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

MACNEAL HOSPITAL

Berwyn, IL · CCN 140054 · Rates published

Your selected procedure

You selected 93306 (HCPCS)

Echo Pvi Protocol 2d M-Mode W/ Dopp & Colr Flow

This hospital’s price: $679 across 14 payers · range $98-$4,507

Source: https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/macnealhospital · observed 2026-03-31

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.

31,417 distinct procedures filed
14 distinct payers
864,593 rate rows
2026-03-31 last MRF observed
Data quality

583,225 of 864,593 rate rows are consumer-grade (67.5%)

281,368 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 274,907
per-diem day rate — not a per-procedure price 2,384
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 1,537
percent-of-charges filed in the dollar field — excluded from medians 674
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 631
template filing: same amount across many unrelated codes — excluded 586
placeholder amount (≤ $0.02) — excluded from medians 547
exceeds 10× this hospital's gross charge — excluded from medians 102
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/macnealhospital
Found on page https://www.loyolamedicine.org/for-patients/billing-and-insurance/insurance-information/price-estimates-list
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-19
Content fingerprint ac3a632edd6ecc7c… · 15,248,638 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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 8 $752,930.00 $4,791,353.23 $4,563,193.55 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 12 $638,120.00 $4,834,222.75 $4,022,073.33 nat. median
$3,710,000
1.1× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 12 $23,609.42 $4,801,994.60 $3,929,952.38 nat. median
$3,703,693
1.1× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 12 $560,953.06 $4,432,181.45 $3,569,686.76 nat. median
$3,286,000
1.1× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 12 $23,609.42 $4,518,093.21 $3,557,438.65 nat. median
$3,324,572
1.1× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 13 $507,518.11 $4,864,551.99 $3,229,647.54 nat. median
$2,994,107
1.1× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 13 $421,763.88 $3,998,166.53 $2,683,941.06 nat. median
$2,466,282
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 13 $401,104.00 $3,847,800.00 $2,552,469.61 nat. median
$2,401,960
1.1× median
Q2057
HCPCS 		Afamitresgene Autoleucel 13 $132,546.64 $1,271,523.00 $843,475.19 nat. median
$809,217
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 13 $37,727.52 $954,972.35 $626,971.39 nat. median
$738,272
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 13 $37,727.52 $912,729.35 $599,927.28 nat. median
$646,415
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 13 $37,727.52 $852,129.78 $587,196.32 nat. median
$640,950
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 13 $37,727.52 $870,577.06 $586,789.54 nat. median
$622,245
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 13 $37,727.52 $829,687.20 $577,917.17 nat. median
$608,101
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 13 $37,727.52 $807,508.61 $530,913.68 nat. median
$591,650
0.9× median
C9301
HCPCS 		Obecabtagene Car Pos T 1 $459,112.50 $459,112.50 $459,112.50 nat. median
$459,112
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 $347,116.37 $553,246.78 $375,744.53 nat. median
$359,358
1.0× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 12 $46,504.50 $367,439.63 $295,936.52 nat. median
$319,951
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 13 $259,439.21 $413,228.96 $280,836.26 nat. median
$249,124
1.1× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 13 $218,602.20 $348,013.48 $236,631.24 nat. median
$198,433
1.2× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 13 $197,554.89 $314,401.57 $213,848.08 nat. median
$190,557
1.1× median
5834
APR_DRG 		Neonate With Ecmo 3 $193,972.12 $193,972.12 $193,972.12 nat. median
$307,273
0.6× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $159,109.75 $159,109.75 $159,109.75 nat. median
$247,214
0.6× median
5833
APR_DRG 		Neonate With Ecmo 3 $153,629.62 $153,629.62 $153,629.62 nat. median
$244,017
0.6× median
1614
APR_DRG 		Implantable Heart Assist Systems 3 $152,127.81 $152,127.81 $152,127.81 nat. median
$202,993
0.7× median
24
APR_DRG 		Heart And/or Lung Transplant 3 $146,807.88 $146,807.88 $146,807.88 nat. median
$241,915
0.6× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 13 $130,481.33 $207,287.10 $141,242.68 nat. median
$126,722
1.1× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $128,711.24 $139,909.44 $138,442.89 nat. median
$93,270
1.5× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 13 $121,036.14 $192,203.41 $131,018.51 nat. median
$110,192
1.2× median
7
MS_DRG 		Lung Transplant 13 $120,733.00 $191,719.30 $130,690.36 nat. median
$117,894
1.1× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $130,327.56 $130,327.56 $130,327.56 nat. median
$75,037
1.7× median
850
MS_DRG 		Acute Leukemia With Other Procedures 2 $113,186.62 $123,034.14 $121,744.47 nat. median
$78,262
1.6× median
5063312011
NDC 		Digoxin Immune Fab 40 Mg Inj 6 $58,607.11 $427,215.01 $117,584.38 nat. median
$5,219
outlier · 22.5×
1613
APR_DRG 		Implantable Heart Assist Systems 3 $116,545.54 $116,545.54 $116,545.54 nat. median
$120,517
1.0× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 $115,487.75 $115,487.75 $115,487.75 nat. median
$154,011
0.7× median
5832
APR_DRG 		Neonate With Ecmo 3 $113,287.12 $113,287.12 $113,287.12 nat. median
$159,249
0.7× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 13 $101,909.66 $161,659.00 $110,314.59 nat. median
$103,967
1.1× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 $102,480.95 $111,397.05 $110,229.37 nat. median
$78,037
1.4× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve?procedures 13 $100,754.06 $159,813.51 $109,063.67 nat. median
$97,414
1.1× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 3 $107,281.08 $107,281.08 $107,281.08 nat. median
$156,153
0.7× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 13 $98,508.04 $156,226.70 $106,632.41 nat. median
$94,964
1.1× median
215
MS_DRG 		Other Heart Assist System Implant 13 $98,006.47 $155,425.72 $106,089.48 nat. median
$93,917
1.1× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 3 $103,769.84 $103,769.84 $103,769.84 nat. median
$151,838
0.7× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $102,504.55 $102,504.55 $102,504.55 nat. median
$175,429
0.6× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $100,371.89 $100,371.89 $100,371.89 nat. median
$145,061
0.7× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 3 $100,206.92 $100,206.92 $100,206.92 nat. median
$162,514
0.6× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $100,078.12 $100,078.12 $100,078.12 nat. median
$124,042
0.8× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 $99,567.72 $99,567.72 $99,567.72 nat. median
$165,000
0.6× median
5831
APR_DRG 		Neonate With Ecmo 3 $97,900.54 $97,900.54 $97,900.54 nat. median
$146,591
0.7× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 $89,337.50 $141,581.64 $96,705.55 nat. median
$90,581
1.1× median

Other procedures at this hospital

Browse this hospital's 31,417 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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 9 8 — — $752,930.00 $4,791,353.23 $4,563,193.55 2026-03-31
J1414 HCPCS Inj, Beqvez, Per Tx Dose 14 12 — — $638,120.00 $4,834,222.75 $4,022,073.33 2026-03-31
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 17 12 — — $23,609.42 $4,801,994.60 $3,929,952.38 2026-03-31
J3394 HCPCS Inj, Lovotibeglogene Autotem 15 12 — — $560,953.06 $4,432,181.45 $3,569,686.76 2026-03-31
J1413 HCPCS Inj Delandistrogene Mox Rokl 18 12 — — $23,609.42 $4,518,093.21 $3,557,438.65 2026-03-31
J3393 HCPCS Inj, Betibeglogene Autotemce 17 13 — — $507,518.11 $4,864,551.99 $3,229,647.54 2026-03-31
J3399 HCPCS Inj Onase Abepar-xioi Treat 17 13 — — $421,763.88 $3,998,166.53 $2,683,941.06 2026-03-31
J3392 HCPCS Inj, Exagamglogene Autotem 17 13 — — $401,104.00 $3,847,800.00 $2,552,469.61 2026-03-31
Q2057 HCPCS Afamitresgene Autoleucel 17 13 — — $132,546.64 $1,271,523.00 $843,475.19 2026-03-31
Q2042 HCPCS Tisagenlecleucel Car-pos T 20 13 — — $37,727.52 $954,972.35 $626,971.39 2026-03-31
Q2056 HCPCS Ciltacabtagene Car-pos T 20 13 — — $37,727.52 $912,729.35 $599,927.28 2026-03-31
Q2054 HCPCS Lisocabtagene Mara Car Pos T 20 13 — — $37,727.52 $852,129.78 $587,196.32 2026-03-31
Q2055 HCPCS Idecabtagene Vicleucel Car 20 13 — — $37,727.52 $870,577.06 $586,789.54 2026-03-31
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 20 13 — — $37,727.52 $829,687.20 $577,917.17 2026-03-31
Q2053 HCPCS Brexucabtagene Car Pos T 20 13 — — $37,727.52 $807,508.61 $530,913.68 2026-03-31
C9301 HCPCS Obecabtagene Car Pos T 2 1 — — $459,112.50 $459,112.50 $459,112.50 2026-03-31
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 17 13 — — $347,116.37 $553,246.78 $375,744.53 2026-03-31
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 15 12 — — $46,504.50 $367,439.63 $295,936.52 2026-03-31
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 17 13 — — $259,439.21 $413,228.96 $280,836.26 2026-03-31
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 17 13 — — $218,602.20 $348,013.48 $236,631.24 2026-03-31
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 17 13 — — $197,554.89 $314,401.57 $213,848.08 2026-03-31
5834 APR_DRG Neonate With Ecmo 3 3 — — $193,972.12 $193,972.12 $193,972.12 2026-03-31
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $159,109.75 $159,109.75 $159,109.75 2026-03-31
5833 APR_DRG Neonate With Ecmo 3 3 — — $153,629.62 $153,629.62 $153,629.62 2026-03-31
1614 APR_DRG Implantable Heart Assist Systems 3 3 — — $152,127.81 $152,127.81 $152,127.81 2026-03-31
24 APR_DRG Heart And/or Lung Transplant 3 3 — — $146,807.88 $146,807.88 $146,807.88 2026-03-31
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 17 13 — — $130,481.33 $207,287.10 $141,242.68 2026-03-31
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $128,711.24 $139,909.44 $138,442.89 2026-03-31
14 MS_DRG Allogeneic Bone Marrow Transplant 17 13 — — $121,036.14 $192,203.41 $131,018.51 2026-03-31
7 MS_DRG Lung Transplant 17 13 — — $120,733.00 $191,719.30 $130,690.36 2026-03-31
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $130,327.56 $130,327.56 $130,327.56 2026-03-31
850 MS_DRG Acute Leukemia With Other Procedures 3 2 — — $113,186.62 $123,034.14 $121,744.47 2026-03-31
5063312011 NDC Digoxin Immune Fab 40 Mg Inj 16 6 $308,458.49 — $58,607.11 $427,215.01 $117,584.38 2026-03-31
1613 APR_DRG Implantable Heart Assist Systems 3 3 — — $116,545.54 $116,545.54 $116,545.54 2026-03-31
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $115,487.75 $115,487.75 $115,487.75 2026-03-31
5832 APR_DRG Neonate With Ecmo 3 3 — — $113,287.12 $113,287.12 $113,287.12 2026-03-31
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 17 13 — — $101,909.66 $161,659.00 $110,314.59 2026-03-31
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 2 — — $102,480.95 $111,397.05 $110,229.37 2026-03-31
212 MS_DRG Concomitant Aortic And Mitral Valve?procedures 17 13 — — $100,754.06 $159,813.51 $109,063.67 2026-03-31
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 — — $107,281.08 $107,281.08 $107,281.08 2026-03-31
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 17 13 — — $98,508.04 $156,226.70 $106,632.41 2026-03-31
215 MS_DRG Other Heart Assist System Implant 17 13 — — $98,006.47 $155,425.72 $106,089.48 2026-03-31
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $103,769.84 $103,769.84 $103,769.84 2026-03-31
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $102,504.55 $102,504.55 $102,504.55 2026-03-31
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $100,371.89 $100,371.89 $100,371.89 2026-03-31
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $100,206.92 $100,206.92 $100,206.92 2026-03-31
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 3 — — $100,078.12 $100,078.12 $100,078.12 2026-03-31
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $99,567.72 $99,567.72 $99,567.72 2026-03-31
5831 APR_DRG Neonate With Ecmo 3 3 — — $97,900.54 $97,900.54 $97,900.54 2026-03-31
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 13 — — $89,337.50 $141,581.64 $96,705.55 2026-03-31
74 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $96,244.90 $96,244.90 $96,244.90 2026-03-31
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 3 — — $95,589.40 $95,589.40 $95,589.40 2026-03-31
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $95,331.01 $95,331.01 $95,331.01 2026-03-31
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $87,270.87 $94,863.66 $93,869.28 2026-03-31
14 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $93,848.68 $93,848.68 $93,848.68 2026-03-31
1612 APR_DRG Implantable Heart Assist Systems 3 3 — — $93,575.99 $93,575.99 $93,575.99 2026-03-31
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $93,331.52 $93,331.52 $93,331.52 2026-03-31
23 APR_DRG Heart And/or Lung Transplant 3 3 — — $90,783.85 $90,783.85 $90,783.85 2026-03-31
1611 APR_DRG Implantable Heart Assist Systems 3 3 — — $88,896.85 $88,896.85 $88,896.85 2026-03-31
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 3 2 — — $82,380.65 $89,547.97 $88,609.32 2026-03-31
231 MS_DRG Coronary Bypass With Ptca With Mcc 17 13 — — $78,523.58 $124,312.11 $84,999.75 2026-03-31
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 17 13 — — $78,480.40 $124,243.16 $84,953.01 2026-03-31
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 3 — — $83,413.54 $83,413.54 $83,413.54 2026-03-31
64 APR_DRG Pancreas Transplant 3 3 — — $82,879.28 $82,879.28 $82,879.28 2026-03-31
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 3 2 — — $76,012.30 $82,625.56 $81,759.46 2026-03-31
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 17 13 — — $74,731.54 $118,256.34 $80,894.96 2026-03-31
10 MS_DRG Pancreas Transplant 17 13 — — $73,922.24 $116,963.91 $80,018.91 2026-03-31
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 17 13 — — $73,502.43 $116,293.49 $79,564.49 2026-03-31
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 17 13 — — $72,483.69 $114,666.59 $78,461.72 2026-03-31
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 13 — — $71,758.90 $113,509.13 $77,677.16 2026-03-31
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 17 13 — — $69,248.33 $109,499.81 $74,959.53 2026-03-31
A9699 HCPCS Radiopharm Rx Agent Noc 2 1 — — $74,614.73 $74,614.73 $74,614.73 2026-03-31
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $74,382.42 $74,382.42 $74,382.42 2026-03-31
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $67,628.88 $73,512.76 $72,742.19 2026-03-31
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 2 — — $67,216.03 $73,064.00 $72,298.13 2026-03-31
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 17 13 — — $65,599.59 $103,672.89 $71,009.86 2026-03-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 17 13 — — $64,584.52 $102,051.86 $69,911.08 2026-03-31
J9029 HCPCS Instill Adstiladrin, Tx Dose 20 13 — — $10,910.14 $104,338.76 $68,766.67 2026-03-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 17 13 — — $63,406.85 $100,171.16 $68,636.28 2026-03-31
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 3 2 — — $63,279.28 $68,784.74 $68,063.72 2026-03-31
22 APR_DRG Heart And/or Lung Transplant 3 3 — — $67,371.47 $67,371.47 $67,371.47 2026-03-31
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 17 13 — — $62,034.45 $97,979.46 $67,150.69 2026-03-31
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 17 13 — — $61,930.64 $97,813.69 $67,038.32 2026-03-31
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $66,730.68 $66,730.68 $66,730.68 2026-03-31
3621387-256 CDM Heartmate Ii Lvad Sys 16 6 $175,000.00 — $33,250.00 $242,375.00 $66,710.00 2026-03-31
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $66,068.42 $66,068.42 $66,068.42 2026-03-31
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $65,237.61 $65,237.61 $65,237.61 2026-03-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 17 13 — — $60,089.74 $94,873.82 $65,045.60 2026-03-31
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 13 — — $60,004.31 $94,737.39 $64,953.12 2026-03-31
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 3 3 — — $64,371.83 $64,371.83 $64,371.83 2026-03-31
3621431-256 CDM Hw Hvad - Sterile Implant Kit #5400 16 6 $168,400.00 — $31,996.00 $233,234.00 $64,194.08 2026-03-31
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 17 13 — — $58,777.04 $92,777.48 $63,624.63 2026-03-31
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 — — $62,825.10 $62,825.10 $62,825.10 2026-03-31
276 MS_DRG Cardiac Defibrillator Implant With Mcc 17 13 — — $57,583.76 $90,871.85 $62,332.94 2026-03-31
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 17 13 — — $57,251.22 $90,340.79 $61,972.97 2026-03-31
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 17 13 — — $57,053.72 $90,025.39 $61,759.18 2026-03-31
A9543 HCPCS Y90 Ibritumomab, Rx 20 13 — — $9,773.82 $93,760.51 $61,604.45 2026-03-31
232 MS_DRG Coronary Bypass With Ptca Without Mcc 17 13 — — $56,796.51 $89,614.63 $61,480.76 2026-03-31
28 MS_DRG Spinal Procedures With Mcc 17 13 — — $56,528.27 $89,186.27 $61,190.40 2026-03-31
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 17 13 — — $56,127.76 $88,546.65 $60,756.85 2026-03-31
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 17 13 — — $56,127.76 $88,546.65 $60,756.85 2026-03-31
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 3 — — $60,669.38 $60,669.38 $60,669.38 2026-03-31
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 20 13 — — $9,622.71 $94,078.22 $60,651.96 2026-03-31
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 17 13 — — $55,713.46 $87,885.04 $60,308.39 2026-03-31
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 13 — — $55,332.23 $87,276.23 $59,895.72 2026-03-31
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 15 12 — — $55,290.90 $87,210.22 $59,850.98 2026-03-31
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 17 13 — — $54,734.22 $86,321.21 $59,248.38 2026-03-31
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $58,706.06 $58,706.06 $58,706.06 2026-03-31
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $58,652.40 $58,652.40 $58,652.40 2026-03-31
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 17 13 — — $54,165.60 $85,413.14 $58,632.86 2026-03-31
63 APR_DRG Pancreas Transplant 3 3 — — $58,276.35 $58,276.35 $58,276.35 2026-03-31
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 — — $58,001.67 $58,001.67 $58,001.67 2026-03-31
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 17 13 — — $53,404.07 $84,197.00 $57,808.53 2026-03-31
21 APR_DRG Heart And/or Lung Transplant 3 3 — — $57,755.21 $57,755.21 $57,755.21 2026-03-31
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 17 13 — — $53,088.98 $83,693.82 $57,467.46 2026-03-31
38240 HCPCS Trnsplj Allogeneic Hematopoietic Cells Per Donor 31 14 $91,360.00 — $1,285.52 $126,533.60 $57,335.57 2026-03-31
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $57,132.30 $57,132.30 $57,132.30 2026-03-31
3621004-256 CDM Hvad Heartware Pump 16 6 $149,300.00 — $28,367.00 $206,780.50 $56,913.16 2026-03-31
73 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $56,719.68 $56,719.68 $56,719.68 2026-03-31
653 MS_DRG Major Bladder Procedures With Mcc 17 13 — — $51,890.19 $81,779.38 $56,169.79 2026-03-31
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $55,801.03 $55,801.03 $55,801.03 2026-03-31
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 17 13 — — $51,455.69 $81,085.49 $55,699.46 2026-03-31
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 17 13 — — $51,455.69 $81,085.49 $55,699.46 2026-03-31
4404 APR_DRG Kidney Transplant 3 3 — — $55,140.76 $55,140.76 $55,140.76 2026-03-31
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 17 13 — — $50,663.84 $79,820.94 $54,842.30 2026-03-31
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 17 13 — — $50,549.93 $79,639.03 $54,719.00 2026-03-31
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 17 13 — — $50,295.47 $79,232.67 $54,443.55 2026-03-31
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 17 13 — — $50,248.62 $79,157.85 $54,392.84 2026-03-31
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 17 13 — — $50,243.11 $79,149.05 $54,386.87 2026-03-31
13 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $54,256.69 $54,256.69 $54,256.69 2026-03-31
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 3 3 — — $54,216.93 $54,216.93 $54,216.93 2026-03-31
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $50,173.96 $54,539.23 $53,967.54 2026-03-31
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 17 13 — — $49,553.24 $78,047.33 $53,640.10 2026-03-31
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 13 — — $49,337.35 $77,702.59 $53,406.41 2026-03-31
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $52,890.43 $52,890.43 $52,890.43 2026-03-31
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 17 13 — — $47,833.58 $75,301.11 $51,778.62 2026-03-31
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 2 — — $48,069.20 $52,251.34 $51,703.64 2026-03-31
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 3 3 — — $51,625.94 $51,625.94 $51,625.94 2026-03-31
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 17 13 — — $47,480.84 $74,737.78 $51,396.79 2026-03-31
1784 APR_DRG External Heart Assist Systems 3 3 — — $51,281.29 $51,281.29 $51,281.29 2026-03-31
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 17 13 — — $47,337.53 $74,508.93 $51,241.66 2026-03-31
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 17 13 — — $46,950.79 $73,891.32 $50,823.02 2026-03-31
62 APR_DRG Pancreas Transplant 3 3 — — $50,589.62 $50,589.62 $50,589.62 2026-03-31
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 17 13 — — $46,677.97 $73,455.62 $50,527.70 2026-03-31
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 17 13 — — $46,642.14 $73,398.41 $50,488.91 2026-03-31
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 17 13 — — $46,623.77 $73,369.07 $50,469.03 2026-03-31
228 MS_DRG Other Cardiothoracic Procedures With Mcc 17 13 — — $46,458.42 $73,105.01 $50,290.04 2026-03-31
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $49,604.98 $49,604.98 $49,604.98 2026-03-31
J9226 HCPCS Supprelin La Implant 20 13 — — $7,836.39 $74,599.87 $49,392.78 2026-03-31
245 MS_DRG Aicd Generator Procedures 17 13 — — $45,571.96 $71,689.36 $49,330.47 2026-03-31
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 3 — — $49,261.13 $49,261.13 $49,261.13 2026-03-31
471 MS_DRG Cervical Spinal Fusion With Mcc 17 13 — — $45,300.97 $71,256.59 $49,037.13 2026-03-31
6 MS_DRG Liver Transplant Without Mcc 17 13 — — $45,226.56 $71,137.76 $48,956.59 2026-03-31
84 APR_DRG Autologous Bone Marrow Transplant 3 3 — — $48,686.32 $48,686.32 $48,686.32 2026-03-31
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 17 13 — — $44,549.54 $70,056.59 $48,223.73 2026-03-31
33276 HCPCS Insj Phrnc Nrv Stim Sys 18 12 — — $8,068.42 $63,749.90 $48,152.52 2026-03-31
0266T OTHER Implt/rpl Crtd Sns Dev Total 18 12 — — $8,068.42 $63,749.90 $48,152.52 2026-03-31
799 MS_DRG Splenic Procedures With Mcc 17 13 — — $44,359.38 $69,752.92 $48,017.89 2026-03-31
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 17 13 — — $44,351.12 $69,739.71 $48,008.94 2026-03-31
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 17 13 — — $43,899.15 $69,017.95 $47,519.70 2026-03-31
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 17 13 — — $43,667.66 $68,648.27 $47,269.12 2026-03-31
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 3 3 — — $47,210.75 $47,210.75 $47,210.75 2026-03-31
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 17 13 — — $43,414.13 $68,243.37 $46,994.68 2026-03-31
163 MS_DRG Major Chest Procedures With Mcc 17 13 — — $43,021.89 $67,616.96 $46,570.08 2026-03-31
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 17 13 — — $43,004.43 $67,589.09 $46,551.18 2026-03-31
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 3 3 — — $46,437.98 $46,437.98 $46,437.98 2026-03-31
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 13 — — $42,869.39 $67,373.44 $46,405.01 2026-03-31
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 17 13 — — $42,862.96 $67,363.17 $46,398.05 2026-03-31
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 — — $46,263.47 $46,263.47 $46,263.47 2026-03-31
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 17 13 — — $42,125.32 $66,185.17 $45,599.57 2026-03-31
12 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $45,473.61 $45,473.61 $45,473.61 2026-03-31
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 17 13 — — $41,878.21 $65,790.55 $45,332.08 2026-03-31
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 17 13 — — $41,764.30 $65,608.64 $45,208.78 2026-03-31
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 3 3 — — $44,851.11 $44,851.11 $44,851.11 2026-03-31
901 MS_DRG Wound Debridements For Injuries With Mcc 17 13 — — $41,380.32 $64,995.44 $44,793.13 2026-03-31
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $44,753.72 $44,753.72 $44,753.72 2026-03-31
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 3 3 — — $44,519.18 $44,519.18 $44,519.18 2026-03-31
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $44,445.64 $44,445.64 $44,445.64 2026-03-31
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 17 13 — — $41,034.00 $64,442.38 $44,418.24 2026-03-31
72 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $44,366.54 $44,366.54 $44,366.54 2026-03-31
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 3 3 — — $43,916.95 $43,916.95 $43,916.95 2026-03-31
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 17 13 — — $40,428.63 $63,475.62 $43,762.95 2026-03-31
1834 APR_DRG Percutaneous Structural Cardiac Procedures 3 3 — — $43,760.73 $43,760.73 $43,760.73 2026-03-31
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 17 13 — — $40,346.88 $63,345.06 $43,674.46 2026-03-31
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 3 3 — — $43,416.08 $43,416.08 $43,416.08 2026-03-31
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 17 13 — — $39,866.44 $62,577.82 $43,154.39 2026-03-31
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 17 13 — — $39,808.57 $62,485.40 $43,091.75 2026-03-31
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $43,015.78 $43,015.78 $43,015.78 2026-03-31
140 MS_DRG Major Head And Neck Procedures With Mcc 17 13 — — $39,531.15 $62,042.36 $42,791.45 2026-03-31
8634 APR_DRG Neonatal Aftercare 3 3 — — $42,563.41 $42,563.41 $42,563.41 2026-03-31
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 3 3 — — $42,556.26 $42,556.26 $42,556.26 2026-03-31
31 MS_DRG Ventricular Shunt Procedures With Mcc 17 13 — — $39,176.56 $61,476.10 $42,407.62 2026-03-31
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 17 13 — — $39,167.38 $61,461.43 $42,397.68 2026-03-31
793 MS_DRG Full Term Neonate With Major Problems 15 12 — — $38,991.92 $61,181.24 $42,207.75 2026-03-31
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 17 13 — — $38,901.90 $61,037.47 $42,110.30 2026-03-31
9104 APR_DRG Craniotomy For Multiple Significant Trauma 3 3 — — $42,041.08 $42,041.08 $42,041.08 2026-03-31
1794 APR_DRG Defibrillator Implants 3 3 — — $41,780.31 $41,780.31 $41,780.31 2026-03-31
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 17 13 — — $38,455.45 $60,324.51 $41,627.03 2026-03-31
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 3 3 — — $41,607.00 $41,607.00 $41,607.00 2026-03-31
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 17 13 — — $38,434.32 $60,290.77 $41,604.16 2026-03-31
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 3 3 — — $41,553.33 $41,553.33 $41,553.33 2026-03-31
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 17 13 — — $38,378.28 $60,201.28 $41,543.50 2026-03-31
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $41,516.76 $41,516.76 $41,516.76 2026-03-31
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 17 13 — — $38,044.83 $59,668.76 $41,182.54 2026-03-31
791 MS_DRG Prematurity With Major Problems 15 12 — — $37,975.94 $59,558.73 $41,107.97 2026-03-31
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $37,917.68 $41,216.62 $40,784.58 2026-03-31
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 3 3 — — $40,732.86 $40,732.86 $40,732.86 2026-03-31
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 3 — — $40,591.74 $40,591.74 $40,591.74 2026-03-31
11 APR_DRG Liver Transplant And/or Intestinal Transplant 3 3 — — $40,374.70 $40,374.70 $40,374.70 2026-03-31
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 17 13 — — $37,275.95 $58,440.88 $40,350.25 2026-03-31
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 17 13 — — $37,250.23 $58,399.80 $40,322.42 2026-03-31
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 17 13 — — $36,926.87 $57,883.42 $39,972.39 2026-03-31
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 17 13 — — $36,852.46 $57,764.59 $39,891.84 2026-03-31
1694 APR_DRG Major Abdominal Vascular Procedures 3 3 — — $39,831.30 $39,831.30 $39,831.30 2026-03-31
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 17 13 — — $36,778.98 $57,647.23 $39,812.29 2026-03-31
61 APR_DRG Pancreas Transplant 3 3 — — $39,765.71 $39,765.71 $39,765.71 2026-03-31
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 3 3 — — $39,718.01 $39,718.01 $39,718.01 2026-03-31
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 17 13 — — $36,601.69 $57,364.10 $39,620.39 2026-03-31
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 3 3 — — $39,544.69 $39,544.69 $39,544.69 2026-03-31
71 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $39,504.94 $39,504.94 $39,504.94 2026-03-31
34 MS_DRG Carotid Artery Stent Procedures With Mcc 17 13 — — $36,403.27 $57,047.23 $39,405.60 2026-03-31
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 3 3 — — $39,370.98 $39,370.98 $39,370.98 2026-03-31
914 APR_DRG Other Major Head And Neck Procedures 3 3 — — $39,337.59 $39,337.59 $39,337.59 2026-03-31
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 17 13 — — $36,185.55 $56,699.55 $39,169.92 2026-03-31
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 17 13 — — $36,149.73 $56,642.34 $39,131.15 2026-03-31
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 17 13 — — $36,050.52 $56,483.90 $39,023.75 2026-03-31
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 17 13 — — $35,794.22 $56,074.61 $38,746.32 2026-03-31
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 3 3 — — $38,589.47 $38,589.47 $38,589.47 2026-03-31
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 17 13 — — $35,604.07 $55,770.94 $38,540.49 2026-03-31
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 17 13 — — $35,332.16 $55,336.71 $38,246.16 2026-03-31
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 17 13 — — $35,055.65 $54,895.14 $37,946.84 2026-03-31
1783 APR_DRG External Heart Assist Systems 3 3 — — $37,937.94 $37,937.94 $37,937.94 2026-03-31
5024204413 NDC Alteplase 1 Mg Inj 16 6 $99,238.31 — $18,855.28 $137,445.06 $37,829.64 2026-03-31
5024208525_2 NDC Alteplase 1 Mg Inj 16 6 $99,238.21 — $18,855.26 $137,444.92 $37,829.61 2026-03-31
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 3 3 — — $37,783.71 $37,783.71 $37,783.71 2026-03-31
Q2040 HCPCS Tisagenlecleucel Car-pos T 3 3 — — $37,727.52 $37,727.52 $37,727.52 2026-03-31
C9098 HCPCS Ciltacabtagene Car Pos T 3 3 — — $37,727.52 $37,727.52 $37,727.52 2026-03-31
C9081 HCPCS Idecabtagene Car Pos T 3 3 — — $37,727.52 $37,727.52 $37,727.52 2026-03-31
C9076 HCPCS Lisocabtagene Car Pos T 3 3 — — $37,727.52 $37,727.52 $37,727.52 2026-03-31
C9073 HCPCS Brexucabtagene Autoleucel Ca 3 3 — — $37,727.52 $37,727.52 $37,727.52 2026-03-31
234 APR_DRG Spinal Procedures 3 3 — — $37,686.71 $37,686.71 $37,686.71 2026-03-31
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 18 12 — — $6,275.46 $49,583.42 $37,452.08 2026-03-31
214 APR_DRG Open Craniotomy Except Trauma 3 3 — — $37,170.34 $37,170.34 $37,170.34 2026-03-31
4414 APR_DRG Major Bladder Procedures 3 3 — — $37,163.58 $37,163.58 $37,163.58 2026-03-31
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 17 13 — — $34,198.59 $53,526.43 $37,019.09 2026-03-31
335 MS_DRG Peritoneal Adhesiolysis With Mcc 17 13 — — $33,966.18 $53,155.28 $36,767.51 2026-03-31
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 3 — — $36,708.83 $36,708.83 $36,708.83 2026-03-31
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 3 3 — — $36,697.70 $36,697.70 $36,697.70 2026-03-31
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 17 13 — — $33,611.60 $52,589.02 $36,383.69 2026-03-31
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 17 13 — — $33,609.75 $52,586.08 $36,381.69 2026-03-31
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 17 13 — — $33,604.24 $52,577.28 $36,375.73 2026-03-31
4403 APR_DRG Kidney Transplant 3 3 — — $36,346.30 $36,346.30 $36,346.30 2026-03-31
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 3 3 — — $36,227.44 $36,227.44 $36,227.44 2026-03-31
265 MS_DRG Aicd Lead Procedures 17 13 — — $33,449.92 $52,330.82 $36,208.67 2026-03-31
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 3 3 — — $36,173.77 $36,173.77 $36,173.77 2026-03-31
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 17 13 — — $33,302.94 $52,096.10 $36,049.58 2026-03-31
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 17 13 — — $33,111.87 $51,790.97 $35,842.75 2026-03-31
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 17 13 — — $33,103.60 $51,777.77 $35,833.79 2026-03-31
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 17 13 — — $33,021.85 $51,647.20 $35,745.30 2026-03-31
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 17 13 — — $32,867.52 $51,400.75 $35,578.24 2026-03-31
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 17 13 — — $32,857.41 $51,384.61 $35,567.30 2026-03-31
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 17 13 — — $32,844.55 $51,364.07 $35,553.38 2026-03-31
C9031 HCPCS Lutetium Lu 177 Dotatate, Tx 3 3 — — $35,545.22 $35,545.22 $35,545.22 2026-03-31
264 MS_DRG Other Circulatory System O.r. Procedures 17 13 — — $32,787.60 $51,273.12 $35,491.73 2026-03-31
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 3 3 — — $35,478.92 $35,478.92 $35,478.92 2026-03-31
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $35,403.79 $35,403.79 $35,403.79 2026-03-31
1782 APR_DRG External Heart Assist Systems 3 3 — — $35,346.15 $35,346.15 $35,346.15 2026-03-31
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 17 13 — — $32,579.99 $50,941.58 $35,267.00 2026-03-31
332 MS_DRG Rectal Resection With Mcc 17 13 — — $32,545.08 $50,885.83 $35,229.21 2026-03-31
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 3 3 — — $35,207.42 $35,207.42 $35,207.42 2026-03-31
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 17 13 — — $32,510.18 $50,830.08 $35,191.43 2026-03-31
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 15 12 — — $5,748.52 $45,420.00 $35,092.71 2026-03-31
271 MS_DRG Other Major Cardiovascular Procedures With Cc 17 13 — — $32,321.86 $50,529.35 $34,987.58 2026-03-31
894 APR_DRG Major Cranial Or Facial Bone Procedures 3 3 — — $34,969.70 $34,969.70 $34,969.70 2026-03-31
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 17 13 — — $32,272.26 $50,450.13 $34,933.89 2026-03-31
665 MS_DRG Prostatectomy With Mcc 17 13 — — $32,222.65 $50,370.91 $34,880.19 2026-03-31
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 3 3 — — $34,868.34 $34,868.34 $34,868.34 2026-03-31
252 MS_DRG Other Vascular Procedures With Mcc 17 13 — — $32,193.25 $50,323.97 $34,848.37 2026-03-31
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 17 13 — — $32,145.49 $50,247.68 $34,796.66 2026-03-31
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 3 3 — — $34,625.06 $34,625.06 $34,625.06 2026-03-31
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 17 13 — — $31,970.95 $49,968.95 $34,607.73 2026-03-31
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 3 3 — — $34,555.10 $34,555.10 $34,555.10 2026-03-31
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 17 13 — — $31,840.50 $49,760.64 $34,466.52 2026-03-31
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 3 3 — — $34,450.95 $34,450.95 $34,450.95 2026-03-31
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $34,415.57 $34,415.57 $34,415.57 2026-03-31
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 3 3 — — $34,368.66 $34,368.66 $34,368.66 2026-03-31
3657004-256 CDM Ab Pump Set Abiomed 15 6 $90,000.00 — $17,100.00 $124,650.00 $34,308.00 2026-03-31
33249 HCPCS Insrt Or Replc Icd With Trnsven Lead Sing Or Dual Chamb 34 14 $91,718.00 — $1,276.00 $127,029.43 $34,307.31 2026-03-31
0408T OTHER Insj/rplc Cardiac Modulj Sys 18 12 — — $5,748.52 $45,420.00 $34,307.31 2026-03-31
204 APR_DRG Open Craniotomy For Trauma 3 3 — — $34,292.34 $34,292.34 $34,292.34 2026-03-31
1204 APR_DRG Major Respiratory And Chest Procedures 3 3 — — $34,134.13 $34,134.13 $34,134.13 2026-03-31
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 17 13 — — $31,516.23 $49,242.79 $34,115.51 2026-03-31
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 3 3 — — $34,060.59 $34,060.59 $34,060.59 2026-03-31
69930 HCPCS Implant Cochlear Device 18 12 — — $5,703.02 $45,060.51 $34,035.77 2026-03-31
6904 APR_DRG Acute Leukemia 3 3 — — $33,960.81 $33,960.81 $33,960.81 2026-03-31
7594 APR_DRG Eating Disorders 3 3 — — $33,899.99 $33,899.99 $33,899.99 2026-03-31
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 3 3 — — $33,863.82 $33,863.82 $33,863.82 2026-03-31
37 MS_DRG Extracranial Procedures With Mcc 17 13 — — $31,187.37 $48,717.60 $33,759.53 2026-03-31
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 17 13 — — $31,012.83 $48,438.87 $33,570.59 2026-03-31
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 3 3 — — $33,489.36 $33,489.36 $33,489.36 2026-03-31
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