
$60,083.06
|
$37,654.46
|
2026-05-08
|
|
420087009
|
OTHER
|
Joint/joint Dev Cl 59 12500-13000
|
30
|
16
|
$64,616.66
|
$16,154.17
75% off
|
$74.35
|
$72,370.66
|
$37,154.58
|
2026-05-08
|
|
356080084
|
OTHER
|
Icd Dual C1721(12000-13000)
|
30
|
16
|
$64,480.00
|
$16,120.00
75% off
|
$74.35
|
$72,217.60
|
$37,076.00
|
2026-05-08
|
|
356080090
|
OTHER
|
Icd Single Rr C1722 (12001-13000)
|
30
|
16
|
$64,480.00
|
$16,120.00
75% off
|
$74.35
|
$72,217.60
|
$37,076.00
|
2026-05-08
|
|
420086944
|
OTHER
|
Mesh Cl 62 (11001-13000)
|
30
|
16
|
$64,480.00
|
$16,120.00
75% off
|
$74.35
|
$72,217.60
|
$37,076.00
|
2026-05-08
|
|
356080111
|
OTHER
|
Pm Biv-p/c2621 (12001-13000)
|
30
|
16
|
$64,480.00
|
$16,120.00
75% off
|
$74.35
|
$72,217.60
|
$37,076.00
|
2026-05-08
|
|
420079946
|
OTHER
|
Urinary Sphincter (12001-13000)
|
30
|
16
|
$64,480.00
|
$16,120.00
75% off
|
$74.35
|
$72,217.60
|
$37,076.00
|
2026-05-08
|
|
592
|
OTHER
|
Skin Ulcers With Mcc
|
18
|
11
|
$64,252.47
|
$16,063.12
75% off
|
$14,991.12
|
$59,100.12
|
$37,045.62
|
2026-05-08
|
|
420079908
|
OTHER
|
Graft Cl 50 (12000-12800)
|
30
|
16
|
$63,488.00
|
$15,872.00
75% off
|
$74.35
|
$71,106.56
|
$36,505.60
|
2026-05-08
|
|
011-1
|
OTHER
|
Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies
|
10
|
6
|
—
|
—
|
$34,745.58
|
$38,915.05
|
$36,482.86
|
2026-05-08
|
|
483-4
|
OTHER
|
Penis, Testes And Scrotal Procedures
|
10
|
6
|
—
|
—
|
$34,710.96
|
$38,876.28
|
$36,446.51
|
2026-05-08
|
|
539
|
OTHER
|
Osteomyelitis With Mcc
|
18
|
11
|
$71,808.58
|
$17,952.14
75% off
|
$14,758.47
|
$58,125.80
|
$36,442.14
|
2026-05-08
|
|
908
|
OTHER
|
Other O.r. Procedures For Injuries With Cc
|
18
|
11
|
$77,877.52
|
$19,469.38
75% off
|
$14,722.09
|
$57,973.47
|
$36,347.78
|
2026-05-08
|
|
516
|
OTHER
|
Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc
|
18
|
11
|
$76,472.10
|
$19,118.02
75% off
|
$14,685.04
|
$57,818.27
|
$36,251.65
|
2026-05-08
|
|
001-3
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
10
|
6
|
—
|
—
|
$34,436.53
|
$38,568.91
|
$36,158.36
|
2026-05-08
|
|
162-4
|
OTHER
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
10
|
6
|
—
|
—
|
$34,306.45
|
$38,423.22
|
$36,021.77
|
2026-05-08
|
|
854
|
OTHER
|
Infectious And Parasitic Diseases With O.r. Procedures With Cc
|
18
|
11
|
$91,600.19
|
$22,900.05
75% off
|
$14,591.70
|
$57,427.39
|
$36,009.54
|
2026-05-08
|
|
623-3
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
10
|
6
|
—
|
—
|
$34,148.97
|
$38,246.85
|
$35,856.42
|
2026-05-08
|
|
64
|
OTHER
|
Intracranial Hemorrhage Or Cerebral Infarction With Mcc
|
18
|
11
|
$72,446.14
|
$18,111.54
75% off
|
$14,530.60
|
$57,171.60
|
$35,851.10
|
2026-05-08
|
|
100
|
OTHER
|
Seizures With Mcc
|
18
|
11
|
$64,213.76
|
$16,053.44
75% off
|
$14,503.84
|
$57,059.51
|
$35,781.68
|
2026-05-08
|
|
420087008
|
OTHER
|
Joint/joint Dev Cl 58 12000-12500
|
30
|
16
|
$62,000.00
|
$15,500.00
75% off
|
$74.35
|
$69,440.00
|
$35,650.00
|
2026-05-08
|
|
420079697
|
OTHER
|
Nurostm Gen Nonrchg (12001-12500)
|
30
|
16
|
$62,000.00
|
$15,500.00
75% off
|
$74.35
|
$69,440.00
|
$35,650.00
|
2026-05-08
|
|
005-3
|
OTHER
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
10
|
6
|
—
|
—
|
$33,871.27
|
$37,935.82
|
$35,564.83
|
2026-05-08
|
|
496
|
OTHER
|
Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…
|
18
|
11
|
$133,415.85
|
$33,353.96
75% off
|
$14,419.42
|
$56,705.99
|
$35,562.71
|
2026-05-08
|
|
519
|
OTHER
|
Back And Neck Procedures Except Spinal Fusion With Cc
|
18
|
11
|
$135,983.74
|
$33,995.93
75% off
|
$14,411.87
|
$56,674.38
|
$35,543.12
|
2026-05-08
|
|
232-4
|
OTHER
|
Gastric Fundoplication
|
10
|
6
|
—
|
—
|
$33,765.46
|
$37,817.32
|
$35,453.73
|
2026-05-08
|
|
488
|
OTHER
|
Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc
|
18
|
11
|
$73,362.29
|
$18,340.57
75% off
|
$14,367.26
|
$56,487.56
|
$35,427.41
|
2026-05-08
|
|
871
|
OTHER
|
Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc
|
18
|
11
|
$96,858.18
|
$24,214.55
75% off
|
$14,344.61
|
$56,392.72
|
$35,368.67
|
2026-05-08
|
|
511
|
OTHER
|
Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc
|
18
|
11
|
$79,367.50
|
$19,841.87
75% off
|
$14,338.43
|
$56,366.85
|
$35,352.64
|
2026-05-08
|
|
432
|
OTHER
|
Cirrhosis And Alcoholic Hepatitis With Mcc
|
18
|
11
|
$70,466.41
|
$17,616.60
75% off
|
$14,324.02
|
$56,306.49
|
$35,315.25
|
2026-05-08
|
|
440-4
|
OTHER
|
Kidney Transplant
|
10
|
6
|
—
|
—
|
$33,592.77
|
$37,623.90
|
$35,272.41
|
2026-05-08
|
|
283
|
OTHER
|
Acute Myocardial Infarction, Expired With Mcc
|
18
|
11
|
$63,592.63
|
$15,898.16
75% off
|
$14,298.63
|
$56,200.15
|
$35,249.39
|
2026-05-08
|
|
006-3
|
OTHER
|
Pancreas Transplant
|
10
|
6
|
—
|
—
|
$33,389.74
|
$37,396.51
|
$35,059.23
|
2026-05-08
|
|
589-2
|
OTHER
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …
|
10
|
6
|
—
|
—
|
$33,354.00
|
$37,356.48
|
$35,021.70
|
2026-05-08
|
|
607-2
|
OTHER
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…
|
10
|
6
|
—
|
—
|
$33,333.50
|
$37,333.52
|
$35,000.18
|
2026-05-08
|
|
507
|
OTHER
|
Major Shoulder Or Elbow Joint Procedures With Cc/mcc
|
18
|
11
|
$131,920.25
|
$32,980.06
75% off
|
$14,180.58
|
$55,705.81
|
$34,943.19
|
2026-05-08
|
|
617
|
OTHER
|
Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…
|
18
|
11
|
$79,811.58
|
$19,952.89
75% off
|
$14,135.28
|
$55,516.12
|
$34,825.70
|
2026-05-08
|
|
380
|
OTHER
|
Complicated Peptic Ulcer With Mcc
|
18
|
11
|
$104,854.06
|
$26,213.51
75% off
|
$14,085.17
|
$55,306.31
|
$34,695.74
|
2026-05-08
|
|
623
|
OTHER
|
Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…
|
18
|
11
|
$78,731.12
|
$19,682.78
75% off
|
$14,006.26
|
$54,975.78
|
$34,491.02
|
2026-05-08
|
|
420086445
|
OTHER
|
Pumpimplant Cl (11000-12000)
|
30
|
16
|
$59,520.00
|
$14,880.00
75% off
|
$74.35
|
$66,662.40
|
$34,224.00
|
2026-05-08
|
|
420079907
|
OTHER
|
Graft Cl 49 (11500-12000)
|
30
|
16
|
$59,520.00
|
$14,880.00
75% off
|
$74.35
|
$66,662.40
|
$34,224.00
|
2026-05-08
|
|
356080301
|
OTHER
|
Septal Occluder (11500-12000)
|
30
|
16
|
$59,520.00
|
$14,880.00
75% off
|
$74.35
|
$66,662.40
|
$34,224.00
|
2026-05-08
|
|
356080089
|
OTHER
|
Icd Single Rr C1722 (11000-12000)
|
30
|
16
|
$59,520.00
|
$14,880.00
75% off
|
$74.35
|
$66,662.40
|
$34,224.00
|
2026-05-08
|
|
356080110
|
OTHER
|
Pm Biv-p/c2621 (10001-12000)
|
30
|
16
|
$59,520.00
|
$14,880.00
75% off
|
$74.35
|
$66,662.40
|
$34,224.00
|
2026-05-08
|
|
420079696
|
OTHER
|
Nurostm Gen Nonrchg (10501-12000)
|
30
|
16
|
$59,520.00
|
$14,880.00
75% off
|
$74.35
|
$66,662.40
|
$34,224.00
|
2026-05-08
|
|
420087007
|
OTHER
|
Joint/joint Dev Cl 57 11500-12000
|
30
|
16
|
$59,520.00
|
$14,880.00
75% off
|
$74.35
|
$66,662.40
|
$34,224.00
|
2026-05-08
|
|
261
|
OTHER
|
Cardiac Pacemaker Revision Except Device Replacement With Cc
|
18
|
11
|
$57,634.87
|
$14,408.72
75% off
|
$13,901.94
|
$54,538.92
|
$34,220.43
|
2026-05-08
|
|
902
|
OTHER
|
Wound Debridements For Injuries With Cc
|
18
|
11
|
$77,777.60
|
$19,444.40
75% off
|
$13,901.94
|
$54,538.92
|
$34,220.43
|
2026-05-08
|
|
843
|
OTHER
|
Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses…
|
18
|
11
|
$26,056.32
|
$6,514.08
75% off
|
$13,872.42
|
$54,415.34
|
$34,143.88
|
2026-05-08
|
|
441
|
OTHER
|
Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc
|
18
|
11
|
$73,173.60
|
$18,293.40
75% off
|
$13,852.51
|
$54,331.99
|
$34,092.25
|
2026-05-08
|
|
205
|
OTHER
|
Other Respiratory System Diagnoses With Mcc
|
18
|
11
|
$65,389.19
|
$16,347.30
75% off
|
$13,834.67
|
$54,257.26
|
$34,045.96
|
2026-05-08
|
|
686
|
OTHER
|
Kidney And Urinary Tract Neoplasms With Mcc
|
18
|
11
|
$20,293.73
|
$5,073.43
75% off
|
$13,820.26
|
$54,196.90
|
$34,008.58
|
2026-05-08
|
|
470
|
OTHER
|
Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without …
|
18
|
11
|
$116,059.87
|
$29,014.97
75% off
|
$13,818.88
|
$54,191.16
|
$34,005.02
|
2026-05-08
|
|
494
|
OTHER
|
Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc
|
18
|
11
|
$119,236.90
|
$29,809.23
75% off
|
$13,818.20
|
$54,188.28
|
$34,003.24
|
2026-05-08
|
|
196
|
OTHER
|
Interstitial Lung Disease With Mcc
|
18
|
11
|
$78,732.64
|
$19,683.16
75% off
|
$13,809.28
|
$54,150.92
|
$33,980.10
|
2026-05-08
|
|
542
|
OTHER
|
Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With…
|
18
|
11
|
$79,162.30
|
$19,790.58
75% off
|
$13,678.87
|
$53,604.84
|
$33,641.86
|
2026-05-08
|
|
559
|
OTHER
|
Aftercare, Musculoskeletal System And Connective Tissue With Mcc
|
18
|
11
|
$34,293.86
|
$8,573.47
75% off
|
$13,618.49
|
$53,351.92
|
$33,485.21
|
2026-05-08
|
|
717
|
OTHER
|
Other Male Reproductive System O.r. Procedures Except Malignancy With Cc/mcc
|
18
|
11
|
$52,682.07
|
$13,170.52
75% off
|
$13,612.98
|
$53,328.93
|
$33,470.96
|
2026-05-08
|
|
51046
|
CPT
|
Botulism Immune Globulin 100 Mg Pwdi
|
18
|
11
|
$91,374.75
|
$22,843.69
75% off
|
$74.35
|
$86,806.01
|
$33,397.47
|
2026-05-08
|