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 DULUTH

Duluth, GA · CCN 110252 · Rates published

15,724 distinct procedures filed
72 distinct payers
1,869,600 rate rows
2026-02-14 last MRF observed
Data quality

1,648,964 of 1,869,600 rate rows are consumer-grade (88.2%)

220,636 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 91,172
template filing: same amount across many unrelated codes — excluded 85,947
per-diem day rate — not a per-procedure price 41,706
exceeds 10× this hospital's gross charge — excluded from medians 1,164
placeholder amount (≤ $0.02) — excluded from medians 647
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://assets.northside.com/price-transparency/581954432-1790715381_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 e7ffd9be5c769c2f… · 1,090,471,364 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 $442,967.02 $3,506,913.00 $2,139,216.93 nat. median
$674,188
outlier · 3.2×
Q2055
HCPCS 		Idecabtagene Vicleucel Car T 58 $440,434.39 $3,486,862.50 $2,126,986.12 nat. median
$625,184
outlier · 3.4×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 58 $435,218.19 $3,445,566.50 $2,101,795.56 nat. median
$675,122
outlier · 3.1×
Q2053
HCPCS 		Brexucabtagene Tecartus T-cell 58 $385,152.14 $3,049,200.00 $1,860,012.00 nat. median
$620,080
outlier · 3.0×
Q2042
HCPCS 		Kymriah T-cell Susp For Infusion 58 $380,934.69 $3,015,811.00 $1,839,644.71 nat. median
$754,974
outlier · 2.4×
Q2041
HCPCS 		Yescarta T-cell Susp For Infusion 58 $310,956.17 $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 34 $297,174.15 $2,860,061.00 $493,060.27 nat. median
$370,174
1.3× 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 34 $102,981.20 $2,162,847.20 $335,924.34 nat. median
$122,708
outlier · 2.7×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 32 $202,536.67 $846,592.03 $222,377.26 nat. median
$265,286
0.8× median
1614
APR_DRG 		4 $190,415.56 $196,128.02 $190,415.56 nat. median
$207,730
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 33 $10,000.00 $465,667.50 $171,344.50 nat. median
$206,368
0.8× median
Q2043
HCPCS 		Provenge(sipuleucel-t) Auto Cd54 59 $39,344.21 $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… 34 $11,006.97 $645,099.41 $165,756.77 nat. median
$202,986
0.8× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 34 $7,240.06 $949,211.27 $143,551.26 nat. median
$133,176
1.1× median
6304
APR_DRG 		4 $116,846.87 $120,352.27 $116,846.87 nat. median
$150,721
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 34 $21,278.50 $752,886.92 $108,674.15 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 $99,205.33 nat. median
$60,185
1.6× 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 34 $6,602.08 $226,879.83 $92,621.48 nat. median
$117,303
0.8× median
212
MS_DRG 		Hip & Femur Procedures Except Major Joint Age 0-17 34 $13,501.72 $148,868.05 $85,843.14 nat. median
$102,358
0.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 34 $9,200.48 $473,562.45 $83,116.40 nat. median
$100,136
0.8× median
J9269
HCPCS 		Elzonris 1000mcg/1ml Soln 58 $356.93 $188,362.50 $81,711.65 nat. median
$509
outlier · 160.5×
215
MS_DRG 		Other Heart Assist System Implant 34 $30,788.56 $335,128.60 $81,600.66 nat. median
$99,019
0.8× median
J9600
HCPCS 		Photofrin 75mg Vial 50 $14,397.48 $872,223.12 $78,477.29 nat. median
$31,644
outlier · 2.5×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 $12,851.04 $303,808.65 $78,433.17 nat. median
$93,672
0.8× median
1604
APR_DRG 		4 $77,860.69 $80,196.51 $77,860.69 nat. median
$97,957
0.8× median
6
MS_DRG 		Liver Transplant Without Mcc 34 $38,211.34 $613,006.45 $75,854.10 nat. median
$46,260
1.6× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 35 $18,892.83 $273,655.62 $75,064.92 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×
6314
APR_DRG 		4 $73,953.51 $76,172.12 $73,953.51 nat. median
$122,924
0.6× median
8
MS_DRG 		Simultaneous Pancreas And Kidney Transplant 34 $38,650.29 $591,940.40 $73,814.24 nat. median
$53,171
1.4× median
5833
APR_DRG 		4 $72,445.66 $74,619.03 $72,445.66 nat. median
$244,017
outlier · 0.3×
5834
APR_DRG 		4 $72,445.66 $74,619.03 $72,445.66 nat. median
$309,665
outlier · 0.2×
5884
APR_DRG 		4 $72,445.66 $74,619.03 $72,445.66 nat. median
$246,434
outlier · 0.3×
9504
APR_DRG 		4 $72,296.50 $74,465.39 $72,296.50 nat. median
$53,715
1.3× median
0024
APR_DRG 		4 $72,117.85 $74,281.38 $72,117.85 nat. median
$372,987
outlier · 0.2×
5832
APR_DRG 		4 $71,790.04 $73,943.74 $71,790.04 nat. median
$156,126
outlier · 0.5×
5831
APR_DRG 		4 $71,790.04 $73,943.74 $71,790.04 nat. median
$145,122
outlier · 0.5×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 34 $65,216.76 $312,560.30 $71,763.32 nat. median
$79,312
0.9× median
6344
APR_DRG 		4 $71,735.72 $73,887.79 $71,735.72 nat. median
$37,344
1.9× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 34 $25,383.29 $557,980.25 $69,485.77 nat. median
$62,134
1.1× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 35 $11,234.41 $325,502.69 $68,282.60 nat. median
$81,118
0.8× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 33 $52,540.21 $540,754.16 $67,698.93 nat. median
$65,950
1.0× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 36 $15,693.75 $302,432.06 $65,749.67 nat. median
$74,915
0.9× median
0074
APR_DRG 		4 $65,561.68 $67,528.53 $65,561.68 nat. median
$178,275
outlier · 0.4×
1613
APR_DRG 		4 $65,561.68 $67,528.53 $65,561.68 nat. median
$119,796
0.5× median
C1605
HCPCS 		05932602_aveir Dr 55 $16,412.80 $129,938.00 $64,969.00 nat. median
$22,209
outlier · 2.9×
570
MS_DRG 		Skin Debridement With Mcc 34 $23,720.16 $561,768.89 $64,486.08 nat. median
$29,069
outlier · 2.2×

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
             
Q2054 HCPCS Lisocabtagene Mara Car Pos T 114 58 $3,506,913.00 $2,630,184.75 25% off $442,967.02 $3,506,913.00 $2,139,216.93 2026-02-14
Q2055 HCPCS Idecabtagene Vicleucel Car T 114 58 $3,486,862.50 $2,615,146.88 25% off $440,434.39 $3,486,862.50 $2,126,986.12 2026-02-14
Q2056 HCPCS Ciltacabtagene Car-pos T 114 58 $3,445,566.50 $2,584,174.88 25% off $435,218.19 $3,445,566.50 $2,101,795.56 2026-02-14
Q2053 HCPCS Brexucabtagene Tecartus T-cell 114 58 $3,049,200.00 $2,286,900.00 25% off $385,152.14 $3,049,200.00 $1,860,012.00 2026-02-14
Q2042 HCPCS Kymriah T-cell Susp For Infusion 114 58 $3,015,811.00 $2,261,858.25 25% off $380,934.69 $3,015,811.00 $1,839,644.71 2026-02-14
Q2041 HCPCS Yescarta T-cell Susp For Infusion 114 58 $2,461,800.00 $1,846,350.00 25% off $310,956.17 $2,461,800.00 $1,501,698.00 2026-02-14
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 35 34 — — $297,174.15 $2,860,061.00 $493,060.27 2026-02-14
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 2026-02-14
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 34 32 — — $202,536.67 $846,592.03 $222,377.26 2026-02-14
1614 APR_DRG — 4 4 — — $190,415.56 $196,128.02 $190,415.56 2026-02-14
6304 APR_DRG — 4 4 — — $116,846.87 $120,352.27 $116,846.87 2026-02-14
7 MS_DRG Lung Transplant 36 34 — — $102,981.20 $2,162,847.20 $335,924.34 2026-02-14
1604 APR_DRG — 4 4 — — $77,860.69 $80,196.51 $77,860.69 2026-02-14
6314 APR_DRG — 4 4 — — $73,953.51 $76,172.12 $73,953.51 2026-02-14
5834 APR_DRG — 4 4 — — $72,445.66 $74,619.03 $72,445.66 2026-02-14
5833 APR_DRG — 4 4 — — $72,445.66 $74,619.03 $72,445.66 2026-02-14
5884 APR_DRG — 4 4 — — $72,445.66 $74,619.03 $72,445.66 2026-02-14
9504 APR_DRG — 4 4 — — $72,296.50 $74,465.39 $72,296.50 2026-02-14
0024 APR_DRG — 4 4 — — $72,117.85 $74,281.38 $72,117.85 2026-02-14
5831 APR_DRG — 4 4 — — $71,790.04 $73,943.74 $71,790.04 2026-02-14
5832 APR_DRG — 4 4 — — $71,790.04 $73,943.74 $71,790.04 2026-02-14
6344 APR_DRG — 4 4 — — $71,735.72 $73,887.79 $71,735.72 2026-02-14
0074 APR_DRG — 4 4 — — $65,561.68 $67,528.53 $65,561.68 2026-02-14
1613 APR_DRG — 4 4 — — $65,561.68 $67,528.53 $65,561.68 2026-02-14
231 MS_DRG Coronary Bypass With Ptca With Mcc 41 34 — — $65,216.76 $312,560.30 $71,763.32 2026-02-14
8414 APR_DRG — 4 4 — — $62,283.60 $64,152.10 $62,283.60 2026-02-14
1634 APR_DRG — 4 4 — — $61,684.47 $63,535.01 $61,684.47 2026-02-14
6334 APR_DRG — 4 4 — — $58,900.29 $60,667.29 $58,900.29 2026-02-14
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 34 32 — — $58,817.36 $179,465.74 $63,899.74 2026-02-14
1612 APR_DRG — 4 4 — — $57,974.47 $59,713.71 $57,974.47 2026-02-14
0083 APR_DRG — 4 4 — — $55,653.18 $57,322.77 $55,653.18 2026-02-14
0113 APR_DRG — 4 4 — — $55,462.50 $57,126.37 $55,462.50 2026-02-14
7114 APR_DRG — 4 4 — — $54,938.90 $56,587.07 $54,938.90 2026-02-14
6094 APR_DRG — 4 4 — — $54,088.39 $55,711.04 $54,088.39 2026-02-14
955 MS_DRG Craniotomy For Multiple Significant Trauma 34 32 — — $53,311.13 $203,377.17 $57,073.82 2026-02-14
9124 APR_DRG — 4 4 — — $53,280.58 $54,879.00 $53,280.58 2026-02-14
1784 APR_DRG — 4 4 — — $53,075.13 $54,667.38 $53,075.13 2026-02-14
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 39 33 — — $52,540.21 $540,754.16 $67,698.93 2026-02-14
1303 APR_DRG — 4 4 — — $51,404.75 $52,946.89 $51,404.75 2026-02-14
9104 APR_DRG — 4 4 — — $51,088.82 $52,621.49 $51,088.82 2026-02-14
1664 APR_DRG — 4 4 — — $50,645.54 $52,164.91 $50,645.54 2026-02-14
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 34 32 — — $49,835.04 $740,885.64 $99,205.33 2026-02-14
1674 APR_DRG — 4 4 — — $48,899.17 $50,366.15 $48,899.17 2026-02-14
3033 APR_DRG — 4 4 — — $48,789.41 $50,253.09 $48,789.41 2026-02-14
0093 APR_DRG — 4 4 — — $48,431.27 $49,884.20 $48,431.27 2026-02-14
6093 APR_DRG — 4 4 — — $48,217.37 $49,663.89 $48,217.37 2026-02-14
8634 APR_DRG — 4 4 — — $47,921.85 $49,359.50 $47,921.85 2026-02-14
4403 APR_DRG — 4 4 — — $47,474.35 $48,898.58 $47,474.35 2026-02-14
3032 APR_DRG — 4 4 — — $47,435.39 $48,858.46 $47,435.39 2026-02-14
0304 APR_DRG — 4 4 — — $47,182.35 $48,597.82 $47,182.35 2026-02-14
0914 APR_DRG — 4 4 — — $46,601.16 $47,999.20 $46,601.16 2026-02-14
0023 APR_DRG — 4 4 — — $45,893.18 $47,269.97 $45,893.18 2026-02-14
0094 APR_DRG — 4 4 — — $45,565.37 $46,932.33 $45,565.37 2026-02-14
7104 APR_DRG — 4 4 — — $45,276.25 $46,634.54 $45,276.25 2026-02-14
0022 APR_DRG — 4 4 — — $45,237.56 $46,594.69 $45,237.56 2026-02-14
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 36 34 — — $44,844.45 $373,981.41 $48,430.76 2026-02-14
1794 APR_DRG — 4 4 — — $44,569.67 $45,906.76 $44,569.67 2026-02-14
0071 APR_DRG — 4 4 — — $44,478.35 $45,812.70 $44,478.35 2026-02-14
1833 APR_DRG — 4 4 — — $44,450.91 $45,784.44 $44,450.91 2026-02-14
8413 APR_DRG — 4 4 — — $44,327.08 $45,656.89 $44,327.08 2026-02-14
1783 APR_DRG — 4 4 — — $43,330.05 $44,629.95 $43,330.05 2026-02-14
5883 APR_DRG — 4 4 — — $43,270.71 $44,568.83 $43,270.71 2026-02-14
0073 APR_DRG — 4 4 — — $43,270.71 $44,568.83 $43,270.71 2026-02-14
1654 APR_DRG — 4 4 — — $43,192.17 $44,487.94 $43,192.17 2026-02-14
5882 APR_DRG — 4 4 — — $42,615.09 $43,893.54 $42,615.09 2026-02-14
1653 APR_DRG — 4 4 — — $42,595.48 $43,873.34 $42,595.48 2026-02-14
2604 APR_DRG — 4 4 — — $40,169.41 $41,374.49 $40,169.41 2026-02-14
5934 APR_DRG — 4 4 — — $39,664.82 $40,854.76 $39,664.82 2026-02-14
3031 APR_DRG — 4 4 — — $39,656.56 $40,846.26 $39,656.56 2026-02-14
9114 APR_DRG — 4 4 — — $39,512.24 $40,697.60 $39,512.24 2026-02-14
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 34 32 — — $39,456.38 $468,312.38 $52,866.03 2026-02-14
Q2043 HCPCS Provenge(sipuleucel-t) Auto Cd54 150 59 $311,483.00 $233,612.25 25% off $39,344.21 $311,483.00 $170,528.23 2026-02-14
5914 APR_DRG — 4 4 — — $39,337.01 $40,517.12 $39,337.01 2026-02-14
3034 APR_DRG — 4 4 — — $39,337.01 $40,517.12 $39,337.01 2026-02-14
0084 APR_DRG — 4 4 — — $39,337.01 $40,517.12 $39,337.01 2026-02-14
0072 APR_DRG — 4 4 — — $39,337.01 $40,517.12 $39,337.01 2026-02-14
0014 APR_DRG — 4 4 — — $39,337.01 $40,517.12 $39,337.01 2026-02-14
8424 APR_DRG — 4 4 — — $39,337.01 $40,517.12 $39,337.01 2026-02-14
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 34 33 — — $39,113.56 $97,783.91 $45,055.70 2026-02-14
0214 APR_DRG — 4 4 — — $38,867.51 $40,033.53 $38,867.51 2026-02-14
1611 APR_DRG — 4 4 — — $38,677.46 $39,837.78 $38,677.46 2026-02-14
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 36 34 — — $38,650.29 $591,940.40 $73,814.24 2026-02-14
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 37 35 — — $38,415.07 $146,158.35 $41,164.51 2026-02-14
6 MS_DRG Liver Transplant Without Mcc 36 34 — — $38,211.34 $613,006.45 $75,854.10 2026-02-14
1834 APR_DRG — 4 4 — — $37,697.97 $38,828.90 $37,697.97 2026-02-14
6904 APR_DRG — 4 4 — — $37,697.97 $38,828.90 $37,697.97 2026-02-14
799 MS_DRG Splenectomy With Mcc 34 32 — — $37,467.48 $103,507.48 $40,161.12 2026-02-14
1633 APR_DRG — 4 4 — — $37,091.85 $38,204.61 $37,091.85 2026-02-14
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 37 35 — — $37,072.69 $166,713.80 $42,406.29 2026-02-14
0274 APR_DRG — 4 4 — — $36,887.75 $37,994.38 $36,887.75 2026-02-14
3124 APR_DRG — 4 4 — — $36,511.35 $37,606.69 $36,511.35 2026-02-14
2614 APR_DRG — 4 4 — — $36,316.41 $37,405.91 $36,316.41 2026-02-14
2314 APR_DRG — 4 4 — — $36,256.61 $37,344.30 $36,256.61 2026-02-14
6814 APR_DRG — 4 4 — — $36,058.92 $37,140.69 $36,058.92 2026-02-14
1624 APR_DRG — 4 4 — — $36,058.92 $37,140.69 $36,058.92 2026-02-14
0044 APR_DRG — 4 4 — — $36,058.92 $37,140.69 $36,058.92 2026-02-14
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 37 35 — — $35,947.56 $187,383.61 $51,541.61 2026-02-14
0213 APR_DRG — 4 4 — — $35,689.49 $36,760.18 $35,689.49 2026-02-14
0204 APR_DRG — 4 4 — — $35,652.20 $36,721.77 $35,652.20 2026-02-14
5104 APR_DRG — 4 4 — — $35,515.00 $36,580.45 $35,515.00 2026-02-14
0234 APR_DRG — 4 4 — — $35,264.51 $36,322.44 $35,264.51 2026-02-14
0924 APR_DRG — 4 4 — — $35,037.24 $36,088.36 $35,037.24 2026-02-14
5891 APR_DRG — 4 4 — — $34,999.25 $36,049.22 $34,999.25 2026-02-14
1204 APR_DRG — 4 4 — — $34,947.18 $35,995.59 $34,947.18 2026-02-14
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 37 35 — — $34,809.68 $165,559.11 $51,452.58 2026-02-14
4014 APR_DRG — 4 4 — — $34,794.49 $35,838.33 $34,794.49 2026-02-14
0303 APR_DRG — 4 4 — — $34,767.76 $35,810.79 $34,767.76 2026-02-14
1792 APR_DRG — 4 4 — — $34,662.21 $35,702.08 $34,662.21 2026-02-14
0D760ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D768DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DF60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D164ZL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D160ZB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D164K9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D1687L OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DQ60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D160JB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D168ZB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D764ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D1647A OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D768ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DF68ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D160KB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D164ZB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D168KB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DP67DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DQ63ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D1647B OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D164KB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D160ZL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D168JL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D168KA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DM60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DN68ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D160ZA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D168K9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D164KA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DN60ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DP64CZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D164JA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D160KA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D164J9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D164ZA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D168JA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DN64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D16479 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D16879 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D763ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DQ64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DQ68ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DU60KZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D160Z9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D763DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DF63ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D1607B OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D164JL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DQ67ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D1647L OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DF64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D164KL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D1687A OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D168J9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D168Z9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DP68DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DU60JZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D164JB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D16079 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D767ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D1607L OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D1687B OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D160K9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D760DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DF67ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DM64ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DN63ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D160JA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D1607A OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D160JL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D168JB OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D168KL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D168ZL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D160J9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D767DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DP643Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D164Z9 OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D168ZA OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D160KL OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0D764DZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DN67ZZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DU607Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DU647Z OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DU64JZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
0DU64KZ OTHER Bariatric Surgery 1 1 — — $34,622.00 $34,622.00 $34,622.00 2026-02-14
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 34 32 — — $33,846.06 $107,506.88 $42,786.26 2026-02-14
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 34 32 — — $33,613.41 $330,339.55 $38,769.89 2026-02-14
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 34 32 — — $33,429.41 $138,107.65 $35,286.69 2026-02-14
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 39 33 — — $32,786.02 $209,018.27 $38,104.89 2026-02-14
215 MS_DRG Other Heart Assist System Implant 36 34 — — $30,788.56 $335,128.60 $81,600.66 2026-02-14
163 MS_DRG Major Chest Procedures With Mcc 36 34 — — $30,096.16 $460,004.33 $50,801.40 2026-02-14
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 34 32 — — $29,256.10 $79,703.09 $37,275.08 2026-02-14
10 MS_DRG Pancreas Transplant 36 34 — — $26,373.64 $363,908.35 $60,488.32 2026-02-14
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 37 35 — — $25,874.95 $108,681.72 $37,149.51 2026-02-14
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 36 34 — — $25,383.29 $557,980.25 $69,485.77 2026-02-14
570 MS_DRG Skin Debridement With Mcc 36 34 — — $23,720.16 $561,768.89 $64,486.08 2026-02-14
471 MS_DRG Cervical Spinal Fusion With Mcc 37 35 — — $23,640.38 $389,336.94 $41,977.54 2026-02-14
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 43 36 — — $23,530.46 $129,859.38 $43,533.90 2026-02-14
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 2026-02-14
653 MS_DRG Major Bladder Procedures With Mcc 36 34 — — $22,646.94 $432,627.77 $48,760.00 2026-02-14
276 MS_DRG Non-maligant Breast Disorders 43 34 — — $22,328.00 $70,317.29 $50,163.00 2026-02-14
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 36 34 — — $21,278.50 $752,886.92 $108,674.15 2026-02-14
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 37 35 — — $18,901.79 $142,619.85 $50,325.22 2026-02-14
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 37 35 — — $18,892.83 $273,655.62 $75,064.92 2026-02-14
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 44 36 — — $17,973.73 $111,085.61 $46,830.90 2026-02-14
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 43 34 — — $17,826.73 $149,021.59 $58,915.00 2026-02-14
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 2026-02-14
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 51 36 — — $16,809.65 $120,412.94 $51,269.96 2026-02-14
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 36 34 — — $16,695.11 $85,954.55 $34,727.81 2026-02-14
C1605 HCPCS 05932602_aveir Dr 118 55 $129,938.00 $97,453.50 25% off $16,412.80 $129,938.00 $64,969.00 2026-02-14
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 51 36 — — $16,314.70 $114,991.56 $53,785.83 2026-02-14
245 MS_DRG Aicd Generator Procedures 37 35 — — $16,217.09 $97,360.51 $40,017.92 2026-02-14
459 MS_DRG Spinal Fusion Except Cervical With Mcc 37 35 — — $16,209.49 $176,973.88 $57,380.46 2026-02-14
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 36 35 — — $15,981.72 $117,267.40 $36,521.35 2026-02-14
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 51 36 — — $15,902.33 $215,419.13 $62,703.25 2026-02-14
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 51 36 — — $15,896.72 $151,346.44 $48,022.32 2026-02-14
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 43 36 — — $15,693.75 $302,432.06 $65,749.67 2026-02-14
J7330 HCPCS Cultured Chondrocytes 69866103005 96 40 $123,857.00 $92,892.75 25% off $15,644.69 $123,857.00 $61,928.50 2026-02-14
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 51 36 — — $15,522.87 $99,681.47 $37,829.64 2026-02-14
232 MS_DRG Coronary Bypass With Ptca Without Mcc 43 36 — — $15,410.93 $194,247.61 $52,822.21 2026-02-14
J9600 HCPCS Photofrin 75mg Vial 116 50 $113,983.00 $85,487.25 25% off $14,397.48 $872,223.12 $78,477.29 2026-02-14
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 51 36 — — $14,322.08 $162,028.05 $56,924.39 2026-02-14
228 MS_DRG Other Cardiothoracic Procedures With Mcc 43 36 — — $13,747.25 $150,959.34 $43,899.31 2026-02-14
C1721 HCPCS Cardiovert Defib Dual Chamber 96 40 $108,296.00 $81,222.00 25% off $13,679.14 $108,296.00 $54,148.00 2026-02-14
212 MS_DRG Hip & Femur Procedures Except Major Joint Age 0-17 35 34 — — $13,501.72 $148,868.05 $85,843.14 2026-02-14
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 36 34 — — $13,109.74 $106,360.95 $44,536.46 2026-02-14
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 51 36 — — $12,851.04 $303,808.65 $78,433.17 2026-02-14
34 MS_DRG Carotid Artery Stent Procedures With Mcc 37 35 — — $12,710.37 $94,876.96 $34,927.91 2026-02-14
C1822 HCPCS Gen Neurostimulator High Freq 97 41 $100,065.00 $75,048.75 25% off $12,639.46 $100,065.00 $50,032.50 2026-02-14
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 36 34 — — $12,513.94 $91,615.14 $39,584.47 2026-02-14
C1722 HCPCS Cardiovert Defib Single Chamber 96 40 $92,020.00 $69,015.00 25% off $11,623.28 $92,020.00 $46,010.00 2026-02-14
C1882 HCPCS Aicd Other Than Sing/dual 96 40 $91,645.00 $68,733.75 25% off $11,575.91 $91,645.00 $45,822.50 2026-02-14
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 37 35 — — $11,234.41 $325,502.69 $68,282.60 2026-02-14
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 36 34 — — $11,173.01 $129,419.50 $36,829.07 2026-02-14
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 36 34 — — $11,006.97 $645,099.41 $165,756.77 2026-02-14
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 36 34 — — $10,663.90 $225,144.85 $46,579.67 2026-02-14
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 36 34 — — $10,598.30 $387,183.73 $64,348.65 2026-02-14
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 36 34 — — $10,186.90 $149,954.58 $40,867.11 2026-02-14
C1736 HCPCS Cath Renal Denerv Ultrasnd 118 55 $80,000.00 $60,000.00 25% off $10,105.00 $80,000.00 $40,000.00 2026-02-14
C1735 HCPCS Cath Renal Denerv Radiofreq 118 55 $80,000.00 $60,000.00 25% off $10,105.00 $80,000.00 $40,000.00 2026-02-14
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 35 33 — — $10,000.00 $465,667.50 $171,344.50 2026-02-14
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 37 35 — — $10,000.00 $381,082.36 $43,145.36 2026-02-14
C1823 HCPCS Gen Neuro Trans Sen/stim 96 40 $78,750.00 $59,062.50 25% off $9,947.11 $78,750.00 $39,375.00 2026-02-14
C1825 HCPCS Gen Neuro Carot Sinus Baro 96 40 $77,175.00 $57,881.25 25% off $9,748.17 $77,175.00 $38,587.50 2026-02-14
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 36 34 — — $9,736.31 $286,913.55 $48,612.12 2026-02-14
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 35 34 — — $9,553.43 $236,647.50 $40,843.34 2026-02-14
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 35 34 — — $9,513.34 $124,093.30 $38,941.81 2026-02-14
28 MS_DRG Spinal Procedures With Mcc 37 35 — — $9,294.91 $111,429.89 $50,657.83 2026-02-14
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 36 34 — — $9,200.48 $473,562.45 $83,116.40 2026-02-14
140 MS_DRG Major Head And Neck Procedures With Mcc 35 34 — — $9,047.26 $184,620.42 $37,491.51 2026-02-14
C2616 HCPCS Nm Ns Yttrium-90 Per Source 123 60 $71,433.00 $53,574.75 25% off $9,022.88 $71,433.00 $35,716.50 2026-02-14
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 36 34 — — $8,955.03 $369,444.80 $45,400.06 2026-02-14
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 66 35 — — $8,824.50 $157,405.59 $43,627.13 2026-02-14
C2624 HCPCS Wireless Pressure Sensor 96 40 $69,670.00 $52,252.50 25% off $8,800.19 $69,670.00 $34,835.00 2026-02-14
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 36 34 — — $8,576.26 $170,114.57 $37,290.46 2026-02-14
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 36 34 — — $8,453.65 $208,935.75 $34,692.03 2026-02-14
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 36 34 — — $8,426.96 $205,349.01 $57,306.40 2026-02-14
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 36 34 — — $8,341.81 $76,548.17 $54,362.88 2026-02-14
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 36 34 — — $8,303.23 $159,643.33 $49,601.85 2026-02-14
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 36 34 — — $7,801.91 $74,212.95 $37,853.65 2026-02-14
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 36 34 — — $7,694.13 $99,472.98 $39,727.03 2026-02-14
L8614 HCPCS Cochlear Implant Dev/sys Lvl 1 192 41 $60,486.00 $45,364.50 25% off $7,640.14 $105,246.00 $42,249.47 2026-02-14
277 MS_DRG Cellulitis Age >17 W Cc 43 34 — — $7,571.47 $232,912.00 $40,430.76 2026-02-14
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 36 34 — — $7,548.50 $126,655.08 $48,155.07 2026-02-14
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 36 34 — — $7,483.66 $103,170.93 $40,775.04 2026-02-14
901 MS_DRG Wound Debridements For Injuries With Mcc 36 34 — — $7,242.74 $89,423.75 $37,148.38 2026-02-14
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 36 34 — — $7,240.06 $949,211.27 $143,551.26 2026-02-14
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 36 34 — — $7,102.50 $162,067.99 $40,268.85 2026-02-14
31 MS_DRG Ventricular Shunt Procedures With Mcc 36 34 — — $7,058.08 $123,249.83 $39,126.52 2026-02-14
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 36 34 — — $6,818.98 $85,899.38 $45,314.01 2026-02-14
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 36 34 — — $6,714.11 $195,923.00 $42,661.89 2026-02-14
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 36 34 — — $6,633.88 $230,149.08 $35,081.21 2026-02-14
14 MS_DRG Allogeneic Bone Marrow Transplant 36 34 — — $6,602.08 $226,879.83 $92,621.48 2026-02-14
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 36 34 — — $6,588.37 $174,696.12 $37,251.69 2026-02-14
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 36 34 — — $6,414.66 $108,884.06 $45,281.67 2026-02-14
C9760 HCPCS Non-blind Interatrial Shunt 107 53 — — $6,315.63 $72,037.56 $39,176.60 2026-02-14
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 2026-02-14
323 MS_DRG Urinary Stones W Cc, &/or Esw Lithotripsy 35 34 — — $5,937.16 $53,161.41 $37,759.24 2026-02-14
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 36 34 — — $5,835.46 $176,947.00 $50,079.43 2026-02-14
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 35 34 — — $5,767.19 $78,083.19 $57,261.73 2026-02-14
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 36 34 — — $5,392.10 $170,430.30 $40,182.76 2026-02-14
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 2026-02-14
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 36 34 — — $5,092.18 $85,527.73 $41,498.88 2026-02-14
278 MS_DRG Cellulitis Age >17 Without Cc 35 34 — — $4,110.82 $54,176.65 $45,598.68 2026-02-14
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 36 34 — — $3,741.64 $86,300.43 $34,694.29 2026-02-14
793 MS_DRG Full Term Neonate With Major Problems 36 34 — — $3,415.28 $74,264.57 $35,889.86 2026-02-14
791 MS_DRG Prematurity With Major Problems 36 34 — — $3,359.50 $72,296.87 $35,103.11 2026-02-14
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 36 34 — — $2,050.02 $105,855.09 $48,508.29 2026-02-14
J9269 HCPCS Elzonris 1000mcg/1ml Soln 132 58 $188,362.50 $141,271.88 25% off $356.93 $188,362.50 $81,711.65 2026-02-14
C9293 HCPCS Voraxaze 1000units/ml Soln 95 35 $117,450.00 $88,087.50 25% off $355.34 $117,450.00 $73,993.50 2026-02-14
J1744 HCPCS Firazyr 30mg/3ml Syr 98 44 $59,093.00 $44,319.75 25% off $224.02 $59,093.00 $38,410.45 2026-02-14
J3357 HCPCS Stelara 45mg Syrg 257 44 $81,333.00 $60,999.75 25% off $108.24 $162,665.50 $50,426.46 2026-02-14
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