Price Transparency Hospital negotiated rates

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

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Hospital

NORTHSIDE HOSPITAL GWINNETT

Lawrenceville, GA · CCN 110087 · Rates published

15,724 distinct procedures filed
72 distinct payers
1,869,992 rate rows
2026-02-15 last MRF observed
Data quality

1,650,999 of 1,869,992 rate rows are consumer-grade (88.3%)

218,993 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 91,045
template filing: same amount across many unrelated codes — excluded 84,438
per-diem day rate — not a per-procedure price 41,706
exceeds 10× this hospital's gross charge — excluded from medians 1,156
placeholder amount (≤ $0.02) — excluded from medians 648
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://assets.northside.com/price-transparency/581954432-1952340994_northside-hospital-inc_standardcharges.json
Found on page https://www.northside.com/patients-visitors/billing-and-insurance/price-transparency-information
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint cb79ce126a5618dd… · 1,091,272,478 bytes · first seen 2026-05-05

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
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 50 $278,250.00 $3,465,000.00 $2,182,950.00 nat. median
$324,450
outlier · 6.7×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 58 $527,558.67 $3,506,913.00 $2,139,216.93 nat. median
$674,188
outlier · 3.2×
Q2055
HCPCS 		Idecabtagene Vicleucel Car T 58 $524,542.39 $3,486,862.50 $2,126,986.12 nat. median
$625,184
outlier · 3.4×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 58 $518,330.08 $3,445,566.50 $2,101,795.56 nat. median
$675,122
outlier · 3.1×
Q2053
HCPCS 		Brexucabtagene Tecartus T-cell 58 $458,703.11 $3,049,200.00 $1,860,012.00 nat. median
$620,080
outlier · 3.0×
Q2042
HCPCS 		Kymriah T-cell Susp For Infusion 58 $453,680.27 $3,015,811.00 $1,839,644.71 nat. median
$754,974
outlier · 2.4×
Q2041
HCPCS 		Yescarta T-cell Susp For Infusion 58 $370,338.22 $2,461,800.00 $1,501,698.00 nat. median
$634,511
outlier · 2.4×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 32 $297,174.15 $2,860,061.00 $515,466.43 nat. median
$370,174
1.4× median
J2326
HCPCS 		Spinraza(nusinersen)12mg/5ml Soln 59 $6,149.45 $816,348.50 $367,356.83 nat. median
$2,677
outlier · 137.2×
7
MS_DRG 		Lung Transplant 32 $102,981.20 $2,162,847.20 $355,151.91 nat. median
$122,708
outlier · 2.9×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 32 $202,655.78 $846,592.03 $222,442.77 nat. median
$265,286
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 33 $10,000.00 $465,667.50 $170,912.88 nat. median
$206,368
0.8× median
Q2043
HCPCS 		Provenge(sipuleucel-t) Auto Cd54 59 $46,857.61 $311,483.00 $170,528.23 nat. median
$66,682
outlier · 2.6×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 32 $154,487.60 $645,099.41 $169,407.91 nat. median
$202,986
0.8× median
1614
APR_DRG 		4 $154,022.14 $158,642.80 $154,022.14 nat. median
$207,730
0.7× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 32 $111,343.38 $949,211.27 $150,039.18 nat. median
$133,176
1.1× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 32 $86,834.44 $752,886.92 $113,024.05 nat. median
$108,660
1.0× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 32 $49,835.04 $740,885.64 $103,677.45 nat. median
$60,185
1.7× median
J9266
HCPCS 		Oncaspar 3750u/5ml Sd Vial 59 $17,391.60 $390,830.85 $97,258.85 nat. median
$34,109
outlier · 2.9×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 32 $15,552.82 $226,879.83 $94,702.28 nat. median
$117,303
0.8× median
6304
APR_DRG 		4 $94,514.36 $97,349.79 $94,514.36 nat. median
$150,721
0.6× median
212
MS_DRG 		Hip & Femur Procedures Except Major Joint Age 0-17 32 $59,547.22 $148,868.05 $86,971.20 nat. median
$102,358
0.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 32 $77,157.92 $473,562.45 $85,565.45 nat. median
$100,136
0.9× median
215
MS_DRG 		Other Heart Assist System Implant 32 $74,653.43 $335,128.60 $83,535.41 nat. median
$99,019
0.8× median
J9269
HCPCS 		Elzonris 1000mcg/1ml Soln 58 $356.93 $188,362.50 $81,711.65 nat. median
$509
outlier · 160.5×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 35 $26,794.00 $683,022.22 $81,514.34 nat. median
$93,672
0.9× median
6
MS_DRG 		Liver Transplant Without Mcc 32 $38,211.34 $613,006.45 $79,936.20 nat. median
$46,260
1.7× median
1604
APR_DRG 		4 $79,428.67 $81,811.53 $79,428.67 nat. median
$97,957
0.8× median
J9600
HCPCS 		Photofrin 75mg Vial 50 $17,146.91 $872,223.12 $78,477.29 nat. median
$31,644
outlier · 2.5×
8
MS_DRG 		Simultaneous Pancreas And Kidney Transplant 32 $42,875.48 $591,940.40 $77,810.30 nat. median
$53,171
1.5× median
6314
APR_DRG 		4 $75,442.81 $77,706.09 $75,442.81 nat. median
$122,924
0.6× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 33 $66,891.19 $273,655.62 $75,215.84 nat. median
$87,411
0.9× median
C9293
HCPCS 		Voraxaze 1000units/ml Soln 35 $355.34 $117,450.00 $73,993.50 nat. median
$21,340
outlier · 3.5×
9504
APR_DRG 		4 $73,752.43 $75,965.00 $73,752.43 nat. median
$53,715
1.4× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 32 $50,961.07 $557,980.25 $73,308.48 nat. median
$62,134
1.2× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 34 $63,834.03 $312,560.30 $72,039.02 nat. median
$79,312
0.9× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 33 $63,646.31 $325,502.69 $71,551.32 nat. median
$81,118
0.9× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 33 $52,540.21 $540,754.16 $71,057.56 nat. median
$65,950
1.1× median
570
MS_DRG 		Skin Debridement With Mcc 32 $23,720.16 $561,768.89 $69,023.36 nat. median
$29,069
outlier · 2.4×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 32 $59,858.70 $387,183.73 $66,559.23 nat. median
$77,576
0.9× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 34 $58,509.03 $302,432.06 $66,356.61 nat. median
$74,915
0.9× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 34 $21,737.00 $215,419.13 $65,484.82 nat. median
$73,807
0.9× median
C1605
HCPCS 		05932602_aveir Dr 55 $19,547.08 $129,938.00 $64,969.00 nat. median
$22,209
outlier · 2.9×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 32 $58,095.26 $179,465.74 $64,593.59 nat. median
$72,138
0.9× median
J7330
HCPCS 		Cultured Chondrocytes 69866103005 40 $18,632.29 $123,857.00 $61,928.50 nat. median
$76,377
0.8× median
10
MS_DRG 		Pancreas Transplant 32 $54,948.15 $363,908.35 $61,728.29 nat. median
$68,882
0.9× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 32 $53,078.43 $205,349.01 $59,616.77 nat. median
$66,526
0.9× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 32 $22,328.00 $155,140.74 $59,100.00 nat. median
$68,887
0.9× median
5884
APR_DRG 		4 $58,599.39 $60,357.37 $58,599.39 nat. median
$246,434
outlier · 0.2×
5833
APR_DRG 		4 $58,599.39 $60,357.37 $58,599.39 nat. median
$244,017
outlier · 0.2×

Other procedures at this hospital

Browse this hospital's 15,724 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
5882 APR_DRG — 4 4 — — $34,470.23 $35,504.33 $34,470.23 2026-02-15
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 34 32 — — $30,964.97 $86,300.43 $34,580.37 2026-02-15
0D16879 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DN67ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168KA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DP68DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV63DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1647L OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168K9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1607B OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168KB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DN68ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160ZB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DP643Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DW643Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DW64CZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DQ68ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DP67DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU60JZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU677Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1687A OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168ZA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168ZB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU68KZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV67ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DW04UZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164ZA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1607L OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168KL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1607A OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D767ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DF60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D764DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU687Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU68JZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D16079 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160ZA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164JA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DF64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DQ63ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV67DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DW08UZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
3E0G3GC OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164J9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164KA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D760ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160KA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164K9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU60KZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DN64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164ZL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160JA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D768ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DQ67ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU67JZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV60DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1647A OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160KL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164ZB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160J9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168JL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164KB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1687B OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D763ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DM60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV60CZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV64CZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160ZL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DF63ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164JL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU647Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU64JZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DF67ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160JL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DN60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168JB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DN63ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D760DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D763DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DM64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU607Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU67KZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV63CZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160K9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168ZL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164KL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160JB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1687L OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D767DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168JA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164JB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DP64CZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D768DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DQ64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D16479 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D764ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DQ60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160KB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168Z9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DU64KZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D160Z9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D1647B OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D164Z9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0D168J9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DF68ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV63ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV64DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV68DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
0DV68ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-15
34 MS_DRG Carotid Artery Stent Procedures With Mcc 35 33 — — $30,642.68 $94,876.96 $34,685.77 2026-02-15
0213 APR_DRG — 4 4 — — $34,718.67 $35,760.23 $34,718.67 2026-02-15
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 34 32 — — $27,819.30 $357,603.65 $34,735.95 2026-02-15
1214 APR_DRG — 4 4 — — $34,812.87 $35,857.25 $34,812.87 2026-02-15
C2624 HCPCS Wireless Pressure Sensor 96 40 $69,670.00 $52,252.50 25% off $10,480.73 $69,670.00 $34,835.00 2026-02-15
1654 APR_DRG — 4 4 — — $34,937.01 $35,985.12 $34,937.01 2026-02-15
5883 APR_DRG — 4 4 — — $35,000.54 $36,050.56 $35,000.54 2026-02-15
0073 APR_DRG — 4 4 — — $35,000.54 $36,050.56 $35,000.54 2026-02-15
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 34 32 — — $31,699.01 $138,107.65 $35,170.71 2026-02-15
793 MS_DRG Full Term Neonate With Major Problems 35 32 — — $3,415.28 $74,264.57 $35,332.70 2026-02-15
1792 APR_DRG — 4 4 — — $35,360.25 $36,421.06 $35,360.25 2026-02-15
2314 APR_DRG — 4 4 — — $35,573.67 $36,640.88 $35,573.67 2026-02-15
5891 APR_DRG — 4 4 — — $35,704.07 $36,775.19 $35,704.07 2026-02-15
C2616 HCPCS Nm Ns Yttrium-90 Per Source 123 60 $71,433.00 $53,574.75 25% off $10,745.95 $71,433.00 $35,716.50 2026-02-15
0234 APR_DRG — 4 4 — — $35,974.67 $37,053.91 $35,974.67 2026-02-15
1794 APR_DRG — 4 4 — — $36,051.23 $37,132.77 $36,051.23 2026-02-15
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 34 33 — — $30,812.88 $117,267.40 $36,068.08 2026-02-15
5104 APR_DRG — 4 4 — — $36,230.21 $37,317.11 $36,230.21 2026-02-15
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 34 32 — — $29,256.10 $79,703.09 $36,326.27 2026-02-15
0204 APR_DRG — 4 4 — — $36,370.17 $37,461.28 $36,370.17 2026-02-15
0266T CPT Implt/rpl Crtd Sns Dev Total 112 51 $94,500.00 $70,875.00 25% off $5,305.00 $96,184.51 $36,477.00 2026-02-15
0022 APR_DRG — 4 4 — — $36,591.47 $37,689.22 $36,591.47 2026-02-15
901 MS_DRG Wound Debridements For Injuries With Mcc 34 32 — — $33,841.49 $89,423.75 $36,656.65 2026-02-15
0094 APR_DRG — 4 4 — — $36,856.63 $37,962.33 $36,856.63 2026-02-15
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 34 32 — — $32,336.86 $170,114.57 $36,877.91 2026-02-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 35 32 — — $32,050.81 $129,419.50 $36,885.85 2026-02-15
323 MS_DRG Urinary Stones W Cc, &/or Esw Lithotripsy 33 32 — — $21,264.56 $53,161.41 $37,084.36 2026-02-15
0023 APR_DRG — 4 4 — — $37,121.78 $38,235.44 $37,121.78 2026-02-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 34 32 — — $33,013.74 $174,696.12 $37,202.53 2026-02-15
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 34 32 — — $26,958.36 $74,212.95 $37,398.82 2026-02-15
140 MS_DRG Major Head And Neck Procedures With Mcc 33 32 — — $33,325.79 $184,620.42 $37,491.51 2026-02-15
0274 APR_DRG — 4 4 — — $37,630.60 $38,759.52 $37,630.60 2026-02-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 35 33 — — $33,671.46 $108,681.72 $37,700.03 2026-02-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 40 33 — — $32,786.02 $209,018.27 $38,104.89 2026-02-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 50 35 — — $21,737.00 $103,114.88 $38,154.13 2026-02-15
3032 APR_DRG — 4 4 — — $38,369.24 $39,520.32 $38,369.24 2026-02-15
J1744 HCPCS Firazyr 30mg/3ml Syr 98 44 $59,093.00 $44,319.75 25% off $224.02 $59,093.00 $38,410.45 2026-02-15
C1825 HCPCS Gen Neuro Carot Sinus Baro 96 40 $77,175.00 $57,881.25 25% off $11,609.74 $77,175.00 $38,587.50 2026-02-15
31 MS_DRG Ventricular Shunt Procedures With Mcc 34 32 — — $33,021.63 $123,249.83 $38,732.10 2026-02-15
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 35 32 — — $33,613.41 $388,049.48 $38,754.70 2026-02-15
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 35 32 — — $20,520.08 $99,472.98 $38,770.72 2026-02-15
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 33 32 — — $34,614.94 $124,093.30 $38,941.81 2026-02-15
C1823 HCPCS Gen Neuro Trans Sen/stim 96 40 $78,750.00 $59,062.50 25% off $11,846.67 $78,750.00 $39,375.00 2026-02-15
C9760 HCPCS Non-blind Interatrial Shunt 107 53 — — $6,858.00 $72,037.56 $39,447.78 2026-02-15
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 35 32 — — $35,241.40 $91,615.14 $39,646.58 2026-02-15
0071 APR_DRG — 4 4 — — $39,919.36 $41,116.94 $39,919.36 2026-02-15
C1735 HCPCS Cath Renal Denerv Radiofreq 118 55 $80,000.00 $60,000.00 25% off $12,034.71 $80,000.00 $40,000.00 2026-02-15
C1736 HCPCS Cath Renal Denerv Ultrasnd 118 55 $80,000.00 $60,000.00 25% off $12,034.71 $80,000.00 $40,000.00 2026-02-15
245 MS_DRG Aicd Generator Procedures 35 33 — — $36,433.16 $97,360.51 $40,076.47 2026-02-15
799 MS_DRG Splenectomy With Mcc 34 32 — — $36,195.80 $103,507.48 $40,183.10 2026-02-15
9114 APR_DRG — 4 4 — — $40,307.94 $41,517.18 $40,307.94 2026-02-15
8634 APR_DRG — 4 4 — — $40,330.70 $41,540.62 $40,330.70 2026-02-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 34 32 — — $35,333.96 $103,170.93 $40,473.04 2026-02-15
277 MS_DRG Cellulitis Age >17 W Cc 41 32 — — $22,328.00 $232,912.00 $40,513.68 2026-02-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 34 32 — — $36,591.84 $170,430.30 $40,624.56 2026-02-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 35 32 — — $36,183.84 $162,067.99 $40,706.82 2026-02-15
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 33 32 — — $36,305.19 $236,647.50 $40,843.34 2026-02-15
2604 APR_DRG — 4 4 — — $40,978.35 $42,207.71 $40,978.35 2026-02-15
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 34 32 — — $5,092.18 $85,527.73 $41,116.01 2026-02-15
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 35 33 — — $36,739.21 $146,158.35 $41,164.51 2026-02-15
9104 APR_DRG — 4 4 — — $41,324.41 $42,564.14 $41,324.41 2026-02-15
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 34 32 — — $37,250.75 $149,954.58 $41,359.02 2026-02-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 35 33 — — $37,072.69 $166,713.80 $41,706.78 2026-02-15
L8614 HCPCS Cochlear Implant Dev/sys Lvl 1 192 41 $60,486.00 $45,364.50 25% off $9,099.15 $105,246.00 $42,249.47 2026-02-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 34 32 — — $33,846.06 $107,506.88 $42,375.07 2026-02-15
0093 APR_DRG — 4 4 — — $42,775.14 $44,058.40 $42,775.14 2026-02-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 64 33 — — $10,000.00 $157,405.59 $42,866.96 2026-02-15
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 34 32 — — $38,978.75 $195,923.00 $43,285.15 2026-02-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 35 33 — — $10,000.00 $381,082.36 $43,388.66 2026-02-15
1653 APR_DRG — 4 4 — — $43,453.28 $44,756.88 $43,453.28 2026-02-15
6094 APR_DRG — 4 4 — — $43,750.67 $45,063.19 $43,750.67 2026-02-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 41 34 — — $39,160.84 $150,959.34 $43,899.31 2026-02-15
471 MS_DRG Cervical Spinal Fusion With Mcc 35 33 — — $38,275.18 $389,336.94 $44,113.45 2026-02-15
3033 APR_DRG — 4 4 — — $44,182.52 $45,508.00 $44,182.52 2026-02-15
1783 APR_DRG — 4 4 — — $44,202.65 $45,528.73 $44,202.65 2026-02-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 34 33 — — $39,113.56 $97,783.91 $44,315.14 2026-02-15
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 34 32 — — $28,283.34 $106,360.95 $44,431.25 2026-02-15
7114 APR_DRG — 4 4 — — $44,438.63 $45,771.79 $44,438.63 2026-02-15
9124 APR_DRG — 4 4 — — $44,477.18 $45,811.50 $44,477.18 2026-02-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 41 34 — — $36,189.36 $129,859.38 $44,641.82 2026-02-15
278 MS_DRG Cellulitis Age >17 Without Cc 33 32 — — $5,772.38 $52,253.98 $44,851.33 2026-02-15
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 34 32 — — $7,559.25 $85,899.38 $45,115.00 2026-02-15
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 34 32 — — $15,926.24 $108,884.06 $45,154.64 2026-02-15
8413 APR_DRG — 4 4 — — $45,219.75 $46,576.34 $45,219.75 2026-02-15
1833 APR_DRG — 4 4 — — $45,346.08 $46,706.46 $45,346.08 2026-02-15
C1882 HCPCS Aicd Other Than Sing/dual 96 40 $91,645.00 $68,733.75 25% off $13,786.52 $91,645.00 $45,822.50 2026-02-15
C1722 HCPCS Cardiovert Defib Single Chamber 96 40 $92,020.00 $69,015.00 25% off $13,842.93 $92,020.00 $46,010.00 2026-02-15
7104 APR_DRG — 4 4 — — $46,188.04 $47,573.68 $46,188.04 2026-02-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 34 32 — — $41,615.05 $369,444.80 $46,223.74 2026-02-15
1612 APR_DRG — 4 4 — — $46,894.03 $48,300.85 $46,894.03 2026-02-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 41 34 — — $41,737.61 $111,085.61 $46,982.97 2026-02-15
0914 APR_DRG — 4 4 — — $47,539.63 $48,965.82 $47,539.63 2026-02-15
6334 APR_DRG — 4 4 — — $47,642.89 $49,072.18 $47,642.89 2026-02-15
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 35 32 — — $42,519.30 $225,144.85 $47,834.22 2026-02-15
0304 APR_DRG — 4 4 — — $48,132.52 $49,576.50 $48,132.52 2026-02-15
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 34 32 — — $42,559.48 $126,655.08 $48,408.90 2026-02-15
4403 APR_DRG — 4 4 — — $48,430.40 $49,883.31 $48,430.40 2026-02-15
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 36 34 — — $43,238.91 $373,981.41 $48,430.76 2026-02-15
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 34 32 — — $2,050.02 $105,855.09 $48,529.04 2026-02-15
6093 APR_DRG — 4 4 — — $49,188.38 $50,664.03 $49,188.38 2026-02-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 51 35 — — $21,737.00 $173,429.85 $49,605.72 2026-02-15
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 34 32 — — $44,707.62 $286,913.55 $49,670.90 2026-02-15
276 MS_DRG Non-maligant Breast Disorders 41 32 — — $22,328.00 $70,317.29 $49,880.13 2026-02-15
1674 APR_DRG — 4 4 — — $49,883.92 $51,380.43 $49,883.92 2026-02-15
1634 APR_DRG — 4 4 — — $49,894.95 $51,391.80 $49,894.95 2026-02-15
C1822 HCPCS Gen Neurostimulator High Freq 97 41 $100,065.00 $75,048.75 25% off $15,053.17 $100,065.00 $50,032.50 2026-02-15
8414 APR_DRG — 4 4 — — $50,379.56 $51,890.95 $50,379.56 2026-02-15
J3357 HCPCS Stelara 45mg Syrg 257 44 $81,333.00 $60,999.75 25% off $108.24 $162,665.50 $50,426.46 2026-02-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 34 32 — — $45,660.53 $159,643.33 $50,733.08 2026-02-15
653 MS_DRG Major Bladder Procedures With Mcc 34 32 — — $43,927.45 $432,627.77 $50,816.94 2026-02-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 35 33 — — $29,523.14 $142,619.85 $50,879.31 2026-02-15
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 34 32 — — $46,120.34 $176,947.00 $51,245.61 2026-02-15
28 MS_DRG Spinal Procedures With Mcc 35 33 — — $30,773.79 $111,429.89 $51,344.95 2026-02-15
1664 APR_DRG — 4 4 — — $51,665.46 $53,215.42 $51,665.46 2026-02-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 50 34 — — $21,737.00 $120,412.94 $51,716.46 2026-02-15
1303 APR_DRG — 4 4 — — $52,439.95 $54,013.15 $52,439.95 2026-02-15
1784 APR_DRG — 4 4 — — $52,652.11 $54,231.67 $52,652.11 2026-02-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 41 34 — — $36,648.00 $194,247.61 $52,822.21 2026-02-15
1613 APR_DRG — 4 4 — — $53,031.12 $54,622.05 $53,031.12 2026-02-15
0074 APR_DRG — 4 4 — — $53,031.12 $54,622.05 $53,031.12 2026-02-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 35 33 — — $47,207.07 $187,383.61 $53,107.96 2026-02-15
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 35 33 — — $35,838.64 $165,559.11 $53,251.88 2026-02-15
163 MS_DRG Major Chest Procedures With Mcc 34 32 — — $36,320.17 $460,004.33 $53,917.59 2026-02-15
C1721 HCPCS Cardiovert Defib Dual Chamber 96 40 $108,296.00 $81,222.00 25% off $16,291.39 $108,296.00 $54,148.00 2026-02-15
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 49 34 — — $20,990.36 $114,991.56 $54,213.71 2026-02-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 34 32 — — $23,868.21 $76,548.17 $54,311.77 2026-02-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 34 32 — — $39,456.38 $468,312.38 $55,792.94 2026-02-15
0113 APR_DRG — 4 4 — — $56,579.42 $58,276.80 $56,579.42 2026-02-15
0083 APR_DRG — 4 4 — — $56,773.93 $58,477.15 $56,773.93 2026-02-15
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 49 34 — — $26,794.00 $162,028.05 $57,248.76 2026-02-15
459 MS_DRG Spinal Fusion Except Cervical With Mcc 35 33 — — $51,098.20 $176,973.88 $57,380.46 2026-02-15
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 33 32 — — $6,547.56 $78,083.19 $57,389.80 2026-02-15
955 MS_DRG Craniotomy For Multiple Significant Trauma 34 32 — — $51,798.18 $203,377.17 $57,574.47 2026-02-15
6344 APR_DRG — 4 4 — — $58,026.65 $59,767.45 $58,026.65 2026-02-15
5831 APR_DRG — 4 4 — — $58,069.08 $59,811.15 $58,069.08 2026-02-15
5832 APR_DRG — 4 4 — — $58,069.08 $59,811.15 $58,069.08 2026-02-15
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 34 32 — — $23,322.42 $111,124.31 $58,306.05 2026-02-15
0024 APR_DRG — 4 4 — — $58,334.23 $60,084.26 $58,334.23 2026-02-15
5833 APR_DRG — 4 4 — — $58,599.39 $60,357.37 $58,599.39 2026-02-15
5884 APR_DRG — 4 4 — — $58,599.39 $60,357.37 $58,599.39 2026-02-15
5834 APR_DRG — 4 4 — — $58,599.39 $60,357.37 $58,599.39 2026-02-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 42 32 — — $22,328.00 $155,140.74 $59,100.00 2026-02-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 35 32 — — $53,078.43 $205,349.01 $59,616.77 2026-02-15
10 MS_DRG Pancreas Transplant 34 32 — — $54,948.15 $363,908.35 $61,728.29 2026-02-15
J7330 HCPCS Cultured Chondrocytes 69866103005 96 40 $123,857.00 $92,892.75 25% off $18,632.29 $123,857.00 $61,928.50 2026-02-15
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 34 32 — — $58,095.26 $179,465.74 $64,593.59 2026-02-15
C1605 HCPCS 05932602_aveir Dr 118 55 $129,938.00 $97,453.50 25% off $19,547.08 $129,938.00 $64,969.00 2026-02-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 51 34 — — $21,737.00 $215,419.13 $65,484.82 2026-02-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 41 34 — — $58,509.03 $302,432.06 $66,356.61 2026-02-15
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 34 32 — — $59,858.70 $387,183.73 $66,559.23 2026-02-15
570 MS_DRG Skin Debridement With Mcc 34 32 — — $23,720.16 $561,768.89 $69,023.36 2026-02-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 39 33 — — $52,540.21 $540,754.16 $71,057.56 2026-02-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 35 33 — — $63,646.31 $325,502.69 $71,551.32 2026-02-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 41 34 — — $63,834.03 $312,560.30 $72,039.02 2026-02-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 34 32 — — $50,961.07 $557,980.25 $73,308.48 2026-02-15
9504 APR_DRG — 4 4 — — $73,752.43 $75,965.00 $73,752.43 2026-02-15
C9293 HCPCS Voraxaze 1000units/ml Soln 95 35 $117,450.00 $88,087.50 25% off $355.34 $117,450.00 $73,993.50 2026-02-15
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 35 33 — — $66,891.19 $273,655.62 $75,215.84 2026-02-15
6314 APR_DRG — 4 4 — — $75,442.81 $77,706.09 $75,442.81 2026-02-15
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 34 32 — — $42,875.48 $591,940.40 $77,810.30 2026-02-15
J9600 HCPCS Photofrin 75mg Vial 116 50 $113,983.00 $85,487.25 25% off $17,146.91 $872,223.12 $78,477.29 2026-02-15
1604 APR_DRG — 4 4 — — $79,428.67 $81,811.53 $79,428.67 2026-02-15
6 MS_DRG Liver Transplant Without Mcc 34 32 — — $38,211.34 $613,006.45 $79,936.20 2026-02-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 50 35 — — $26,794.00 $683,022.22 $81,514.34 2026-02-15
J9269 HCPCS Elzonris 1000mcg/1ml Soln 132 58 $188,362.50 $141,271.88 25% off $356.93 $188,362.50 $81,711.65 2026-02-15
215 MS_DRG Other Heart Assist System Implant 34 32 — — $74,653.43 $335,128.60 $83,535.41 2026-02-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 34 32 — — $77,157.92 $473,562.45 $85,565.45 2026-02-15
212 MS_DRG Hip & Femur Procedures Except Major Joint Age 0-17 33 32 — — $59,547.22 $148,868.05 $86,971.20 2026-02-15
6304 APR_DRG — 4 4 — — $94,514.36 $97,349.79 $94,514.36 2026-02-15
14 MS_DRG Allogeneic Bone Marrow Transplant 34 32 — — $15,552.82 $226,879.83 $94,702.28 2026-02-15
J9266 HCPCS Oncaspar 3750u/5ml Sd Vial 186 59 $149,629.00 $112,221.75 25% off $17,391.60 $390,830.85 $97,258.85 2026-02-15
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 34 32 — — $49,835.04 $740,885.64 $103,677.45 2026-02-15
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 34 32 — — $86,834.44 $752,886.92 $113,024.05 2026-02-15
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 34 32 — — $111,343.38 $949,211.27 $150,039.18 2026-02-15
1614 APR_DRG — 4 4 — — $154,022.14 $158,642.80 $154,022.14 2026-02-15
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 34 32 — — $154,487.60 $645,099.41 $169,407.91 2026-02-15
Q2043 HCPCS Provenge(sipuleucel-t) Auto Cd54 150 59 $311,483.00 $233,612.25 25% off $46,857.61 $311,483.00 $170,528.23 2026-02-15
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 35 33 — — $10,000.00 $465,667.50 $170,912.88 2026-02-15
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 34 32 — — $202,655.78 $846,592.03 $222,442.77 2026-02-15
7 MS_DRG Lung Transplant 34 32 — — $102,981.20 $2,162,847.20 $355,151.91 2026-02-15
J2326 HCPCS Spinraza(nusinersen)12mg/5ml Soln 130 59 $816,348.50 $612,261.38 25% off $6,149.45 $816,348.50 $367,356.83 2026-02-15
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 33 32 — — $297,174.15 $2,860,061.00 $515,466.43 2026-02-15
Q2041 HCPCS Yescarta T-cell Susp For Infusion 114 58 $2,461,800.00 $1,846,350.00 25% off $370,338.22 $2,461,800.00 $1,501,698.00 2026-02-15
Q2042 HCPCS Kymriah T-cell Susp For Infusion 114 58 $3,015,811.00 $2,261,858.25 25% off $453,680.27 $3,015,811.00 $1,839,644.71 2026-02-15
Q2053 HCPCS Brexucabtagene Tecartus T-cell 114 58 $3,049,200.00 $2,286,900.00 25% off $458,703.11 $3,049,200.00 $1,860,012.00 2026-02-15
Q2056 HCPCS Ciltacabtagene Car-pos T 114 58 $3,445,566.50 $2,584,174.88 25% off $518,330.08 $3,445,566.50 $2,101,795.56 2026-02-15
Q2055 HCPCS Idecabtagene Vicleucel Car T 114 58 $3,486,862.50 $2,615,146.88 25% off $524,542.39 $3,486,862.50 $2,126,986.12 2026-02-15
Q2054 HCPCS Lisocabtagene Mara Car Pos T 114 58 $3,506,913.00 $2,630,184.75 25% off $527,558.67 $3,506,913.00 $2,139,216.93 2026-02-15
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 106 50 $3,465,000.00 $2,598,750.00 25% off $278,250.00 $3,465,000.00 $2,182,950.00 2026-02-15
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