Hospital

SOUTHWELL MEDICAL, A CAMPUS OF TRMC

Adel, GA · CCN 110101 · Rates published

58,493 distinct procedures filed

26 distinct payers

3,016,510 rate rows

2026-05-06 last MRF observed

Data quality

2,988,891 of 3,016,510 rate rows are consumer-grade (99.1%)

27,619 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
placeholder amount (≤ $0.02) — excluded from medians	12,787
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	11,744
per-diem day rate — not a per-procedure price	1,588
template filing: same amount across many unrelated codes — excluded	828
exceeds 10× this hospital's gross charge — excluded from medians	672

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

Source MRF file	https://s3.amazonaws.com/assets.bbmconnect.com/Southwell/453072990_SouthwellMedicalCenter_standardcharges.csv
Found on page	https://mysouthwell.com/chargemaster/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-17
Content fingerprint	574bfd2d54a7075b… · 709,174,711 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
018 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	14	$357,534.09	$3,408,933.14	$1,704,466.57	nat. median $424,868 outlier · 4.0×
18 OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	14	$371,467.69	$2,860,061.00	$1,374,208.86	nat. median $386,529 outlier · 3.6×
007 OTHER	Lung Transplant	16	$40,722.24	$2,510,219.58	$1,254,641.04	nat. median $141,082 outlier · 8.9×
7 OTHER	Lung Transplant	16	$40,722.24	$2,162,847.20	$1,007,479.35	nat. median $169,933 outlier · 5.9×
004 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	17	$30,863.85	$1,083,889.22	$541,944.61	nat. median $150,232 outlier · 3.6×
001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	17	$41,624.32	$1,007,091.72	$503,461.79	nat. median $263,894 1.9× median
4 OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	17	$30,863.85	$949,211.27	$437,110.81	nat. median $134,983 outlier · 3.2×
002 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	16	$25,620.52	$842,851.10	$421,290.27	nat. median $117,167 outlier · 3.6×
969 OTHER	HIV With Extensive O.r. Procedures With Mcc	14	$62,293.79	$813,967.46	$406,854.23	nat. median $64,729 outlier · 6.3×
1 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	17	$41,624.32	$846,592.03	$406,428.05	nat. median $239,422 1.7× median
003 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	14	$206,899.44	$748,576.46	$374,288.23	nat. median $218,232 1.7× median
2 OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	16	$25,620.52	$752,886.92	$341,347.34	nat. median $111,558 outlier · 3.1×
006 OTHER	Liver Transplant Without Mcc	16	$39,498.00	$658,693.16	$329,248.13	nat. median $50,611 outlier · 6.5×
008 OTHER	Simultaneous Pancreas And Kidney Transplant	16	$4,639.24	$635,736.22	$317,774.26	nat. median $59,265 outlier · 5.4×
3 OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	14	$211,099.33	$645,099.41	$303,040.97	nat. median $181,005 1.7× median
570 OTHER	Skin Debridement With Mcc	14	$28,358.02	$592,559.86	$296,194.71	nat. median $33,751 outlier · 8.8×
268 OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	14	$65,675.26	$579,290.72	$289,562.79	nat. median $67,670 outlier · 4.3×
927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	14	$171,961.29	$564,738.12	$282,289.41	nat. median $146,562 1.9× median
6 OTHER	Liver Transplant Without Mcc	16	$39,498.00	$613,006.45	$267,087.44	nat. median $52,924 outlier · 5.0×
8 OTHER	Simultaneous Pancreas And Kidney Transplant	16	$4,639.24	$591,940.40	$258,375.45	nat. median $57,589 outlier · 4.5×
005 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	16	$28,995.27	$512,643.94	$256,252.73	nat. median $104,489 outlier · 2.5×
207 OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	17	$4,188.20	$598,953.70	$252,003.27	nat. median $66,849 outlier · 3.8×
837 OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	14	$47,007.82	$488,739.74	$244,305.41	nat. median $38,617 outlier · 6.3×
161-4 OTHER	Implantable Heart Assist Systems	1	$209,413.18	$260,602.86	$235,008.02	nat. median $202,242 1.2× median
653 OTHER	Major Bladder Procedures With Mcc	14	$52,535.42	$448,485.22	$224,186.21	nat. median $54,646 outlier · 4.1×
5 OTHER	Liver Transplant With Mcc Or Intestinal Transplant	16	$28,995.27	$473,562.45	$208,504.74	nat. median $94,894 outlier · 2.2×
163 OTHER	Major Chest Procedures With Mcc	17	$30,541.68	$477,702.92	$201,691.79	nat. median $47,944 outlier · 4.2×
020 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	17	$13,595.56	$402,761.14	$201,380.57	nat. median $82,426 outlier · 2.4×
471 OTHER	Cervical Spinal Fusion With Mcc	14	$47,735.65	$395,235.90	$197,572.20	nat. median $399 outlier · 494.8×
010 OTHER	Pancreas Transplant	13	$46,712.81	$375,066.04	$191,283.68	nat. median $67,882 outlier · 2.8×
021 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	17	$14,368.77	$373,907.12	$186,953.56	nat. median $58,177 outlier · 3.2×
022 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	17	$9,407.35	$357,603.65	$176,843.44	nat. median $36,711 outlier · 4.8×
215 OTHER	Other Heart Assist System Implant	14	$99,127.89	$349,397.38	$174,662.10	nat. median $92,359 1.9× median
456 OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	14	$81,801.76	$331,382.50	$165,658.27	nat. median $76,493 outlier · 2.2×
20 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	17	$13,595.56	$387,183.73	$164,796.75	nat. median $74,209 outlier · 2.2×
326 OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	17	$10,180.56	$386,208.26	$163,857.02	nat. median $45,545 outlier · 3.6×
356 OTHER	Other Digestive System O.r. Procedures With Mcc	14	$41,521.96	$330,339.55	$161,908.02	nat. median $43,743 outlier · 3.7×
461 OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	17	$4,059.34	$381,165.10	$161,087.67	nat. median $53,999 outlier · 3.0×
10 OTHER	Pancreas Transplant	13	$78,533.33	$363,908.35	$156,021.28	nat. median $62,879 outlier · 2.5×
630-4 OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	1	$150,777.49	$159,916.70	$155,347.10	nat. median $210,669 0.7× median
216 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	14	$94,183.53	$309,538.74	$154,740.76	nat. median $90,130 1.7× median
21 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	17	$14,368.77	$369,444.80	$153,215.79	nat. median $55,888 outlier · 2.7×
219 OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	14	$74,832.11	$302,432.06	$150,926.59	nat. median $72,612 outlier · 2.1×
8270618-72026826 OTHER	Inebilizumab Cdon (Uplizna) 100 Mg/10 Ml Sol	15	$34,529.45	$219,245.50	$145,685.63	nat. median $162,680 0.9× median
22 OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	17	$9,407.35	$357,603.65	$144,987.74	nat. median $36,392 outlier · 4.0×
023 OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	17	$7,409.90	$286,913.55	$138,599.71	nat. median $59,073 outlier · 2.3×
970 OTHER	HIV With Extensive O.r. Procedures Without Mcc	14	$26,134.77	$290,321.10	$135,815.70	nat. median $27,516 outlier · 4.9×
453 OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	14	$84,408.33	$273,655.62	$135,758.68	nat. median $65,342 outlier · 2.1×
231 OTHER	Coronary Bypass With Ptca With Mcc	17	$10,631.60	$316,151.14	$134,898.14	nat. median $74,989 1.8× median
849 OTHER	Radiotherapy	14	$26,118.26	$266,108.00	$121,587.83	nat. median $25,415 outlier · 4.8×

Other procedures at this hospital

Browse this hospital's 58,493 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

018	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	15	14	—	—	$357,534.09	$3,408,933.14	$1,704,466.57	2026-05-06
18	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	15	14	—	—	$371,467.69	$2,860,061.00	$1,374,208.86	2026-05-06
007	OTHER	Lung Transplant	17	16	—	—	$40,722.24	$2,510,219.58	$1,254,641.04	2026-05-06
7	OTHER	Lung Transplant	17	16	—	—	$40,722.24	$2,162,847.20	$1,007,479.35	2026-05-06
004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	19	17	—	—	$30,863.85	$1,083,889.22	$541,944.61	2026-05-06
001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	18	17	—	—	$41,624.32	$1,007,091.72	$503,461.79	2026-05-06
4	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	19	17	—	—	$30,863.85	$949,211.27	$437,110.81	2026-05-06
002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	17	16	—	—	$25,620.52	$842,851.10	$421,290.27	2026-05-06
969	OTHER	HIV With Extensive O.r. Procedures With Mcc	30	14	—	—	$62,293.79	$813,967.46	$406,854.23	2026-05-06
1	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	18	17	—	—	$41,624.32	$846,592.03	$406,428.05	2026-05-06
003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	15	14	—	—	$206,899.44	$748,576.46	$374,288.23	2026-05-06
2	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	17	16	—	—	$25,620.52	$752,886.92	$341,347.34	2026-05-06
006	OTHER	Liver Transplant Without Mcc	17	16	—	—	$39,498.00	$658,693.16	$329,248.13	2026-05-06
008	OTHER	Simultaneous Pancreas And Kidney Transplant	17	16	—	—	$4,639.24	$635,736.22	$317,774.26	2026-05-06
3	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	15	14	—	—	$211,099.33	$645,099.41	$303,040.97	2026-05-06
570	OTHER	Skin Debridement With Mcc	30	14	—	—	$28,358.02	$592,559.86	$296,194.71	2026-05-06
268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	30	14	—	—	$65,675.26	$579,290.72	$289,562.79	2026-05-06
927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	30	14	—	—	$171,961.29	$564,738.12	$282,289.41	2026-05-06
6	OTHER	Liver Transplant Without Mcc	17	16	—	—	$39,498.00	$613,006.45	$267,087.44	2026-05-06
8	OTHER	Simultaneous Pancreas And Kidney Transplant	17	16	—	—	$4,639.24	$591,940.40	$258,375.45	2026-05-06
005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	17	16	—	—	$28,995.27	$512,643.94	$256,252.73	2026-05-06
207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	38	17	—	—	$4,188.20	$598,953.70	$252,003.27	2026-05-06
837	OTHER	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	30	14	—	—	$47,007.82	$488,739.74	$244,305.41	2026-05-06
161-4	OTHER	Implantable Heart Assist Systems	2	1	—	—	$209,413.18	$260,602.86	$235,008.02	2026-05-06
653	OTHER	Major Bladder Procedures With Mcc	30	14	—	—	$52,535.42	$448,485.22	$224,186.21	2026-05-06
5	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	17	16	—	—	$28,995.27	$473,562.45	$208,504.74	2026-05-06
163	OTHER	Major Chest Procedures With Mcc	38	17	—	—	$30,541.68	$477,702.92	$201,691.79	2026-05-06
020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	19	17	—	—	$13,595.56	$402,761.14	$201,380.57	2026-05-06
471	OTHER	Cervical Spinal Fusion With Mcc	30	14	—	—	$47,735.65	$395,235.90	$197,572.20	2026-05-06
010	OTHER	Pancreas Transplant	13	13	—	—	$46,712.81	$375,066.04	$191,283.68	2026-05-06
021	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	19	17	—	—	$14,368.77	$373,907.12	$186,953.56	2026-05-06
022	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	19	17	—	—	$9,407.35	$357,603.65	$176,843.44	2026-05-06
215	OTHER	Other Heart Assist System Implant	30	14	—	—	$99,127.89	$349,397.38	$174,662.10	2026-05-06
456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	30	14	—	—	$81,801.76	$331,382.50	$165,658.27	2026-05-06
20	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	19	17	—	—	$13,595.56	$387,183.73	$164,796.75	2026-05-06
326	OTHER	Stomach, Esophageal And Duodenal Procedures With Mcc	38	17	—	—	$10,180.56	$386,208.26	$163,857.02	2026-05-06
356	OTHER	Other Digestive System O.r. Procedures With Mcc	30	14	—	—	$41,521.96	$330,339.55	$161,908.02	2026-05-06
461	OTHER	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	38	17	—	—	$4,059.34	$381,165.10	$161,087.67	2026-05-06
10	OTHER	Pancreas Transplant	13	13	—	—	$78,533.33	$363,908.35	$156,021.28	2026-05-06
630-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	2	1	—	—	$150,777.49	$159,916.70	$155,347.10	2026-05-06
216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	30	14	—	—	$94,183.53	$309,538.74	$154,740.76	2026-05-06
21	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	19	17	—	—	$14,368.77	$369,444.80	$153,215.79	2026-05-06
219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	30	14	—	—	$74,832.11	$302,432.06	$150,926.59	2026-05-06
8270618-72026826	OTHER	Inebilizumab Cdon (Uplizna) 100 Mg/10 Ml Sol	32	15	$214,957.00	$107,478.50 50% off	$34,529.45	$219,245.50	$145,685.63	2026-05-06
22	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	19	17	—	—	$9,407.35	$357,603.65	$144,987.74	2026-05-06
023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	19	17	—	—	$7,409.90	$286,913.55	$138,599.71	2026-05-06
970	OTHER	HIV With Extensive O.r. Procedures Without Mcc	30	14	—	—	$26,134.77	$290,321.10	$135,815.70	2026-05-06
453	OTHER	Combined Anterior And Posterior Spinal Fusion With Mcc	30	14	—	—	$84,408.33	$273,655.62	$135,758.68	2026-05-06
231	OTHER	Coronary Bypass With Ptca With Mcc	38	17	—	—	$10,631.60	$316,151.14	$134,898.14	2026-05-06
849	OTHER	Radiotherapy	30	14	—	—	$26,118.26	$266,108.00	$121,587.83	2026-05-06
347	OTHER	Anal And Stomal Procedures With Mcc	38	17	—	—	$4,317.07	$294,993.23	$118,385.59	2026-05-06
8275471-72026826	OTHER	Tremelimumab Actl 300 Mg/15 Ml Sol	33	15	$191,412.00	$95,706.00 50% off	$30,145.92	$191,412.00	$117,909.79	2026-05-06
197	OTHER	Interstitial Lung Disease With Cc	38	17	—	—	$4,768.11	$296,166.91	$117,213.98	2026-05-06
23	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	19	17	—	—	$7,409.90	$286,913.55	$114,861.54	2026-05-06
014	OTHER	Allogeneic Bone Marrow Transplant	13	13	—	—	$38,882.04	$214,927.94	$109,613.25	2026-05-06
745	OTHER	D&c, Conization, Laparoscopy And Tubal Interruption Without Cc/mcc	30	14	—	—	$10,052.73	$243,234.30	$105,536.50	2026-05-06
277	OTHER	Cellulitis Age >17 W Cc	30	14	—	—	$45,820.80	$232,912.00	$105,152.37	2026-05-06
432	OTHER	Cirrhosis And Alcoholic Hepatitis With Mcc	30	14	—	—	$18,593.52	$239,740.52	$103,917.13	2026-05-06
485	OTHER	Knee Procedures With Principal Diagnosis Of Infection With Mcc	30	14	—	—	$31,709.82	$233,889.68	$103,479.30	2026-05-06
802	OTHER	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	30	14	—	—	$33,293.65	$230,149.08	$101,850.68	2026-05-06
011	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	19	17	—	—	$18,105.93	$225,144.85	$101,754.57	2026-05-06
583-4	OTHER	Neonate With Ecmo	2	1	—	—	$99,149.17	$99,149.17	$99,149.17	2026-05-06
583-3	OTHER	Neonate With Ecmo	2	1	—	—	$99,149.17	$99,149.17	$99,149.17	2026-05-06
588-4	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	2	1	—	—	$99,149.17	$99,149.17	$99,149.17	2026-05-06
002-4	OTHER	Heart And/or Lung Transplant	2	1	—	—	$98,700.54	$98,700.54	$98,700.54	2026-05-06
583-1	OTHER	Neonate With Ecmo	2	1	—	—	$98,251.90	$98,251.90	$98,251.90	2026-05-06
583-2	OTHER	Neonate With Ecmo	2	1	—	—	$98,251.90	$98,251.90	$98,251.90	2026-05-06
650	OTHER	Kidney Transplant With Hemodialysis With Mcc	38	17	—	—	$9,600.65	$236,647.50	$93,046.86	2026-05-06
870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	30	14	—	—	$58,438.97	$205,349.01	$92,541.65	2026-05-06
333	OTHER	Rectal Resection With Cc	30	14	—	—	$20,180.18	$216,636.10	$91,603.81	2026-05-06
327	OTHER	Stomach, Esophageal And Duodenal Procedures With Cc	30	14	—	—	$23,916.57	$215,405.31	$91,354.46	2026-05-06
955	OTHER	Craniotomy For Multiple Significant Trauma	30	14	—	—	$57,572.53	$203,377.17	$91,179.48	2026-05-06
212	OTHER	Hip & Femur Procedures Except Major Joint Age 0-17	30	14	—	—	$51,029.91	$180,868.46	$90,434.23	2026-05-06
269	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	30	14	—	—	$40,356.47	$209,018.27	$90,313.58	2026-05-06
8286704-72026826	OTHER	Loncastuximab Tesirine Lpyl 10 Mg Inj	16	15	$132,630.25	$66,315.13 50% off	$21,738.65	$132,630.25	$90,055.94	2026-05-06
007-4	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$89,727.76	$89,727.76	$89,727.76	2026-05-06
161-3	OTHER	Implantable Heart Assist Systems	2	1	—	—	$89,727.76	$89,727.76	$89,727.76	2026-05-06
040	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	19	17	—	—	$5,219.15	$208,935.75	$89,657.59	2026-05-06
233	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	38	17	—	—	$8,376.41	$215,419.13	$86,506.80	2026-05-06
11	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	19	17	—	—	$18,105.93	$225,144.85	$85,422.23	2026-05-06
841-4	OTHER	Extensive Third Degree Burns With Skin Graft	2	1	—	—	$85,241.37	$85,241.37	$85,241.37	2026-05-06
503	OTHER	Foot Procedures With Mcc	30	14	—	—	$26,026.07	$204,187.44	$85,092.75	2026-05-06
239	OTHER	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	30	14	—	—	$46,646.82	$195,923.00	$83,978.86	2026-05-06
160-4	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	2	1	—	—	$71,329.35	$95,375.05	$83,352.20	2026-05-06
651	OTHER	Kidney Transplant With Hemodialysis Without Mcc	38	17	—	—	$7,216.60	$219,147.25	$83,222.62	2026-05-06
7450333-72026826	OTHER	Sipuleucel-t IV Susp 250 Ml	47	26	$168,526.50	$84,263.25 50% off	$41,261.42	$273,971.00	$82,522.84	2026-05-06
908	OTHER	Other O.r. Procedures For Injuries With Cc	30	14	—	—	$19,448.47	$199,020.30	$81,061.56	2026-05-06
959	OTHER	Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc	30	14	—	—	$24,575.27	$197,083.71	$80,905.16	2026-05-06
266	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	30	14	—	—	$51,354.73	$187,383.61	$80,447.34	2026-05-06
8326087-72026826	OTHER	Pembrolizumab-berahyaluronidase 790 Mg/9600 Units	16	15	$118,100.00	$59,050.00 50% off	$19,357.08	$118,100.00	$80,189.90	2026-05-06
161-2	OTHER	Implantable Heart Assist Systems	2	1	—	—	$79,343.90	$79,343.90	$79,343.90	2026-05-06
631-4	OTHER	Neonate Birth Weight > 2499 Grams With Other Major Procedure	2	1	—	—	$67,721.00	$90,550.30	$79,135.65	2026-05-06
163-4	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	2	1	—	—	$71,844.83	$84,421.41	$78,133.12	2026-05-06
957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	30	14	—	—	$49,956.42	$179,465.74	$78,097.36	2026-05-06
950-4	OTHER	Extensive O.r. Procedure Unrelated To Principal Diagnosis	2	1	—	—	$66,239.00	$88,568.70	$77,403.85	2026-05-06
634-4	OTHER	Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma…	2	1	—	—	$65,723.52	$87,879.45	$76,801.49	2026-05-06
14	OTHER	Allogeneic Bone Marrow Transplant	13	13	—	—	$38,882.04	$150,393.38	$76,700.62	2026-05-06
8203406-72026826	OTHER	Ravulizumab 100 mg/mL Inj 11 Ml	32	15	$112,992.25	$56,496.12 50% off	$18,150.42	$115,246.50	$76,579.72	2026-05-06
016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	13	13	—	—	$55,778.25	$176,947.00	$75,858.42	2026-05-06
40	OTHER	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	19	17	—	—	$5,219.15	$208,935.75	$75,791.13	2026-05-06
288	OTHER	Acute And Subacute Endocarditis With Mcc	30	14	—	—	$25,163.35	$187,723.59	$75,529.59	2026-05-06
7447077-72026826	OTHER	Ipilimumab 5 mg/mL IV Soln 40 Ml	32	15	$111,441.00	$55,720.50 50% off	$17,901.25	$113,664.25	$75,528.38	2026-05-06
459	OTHER	Spinal Fusion Except Cervical With Mcc	30	14	—	—	$48,148.88	$176,973.88	$75,323.34	2026-05-06
232	OTHER	Coronary Bypass With Ptca Without Mcc	38	17	—	—	$4,961.41	$194,247.61	$74,131.82	2026-05-06
609-4	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	2	1	—	—	$74,025.40	$74,025.40	$74,025.40	2026-05-06
633-4	OTHER	Neonate Birth Weight > 2499 Grams With Major Anomaly	2	1	—	—	$67,334.39	$80,610.97	$73,972.68	2026-05-06
783	OTHER	Cesarean Section With Sterilization With Mcc	30	14	—	—	$17,194.15	$186,295.25	$73,291.71	2026-05-06
841	OTHER	Lymphoma And Non-acute Leukemia With Cc	38	17	—	—	$1,234.40	$198,513.05	$70,472.71	2026-05-06
673	OTHER	Other Kidney And Urinary Tract Procedures With Mcc	30	14	—	—	$35,886.65	$174,696.12	$70,146.04	2026-05-06
652	OTHER	Kidney Transplant	26	13	—	—	$29,155.72	$177,139.02	$69,831.70	2026-05-06
314	OTHER	Other Circulatory System Diagnoses With Mcc	38	17	—	—	$7,538.77	$195,514.55	$69,598.12	2026-05-06
598	OTHER	Malignant Breast Disorders With Cc	30	14	—	—	$10,627.07	$181,097.00	$69,031.50	2026-05-06
399	OTHER	Reticuloendothelial & Immunity Disorders Without Cc	30	14	—	—	$10,801.90	$180,382.64	$68,681.24	2026-05-06
823	OTHER	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	30	14	—	—	$43,687.97	$170,430.30	$68,402.74	2026-05-06
012	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	15	14	—	—	$30,961.51	$170,114.57	$67,319.00	2026-05-06
140	OTHER	Major Head And Neck Procedures With Mcc	38	17	—	—	$1,699.41	$184,620.42	$67,108.84	2026-05-06
019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	15	14	—	—	$16,368.90	$133,674.14	$66,843.63	2026-05-06
267	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	30	14	—	—	$42,766.46	$166,713.80	$66,253.30	2026-05-06
217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	30	14	—	—	$42,813.52	$162,028.05	$66,246.38	2026-05-06
910-4	OTHER	Craniotomy For Multiple Significant Trauma	2	1	—	—	$61,084.21	$69,920.20	$65,502.21	2026-05-06
070	OTHER	Nonspecific Cerebrovascular Disorders With Mcc	15	14	—	—	$17,365.92	$173,317.67	$65,492.79	2026-05-06
929	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	30	14	—	—	$31,204.31	$162,010.38	$65,029.67	2026-05-06
16	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	13	13	—	—	$47,479.95	$176,947.00	$64,572.73	2026-05-06
820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	30	14	—	—	$41,303.91	$159,643.33	$63,843.72	2026-05-06
329	OTHER	Major Small And Large Bowel Procedures With Mcc	30	14	—	—	$40,970.42	$162,067.99	$63,339.78	2026-05-06
711-4	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	2	1	—	—	$54,125.25	$72,371.31	$63,248.28	2026-05-06
002-3	OTHER	Heart And/or Lung Transplant	2	1	—	—	$62,809.43	$62,809.43	$62,809.43	2026-05-06
009-4	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	2	1	—	—	$62,360.79	$62,360.79	$62,360.79	2026-05-06
275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	30	14	—	—	$38,738.03	$149,021.59	$62,076.31	2026-05-06
500	OTHER	Soft Tissue Procedures With Mcc	38	17	—	—	$3,286.13	$176,939.48	$61,937.51	2026-05-06
895	OTHER	Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy	30	14	—	—	$14,261.68	$245,827.15	$61,507.88	2026-05-06
867	OTHER	Other Infectious And Parasitic Diseases Diagnoses With Mcc	30	14	—	—	$20,304.39	$164,328.63	$60,827.92	2026-05-06
008-3	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	2	1	—	—	$50,967.95	$68,149.65	$59,558.80	2026-05-06
002-2	OTHER	Heart And/or Lung Transplant	2	1	—	—	$56,831.52	$61,912.15	$59,371.83	2026-05-06
011-3	OTHER	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	1	—	—	$50,774.64	$67,891.19	$59,332.92	2026-05-06
588-3	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	2	1	—	—	$59,220.32	$59,220.32	$59,220.32	2026-05-06
588-2	OTHER	Neonate Birth Weight < 1500 Grams With Major Procedure	2	1	—	—	$58,323.04	$58,323.04	$58,323.04	2026-05-06
165-4	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	2	1	—	—	$57,411.43	$59,112.84	$58,262.13	2026-05-06
12	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	15	14	—	—	$30,346.50	$170,114.57	$57,953.62	2026-05-06
928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	30	14	—	—	$33,659.99	$114,070.84	$57,040.66	2026-05-06
912-4	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	2	1	—	—	$48,777.16	$65,220.34	$56,998.75	2026-05-06
7878595-72026826	OTHER	Ocrelizumab (Ocrevus) 300 Mg/10 Ml Sol	33	15	$79,755.00	$39,877.50 50% off	$12,560.80	$79,755.00	$56,863.17	2026-05-06
178-4	OTHER	External Heart Assist Systems	2	1	—	—	$48,583.86	$64,961.87	$56,772.87	2026-05-06
826	OTHER	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	30	14	—	—	$36,765.84	$149,954.58	$56,493.28	2026-05-06
242	OTHER	Permanent Cardiac Pacemaker Implant With Mcc	38	17	—	—	$3,286.13	$165,390.68	$56,341.54	2026-05-06
70	OTHER	Nonspecific Cerebrovascular Disorders With Mcc	15	14	—	—	$17,127.02	$173,317.67	$56,270.99	2026-05-06
007-3	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$52,321.08	$59,220.32	$55,770.70	2026-05-06
405	OTHER	Pancreas, Liver And Shunt Procedures With Mcc	38	17	—	—	$6,185.66	$157,405.59	$55,397.36	2026-05-06
130-3	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	2	1	—	—	$47,101.86	$62,980.27	$55,041.07	2026-05-06
593-4	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	2	1	—	—	$54,285.29	$54,285.29	$54,285.29	2026-05-06
166-4	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	2	1	—	—	$46,393.07	$62,032.56	$54,212.82	2026-05-06
455	OTHER	Combined Anterior And Posterior Spinal Fusion Without Cc/mcc	30	14	—	—	$35,356.49	$146,158.35	$53,990.53	2026-05-06
303-4	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	2	1	—	—	$53,836.66	$53,836.66	$53,836.66	2026-05-06
842-4	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	2	1	—	—	$53,836.66	$53,836.66	$53,836.66	2026-05-06
591-4	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	2	1	—	—	$53,836.66	$53,836.66	$53,836.66	2026-05-06
001-4	OTHER	Liver Transplant And/or Intestinal Transplant	2	1	—	—	$53,836.66	$53,836.66	$53,836.66	2026-05-06
8321231-72026826	OTHER	Efgartigimod Alfa-hyaluronidase Qvfc 180 Mg-2000 U	16	15	$78,962.25	$39,481.13 50% off	$12,942.24	$78,962.25	$53,615.37	2026-05-06
028	OTHER	Spinal Procedures With Mcc	15	14	—	—	$39,246.98	$104,658.60	$53,375.89	2026-05-06
8092024-626883	OTHER	Impella Cp 0048-0003	33	15	$71,809.00	$35,904.50 50% off	$11,769.80	$77,669.00	$53,282.28	2026-05-06
276	OTHER	Non-maligant Breast Disorders	30	14	—	—	$28,187.74	$106,462.86	$53,237.43	2026-05-06
021-4	OTHER	Open Craniotomy Except Trauma	2	1	—	—	$53,194.10	$53,194.10	$53,194.10	2026-05-06
017	OTHER	Autologous Bone Marrow Transplant Without Cc/mcc	13	13	—	—	$18,898.13	$103,973.96	$53,026.72	2026-05-06
573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	30	14	—	—	$30,744.37	$105,894.42	$52,953.26	2026-05-06
161-1	OTHER	Implantable Heart Assist Systems	2	1	—	—	$52,934.00	$52,934.00	$52,934.00	2026-05-06
234	OTHER	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	38	17	—	—	$4,768.11	$151,346.44	$52,797.82	2026-05-06
454	OTHER	Combined Anterior And Posterior Spinal Fusion With Cc	30	14	—	—	$28,702.54	$105,236.46	$52,624.36	2026-05-06
8242630-72026826	OTHER	Polatuzumab Vedotin (Polivy) 140 Mg	32	15	$77,319.25	$38,659.63 50% off	$12,420.13	$78,861.75	$52,402.60	2026-05-06
008-4	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	2	1	—	—	$50,967.95	$53,836.66	$52,402.31	2026-05-06
8088171-72026826	OTHER	Canakinumab 150 mg/mL Sol	32	15	$77,256.75	$38,628.38 50% off	$12,410.09	$78,798.00	$52,360.24	2026-05-06
167-4	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	2	1	—	—	$44,782.20	$59,878.65	$52,330.43	2026-05-06
303-3	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	2	1	—	—	$44,653.33	$59,706.33	$52,179.83	2026-05-06
303-2	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	2	1	—	—	$44,653.33	$59,706.33	$52,179.83	2026-05-06
009-3	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	2	1	—	—	$44,331.16	$59,275.55	$51,803.36	2026-05-06
609-3	OTHER	Neonate Birth Weight 1500-2499 Grams With Major Procedure	2	1	—	—	$44,137.85	$59,017.08	$51,577.46	2026-05-06
235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	30	14	—	—	$27,540.13	$120,412.94	$51,535.71	2026-05-06
218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	30	14	—	—	$30,856.53	$102,614.10	$51,313.43	2026-05-06
863-4	OTHER	Neonatal Aftercare	2	1	—	—	$43,880.12	$58,672.46	$51,276.29	2026-05-06
790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	30	14	—	—	$5,125.05	$102,543.46	$51,271.73	2026-05-06
179-4	OTHER	Defibrillator Implants	2	1	—	—	$43,557.94	$58,241.68	$50,899.81	2026-05-06
440-3	OTHER	Kidney Transplant	2	1	—	—	$43,493.51	$58,155.52	$50,824.51	2026-05-06
030-4	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	2	1	—	—	$43,235.77	$57,810.90	$50,523.33	2026-05-06
933	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	30	14	—	—	$29,423.56	$138,107.65	$50,091.28	2026-05-06
091-4	OTHER	Other Major Head And Neck Procedures	2	1	—	—	$42,655.85	$57,035.49	$49,845.67	2026-05-06
7727647-72066996	OTHER	Generator Bionics Pulse Sys	35	17	$80,732.00	$40,366.00 50% off	$12,233.97	$80,732.00	$49,730.91	2026-05-06
457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	30	14	—	—	$27,983.60	$99,318.10	$49,665.76	2026-05-06
800	OTHER	Splenectomy With Cc	30	14	—	—	$27,343.92	$143,242.90	$49,616.72	2026-05-06
303-1	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	2	1	—	—	$44,653.33	$54,274.00	$49,463.67	2026-05-06
7728949-72066996	OTHER	Pulse Generator Kit Percision	37	17	$72,039.00	$36,019.50 50% off	$10,916.51	$72,039.00	$49,419.43	2026-05-06
7728662-72066996	OTHER	Pulse Generatr Nerve Stimulatr	35	17	$80,182.00	$40,091.00 50% off	$12,150.55	$80,182.00	$49,392.11	2026-05-06
162-4	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	2	1	—	—	$49,350.27	$49,350.27	$49,350.27	2026-05-06
004-4	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	2	1	—	—	$49,350.27	$49,350.27	$49,350.27	2026-05-06
741	OTHER	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy Without…	30	14	—	—	$12,608.85	$146,177.20	$48,926.51	2026-05-06
710-4	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	2	1	—	—	$41,431.59	$55,398.52	$48,415.05	2026-05-06
007-2	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$42,849.16	$53,836.66	$48,342.91	2026-05-06
834	OTHER	Acute Leukemia Without Major O.r. Procedures With Mcc	30	14	—	—	$25,762.97	$95,987.56	$47,993.78	2026-05-06
7727647-626883	OTHER	Generator Bionics Pulse Sys	70	17	$72,245.38	$36,122.69 50% off	$11,448.67	$80,732.00	$47,854.89	2026-05-06
163-3	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	2	1	—	—	$44,782.20	$50,763.94	$47,773.07	2026-05-06
736	OTHER	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	30	14	—	—	$31,233.82	$137,231.03	$47,683.39	2026-05-06
007-1	OTHER	Allogeneic Bone Marrow Transplant	2	1	—	—	$40,722.81	$54,450.80	$47,586.81	2026-05-06
183-3	OTHER	Percutaneous Structural Cardiac Procedures	2	1	—	—	$40,722.81	$54,450.80	$47,586.81	2026-05-06
7728662-626883	OTHER	Pulse Generatr Nerve Stimulatr	70	17	$71,752.99	$35,876.50 50% off	$11,370.69	$80,182.00	$47,528.71	2026-05-06
841-3	OTHER	Extensive Third Degree Burns With Skin Graft	2	1	—	—	$40,593.94	$54,278.49	$47,436.21	2026-05-06
939	OTHER	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	30	14	—	—	$31,202.36	$138,795.87	$47,406.02	2026-05-06
809	OTHER	Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co…	30	14	—	—	$11,687.91	$142,873.10	$46,768.24	2026-05-06
183-4	OTHER	Percutaneous Structural Cardiac Procedures	2	1	—	—	$41,560.46	$51,593.46	$46,576.96	2026-05-06
178-3	OTHER	External Heart Assist Systems	2	1	—	—	$39,691.85	$53,072.30	$46,382.07	2026-05-06
576	OTHER	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	30	14	—	—	$12,730.44	$93,914.78	$46,025.76	2026-05-06
690-4	OTHER	Acute Leukemia	2	1	—	—	$39,820.72	$51,593.46	$45,707.09	2026-05-06
630	OTHER	Other Endocrine, Nutritional And Metabolic O.r. Procedures Without Cc/mcc	38	17	—	—	$13,550.17	$148,101.70	$45,664.85	2026-05-06
165-3	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	2	1	—	—	$38,983.07	$52,124.58	$45,553.82	2026-05-06
312-4	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	2	1	—	—	$40,787.24	$49,969.45	$45,378.35	2026-05-06
7728949-626883	OTHER	Pulse Generator Kit Percision	72	17	$66,603.00	$33,301.50 50% off	$10,215.95	$72,039.00	$45,311.99	2026-05-06
8194615-72026828	OTHER	Pembrolizumab (Keytruda) 25 mg/mL 8 Ml	32	15	$66,809.88	$33,404.94 50% off	$10,732.61	$68,138.75	$45,280.18	2026-05-06
198	OTHER	Interstitial Lung Disease Without Cc/mcc	38	17	—	—	$3,286.13	$148,872.00	$45,077.79	2026-05-06
463	OTHER	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	38	17	—	—	$3,479.43	$126,655.08	$44,912.45	2026-05-06
270	OTHER	Other Major Cardiovascular Procedures With Mcc	30	14	—	—	$24,760.59	$97,783.91	$44,905.65	2026-05-06
607-4	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$44,863.88	$44,863.88	$44,863.88	2026-05-06
602-4	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$44,863.88	$44,863.88	$44,863.88	2026-05-06
19	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	15	14	—	—	$16,368.90	$89,283.22	$44,657.94	2026-05-06
593-3	OTHER	Neonate Birth Weight 750-999 Grams Without Major Procedure	2	1	—	—	$44,415.24	$44,415.24	$44,415.24	2026-05-06
221	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	30	14	—	—	$30,004.33	$129,859.38	$44,377.79	2026-05-06
7732644-72066996	OTHER	Vagal Nerve Stimulator	36	17	$65,586.00	$32,793.00 50% off	$10,328.42	$68,157.00	$44,370.92	2026-05-06
160-3	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	2	1	—	—	$43,622.38	$44,863.88	$44,243.13	2026-05-06
7729698-72066996	OTHER	Generator Nerve Stimulator Duo	35	17	$71,376.00	$35,688.00 50% off	$10,816.20	$71,376.00	$43,967.62	2026-05-06
853	OTHER	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	30	14	—	—	$23,175.82	$87,727.92	$43,871.83	2026-05-06
509	OTHER	Arthroscopy	30	14	—	—	$13,257.10	$136,252.68	$43,682.54	2026-05-06
278	OTHER	Cellulitis Age >17 Without Cc	30	14	—	—	$14,430.94	$87,759.30	$43,582.44	2026-05-06
7724414-72066996	OTHER	Xenmatrix 19 X 35cm	36	17	$66,659.00	$33,329.50 50% off	$10,101.25	$66,659.00	$43,395.33	2026-05-06
675	OTHER	Other Kidney And Urinary Tract Procedures Without Cc/mcc	30	14	—	—	$15,395.94	$136,275.20	$43,395.25	2026-05-06
656	OTHER	Kidney And Ureter Procedures For Neoplasm With Mcc	30	14	—	—	$28,895.26	$131,651.34	$43,329.80	2026-05-06
8312128-626883	OTHER	Inceptiv Perc Implant Sys Lead/gen/acs Kit	18	17	$63,631.00	$31,815.50 50% off	$10,429.39	$63,631.00	$43,205.45	2026-05-06
8312128-72066996	OTHER	Inceptiv Perc Implant Sys Lead/gen/acs Kit	18	17	$63,631.00	$31,815.50 50% off	$10,429.39	$63,631.00	$43,205.45	2026-05-06
260-4	OTHER	Major Pancreas, Liver And Shunt Procedures	2	1	—	—	$36,792.28	$49,195.26	$42,993.77	2026-05-06
089-4	OTHER	Major Cranial Or Facial Bone Procedures	2	1	—	—	$40,529.50	$44,863.88	$42,696.69	2026-05-06
630-3	OTHER	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	2	1	—	—	$42,620.69	$42,620.69	$42,620.69	2026-05-06
130-4	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	2	1	—	—	$42,620.69	$42,620.69	$42,620.69	2026-05-06
616	OTHER	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	30	14	—	—	$28,150.85	$128,738.60	$42,567.35	2026-05-06
271	OTHER	Other Major Cardiovascular Procedures With Cc	30	14	—	—	$28,523.00	$129,608.65	$42,419.35	2026-05-06
911-4	OTHER	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	2	1	—	—	$36,212.37	$48,419.86	$42,316.12	2026-05-06
7729698-626883	OTHER	Generator Nerve Stimulator Duo	70	17	$63,873.12	$31,936.57 50% off	$10,121.94	$71,376.00	$42,309.04	2026-05-06
681-4	OTHER	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	2	1	—	—	$36,147.94	$48,333.70	$42,240.82	2026-05-06
904	OTHER	Skin Grafts For Injuries With Cc/mcc	30	14	—	—	$28,132.40	$128,193.20	$42,239.99	2026-05-06
7748984-626883	OTHER	Insert Ventricular Assist Device 33990	76	20	$79,568.25	$39,784.13 50% off	$332.36	$96,563.00	$42,211.32	2026-05-06
690-3	OTHER	Acute Leukemia	2	1	—	—	$39,820.72	$44,415.24	$42,117.98	2026-05-06
799	OTHER	Splenectomy With Mcc	30	14	—	—	$21,253.19	$101,529.57	$41,985.51	2026-05-06
7732644-626883	OTHER	Vagal Nerve Stimulator	71	17	$63,015.00	$31,507.50 50% off	$9,665.46	$68,157.00	$41,984.71	2026-05-06
981	OTHER	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	30	14	—	—	$22,017.65	$88,334.89	$41,929.78	2026-05-06
304-4	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	2	1	—	—	$40,078.46	$43,517.96	$41,798.21	2026-05-06
162-3	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	2	1	—	—	$39,627.42	$43,966.60	$41,797.01	2026-05-06
7725341-72066996	OTHER	Vagal Nerve Stimulator Demi	35	17	$67,756.00	$33,878.00 50% off	$10,267.61	$67,756.00	$41,737.70	2026-05-06
611-4	OTHER	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	2	1	—	—	$41,723.41	$41,723.41	$41,723.41	2026-05-06
406	OTHER	Pancreas, Liver And Shunt Procedures With Cc	30	14	—	—	$27,662.49	$130,087.47	$41,702.68	2026-05-06
7888965-626883	OTHER	Medt Visia Af MRI Vr Surescan Dvab1d4	35	17	$67,500.00	$33,750.00 50% off	$11,063.53	$67,500.00	$41,580.00	2026-05-06
7736618-626883	OTHER	MRI Visia Af Vr Surescan	35	17	$67,500.00	$33,750.00 50% off	$11,063.53	$67,500.00	$41,580.00	2026-05-06
8185209-72026826	OTHER	Phesgo--pertuzumab/trastuzumab/hyaluronidase-zzxf	32	15	$61,146.12	$30,573.07 50% off	$9,822.16	$62,366.00	$41,441.37	2026-05-06
602-3	OTHER	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$41,274.77	$41,274.77	$41,274.77	2026-05-06
001-3	OTHER	Liver Transplant And/or Intestinal Transplant	2	1	—	—	$41,274.77	$41,274.77	$41,274.77	2026-05-06
495	OTHER	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	30	14	—	—	$27,714.44	$127,136.41	$41,082.85	2026-05-06
7724414-626883	OTHER	Xenmatrix 19 X 35cm	71	17	$61,629.00	$30,814.50 50% off	$9,452.89	$66,659.00	$41,061.94	2026-05-06
8113583-72066996	OTHER	Ipg Kit Senza Omnia	35	17	$66,572.00	$33,286.00 50% off	$10,088.30	$66,572.00	$41,008.35	2026-05-06
8113583-626883	OTHER	Ipg Kit Senza Omnia	35	17	$66,572.00	$33,286.00 50% off	$10,088.30	$66,572.00	$41,008.35	2026-05-06
8090801-72026828	OTHER	Cemiplimab 350 Mg/7 Ml Sol	32	15	$60,390.50	$30,195.26 50% off	$9,701.37	$61,591.75	$40,929.47	2026-05-06
013	OTHER	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc	15	14	—	—	$26,062.95	$129,151.39	$40,919.53	2026-05-06
220	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	38	17	—	—	$9,793.96	$111,085.61	$40,851.71	2026-05-06
004-3	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	2	1	—	—	$40,826.13	$40,826.13	$40,826.13	2026-05-06
591-3	OTHER	Neonate Birth Weight 500-749 Grams Without Major Procedure	2	1	—	—	$40,826.13	$40,826.13	$40,826.13	2026-05-06
680-4	OTHER	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	2	1	—	—	$38,403.16	$43,069.32	$40,736.24	2026-05-06
319	OTHER	Other Endovascular Cardiac Valve Procedures With Mcc	30	14	—	—	$27,424.76	$124,093.30	$40,709.18	2026-05-06
025	OTHER	Craniotomy And Endovascular Intracranial Procedures With Mcc	15	14	—	—	$29,782.94	$91,615.14	$40,504.79	2026-05-06
091-3	OTHER	Other Major Head And Neck Procedures	2	1	—	—	$40,377.49	$40,377.49	$40,377.49	2026-05-06
440-4	OTHER	Kidney Transplant	2	1	—	—	$40,377.49	$40,377.49	$40,377.49	2026-05-06
182-4	OTHER	Other Peripheral Vascular And Related Procedures	2	1	—	—	$40,377.49	$40,377.49	$40,377.49	2026-05-06
423	OTHER	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	38	17	—	—	$3,350.56	$129,419.50	$40,343.09	2026-05-06
668	OTHER	Transurethral Procedures With Mcc	30	14	—	—	$27,143.98	$127,396.42	$40,287.08	2026-05-06
7725341-626883	OTHER	Vagal Nerve Stimulator Demi	70	17	$60,633.94	$30,316.97 50% off	$9,608.70	$67,756.00	$40,163.20	2026-05-06
8326086-72026826	OTHER	Pembrolizumab-berahyaluronidase 395 Mg/4800 Units	16	15	$59,050.00	$29,525.00 50% off	$9,678.54	$59,050.00	$40,094.95	2026-05-06
856	OTHER	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	30	14	—	—	$21,346.10	$80,038.30	$40,027.79	2026-05-06
031	OTHER	Ventricular Shunt Procedures With Mcc	15	14	—	—	$29,884.31	$123,249.83	$39,948.89	2026-05-06
178-2	OTHER	External Heart Assist Systems	2	1	—	—	$35,761.33	$43,966.60	$39,863.96	2026-05-06
474	OTHER	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	30	14	—	—	$20,145.69	$79,615.88	$39,807.94	2026-05-06
169-4	OTHER	Major Abdominal Vascular Procedures	2	1	—	—	$34,150.46	$45,308.60	$39,729.53	2026-05-06
499	OTHER	Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without…	30	14	—	—	$11,433.78	$130,921.62	$39,606.80	2026-05-06
114	OTHER	Orbital Procedures Without Cc/mcc	38	17	—	—	$2,835.10	$135,936.86	$39,594.21	2026-05-06
7441775-72026828	OTHER	Alteplase 100 Mg IV Inj	32	15	$58,399.62	$29,199.82 50% off	$9,381.55	$59,561.25	$39,580.17	2026-05-06
005-4	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	2	1	—	—	$39,480.21	$39,480.21	$39,480.21	2026-05-06
027-4	OTHER	Other Open Craniotomy	2	1	—	—	$33,763.85	$45,145.92	$39,454.88	2026-05-06
466	OTHER	Revision Of Hip Or Knee Replacement With Mcc	38	17	—	—	$3,221.70	$89,193.00	$39,442.54	2026-05-06
901	OTHER	Wound Debridements For Injuries With Mcc	30	14	—	—	$19,693.78	$89,423.75	$39,382.39	2026-05-06
7692728-72357878	OTHER	Leuprolide 45 Mg/6 Months IM Inj ER	32	15	$58,100.38	$29,050.19 50% off	$9,333.48	$59,256.00	$39,377.35	2026-05-06
7703959-72026828	OTHER	Atezolizumab 1200 Mg/20 Ml Sol	32	15	$58,063.25	$29,031.63 50% off	$9,327.50	$59,218.25	$39,352.18	2026-05-06
130-2	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	2	1	—	—	$38,596.46	$39,928.85	$39,262.65	2026-05-06
458	OTHER	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	30	14	—	—	$21,174.65	$107,178.61	$39,106.26	2026-05-06
963	OTHER	Other Multiple Significant Trauma With Mcc	30	14	—	—	$26,428.57	$125,866.54	$39,072.58	2026-05-06
001-2	OTHER	Liver Transplant And/or Intestinal Transplant	2	1	—	—	$39,031.58	$39,031.58	$39,031.58	2026-05-06
7443000-72026828	OTHER	Cabazitaxel (Jevtana) 60 mg/6mL IV Soln	32	15	$57,472.75	$28,736.38 50% off	$9,232.64	$58,616.00	$38,951.97	2026-05-06
261-4	OTHER	Major Biliary Tract Procedures	2	1	—	—	$33,248.37	$44,456.66	$38,852.51	2026-05-06
231-4	OTHER	Major Large Bowel Procedures	2	1	—	—	$33,183.93	$44,370.51	$38,777.22	2026-05-06
607-3	OTHER	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	2	1	—	—	$38,582.94	$38,582.94	$38,582.94	2026-05-06
28	OTHER	Spinal Procedures With Mcc	15	14	—	—	$28,195.71	$76,934.47	$38,346.17	2026-05-06
021-3	OTHER	Open Craniotomy Except Trauma	2	1	—	—	$32,668.46	$43,681.26	$38,174.86	2026-05-06

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