Price Transparencybeta 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

ATRIUM HEALTH NAVICENT PEACH

Byron, GA · CCN 111310 · Rates published

9,087 distinct procedures filed
17 distinct payers
849,875 rate rows
2025-11-19 last MRF observed
Data quality

664,804 of 849,875 rate rows are consumer-grade (78.2%)

185,071 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
professional (physician) fee — not the facility price 184,248
percent-of-charges filed in the dollar field — excluded from medians 502
template filing: same amount across many unrelated codes — excluded 136
per-diem day rate — not a per-procedure price 115
placeholder amount (≤ $0.02) — excluded from medians 36
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 28
exceeds 10× this hospital's gross charge — excluded from medians 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/11182/453765471_the-medical-center-of-peach-county-inc_standardcharges.csv
Found on page https://navicenthealth.org/for-patients-and-visitors/pt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-11
Content fingerprint 5a40b2f7b89271e4… · 1,264,008,707 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J2326
HCPCS 		Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 17 $2,207.41 $1,378,686.64 $941,361.31 nat. median
$1,667
outlier · 564.8×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $367,247.25 $393,475.37 $367,247.25 nat. median
$168,055
outlier · 2.2×
J0801
HCPCS 		Corticotropin 80 Unit/ml Injection Gel 17 $97,516.86 $431,860.38 $294,872.41 nat. median
$4,547
outlier · 64.9×
C9293
HCPCS 		Glucarpidase 1,000 Unit Intravenous Solution 17 $728.60 $411,660.32 $281,079.90 nat. median
$57,284
outlier · 4.9×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $274,302.91 $293,893.11 $274,302.91 nat. median
$186,516
1.5× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 $231,012.63 $247,511.12 $231,012.63 nat. median
$131,925
1.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 2 $208,700.92 $223,605.96 $208,700.92 nat. median
$145,435
1.4× median
J9269
HCPCS 		Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution 17 $641.37 $290,438.12 $198,309.90 nat. median
$544
outlier · 364.7×
J9348
HCPCS 		Naxitamab-gqgk 4 Mg/ml Intravenous Solution 17 $1,152.41 $260,617.11 $177,948.24 nat. median
$720
outlier · 247.0×
J2350
HCPCS 		Ocrelizumab 30 Mg/ml Intravenous Solution 17 $122.11 $206,381.28 $140,916.25 nat. median
$133
outlier · 1059.8×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 2 $137,597.94 $147,424.93 $137,597.94 nat. median
$97,418
1.4× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 2 $127,585.33 $136,697.24 $127,585.33 nat. median
$72,715
1.8× median
7
MS_DRG 		Lung Transplant 2 $127,263.97 $136,352.93 $127,263.97 nat. median
$70,649
1.8× median
J9274
HCPCS 		Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution 17 $405.23 $176,225.70 $120,326.15 nat. median
$285
outlier · 422.2×
J9334
HCPCS 		Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11,200 Unit/5.6 Ml Subcut Soln 17 $36,319.70 $160,844.38 $109,823.85 nat. median
$45
outlier · 2423.8×
J9266
HCPCS 		Pegaspargase 750 Unit/ml Injection Solution 17 $36,143.69 $160,064.90 $109,291.62 nat. median
$31,084
outlier · 3.5×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 $107,309.84 $114,973.71 $107,309.84 nat. median
$65,418
1.6× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 2 $106,084.80 $113,661.18 $106,084.80 nat. median
$74,509
1.4× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 2 $103,703.86 $111,110.20 $103,703.86 nat. median
$69,922
1.5× median
J0202
HCPCS 		Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 17 $4,540.28 $151,777.40 $103,632.96 nat. median
$3,427
outlier · 30.2×
215
MS_DRG 		Other Heart Assist System Implant 2 $103,172.16 $110,540.53 $103,172.16 nat. median
$73,023
1.4× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $102,009.45 $109,294.77 $102,009.45 nat. median
$2,736
outlier · 37.3×
J1304
HCPCS 		Tofersen 100 Mg/15 Ml (6.7 Mg/ml) Intrathecal Solution 17 $32,284.85 $142,975.78 $97,623.25 nat. median
$172
outlier · 569.1×
J3357
HCPCS 		Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe 17 $293.55 $282,698.52 $96,512.76 nat. median
$20,264
outlier · 4.8×
J1305
HCPCS 		Evinacumab-dgnb 150 Mg/ml Intravenous Solution 17 $349.47 $421,741.79 $96,184.34 nat. median
$260
outlier · 370.0×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 $93,982.41 $100,694.46 $93,982.41 nat. median
$69,822
1.3× median
850
MS_DRG 		Acute Leukemia With Other Procedures 2 $89,705.48 $96,112.08 $89,705.48 nat. median
$2,633
outlier · 34.1×
J9298
HCPCS 		Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 17 $365.08 $130,112.72 $88,840.40 nat. median
$446
outlier · 199.0×
J9043
HCPCS 		Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 17 $409.61 $123,567.52 $84,371.37 nat. median
$509
outlier · 165.7×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 2 $82,518.84 $88,412.18 $82,518.84 nat. median
$60,505
1.4× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 $82,473.07 $88,363.14 $82,473.07 nat. median
$59,651
1.4× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 $81,220.76 $87,021.40 $81,220.76 nat. median
$2,596
outlier · 31.3×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 $78,498.99 $84,105.25 $78,498.99 nat. median
$56,428
1.4× median
10
MS_DRG 		Pancreas Transplant 2 $77,641.07 $83,186.06 $77,641.07 nat. median
$23,080
outlier · 3.4×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 $77,196.05 $82,709.25 $77,196.05 nat. median
$45,605
1.7× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 $76,116.10 $81,552.17 $76,116.10 nat. median
$55,935
1.4× median
J2329
HCPCS 		Ublituximab-xiiy 25 Mg/ml Intravenous Solution 17 $130.34 $111,095.52 $75,855.54 nat. median
$116
outlier · 655.1×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 $75,347.78 $80,728.97 $75,347.78 nat. median
$55,923
1.3× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 $72,686.38 $77,877.51 $72,686.38 nat. median
$52,327
1.4× median
J9382
HCPCS 		Zenocutuzumab-zbco 375 Mg/18.75 Ml (20 Mg/ml) Intravenous Solution 17 $23,077.68 $204,355.97 $69,782.50 nat. median
$37
outlier · 1873.4×
J2840
HCPCS 		Sebelipase Alfa 2 Mg/ml Intravenous Solution 17 $1,014.92 $102,097.73 $69,711.89 nat. median
$742
outlier · 94.0×
J9272
HCPCS 		Dostarlimab-gxly 50 Mg/ml Intravenous Solution 17 $451.16 $101,507.69 $69,309.01 nat. median
$567
outlier · 122.3×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $69,166.09 $74,105.81 $69,166.09 nat. median
$9,905
outlier · 7.0×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 $68,818.45 $73,733.33 $68,818.45 nat. median
$51,518
1.3× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 2 $67,742.40 $72,580.43 $67,742.40 nat. median
$48,611
1.4× median
J9228
HCPCS 		Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 17 $333.86 $305,510.30 $67,358.74 nat. median
$6,073
outlier · 11.1×
J0222
HCPCS 		Patisiran (lipid Complex) 2 Mg/ml Intravenous Solution 17 $199.74 $97,848.79 $66,810.74 nat. median
$122
outlier · 548.5×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 2 $66,493.99 $71,242.86 $66,493.99 nat. median
$47,340
1.4× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 $65,290.37 $69,953.29 $65,290.37 nat. median
$2,958
outlier · 22.1×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 $65,039.13 $69,684.10 $65,039.13 nat. median
$37,013
1.8× median

Other procedures at this hospital

Browse this hospital's 9,087 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
J2326 HCPCS Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 40 17 $1,482,458.75 $741,229.38 50% off $2,207.41 $1,378,686.64 $941,361.31 2025-11-19
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 2 — — $367,247.25 $393,475.37 $367,247.25 2025-11-19
J0801 HCPCS Corticotropin 80 Unit/ml Injection Gel 40 17 $464,366.00 $232,183.00 50% off $97,516.86 $431,860.38 $294,872.41 2025-11-19
C9293 HCPCS Glucarpidase 1,000 Unit Intravenous Solution 40 17 $442,645.50 $221,322.75 50% off $728.60 $411,660.32 $281,079.90 2025-11-19
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 3 2 — — $274,302.91 $293,893.11 $274,302.91 2025-11-19
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 2 — — $231,012.63 $247,511.12 $231,012.63 2025-11-19
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 3 2 — — $208,700.92 $223,605.96 $208,700.92 2025-11-19
J9269 HCPCS Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution 40 17 $312,299.05 $156,149.53 50% off $641.37 $290,438.12 $198,309.90 2025-11-19
J9348 HCPCS Naxitamab-gqgk 4 Mg/ml Intravenous Solution 40 17 $280,233.45 $140,116.73 50% off $1,152.41 $260,617.11 $177,948.24 2025-11-19
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 40 17 $221,915.35 $110,957.68 50% off $122.11 $206,381.28 $140,916.25 2025-11-19
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 3 2 — — $137,597.94 $147,424.93 $137,597.94 2025-11-19
14 MS_DRG Allogeneic Bone Marrow Transplant 3 2 — — $127,585.33 $136,697.24 $127,585.33 2025-11-19
7 MS_DRG Lung Transplant 3 2 — — $127,263.97 $136,352.93 $127,263.97 2025-11-19
J9274 HCPCS Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution 40 17 $189,490.00 $94,745.00 50% off $405.23 $176,225.70 $120,326.15 2025-11-19
J9334 HCPCS Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11,200 Unit/5.6 Ml Subcut Soln 40 17 $172,950.95 $86,475.48 50% off $36,319.70 $160,844.38 $109,823.85 2025-11-19
J9266 HCPCS Pegaspargase 750 Unit/ml Injection Solution 40 17 $172,112.80 $86,056.40 50% off $36,143.69 $160,064.90 $109,291.62 2025-11-19
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 2 — — $107,309.84 $114,973.71 $107,309.84 2025-11-19
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 3 2 — — $106,084.80 $113,661.18 $106,084.80 2025-11-19
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 3 2 — — $103,703.86 $111,110.20 $103,703.86 2025-11-19
J0202 HCPCS Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 40 17 $163,201.50 $81,600.75 50% off $4,540.28 $151,777.40 $103,632.96 2025-11-19
215 MS_DRG Other Heart Assist System Implant 3 2 — — $103,172.16 $110,540.53 $103,172.16 2025-11-19
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $102,009.45 $109,294.77 $102,009.45 2025-11-19
J1304 HCPCS Tofersen 100 Mg/15 Ml (6.7 Mg/ml) Intrathecal Solution 40 17 $153,737.40 $76,868.70 50% off $32,284.85 $142,975.78 $97,623.25 2025-11-19
J3357 HCPCS Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe 66 17 $151,988.60 $75,994.30 50% off $293.55 $282,698.52 $96,512.76 2025-11-19
J1305 HCPCS Evinacumab-dgnb 150 Mg/ml Intravenous Solution 66 17 $291,940.40 $145,970.20 50% off $349.47 $421,741.79 $96,184.34 2025-11-19
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 2 — — $93,982.41 $100,694.46 $93,982.41 2025-11-19
850 MS_DRG Acute Leukemia With Other Procedures 3 2 — — $89,705.48 $96,112.08 $89,705.48 2025-11-19
J9298 HCPCS Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 40 17 $139,906.15 $69,953.08 50% off $365.08 $130,112.72 $88,840.40 2025-11-19
J9043 HCPCS Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 40 17 $132,868.30 $66,434.15 50% off $409.61 $123,567.52 $84,371.37 2025-11-19
231 MS_DRG Coronary Bypass With Ptca With Mcc 3 2 — — $82,518.84 $88,412.18 $82,518.84 2025-11-19
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 2 — — $82,473.07 $88,363.14 $82,473.07 2025-11-19
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 2 — — $81,220.76 $87,021.40 $81,220.76 2025-11-19
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 2 — — $78,498.99 $84,105.25 $78,498.99 2025-11-19
10 MS_DRG Pancreas Transplant 3 2 — — $77,641.07 $83,186.06 $77,641.07 2025-11-19
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 2 — — $77,196.05 $82,709.25 $77,196.05 2025-11-19
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 3 2 — — $76,116.10 $81,552.17 $76,116.10 2025-11-19
J2329 HCPCS Ublituximab-xiiy 25 Mg/ml Intravenous Solution 40 17 $119,457.55 $59,728.78 50% off $130.34 $111,095.52 $75,855.54 2025-11-19
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $75,347.78 $80,728.97 $75,347.78 2025-11-19
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 2 — — $72,686.38 $77,877.51 $72,686.38 2025-11-19
J9382 HCPCS Zenocutuzumab-zbco 375 Mg/18.75 Ml (20 Mg/ml) Intravenous Solution 68 17 $109,893.70 $54,946.85 50% off $23,077.68 $204,355.97 $69,782.50 2025-11-19
J2840 HCPCS Sebelipase Alfa 2 Mg/ml Intravenous Solution 40 17 $109,782.50 $54,891.25 50% off $1,014.92 $102,097.73 $69,711.89 2025-11-19
J9272 HCPCS Dostarlimab-gxly 50 Mg/ml Intravenous Solution 40 17 $109,148.05 $54,574.03 50% off $451.16 $101,507.69 $69,309.01 2025-11-19
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $69,166.09 $74,105.81 $69,166.09 2025-11-19
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 3 2 — — $68,818.45 $73,733.33 $68,818.45 2025-11-19
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 3 2 — — $67,742.40 $72,580.43 $67,742.40 2025-11-19
J9228 HCPCS Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 66 17 $82,164.10 $41,082.05 50% off $333.86 $305,510.30 $67,358.74 2025-11-19
J0222 HCPCS Patisiran (lipid Complex) 2 Mg/ml Intravenous Solution 40 17 $105,213.75 $52,606.88 50% off $199.74 $97,848.79 $66,810.74 2025-11-19
955 MS_DRG Craniotomy For Multiple Significant Trauma 3 2 — — $66,493.99 $71,242.86 $66,493.99 2025-11-19
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 3 2 — — $65,290.37 $69,953.29 $65,290.37 2025-11-19
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 3 2 — — $65,039.13 $69,684.10 $65,039.13 2025-11-19
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 2 — — $64,929.09 $69,566.20 $64,929.09 2025-11-19
J3263 HCPCS Toripalimab-tpzi 240 Mg/6 Ml (40 Mg/ml) Intravenous Solution 40 17 $99,929.55 $49,964.78 50% off $20,985.21 $92,934.48 $63,455.26 2025-11-19
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 3 2 — — $62,977.59 $67,475.34 $62,977.59 2025-11-19
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 2 — — $62,887.03 $67,378.31 $62,887.03 2025-11-19
J9119 HCPCS Cemiplimab-rwlc 50 Mg/ml Intravenous Solution 40 17 $98,162.55 $49,081.28 50% off $53.52 $91,291.17 $62,333.22 2025-11-19
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 3 2 — — $61,586.03 $65,984.39 $61,586.03 2025-11-19
J9210 HCPCS Emapalumab-lzsg 5 Mg/ml Intravenous Solution 66 17 $217,443.23 $108,721.61 50% off $782.76 $337,639.85 $61,057.92 2025-11-19
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 3 2 — — $60,321.07 $64,629.09 $60,321.07 2025-11-19
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 3 2 — — $60,243.16 $64,545.62 $60,243.16 2025-11-19
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 2 — — $59,968.55 $64,251.39 $59,968.55 2025-11-19
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 3 2 — — $59,759.18 $64,027.08 $59,759.18 2025-11-19
232 MS_DRG Coronary Bypass With Ptca Without Mcc 3 2 — — $59,486.52 $63,734.94 $59,486.52 2025-11-19
28 MS_DRG Spinal Procedures With Mcc 3 2 — — $59,202.17 $63,430.28 $59,202.17 2025-11-19
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 3 2 — — $58,777.59 $62,975.38 $58,777.59 2025-11-19
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 3 2 — — $58,777.59 $62,975.38 $58,777.59 2025-11-19
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 2 — — $58,338.41 $62,504.83 $58,338.41 2025-11-19
J2323 HCPCS Natalizumab 300 Mg/15 Ml Intravenous Solution 40 17 $91,805.45 $45,902.73 50% off $49.42 $85,379.07 $58,296.46 2025-11-19
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 2 — — $57,934.28 $62,071.84 $57,934.28 2025-11-19
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 3 2 — — $57,890.46 $62,024.89 $57,890.46 2025-11-19
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 3 2 — — $57,300.34 $61,392.62 $57,300.34 2025-11-19
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 2 — — $56,697.56 $60,746.79 $56,697.56 2025-11-19
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 2 — — $55,890.28 $59,881.86 $55,890.28 2025-11-19
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $55,556.26 $59,523.99 $55,556.26 2025-11-19
653 MS_DRG Major Bladder Procedures With Mcc 3 2 — — $54,285.45 $58,162.42 $54,285.45 2025-11-19
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 2 — — $53,824.85 $57,668.92 $53,824.85 2025-11-19
834 MS_DRG Acute Leukemia With Mcc 3 2 — — $53,824.85 $57,668.92 $53,824.85 2025-11-19
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $53,598.93 $57,426.86 $53,598.93 2025-11-19
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 2 — — $53,271.73 $57,076.30 $53,271.73 2025-11-19
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 3 2 — — $52,985.43 $56,769.55 $52,985.43 2025-11-19
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 3 2 — — $52,864.68 $56,640.18 $52,864.68 2025-11-19
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 2 — — $52,594.94 $56,351.17 $52,594.94 2025-11-19
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 3 2 — — $52,545.27 $56,297.96 $52,545.27 2025-11-19
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 2 — — $52,539.43 $56,291.70 $52,539.43 2025-11-19
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 3 2 — — $51,808.11 $55,508.15 $51,808.11 2025-11-19
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $51,579.26 $55,262.96 $51,579.26 2025-11-19
J9301 HCPCS Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution 40 17 $79,717.70 $39,858.85 50% off $140.27 $74,137.46 $50,620.74 2025-11-19
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 3 2 — — $50,151.67 $53,733.41 $50,151.67 2025-11-19
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 2 — — $49,985.15 $53,555.00 $49,985.15 2025-11-19
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 3 2 — — $49,611.21 $53,154.36 $49,611.21 2025-11-19
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 3 2 — — $49,459.30 $52,991.59 $49,459.30 2025-11-19
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 2 — — $49,049.33 $52,552.35 $49,049.33 2025-11-19
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 3 2 — — $48,760.11 $52,242.47 $48,760.11 2025-11-19
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 2 — — $48,722.14 $52,201.78 $48,722.14 2025-11-19
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 2 — — $48,702.66 $52,180.91 $48,702.66 2025-11-19
228 MS_DRG Other Cardiothoracic Procedures With Mcc 3 2 — — $48,527.38 $51,993.11 $48,527.38 2025-11-19
245 MS_DRG Aicd Generator Procedures 3 2 — — $47,587.66 $50,986.28 $47,587.66 2025-11-19
471 MS_DRG Cervical Spinal Fusion With Mcc 3 2 — — $47,300.39 $50,678.49 $47,300.39 2025-11-19
6 MS_DRG Liver Transplant Without Mcc 3 2 — — $47,221.51 $50,593.98 $47,221.51 2025-11-19
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 2 — — $46,503.82 $49,825.04 $46,503.82 2025-11-19
799 MS_DRG Splenic Procedures With Mcc 3 2 — — $46,302.24 $49,609.06 $46,302.24 2025-11-19
J9022 HCPCS Atezolizumab 1,200 Mg/20 Ml (60 Mg/ml) Intravenous Solution 66 17 $104,129.35 $52,064.68 50% off $164.38 $96,840.30 $46,295.03 2025-11-19
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 2 — — $46,293.48 $49,599.67 $46,293.48 2025-11-19
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 3 2 — — $45,814.37 $49,086.35 $45,814.37 2025-11-19
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 2 — — $45,568.97 $48,823.42 $45,568.97 2025-11-19
J9333 HCPCS Rozanolixizumab-noli 140 Mg/ml Subcutaneous Solution 68 17 $131,726.00 $65,863.01 50% off $13,833.87 $183,746.10 $45,388.26 2025-11-19
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 3 2 — — $45,300.20 $48,535.46 $45,300.20 2025-11-19
J9063 HCPCS Mirvetuximab Soravtansine-gynx 5 Mg/ml Intravenous Solution 40 17 $71,331.05 $35,665.53 50% off $130.82 $66,337.88 $45,295.22 2025-11-19
163 MS_DRG Major Chest Procedures With Mcc 3 2 — — $44,884.39 $48,089.95 $44,884.39 2025-11-19
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 3 2 — — $44,865.89 $48,070.13 $44,865.89 2025-11-19
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $44,722.74 $47,916.75 $44,722.74 2025-11-19
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 2 — — $44,715.92 $47,909.45 $44,715.92 2025-11-19
J1323 HCPCS Elranatamab-bcmm 40 Mg/ml Subcutaneous Solution 68 17 $69,940.05 $34,970.03 50% off $14,687.41 $112,315.36 $44,411.93 2025-11-19
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 3 2 — — $43,933.96 $47,071.64 $43,933.96 2025-11-19
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 3 2 — — $43,672.01 $46,790.98 $43,672.01 2025-11-19
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 2 — — $43,551.26 $46,661.61 $43,551.26 2025-11-19
901 MS_DRG Wound Debridements For Injuries With Mcc 3 2 — — $43,144.21 $46,225.49 $43,144.21 2025-11-19
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 2 — — $42,777.09 $45,832.15 $42,777.09 2025-11-19
J9332 HCPCS Efgartigimod Alfa-fcab 20 Mg/ml Intravenous Solution 40 17 $66,571.60 $33,285.80 50% off $63.24 $61,911.59 $42,272.96 2025-11-19
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 3 2 — — $42,135.35 $45,144.58 $42,135.35 2025-11-19
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 2 — — $42,048.68 $45,051.72 $42,048.68 2025-11-19
J1930 HCPCS Lanreotide 60 Mg/0.2 Ml Subcutaneous Syringe 92 17 $87,161.05 $43,580.53 50% off $107.71 $95,596.10 $41,558.21 2025-11-19
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 2 — — $41,539.39 $44,506.05 $41,539.39 2025-11-19
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 3 2 — — $41,478.04 $44,440.32 $41,478.04 2025-11-19
140 MS_DRG Major Head And Neck Procedures With Mcc 3 2 — — $41,183.95 $44,125.23 $41,183.95 2025-11-19
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 2 — — $40,808.06 $43,722.50 $40,808.06 2025-11-19
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 2 — — $40,798.32 $43,712.07 $40,798.32 2025-11-19
793 MS_DRG Full Term Neonate With Major Problems 3 2 — — $40,612.33 $43,512.79 $40,612.33 2025-11-19
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 2 — — $40,516.90 $43,410.54 $40,516.90 2025-11-19
J9306 HCPCS Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution 40 17 $63,139.60 $31,569.80 50% off $30.55 $58,719.83 $40,093.64 2025-11-19
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 3 2 — — $40,043.63 $42,903.47 $40,043.63 2025-11-19
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 2 — — $40,021.23 $42,879.48 $40,021.23 2025-11-19
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 3 2 — — $39,961.83 $42,815.83 $39,961.83 2025-11-19
J9307 HCPCS Pralatrexate 20 Mg/ml (1 Ml) Intravenous Solution 118 17 $67,912.00 $33,956.00 50% off $708.78 $126,269.82 $39,899.97 2025-11-19
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $39,765.12 $42,605.07 $39,765.12 2025-11-19
J1932 HCPCS Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe 40 17 $62,611.80 $31,305.90 50% off $102.15 $58,228.97 $39,758.49 2025-11-19
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 2 — — $39,608.34 $42,437.10 $39,608.34 2025-11-19
791 MS_DRG Prematurity With Major Problems 3 2 — — $39,535.31 $42,358.84 $39,535.31 2025-11-19
J1303 HCPCS Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 66 17 $50,648.65 $25,324.33 50% off $441.12 $172,649.80 $38,985.44 2025-11-19
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 3 2 — — $38,793.27 $41,563.81 $38,793.27 2025-11-19
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 3 2 — — $38,766.00 $41,534.60 $38,766.00 2025-11-19
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 3 2 — — $38,423.23 $41,167.34 $38,423.23 2025-11-19
J1299 HCPCS Eculizumab 300 Mg/30 Ml Intravenous Solution 40 17 $60,387.70 $30,193.85 50% off $12,681.42 $56,160.56 $38,346.19 2025-11-19
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 3 2 — — $38,344.35 $41,082.83 $38,344.35 2025-11-19
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 3 2 — — $38,266.44 $40,999.36 $38,266.44 2025-11-19
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 2 — — $38,097.00 $40,817.82 $38,097.00 2025-11-19
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 3 2 — — $38,078.50 $40,798.00 $38,078.50 2025-11-19
34 MS_DRG Carotid Artery Stent Procedures With Mcc 3 2 — — $37,868.16 $40,572.63 $37,868.16 2025-11-19
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 3 2 — — $37,637.37 $40,325.36 $37,637.37 2025-11-19
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 3 2 — — $37,599.39 $40,284.67 $37,599.39 2025-11-19
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 3 2 — — $37,494.22 $40,171.99 $37,494.22 2025-11-19
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 2 — — $37,222.53 $39,880.90 $37,222.53 2025-11-19
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $37,020.95 $39,664.92 $37,020.95 2025-11-19
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 3 2 — — $36,732.71 $39,356.09 $36,732.71 2025-11-19
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 3 2 — — $36,439.60 $39,042.04 $36,439.60 2025-11-19
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 2 — — $35,531.04 $38,068.60 $35,531.04 2025-11-19
J0517 HCPCS Benralizumab 30 Mg/ml Subcutaneous Syringe 40 17 $55,627.40 $27,813.70 50% off $339.82 $51,733.48 $35,323.40 2025-11-19
335 MS_DRG Peritoneal Adhesiolysis With Mcc 3 2 — — $35,284.67 $37,804.64 $35,284.67 2025-11-19
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 3 2 — — $34,908.78 $37,401.90 $34,908.78 2025-11-19
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 3 2 — — $34,906.83 $37,399.82 $34,906.83 2025-11-19
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 3 2 — — $34,900.99 $37,393.56 $34,900.99 2025-11-19
265 MS_DRG Aicd Lead Procedures 3 2 — — $34,737.39 $37,218.27 $34,737.39 2025-11-19
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 3 2 — — $34,581.59 $37,051.34 $34,581.59 2025-11-19
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 3 2 — — $34,379.04 $36,834.32 $34,379.04 2025-11-19
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 2 — — $34,370.27 $36,824.93 $34,370.27 2025-11-19
J2267 HCPCS Mirikizumab-mrkz 100 Mg/ml Subcutaneous Pen Injector 68 17 $54,058.35 $27,029.18 50% off $11,352.25 $95,931.50 $34,327.06 2025-11-19
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 2 — — $34,283.60 $36,732.07 $34,283.60 2025-11-19
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 3 2 — — $34,120.00 $36,556.79 $34,120.00 2025-11-19
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 2 — — $34,109.29 $36,545.32 $34,109.29 2025-11-19
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 2 — — $34,095.66 $36,530.71 $34,095.66 2025-11-19
264 MS_DRG Other Circulatory System O.r. Procedures 3 2 — — $34,035.28 $36,466.02 $34,035.28 2025-11-19
J9271 HCPCS Pembrolizumab 25 Mg/ml Intravenous Solution 40 17 $53,534.25 $26,767.13 50% off $108.96 $49,786.85 $33,994.25 2025-11-19
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 3 2 — — $33,815.21 $36,230.22 $33,815.21 2025-11-19
332 MS_DRG Rectal Resection With Mcc 3 2 — — $33,778.20 $36,190.58 $33,778.20 2025-11-19
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 3 2 — — $33,741.20 $36,150.93 $33,741.20 2025-11-19
271 MS_DRG Other Major Cardiovascular Procedures With Cc 3 2 — — $33,541.57 $35,937.04 $33,541.57 2025-11-19
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 3 2 — — $33,488.98 $35,880.70 $33,488.98 2025-11-19
665 MS_DRG Prostatectomy With Mcc 3 2 — — $33,436.40 $35,824.36 $33,436.40 2025-11-19
252 MS_DRG Other Vascular Procedures With Mcc 3 2 — — $33,405.24 $35,790.98 $33,405.24 2025-11-19
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 3 2 — — $33,354.60 $35,736.72 $33,354.60 2025-11-19
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 3 2 — — $33,169.58 $35,538.49 $33,169.58 2025-11-19
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 3 2 — — $33,031.30 $35,390.33 $33,031.30 2025-11-19
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 3 2 — — $32,687.54 $35,022.03 $32,687.54 2025-11-19
J9038 HCPCS Axatilimab-csfr 50 Mg/ml Intravenous Solution 68 17 $50,818.75 $25,409.38 50% off $10,671.94 $115,494.38 $32,651.05 2025-11-19
37 MS_DRG Extracranial Procedures With Mcc 3 2 — — $32,338.92 $34,648.51 $32,338.92 2025-11-19
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 3 2 — — $32,153.90 $34,450.27 $32,153.90 2025-11-19
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 3 2 — — $31,830.60 $34,103.88 $31,830.60 2025-11-19
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 3 2 — — $31,740.04 $34,006.85 $31,740.04 2025-11-19
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 3 2 — — $31,726.40 $33,992.25 $31,726.40 2025-11-19
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 3 2 — — $31,349.54 $33,588.47 $31,349.54 2025-11-19
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 2 — — $31,204.45 $33,433.01 $31,204.45 2025-11-19
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 3 2 — — $31,113.88 $33,335.98 $31,113.88 2025-11-19
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 3 2 — — $31,054.48 $33,272.34 $31,054.48 2025-11-19
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 3 2 — — $30,970.74 $33,182.61 $30,970.74 2025-11-19
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 3 2 — — $30,908.41 $33,115.83 $30,908.41 2025-11-19
500 MS_DRG Soft Tissue Procedures With Mcc 3 2 — — $30,856.80 $33,060.54 $30,856.80 2025-11-19
J2506 HCPCS Pegfilgrastim 6 Mg/0.6 Ml (deliverable) Wearable Subcutaneous Injector 40 17 $48,331.50 $24,165.75 50% off $170.40 $44,948.30 $30,690.51 2025-11-19
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 3 2 — — $30,392.30 $32,562.86 $30,392.30 2025-11-19
662 MS_DRG Minor Bladder Procedures With Mcc 3 2 — — $30,378.66 $32,548.25 $30,378.66 2025-11-19
A9517 HCPCS Sodium Iodide-131 (i-131) 500 Mci/0.5 Ml Oral Kit (therapeutic) 41 17 $42,187.50 $21,093.75 50% off $8,859.38 $39,234.38 $30,375.01 2025-11-19
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 3 2 — — $30,249.15 $32,409.49 $30,249.15 2025-11-19
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 3 2 — — $30,113.79 $32,264.46 $30,113.79 2025-11-19
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $30,051.47 $32,197.69 $30,051.47 2025-11-19
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 3 2 — — $30,030.04 $32,174.73 $30,030.04 2025-11-19
652 MS_DRG Kidney Transplant 3 2 — — $29,909.29 $32,045.36 $29,909.29 2025-11-19
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 3 2 — — $29,882.03 $32,016.15 $29,882.03 2025-11-19
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 3 2 — — $29,784.65 $31,911.81 $29,784.65 2025-11-19
570 MS_DRG Skin Debridement With Mcc 3 2 — — $29,313.33 $31,406.83 $29,313.33 2025-11-19
974 MS_DRG HIV With Major Related Condition With Mcc 3 2 — — $29,079.62 $31,156.43 $29,079.62 2025-11-19
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 2 — — $28,713.47 $30,764.13 $28,713.47 2025-11-19
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 3 2 — — $28,639.46 $30,684.84 $28,639.46 2025-11-19
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 3 2 — — $28,561.55 $30,601.37 $28,561.55 2025-11-19
J0584 HCPCS Burosumab-twza 30 Mg/ml Subcutaneous Solution 92 17 $66,891.90 $33,445.95 50% off $847.07 $93,723.31 $28,543.47 2025-11-19
668 MS_DRG Transurethral Procedures With Mcc 3 2 — — $28,398.93 $30,427.13 $28,398.93 2025-11-19
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 3 2 — — $28,383.35 $30,410.44 $28,383.35 2025-11-19
800 MS_DRG Splenic Procedures With Cc 3 2 — — $28,374.58 $30,401.04 $28,374.58 2025-11-19
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 3 2 — — $28,359.00 $30,384.35 $28,359.00 2025-11-19
472 MS_DRG Cervical Spinal Fusion With Cc 3 2 — — $28,212.93 $30,227.85 $28,212.93 2025-11-19
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 3 2 — — $27,919.82 $29,913.80 $27,919.82 2025-11-19
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 3 2 — — $27,887.68 $29,879.37 $27,887.68 2025-11-19
J9347 HCPCS Tremelimumab-actl 20 Mg/ml Intravenous Solution 66 17 $375,374.30 $187,687.15 50% off $271.50 $349,098.10 $27,881.08 2025-11-19
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 3 2 — — $27,871.13 $29,861.63 $27,871.13 2025-11-19
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 3 2 — — $27,832.18 $29,819.90 $27,832.18 2025-11-19
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 3 2 — — $27,722.14 $29,702.00 $27,722.14 2025-11-19
J9204 HCPCS Mogamulizumab-kpkc 4 Mg/ml Intravenous Solution 40 17 $43,419.75 $21,709.88 50% off $450.72 $40,380.37 $27,571.54 2025-11-19
654 MS_DRG Major Bladder Procedures With Cc 3 2 — — $27,481.61 $29,444.30 $27,481.61 2025-11-19
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 3 2 — — $27,348.20 $29,301.36 $27,348.20 2025-11-19
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 3 2 — — $27,319.96 $29,271.10 $27,319.96 2025-11-19
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 3 2 — — $26,647.06 $28,550.15 $26,647.06 2025-11-19
288 MS_DRG Acute And Subacute Endocarditis With Mcc 3 2 — — $26,599.35 $28,499.02 $26,599.35 2025-11-19
619 MS_DRG O.r. Procedures For Obesity With Mcc 3 2 — — $26,550.66 $28,446.86 $26,550.66 2025-11-19
963 MS_DRG Other Multiple Significant Trauma With Mcc 3 2 — — $26,455.22 $28,344.61 $26,455.22 2025-11-19
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 3 2 — — $26,325.71 $28,205.84 $26,325.71 2025-11-19
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 3 2 — — $26,239.04 $28,112.98 $26,239.04 2025-11-19
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 3 2 — — $26,134.84 $28,001.35 $26,134.84 2025-11-19
263 MS_DRG Vein Ligation And Stripping 3 2 — — $26,118.29 $27,983.61 $26,118.29 2025-11-19
849 MS_DRG Radiotherapy 3 2 — — $26,011.17 $27,868.84 $26,011.17 2025-11-19
J0565 HCPCS Bezlotoxumab 25 Mg/ml Intravenous Solution 40 17 $40,874.60 $20,437.30 50% off $79.23 $38,013.38 $25,955.37 2025-11-19
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 3 2 — — $25,930.35 $27,782.24 $25,930.35 2025-11-19
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 3 2 — — $25,837.84 $27,683.13 $25,837.84 2025-11-19
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 3 2 — — $25,805.70 $27,648.70 $25,805.70 2025-11-19
503 MS_DRG Foot Procedures With Mcc 3 2 — — $25,772.59 $27,613.22 $25,772.59 2025-11-19
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 3 2 — — $25,746.30 $27,585.05 $25,746.30 2025-11-19
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 3 2 — — $25,545.70 $27,370.12 $25,545.70 2025-11-19
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 3 2 — — $25,479.48 $27,299.17 $25,479.48 2025-11-19
J3110 HCPCS Teriparatide 20 Mcg/dose (560 Mcg/2.24 Ml) Subcutaneous Pen Injector 40 17 $39,792.20 $19,896.10 50% off $104.16 $37,006.75 $25,268.05 2025-11-19
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 3 2 — — $25,207.79 $27,008.08 $25,207.79 2025-11-19
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 3 2 — — $25,165.91 $26,963.22 $25,165.91 2025-11-19
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 3 2 — — $24,868.90 $26,645.00 $24,868.90 2025-11-19
253 MS_DRG Other Vascular Procedures With Cc 3 2 — — $24,861.11 $26,636.65 $24,861.11 2025-11-19
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 3 2 — — $24,814.37 $26,586.57 $24,814.37 2025-11-19
C9482 HCPCS Sotalol 150 Mg/10 Ml (15 Mg/ml) Intravenous Solution 40 17 $38,972.25 $19,486.13 50% off $39.75 $36,244.19 $24,747.38 2025-11-19
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 3 2 — — $24,686.80 $26,449.89 $24,686.80 2025-11-19
545 MS_DRG Connective Tissue Disorders With Mcc 3 2 — — $24,606.95 $26,364.34 $24,606.95 2025-11-19
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 3 2 — — $24,587.48 $26,343.47 $24,587.48 2025-11-19
164 MS_DRG Major Chest Procedures With Cc 3 2 — — $24,510.55 $26,261.04 $24,510.55 2025-11-19
56 MS_DRG Degenerative Nervous System Disorders With Mcc 3 2 — — $24,384.93 $26,126.45 $24,384.93 2025-11-19
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 3 2 — — $24,366.42 $26,106.63 $24,366.42 2025-11-19
397 MS_DRG Appendix Procedures With Mcc 3 2 — — $24,128.82 $25,852.05 $24,128.82 2025-11-19
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 3 2 — — $24,031.44 $25,747.72 $24,031.44 2025-11-19
J2427 HCPCS Paliperidone Palmitate (3 Month) 273 Mg/0.88 Ml Intramuscular Syringe 118 17 $54,708.70 $27,354.35 50% off $24.08 $101,759.58 $23,935.06 2025-11-19
792 MS_DRG Prematurity Without Major Problems 3 2 — — $23,855.18 $25,558.87 $23,855.18 2025-11-19
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 3 2 — — $23,841.55 $25,544.26 $23,841.55 2025-11-19
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 3 2 — — $23,644.84 $25,333.51 $23,644.84 2025-11-19
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 3 2 — — $23,553.30 $25,235.43 $23,553.30 2025-11-19
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 3 2 — — $23,479.29 $25,156.14 $23,479.29 2025-11-19
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 3 2 — — $23,380.94 $25,050.76 $23,380.94 2025-11-19
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 3 2 — — $23,343.93 $25,011.11 $23,343.93 2025-11-19
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 3 2 — — $23,343.93 $25,011.11 $23,343.93 2025-11-19
J1306 HCPCS Inclisiran 284 Mg/1.5 Ml Subcutaneous Syringe 40 17 $36,713.85 $18,356.93 50% off $23.97 $34,143.88 $23,313.29 2025-11-19
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 3 2 — — $23,142.36 $24,795.14 $23,142.36 2025-11-19
J0739 HCPCS Cabotegravir ER 600 Mg/3 Ml (200 Mg/ml) IM Suspension,extended Release 66 17 $36,517.30 $18,258.65 50% off $12.45 $40,265.42 $23,097.19 2025-11-19
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 3 2 — — $23,053.74 $24,700.20 $23,053.74 2025-11-19
347 MS_DRG Anal And Stomal Procedures With Mcc 3 2 — — $23,047.90 $24,693.94 $23,047.90 2025-11-19
330 MS_DRG Major Small And Large Bowel Procedures With Cc 3 2 — — $23,017.71 $24,661.59 $23,017.71 2025-11-19
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 2 — — $22,980.71 $24,621.95 $22,980.71 2025-11-19
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 3 2 — — $22,773.29 $24,399.71 $22,773.29 2025-11-19
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 3 2 — — $22,594.11 $24,207.74 $22,594.11 2025-11-19
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 3 2 — — $22,541.52 $24,151.40 $22,541.52 2025-11-19
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 3 2 — — $22,520.10 $24,128.44 $22,520.10 2025-11-19
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 3 2 — — $22,479.20 $24,084.62 $22,479.20 2025-11-19
J9061 HCPCS Amivantamab-vmjw 50 Mg/ml Intravenous Solution 40 17 $35,261.80 $17,630.90 50% off $39.03 $32,793.47 $22,391.24 2025-11-19
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 3 2 — — $22,339.95 $23,935.42 $22,339.95 2025-11-19
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 3 2 — — $22,302.94 $23,895.78 $22,302.94 2025-11-19
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 3 2 — — $22,234.78 $23,822.74 $22,234.78 2025-11-19
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 3 2 — — $22,192.90 $23,777.88 $22,192.90 2025-11-19
35 MS_DRG Carotid Artery Stent Procedures With Cc 3 2 — — $22,152.00 $23,734.06 $22,152.00 2025-11-19
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 3 2 — — $22,066.31 $23,642.24 $22,066.31 2025-11-19
J1743 HCPCS Idursulfase 6 Mg/3 Ml Intravenous Solution 40 17 $34,746.45 $17,373.23 50% off $1,079.38 $32,314.20 $22,063.99 2025-11-19
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 3 2 — — $21,991.33 $23,561.91 $21,991.33 2025-11-19
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 3 2 — — $21,990.35 $23,560.86 $21,990.35 2025-11-19
113 MS_DRG Orbital Procedures With Cc/mcc 3 2 — — $21,974.77 $23,544.17 $21,974.77 2025-11-19
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 3 2 — — $21,937.77 $23,504.52 $21,937.77 2025-11-19
357 MS_DRG Other Digestive System O.r. Procedures With Cc 3 2 — — $21,929.98 $23,496.17 $21,929.98 2025-11-19
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 3 2 — — $21,901.74 $23,465.92 $21,901.74 2025-11-19
709 MS_DRG Penis Procedures With Cc/mcc 3 2 — — $21,882.26 $23,445.05 $21,882.26 2025-11-19
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 3 2 — — $21,739.11 $23,291.68 $21,739.11 2025-11-19
30 MS_DRG Spinal Procedures Without Cc/mcc 3 2 — — $21,670.95 $23,218.64 $21,670.95 2025-11-19
J7504 HCPCS Lymphocyte,anti-thymo Immune Globulin 50 Mg/ml Intravenous Solution 40 17 $34,090.40 $17,045.20 50% off $5,943.31 $31,704.07 $21,647.40 2025-11-19
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 3 2 — — $21,553.12 $23,092.40 $21,553.12 2025-11-19
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 3 2 — — $21,417.76 $22,947.37 $21,417.76 2025-11-19
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