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

ST LUKE'S MCCALL

Mccall, ID · CCN 131312 · Rates published

66,682 distinct procedures filed
28 distinct payers
2,480,145 rate rows
2026-05-09 last MRF observed
Data quality

2,447,125 of 2,480,145 rate rows are consumer-grade (98.7%)

33,020 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 27,372
percent-of-charges filed in the dollar field — excluded from medians 4,138
placeholder amount (≤ $0.02) — excluded from medians 1,208
per-diem day rate — not a per-procedure price 292
exceeds 10× this hospital's gross charge — excluded from medians 10
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://assets.slhs.org/download/assets/273311774_St-Lukes-McCall-LTD_standardcharges.csv/8ce4df342a2111f1b690eeb323b4f562
Found on page https://stlukesonline.org/en/patients-visitors/billing-and-insurance/price-estimates/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint 73b14e28acbf34c4… · 357,288,550 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
PX-36002153
OTHER 		Transplantation Of Donor Stem Cells Per Donor 21 $96,047.42 $158,975.04 $145,727.12 nat. median
$85,523
1.7× median
RX-41815
OTHER 		Kit For Yttrium-90-ibritumomab 3.2 Mg/2 Ml Intravenous 21 $84,554.97 $140,013.53 $128,345.74 nat. median
$106,812
1.2× median
RX-186707
OTHER 		Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution 21 $83,604.33 $138,440.06 $126,903.39 nat. median
$115,367
1.1× median
PX-36004882
OTHER 		Hc Insertion Phrenic Nerve Stimulator System 21 $73,080.58 $120,960.96 $110,880.88 nat. median
$100,801
1.1× median
PX-36003449
OTHER 		Insertion Of Cranial Nerve Neurostimulator Electrode And Generator 21 $73,080.58 $120,960.96 $110,880.88 nat. median
$69,170
1.6× median
482
OTHER 		Hip And Femur Procedures Except Major Joint Without Cc/mcc 1 $100,686.00 $100,686.00 $100,686.00 nat. median
$14,209
outlier · 7.1×
PX-27073371
OTHER 		Hc Aprevo Kit Implant Level 5 Patient Specific 21 $45,240.00 $78,000.00 $69,420.00 nat. median
$64,350
1.1× median
371
OTHER 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 1 $63,820.41 $63,820.41 $63,820.41 nat. median
$16,993
outlier · 3.8×
PX-51001348
OTHER 		Hc Nadofaragene Firadenovec-vncg, Instill, 75 Ml 21 $41,760.00 $69,120.00 $62,280.00 nat. median
$61,200
1.0× median
PX-27073369
OTHER 		Hc Aprevo Kit Implant Level 4 Patient Specific 21 $39,811.20 $68,640.00 $61,089.60 nat. median
$56,628
1.1× median
PX-27078167
OTHER 		Hc Kit Heart Valve 52mm Evoque Tricupsid Replacement 21 $38,906.40 $67,080.00 $59,701.20 nat. median
$57,018
1.0× median
PX-27078168
OTHER 		Hc Kit Heart Valve 56mm Evoque Tricupsid Replacement 21 $38,906.40 $67,080.00 $59,701.20 nat. median
$57,018
1.0× median
PX-27078165
OTHER 		Hc Kit Heart Valve 44mm Evoque Tricupsid Replacement 21 $38,906.40 $67,080.00 $59,701.20 nat. median
$57,018
1.0× median
PX-27078166
OTHER 		Hc Kit Heart Valve 48mm Evoque Tricupsid Replacement 21 $38,906.40 $67,080.00 $59,701.20 nat. median
$57,018
1.0× median
PX-27064932
OTHER 		Hc Generator Vns Sentiva 21 $36,303.36 $62,592.00 $55,706.88 nat. median
$53,203
1.0× median
PX-27076921
OTHER 		Hc Generator Duo Sentiva 21 $36,303.36 $62,592.00 $55,706.88 nat. median
$51,325
1.1× median
PX-27072019
OTHER 		Hc Graft Skin 10x10cm Autologous 21 $36,192.00 $62,400.00 $55,536.00 nat. median
$49,920
1.1× median
PX-48000135
OTHER 		Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma… 21 $35,962.90 $59,524.80 $54,564.40 nat. median
$40,303
1.4× median
PX-48000138
OTHER 		Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma… 21 $35,962.90 $59,524.80 $54,564.40 nat. median
$40,303
1.4× median
PX-48000136
OTHER 		Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma… 21 $35,962.90 $59,524.80 $54,564.40 nat. median
$43,382
1.3× median
PX-27078257
OTHER 		Hc Triclip G4 System - Procedure Code 21 $35,061.00 $60,450.00 $53,800.50 nat. median
$51,382
1.0× median
PX-27073368
OTHER 		Hc Aprevo Kit Implant Level 3 Patient Specific 21 $34,382.40 $59,280.00 $52,759.20 nat. median
$48,906
1.1× median
PX-51001216
OTHER 		Hc Histerlin, Implant, 50 Mg 21 $34,926.41 $57,809.22 $51,185.25 nat. median
$49,379
1.0× median
PX-27064180
OTHER 		Hc Imp Ult Hires Hifocus Slimj 21 $32,468.98 $55,981.00 $49,823.09 nat. median
$47,584
1.0× median
PX-27063440
OTHER 		Hc Imp Hires Slimj E Coch 21 $32,468.98 $55,981.00 $49,823.09 nat. median
$47,584
1.0× median
PX-27050586
OTHER 		Hc Gntr Nrstm 7mm Vns Thk Aspirsr 21 $32,267.72 $55,634.00 $49,514.26 nat. median
$47,289
1.0× median
787
OTHER 		Cesarean Section Without Sterilization With Cc 2 $43,819.72 $54,466.06 $49,142.89 nat. median
$10,422
outlier · 4.7×
PX-27075308
OTHER 		Hc Stimulator Spinal Cord Inceptiv 21 $31,326.38 $54,011.00 $48,069.79 nat. median
$44,559
1.1× median
PX-33000069
OTHER 		Complete Single Session Course Of Cranial Lesion Surgery Using Radiation And A M… 21 $31,294.48 $51,797.76 $47,481.28 nat. median
$27,401
1.7× median
PX-27073836
OTHER 		Hc Valve Heart Transcatheter 23mm Commander System 21 $30,763.20 $53,040.00 $47,205.60 nat. median
$45,084
1.0× median
PX-27073837
OTHER 		Hc Valve Heart Transcatheter 26mm Commander System 21 $30,763.20 $53,040.00 $47,205.60 nat. median
$45,084
1.0× median
PX-27073838
OTHER 		Hc Valve Heart Transcatheter 29mm Commander System 21 $30,763.20 $53,040.00 $47,205.60 nat. median
$45,084
1.0× median
PX-27073835
OTHER 		Hc Valve Heart Transcatheter 20mm Commander System 21 $30,763.20 $53,040.00 $47,205.60 nat. median
$45,084
1.0× median
PX-27041668
OTHER 		Hc Impl Coclr Hires 90k Adv 21 $30,310.80 $52,260.00 $46,511.40 nat. median
$44,421
1.0× median
RX-184802
OTHER 		Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln 21 $30,419.66 $50,464.02 $46,153.97 nat. median
$37,711
1.2× median
PX-27074914
OTHER 		Hc Valve Heart Aortic Transcatheter 26mm Evoluttm Fx 21 $29,858.40 $51,480.00 $45,817.20 nat. median
$43,758
1.0× median
PX-27074916
OTHER 		Hc Valve Heart Aortic Transcatheter 34mm Evoluttm Fx 21 $29,858.40 $51,480.00 $45,817.20 nat. median
$43,758
1.0× median
PX-27074915
OTHER 		Hc Valve Heart Aortic Transcatheter 29mm Evoluttm Fx 21 $29,858.40 $51,480.00 $45,817.20 nat. median
$43,758
1.0× median
PX-27074917
OTHER 		Hc Valve Heart Aortic Transcatheter 23mm Evoluttm Fx 21 $29,858.40 $51,480.00 $45,817.20 nat. median
$43,758
1.0× median
PX-27052532
OTHER 		Hc Valve Hrt 26mm Transcath Sys 21 $29,406.00 $50,700.00 $45,123.00 nat. median
$43,095
1.0× median
PX-27052533
OTHER 		Hc Valve Hrt 29mm Transcath Sys 21 $29,406.00 $50,700.00 $45,123.00 nat. median
$43,095
1.0× median
PX-27041795
OTHER 		Hc Vlv Trnscath Hrt 29mm Sapienxt 21 $29,406.00 $50,700.00 $45,123.00 nat. median
$43,095
1.0× median
PX-27052531
OTHER 		Hc Valve Hrt 23mm Transcath Sys 21 $29,406.00 $50,700.00 $45,123.00 nat. median
$43,095
1.0× median
PX-27069601
OTHER 		Hc Valve 26mm Sapien 3 Ultra 21 $29,406.00 $50,700.00 $45,123.00 nat. median
$43,095
1.0× median
PX-27069599
OTHER 		Hc Valve 20mm Sapien 3 Ultra 21 $29,406.00 $50,700.00 $45,123.00 nat. median
$43,095
1.0× median
PX-27052530
OTHER 		Hc Valve Hrt 20mm Transcath Sys 21 $29,406.00 $50,700.00 $45,123.00 nat. median
$43,095
1.0× median
PX-27069600
OTHER 		Hc Valve 23mm Sapien 3 Ultra 21 $29,406.00 $50,700.00 $45,123.00 nat. median
$43,095
1.0× median
PX-27080771
OTHER 		Hc Prostep Mis Arthrodesis Kit 21 $29,685.56 $49,134.72 $45,040.16 nat. median
$43,505
1.0× median
PX-27073367
OTHER 		Hc Aprevo Kit Implant Level 2 Patient Specific 21 $28,953.60 $49,920.00 $44,428.80 nat. median
$41,184
1.1× median
PX-27020944
OTHER 		Hc Generator Dual Lead Cyberonics 21 $28,317.34 $48,823.00 $43,452.47 nat. median
$40,035
1.1× median

Other procedures at this hospital

Browse this hospital's 66,682 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
             
PX-36002153 OTHER Transplantation Of Donor Stem Cells Per Donor 36 21 $165,599.00 $165,599.00 $96,047.42 $158,975.04 $145,727.12 2026-05-09
RX-41815 OTHER Kit For Yttrium-90-ibritumomab 3.2 Mg/2 Ml Intravenous 72 21 $145,815.93 $145,815.93 $84,554.97 $140,013.53 $128,345.74 2026-05-09
RX-186707 OTHER Lutetium Lu 177 Dotatate 10 Mci/ml (370 Mbq/ml) Intravenous Solution 72 21 $144,176.90 $144,176.90 $83,604.33 $138,440.06 $126,903.39 2026-05-09
PX-36004882 OTHER Hc Insertion Phrenic Nerve Stimulator System 36 21 $126,001.00 $126,001.00 $73,080.58 $120,960.96 $110,880.88 2026-05-09
PX-36003449 OTHER Insertion Of Cranial Nerve Neurostimulator Electrode And Generator 36 21 $126,001.00 $126,001.00 $73,080.58 $120,960.96 $110,880.88 2026-05-09
482 OTHER Hip And Femur Procedures Except Major Joint Without Cc/mcc 1 1 $83,476.85 $83,476.85 $100,686.00 $100,686.00 $100,686.00 2026-05-09
PX-27073371 OTHER Hc Aprevo Kit Implant Level 5 Patient Specific 36 21 $78,000.00 $78,000.00 $45,240.00 $78,000.00 $69,420.00 2026-05-09
371 OTHER Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 1 1 $56,454.59 $56,454.59 $63,820.41 $63,820.41 $63,820.41 2026-05-09
PX-51001348 OTHER Hc Nadofaragene Firadenovec-vncg, Instill, 75 Ml 36 21 $72,000.00 $72,000.00 $41,760.00 $69,120.00 $62,280.00 2026-05-09
PX-27073369 OTHER Hc Aprevo Kit Implant Level 4 Patient Specific 36 21 $68,640.00 $68,640.00 $39,811.20 $68,640.00 $61,089.60 2026-05-09
PX-27078168 OTHER Hc Kit Heart Valve 56mm Evoque Tricupsid Replacement 36 21 $67,080.00 $67,080.00 $38,906.40 $67,080.00 $59,701.20 2026-05-09
PX-27078166 OTHER Hc Kit Heart Valve 48mm Evoque Tricupsid Replacement 36 21 $67,080.00 $67,080.00 $38,906.40 $67,080.00 $59,701.20 2026-05-09
PX-27078167 OTHER Hc Kit Heart Valve 52mm Evoque Tricupsid Replacement 36 21 $67,080.00 $67,080.00 $38,906.40 $67,080.00 $59,701.20 2026-05-09
PX-27078165 OTHER Hc Kit Heart Valve 44mm Evoque Tricupsid Replacement 36 21 $67,080.00 $67,080.00 $38,906.40 $67,080.00 $59,701.20 2026-05-09
PX-27064932 OTHER Hc Generator Vns Sentiva 36 21 $62,592.00 $62,592.00 $36,303.36 $62,592.00 $55,706.88 2026-05-09
PX-27076921 OTHER Hc Generator Duo Sentiva 36 21 $62,592.00 $62,592.00 $36,303.36 $62,592.00 $55,706.88 2026-05-09
PX-27072019 OTHER Hc Graft Skin 10x10cm Autologous 36 21 $62,400.00 $62,400.00 $36,192.00 $62,400.00 $55,536.00 2026-05-09
PX-48000138 OTHER Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma… 36 21 $62,005.00 $62,005.00 $35,962.90 $59,524.80 $54,564.40 2026-05-09
PX-48000135 OTHER Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma… 36 21 $62,005.00 $62,005.00 $35,962.90 $59,524.80 $54,564.40 2026-05-09
PX-48000136 OTHER Comprehensive Electrophysiologic Evaluation With Catheter Destruction Of Abnorma… 36 21 $62,005.00 $62,005.00 $35,962.90 $59,524.80 $54,564.40 2026-05-09
PX-27078257 OTHER Hc Triclip G4 System - Procedure Code 36 21 $60,450.00 $60,450.00 $35,061.00 $60,450.00 $53,800.50 2026-05-09
PX-27073368 OTHER Hc Aprevo Kit Implant Level 3 Patient Specific 36 21 $59,280.00 $59,280.00 $34,382.40 $59,280.00 $52,759.20 2026-05-09
PX-51001216 OTHER Hc Histerlin, Implant, 50 Mg 39 21 $60,217.94 $60,217.94 $34,926.41 $57,809.22 $51,185.25 2026-05-09
PX-27063440 OTHER Hc Imp Hires Slimj E Coch 36 21 $55,981.00 $55,981.00 $32,468.98 $55,981.00 $49,823.09 2026-05-09
PX-27064180 OTHER Hc Imp Ult Hires Hifocus Slimj 36 21 $55,981.00 $55,981.00 $32,468.98 $55,981.00 $49,823.09 2026-05-09
PX-27050586 OTHER Hc Gntr Nrstm 7mm Vns Thk Aspirsr 36 21 $55,634.00 $55,634.00 $32,267.72 $55,634.00 $49,514.26 2026-05-09
787 OTHER Cesarean Section Without Sterilization With Cc 2 2 $56,294.38 $56,294.38 $43,819.72 $54,466.06 $49,142.89 2026-05-09
PX-27075308 OTHER Hc Stimulator Spinal Cord Inceptiv 36 21 $54,011.00 $54,011.00 $31,326.38 $54,011.00 $48,069.79 2026-05-09
PX-33000069 OTHER Complete Single Session Course Of Cranial Lesion Surgery Using Radiation And A M… 36 21 $53,956.00 $53,956.00 $31,294.48 $51,797.76 $47,481.28 2026-05-09
PX-27073836 OTHER Hc Valve Heart Transcatheter 23mm Commander System 36 21 $53,040.00 $53,040.00 $30,763.20 $53,040.00 $47,205.60 2026-05-09
PX-27073835 OTHER Hc Valve Heart Transcatheter 20mm Commander System 36 21 $53,040.00 $53,040.00 $30,763.20 $53,040.00 $47,205.60 2026-05-09
PX-27073837 OTHER Hc Valve Heart Transcatheter 26mm Commander System 36 21 $53,040.00 $53,040.00 $30,763.20 $53,040.00 $47,205.60 2026-05-09
PX-27073838 OTHER Hc Valve Heart Transcatheter 29mm Commander System 36 21 $53,040.00 $53,040.00 $30,763.20 $53,040.00 $47,205.60 2026-05-09
PX-27041668 OTHER Hc Impl Coclr Hires 90k Adv 36 21 $52,260.00 $52,260.00 $30,310.80 $52,260.00 $46,511.40 2026-05-09
RX-184802 OTHER Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln 78 21 $52,507.19 $52,507.19 $30,419.66 $50,464.02 $46,153.97 2026-05-09
PX-27074914 OTHER Hc Valve Heart Aortic Transcatheter 26mm Evoluttm Fx 36 21 $51,480.00 $51,480.00 $29,858.40 $51,480.00 $45,817.20 2026-05-09
PX-27074916 OTHER Hc Valve Heart Aortic Transcatheter 34mm Evoluttm Fx 36 21 $51,480.00 $51,480.00 $29,858.40 $51,480.00 $45,817.20 2026-05-09
PX-27074917 OTHER Hc Valve Heart Aortic Transcatheter 23mm Evoluttm Fx 36 21 $51,480.00 $51,480.00 $29,858.40 $51,480.00 $45,817.20 2026-05-09
PX-27074915 OTHER Hc Valve Heart Aortic Transcatheter 29mm Evoluttm Fx 36 21 $51,480.00 $51,480.00 $29,858.40 $51,480.00 $45,817.20 2026-05-09
PX-27069599 OTHER Hc Valve 20mm Sapien 3 Ultra 36 21 $50,700.00 $50,700.00 $29,406.00 $50,700.00 $45,123.00 2026-05-09
PX-27069601 OTHER Hc Valve 26mm Sapien 3 Ultra 36 21 $50,700.00 $50,700.00 $29,406.00 $50,700.00 $45,123.00 2026-05-09
PX-27052532 OTHER Hc Valve Hrt 26mm Transcath Sys 36 21 $50,700.00 $50,700.00 $29,406.00 $50,700.00 $45,123.00 2026-05-09
PX-27069600 OTHER Hc Valve 23mm Sapien 3 Ultra 36 21 $50,700.00 $50,700.00 $29,406.00 $50,700.00 $45,123.00 2026-05-09
PX-27041795 OTHER Hc Vlv Trnscath Hrt 29mm Sapienxt 36 21 $50,700.00 $50,700.00 $29,406.00 $50,700.00 $45,123.00 2026-05-09
PX-27052531 OTHER Hc Valve Hrt 23mm Transcath Sys 36 21 $50,700.00 $50,700.00 $29,406.00 $50,700.00 $45,123.00 2026-05-09
PX-27052530 OTHER Hc Valve Hrt 20mm Transcath Sys 36 21 $50,700.00 $50,700.00 $29,406.00 $50,700.00 $45,123.00 2026-05-09
PX-27052533 OTHER Hc Valve Hrt 29mm Transcath Sys 36 21 $50,700.00 $50,700.00 $29,406.00 $50,700.00 $45,123.00 2026-05-09
PX-27080771 OTHER Hc Prostep Mis Arthrodesis Kit 36 21 $51,182.00 $51,182.00 $29,685.56 $49,134.72 $45,040.16 2026-05-09
PX-27073367 OTHER Hc Aprevo Kit Implant Level 2 Patient Specific 36 21 $49,920.00 $49,920.00 $28,953.60 $49,920.00 $44,428.80 2026-05-09
PX-27020944 OTHER Hc Generator Dual Lead Cyberonics 36 21 $48,823.00 $48,823.00 $28,317.34 $48,823.00 $43,452.47 2026-05-09
PX-27068002 OTHER Hc Cmpnt Fem Sz5 Rt Cmnt Rk 36 21 $47,736.00 $47,736.00 $27,686.88 $47,736.00 $42,485.04 2026-05-09
PX-27062634 OTHER Hc Cmpnt Fem Sz5 Lt Cmnt Rk 36 21 $47,736.00 $47,736.00 $27,686.88 $47,736.00 $42,485.04 2026-05-09
PX-27077786 OTHER Hc Pascal Mitral Procedure Billing Code 36 21 $47,736.00 $47,736.00 $27,686.88 $47,736.00 $42,485.04 2026-05-09
PX-27023911 OTHER Hc Cmpnt Fem 4 Lt Kn Cnstrn 36 21 $47,736.00 $47,736.00 $27,686.88 $47,736.00 $42,485.04 2026-05-09
PX-27089366 OTHER Hc Ultrasound Paradise Rdn Price Per Procedure 36 21 $48,128.00 $48,128.00 $27,914.24 $46,202.88 $42,352.64 2026-05-09
PX-36003902 OTHER Hc Process Auto Islet Transcon 36 21 $47,580.00 $47,580.00 $27,596.40 $45,676.80 $41,870.40 2026-05-09
PX-27070813 OTHER Hc Valve Mitraclip Clip Procedure Code 36 21 $46,800.00 $46,800.00 $27,144.00 $46,800.00 $41,652.00 2026-05-09
PX-27071169 OTHER Hc Valve Aor Trncht 26mm 36 21 $46,800.00 $46,800.00 $27,144.00 $46,800.00 $41,652.00 2026-05-09
PX-27071170 OTHER Hc Valve Aor Trncht 23mm 36 21 $46,800.00 $46,800.00 $27,144.00 $46,800.00 $41,652.00 2026-05-09
PX-27071957 OTHER Hc Valve Aor Trncht 29mm 36 21 $46,800.00 $46,800.00 $27,144.00 $46,800.00 $41,652.00 2026-05-09
PX-27054788 OTHER Hc Valve Aor Trncth 29mm Evolut R 36 21 $46,800.00 $46,800.00 $27,144.00 $46,800.00 $41,652.00 2026-05-09
PX-27065362 OTHER Hc Bundle Cth 2xtr 1ntr Mitraclip 36 21 $46,800.00 $46,800.00 $27,144.00 $44,928.00 $41,184.00 2026-05-09
PX-27065354 OTHER Hc Bundle Gdcath 1ntr Mitraclip 36 21 $46,800.00 $46,800.00 $27,144.00 $44,928.00 $41,184.00 2026-05-09
PX-27065356 OTHER Hc Bundle Gdcath 3ntr Mitraclip 36 21 $46,800.00 $46,800.00 $27,144.00 $44,928.00 $41,184.00 2026-05-09
PX-27065357 OTHER Hc Bundle Gdcath 1xtr Mitraclip 36 21 $46,800.00 $46,800.00 $27,144.00 $44,928.00 $41,184.00 2026-05-09
PX-27065358 OTHER Hc Bundle Gdcath 2xtr Mitraclip 36 21 $46,800.00 $46,800.00 $27,144.00 $44,928.00 $41,184.00 2026-05-09
PX-27065355 OTHER Hc Bundle Gdcath 2ntr Mitraclip 36 21 $46,800.00 $46,800.00 $27,144.00 $44,928.00 $41,184.00 2026-05-09
PX-27065360 OTHER Hc Bundle Cth 1xtr 1ntr Mitraclip 36 21 $46,800.00 $46,800.00 $27,144.00 $44,928.00 $41,184.00 2026-05-09
PX-27065361 OTHER Hc Bundle Cth 1xtr 2ntr Mitraclip 36 21 $46,800.00 $46,800.00 $27,144.00 $44,928.00 $41,184.00 2026-05-09
PX-27065359 OTHER Hc Bundle Gdcath 3xtr Mitraclip 36 21 $46,800.00 $46,800.00 $27,144.00 $44,928.00 $41,184.00 2026-05-09
RX-182355 OTHER Ocrelizumab 30 Mg/ml Intravenous Solution 78 21 $46,713.73 $46,713.73 $20,149.20 $44,872.06 $41,083.44 2026-05-09
PX-27043076 OTHER Hc Sys Viva Quad S Crt-d System 36 21 $45,431.00 $45,431.00 $26,349.98 $45,431.00 $40,433.59 2026-05-09
PX-27043077 OTHER Hc Sys Viva S Crtd System 36 21 $45,431.00 $45,431.00 $26,349.98 $45,431.00 $40,433.59 2026-05-09
PX-27052300 OTHER Hc Plt Prox Tib 3.5mm Low Bnd Set 36 21 $45,097.00 $45,097.00 $26,156.26 $45,097.00 $40,136.33 2026-05-09
PX-27089751 OTHER Hc Stent Aortic 20-35x40x527mm Amds Straight Strl 36 21 $44,795.00 $44,795.00 $25,981.10 $44,795.00 $39,867.55 2026-05-09
PX-27062181 OTHER Hc Generator Nrstm 7mm Vns 36 21 $44,666.00 $44,666.00 $25,906.28 $44,666.00 $39,752.74 2026-05-09
PX-27035439 OTHER Hc Generator Aspirehc Model 105 36 21 $44,564.00 $44,564.00 $25,847.12 $44,564.00 $39,661.96 2026-05-09
PX-27067769 OTHER Hc Imp Coclr Ncl Prfl Pls W Slim Modiolar 36 21 $44,226.00 $44,226.00 $25,651.08 $44,226.00 $39,361.14 2026-05-09
PX-27065430 OTHER Hc Imp Coclr Ncl Slim Modiolar 36 21 $44,226.00 $44,226.00 $25,651.08 $44,226.00 $39,361.14 2026-05-09
PX-27045096 OTHER Hc Gft Sft Tis 25x45cm Xcm Hydrtd 36 21 $44,665.00 $44,665.00 $25,905.70 $42,878.40 $39,305.20 2026-05-09
PX-27042824 OTHER Hc Imp Ear Mdel Mi1000 Cncrt Cust 36 21 $43,524.00 $43,524.00 $25,243.92 $43,524.00 $38,736.36 2026-05-09
PX-27078225 OTHER Hc Impella Cp Abiomed 14fr Smart Assist 36 21 $43,400.00 $43,400.00 $25,172.00 $43,400.00 $38,626.00 2026-05-09
PX-27089724 OTHER Hc Ipg Dbs Vercise Genus R32 36 21 $43,400.00 $43,400.00 $25,172.00 $43,400.00 $38,626.00 2026-05-09
PX-27064753 OTHER Hc Crt-d Is4/df-1 Amplia MRI 36 21 $42,986.00 $42,986.00 $24,931.88 $42,986.00 $38,257.54 2026-05-09
PX-27072688 OTHER Hc Generator Pulse Implant Remede 36 21 $42,900.00 $42,900.00 $24,882.00 $42,900.00 $38,181.00 2026-05-09
PX-27068452 OTHER Hc Generator Pulse Imp Remede 36 21 $42,900.00 $42,900.00 $24,882.00 $42,900.00 $38,181.00 2026-05-09
PX-27052757 OTHER Hc Cochlear Imp Ci522 Slim St 36 21 $41,886.00 $41,886.00 $24,293.88 $41,886.00 $37,278.54 2026-05-09
PX-27067768 OTHER Hc Imp Coclr Ncl Prfl Pls W Slim 36 21 $41,886.00 $41,886.00 $24,293.88 $41,886.00 $37,278.54 2026-05-09
PX-27062374 OTHER Hc Generator DRG Ipg Modl 3664 36 21 $41,184.00 $41,184.00 $23,886.72 $41,184.00 $36,653.76 2026-05-09
PX-36003658 OTHER Implantation Of Eye Drug Delivery System 36 21 $41,585.00 $41,585.00 $24,119.30 $39,921.60 $36,594.80 2026-05-09
PX-27089894 OTHER Hc Nail Bone 10.7x275x80mm 10deg Precice System Antgr Fem Strl 36 21 $40,987.00 $40,987.00 $23,772.46 $40,987.00 $36,478.43 2026-05-09
PX-27078027 OTHER Hc Generator Deep Brain Stimulation 36 21 $40,950.00 $40,950.00 $23,751.00 $40,950.00 $36,445.50 2026-05-09
PX-27061746 OTHER Hc Neurostimulator 2ch Activa Rc 36 21 $40,705.00 $40,705.00 $23,608.90 $40,705.00 $36,227.45 2026-05-09
PX-27073370 OTHER Hc Aprevo Kit Implant Level 1 Patient Specific 36 21 $40,560.00 $40,560.00 $23,524.80 $40,560.00 $36,098.40 2026-05-09
PX-27075517 OTHER Hc Crtd Cobalt Hf Quad MRI Is4 Df1 36 21 $39,599.00 $39,599.00 $22,967.42 $39,599.00 $35,243.11 2026-05-09
PX-27075518 OTHER Hc Crtd Cobalt Hf Quad MRI Is4 Df4 36 21 $39,599.00 $39,599.00 $22,967.42 $39,599.00 $35,243.11 2026-05-09
PX-27023168 OTHER Hc Cath Impella Hrt Pmp 14fr 3.5 Lt 36 21 $39,000.00 $39,000.00 $22,620.00 $37,440.00 $34,320.00 2026-05-09
PX-27065691 OTHER Hc Stem Fem Sz15 190mm Slvls Rev 36 21 $38,509.00 $38,509.00 $22,335.22 $38,509.00 $34,273.01 2026-05-09
PX-27070684 OTHER Hc Stem Fem Sz17 190mm Slvls Rev 36 21 $38,509.00 $38,509.00 $22,335.22 $38,509.00 $34,273.01 2026-05-09
PX-27071672 OTHER Hc Stem 190mm Slvls Sz19 Hiofst 36 21 $38,509.00 $38,509.00 $22,335.22 $38,509.00 $34,273.01 2026-05-09
PX-27058904 OTHER Hc Crt-d Quadra Assura Mp Mrlnpkg 36 21 $38,501.00 $38,501.00 $22,330.58 $38,501.00 $34,265.89 2026-05-09
PX-27058906 OTHER Hc Crt-d Qdra Assra Mp Df4 Mrlnpk 36 21 $38,501.00 $38,501.00 $22,330.58 $38,501.00 $34,265.89 2026-05-09
PX-27073844 OTHER Hc Proclaim Plus 7 Ipg 36 21 $38,400.00 $38,400.00 $22,272.00 $38,400.00 $34,176.00 2026-05-09
PX-27073843 OTHER Hc Proclaim Plus 5 Ipg 36 21 $38,400.00 $38,400.00 $22,272.00 $38,400.00 $34,176.00 2026-05-09
PX-27075520 OTHER Hc Crtd Cobalt Hf MRI Is1 Df4 36 21 $38,370.00 $38,370.00 $22,254.60 $38,370.00 $34,149.30 2026-05-09
PX-27075519 OTHER Hc Crtd Cobalt Hf MRI Is1 Df1 36 21 $38,370.00 $38,370.00 $22,254.60 $38,370.00 $34,149.30 2026-05-09
RX-164173 OTHER Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln 72 21 $38,731.50 $38,731.50 $22,446.00 $37,212.48 $34,111.44 2026-05-09
RX-189142 OTHER Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe 78 21 $38,623.60 $38,623.60 $14,013.60 $37,084.90 $33,983.05 2026-05-09
PX-27071941 OTHER Hc Icd Bi-vent Gallant Hf Crt-d 36 21 $37,799.00 $37,799.00 $21,923.42 $37,799.00 $33,641.11 2026-05-09
PX-27058903 OTHER Hc Crt-d Quadra Assura Mp 36 21 $37,799.00 $37,799.00 $21,923.42 $37,799.00 $33,641.11 2026-05-09
PX-27077250 OTHER Hc Defib Implantable Gallant Therapy Resynch Cardiac Strl Hf 36 21 $37,799.00 $37,799.00 $21,923.42 $37,799.00 $33,641.11 2026-05-09
PX-27058905 OTHER Hc Crt-d Quadra Assra Mp Df4 Cnct 36 21 $37,799.00 $37,799.00 $21,923.42 $37,799.00 $33,641.11 2026-05-09
PX-27054588 OTHER Hc Electrode Flex28 Array 28mm 36 21 $37,050.00 $37,050.00 $21,489.00 $37,050.00 $32,974.50 2026-05-09
PX-27072851 OTHER Hc Synchrony 2 Electrode Array Flex28 36 21 $37,050.00 $37,050.00 $21,489.00 $37,050.00 $32,974.50 2026-05-09
PX-27073008 OTHER Hc Implant Cochlear Synchrony 2 Pin Flex 28 36 21 $37,050.00 $37,050.00 $21,489.00 $37,050.00 $32,974.50 2026-05-09
PX-27045354 OTHER Hc Imp Flex 28 Cynchrony 36 21 $37,050.00 $37,050.00 $21,489.00 $37,050.00 $32,974.50 2026-05-09
PX-27069052 OTHER Hc Imp Coch Synchrony 2 Flxsft 36 21 $37,050.00 $37,050.00 $21,489.00 $37,050.00 $32,974.50 2026-05-09
PX-27069328 OTHER Hc Imp Flex Electrode 31.5mm 36 21 $37,050.00 $37,050.00 $21,489.00 $37,050.00 $32,974.50 2026-05-09
PX-27060610 OTHER Hc Imp Flex 28 Mi1200 Synchrny 36 21 $37,050.00 $37,050.00 $21,489.00 $37,050.00 $32,974.50 2026-05-09
PX-27068359 OTHER Hc Imp Flex B Synchrony 2 36 21 $37,050.00 $37,050.00 $21,489.00 $37,050.00 $32,974.50 2026-05-09
PX-27073267 OTHER Hc Synchrony 2 Flexsoft Cochlear Implant 36 21 $37,050.00 $37,050.00 $21,489.00 $37,050.00 $32,974.50 2026-05-09
PX-27055437 OTHER Hc Defib Card Amplia MRI 4 Crt-d 36 21 $36,965.00 $36,965.00 $21,439.70 $36,965.00 $32,898.85 2026-05-09
PX-27061887 OTHER Hc Neurostimulator 6.5x4.8x1.1 36 21 $36,660.00 $36,660.00 $21,262.80 $36,660.00 $32,627.40 2026-05-09
PX-27064523 OTHER Hc Intrnl Pulse Gen Proclaim 5 36 21 $36,660.00 $36,660.00 $21,262.80 $36,660.00 $32,627.40 2026-05-09
PX-27045585 OTHER Hc Crt-d Qd Asr Nxt Gnrtn Mrln Pk 36 21 $36,629.00 $36,629.00 $21,244.82 $36,629.00 $32,599.81 2026-05-09
PX-27062003 OTHER Hc Icd Evera MRI Xt Vr/Dr Df-1 36 21 $36,410.00 $36,410.00 $21,117.80 $36,410.00 $32,404.90 2026-05-09
PX-27040767 OTHER Hc Dfbr Quadra Assura 40 Crtd 36 21 $35,927.00 $35,927.00 $20,837.66 $35,927.00 $31,975.03 2026-05-09
PX-27040768 OTHER Hc Dfbr Quadra Assura 40 Df4 Crtd 36 21 $35,927.00 $35,927.00 $20,837.66 $35,927.00 $31,975.03 2026-05-09
PX-27073168 OTHER Hc Implant Brain Gammatile Therapy Cesium-131 36 21 $35,880.00 $35,880.00 $20,810.40 $35,880.00 $31,933.20 2026-05-09
PX-27063231 OTHER Hc Crt-d Is1/df-1 Amplia MRI 36 21 $35,771.00 $35,771.00 $20,747.18 $35,771.00 $31,836.19 2026-05-09
PX-27055436 OTHER Hc Defib Card Amplia MRI Crt-d 2 36 21 $35,771.00 $35,771.00 $20,747.18 $35,771.00 $31,836.19 2026-05-09
PX-27068461 OTHER Hc Crt-d Dynagen Df1 36 21 $35,579.00 $35,579.00 $20,635.82 $35,579.00 $31,665.31 2026-05-09
372 OTHER Major Gastrointestinal Disorders And Peritoneal Infections With Cc 1 1 $34,444.57 $34,444.57 $31,480.63 $31,480.63 $31,480.63 2026-05-09
PX-27060399 OTHER Hc S-icd Emblem MRI Pulse Gntr 36 21 $35,346.00 $35,346.00 $20,500.68 $35,346.00 $31,457.94 2026-05-09
PX-27040205 OTHER Hc Ncl 24 Dbl Ary Ci 11+11+2m 36 21 $35,334.00 $35,334.00 $20,493.72 $35,334.00 $31,447.26 2026-05-09
PX-27071897 OTHER Hc Graft Stent Thora 34x150mm 36 21 $35,195.00 $35,195.00 $20,413.10 $35,195.00 $31,323.55 2026-05-09
PX-27071893 OTHER Hc Graft Stent Thora 28x150mm 36 21 $35,195.00 $35,195.00 $20,413.10 $35,195.00 $31,323.55 2026-05-09
PX-27071900 OTHER Hc Graft Stent Thora 32x150mm 36 21 $35,195.00 $35,195.00 $20,413.10 $35,195.00 $31,323.55 2026-05-09
PX-27059189 OTHER Hc Generator Ipc Proclaim 5 Elite 36 21 $35,178.00 $35,178.00 $20,403.24 $35,178.00 $31,308.42 2026-05-09
PX-27071536 OTHER Hc Stem Slvls Mono 190mm Sz16 36 21 $35,006.00 $35,006.00 $20,303.48 $35,006.00 $31,155.34 2026-05-09
PX-27076361 OTHER Hc Excluder Ctag Cmds/Cmds 21mmx21mmx10cm 18fr 36 21 $34,787.00 $34,787.00 $20,176.46 $34,787.00 $30,960.43 2026-05-09
PX-27076724 OTHER Hc Graft Throracic Stent 34x34mmx15cm 22fr 36 21 $34,787.00 $34,787.00 $20,176.46 $34,787.00 $30,960.43 2026-05-09
PX-27077791 OTHER Hc Stent Ctag Endovascular 31mm 10cm 20fr Active Control 36 21 $34,787.00 $34,787.00 $20,176.46 $34,787.00 $30,960.43 2026-05-09
PX-27076362 OTHER Hc Excluder Ctag Cmds 26mmx26mmx26mmx10cm 20fr 36 21 $34,787.00 $34,787.00 $20,176.46 $34,787.00 $30,960.43 2026-05-09
PX-48000132 OTHER Insertion Of Stent, Removal Of Plaque And/or Balloon Dilation Of Coronary Vessel… 36 21 $35,025.00 $35,025.00 $20,314.50 $33,624.00 $30,822.00 2026-05-09
PX-27072222 OTHER Hc Kit Generator Rechargeable 36 21 $34,320.00 $34,320.00 $19,905.60 $34,320.00 $30,544.80 2026-05-09
PX-27066548 OTHER Hc Kit Ipg 16 Vercise Gevia 36 21 $34,320.00 $34,320.00 $19,905.60 $34,320.00 $30,544.80 2026-05-09
PX-27076896 OTHER Hc Implant Cochlear Mi1250 Synchrony2 Flex23 36 21 $33,634.00 $33,634.00 $19,507.72 $33,634.00 $29,934.26 2026-05-09
PX-27069990 OTHER Hc Stent Valiant 40x34x200mm 36 21 $33,533.00 $33,533.00 $19,449.14 $33,533.00 $29,844.37 2026-05-09
PX-27069989 OTHER Hc Stent Valiant 34x28x207mm 36 21 $33,533.00 $33,533.00 $19,449.14 $33,533.00 $29,844.37 2026-05-09
PX-27071895 OTHER Hc System Graft Thor Stnt 8tu 36 21 $33,533.00 $33,533.00 $19,449.14 $33,533.00 $29,844.37 2026-05-09
PX-27068638 OTHER Hc Graft 43x43x223 Thoracic Gra 36 21 $33,533.00 $33,533.00 $19,449.14 $33,533.00 $29,844.37 2026-05-09
PX-27068636 OTHER Hc Graft 40x40x223 Thoracic Gra 36 21 $33,533.00 $33,533.00 $19,449.14 $33,533.00 $29,844.37 2026-05-09
PX-27078217 OTHER Hc Generator Pulse 50.7x44x8.4mm Inspire V Slp Apnea Implant Lf 36 21 $33,480.00 $33,480.00 $19,418.40 $33,480.00 $29,797.20 2026-05-09
RX-201951 OTHER Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 78 21 $33,879.91 $33,879.91 $19,615.84 $32,581.83 $29,761.96 2026-05-09
PX-27063193 OTHER Hc Condyle Fem Whl Lt 36 21 $33,306.00 $33,306.00 $19,317.48 $33,306.00 $29,642.34 2026-05-09
PX-27059297 OTHER Hc Allograft Fem Whl Cndyl Rt Fsh 36 21 $33,306.00 $33,306.00 $19,317.48 $33,306.00 $29,642.34 2026-05-09
PX-27071354 OTHER Hc Device Percept Pc Brainsense 36 21 $33,290.00 $33,290.00 $19,308.20 $33,290.00 $29,628.10 2026-05-09
PX-48000128 OTHER Percutaneous Transluminal Coronary Atherectomy, With Intracoronary Stent, With C… 36 21 $33,500.00 $33,500.00 $19,430.00 $32,160.00 $29,480.00 2026-05-09
PX-48000209 OTHER Insertion Of 2 Stents For 2 Or More Lesions In 2 Or More Coronary Segments Or, W… 36 21 $33,500.00 $33,500.00 $19,430.00 $32,160.00 $29,480.00 2026-05-09
PX-36003935 OTHER Catheter Removal Of Plaque From Groin Artery, Accessed Through The Skin Or Open … 36 21 $33,500.00 $33,500.00 $19,430.00 $32,160.00 $29,480.00 2026-05-09
PX-48000147 OTHER Hc Perc D-e Cor Revasc Chro Sing 36 21 $33,500.00 $33,500.00 $19,430.00 $32,160.00 $29,480.00 2026-05-09
PX-48000142 OTHER Hc Perc D-e Cor Stent Ather S 36 21 $33,500.00 $33,500.00 $19,430.00 $32,160.00 $29,480.00 2026-05-09
PX-27061399 OTHER Hc Nail Tib Antgrd 8.5x155mm 10dg 36 21 $33,000.00 $33,000.00 $19,140.00 $33,000.00 $29,370.00 2026-05-09
PX-27061702 OTHER Hc Nail Fem 10deg 8.5x275mm Antgr 36 21 $33,000.00 $33,000.00 $19,140.00 $33,000.00 $29,370.00 2026-05-09
PX-27065785 OTHER Hc Rod Fem 10.7x215mm Ante 36 21 $33,000.00 $33,000.00 $19,140.00 $33,000.00 $29,370.00 2026-05-09
PX-27070564 OTHER Hc Nail Troch 10deg 10.7x245mm 36 21 $33,000.00 $33,000.00 $19,140.00 $33,000.00 $29,370.00 2026-05-09
PX-27061857 OTHER Hc Nail Tib Antgrd 8.5x305mm 10dg 36 21 $33,000.00 $33,000.00 $19,140.00 $33,000.00 $29,370.00 2026-05-09
PX-27055313 OTHER Hc Nail Troch 10deg 10.7x80x305mm 36 21 $33,000.00 $33,000.00 $19,140.00 $33,000.00 $29,370.00 2026-05-09
PX-27069963 OTHER Hc Nail Fem Antgrd 8.5x190mm 10dg 36 21 $33,000.00 $33,000.00 $19,140.00 $33,000.00 $29,370.00 2026-05-09
PX-27067834 OTHER Hc Nail Fem St 8.5x245mm Rtrgrd 36 21 $33,000.00 $33,000.00 $19,140.00 $33,000.00 $29,370.00 2026-05-09
PX-27068167 OTHER Hc Nail Hum 8.5x255mm 36 21 $33,000.00 $33,000.00 $19,140.00 $33,000.00 $29,370.00 2026-05-09
PX-27066807 OTHER Hc Dressing Polymem 3x3in Non Adh 36 21 $33,306.00 $33,306.00 $19,317.48 $31,973.76 $29,309.28 2026-05-09
PX-27074769 OTHER Hc Component Knee Femoral Crs Sz3 Cemented Left 36 21 $32,904.00 $32,904.00 $19,084.32 $32,904.00 $29,284.56 2026-05-09
PX-27074770 OTHER Hc Component Knee Femoral Crs Sz9 Cemented Right 36 21 $32,904.00 $32,904.00 $19,084.32 $32,904.00 $29,284.56 2026-05-09
PX-27043073 OTHER Hc Sys Evera S Dr System 36 21 $32,714.00 $32,714.00 $18,974.12 $32,714.00 $29,115.46 2026-05-09
RX-119469 OTHER Ustekinumab 90 Mg/ml Subcutaneous Syringe 78 21 $32,961.21 $32,961.21 $19,084.73 $31,697.00 $28,956.14 2026-05-09
PX-27075148 OTHER Hc Nail Fusion 10mmx26cm 36 21 $32,510.00 $32,510.00 $18,855.80 $32,510.00 $28,933.90 2026-05-09
PX-27074806 OTHER Hc Stem Femoral 135deg Sz14 12/14 Amt Collar Standard Cementless 36 21 $32,501.00 $32,501.00 $18,850.58 $32,501.00 $28,925.89 2026-05-09
PX-27069837 OTHER Hc Nail Dynanail Xl 12mmx30cm 36 21 $32,488.00 $32,488.00 $18,843.04 $32,488.00 $28,914.32 2026-05-09
PX-36004962 OTHER Hc Thoracoscopy W/Exc Pericardial Cyst Tumor/Mass 36 21 $32,839.00 $32,839.00 $19,046.62 $31,525.44 $28,898.32 2026-05-09
PX-36004957 OTHER Hc Thoracoscopy W/Parietal Pleurectomy 36 21 $32,839.00 $32,839.00 $19,046.62 $31,525.44 $28,898.32 2026-05-09
PX-36004902 OTHER Removal Of Uterus Through Abdomen With Partial Removal Of Vagina 36 21 $32,839.00 $32,839.00 $19,046.62 $31,525.44 $28,898.32 2026-05-09
PX-36004317 OTHER Partial Removal Of Stomach For Weight Loss Using An Endoscope 36 21 $32,839.00 $32,839.00 $19,046.62 $31,525.44 $28,898.32 2026-05-09
PX-36004537 OTHER Hc Laps Tot Hyst Resj Mal 36 21 $32,839.00 $32,839.00 $19,046.62 $31,525.44 $28,898.32 2026-05-09
PX-36003178 OTHER Removal Of Uterus And Cervix Through Abdomen 36 21 $32,839.00 $32,839.00 $19,046.62 $31,525.44 $28,898.32 2026-05-09
PX-27060575 OTHER Hc Crt-d Dynagen Df4 36 21 $32,358.00 $32,358.00 $18,767.64 $32,358.00 $28,798.62 2026-05-09
PX-27075515 OTHER Hc Icd Cobalt Dr MRI Is1 Df1 36 21 $32,304.00 $32,304.00 $18,736.32 $32,304.00 $28,750.56 2026-05-09
PX-27075516 OTHER Hc Icd Cobalt Dr MRI Is1 Df4 36 21 $32,304.00 $32,304.00 $18,736.32 $32,304.00 $28,750.56 2026-05-09
PX-27053982 OTHER Hc Generator Ipg Proclaim 7 Elite 36 21 $32,292.00 $32,292.00 $18,729.36 $32,292.00 $28,739.88 2026-05-09
PX-27060534 OTHER Hc Crt-d Dynagen X4 Is-1/df-1/is4 36 21 $32,021.00 $32,021.00 $18,572.18 $32,021.00 $28,498.69 2026-05-09
PX-27042902 OTHER Hc Dfbr Crd Viva Crt D Qd S Df1 36 21 $31,699.00 $31,699.00 $18,385.42 $31,699.00 $28,212.11 2026-05-09
PX-27042903 OTHER Hc Dfbr Crd Viva Crt D Qd S Df4 36 21 $31,699.00 $31,699.00 $18,385.42 $31,699.00 $28,212.11 2026-05-09
PX-27042639 OTHER Hc Dfbr Crd .99cm Thn 5.37x8.08cm 36 21 $31,684.00 $31,684.00 $18,376.72 $31,684.00 $28,198.76 2026-05-09
PX-27044329 OTHER Hc Gft Stnt 32x32x200mm Thor 36 21 $31,630.00 $31,630.00 $18,345.40 $31,630.00 $28,150.70 2026-05-09
PX-27042816 OTHER Hc Gft Stnt 200mm 34mm 24fr 36 21 $31,630.00 $31,630.00 $18,345.40 $31,630.00 $28,150.70 2026-05-09
PX-27045418 OTHER Hc Gft Stnt 200mm 38mm 38mm 36 21 $31,630.00 $31,630.00 $18,345.40 $31,630.00 $28,150.70 2026-05-09
PX-27041743 OTHER Hc Therasphere Y90 Gls Mcsph 36 21 $31,512.00 $31,512.00 $18,276.96 $31,512.00 $28,045.68 2026-05-09
PX-27045095 OTHER Hc Gft Sft Tis 20x40cm Xcm Hydrtd 36 21 $31,762.00 $31,762.00 $18,421.96 $30,491.52 $27,950.56 2026-05-09
PX-27055435 OTHER Hc Defib Card Viva Xt Crt-d Df-1 36 21 $31,403.00 $31,403.00 $18,213.74 $31,403.00 $27,948.67 2026-05-09
PX-27055434 OTHER Hc Icd Evera MRI Xt Dr Surescan 36 21 $31,364.00 $31,364.00 $18,191.12 $31,364.00 $27,913.96 2026-05-09
PX-36002780 OTHER Revision Of Kidney/ureter 36 21 $32,839.00 $32,839.00 $19,046.62 $31,525.44 $27,913.15 2026-05-09
PX-27044796 OTHER Hc Crt-d 5.37x8.08x0.99cm Inogen 36 21 $31,345.00 $31,345.00 $18,180.10 $31,345.00 $27,897.05 2026-05-09
PX-27070857 OTHER Hc Cup Actb 64mm Bhr 36 21 $31,318.00 $31,318.00 $18,164.44 $31,318.00 $27,873.02 2026-05-09
PX-27026266 OTHER Hc Cup Actb 62mm Bhr Hmsphr 36 21 $31,318.00 $31,318.00 $18,164.44 $31,318.00 $27,873.02 2026-05-09
PX-27001600 OTHER Hc Cup Actb 56mm 50mm Birmingham 36 21 $31,318.00 $31,318.00 $18,164.44 $31,318.00 $27,873.02 2026-05-09
PX-27063928 OTHER Hc Cup Actb 58mm Birmingham Hip 36 21 $31,318.00 $31,318.00 $18,164.44 $31,318.00 $27,873.02 2026-05-09
PX-27063947 OTHER Hc Cup Actb Bhr 60mm/54mm Head 36 21 $31,318.00 $31,318.00 $18,164.44 $31,318.00 $27,873.02 2026-05-09
PX-27070480 OTHER Hc Watchman Flx Procedure Code 36 21 $31,200.00 $31,200.00 $18,096.00 $31,200.00 $27,768.00 2026-05-09
PX-27038083 OTHER Hc Dfbr Crd Thk14mm 40 J 41x76mm 36 21 $31,193.00 $31,193.00 $18,091.94 $31,193.00 $27,761.77 2026-05-09
PX-27038082 OTHER Hc Dfbr Crd Thk14mm 40 J 41x83mm 36 21 $31,193.00 $31,193.00 $18,091.94 $31,193.00 $27,761.77 2026-05-09
PX-27071896 OTHER Hc System Graft Thor Stnt 75tu 36 21 $31,193.00 $31,193.00 $18,091.94 $31,193.00 $27,761.77 2026-05-09
PX-27069292 OTHER Hc Stent Graft 31x31x182mm 36 21 $31,193.00 $31,193.00 $18,091.94 $31,193.00 $27,761.77 2026-05-09
PX-27071827 OTHER Hc Stent Graft Valiant Navion 36 21 $31,193.00 $31,193.00 $18,091.94 $31,193.00 $27,761.77 2026-05-09
PX-27067073 OTHER Hc Cmpnt Fem Sz3 Rt Cr 36 21 $31,177.00 $31,177.00 $18,082.66 $31,177.00 $27,747.53 2026-05-09
PX-27070245 OTHER Hc Cmpnt Fem Sz5 Rt Cr 36 21 $31,177.00 $31,177.00 $18,082.66 $31,177.00 $27,747.53 2026-05-09
PX-27071509 OTHER Hc Insert Jrny2 Cr Fem Np Rt Sz 4 36 21 $31,177.00 $31,177.00 $18,082.66 $31,177.00 $27,747.53 2026-05-09
PX-27052162 OTHER Hc Dfbr Unify Asr+Cell Adapter 36 21 $31,148.00 $31,148.00 $18,065.84 $31,148.00 $27,721.72 2026-05-09
PX-36000601 OTHER Fusion Of Lower Spine Bone Through Abdomen With Partial Removal Of Disc 36 21 $31,328.00 $31,328.00 $18,170.24 $30,074.88 $27,568.64 2026-05-09
PX-36004808 OTHER Partial Removal Of Large Bowel And Reattachment To Rectum Using An Endoscope 36 21 $31,159.00 $31,159.00 $18,072.22 $29,912.64 $27,419.92 2026-05-09
PX-27052518 OTHER Hc Defibrillator Evera MRI S Dr 36 21 $30,772.00 $30,772.00 $17,847.76 $30,772.00 $27,387.08 2026-05-09
PX-27044572 OTHER Hc Pn Cncrt Flex28 Coclr Imp 36 21 $30,576.00 $30,576.00 $17,734.08 $30,576.00 $27,212.64 2026-05-09
PX-27040305 OTHER Hc Imp Coclr Concerto Flex 24 36 21 $30,576.00 $30,576.00 $17,734.08 $30,576.00 $27,212.64 2026-05-09
PX-27038504 OTHER Hc Implant Ear Med-el Concert 36 21 $30,576.00 $30,576.00 $17,734.08 $30,576.00 $27,212.64 2026-05-09
PX-27039593 OTHER Hc Impl Coclr Concerto Flex28 36 21 $30,576.00 $30,576.00 $17,734.08 $30,576.00 $27,212.64 2026-05-09
PX-27023465 OTHER Hc Cup Actb 58mm 48mm Hap 36 21 $30,522.00 $30,522.00 $17,702.76 $30,522.00 $27,164.58 2026-05-09
PX-27063868 OTHER Hc Cup Actb Sz60 52mm 36 21 $30,522.00 $30,522.00 $17,702.76 $30,522.00 $27,164.58 2026-05-09
PX-27062468 OTHER Hc Cup Actb Sz54/48 Bhr 36 21 $30,522.00 $30,522.00 $17,702.76 $30,522.00 $27,164.58 2026-05-09
PX-27056629 OTHER Hc Cup Actb Sz56/62 Hap 36 21 $30,522.00 $30,522.00 $17,702.76 $30,522.00 $27,164.58 2026-05-09
PX-27039852 OTHER Hc Icd Viva S Crt-d Df1 36 21 $30,514.00 $30,514.00 $17,698.12 $30,514.00 $27,157.46 2026-05-09
PX-27039851 OTHER Hc Icd Viva S Crt-d Df-4 36 21 $30,514.00 $30,514.00 $17,698.12 $30,514.00 $27,157.46 2026-05-09
PX-27059910 OTHER Hc Ipg Kit Senza 36 21 $30,463.00 $30,463.00 $17,668.54 $30,463.00 $27,112.07 2026-05-09
PX-27040769 OTHER Hc Dfbr Crd Unify Asr .5 Chmbr 36 21 $30,446.00 $30,446.00 $17,658.68 $30,446.00 $27,096.94 2026-05-09
PX-27040770 OTHER Hc Dfbr Crd Unify Asr 36 21 $30,446.00 $30,446.00 $17,658.68 $30,446.00 $27,096.94 2026-05-09
PX-27041074 OTHER Hc Sicd Sq-rx Cameron 36 21 $30,420.00 $30,420.00 $17,643.60 $30,420.00 $27,073.80 2026-05-09
PX-27069841 OTHER Hc Pacemaker Av Micra Transcatheter 36 21 $30,420.00 $30,420.00 $17,643.60 $30,420.00 $27,073.80 2026-05-09
PX-27050570 OTHER Hc Gntr Pcmkr 83.1x69.1mm Eblm 36 21 $30,420.00 $30,420.00 $17,643.60 $30,420.00 $27,073.80 2026-05-09
PX-27053263 OTHER Hc Graft Stnt 25fr 42x42x200mm 36 21 $30,413.00 $30,413.00 $17,639.54 $30,413.00 $27,067.57 2026-05-09
PX-27038584 OTHER Hc Stent Grft Prox Main 36x36x200 36 21 $30,413.00 $30,413.00 $17,639.54 $30,413.00 $27,067.57 2026-05-09
PX-27053634 OTHER Hc Graft Stnt 24fr 40x40x200mm 36 21 $30,413.00 $30,413.00 $17,639.54 $30,413.00 $27,067.57 2026-05-09
PX-36004815 OTHER Repair Of Aneurysm Or Liver, Kidneys, Stomach And/or Intestines Artery With Graf… 36 21 $30,732.00 $30,732.00 $17,824.56 $29,502.72 $27,044.16 2026-05-09
PX-36004807 OTHER Repair Of Aneurysm Or Lower Leg Artery With Graft 36 21 $30,732.00 $30,732.00 $17,824.56 $29,502.72 $27,044.16 2026-05-09
PX-27089686 OTHER Hc Synchrony 2 With S-vector Magnet Flex34 36 21 $30,380.00 $30,380.00 $17,620.40 $30,380.00 $27,038.20 2026-05-09
PX-27043074 OTHER Hc Sys Evera S Vr System 36 21 $30,270.00 $30,270.00 $17,556.60 $30,270.00 $26,940.30 2026-05-09
PX-27073873 OTHER Hc Ipg 16 Channel Eterna 36 21 $30,225.00 $30,225.00 $17,530.50 $30,225.00 $26,900.25 2026-05-09
PX-27054829 OTHER Hc Stent Thor Valiant 34x34x150mm 36 21 $30,007.00 $30,007.00 $17,404.06 $30,007.00 $26,706.23 2026-05-09
PX-27054828 OTHER Hc Stent Thor Valiant 32x32x150mm 36 21 $30,007.00 $30,007.00 $17,404.06 $30,007.00 $26,706.23 2026-05-09
PX-27063865 OTHER Hc Graft Stnt 22fr 28x157mm Prox 36 21 $30,007.00 $30,007.00 $17,404.06 $30,007.00 $26,706.23 2026-05-09
PX-27054831 OTHER Hc Stent Thor Valiant 36x36x150mm 36 21 $30,007.00 $30,007.00 $17,404.06 $30,007.00 $26,706.23 2026-05-09
PX-27061724 OTHER Hc Graft Stnt 44x40x150mm Thor 36 21 $30,007.00 $30,007.00 $17,404.06 $30,007.00 $26,706.23 2026-05-09
PX-27061725 OTHER Hc Graft Stnt 46x42x150mm Thor 36 21 $30,007.00 $30,007.00 $17,404.06 $30,007.00 $26,706.23 2026-05-09
PX-27086500 OTHER Hc Prostep Mis Lapidus Consumables Kit 36 21 $29,996.00 $29,996.00 $17,397.68 $29,996.00 $26,696.44 2026-05-09
PX-27056564 OTHER Hc Matrix Tiss 20x30cm Hdrt 36 21 $29,411.00 $29,411.00 $17,058.38 $29,411.00 $26,175.79 2026-05-09
PX-33000082 OTHER Insertion Of Needles Or Tubes Into Pelvic Or Genital Organs For Radiation Therap… 36 21 $29,725.00 $29,725.00 $17,240.50 $28,536.00 $26,158.00 2026-05-09
PX-27070138 OTHER Hc Crt-d Dynagen Is-1/df-1/lv-1 36 21 $29,323.00 $29,323.00 $17,007.34 $29,323.00 $26,097.47 2026-05-09
PX-27042564 OTHER Hc Impl Coclr Frdm Hbrd Mdlr C124 36 21 $29,218.00 $29,218.00 $16,946.44 $29,218.00 $26,004.02 2026-05-09
PX-27067728 OTHER Hc Nail 12mmx22cm Dynanail 36 21 $29,212.00 $29,212.00 $16,942.96 $29,212.00 $25,998.68 2026-05-09
PX-27065101 OTHER Hc Nail 10mmx22cm Dynanail 36 21 $29,212.00 $29,212.00 $16,942.96 $29,212.00 $25,998.68 2026-05-09
PX-48000163 OTHER Repair Of Mitral Valve Through The Skin, Additional Prosthesis 36 21 $29,508.00 $29,508.00 $17,114.64 $28,327.68 $25,967.04 2026-05-09
PX-48000188 OTHER Insertion Of Artificial Valve Between Left Heart Chambers, Accessed Through The … 36 21 $29,508.00 $29,508.00 $17,114.64 $28,327.68 $25,967.04 2026-05-09
PX-36004961 OTHER Hc Ttvi/Rplcmt Prostc Vlv Perq W/r Hrt Cath&Angrph 33 18 $29,508.00 $29,508.00 $17,114.64 $28,327.68 $25,967.04 2026-05-09
PX-36004960 OTHER Hc Ttvr Percutaneous Approach Each Addl Prosthesis 36 21 $29,508.00 $29,508.00 $17,114.64 $28,327.68 $25,967.04 2026-05-09
PX-36004959 OTHER Hc Ttvr Percutaneous Approach Initial Prosthesis 36 21 $29,508.00 $29,508.00 $17,114.64 $28,327.68 $25,967.04 2026-05-09
PX-36004379 OTHER Replacement Of Aortic Valve Through The Skin And Femoral Artery 36 21 $29,508.00 $29,508.00 $17,114.64 $28,327.68 $25,967.04 2026-05-09
PX-48000162 OTHER Repair Of Mitral Valve Through The Skin, Initial Prosthesis 36 21 $29,508.00 $29,508.00 $17,114.64 $28,327.68 $25,967.04 2026-05-09
392 OTHER Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 2 2 $22,636.19 $22,636.19 $18,560.98 $33,296.87 $25,928.93 2026-05-09
PX-27038081 OTHER Hc Dfbr Crd Thk14mm 2.5v 40 J 40 36 21 $28,860.00 $28,860.00 $16,738.80 $28,860.00 $25,685.40 2026-05-09
PX-27038080 OTHER Hc Dfbr Crd Thk14mm 2.5v 40 J 40 36 21 $28,860.00 $28,860.00 $16,738.80 $28,860.00 $25,685.40 2026-05-09
PX-27051815 OTHER Hc Gntr/Nrstmltr Prtg MRI Ipg 36 21 $28,860.00 $28,860.00 $16,738.80 $28,860.00 $25,685.40 2026-05-09
PX-27063784 OTHER Hc Graft Thor Evas 34x161mm Prox 36 21 $28,859.00 $28,859.00 $16,738.22 $28,859.00 $25,684.51 2026-05-09
PX-27063785 OTHER Hc Graft Thor Evas 36x161mm Prox 36 21 $28,859.00 $28,859.00 $16,738.22 $28,859.00 $25,684.51 2026-05-09
PX-27069091 OTHER Hc Stent Valiant Nav 37x37x90mm 36 21 $28,853.00 $28,853.00 $16,734.74 $28,853.00 $25,679.17 2026-05-09
PX-27068637 OTHER Hc Graft 43x43x95 Thoracic Graf 36 21 $28,853.00 $28,853.00 $16,734.74 $28,853.00 $25,679.17 2026-05-09
PX-27053262 OTHER Hc Graft Stnt 25fr 42x42x150mm 36 21 $28,790.00 $28,790.00 $16,698.20 $28,790.00 $25,623.10 2026-05-09
PX-27052227 OTHER Hc Gft Stnt 24fr 34x38x150mm Tpr 36 21 $28,790.00 $28,790.00 $16,698.20 $28,790.00 $25,623.10 2026-05-09
PX-27063864 OTHER Hc Graft Stnt 22fr 26x145mm Close 36 21 $28,790.00 $28,790.00 $16,698.20 $28,790.00 $25,623.10 2026-05-09
PX-27053633 OTHER Hc Graft Stnt 24fr 40x40x160mm 36 21 $28,790.00 $28,790.00 $16,698.20 $28,790.00 $25,623.10 2026-05-09
RX-151679 OTHER Leuprolide Acetate (6 Month) 45 Mg Intramuscular Syringe Kit 78 21 $29,128.57 $29,128.57 $1,449.99 $28,017.67 $25,583.42 2026-05-09
PX-27026301 OTHER Hc Cochlear Nucleus 5 External 36 21 $28,680.00 $28,680.00 $16,634.40 $28,680.00 $25,525.20 2026-05-09
PX-27069047 OTHER Hc Imp Coch Ci612 Contour Advance 36 21 $28,680.00 $28,680.00 $16,634.40 $28,680.00 $25,525.20 2026-05-09
PX-27059905 OTHER Hc Ipg Prodigy MRI 16 Ch Recharge 36 21 $28,860.00 $28,860.00 $16,738.80 $27,705.60 $25,396.80 2026-05-09
PX-40400010 OTHER Nuclear Medicine Studies Of Blood Flow In Heart Muscle At Rest And With Stress W… 36 21 $28,806.00 $28,806.00 $16,707.48 $27,653.76 $25,349.28 2026-05-09
PX-27069832 OTHER Hc Imp Pulse Generator 36 21 $28,432.00 $28,432.00 $16,490.56 $28,432.00 $25,304.48 2026-05-09
788 OTHER Cesarean Section Without Sterilization Without Cc/mcc 20 10 $56,794.43 $56,794.43 $25,242.00 $64,548.51 $25,242.00 2026-05-09
PX-27009675 OTHER Hc Impl Coclr Ncl Frdm Cntr Adv 36 21 $28,141.00 $28,141.00 $16,321.78 $28,141.00 $25,045.49 2026-05-09
PX-27060493 OTHER Hc Intramedullary 8.5mm 80x275 36 21 $28,120.00 $28,120.00 $16,309.60 $28,120.00 $25,026.80 2026-05-09
PX-27063295 OTHER Hc Nail Fem Rtrgd St 36 21 $28,120.00 $28,120.00 $16,309.60 $28,120.00 $25,026.80 2026-05-09
PX-27055424 OTHER Hc Nail 10d 8.5x160x30 Antgrd Tib 36 21 $28,120.00 $28,120.00 $16,309.60 $28,120.00 $25,026.80 2026-05-09
PX-27055433 OTHER Hc Defib Card Evera Xt Icd Dr-4 36 21 $28,088.00 $28,088.00 $16,291.04 $28,088.00 $24,998.32 2026-05-09
RX-189827 OTHER Antivenin Crotalidae (equine) 120 Mg Solution For Injection 78 21 $28,386.50 $28,386.50 $16,460.40 $55,756.56 $24,985.84 2026-05-09
PX-27075514 OTHER Hc Icd Cobalt Vr MRI Df4 36 21 $28,070.00 $28,070.00 $16,280.60 $28,070.00 $24,982.30 2026-05-09
PX-27075513 OTHER Hc Icd Cobalt Vr MRI Is1 Df1 36 21 $28,070.00 $28,070.00 $16,280.60 $28,070.00 $24,982.30 2026-05-09
PX-27071942 OTHER Hc Icd Dual Chamber Gallant Dr 36 21 $27,995.00 $27,995.00 $16,237.10 $27,995.00 $24,915.55 2026-05-09
PX-27077249 OTHER Hc Defib Implantable Gallant Dual Chamb Strl Dr Cardio 36 21 $27,995.00 $27,995.00 $16,237.10 $27,995.00 $24,915.55 2026-05-09
PX-27027906 OTHER Hc Prgmr Nrstm 1.9inx2.6in Activa 36 21 $27,979.00 $27,979.00 $16,227.82 $27,979.00 $24,901.31 2026-05-09
PX-27089895 OTHER Hc Cochlear Implant Nucleus Nexa Slim Modiolar Electrode 36 21 $27,751.00 $27,751.00 $16,095.58 $27,751.00 $24,698.39 2026-05-09
PX-48000022 OTHER Balloon Dilation Of Pulmonary Artery, Each Additional Vessel 36 21 $28,020.00 $28,020.00 $16,251.60 $26,899.20 $24,657.60 2026-05-09
PX-48000124 OTHER Percutaneous Transluminal Coronary Atherectomy, With Coronary Angioplasty When P… 36 21 $28,020.00 $28,020.00 $16,251.60 $26,899.20 $24,657.60 2026-05-09
PX-48000126 OTHER Percutaneous Transcatheter Placement Of Intracoronary Stent(s), With Coronary An… 36 21 $28,020.00 $28,020.00 $16,251.60 $26,899.20 $24,657.60 2026-05-09
PX-48000016 OTHER Balloon Dilation Repair Of Mitral Valve 36 21 $28,020.00 $28,020.00 $16,251.60 $26,899.20 $24,657.60 2026-05-09
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