Hospital

BAYCARE HOSPITAL WESLEY CHAPEL

Wesley Chapel, FL · CCN 100362 · Rates published

31,038 distinct procedures filed

25 distinct payers

809,754 rate rows

2026-05-09 last MRF observed

Data quality

808,285 of 809,754 rate rows are consumer-grade (99.8%)

1,469 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reason	Rows
percent-of-charges filed in the dollar field — excluded from medians	736
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	380
per-diem day rate — not a per-procedure price	192
placeholder amount (≤ $0.02) — excluded from medians	161

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

Source MRF file	https://baycare.org/-/media/project/baycare/consumer-portal/billing-and-insurance/pricing-files-compressed/832099849_baycarehospitalwesleychapel_standardcharges.zip
Found on page	https://baycare.org/billing-and-insurance
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-18
Content fingerprint	e57948cd0d381ee6… · 6,640,729 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 OTHER	Inj Atidarsagene Autotemcel	1	$4,246,175.00	$4,246,175.00	$4,246,175.00	nat. median $4,505,000 0.9× median
J1414 OTHER	Inj Beqvez Per Tx Dose	8	$3,598,700.00	$4,637,500.00	$3,969,700.00	nat. median $3,710,000 1.1× median
J1413 OTHER	Inj Delandistrogene Mox Rokl	9	$3,224,834.74	$4,650,494.11	$3,604,132.94	nat. median $3,327,860 1.1× median
J3394 OTHER	Inj Lovotibeglogene Autotem	9	$3,163,514.35	$4,470,200.00	$3,464,405.00	nat. median $3,286,000 1.1× median
J3393 OTHER	Inj Betibeglogene Autotemce	9	$2,862,166.07	$4,155,200.00	$3,220,280.00	nat. median $2,968,000 1.1× median
J3392 OTHER	Inj Exagamglogene Autotem	9	$2,262,040.00	$3,264,800.00	$2,530,220.00	nat. median $2,332,000 1.1× median
J3399 OTHER	Inj Onase Abepar-xioi Treat	15	$10,687.19	$3,364,842.25	$2,391,610.02	nat. median $2,472,216 1.0× median
J1411 OTHER	Inj Hemgenix Per Tx Dose	14	$15,363.65	$4,637,500.00	$1,795,720.67	nat. median $3,685,267 outlier · 0.5×
Q2042 OTHER	Tisagenlecleucel Car-pos T	10	$560,974.84	$1,442,340.79	$636,326.82	nat. median $591,726 1.1× median
Q2056 OTHER	Ciltacabtagene Car-pos T	10	$536,777.47	$1,405,861.77	$620,233.13	nat. median $583,076 1.1× median
Q2055 OTHER	Idecabtagene Vicleucel Car	10	$525,022.64	$1,347,196.70	$594,351.48	nat. median $558,082 1.1× median
Q2054 OTHER	Lisocabtagene Mara Car Pos T	10	$516,485.97	$1,317,039.22	$581,046.72	nat. median $562,538 1.0× median
Q2041 OTHER	Axicabtagene Ciloleucel Car+	10	$489,517.15	$1,248,268.73	$550,706.79	nat. median $533,230 1.0× median
Q2053 OTHER	Brexucabtagene Car Pos T	10	$475,028.40	$1,244,531.35	$549,057.95	nat. median $489,720 1.1× median
5834 OTHER	Neonate With Ecmo	9	$210,343.71	$529,191.44	$357,490.58	nat. median $372,748 1.0× median
MS-018 OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	17	$250,888.25	$1,277,596.53	$351,243.55	nat. median $309,559 1.1× median
MS-001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	18	$187,392.49	$954,257.50	$322,913.82	nat. median $224,278 1.4× median
MS-633 OTHER	Neonate- Birthwt 1000-1499g- W Signif O.r. Pro- Discharged Alive	1	$312,460.08	$312,460.08	$312,460.08	nat. median $297,836 1.0× median
MS-612 OTHER	Neonate- Birthwt <750g-- Discharged Alive	1	$286,326.48	$286,326.48	$286,326.48	nat. median $272,926 1.0× median
Q2058 OTHER	Obecbtge Autol Up To 400 Mil	1	$262,263.75	$262,263.75	$262,263.75	nat. median $281,111 0.9× median
MS-927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	18	$157,818.35	$803,657.30	$231,363.47	nat. median $175,322 1.3× median
MS-426 OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	7	$18,645.74	$354,875.13	$228,075.64	nat. median $84,247 outlier · 2.7×
MS-003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	18	$142,575.90	$726,038.31	$219,152.29	nat. median $169,886 1.3× median
5884 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	9	$128,831.50	$324,119.63	$218,956.14	nat. median $243,175 0.9× median
MS-631 OTHER	Neonate- Birthwt 750-999g- Discharged Alive	1	$207,618.07	$207,618.07	$207,618.07	nat. median $197,901 1.0× median
114 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	9	$120,435.79	$302,997.38	$204,687.19	nat. median $10,012 outlier · 20.4×
24 OTHER	Heart And/or Lung Transplant	9	$120,356.31	$302,797.40	$204,552.10	nat. median $27,988 outlier · 7.3×
5833 OTHER	Neonate With Ecmo	9	$119,797.74	$301,392.11	$203,602.77	nat. median $252,069 0.8× median
MS-636 OTHER	Neonate- Birthwt 1500-1999g- W Signif O.r. Proc W Mult Major Prob	1	$183,596.31	$183,596.31	$183,596.31	nat. median $183,596 1.0× median
MS-453 OTHER	Combined Anterior/posterior Spinal Fusion W Mcc	3	$99,714.20	$264,016.55	$183,479.71	nat. median $121,295 1.5× median
2424195 OTHER	Impl Maci Double Membrane	15	$56,430.00	$313,500.00	$160,982.25	nat. median $165,904 1.0× median
2423837 OTHER	Impl-cardio Vasc 99001-100000	15	$53,730.00	$298,500.00	$153,279.75	nat. median $157,966 1.0× median
1614 OTHER	Implantable Heart Assist Systems	9	$89,815.36	$225,961.22	$152,646.10	nat. median $194,298 0.8× median
6094 OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	9	$89,760.19	$225,822.43	$152,552.34	nat. median $170,784 0.9× median
113 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	9	$89,629.89	$225,494.62	$152,330.89	nat. median $18,223 outlier · 8.4×
94 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	9	$88,048.17	$221,515.25	$149,642.67	nat. median $34,661 outlier · 4.3×
6314 OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	9	$86,333.24	$217,200.76	$146,728.05	nat. median $163,675 0.9× median
5883 OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	9	$85,801.52	$215,863.04	$145,824.36	nat. median $163,694 0.9× median
5914 OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	9	$84,481.48	$212,542.03	$143,580.89	nat. median $149,152 1.0× median
MS-004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	18	$94,001.27	$478,682.01	$141,961.30	nat. median $107,587 1.3× median
2423695 OTHER	Impl-heart 89001-90000	15	$48,330.00	$268,500.00	$137,874.75	nat. median $142,090 1.0× median
MS-459 OTHER	Spinal Fusion Except Cervical With Mcc	3	$44,989.74	$197,602.75	$137,227.66	nat. median $72,631 1.9× median
8414 OTHER	Extensive Third Degree Burns With Skin Graft	9	$79,893.10	$200,998.39	$135,782.68	nat. median $161,322 0.8× median
2423618 OTHER	Impl-cardio Vasc 87001-88000	15	$47,250.00	$262,500.00	$134,793.75	nat. median $139,650 1.0× median
6304 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	9	$78,295.40	$196,978.84	$133,067.30	nat. median $164,743 0.8× median
MS-224 OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami- Hf Or Sh…	5	$83.30	$241,784.27	$132,922.50	nat. median $78,400 1.7× median
MS-014 OTHER	Allogeneic Bone Marrow Transplant	18	$87,161.06	$443,849.68	$128,613.18	nat. median $91,600 1.4× median
MS-002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	18	$73,309.68	$373,314.38	$127,903.14	nat. median $91,287 1.4× median
MS-454 OTHER	Combined Anterior/posterior Spinal Fusion W Cc	3	$64,925.00	$182,229.04	$126,641.05	nat. median $85,830 1.5× median
5934 OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	9	$74,275.40	$186,865.14	$126,235.09	nat. median $129,842 1.0× median

Other procedures at this hospital

Browse this hospital's 31,038 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

2424195	OTHER	Impl Maci Double Membrane	32	15	$313,500.00	$188,100.00 40% off	$56,430.00	$313,500.00	$160,982.25	2026-05-09
2423837	OTHER	Impl-cardio Vasc 99001-100000	32	15	$298,500.00	$179,100.00 40% off	$53,730.00	$298,500.00	$153,279.75	2026-05-09
2423695	OTHER	Impl-heart 89001-90000	32	15	$268,500.00	$161,100.00 40% off	$48,330.00	$268,500.00	$137,874.75	2026-05-09
2423618	OTHER	Impl-cardio Vasc 87001-88000	32	15	$262,500.00	$157,500.00 40% off	$47,250.00	$262,500.00	$134,793.75	2026-05-09
2423694	OTHER	Impl-heart 79001-80000	32	15	$238,500.00	$143,100.00 40% off	$42,930.00	$238,500.00	$122,469.75	2026-05-09
2424194	OTHER	Impl Maci Single Membrane	32	15	$157,500.00	$94,500.00 40% off	$28,350.00	$157,500.00	$80,876.25	2026-05-09
2424631	OTHER	C1767 Neurostm Gen 49001-50000	32	15	$148,501.00	$89,100.60 40% off	$26,730.18	$148,501.00	$76,255.26	2026-05-09
2424856	OTHER	Impl-heart 49001-50000	32	15	$148,501.00	$89,100.60 40% off	$26,730.18	$148,501.00	$76,255.26	2026-05-09
2422945	OTHER	Impl-spine 49001-50000	32	15	$148,501.00	$89,100.60 40% off	$26,730.18	$148,501.00	$76,255.26	2026-05-09
2424630	OTHER	C1767 Neurostm Gen 48001-49000	32	15	$145,501.00	$87,300.60 40% off	$26,190.18	$145,501.00	$74,714.76	2026-05-09
2422944	OTHER	Impl-spine 48001-49000	32	15	$145,501.00	$87,300.60 40% off	$26,190.18	$145,501.00	$74,714.76	2026-05-09
2424855	OTHER	Impl-heart 48001-49000	32	15	$145,501.00	$87,300.60 40% off	$26,190.18	$145,501.00	$74,714.76	2026-05-09
2422800	OTHER	Impl-totl Knee 48001-49000	32	15	$145,501.00	$87,300.60 40% off	$26,190.18	$145,501.00	$74,714.76	2026-05-09
2424077	OTHER	L8614 Cochlear Imp 47001-48000	32	15	$142,501.00	$85,500.60 40% off	$25,650.18	$142,501.00	$73,174.26	2026-05-09
2424629	OTHER	C1767 Neurostm Gen 47001-48000	32	15	$142,501.00	$85,500.60 40% off	$25,650.18	$142,501.00	$73,174.26	2026-05-09
2424854	OTHER	Impl-heart 47001-48000	32	15	$142,501.00	$85,500.60 40% off	$25,650.18	$142,501.00	$73,174.26	2026-05-09
2422943	OTHER	Impl-spine 47001-48000	32	15	$142,501.00	$85,500.60 40% off	$25,650.18	$142,501.00	$73,174.26	2026-05-09
2424628	OTHER	C1767 Neurostm Gen 46001-47000	32	15	$139,501.00	$83,700.60 40% off	$25,110.18	$139,501.00	$71,633.76	2026-05-09
2424853	OTHER	Impl-heart 46001-47000	32	15	$139,501.00	$83,700.60 40% off	$25,110.18	$139,501.00	$71,633.76	2026-05-09
2422942	OTHER	Impl-spine 46001-47000	32	15	$139,501.00	$83,700.60 40% off	$25,110.18	$139,501.00	$71,633.76	2026-05-09
2424076	OTHER	L8614 Cochlear Imp 46001-47000	32	15	$139,501.00	$83,700.60 40% off	$25,110.18	$139,501.00	$71,633.76	2026-05-09
2424075	OTHER	L8614 Cochlear Imp 45001-46000	32	15	$136,501.00	$81,900.60 40% off	$24,570.18	$136,501.00	$70,093.26	2026-05-09
2424627	OTHER	C1767 Neurostm Gen 45001-46000	32	15	$136,501.00	$81,900.60 40% off	$24,570.18	$136,501.00	$70,093.26	2026-05-09
2422941	OTHER	Impl-spine 45001-46000	32	15	$136,501.00	$81,900.60 40% off	$24,570.18	$136,501.00	$70,093.26	2026-05-09
2424626	OTHER	C1767 Neurostm Gen 44001-45000	32	15	$133,501.00	$80,100.60 40% off	$24,030.18	$133,501.00	$68,552.76	2026-05-09
2424074	OTHER	L8614 Cochlear Imp 44001-45000	32	15	$133,501.00	$80,100.60 40% off	$24,030.18	$133,501.00	$68,552.76	2026-05-09
2424120	OTHER	Cardiovasc Supply 44001-45000	32	15	$133,501.00	$80,100.60 40% off	$24,030.18	$133,501.00	$68,552.76	2026-05-09
2422940	OTHER	Impl-spine 44001-45000	32	15	$133,501.00	$80,100.60 40% off	$24,030.18	$133,501.00	$68,552.76	2026-05-09
2423699	OTHER	Impl-heart 44001-45000	32	15	$133,501.00	$80,100.60 40% off	$24,030.18	$133,501.00	$68,552.76	2026-05-09
2424376	OTHER	Impl-totl Knee 43001-44000	32	15	$130,501.00	$78,300.60 40% off	$23,490.18	$130,501.00	$67,012.26	2026-05-09
2424852	OTHER	Impl-heart 43001-44000	32	15	$130,501.00	$78,300.60 40% off	$23,490.18	$130,501.00	$67,012.26	2026-05-09
2424625	OTHER	C1767 Neurostm Gen 43001-44000	32	15	$130,501.00	$78,300.60 40% off	$23,490.18	$130,501.00	$67,012.26	2026-05-09
2424213	OTHER	Cardiovasc Supply 43001-44000	32	15	$130,501.00	$78,300.60 40% off	$23,490.18	$130,501.00	$67,012.26	2026-05-09
2424073	OTHER	L8614 Cochlear Imp 43001-44000	32	15	$130,501.00	$78,300.60 40% off	$23,490.18	$130,501.00	$67,012.26	2026-05-09
2422939	OTHER	Impl-spine 43001-44000	32	15	$130,501.00	$78,300.60 40% off	$23,490.18	$130,501.00	$67,012.26	2026-05-09
2424375	OTHER	Impl-totl Knee 42001-43000	32	15	$127,501.00	$76,500.60 40% off	$22,950.18	$127,501.00	$65,471.76	2026-05-09
2424212	OTHER	Cardiovasc Supply 42001-43000	32	15	$127,501.00	$76,500.60 40% off	$22,950.18	$127,501.00	$65,471.76	2026-05-09
2424851	OTHER	Impl-heart 42001-43000	32	15	$127,501.00	$76,500.60 40% off	$22,950.18	$127,501.00	$65,471.76	2026-05-09
2424624	OTHER	C1767 Neurostm Gen 42001-43000	32	15	$127,501.00	$76,500.60 40% off	$22,950.18	$127,501.00	$65,471.76	2026-05-09
2424072	OTHER	L8614 Cochlear Imp 42001-43000	32	15	$127,501.00	$76,500.60 40% off	$22,950.18	$127,501.00	$65,471.76	2026-05-09
2422938	OTHER	Impl-spine 42001-43000	32	15	$127,501.00	$76,500.60 40% off	$22,950.18	$127,501.00	$65,471.76	2026-05-09
2424374	OTHER	Impl-totl Knee 41001-42000	32	15	$124,501.00	$74,700.60 40% off	$22,410.18	$124,501.00	$63,931.26	2026-05-09
2424071	OTHER	L8614 Cochlear Imp 41001-42000	32	15	$124,501.00	$74,700.60 40% off	$22,410.18	$124,501.00	$63,931.26	2026-05-09
2424152	OTHER	Impl-heart 41001-42000	32	15	$124,501.00	$74,700.60 40% off	$22,410.18	$124,501.00	$63,931.26	2026-05-09
2424211	OTHER	Cardiovasc Supply 41001-42000	32	15	$124,501.00	$74,700.60 40% off	$22,410.18	$124,501.00	$63,931.26	2026-05-09
2424623	OTHER	C1767 Neurostm Gen 41001-42000	32	15	$124,501.00	$74,700.60 40% off	$22,410.18	$124,501.00	$63,931.26	2026-05-09
2422937	OTHER	Impl-spine 41001-42000	32	15	$124,501.00	$74,700.60 40% off	$22,410.18	$124,501.00	$63,931.26	2026-05-09
3550723	OTHER	Cl Endovascular Venous Arterialization Tibl/prnl Vn	32	15	$122,965.00	$73,779.00 40% off	$22,133.70	$122,965.00	$63,142.53	2026-05-09
2424373	OTHER	Impl-totl Knee 40001-41000	32	15	$121,501.00	$72,900.60 40% off	$21,870.18	$121,501.00	$62,390.76	2026-05-09
2424850	OTHER	Impl-heart 40001-41000	32	15	$121,501.00	$72,900.60 40% off	$21,870.18	$121,501.00	$62,390.76	2026-05-09
2424210	OTHER	Cardiovasc Supply 40001-41000	32	15	$121,501.00	$72,900.60 40% off	$21,870.18	$121,501.00	$62,390.76	2026-05-09
2424622	OTHER	C1767 Neurostm Gen 40001-41000	32	15	$121,501.00	$72,900.60 40% off	$21,870.18	$121,501.00	$62,390.76	2026-05-09
2424070	OTHER	L8614 Cochlear Imp 40001-41000	32	15	$121,501.00	$72,900.60 40% off	$21,870.18	$121,501.00	$62,390.76	2026-05-09
2422936	OTHER	Impl-spine 40001-41000	32	15	$121,501.00	$72,900.60 40% off	$21,870.18	$121,501.00	$62,390.76	2026-05-09
2424849	OTHER	Impl-heart 39001-40000	32	15	$118,501.00	$71,100.60 40% off	$21,330.18	$118,501.00	$60,850.26	2026-05-09
2424372	OTHER	Impl-totl Knee 39001-40000	32	15	$118,501.00	$71,100.60 40% off	$21,330.18	$118,501.00	$60,850.26	2026-05-09
2424580	OTHER	C1822 Gen Neu Rchg Hf 39001-40000	32	15	$118,501.00	$71,100.60 40% off	$21,330.18	$118,501.00	$60,850.26	2026-05-09
2423367	OTHER	L8614 Cochlear Imp 39001-40000	32	15	$118,501.00	$71,100.60 40% off	$21,330.18	$118,501.00	$60,850.26	2026-05-09
2422935	OTHER	Impl-spine 39001-40000	32	15	$118,501.00	$71,100.60 40% off	$21,330.18	$118,501.00	$60,850.26	2026-05-09
2424209	OTHER	Cardiovasc Supply 39001-40000	32	15	$118,501.00	$71,100.60 40% off	$21,330.18	$118,501.00	$60,850.26	2026-05-09
2424012	OTHER	C1767 Neurostm Gen 39001-40000	32	15	$118,501.00	$71,100.60 40% off	$21,330.18	$118,501.00	$60,850.26	2026-05-09
2424371	OTHER	Impl-totl Knee 38001-39000	32	15	$115,501.00	$69,300.60 40% off	$20,790.18	$115,501.00	$59,309.76	2026-05-09
2424579	OTHER	C1822 Gen Neu Rchg Hf 38001-39000	32	15	$115,501.00	$69,300.60 40% off	$20,790.18	$115,501.00	$59,309.76	2026-05-09
2423366	OTHER	L8614 Cochlear Imp 38001-39000	32	15	$115,501.00	$69,300.60 40% off	$20,790.18	$115,501.00	$59,309.76	2026-05-09
2424208	OTHER	Cardiovasc Supply 38001-39000	32	15	$115,501.00	$69,300.60 40% off	$20,790.18	$115,501.00	$59,309.76	2026-05-09
2424848	OTHER	Impl-heart 38001-39000	32	15	$115,501.00	$69,300.60 40% off	$20,790.18	$115,501.00	$59,309.76	2026-05-09
2424830	OTHER	C1889 Implantable Device Nos 38001-39000	32	15	$115,501.00	$69,300.60 40% off	$20,790.18	$115,501.00	$59,309.76	2026-05-09
2424011	OTHER	C1767 Neurostm Gen 38001-39000	32	15	$115,501.00	$69,300.60 40% off	$20,790.18	$115,501.00	$59,309.76	2026-05-09
2422934	OTHER	Impl-spine 38001-39000	32	15	$115,501.00	$69,300.60 40% off	$20,790.18	$115,501.00	$59,309.76	2026-05-09
2424370	OTHER	Impl-totl Knee 37001-38000	32	15	$112,501.00	$67,500.60 40% off	$20,250.18	$112,501.00	$57,769.26	2026-05-09
2423380	OTHER	Impl-heart 37001-38000	32	15	$112,501.00	$67,500.60 40% off	$20,250.18	$112,501.00	$57,769.26	2026-05-09
2424578	OTHER	C1822 Gen Neu Rchg Hf 37001-38000	32	15	$112,501.00	$67,500.60 40% off	$20,250.18	$112,501.00	$57,769.26	2026-05-09
2422933	OTHER	Impl-spine 37001-38000	32	15	$112,501.00	$67,500.60 40% off	$20,250.18	$112,501.00	$57,769.26	2026-05-09
2423365	OTHER	L8614 Cochlear Imp 37001-38000	32	15	$112,501.00	$67,500.60 40% off	$20,250.18	$112,501.00	$57,769.26	2026-05-09
2424010	OTHER	C1767 Neurostm Gen 37001-38000	32	15	$112,501.00	$67,500.60 40% off	$20,250.18	$112,501.00	$57,769.26	2026-05-09
2424829	OTHER	C1889 Implantable Device Nos 37001-38000	32	15	$112,501.00	$67,500.60 40% off	$20,250.18	$112,501.00	$57,769.26	2026-05-09
2424207	OTHER	Cardiovasc Supply 37001-38000	32	15	$112,501.00	$67,500.60 40% off	$20,250.18	$112,501.00	$57,769.26	2026-05-09
2424369	OTHER	Impl-totl Knee 36001-37000	32	15	$109,501.00	$65,700.60 40% off	$19,710.18	$109,501.00	$56,228.76	2026-05-09
2423379	OTHER	Impl-heart 36001-37000	32	15	$109,501.00	$65,700.60 40% off	$19,710.18	$109,501.00	$56,228.76	2026-05-09
2424009	OTHER	C1767 Neurostm Gen 36001-37000	32	15	$109,501.00	$65,700.60 40% off	$19,710.18	$109,501.00	$56,228.76	2026-05-09
2424577	OTHER	C1822 Gen Neu Rchg Hf 36001-37000	32	15	$109,501.00	$65,700.60 40% off	$19,710.18	$109,501.00	$56,228.76	2026-05-09
2422932	OTHER	Impl-spine 36001-37000	32	15	$109,501.00	$65,700.60 40% off	$19,710.18	$109,501.00	$56,228.76	2026-05-09
2423364	OTHER	L8614 Cochlear Imp 36001-37000	32	15	$109,501.00	$65,700.60 40% off	$19,710.18	$109,501.00	$56,228.76	2026-05-09
2424206	OTHER	Cardiovasc Supply 36001-37000	32	15	$109,501.00	$65,700.60 40% off	$19,710.18	$109,501.00	$56,228.76	2026-05-09
2424828	OTHER	C1889 Implantable Device Nos 36001-37000	32	15	$109,501.00	$65,700.60 40% off	$19,710.18	$109,501.00	$56,228.76	2026-05-09
2424368	OTHER	Impl-totl Knee 35001-36000	32	15	$106,501.00	$63,900.60 40% off	$19,170.18	$106,501.00	$54,688.26	2026-05-09
2424827	OTHER	C1889 Implantable Device Nos 35001-36000	32	15	$106,501.00	$63,900.60 40% off	$19,170.18	$106,501.00	$54,688.26	2026-05-09
2424008	OTHER	C1767 Neurostm Gen 35001-36000	32	15	$106,501.00	$63,900.60 40% off	$19,170.18	$106,501.00	$54,688.26	2026-05-09
2423378	OTHER	Impl-heart 35001-36000	32	15	$106,501.00	$63,900.60 40% off	$19,170.18	$106,501.00	$54,688.26	2026-05-09
2423817	OTHER	C1822 Gen Neu Rchg Hf 35001-36000	32	15	$106,501.00	$63,900.60 40% off	$19,170.18	$106,501.00	$54,688.26	2026-05-09
2422931	OTHER	Impl-spine 35001-36000	32	15	$106,501.00	$63,900.60 40% off	$19,170.18	$106,501.00	$54,688.26	2026-05-09
2423363	OTHER	L8614 Cochlear Imp 35001-36000	32	15	$106,501.00	$63,900.60 40% off	$19,170.18	$106,501.00	$54,688.26	2026-05-09
2423079	OTHER	Cardiovasc Supply 35001-36000	32	15	$106,501.00	$63,900.60 40% off	$19,170.18	$106,501.00	$54,688.26	2026-05-09
3550705	OTHER	Cl Insert/repl Ss Icd & Lead (s)	32	15	$103,975.00	$62,385.00 40% off	$18,715.50	$103,975.00	$53,391.16	2026-05-09
2422739	OTHER	Impl-spine 34001-35000	32	15	$103,501.00	$62,100.60 40% off	$18,630.18	$103,501.00	$53,147.76	2026-05-09
2424576	OTHER	C1822 Gen Neu Rchg Hf 34001-35000	32	15	$103,501.00	$62,100.60 40% off	$18,630.18	$103,501.00	$53,147.76	2026-05-09
2423377	OTHER	Impl-heart 34001-35000	32	15	$103,501.00	$62,100.60 40% off	$18,630.18	$103,501.00	$53,147.76	2026-05-09
2424826	OTHER	C1889 Implantable Device Nos 34001-35000	32	15	$103,501.00	$62,100.60 40% off	$18,630.18	$103,501.00	$53,147.76	2026-05-09
2423670	OTHER	C1767 Neurostm Gen 34001-35000	32	15	$103,501.00	$62,100.60 40% off	$18,630.18	$103,501.00	$53,147.76	2026-05-09
2424618	OTHER	C1781 Surg Mesh 34001-35000	32	15	$103,501.00	$62,100.60 40% off	$18,630.18	$103,501.00	$53,147.76	2026-05-09
2423362	OTHER	L8614 Cochlear Imp 34001-35000	32	15	$103,501.00	$62,100.60 40% off	$18,630.18	$103,501.00	$53,147.76	2026-05-09
2423078	OTHER	Cardiovasc Supply 34001-35000	32	15	$103,501.00	$62,100.60 40% off	$18,630.18	$103,501.00	$53,147.76	2026-05-09
2422860	OTHER	Impl-totl Knee 34001-35000	32	15	$103,501.00	$62,100.60 40% off	$18,630.18	$103,501.00	$53,147.76	2026-05-09
3550355	OTHER	Cl Insert Defib Pulse Gen Only W/mult Leads	32	15	$100,849.00	$60,509.40 40% off	$18,152.82	$100,849.00	$51,785.96	2026-05-09
2422738	OTHER	Impl-spine 33001-34000	32	15	$100,501.00	$60,300.60 40% off	$18,090.18	$100,501.00	$51,607.26	2026-05-09
2424825	OTHER	C1889 Implantable Device Nos 33001-34000	32	15	$100,501.00	$60,300.60 40% off	$18,090.18	$100,501.00	$51,607.26	2026-05-09
2424736	OTHER	C1827 Gen Neuro Imp Led Ex Cntr 33001-34000	32	15	$100,501.00	$60,300.60 40% off	$18,090.18	$100,501.00	$51,607.26	2026-05-09
2423376	OTHER	Impl-heart 33001-34000	32	15	$100,501.00	$60,300.60 40% off	$18,090.18	$100,501.00	$51,607.26	2026-05-09
2424413	OTHER	C1825 Gen Neuro Carot Sinus Baro 33001-34000	32	15	$100,501.00	$60,300.60 40% off	$18,090.18	$100,501.00	$51,607.26	2026-05-09
2422859	OTHER	Impl-totl Knee 33001-34000	32	15	$100,501.00	$60,300.60 40% off	$18,090.18	$100,501.00	$51,607.26	2026-05-09
2424617	OTHER	C1781 Surg Mesh 33001-34000	32	15	$100,501.00	$60,300.60 40% off	$18,090.18	$100,501.00	$51,607.26	2026-05-09
2423077	OTHER	Cardiovasc Supply 33001-34000	32	15	$100,501.00	$60,300.60 40% off	$18,090.18	$100,501.00	$51,607.26	2026-05-09
2424575	OTHER	C1822 Gen Neu Rchg Hf 33001-34000	32	15	$100,501.00	$60,300.60 40% off	$18,090.18	$100,501.00	$51,607.26	2026-05-09
2423669	OTHER	C1767 Neurostm Gen 33001-34000	32	15	$100,501.00	$60,300.60 40% off	$18,090.18	$100,501.00	$51,607.26	2026-05-09
2423263	OTHER	L8614 Cochlear Imp 33001-34000	32	15	$100,501.00	$60,300.60 40% off	$18,090.18	$100,501.00	$51,607.26	2026-05-09
3550480	OTHER	Cl Ins/replac Sq Impltbl Defib	32	15	$100,354.00	$60,212.40 40% off	$18,063.72	$100,354.00	$51,531.78	2026-05-09
2422737	OTHER	Impl-spine 32001-33000	32	15	$97,501.00	$58,500.60 40% off	$17,550.18	$97,501.00	$50,066.76	2026-05-09
2424412	OTHER	C1825 Gen Neuro Carot Sinus Baro 32001-33000	32	15	$97,501.00	$58,500.60 40% off	$17,550.18	$97,501.00	$50,066.76	2026-05-09
2424735	OTHER	C1827 Gen Neuro Imp Led Ex Cntr 32001-33000	32	15	$97,501.00	$58,500.60 40% off	$17,550.18	$97,501.00	$50,066.76	2026-05-09
2424824	OTHER	C1889 Implantable Device Nos 32001-33000	32	15	$97,501.00	$58,500.60 40% off	$17,550.18	$97,501.00	$50,066.76	2026-05-09
2424574	OTHER	C1822 Gen Neu Rchg Hf 32001-33000	32	15	$97,501.00	$58,500.60 40% off	$17,550.18	$97,501.00	$50,066.76	2026-05-09
J3391	OTHER	Inj Atidarsagene Autotemcel	1	1	—	—	$4,246,175.00	$4,246,175.00	$4,246,175.00	2026-05-09
J1414	OTHER	Inj Beqvez Per Tx Dose	9	8	—	—	$3,598,700.00	$4,637,500.00	$3,969,700.00	2026-05-09
J1413	OTHER	Inj Delandistrogene Mox Rokl	10	9	—	—	$3,224,834.74	$4,650,494.11	$3,604,132.94	2026-05-09
J3394	OTHER	Inj Lovotibeglogene Autotem	10	9	—	—	$3,163,514.35	$4,470,200.00	$3,464,405.00	2026-05-09
J3393	OTHER	Inj Betibeglogene Autotemce	10	9	—	—	$2,862,166.07	$4,155,200.00	$3,220,280.00	2026-05-09
J3392	OTHER	Inj Exagamglogene Autotem	10	9	—	—	$2,262,040.00	$3,264,800.00	$2,530,220.00	2026-05-09
J3399	OTHER	Inj Onase Abepar-xioi Treat	22	15	—	—	$10,687.19	$3,364,842.25	$2,391,610.02	2026-05-09
J1411	OTHER	Inj Hemgenix Per Tx Dose	18	14	—	—	$15,363.65	$4,637,500.00	$1,795,720.67	2026-05-09
Q2042	OTHER	Tisagenlecleucel Car-pos T	12	10	—	—	$560,974.84	$1,442,340.79	$636,326.82	2026-05-09
Q2056	OTHER	Ciltacabtagene Car-pos T	12	10	—	—	$536,777.47	$1,405,861.77	$620,233.13	2026-05-09
Q2055	OTHER	Idecabtagene Vicleucel Car	12	10	—	—	$525,022.64	$1,347,196.70	$594,351.48	2026-05-09
Q2054	OTHER	Lisocabtagene Mara Car Pos T	12	10	—	—	$516,485.97	$1,317,039.22	$581,046.72	2026-05-09
Q2041	OTHER	Axicabtagene Ciloleucel Car+	12	10	—	—	$489,517.15	$1,248,268.73	$550,706.79	2026-05-09
Q2053	OTHER	Brexucabtagene Car Pos T	12	10	—	—	$475,028.40	$1,244,531.35	$549,057.95	2026-05-09
5834	OTHER	Neonate With Ecmo	18	9	—	—	$210,343.71	$529,191.44	$357,490.58	2026-05-09
MS-018	OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	31	17	—	—	$250,888.25	$1,277,596.53	$351,243.55	2026-05-09
MS-001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	32	18	—	—	$187,392.49	$954,257.50	$322,913.82	2026-05-09
MS-633	OTHER	Neonate- Birthwt 1000-1499g- W Signif O.r. Pro- Discharged Alive	1	1	—	—	$312,460.08	$312,460.08	$312,460.08	2026-05-09
MS-612	OTHER	Neonate- Birthwt <750g-- Discharged Alive	1	1	—	—	$286,326.48	$286,326.48	$286,326.48	2026-05-09
Q2058	OTHER	Obecbtge Autol Up To 400 Mil	1	1	—	—	$262,263.75	$262,263.75	$262,263.75	2026-05-09
MS-927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	32	18	—	—	$157,818.35	$803,657.30	$231,363.47	2026-05-09
MS-426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	12	7	—	—	$18,645.74	$354,875.13	$228,075.64	2026-05-09
MS-003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	32	18	—	—	$142,575.90	$726,038.31	$219,152.29	2026-05-09
5884	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	18	9	—	—	$128,831.50	$324,119.63	$218,956.14	2026-05-09
MS-631	OTHER	Neonate- Birthwt 750-999g- Discharged Alive	1	1	—	—	$207,618.07	$207,618.07	$207,618.07	2026-05-09
114	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	18	9	—	—	$120,435.79	$302,997.38	$204,687.19	2026-05-09
24	OTHER	Heart And/or Lung Transplant	18	9	—	—	$120,356.31	$302,797.40	$204,552.10	2026-05-09
5833	OTHER	Neonate With Ecmo	18	9	—	—	$119,797.74	$301,392.11	$203,602.77	2026-05-09
MS-636	OTHER	Neonate- Birthwt 1500-1999g- W Signif O.r. Proc W Mult Major Prob	1	1	—	—	$183,596.31	$183,596.31	$183,596.31	2026-05-09
MS-453	OTHER	Combined Anterior/posterior Spinal Fusion W Mcc	8	3	—	—	$99,714.20	$264,016.55	$183,479.71	2026-05-09
1614	OTHER	Implantable Heart Assist Systems	18	9	—	—	$89,815.36	$225,961.22	$152,646.10	2026-05-09
6094	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	18	9	—	—	$89,760.19	$225,822.43	$152,552.34	2026-05-09
113	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	18	9	—	—	$89,629.89	$225,494.62	$152,330.89	2026-05-09
94	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	18	9	—	—	$88,048.17	$221,515.25	$149,642.67	2026-05-09
6314	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	18	9	—	—	$86,333.24	$217,200.76	$146,728.05	2026-05-09
5883	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	18	9	—	—	$85,801.52	$215,863.04	$145,824.36	2026-05-09
5914	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	18	9	—	—	$84,481.48	$212,542.03	$143,580.89	2026-05-09
MS-004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	32	18	—	—	$94,001.27	$478,682.01	$141,961.30	2026-05-09
MS-459	OTHER	Spinal Fusion Except Cervical With Mcc	8	3	—	—	$44,989.74	$197,602.75	$137,227.66	2026-05-09
8414	OTHER	Extensive Third Degree Burns With Skin Graft	18	9	—	—	$79,893.10	$200,998.39	$135,782.68	2026-05-09
6304	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	18	9	—	—	$78,295.40	$196,978.84	$133,067.30	2026-05-09
MS-224	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami- Hf Or Sh…	9	5	—	—	$83.30	$241,784.27	$132,922.50	2026-05-09
MS-014	OTHER	Allogeneic Bone Marrow Transplant	32	18	—	—	$87,161.06	$443,849.68	$128,613.18	2026-05-09
MS-002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	32	18	—	—	$73,309.68	$373,314.38	$127,903.14	2026-05-09
MS-454	OTHER	Combined Anterior/posterior Spinal Fusion W Cc	8	3	—	—	$64,925.00	$182,229.04	$126,641.05	2026-05-09
5934	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	18	9	—	—	$74,275.40	$186,865.14	$126,235.09	2026-05-09
MS-681	OTHER	Neonate- Birthwt >2499g- W Signif O.r. Proc- W Mult Major Prob	1	1	—	—	$125,052.34	$125,052.34	$125,052.34	2026-05-09
Q0480	OTHER	Driver Pneumatic Vad Rep	12	10	—	—	$106,036.81	$278,756.57	$122,980.84	2026-05-09
74	OTHER	Allogeneic Bone Marrow Transplant	18	9	—	—	$70,861.16	$178,275.43	$120,432.39	2026-05-09
MS-226	OTHER	Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc	9	5	—	—	$83.30	$232,381.28	$120,016.88	2026-05-09
5832	OTHER	Neonate With Ecmo	18	9	—	—	$91,982.52	$152,272.05	$119,996.20	2026-05-09
1613	OTHER	Implantable Heart Assist Systems	18	9	—	—	$70,327.62	$176,933.15	$119,525.62	2026-05-09
MS-007	OTHER	Lung Transplant	32	18	—	—	$86,941.52	$442,731.74	$118,026.46	2026-05-09
MS-005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	32	18	—	—	$70,846.22	$360,769.72	$117,230.31	2026-05-09
MS-020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	32	18	—	—	$53,627.29	$273,085.88	$117,142.18	2026-05-09
44	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	18	9	—	—	$67,666.12	$170,237.25	$115,002.26	2026-05-09
14	OTHER	Liver Transplant And/or Intestinal Transplant	18	9	—	—	$66,992.86	$168,543.42	$113,858.01	2026-05-09
MS-634	OTHER	Neonate- Birthwt 1000-1499g- Without Signif O.r. Proc- Discharged Alive	1	1	—	—	$111,995.64	$111,995.64	$111,995.64	2026-05-09
23	OTHER	Heart And/or Lung Transplant	18	9	—	—	$65,560.30	$164,939.34	$111,423.30	2026-05-09
MS-212	OTHER	Testes Procedures Age 0-17	31	17	—	—	$72,472.78	$369,052.65	$111,029.70	2026-05-09
5913	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	18	9	—	—	$63,713.63	$160,293.39	$108,284.77	2026-05-09
MS-222	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami- Hf Or Shock…	9	5	—	—	$83.30	$259,382.64	$104,715.59	2026-05-09
5893	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	18	9	—	—	$60,053.30	$151,084.59	$102,063.86	2026-05-09
MS-632	OTHER	Neonate- Birthwt 750-999g- Died	1	1	—	—	$101,894.61	$101,894.61	$101,894.61	2026-05-09
93	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	18	9	—	—	$59,173.88	$148,872.10	$100,569.23	2026-05-09
MS-215	OTHER	Other Heart Assist System Implant	37	18	—	—	$65.55	$358,920.04	$97,389.03	2026-05-09
5882	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	18	9	—	—	$73,522.65	$121,712.74	$95,914.29	2026-05-09
MS-455	OTHER	Combined Anterior/posterior Spinal Fusion Without Cc/mcc	8	3	—	—	$51,020.98	$137,219.25	$95,361.26	2026-05-09
6024	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	18	9	—	—	$55,954.17	$140,771.83	$95,097.16	2026-05-09
MS-225	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami- Hf Or Sh…	9	5	—	—	$83.30	$177,232.59	$94,831.88	2026-05-09
MS-227	OTHER	Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc	9	5	—	—	$83.30	$170,086.25	$94,138.13	2026-05-09
112	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	18	9	—	—	$71,254.59	$117,958.09	$92,955.49	2026-05-09
5933	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	18	9	—	—	$54,334.70	$136,697.49	$92,344.77	2026-05-09
MS-216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	37	18	—	—	$65.55	$335,720.20	$89,886.90	2026-05-09
1604	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	18	9	—	—	$51,558.87	$129,713.96	$87,627.12	2026-05-09
MS-456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	32	18	—	—	$56,342.22	$286,911.09	$87,569.91	2026-05-09
5831	OTHER	Neonate With Ecmo	9	9	—	—	$82,565.48	$89,922.80	$85,835.40	2026-05-09
MS-850	OTHER	Acute Leukemia With Other Procedures	29	17	—	—	$61,283.10	$312,071.54	$85,796.35	2026-05-09
MS-019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	31	17	—	—	$52,737.17	$268,553.14	$80,794.54	2026-05-09
54	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	18	9	—	—	$47,138.54	$118,593.09	$80,114.51	2026-05-09
43	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	18	9	—	—	$46,660.90	$117,391.43	$79,302.74	2026-05-09
5892	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	18	9	—	—	$60,053.30	$99,414.97	$78,342.79	2026-05-09
MS-010	OTHER	Pancreas Transplant	32	18	—	—	$42,146.66	$270,101.32	$77,758.86	2026-05-09
MS-429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	29	17	—	—	$55,486.69	$282,554.51	$77,681.37	2026-05-09
73	OTHER	Allogeneic Bone Marrow Transplant	18	9	—	—	$45,068.28	$113,384.67	$76,596.01	2026-05-09
8424	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	18	9	—	—	$44,728.57	$112,529.99	$76,018.64	2026-05-09
L8702	OTHER	Ewhf S/d Uprt Micro Sensor	12	10	—	—	$65,429.08	$172,004.28	$75,884.24	2026-05-09
MS-460	OTHER	Spinal Fusion Except Cervical Without Mcc	8	3	—	—	$26,489.41	$108,983.47	$75,738.65	2026-05-09
MS-957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	32	18	—	—	$49,656.35	$252,864.70	$74,688.05	2026-05-09
64	OTHER	Pancreas Transplant	18	9	—	—	$43,759.49	$110,091.96	$74,371.65	2026-05-09
38240	OTHER	Transplt Allo Hct/donor	19	10	—	—	$14,280.00	$151,383.01	$74,207.36	2026-05-09
6074	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	18	9	—	—	$43,252.83	$108,817.25	$73,510.52	2026-05-09
6303	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	18	9	—	—	$43,158.09	$108,578.92	$73,349.52	2026-05-09
MS-233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	37	18	—	—	$65.55	$264,796.18	$72,799.16	2026-05-09
MS-834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	32	18	—	—	$36,770.93	$187,248.34	$72,332.54	2026-05-09
MS-219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	37	18	—	—	$65.55	$276,498.26	$72,064.31	2026-05-09
J9029	OTHER	Instill Adstiladrin Tx Dose	12	10	—	—	$61,528.12	$161,675.20	$71,327.30	2026-05-09
5912	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	18	9	—	—	$54,647.92	$90,466.66	$71,291.19	2026-05-09
8514	OTHER	Gender Related Procedures	18	9	—	—	$41,273.67	$103,838.01	$70,146.85	2026-05-09
8513	OTHER	Gender Related Procedures	18	9	—	—	$41,273.67	$103,838.01	$70,146.85	2026-05-09
6034	OTHER	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	18	9	—	—	$40,925.24	$102,961.42	$69,554.67	2026-05-09
MS-870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	32	18	—	—	$46,278.83	$235,665.35	$68,486.33	2026-05-09
S2068	OTHER	Breast Diep Or Siea Flap	1	1	—	—	$68,089.13	$68,089.13	$68,089.13	2026-05-09
1612	OTHER	Implantable Heart Assist Systems	18	9	—	—	$51,747.25	$85,664.75	$67,507.10	2026-05-09
MS-021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	32	18	—	—	$36,770.93	$187,248.34	$66,485.38	2026-05-09
MS-338	OTHER	Appendectomy With Complicated Principal Diagnosis With Mcc	4	2	—	—	$30,847.06	$79,147.76	$66,096.38	2026-05-09
6023	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	18	9	—	—	$38,849.90	$97,740.21	$66,027.53	2026-05-09
MS-275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	33	17	—	—	$52.30	$239,408.76	$65,819.51	2026-05-09
MS-317	OTHER	Endovascular Cardiac Valve Replacement & Supplement Procedures W Mcc	31	17	—	—	$41,155.66	$209,576.67	$65,712.30	2026-05-09
MS-266	OTHER	Endovascular Cardiac Valve Replacement W Mcc	32	18	—	—	$38,568.69	$202,950.33	$65,641.51	2026-05-09
5881	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	9	9	—	—	$63,019.67	$68,635.28	$65,515.50	2026-05-09
MS-223	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami- Hf Or Shock…	9	5	—	—	$83.30	$176,793.90	$65,054.62	2026-05-09
22	OTHER	Heart And/or Lung Transplant	18	9	—	—	$49,644.69	$82,184.08	$64,764.20	2026-05-09
MS-016	OTHER	Autolous Bone Marrow Transplant With Cc/mcc	32	18	—	—	$40,154.44	$204,478.18	$64,599.67	2026-05-09
MS-969	OTHER	HIV With Extensive O.r. Procedures With Mcc	32	18	—	—	$45,720.67	$214,248.31	$64,233.04	2026-05-09
0100T	OTHER	Prosth Retina Receive&gen	1	1	—	—	$64,230.00	$64,230.00	$64,230.00	2026-05-09
0424T	OTHER	Insj/rplc Nstim Apnea Compl	1	1	—	—	$64,230.00	$64,230.00	$64,230.00	2026-05-09
MS-928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	32	18	—	—	$31,589.50	$226,261.10	$63,935.42	2026-05-09
A9543	OTHER	Y90 Ibritumomab Rx	12	10	—	—	$55,119.81	$144,902.60	$63,927.62	2026-05-09
MS-457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	32	18	—	—	$38,181.94	$194,433.65	$63,670.35	2026-05-09
MS-647	OTHER	Neonate- Birthwt 1500-1999g- Without Signif O.r. Proc- W Mult Major Prob	1	1	—	—	$62,463.74	$62,463.74	$62,463.74	2026-05-09
MS-447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	29	17	—	—	$44,603.70	$227,135.12	$62,445.18	2026-05-09
5891	OTHER	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	9	9	—	—	$60,053.30	$65,404.58	$62,431.65	2026-05-09
MS-635	OTHER	Neonate- Birthwt 1000-1499g- Died	1	1	—	—	$62,333.35	$62,333.35	$62,333.35	2026-05-09
MS-268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	33	18	—	—	$70.90	$225,878.29	$62,099.64	2026-05-09
MS-231	OTHER	Coronary Bypass With Ptca With Mcc	37	18	—	—	$65.55	$287,070.31	$62,010.83	2026-05-09
MS-207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	32	18	—	—	$43,023.71	$219,089.33	$61,272.91	2026-05-09
6114	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	18	9	—	—	$35,973.91	$90,504.65	$61,139.61	2026-05-09
6134	OTHER	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	18	9	—	—	$35,643.26	$89,672.80	$60,577.67	2026-05-09
MS-573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	32	18	—	—	$40,968.05	$208,621.34	$60,059.62	2026-05-09
MS-461	OTHER	Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc	32	18	—	—	$40,825.02	$207,892.99	$59,849.79	2026-05-09
8634	OTHER	Neonatal Aftercare	18	9	—	—	$35,183.77	$88,516.80	$59,796.74	2026-05-09
MS-023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	33	18	—	—	$37,953.76	$293,885.73	$59,541.26	2026-05-09
MS-228	OTHER	Other Cardiothoracic Procedures With Mcc	37	18	—	—	$65.55	$293,041.63	$59,329.94	2026-05-09
13	OTHER	Liver Transplant And/or Intestinal Transplant	18	9	—	—	$34,780.90	$87,503.23	$59,112.03	2026-05-09
1624	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	18	9	—	—	$34,649.51	$87,172.69	$58,888.74	2026-05-09
MS-017	OTHER	Autolous Bone Marrow Transplant Without Cc/mcc	32	18	—	—	$40,154.44	$204,478.18	$58,866.65	2026-05-09
3034	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	18	9	—	—	$34,482.20	$86,751.74	$58,604.36	2026-05-09
MS-646	OTHER	Neonate- Birthwt 1500-1999g- W Signif O.r. Proc- Without Mult Major Prob	1	1	—	—	$58,162.92	$58,162.92	$58,162.92	2026-05-09
53	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	18	9	—	—	$34,209.98	$86,066.90	$58,141.74	2026-05-09
MS-028	OTHER	Spinal Procedures With Mcc	32	18	—	—	$40,444.49	$205,955.22	$57,940.26	2026-05-09
4404	OTHER	Kidney Transplant	18	9	—	—	$33,928.70	$85,359.23	$57,663.67	2026-05-09
MS-008	OTHER	Simultaneous Pancreas/kidney Transplant	32	18	—	—	$36,197.47	$184,328.14	$57,492.92	2026-05-09
MS-820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	32	18	—	—	$38,733.44	$197,242.06	$57,411.92	2026-05-09
63	OTHER	Pancreas Transplant	18	9	—	—	$33,723.64	$84,843.32	$57,315.15	2026-05-09
5932	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	18	9	—	—	$43,702.87	$72,347.73	$57,012.79	2026-05-09
MS-011	OTHER	Tracheostomy For Facemouth & Neck Diagnoses W Mcc	32	18	—	—	$35,896.77	$182,796.90	$56,455.68	2026-05-09
MS-248	OTHER	Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4…	9	5	—	—	$83.30	$101,962.99	$56,433.75	2026-05-09
MS-006	OTHER	Liver Transplant Without Mcc	32	18	—	—	$32,259.80	$164,276.35	$56,262.38	2026-05-09
MS-341	OTHER	Appendectomy Without Complicated Principal Diagnosis With Mcc	4	2	—	—	$27,115.86	$67,304.65	$56,206.18	2026-05-09
MS-246	OTHER	Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar…	9	5	—	—	$83.30	$101,475.17	$56,163.75	2026-05-09
Q2043	OTHER	Sipuleucel-t Auto Cd54+	21	16	—	—	$15,363.65	$141,618.08	$55,536.50	2026-05-09
MS-235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	37	18	—	—	$65.55	$199,339.04	$55,526.79	2026-05-09
MS-653	OTHER	Major Bladder Procedures With Mcc	32	18	—	—	$33,543.42	$188,850.72	$55,303.37	2026-05-09
MS-234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	37	18	—	—	$65.55	$328,997.91	$55,186.78	2026-05-09
MS-837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	32	18	—	—	$33,310.91	$169,628.91	$55,109.61	2026-05-09
MS-217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	36	18	—	—	$65.55	$218,774.28	$54,776.34	2026-05-09
L7181	OTHER	Electronic Elbo Simultaneous	12	10	—	—	$47,173.81	$124,013.61	$54,711.89	2026-05-09
MS-463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	32	18	—	—	$35,930.70	$182,969.68	$54,519.94	2026-05-09
MS-427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	29	17	—	—	$13,977.65	$240,618.17	$54,339.15	2026-05-09
MS-270	OTHER	Other Major Cardiovascular Procedures With Mcc	33	18	—	—	$3,353.24	$173,890.64	$54,168.12	2026-05-09
MS-405	OTHER	Pancreas- Liver And Shunt Procedures With Mcc	32	18	—	—	$36,114.98	$183,908.07	$54,044.65	2026-05-09
1611	OTHER	Implantable Heart Assist Systems	9	9	—	—	$51,747.25	$56,358.39	$53,796.64	2026-05-09
84	OTHER	Autologous Bone Marrow Transplant	18	9	—	—	$31,516.91	$79,291.56	$53,564.71	2026-05-09
MS-576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	32	18	—	—	$35,892.78	$182,776.58	$53,195.12	2026-05-09
6093	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	18	9	—	—	$31,136.91	$78,335.52	$52,918.87	2026-05-09
MS-955	OTHER	Craniotomy For Multiple Significant Trauma	37	18	—	—	$65.55	$231,322.32	$52,239.86	2026-05-09
MS-267	OTHER	Endovascular Cardiac Valve Replacement Without Mcc	32	18	—	—	$3,715.93	$159,381.12	$51,989.63	2026-05-09
MS-651	OTHER	Neonate- Birthwt 2000-2499g- W Signif O.r. Proc- W Mult Major Prob	31	17	—	—	$23,101.16	$124,260.86	$51,977.61	2026-05-09
MS-326	OTHER	Stomach- Esophageal And Duodenal Procedures With Mcc	32	18	—	—	$33,788.57	$172,061.28	$51,585.65	2026-05-09
MS-430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	29	17	—	—	$36,393.06	$185,324.13	$50,950.28	2026-05-09
0266T	OTHER	Implt/rpl Crtd Sns Dev Total	12	9	—	—	$43,478.00	$115,185.04	$50,816.93	2026-05-09
MS-466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	32	18	—	—	$33,892.35	$172,589.76	$50,749.87	2026-05-09
MS-826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	32	18	—	—	$31,769.50	$161,779.61	$50,590.70	2026-05-09
MS-423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	32	18	—	—	$27,058.79	$137,791.31	$50,514.17	2026-05-09
2994	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	18	9	—	—	$29,707.98	$74,740.58	$50,490.34	2026-05-09
MS-799	OTHER	Splenic Procedures With Mcc	32	18	—	—	$31,631.79	$161,078.36	$50,434.98	2026-05-09
6073	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	18	9	—	—	$29,654.99	$74,607.26	$50,400.27	2026-05-09
MS-853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	32	18	—	—	$33,271.66	$169,429.04	$50,312.74	2026-05-09

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