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

KAISER FOUNDATION HOSPITAL

Honolulu, HI · CCN 120011 · Rates published

Your selected procedure

You selected 93306 (CPT)

ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D

This hospital’s price: $404 across 1 payer · range $367-$1,211

Source: https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/health-plan-documents/coverage-information/machine-readable/941105628-moanalua-medical-center-standard-charges-hi-en.csv · observed 2026-07-15

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

15,806 distinct procedures filed
4 distinct payers
139,815 rate rows
2026-07-30 last MRF observed
Data quality

135,116 of 139,815 rate rows are consumer-grade (96.6%)

4,699 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
per-diem day rate — not a per-procedure price 3,070
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 1,575
placeholder amount (≤ $0.02) — excluded from medians 41
exceeds 10× this hospital's gross charge — excluded from medians 10
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 3
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://healthy.kaiserpermanente.org/content/dam/kporg/final/documents/health-plan-documents/coverage-information/941105628-moanalua-medical-center-standard-charges-hi-en.xlsx
Found on page https://healthy.kaiserpermanente.org/hawaii/doctors-locations/standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-27
Content fingerprint 25b0557366adb918… · 25,585,299 bytes · first seen 2026-07-30

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3391
HCPCS 		"Inj, Atidarsagene Autotemcel" 1 $4,632,500.00 $4,632,500.00 $4,632,500.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Beqvez (fidanacogene Elaparvovec-dz 1 $3,815,000.00 $3,815,000.00 $3,815,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Etranacogene Dezaparvovec-drlb 1x10exp13 gc/mL Susp 1 Each Kit 1 $3,815,000.00 $3,815,000.00 $3,815,000.00 nat. median
$3,705,478
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $3,383,360.00 $3,383,360.00 $3,383,360.00 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		"Inj, Lovotibeglogene Autotem" 1 $3,379,000.00 $3,379,000.00 $3,379,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		"Inj, Betibeglogene Autotemce" 1 $3,052,000.00 $3,052,000.00 $3,052,000.00 nat. median
$2,994,107
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 1 $2,737,307.00 $2,737,307.00 $2,737,307.00 nat. median
$2,467,386
1.1× median
J3392
HCPCS 		Casgevy (exagamglogene Autotemcel) 1 $2,398,000.00 $2,398,000.00 $2,398,000.00 nat. median
$2,401,965
1.0× median
Q2057
HCPCS 		Tecelra (afamitresgene Autoleucel) 1 $792,430.00 $792,430.00 $792,430.00 nat. median
$813,967
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 1 $605,288.00 $605,288.00 $605,288.00 nat. median
$646,415
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 1 $575,861.00 $575,861.00 $575,861.00 nat. median
$622,450
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 1 $567,588.00 $567,588.00 $567,588.00 nat. median
$640,950
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 1 $557,936.00 $557,936.00 $557,936.00 nat. median
$739,258
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $548,902.00 $548,902.00 $548,902.00 nat. median
$608,239
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 1 $503,580.00 $503,580.00 $503,580.00 nat. median
$591,721
0.9× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 1 $294,709.00 $294,709.00 $294,709.00 nat. median
$319,951
0.9× median
591
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 1 $2,220.80 $229,577.80 $169,939.45 nat. median
$6,406
outlier · 26.5×
583
APR_DRG 		Neonate W Ecmo 1 $99,816.50 $272,371.80 $161,779.25 nat. median
$12,353
outlier · 13.1×
161
APR_DRG 		Implantable Heart Assist Systems 1 $95,664.10 $210,550.80 $144,100.25 nat. median
$137,490
1.0× median
589
APR_DRG 		Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 1 $2,656.30 $149,980.00 $139,436.90 nat. median
$114,872
1.2× median
593
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 1 $6,400.10 $197,893.40 $135,104.80 nat. median
$12,919
outlier · 10.5×
588
APR_DRG 		Neonate Bwt <1500g W Major Procedure 1 $66,541.20 $228,647.10 $121,465.25 nat. median
$259,357
outlier · 0.5×
2
APR_DRG 		Heart &/or Lung Transplant 1 $78,719.80 $191,299.00 $115,260.65 nat. median
$135,990
0.8× median
7
APR_DRG 		Allogeneic Bone Marrow Transplant 1 $75,865.70 $187,109.10 $103,268.30 nat. median
$90,032
1.1× median
602
APR_DRG 		Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 $40,466.80 $160,178.90 $102,396.70 nat. median
$86,947
1.2× median
6
APR_DRG 		Pancreas Transplant 1 $54,135.60 $133,853.90 $86,268.85 nat. median
$69,517
1.2× median
603
APR_DRG 		Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 1 $21,151.80 $132,913.90 $84,832.45 nat. median
$55,411
1.5× median
A9543
HCPCS 		Yttrium-90-ibritumomab 3.2 Mg/2 Ml Kit 1 Each Vial 1 $82,357.00 $138,832.00 $82,357.00 nat. median
$63,528
1.3× median
1
APR_DRG 		Liver Transplant &/or Intestinal Transplant 1 $73,427.10 $148,315.30 $81,761.15 nat. median
$73,184
1.1× median
4
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure 1 $61,911.20 $129,524.80 $79,770.45 nat. median
$117,543
0.7× median
607
APR_DRG 		Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 1 $47,398.30 $124,698.10 $74,178.10 nat. median
$71,946
1.0× median
630
APR_DRG 		Neonate Birthwt >2499g W Major Cardiovascular Procedure 1 $28,125.50 $148,350.40 $67,960.05 nat. median
$82,555
0.8× median
609
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 1 $15,932.90 $181,083.70 $67,515.85 nat. median
$93,344
0.7× median
38240
CPT 		Transplt Allo Hct/donor 1 $48,037.00 $154,332.00 $63,625.00 nat. median
$12,842
outlier · 5.0×
J9029
HCPCS 		"Instill Adstiladrin, Tx Dose" 1 $63,402.00 $106,880.00 $63,402.00 nat. median
$68,423
0.9× median
303
APR_DRG 		Dorsal & Lumbar Fusion Proc For Curvature Of Back 1 $43,641.60 $90,188.90 $60,087.90 nat. median
$27,749
outlier · 2.2×
9
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 1 $36,854.10 $131,770.10 $58,129.35 nat. median
$120,304
outlier · 0.5×
608
APR_DRG 		Neonate Bwt 1250-1499g W Or Without Other Significant Condition 1 $26,430.40 $116,421.40 $57,761.15 nat. median
$44,980
1.3× median
5
APR_DRG 		Tracheostomy W Mv 96+ Hours Without Extensive Procedure 1 $46,336.50 $82,828.80 $56,620.30 nat. median
$87,627
0.6× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 1 $55,920.00 $94,267.00 $55,920.00 nat. median
$65,720
0.9× median
162
APR_DRG 		Cardiac Valve Procedures W Ami Or Complex Pdx 1 $43,404.00 $88,823.90 $55,736.50 nat. median
$68,742
0.8× median
440
APR_DRG 		Kidney Transplant 1 $43,943.70 $85,994.30 $53,620.45 nat. median
$56,304
1.0× median
841
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 1 $30,751.30 $147,941.80 $53,328.40 nat. median
$63,143
0.8× median
8
APR_DRG 		Autologous Bone Marrow Transplant Or T-cell Immunotherapy 1 $36,395.10 $90,349.30 $52,753.60 nat. median
$46,676
1.1× median
178
APR_DRG 		External Heart Assist Systems 1 $40,988.90 $73,914.10 $52,407.10 nat. median
$50,844
1.0× median
A9699
HCPCS 		Radiopharmaceutical Therapeutic Noc 1 $51,935.00 $87,549.00 $51,935.00 nat. median
$1,683
outlier · 30.9×
612
APR_DRG 		Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 1 $30,307.60 $83,882.40 $50,417.50 nat. median
$53,141
0.9× median
160
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 1 $36,733.50 $96,132.40 $48,718.85 nat. median
$65,356
0.7× median
33276
CPT 		Insj Phrnc Nrv Stim Sys 1 $36,551.00 $117,430.00 $48,412.00 nat. median
$43,278
1.1× median
631
APR_DRG 		Neonate Birthwt >2499g W Other Major Procedure 1 $16,282.90 $128,893.80 $47,962.00 nat. median
$56,996
0.8× median

Other procedures at this hospital

Browse this hospital's 15,806 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
             
J3391 HCPCS "Inj, Atidarsagene Autotemcel" 3 1 — — $4,632,500.00 $4,632,500.00 $4,632,500.00 2026-07-15
J1411 HCPCS Etranacogene Dezaparvovec-drlb 1x10exp13 gc/mL Susp 1 Each Kit 6 1 — — $3,815,000.00 $3,815,000.00 $3,815,000.00 2026-07-15
J1414 HCPCS Beqvez (fidanacogene Elaparvovec-dz 3 1 — — $3,815,000.00 $3,815,000.00 $3,815,000.00 2026-07-15
J1413 HCPCS Inj Delandistrogene Mox Rokl 3 1 — — $3,383,360.00 $3,383,360.00 $3,383,360.00 2026-07-15
J3394 HCPCS "Inj, Lovotibeglogene Autotem" 3 1 — — $3,379,000.00 $3,379,000.00 $3,379,000.00 2026-07-15
J3393 HCPCS "Inj, Betibeglogene Autotemce" 3 1 — — $3,052,000.00 $3,052,000.00 $3,052,000.00 2026-07-15
J3399 HCPCS Inj Onase Abepar-xioi Treat 3 1 — — $2,737,307.00 $2,737,307.00 $2,737,307.00 2026-07-15
J3392 HCPCS Casgevy (exagamglogene Autotemcel) 3 1 — — $2,398,000.00 $2,398,000.00 $2,398,000.00 2026-07-15
Q2057 HCPCS Tecelra (afamitresgene Autoleucel) 3 1 — — $792,430.00 $792,430.00 $792,430.00 2026-07-15
Q2056 HCPCS Ciltacabtagene Car-pos T 3 1 — — $605,288.00 $605,288.00 $605,288.00 2026-07-15
Q2055 HCPCS Idecabtagene Vicleucel Car 3 1 — — $575,861.00 $575,861.00 $575,861.00 2026-07-15
Q2054 HCPCS Lisocabtagene Mara Car Pos T 6 1 $1,472,908.31 $1,104,681.24 25% off $567,588.00 $567,588.00 $567,588.00 2026-07-15
Q2042 HCPCS Tisagenlecleucel Car-pos T 3 1 — — $557,936.00 $557,936.00 $557,936.00 2026-07-15
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 3 1 — — $548,902.00 $548,902.00 $548,902.00 2026-07-15
Q2053 HCPCS Brexucabtagene Car Pos T 3 1 — — $503,580.00 $503,580.00 $503,580.00 2026-07-15
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 3 1 — — $294,709.00 $294,709.00 $294,709.00 2026-07-15
591 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 4 1 — — $2,220.80 $229,577.80 $169,939.45 2026-07-15
583 APR_DRG Neonate W Ecmo 4 1 — — $99,816.50 $272,371.80 $161,779.25 2026-07-15
161 APR_DRG Implantable Heart Assist Systems 4 1 — — $95,664.10 $210,550.80 $144,100.25 2026-07-15
589 APR_DRG Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 4 1 — — $2,656.30 $149,980.00 $139,436.90 2026-07-15
593 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 4 1 — — $6,400.10 $197,893.40 $135,104.80 2026-07-15
588 APR_DRG Neonate Bwt <1500g W Major Procedure 4 1 — — $66,541.20 $228,647.10 $121,465.25 2026-07-15
2 APR_DRG Heart &/or Lung Transplant 4 1 — — $78,719.80 $191,299.00 $115,260.65 2026-07-15
7 APR_DRG Allogeneic Bone Marrow Transplant 4 1 — — $75,865.70 $187,109.10 $103,268.30 2026-07-15
602 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 4 1 — — $40,466.80 $160,178.90 $102,396.70 2026-07-15
6 APR_DRG Pancreas Transplant 4 1 — — $54,135.60 $133,853.90 $86,268.85 2026-07-15
603 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 4 1 — — $21,151.80 $132,913.90 $84,832.45 2026-07-15
A9543 HCPCS Yttrium-90-ibritumomab 3.2 Mg/2 Ml Kit 1 Each Vial 6 1 $187,905.16 $140,928.87 25% off $82,357.00 $138,832.00 $82,357.00 2026-07-15
1 APR_DRG Liver Transplant &/or Intestinal Transplant 4 1 — — $73,427.10 $148,315.30 $81,761.15 2026-07-15
4 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 4 1 — — $61,911.20 $129,524.80 $79,770.45 2026-07-15
607 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 4 1 — — $47,398.30 $124,698.10 $74,178.10 2026-07-15
630 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 4 1 — — $28,125.50 $148,350.40 $67,960.05 2026-07-15
609 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 4 1 — — $15,932.90 $181,083.70 $67,515.85 2026-07-15
38240 CPT Transplt Allo Hct/donor 3 1 — — $48,037.00 $154,332.00 $63,625.00 2026-07-15
J9029 HCPCS "Instill Adstiladrin, Tx Dose" 6 1 $43,853.00 $32,889.75 25% off $63,402.00 $106,880.00 $63,402.00 2026-07-15
303 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 4 1 — — $43,641.60 $90,188.90 $60,087.90 2026-07-15
9 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 1 — — $36,854.10 $131,770.10 $58,129.35 2026-07-15
608 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 4 1 — — $26,430.40 $116,421.40 $57,761.15 2026-07-15
5 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 4 1 — — $46,336.50 $82,828.80 $56,620.30 2026-07-15
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 6 1 $180,340.20 $135,255.15 25% off $55,920.00 $94,267.00 $55,920.00 2026-07-15
162 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 4 1 — — $43,404.00 $88,823.90 $55,736.50 2026-07-15
440 APR_DRG Kidney Transplant 4 1 — — $43,943.70 $85,994.30 $53,620.45 2026-07-15
841 APR_DRG Extensive 3rd Degree Burns W Skin Graft 4 1 — — $30,751.30 $147,941.80 $53,328.40 2026-07-15
8 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 4 1 — — $36,395.10 $90,349.30 $52,753.60 2026-07-15
178 APR_DRG External Heart Assist Systems 4 1 — — $40,988.90 $73,914.10 $52,407.10 2026-07-15
A9699 HCPCS Radiopharmaceutical Therapeutic Noc 3 1 — — $51,935.00 $87,549.00 $51,935.00 2026-07-15
612 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 4 1 — — $30,307.60 $83,882.40 $50,417.50 2026-07-15
160 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 1 — — $36,733.50 $96,132.40 $48,718.85 2026-07-15
33276 CPT Insj Phrnc Nrv Stim Sys 3 1 — — $36,551.00 $117,430.00 $48,412.00 2026-07-15
631 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 4 1 — — $16,282.90 $128,893.80 $47,962.00 2026-07-15
Q9982 HCPCS flutemetamoL F-18 5 mCi (185 MBq) Soln 1 Each Vial 2 1 $10,029.00 $7,521.75 25% off $45,628.20 $50,191.02 $47,909.61 2026-07-15
611 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 4 1 — — $17,158.60 $98,794.50 $47,302.90 2026-07-15
613 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 4 1 — — $22,457.10 $65,686.60 $46,566.55 2026-07-15
183 APR_DRG Percutaneous Structural Cardiac Procedures 4 1 — — $40,091.00 $69,867.10 $46,399.75 2026-07-15
165 APR_DRG Coronary Bypass W Ami Or Complex Pdx 4 1 — — $35,706.80 $68,870.90 $46,278.55 2026-07-15
163 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 4 1 — — $36,737.00 $75,299.10 $45,664.60 2026-07-15
J9226 HCPCS Histrelin 50 Mg (65 Mcg/day) Kit 1 Each Kit 6 1 $144,528.07 $108,396.06 25% off $45,540.00 $76,768.00 $45,540.00 2026-07-15
179 APR_DRG Defibrillator Implants 4 1 — — $35,679.90 $64,139.00 $42,499.60 2026-07-15
614 APR_DRG Neonate Bwt 1500-1999g W Or Without Other Significant Condition 4 1 — — $14,559.70 $78,827.50 $38,440.30 2026-07-15
166 APR_DRG Coronary Bypass Without Ami Or Complex Pdx 4 1 — — $31,779.20 $61,639.60 $38,251.25 2026-07-15
304 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 4 1 — — $26,598.90 $64,657.60 $37,963.85 2026-07-15
A9590 HCPCS Iobenguane I-131 30 mCi/2 Ml Soln 1 Each Vial 6 1 $156,579.60 $117,434.71 25% off $5,537.30 $188,411.85 $37,683.86 2026-07-15
0620T CPT Endovascular Venous Arterialization Tibl/prnl Vn 3 1 $136,916.00 $102,687.00 25% off $28,428.00 $91,334.00 $37,654.00 2026-07-15
A9513 HCPCS Lutetium Lu 177 Dotatate 10 mCi/mL (370 MBq/mL) Soln 1 Each Vial 3 1 $193,132.79 $144,849.60 25% off $32,205.10 $106,276.82 $35,425.61 2026-07-15
81416 CPT Exome Sequence Analysis 3 1 — — $11,973.00 $58,410.00 $35,400.00 2026-07-15
130 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 4 1 — — $31,326.10 $48,276.30 $34,853.95 2026-07-15
33249 CPT Insj/rplcmt Perm Dfb W/trnsvns Lds 1/dual Chmbr 3 1 $33,963.00 $25,472.25 25% off $26,041.00 $83,665.00 $34,492.00 2026-07-15
0571T CPT Insj/rplcmt Icds W/substernal Electrode 3 1 $46,476.00 $34,857.00 25% off $26,041.00 $83,665.00 $34,492.00 2026-07-15
33264 CPT Rmvl Impltbl Dfb Pls Gen W/rplcmt Pls Gen Mlt Ld 3 1 $29,128.00 $21,846.00 25% off $26,041.00 $83,665.00 $34,492.00 2026-07-15
0408T CPT Insj/rplc Cardiac Modulj Sys 3 1 — — $26,041.00 $83,665.00 $34,492.00 2026-07-15
33270 CPT Ins/rplcmnt Perm Subq Impltbl Dfb W/subq Eltrd 3 1 $49,467.00 $37,100.25 25% off $26,041.00 $83,665.00 $34,492.00 2026-07-15
33231 CPT Insrt Pulse Gen W/mult Leads 3 1 — — $26,041.00 $83,665.00 $34,492.00 2026-07-15
69930 CPT Implant Cochlear Device 3 1 — — $25,835.00 $83,002.00 $34,219.00 2026-07-15
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 3 1 — — $24,751.00 $79,521.00 $32,784.00 2026-07-15
61886 CPT Implant Neurostim Arrays 3 1 — — $24,751.00 $79,521.00 $32,784.00 2026-07-15
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 3 1 — — $24,751.00 $79,521.00 $32,784.00 2026-07-15
64568 CPT Opn Impltj Crnl Nrv Nea&pg 3 1 — — $24,751.00 $79,521.00 $32,784.00 2026-07-15
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 3 1 — — $24,751.00 $79,521.00 $32,784.00 2026-07-15
63685 CPT Insj/rplcmt Spinal Npg/rcvr Pocket Crtj&connj 3 1 $37,919.00 $28,439.25 25% off $24,751.00 $79,521.00 $32,784.00 2026-07-15
621 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 4 1 — — $7,966.50 $81,898.20 $32,778.90 2026-07-15
167 APR_DRG Other Cardiothoracic & Thoracic Vascular Procedures 4 1 — — $26,453.80 $67,611.20 $32,337.55 2026-07-15
33289 CPT Tcat Impl Wrls P-art Prs Snr 3 1 — — $23,090.00 $74,184.00 $30,583.00 2026-07-15
910 APR_DRG Craniotomy For Multiple Significant Trauma 4 1 — — $19,585.40 $64,242.00 $30,508.95 2026-07-15
90288 CPT Botulism Immune Globulin (human) 100 Mg Recon Soln 1 Each Vial 3 1 $137,525.00 $103,143.75 25% off $27,505.00 $90,766.50 $30,255.50 2026-07-15
21 APR_DRG Open Craniotomy Except Trauma 4 1 — — $18,513.10 $53,037.50 $30,033.70 2026-07-15
169 APR_DRG Major Abdominal Vascular Procedures 4 1 — — $18,655.90 $58,852.20 $29,693.65 2026-07-15
622 APR_DRG Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond 4 1 — — $19,366.50 $56,698.20 $29,624.55 2026-07-15
C9760 HCPCS Nrnd Nbld Pd Nyha Cls Ii Iii IV Hf; 3 1 — — $22,337.00 $71,763.00 $29,585.00 2026-07-15
187001050 NDC Sodium Benzoate-sod Phenylacet 10-10 % Soln 50 Ml Vial 3 1 $131,507.84 $98,630.88 25% off $26,301.60 $86,795.17 $28,931.72 2026-07-15
68875010201 NDC Teduglutide 5 Mg Kit 1 Each Kit 3 1 $135,055.95 $101,291.97 25% off $26,224.50 $86,540.79 $28,846.93 2026-07-15
J9266 HCPCS Pegaspargase Injection 6 1 $79,203.32 $59,402.49 25% off $28,411.00 $47,894.00 $28,411.00 2026-07-15
863 APR_DRG Neonatal Aftercare 4 1 — — $7,906.70 $78,807.60 $28,339.70 2026-07-15
30 APR_DRG Percutaneous Intra & Extracranial Vascular Procedures 4 1 — — $17,055.60 $44,728.00 $27,969.20 2026-07-15
89 APR_DRG Major Cranial/facial Bone Procedures 4 1 — — $15,913.00 $56,133.90 $27,102.90 2026-07-15
260 APR_DRG Major Pancreas, Liver & Shunt Procedures 4 1 — — $17,148.10 $57,418.10 $26,757.55 2026-07-15
120 APR_DRG Major Respiratory & Chest Procedures 4 1 — — $17,788.40 $55,333.20 $26,468.40 2026-07-15
625 APR_DRG Neonate Bwt 2000-2499g W Other Significant Condition 4 1 — — $14,007.10 $34,542.00 $26,347.25 2026-07-15
20 APR_DRG Open Craniotomy For Trauma 4 1 — — $19,195.60 $48,920.20 $26,320.30 2026-07-15
623 APR_DRG Neonate Bwt 2000-2499g W Congenital/perinatal Infection 4 1 — — $13,322.30 $39,825.20 $26,145.30 2026-07-15
C9293 HCPCS "glucarpidase 1,000 Unit Recon Soln 1 Each Vial" 3 1 $124,516.04 $93,387.03 25% off $23,717.20 $78,266.84 $26,088.95 2026-07-15
680 APR_DRG Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 4 1 — — $14,713.10 $58,676.60 $25,897.70 2026-07-15
842 APR_DRG Burns W Skin Graft Except Extensive 3rd Degree Burns 4 1 — — $12,278.00 $76,346.80 $25,736.70 2026-07-15
441 APR_DRG Major Bladder Procedures 4 1 — — $13,977.90 $56,325.90 $25,403.65 2026-07-15
91 APR_DRG Other Major Head & Neck Procedures 4 1 — — $11,453.90 $61,020.30 $25,251.50 2026-07-15
0315U CPT Onc Cutan Sq Cll Ca Mrna 40 3 1 — — $8,481.00 $41,374.00 $25,075.00 2026-07-15
401 APR_DRG Adrenal Procedures 4 1 — — $13,264.90 $40,074.60 $25,044.25 2026-07-15
0211U CPT Onc Pan-tum Dna&rna Gnrj Seq 3 1 — — $8,436.00 $41,154.00 $24,942.00 2026-07-15
181 APR_DRG Lower Extremity Arterial Procedures 4 1 — — $14,470.70 $47,248.50 $24,804.30 2026-07-15
220 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 4 1 — — $13,250.90 $52,165.30 $24,522.70 2026-07-15
23 APR_DRG Spinal Procedures 4 1 — — $13,818.70 $53,936.60 $24,331.90 2026-07-15
J9600 HCPCS Porfimer 75 Mg Recon Soln 1 Each Vial 6 1 $67,175.24 $50,381.43 25% off $24,217.00 $40,824.00 $24,217.00 2026-07-15
33240 CPT Insj Implntbl Defib Pulse Gen W/1 Existing Ld 3 1 $35,326.00 $26,494.50 25% off $18,231.00 $58,573.00 $24,147.00 2026-07-15
0614T CPT Rmvl&rplcmt Ss Impl Dfb Pg 3 1 — — $18,231.00 $58,573.00 $24,147.00 2026-07-15
0515T CPT Insertion Wrls Car Stimulator Lv Pacg Compl Sys 3 1 $50,714.00 $38,035.50 25% off $18,231.00 $58,573.00 $24,147.00 2026-07-15
33263 CPT Rmvl Impltbl Dfb Plse Gen W/rplcmt Plse Gen 2 Ld 3 1 $20,870.00 $15,652.50 25% off $18,231.00 $58,573.00 $24,147.00 2026-07-15
33262 CPT Rmvl Impltbl Dfb Plse Gen W/repl Plse Gen 1 Lead 3 1 $20,870.00 $15,652.50 25% off $18,231.00 $58,573.00 $24,147.00 2026-07-15
0409T CPT Insj/rplc Car Modulj Pls Gn 3 1 — — $18,231.00 $58,573.00 $24,147.00 2026-07-15
33230 CPT Insrt Pulse Gen W/dual Leads 3 1 — — $18,231.00 $58,573.00 $24,147.00 2026-07-15
0414T CPT Rmvl & Rpl Car Modulj Pls Gn 3 1 — — $18,231.00 $58,573.00 $24,147.00 2026-07-15
170 APR_DRG Permanent Cardiac Pacemaker Implant W Ami, Heart Failure Or Shock 4 1 — — $19,408.60 $36,749.90 $23,970.20 2026-07-15
175 APR_DRG Percutaneous Cardiac Intervention Without Ami 4 1 — — $19,470.70 $39,037.40 $23,695.05 2026-07-15
911 APR_DRG Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 4 1 — — $15,228.20 $55,657.40 $23,388.35 2026-07-15
321 APR_DRG Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 4 1 — — $16,066.40 $44,774.80 $23,376.05 2026-07-15
912 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 4 1 — — $17,791.90 $53,894.40 $23,109.10 2026-07-15
61885 CPT Insrt/redo Neurostim 1 Array 3 1 — — $17,418.00 $55,959.00 $23,070.00 2026-07-15
61891 CPT Rev/rplcmt Sk-mnt Crnl Nstm 3 1 — — $17,418.00 $55,959.00 $23,070.00 2026-07-15
0816T CPT Opn Insj/rplcmt Ins Ptn Subq 3 1 — — $17,418.00 $55,959.00 $23,070.00 2026-07-15
63655 CPT Implant Neuroelectrodes 3 1 — — $17,418.00 $55,959.00 $23,070.00 2026-07-15
64580 CPT Opn Impltj Nea Neuromuscular 3 1 — — $17,418.00 $55,959.00 $23,070.00 2026-07-15
64590 CPT Ins/rpl Prph Sac/gstr Npg/r 3 1 — — $17,418.00 $55,959.00 $23,070.00 2026-07-15
0817T CPT Opn Insj/rplcmt Ins Ptn Subf 3 1 — — $17,418.00 $55,959.00 $23,070.00 2026-07-15
0680T CPT Insj/rplcmt Pg Only Isdss 3 1 — — $17,418.00 $55,959.00 $23,070.00 2026-07-15
174 APR_DRG Percutaneous Cardiac Intervention W Ami 4 1 — — $19,340.70 $34,897.90 $23,067.00 2026-07-15
176 APR_DRG Insertion, Revision & Replacements Of Pacemaker & Other Cardiac Devices 4 1 — — $15,132.20 $46,969.90 $22,970.40 2026-07-15
81552 CPT Onc Uveal Mlnma Mrna 15 Gene 3 1 — — $7,759.00 $37,849.00 $22,939.00 2026-07-15
261 APR_DRG Major Biliary Tract Procedures 4 1 — — $13,612.60 $45,952.50 $22,900.75 2026-07-15
230 APR_DRG Major Small Bowel Procedures 4 1 — — $13,397.20 $47,792.80 $22,703.50 2026-07-15
0094U CPT Genome Rapid Sequence Alys 3 1 — — $7,565.00 $36,906.00 $22,367.00 2026-07-15
850 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 4 1 — — $15,989.10 $52,321.00 $22,123.40 2026-07-15
182 APR_DRG Other Peripheral Vascular Procedures 4 1 — — $17,891.40 $42,032.00 $22,071.35 2026-07-15
231 APR_DRG Major Large Bowel Procedures 4 1 — — $14,116.00 $42,696.90 $21,940.20 2026-07-15
650 APR_DRG Splenectomy 4 1 — — $12,582.40 $39,064.30 $21,922.05 2026-07-15
53445 CPT Insert Uro/ves Nck Sphincter 3 1 — — $16,349.00 $52,525.00 $21,654.00 2026-07-15
54411 CPT Remov/replc Penis Pros Comp 3 1 — — $16,349.00 $52,525.00 $21,654.00 2026-07-15
54416 CPT Remv/repl Penis Contain Pros 3 1 — — $16,349.00 $52,525.00 $21,654.00 2026-07-15
54410 CPT Remove/replace Penis Prosth 3 1 — — $16,349.00 $52,525.00 $21,654.00 2026-07-15
54405 CPT Insert Multi-comp Penis Pros 3 1 — — $16,349.00 $52,525.00 $21,654.00 2026-07-15
53444 CPT Insert Tandem Cuff 3 1 — — $16,349.00 $52,525.00 $21,654.00 2026-07-15
54401 CPT Insert Self-contd Prosthesis 3 1 — — $16,349.00 $52,525.00 $21,654.00 2026-07-15
53447 CPT Remove/replace Ur Sphincter 3 1 — — $16,349.00 $52,525.00 $21,654.00 2026-07-15
322 APR_DRG Shoulder & Elbow Joint Replacement 4 1 — — $17,471.20 $33,692.10 $21,484.25 2026-07-15
690 APR_DRG Acute Leukemia 4 1 — — $9,987.00 $46,800.10 $21,421.60 2026-07-15
81529 CPT Onc Cutan Mlnma Mrna 31 Gene 3 1 — — $7,177.00 $35,011.00 $21,219.00 2026-07-15
27 APR_DRG Other Open Craniotomy 4 1 — — $15,318.30 $48,914.40 $20,851.50 2026-07-15
0801T CPT Tcat Rmv&rpl 2chmbr Ldls Pm 3 1 — — $15,490.00 $49,766.00 $20,517.00 2026-07-15
0825T CPT Tcat Rmv&rpl1chmb Ldls Pm Ra 3 1 — — $15,490.00 $49,766.00 $20,517.00 2026-07-15
0796T CPT Tcat Ins 2chmbr Ldls Pm Ra 3 1 — — $15,490.00 $49,766.00 $20,517.00 2026-07-15
0797T CPT Tcat Ins 2chmbr Ldls Pm Rv 3 1 — — $15,490.00 $49,766.00 $20,517.00 2026-07-15
0525T CPT Insj/rplcmt Compl Iims 3 1 — — $15,490.00 $49,766.00 $20,517.00 2026-07-15
0795T CPT Tcat Ins 2chmbr Ldls Pm Cmpl 3 1 — — $15,490.00 $49,766.00 $20,517.00 2026-07-15
0803T CPT Tcat Rmv&rpl2chmb Ldls Pm Rv 3 1 — — $15,490.00 $49,766.00 $20,517.00 2026-07-15
33274 CPT Tcat Insj/rpl Perm Leadless Pacemaker Rv W/img 3 1 $41,922.00 $31,441.50 25% off $15,490.00 $49,766.00 $20,517.00 2026-07-15
33229 CPT Remvl Perm Pm Pls Gen W/repl Plse Gen Mult Lead 3 1 $17,252.00 $12,939.00 25% off $15,490.00 $49,766.00 $20,517.00 2026-07-15
33221 CPT Insert Pulse Gen Mult Leads 3 1 — — $15,490.00 $49,766.00 $20,517.00 2026-07-15
0802T CPT Tcat Rmv&rpl2chmb Ldls Pm Ra 3 1 — — $15,490.00 $49,766.00 $20,517.00 2026-07-15
0823T CPT Tcat Ins 1chmbr Ldls Pm Ra 3 1 — — $15,490.00 $49,766.00 $20,517.00 2026-07-15
792 APR_DRG Extensive Or Procedures For Other Complications Of Treatment 4 1 — — $13,942.80 $46,774.40 $20,222.25 2026-07-15
92 APR_DRG Facial Bone Procedures Except Major Cranial/facial Bone Procedures 4 1 — — $11,706.80 $53,674.30 $20,202.35 2026-07-15
309 APR_DRG Other Significant Hip & Femur Surgery 4 1 — — $13,234.50 $38,388.80 $20,153.80 2026-07-15
37294 CPT Revsc Evasc Tpvt St Athrc Uni Cplx Les 1st Vsl 3 1 $37,457.00 $28,092.75 25% off $15,212.00 $48,873.00 $20,149.00 2026-07-15
37284 CPT Revsc Evasc Tpvt St Plmt Uni Sf Les 1st Vsl 3 1 $37,457.00 $28,092.75 25% off $15,212.00 $48,873.00 $20,149.00 2026-07-15
37286 CPT Revsc Evasc Tpvt St Plmt Uni Cplx Les 1st Vsl 3 1 $37,457.00 $28,092.75 25% off $15,212.00 $48,873.00 $20,149.00 2026-07-15
37277 CPT Revsc Evasc Fpvt St Athrc Uni Cplx Les 1st Vsl 3 1 $37,457.00 $28,092.75 25% off $15,212.00 $48,873.00 $20,149.00 2026-07-15
37288 CPT Revsc Evasc Tpvt Athrc Uni Sf Les 1st Vsl 3 1 $37,457.00 $28,092.75 25% off $15,212.00 $48,873.00 $20,149.00 2026-07-15
37271 CPT Revsc Evasc Fpvt Athrc Uni Sf Les 1st Vsl 3 1 $37,457.00 $28,092.75 25% off $15,212.00 $48,873.00 $20,149.00 2026-07-15
37290 CPT Revsc Evasc Tpvt Athrc Uni Cplx Les 1st Vsl 3 1 $37,457.00 $28,092.75 25% off $15,212.00 $48,873.00 $20,149.00 2026-07-15
37273 CPT Revsc Evasc Fpvt Athrc Uni Cplx Les 1st Vsl 3 1 $37,457.00 $28,092.75 25% off $15,212.00 $48,873.00 $20,149.00 2026-07-15
37275 CPT Revsc Evasc Fpvt St Athrc Uni Sf Les 1st Vsl 3 1 $37,457.00 $28,092.75 25% off $15,212.00 $48,873.00 $20,149.00 2026-07-15
37292 CPT Revsc Evasc Tpvt St Athrc Uni Sf Les 1st Vsl 3 1 $37,457.00 $28,092.75 25% off $15,212.00 $48,873.00 $20,149.00 2026-07-15
61624 CPT Tcat Perm Occls/embolization Perq Cns 3 1 $5,067.00 $3,800.25 25% off $15,212.00 $48,873.00 $20,149.00 2026-07-15
131 APR_DRG Cystic Fibrosis - Pulmonary Disease 4 1 — — $11,813.30 $31,416.30 $20,063.60 2026-07-15
681 APR_DRG Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 4 1 — — $11,023.10 $50,970.10 $19,972.30 2026-07-15
0267U CPT Rare Do Id Opt Gen Mapg&seq 3 1 — — $6,724.00 $32,804.00 $19,881.00 2026-07-15
121 APR_DRG Other Respiratory & Chest Procedures 4 1 — — $12,897.30 $40,570.90 $19,878.10 2026-07-15
22867 CPT Insj Stablj Dev W/dcmprn 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
25442 CPT Arthrp W/prostc Dstl Ulna 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
25446 CPT Arthrp W/prostc Dst Rds&crps 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
20696 CPT App Mltpln Uni Xtrnl Fix 1st 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
22612 CPT Arthrd Pst Tq 1ntrspc Lumbar 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
21243 CPT Reconstruction Of Jaw Joint 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
23472 CPT Reconstruct Shoulder Joint 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
22633 CPT Arthrd Cmbn 1ntrspc Lumbar 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
24363 CPT Replace Elbow Joint 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
24371 CPT Revise Reconst Elbow Joint 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
24361 CPT Reconstruct Elbow Joint 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
22856 CPT Tot Disc Arthrp 1ntrspc Crv 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
27702 CPT Reconstruct Ankle Joint 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
27279 CPT Arthrd Si Jt Plmt Transarticular&/i-artic Device 3 1 $24,557.00 $18,417.75 25% off $14,937.00 $47,989.00 $19,784.00 2026-07-15
22630 CPT Arthrd Pst Tq 1ntrspc Lum 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
28705 CPT Arthrodesis Pantalar 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
23616 CPT Optx Prx Hmrl Fx Fix Rpr Rpl 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
27278 CPT Arthrd Si Jt Prq Wo Tfxj Dev 3 1 — — $14,937.00 $47,989.00 $19,784.00 2026-07-15
29 APR_DRG Other Percutaneous Intracranial Procedures 4 1 — — $14,896.90 $39,243.40 $19,778.00 2026-07-15
950 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 4 1 — — $13,617.30 $45,374.20 $19,742.90 2026-07-15
633 APR_DRG Neonate Birthwt >2499g W Major Anomaly 4 1 — — $3,515.50 $61,582.20 $19,717.10 2026-07-15
171 APR_DRG Perm Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 4 1 — — $15,490.40 $32,754.30 $19,639.85 2026-07-15
442 APR_DRG Kidney & Urinary Tract Procedures For Malignancy 4 1 — — $13,468.60 $39,449.40 $19,525.10 2026-07-15
301 APR_DRG Hip Joint Replacement 4 1 — — $15,778.40 $31,322.60 $19,504.00 2026-07-15
510 APR_DRG Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs 4 1 — — $11,976.00 $39,313.60 $19,499.95 2026-07-15
511 APR_DRG Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy 4 1 — — $12,916.10 $45,088.60 $19,465.45 2026-07-15
224 APR_DRG Peritoneal Adhesiolysis 4 1 — — $12,685.40 $37,840.90 $19,365.30 2026-07-15
710 APR_DRG Infectious & Parasitic Diseases Including HIV W O.r. Procedure 4 1 — — $10,309.00 $41,782.60 $19,327.30 2026-07-15
C9775 HCPCS Revasc Lith-sten-ath Tib/per 3 1 $60,556.00 $45,417.00 25% off $14,585.00 $46,858.00 $19,318.00 2026-07-15
C9774 HCPCS Revasc Lithotr-ather Tib/per 3 1 $60,556.00 $45,417.00 25% off $14,585.00 $46,858.00 $19,318.00 2026-07-15
C9773 HCPCS Revasc Lithotr-stent Tib/per 3 1 $60,556.00 $45,417.00 25% off $14,585.00 $46,858.00 $19,318.00 2026-07-15
0645T CPT Tcat Impltj C Sins Rdctj Dev 3 1 — — $14,585.00 $46,858.00 $19,318.00 2026-07-15
C9766 HCPCS Rev Evar Le Aa; IV Litho & Atherect 3 1 — — $14,585.00 $46,858.00 $19,318.00 2026-07-15
C9767 HCPCS Rev Evr Le Aa; IV Litho & Tl St&ath 3 1 — — $14,585.00 $46,858.00 $19,318.00 2026-07-15
C9765 HCPCS Rev Evr Le Aa;iv Lith&tl Stnt Plcmt 3 1 — — $14,585.00 $46,858.00 $19,318.00 2026-07-15
0632T CPT Perq Tcat US Abltj Nrv P-art 3 1 — — $14,585.00 $46,858.00 $19,318.00 2026-07-15
C9607 HCPCS Pc Tl Rev Chrn Tot Occl Ca Ca Br/cabg; 1 Ves 3 1 $31,961.00 $23,970.75 25% off $14,585.00 $46,858.00 $19,318.00 2026-07-15
C9602 HCPCS Pc Tl Cor Atherect W/rx Elut Ic Stent; 1 Mca/br 3 1 $34,774.00 $26,080.50 25% off $14,585.00 $46,858.00 $19,318.00 2026-07-15
C9797 HCPCS Vasc Emb/occ W/prs-gen Cath 3 1 — — $14,585.00 $46,858.00 $19,318.00 2026-07-15
0238T CPT Trluml Perip Athrc Iliac Art 3 1 — — $14,585.00 $46,858.00 $19,318.00 2026-07-15
37242 CPT Vascular Embolization Or Occlusion Arterial Rs&i 3 1 $18,748.00 $14,061.00 25% off $14,585.00 $46,858.00 $19,318.00 2026-07-15
37184 CPT Prim Prq Trluml Mchnl Thrmbc N-cor N-icra 1st 3 1 $15,526.00 $11,644.50 25% off $14,585.00 $46,858.00 $19,318.00 2026-07-15
36837 CPT Prq Av Fstl Crt Uxtr Sep Acs 3 1 — — $14,585.00 $46,858.00 $19,318.00 2026-07-15
36836 CPT Prq Av Fstl Crtj Uxtr 1 Acs 3 1 — — $14,585.00 $46,858.00 $19,318.00 2026-07-15
33902 CPT Perq P-art Revsc 1 Abnor Uni 3 1 — — $14,585.00 $46,858.00 $19,318.00 2026-07-15
0793T CPT Prq Tcat Thrm Ablt Nrv P-art 3 1 — — $14,585.00 $46,858.00 $19,318.00 2026-07-15
36906 CPT Perq Thrmbc/nfs Dial Circuit Tcat Plmt IV Stent 3 1 $18,188.00 $13,641.00 25% off $14,585.00 $46,858.00 $19,318.00 2026-07-15
22808 CPT Arthrodesis Anterior Spinal Dfrm 2-3 Vrt Seg 3 1 $11,313.00 $8,484.75 25% off $14,550.00 $46,746.00 $19,272.00 2026-07-15
302 APR_DRG Knee Joint Replacement 4 1 — — $15,324.10 $32,406.70 $19,198.50 2026-07-15
62360 CPT Insert Spine Infusion Device 3 1 — — $14,355.00 $46,121.00 $19,014.00 2026-07-15
62362 CPT Implant Spine Infusion Pump 3 1 — — $14,355.00 $46,121.00 $19,014.00 2026-07-15
62361 CPT Implant Spine Infusion Pump 3 1 — — $14,355.00 $46,121.00 $19,014.00 2026-07-15
C1822 HCPCS System Spinal Cord Stimulation Senza Omina 3 3 $41,250.00 $16,087.50 61% off $11,550.00 $41,250.00 $18,975.00 2026-07-30
363 APR_DRG Breast Procedures Except Mastectomy 4 1 — — $10,361.70 $24,195.50 $18,951.50 2026-07-15
C9782 HCPCS Bl P Nyha Ii/iii Hf/ccs Iii/iv Cra 3 1 — — $14,214.00 $45,668.00 $18,827.00 2026-07-15
C9758 HCPCS Bi Prc Nyha 3/4 Hf;trnscth I Ias/pc 3 1 — — $14,214.00 $45,668.00 $18,827.00 2026-07-15
0888T CPT Histotripsy Mal Renal Tissue 3 1 — — $14,214.00 $45,668.00 $18,827.00 2026-07-15
0686T CPT Histotripsy Mal Hepatcel Tis 3 1 — — $14,214.00 $45,668.00 $18,827.00 2026-07-15
26 APR_DRG Other Nervous System & Related Procedures 4 1 — — $13,112.70 $39,073.70 $18,757.75 2026-07-15
19357 CPT Tiss Xpndr Plmt Brst Rcnstj 3 1 — — $14,131.00 $45,401.00 $18,717.00 2026-07-15
187552560 NDC Bexarotene 1 % Gel 60 G Tube 3 1 $83,983.06 $62,987.30 25% off $16,796.60 $55,428.82 $18,476.27 2026-07-15
312 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 4 1 — — $10,812.40 $48,139.40 $18,347.45 2026-07-15
313 APR_DRG Knee & Lower Leg Procedures Except Foot 4 1 — — $11,827.30 $34,632.10 $18,291.25 2026-07-15
223 APR_DRG Other Small & Large Bowel Procedures 4 1 — — $10,220.00 $36,866.90 $18,253.15 2026-07-15
405 APR_DRG Other Procedures For Endocrine, Nutritional & Metabolic Disorders 4 1 — — $12,497.00 $42,727.30 $18,218.05 2026-07-15
740 APR_DRG Mental Illness Diagnosis W O.r. Procedure 4 1 — — $11,312.20 $52,301.10 $18,117.40 2026-07-15
177 APR_DRG Cardiac Pacemaker & Defibrillator Revision Except Device Replacement 4 1 — — $11,174.10 $26,841.30 $17,941.80 2026-07-15
49 APR_DRG Bacterial & Tuberculous Infections Of Nervous System 4 1 — — $10,225.90 $35,733.70 $17,859.25 2026-07-15
37182 CPT Insj Transvns Intrahepatc Portosysic Shunt 2 1 $3,913.00 $2,934.75 25% off $15,212.00 $20,149.00 $17,680.50 2026-07-15
66683 CPT Implantation Iris Prosthesis 3 1 — — $13,334.00 $42,839.00 $17,661.00 2026-07-15
0308T CPT Insj Ocular Telescope Prosth 3 1 — — $13,334.00 $42,839.00 $17,661.00 2026-07-15
651 APR_DRG Other Procedures Of Blood & Blood-forming Organs 4 1 — — $10,012.80 $49,560.60 $17,598.80 2026-07-15
480 APR_DRG Major Male Pelvic Procedures 4 1 — — $11,791.00 $37,468.70 $17,372.25 2026-07-15
308 APR_DRG Hip & Femur Fracture Repair 4 1 — — $12,751.00 $28,402.90 $17,358.80 2026-07-15
264 APR_DRG Other Hepatobiliary, Pancreas & Abdominal Procedures 4 1 — — $12,938.30 $45,160.00 $17,321.30 2026-07-15
227 APR_DRG Hernia Procedures Except Inguinal, Femoral & Umbilical 4 1 — — $11,243.20 $36,644.50 $17,285.05 2026-07-15
951 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 4 1 — — $10,053.80 $38,264.70 $17,215.95 2026-07-15
634 APR_DRG Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond 4 1 — — $7,769.80 $49,859.10 $17,167.35 2026-07-15
512 APR_DRG Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig 4 1 — — $11,293.50 $36,666.70 $17,101.85 2026-07-15
711 APR_DRG Post-op, Post-trauma, Other Device Infections W O.r. Procedure 4 1 — — $9,862.90 $40,085.10 $17,076.05 2026-07-15
22 APR_DRG Ventricular Shunt Procedures 4 1 — — $12,117.70 $42,974.30 $16,846.60 2026-07-15
233 APR_DRG Appendectomy With Complex Principal Diagnosis 4 1 — — $10,407.30 $31,028.80 $16,795.10 2026-07-15
636 APR_DRG Neonate Birthwt >2499g W Congenital/perinatal Infection 4 1 — — $7,324.90 $33,553.90 $16,754.10 2026-07-15
447 APR_DRG Other Kidney, Urinary Tract & Related Procedures 4 1 — — $12,015.80 $41,011.10 $16,689.70 2026-07-15
444 APR_DRG Renal Dialysis Access Device Procedures & Vessel Repair 4 1 — — $9,353.70 $38,429.80 $16,657.00 2026-07-15
404 APR_DRG Thyroid, Parathyroid & Thyroglossal Procedures 4 1 — — $8,729.70 $41,075.50 $16,559.20 2026-07-15
320 APR_DRG Other Musculoskeletal System & Connective Tissue Procedures 4 1 — — $9,923.80 $33,250.70 $16,534.05 2026-07-15
67027 CPT Implant Eye Drug System 3 1 — — $12,479.00 $40,094.00 $16,529.00 2026-07-15
305 APR_DRG Amputation Of Lower Limb Except Toes 4 1 — — $9,461.40 $38,792.70 $16,387.10 2026-07-15
180 APR_DRG Other Circulatory System Procedures 4 1 — — $11,484.30 $33,804.40 $16,337.40 2026-07-15
315 APR_DRG Shoulder, Upper Arm & Forearm Procedures Except Joint Replacement 4 1 — — $8,042.50 $31,312.10 $16,226.75 2026-07-15
232 APR_DRG Gastric Fundoplication 4 1 — — $10,963.40 $42,571.60 $16,222.65 2026-07-15
24 APR_DRG Open Extracranial Vascular Procedures 4 1 — — $9,435.60 $36,275.70 $16,167.60 2026-07-15
0265U CPT Rar Do Whl Gn&mtcdrl DNA Als 3 1 — — $5,464.00 $26,654.00 $16,154.00 2026-07-15
0212U CPT Rare Ds Gen DNA Alys Proband 3 1 — — $5,463.00 $26,651.00 $16,152.00 2026-07-15
229 APR_DRG Other Digestive System & Abdominal Procedures 4 1 — — $10,835.80 $33,311.60 $16,137.15 2026-07-15
81554 CPT Pulm Ds Ipf Mrna 190 Gen Alg 3 1 — — $5,433.00 $26,504.00 $16,063.00 2026-07-15
403 APR_DRG Procedures For Obesity 4 1 — — $11,922.20 $46,144.50 $16,055.85 2026-07-15
443 APR_DRG Kidney & Urinary Tract Procedures For Nonmalignancy 4 1 — — $10,903.70 $34,873.30 $16,050.00 2026-07-15
0295U CPT Onc Brst Dux Carc 7 Proteins 3 1 — — $5,423.00 $26,454.00 $16,033.00 2026-07-15
187000714 NDC Ribavirin 6 Gram Recon Soln 4 Each Vial 3 1 $71,893.39 $53,920.05 25% off $14,378.70 $47,449.64 $15,816.55 2026-07-15
362 APR_DRG Mastectomy Procedures 4 1 — — $10,735.10 $32,556.50 $15,615.65 2026-07-15
0335U CPT Rare Ds Whl Gen Seq Feta 3 1 — — $5,213.00 $25,431.00 $15,413.00 2026-07-15
0214U CPT Rare Ds Xom DNA Alys Proband 3 1 — — $5,213.00 $25,431.00 $15,413.00 2026-07-15
263 APR_DRG Cholecystectomy 4 1 — — $10,608.70 $30,788.80 $15,412.55 2026-07-15
65770 CPT Keratoprosthesis 3 1 — — $11,606.00 $37,288.00 $15,372.00 2026-07-15
952 APR_DRG Nonextensive Procedure Unrelated To Principal Diagnosis 4 1 — — $8,643.10 $35,503.10 $15,334.10 2026-07-15
514 APR_DRG Female Reproductive System Reconstructive Procedures 4 1 — — $7,334.30 $34,475.20 $15,214.15 2026-07-15
639 APR_DRG Neonate Birthwt >2499g W Other Significant Condition 4 1 — — $5,937.70 $30,960.90 $15,206.50 2026-07-15
692 APR_DRG Radiotherapy 4 1 — — $7,123.60 $35,120.30 $15,006.30 2026-07-15
98 APR_DRG Other Ear, Nose, Mouth & Throat Procedures 4 1 — — $8,712.20 $33,656.90 $14,964.75 2026-07-15
317 APR_DRG Tendon, Muscle & Other Soft Tissue Procedures 4 1 — — $9,256.50 $33,467.30 $14,905.05 2026-07-15
81425 CPT Genome Sequence Analysis 3 1 — — $5,020.00 $24,489.00 $14,842.00 2026-07-15
310 APR_DRG Intervertebral Disc Excision & Decompression 4 1 — — $10,184.90 $32,316.50 $14,828.35 2026-07-15
793 APR_DRG Moderately Extensive Or Procedures For Other Complications Of Treatment 4 1 — — $8,489.70 $34,805.40 $14,780.40 2026-07-15
0242U CPT Trgt Gen Seq Alys Pnl 55-74 3 1 — — $4,989.00 $24,338.00 $14,750.00 2026-07-15
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