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

COMMUNITY HOSPITAL OF STAUNTON

Staunton, IL · CCN 141306 · Rates published

21,110 distinct procedures filed
28 distinct payers
453,024 rate rows
2026-05-09 last MRF observed
Data quality

416,497 of 453,024 rate rows are consumer-grade (91.9%)

36,527 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 16,928
per-diem day rate — not a per-procedure price 16,411
template filing: same amount across many unrelated codes — excluded 2,904
exceeds 10× this hospital's gross charge — excluded from medians 225
placeholder amount (≤ $0.02) — excluded from medians 59
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stauntonhospital.org/wp-content/uploads/2025/04/370624255_anderson-healthcare_standardcharges.csv
Found on page https://stauntonhospital.org/visitor-patient-information/price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-18
Content fingerprint 089d7db6dfbb2c9d… · 39,767,587 bytes · first seen 2026-05-13

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
'583-4
APR_DRG 		Neonate With Ecmo 4 $190,753.52 $190,753.52 $190,753.52 —
608
OTHER 		Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period 1 $161,233.19 $161,233.19 $161,233.19 nat. median
$12,228
outlier · 13.2×
'588-4
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $156,469.62 $156,469.62 $156,469.62 —
'583-3
APR_DRG 		Neonate With Ecmo 4 $151,080.42 $151,080.42 $151,080.42 —
'161-4
APR_DRG 		Implantable Heart Assist Systems 4 $149,603.53 $149,603.53 $149,603.53 —
'002-4
APR_DRG 		Heart And/or Lung Transplant 4 $144,371.88 $144,371.88 $144,371.88 —
754-4
OTHER 		Depression Except Major Depressive Disorder 2 $118,078.43 $118,078.43 $118,078.43 nat. median
$15,955
outlier · 7.4×
'161-3
APR_DRG 		Implantable Heart Assist Systems 4 $114,611.68 $114,611.68 $114,611.68 —
841-3
OTHER 		Extensive Third Degree Burns With Skin Graft 2 $114,365.96 $114,365.96 $114,365.96 nat. median
$61,016
1.9× median
'630-4
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 $113,571.45 $113,571.45 $113,571.45 —
841-4
OTHER 		Extensive Third Degree Burns With Skin Graft 2 $112,840.88 $112,840.88 $112,840.88 nat. median
$151,691
0.7× median
'583-2
APR_DRG 		Neonate With Ecmo 4 $111,407.32 $111,407.32 $111,407.32 —
'841-4
APR_DRG 		Extensive Third Degree Burns With Skin Graft 4 $105,500.94 $105,500.94 $105,500.94 —
'593-4
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 4 $102,047.97 $102,047.97 $102,047.97 —
'588-3
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $100,803.67 $100,803.67 $100,803.67 —
'588-2
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $98,706.40 $98,706.40 $98,706.40 —
'591-4
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 4 $98,544.17 $98,544.17 $98,544.17 —
'011-4
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 $98,417.51 $98,417.51 $98,417.51 —
12203919
OTHER 		Tremelimumab Actl 300 Mg 15 Ml Vial 15 $138.08 $140,838.07 $98,164.14 nat. median
$98,164
1.0× median
'609-4
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 $97,915.57 $97,915.57 $97,915.57 —
'583-1
APR_DRG 		Neonate With Ecmo 4 $96,276.06 $96,276.06 $96,276.06 —
'007-4
APR_DRG 		Allogeneic Bone Marrow Transplant 4 $94,647.89 $94,647.89 $94,647.89 —
'631-4
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 $94,003.26 $94,003.26 $94,003.26 —
'004-4
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 4 $93,749.17 $93,749.17 $93,749.17 —
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$620,080
outlier · 0.1×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$674,188
outlier · 0.1×
Q2040
HCPCS 		Tisagenlecleucel Car-pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$25,594
outlier · 3.6×
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$3,286,000
outlier · 0.0×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$634,511
outlier · 0.1×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$754,974
outlier · 0.1×
C9098
HCPCS 		Ciltacabtagene Car Pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$57,174
1.6× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$625,184
outlier · 0.1×
C9073
HCPCS 		Brexucabtagene Autoleucel Ca 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$29,278
outlier · 3.2×
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$3,006,423
outlier · 0.0×
C9076
HCPCS 		Lisocabtagene Car Pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$30,475
outlier · 3.0×
C9081
HCPCS 		Idecabtagene Car Pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$30,475
outlier · 3.0×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $92,877.03 $92,877.03 $92,877.03 nat. median
$675,122
outlier · 0.1×
'001-4
APR_DRG 		Liver Transplant And/or Intestinal Transplant 4 $92,291.43 $92,291.43 $92,291.43 —
'161-2
APR_DRG 		Implantable Heart Assist Systems 4 $92,023.26 $92,023.26 $92,023.26 —
'009-4
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 4 $91,782.85 $91,782.85 $91,782.85 —
'002-3
APR_DRG 		Heart And/or Lung Transplant 4 $89,277.46 $89,277.46 $89,277.46 —
'161-1
APR_DRG 		Implantable Heart Assist Systems 4 $87,421.77 $87,421.77 $87,421.77 —
12203335
OTHER 		Ipilimumab 200 Mg 40 Ml Vial 15 $179.81 $123,596.96 $86,147.08 nat. median
$41,158
outlier · 2.1×
'603-4
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 $82,029.45 $82,029.45 $82,029.45 —
'006-4
APR_DRG 		Pancreas Transplant 4 $81,504.05 $81,504.05 $81,504.05 —
12203493
OTHER 		Ustekinumab 90 Mg Ml Syringe 15 $153.39 $99,479.36 $74,609.52 nat. median
$47,750
1.6× median
C9031
HCPCS 		Lutetium Lu 177 Dotatate, Tx 4 $74,517.38 $74,517.38 $74,517.38 nat. median
$664
outlier · 112.2×
A9543
HCPCS 		Y90 Ibritumomab, Rx 4 $74,517.38 $74,517.38 $74,517.38 nat. median
$62,507
1.2× median
A9607
HCPCS 		Lutetium Lu 177 Vipivotide 4 $74,517.38 $74,517.38 $74,517.38 nat. median
$415
outlier · 179.4×
A9513
HCPCS 		Lutetium Lu 177 Dotatat Ther 4 $74,517.38 $74,517.38 $74,517.38 nat. median
$468
outlier · 159.3×

Other procedures at this hospital

Browse this hospital's 21,110 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
             
'583-4 APR_DRG Neonate With Ecmo 8 4 — — $190,753.52 $190,753.52 $190,753.52 2025-01-21
608 OTHER Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period 1 1 — — $161,233.19 $161,233.19 $161,233.19 2026-05-09
'588-4 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 4 — — $156,469.62 $156,469.62 $156,469.62 2025-01-21
'583-3 APR_DRG Neonate With Ecmo 8 4 — — $151,080.42 $151,080.42 $151,080.42 2025-01-21
'161-4 APR_DRG Implantable Heart Assist Systems 8 4 — — $149,603.53 $149,603.53 $149,603.53 2025-01-21
'002-4 APR_DRG Heart And/or Lung Transplant 8 4 — — $144,371.88 $144,371.88 $144,371.88 2025-01-21
754-4 OTHER Depression Except Major Depressive Disorder 2 2 — — $118,078.43 $118,078.43 $118,078.43 2026-05-09
'161-3 APR_DRG Implantable Heart Assist Systems 8 4 — — $114,611.68 $114,611.68 $114,611.68 2025-01-21
841-3 OTHER Extensive Third Degree Burns With Skin Graft 2 2 — — $114,365.96 $114,365.96 $114,365.96 2026-05-09
'630-4 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 4 — — $113,571.45 $113,571.45 $113,571.45 2025-01-21
841-4 OTHER Extensive Third Degree Burns With Skin Graft 2 2 — — $112,840.88 $112,840.88 $112,840.88 2026-05-09
'583-2 APR_DRG Neonate With Ecmo 8 4 — — $111,407.32 $111,407.32 $111,407.32 2025-01-21
'841-4 APR_DRG Extensive Third Degree Burns With Skin Graft 8 4 — — $105,500.94 $105,500.94 $105,500.94 2025-01-21
'593-4 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 8 4 — — $102,047.97 $102,047.97 $102,047.97 2025-01-21
'588-3 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 4 — — $100,803.67 $100,803.67 $100,803.67 2025-01-21
'588-2 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 4 — — $98,706.40 $98,706.40 $98,706.40 2025-01-21
'591-4 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 4 — — $98,544.17 $98,544.17 $98,544.17 2025-01-21
'011-4 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 4 — — $98,417.51 $98,417.51 $98,417.51 2025-01-21
12203919 OTHER Tremelimumab Actl 300 Mg 15 Ml Vial 26 15 $140,838.07 $70,419.04 50% off $138.08 $140,838.07 $98,164.14 2026-05-09
'609-4 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 4 — — $97,915.57 $97,915.57 $97,915.57 2025-01-21
'583-1 APR_DRG Neonate With Ecmo 8 4 — — $96,276.06 $96,276.06 $96,276.06 2025-01-21
'007-4 APR_DRG Allogeneic Bone Marrow Transplant 8 4 — — $94,647.89 $94,647.89 $94,647.89 2025-01-21
'631-4 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 4 — — $94,003.26 $94,003.26 $94,003.26 2025-01-21
'004-4 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 4 — — $93,749.17 $93,749.17 $93,749.17 2025-01-21
Q2055 HCPCS Idecabtagene Vicleucel Car 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
Q2053 HCPCS Brexucabtagene Car Pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
Q2040 HCPCS Tisagenlecleucel Car-pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
J3393 HCPCS Inj, Betibeglogene Autotemce 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
C9098 HCPCS Ciltacabtagene Car Pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
Q2042 HCPCS Tisagenlecleucel Car-pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
J3394 HCPCS Inj, Lovotibeglogene Autotem 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
Q2054 HCPCS Lisocabtagene Mara Car Pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
Q2056 HCPCS Ciltacabtagene Car-pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
C9081 HCPCS Idecabtagene Car Pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
C9076 HCPCS Lisocabtagene Car Pos T 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
C9073 HCPCS Brexucabtagene Autoleucel Ca 8 4 — — $92,877.03 $92,877.03 $92,877.03 2025-01-21
'001-4 APR_DRG Liver Transplant And/or Intestinal Transplant 8 4 — — $92,291.43 $92,291.43 $92,291.43 2025-01-21
'161-2 APR_DRG Implantable Heart Assist Systems 8 4 — — $92,023.26 $92,023.26 $92,023.26 2025-01-21
'009-4 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 8 4 — — $91,782.85 $91,782.85 $91,782.85 2025-01-21
'002-3 APR_DRG Heart And/or Lung Transplant 8 4 — — $89,277.46 $89,277.46 $89,277.46 2025-01-21
'161-1 APR_DRG Implantable Heart Assist Systems 8 4 — — $87,421.77 $87,421.77 $87,421.77 2025-01-21
12203335 OTHER Ipilimumab 200 Mg 40 Ml Vial 26 15 $123,596.96 $61,798.48 50% off $179.81 $123,596.96 $86,147.08 2026-05-09
'603-4 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 4 — — $82,029.45 $82,029.45 $82,029.45 2025-01-21
'006-4 APR_DRG Pancreas Transplant 8 4 — — $81,504.05 $81,504.05 $81,504.05 2025-01-21
12203493 OTHER Ustekinumab 90 Mg Ml Syringe 25 15 $99,479.36 $49,739.68 50% off $153.39 $99,479.36 $74,609.52 2026-05-09
C9031 HCPCS Lutetium Lu 177 Dotatate, Tx 8 4 — — $74,517.38 $74,517.38 $74,517.38 2025-01-21
A9607 HCPCS Lutetium Lu 177 Vipivotide 8 4 — — $74,517.38 $74,517.38 $74,517.38 2025-01-21
A9543 HCPCS Y90 Ibritumomab, Rx 8 4 — — $74,517.38 $74,517.38 $74,517.38 2025-01-21
A9513 HCPCS Lutetium Lu 177 Dotatat Ther 8 4 — — $74,517.38 $74,517.38 $74,517.38 2025-01-21
'602-4 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 4 — — $73,148.18 $73,148.18 $73,148.18 2025-01-21
12203385 OTHER Alemtuzumab 12 Mg 1.2 Ml Vial 26 15 $101,502.22 $50,751.11 50% off $2,381.29 $101,502.22 $70,747.05 2026-05-09
J0202 HCPCS Alemtuzumab 12 Mg/1.2 Ml Vial 58 14 $99,502.22 $49,751.11 50% off $35,820.80 $90,547.02 $66,666.49 2025-01-21
'002-2 APR_DRG Heart And/or Lung Transplant 8 4 — — $66,253.56 $66,253.56 $66,253.56 2025-01-21
'593-3 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 8 4 — — $65,623.40 $65,623.40 $65,623.40 2025-01-21
'588-1 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 8 4 — — $64,972.13 $64,972.13 $64,972.13 2025-01-21
'004-3 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 4 — — $64,155.11 $64,155.11 $64,155.11 2025-01-21
'160-4 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 8 4 — — $63,303.69 $63,303.69 $63,303.69 2025-01-21
'005-4 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 4 — — $61,782.63 $61,782.63 $61,782.63 2025-01-21
33982 HCPCS Replace Vad Intra Without Bp 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33975 HCPCS Implant Ventricular Device 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33976 HCPCS Implant Ventricular Device 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33990 HCPCS Insj Perq Vad L Hrt Arterial 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
0451T HCPCS Insj/rplcmt Aortic Ventr Sys 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
0453T HCPCS Insj/rplcmt Mech-elec Ntrfce 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33983 HCPCS Replace Vad Intra W/bp 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33981 HCPCS Replace Vad Pump Ext 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
0454T HCPCS Insj/rplcmt Subq Electrode 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
0459T HCPCS Relocaj Rplcmt Aortic Ventr 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33979 HCPCS Insert Intracorporeal Device 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33991 HCPCS Insj Perq Vad L Hrt Artl&ven 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
33995 HCPCS Insj Perq Vad R Hrt Venous 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
0452T HCPCS Insj/rplcmt Dev Vasc Seal 8 4 — — $61,110.38 $61,110.38 $61,110.38 2025-01-21
'162-4 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 4 — — $59,662.68 $59,662.68 $59,662.68 2025-01-21
'591-3 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 8 4 — — $57,731.94 $57,731.94 $57,731.94 2025-01-21
'602-3 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 4 — — $57,679.16 $57,679.16 $57,679.16 2025-01-21
'006-3 APR_DRG Pancreas Transplant 8 4 — — $57,309.36 $57,309.36 $57,309.36 2025-01-21
'303-4 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 8 4 — — $57,039.23 $57,039.23 $57,039.23 2025-01-21
'002-1 APR_DRG Heart And/or Lung Transplant 8 4 — — $56,796.86 $56,796.86 $56,796.86 2025-01-21
'607-4 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 8 4 — — $56,184.29 $56,184.29 $56,184.29 2025-01-21
'007-3 APR_DRG Allogeneic Bone Marrow Transplant 8 4 — — $55,778.52 $55,778.52 $55,778.52 2025-01-21
'630-3 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 4 — — $54,875.11 $54,875.11 $54,875.11 2025-01-21
'440-4 APR_DRG Kidney Transplant 8 4 — — $54,225.79 $54,225.79 $54,225.79 2025-01-21
12203784 OTHER Ravulizumab Cwvz 1100 Mg 11 Ml Vial 27 15 $83,775.95 $41,887.98 50% off $220.61 $83,775.95 $53,951.71 2026-05-09
'001-3 APR_DRG Liver Transplant And/or Intestinal Transplant 8 4 — — $53,356.39 $53,356.39 $53,356.39 2025-01-21
'842-4 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 8 4 — — $53,317.30 $53,317.30 $53,317.30 2025-01-21
'593-2 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 8 4 — — $52,012.81 $52,012.81 $52,012.81 2025-01-21
J3357 HCPCS Ustekinumab 90 Mg/ml Syringe 66 16 $95,013.73 $47,506.87 50% off $14,636.76 $86,462.49 $51,307.41 2025-01-21
'163-4 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 8 4 — — $50,769.30 $50,769.30 $50,769.30 2025-01-21
'178-4 APR_DRG External Heart Assist Systems 8 4 — — $50,430.37 $50,430.37 $50,430.37 2025-01-21
'006-2 APR_DRG Pancreas Transplant 8 4 — — $49,750.17 $49,750.17 $49,750.17 2025-01-21
69930 HCPCS Implant Cochlear Device 8 4 — — $49,271.80 $49,271.80 $49,271.80 2025-01-21
S2235 HCPCS Implant Auditory Brain Imp 8 4 — — $49,271.80 $49,271.80 $49,271.80 2025-01-21
'609-3 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 8 4 — — $48,781.87 $48,781.87 $48,781.87 2025-01-21
'011-3 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 4 — — $48,443.73 $48,443.73 $48,443.73 2025-01-21
'008-4 APR_DRG Autologous Bone Marrow Transplant 8 4 — — $47,878.46 $47,878.46 $47,878.46 2025-01-21
'165-4 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 8 4 — — $46,427.37 $46,427.37 $46,427.37 2025-01-21
C9741 HCPCS Impl Pressure Sensor W/angio 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33249 HCPCS Insj/rplcmt Defib W/lead(s) 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33230 HCPCS Insrt Pulse Gen W/dual Leads 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33231 HCPCS Insrt Pulse Gen W/mult Leads 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33270 HCPCS Ins/rep Subq Defibrillator 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33240 HCPCS Insrt Pulse Gen W/singl Lead 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
0409T HCPCS Insj/rplc Car Modulj Pls Gn 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
0520T HCPCS Rmv&rplcmt Pg Wcs Lv Battery 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
G0448 HCPCS Place Perm Pacing Cardiovert 8 4 — — $45,905.74 $45,905.74 $45,905.74 2025-01-21
'167-4 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 8 4 — — $45,667.43 $45,667.43 $45,667.43 2025-01-21
'005-3 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 8 4 — — $45,495.81 $45,495.81 $45,495.81 2025-01-21
'001-2 APR_DRG Liver Transplant And/or Intestinal Transplant 8 4 — — $44,719.06 $44,719.06 $44,719.06 2025-01-21
C9149 HCPCS Inj, Teplizumab-mzwv, 5 Mcg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
C9085 HCPCS Inj Avalglucosid Alfa-ngpt 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
C9052 HCPCS Injection, Ravulizumab-cwv 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9029 HCPCS Instill Adstiladrin, Tx Dose 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
Q9995 HCPCS Inj. Emicizumab-kxwh, 0.5 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9381 HCPCS Inj Teplizumab Mzwv 5 Mcg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9298 HCPCS Inj Nivol Relatlimab 3mg/1mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9350 HCPCS Inj Mosunetuzumab-axgb, 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9600 HCPCS Porfimer Sodium Injection 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9376 HCPCS Inj Pozelimab-bbfg, 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9226 HCPCS Supprelin La Implant 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9210 HCPCS Inj., Emapalumab-lzsg, 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J9269 HCPCS Inj. Tagraxofusp-erzs 10 Mcg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J7180 HCPCS Factor Xiii Anti-hem Factor 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J7175 HCPCS Inj, Factor X, (human), 1iu 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J7170 HCPCS Inj., Emicizumab-kxwh 0.5 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J2840 HCPCS Inj Sebelipase Alfa 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J2326 HCPCS Inj, Nusinersen, 0.1mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
C9146 HCPCS Inj, Elahere, 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J1300 HCPCS Eculizumab Injection 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J0223 HCPCS Inj Givosiran 0.5 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J0221 HCPCS Lumizyme Injection 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J1747 HCPCS Inj, Spesolimab-sbzo, 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J0217 HCPCS Inj Velmanase Alfa-tycv 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J0219 HCPCS Inj Aval Alfa-nqpt 4mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J2350 HCPCS Injection, Ocrelizumab, 1 Mg 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J1413 HCPCS Inj Delandistrogene Mox Rokl 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 8 4 — — $44,475.48 $44,475.48 $44,475.48 2025-01-21
'004-2 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 8 4 — — $44,106.88 $44,106.88 $44,106.88 2025-01-21
'602-2 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 8 4 — — $44,011.11 $44,011.11 $44,011.11 2025-01-21
'304-4 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 8 4 — — $43,780.47 $43,780.47 $43,780.47 2025-01-21
'607-3 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 8 4 — — $43,708.15 $43,708.15 $43,708.15 2025-01-21
'007-2 APR_DRG Allogeneic Bone Marrow Transplant 8 4 — — $43,630.35 $43,630.35 $43,630.35 2025-01-21
'303-3 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 8 4 — — $43,188.22 $43,188.22 $43,188.22 2025-01-21
'183-4 APR_DRG Percutaneous Structural Cardiac Procedures 8 4 — — $43,034.59 $43,034.59 $43,034.59 2025-01-21
'611-4 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 8 4 — — $42,695.67 $42,695.67 $42,695.67 2025-01-21
'009-3 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 8 4 — — $42,302.01 $42,302.01 $42,302.01 2025-01-21
'863-4 APR_DRG Neonatal Aftercare 8 4 — — $41,857.15 $41,857.15 $41,857.15 2025-01-21
'166-4 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 8 4 — — $41,850.11 $41,850.11 $41,850.11 2025-01-21
'910-4 APR_DRG Craniotomy For Multiple Significant Trauma 8 4 — — $41,343.48 $41,343.48 $41,343.48 2025-01-21
'179-4 APR_DRG Defibrillator Implants 8 4 — — $41,087.04 $41,087.04 $41,087.04 2025-01-21
'680-4 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 8 4 — — $40,916.60 $40,916.60 $40,916.60 2025-01-21
'162-3 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 8 4 — — $40,863.83 $40,863.83 $40,863.83 2025-01-21
'612-4 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 8 4 — — $40,827.86 $40,827.86 $40,827.86 2025-01-21
'613-4 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 8 4 — — $40,056.97 $40,056.97 $40,056.97 2025-01-21
'603-3 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 8 4 — — $39,918.20 $39,918.20 $39,918.20 2025-01-21
'001-1 APR_DRG Liver Transplant And/or Intestinal Transplant 8 4 — — $39,704.75 $39,704.75 $39,704.75 2025-01-21
'169-4 APR_DRG Major Abdominal Vascular Procedures 8 4 — — $39,170.37 $39,170.37 $39,170.37 2025-01-21
'006-1 APR_DRG Pancreas Transplant 8 4 — — $39,105.87 $39,105.87 $39,105.87 2025-01-21
33276 HCPCS Insj Phrnc Nrv Stim Sys 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0316T HCPCS Replc Vagus Nerve Pls Gen 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0424T HCPCS Insj/rplc Nstim Apnea Compl 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0312T HCPCS Laps Impltj Nstim Vagus 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64569 HCPCS Revise/repl Vagus N Eltrd 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64580 HCPCS Opn Impltj Nea Neuromuscular 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64553 HCPCS Implant Neuroelectrodes 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
63685 HCPCS Ins/rplc Spi Npg/rcvr Pocket 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
63655 HCPCS Implant Neuroelectrodes 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
63664 HCPCS Revise Spine Eltrd Plate 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61889 HCPCS Ins Sk-mnt Crnl Nstm Pg/rcvr 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61886 HCPCS Implant Neurostim Arrays 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61864 HCPCS Implant Neuroelectrde Addl 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61863 HCPCS Implant Neuroelectrode 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61867 HCPCS Implant Neuroelectrode 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61868 HCPCS Implant Neuroelectrde Addl 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61860 HCPCS Implant Neuroelectrodes 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61850 HCPCS Implant Neuroelectrodes 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61870 HCPCS Implant Neuroelectrodes 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
61885 HCPCS Insrt/redo Neurostim 1 Array 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0431T HCPCS Rmvl/rplc Nstim Apnea Pls Gn 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0817T HCPCS Opn Insj/rplcmt Ins Ptn Subf 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64590 HCPCS Ins/rpl Prph Sac/gstr Npg/r 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0266T HCPCS Implt/rpl Crtd Sns Dev Total 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0427T HCPCS Insj/rplc Nstim Apnea Pls Gn 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0816T HCPCS Opn Insj/rplcmt Ins Ptn Subq 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
64575 HCPCS Opn Impltj Nea Perph Nerve 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
0466T HCPCS Insj Ch Wal Respir Eltrd/ra 8 4 — — $39,082.13 $39,082.13 $39,082.13 2025-01-21
'911-4 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 8 4 — — $39,058.96 $39,058.96 $39,058.96 2025-01-21
'312-4 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 8 4 — — $38,888.52 $38,888.52 $38,888.52 2025-01-21
'007-1 APR_DRG Allogeneic Bone Marrow Transplant 8 4 — — $38,849.43 $38,849.43 $38,849.43 2025-01-21
'841-3 APR_DRG Extensive Third Degree Burns With Skin Graft 8 4 — — $38,717.69 $38,717.69 $38,717.69 2025-01-21
'091-4 APR_DRG Other Major Head And Neck Procedures 8 4 — — $38,684.85 $38,684.85 $38,684.85 2025-01-21
'912-4 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 8 4 — — $37,949.14 $37,949.14 $37,949.14 2025-01-21
'178-3 APR_DRG External Heart Assist Systems 8 4 — — $37,308.43 $37,308.43 $37,308.43 2025-01-21
'850-4 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 8 4 — — $37,156.75 $37,156.75 $37,156.75 2025-01-21
'023-4 APR_DRG Spinal Procedures 8 4 — — $37,061.37 $37,061.37 $37,061.37 2025-01-21
'021-4 APR_DRG Open Craniotomy Except Trauma 8 4 — — $36,553.56 $36,553.56 $36,553.56 2025-01-21
'441-4 APR_DRG Major Bladder Procedures 8 4 — — $36,546.92 $36,546.92 $36,546.92 2025-01-21
93653 HCPCS Compre Ep Eval Tx Svt 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
93654 HCPCS Compre Ep Eval Tx Vt 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
93609 HCPCS Map Tachycardia Add-on 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
93655 HCPCS Icar Cath Abltj Dscrt Arrhyt 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
93656 HCPCS Compre Ep Eval Abltj Atr Fib 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
0745T HCPCS Car Ablt Rad Arr N-invas Loc 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
0746T HCPCS Car Ablt Rad Arr Cnv Loc Map 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
93657 HCPCS Tx L/r Atrial Fib Addl 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
0747T HCPCS Car Ablt Rad Arrhyt Dlvr Rad 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
93650 HCPCS Ablate Heart Dysrhythm Focus 8 4 — — $36,198.71 $36,198.71 $36,198.71 2025-01-21
33516 HCPCS Cabg Vein Six Or More 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33513 HCPCS Cabg Vein Four 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33514 HCPCS Cabg Vein Five 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33510 HCPCS Cabg Vein Single 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33511 HCPCS Cabg Vein Two 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33507 HCPCS Repair Art Intramural 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33512 HCPCS Cabg Vein Three 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33504 HCPCS Coronary Artery Graft 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33505 HCPCS Repair Artery W/tunnel 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33506 HCPCS Repair Artery Translocation 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33502 HCPCS Coronary Artery Correction 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33503 HCPCS Coronary Artery Graft 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33518 HCPCS Cabg Artery-vein Two 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33535 HCPCS Cabg Arterial Three 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33572 HCPCS Open Coronary Endarterectomy 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33536 HCPCS Cabg Arterial Four Or More 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33530 HCPCS Coronary Artery Bypass/reop 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33533 HCPCS Cabg Arterial Single 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33521 HCPCS Cabg Artery-vein Four 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33519 HCPCS Cabg Artery-vein Three 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33522 HCPCS Cabg Artery-vein Five 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
35600 HCPCS Open Hrv Uxtr Art 1 Sgm Cab 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33523 HCPCS Cabg Art-vein Six Or More 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33534 HCPCS Cabg Arterial Two 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33508 HCPCS Endoscopic Vein Harvest 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33509 HCPCS Ndsc Hrv Uxtr Art 1 Sgm Cab 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
33517 HCPCS Cabg Artery-vein Single 8 4 — — $36,131.04 $36,131.04 $36,131.04 2025-01-21
'631-3 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 8 4 — — $36,099.71 $36,099.71 $36,099.71 2025-01-21
'260-4 APR_DRG Major Pancreas, Liver And Shunt Procedures 8 4 — — $36,088.76 $36,088.76 $36,088.76 2025-01-21
'440-3 APR_DRG Kidney Transplant 8 4 — — $35,743.19 $35,743.19 $35,743.19 2025-01-21
690-4 OTHER Acute Leukemia 2 2 — — $35,720.82 $35,720.82 $35,720.82 2026-05-09
'740-4 APR_DRG Mental Illness Diagnosis With O.r. Procedure 8 4 — — $35,626.31 $35,626.31 $35,626.31 2025-01-21
'608-4 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 8 4 — — $35,573.53 $35,573.53 $35,573.53 2025-01-21
'681-4 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 8 4 — — $34,890.21 $34,890.21 $34,890.21 2025-01-21
'630-2 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 8 4 — — $34,816.32 $34,816.32 $34,816.32 2025-01-21
'178-2 APR_DRG External Heart Assist Systems 8 4 — — $34,759.64 $34,759.64 $34,759.64 2025-01-21
'220-4 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 8 4 — — $34,623.21 $34,623.21 $34,623.21 2025-01-21
'089-4 APR_DRG Major Cranial Or Facial Bone Procedures 8 4 — — $34,389.44 $34,389.44 $34,389.44 2025-01-21
'165-3 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 8 4 — — $34,289.76 $34,289.76 $34,289.76 2025-01-21
12203300 OTHER Cabazitaxel 60 Mg 6 Ml Vial 26 15 $49,137.37 $24,568.69 50% off $222.73 $49,137.37 $34,248.75 2026-05-09
130-4 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 2 2 — — $34,071.77 $34,071.77 $34,071.77 2026-05-09
'950-4 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 8 4 — — $34,050.52 $34,050.52 $34,050.52 2025-01-21
34051 HCPCS Removal Of Artery Clot 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
0338T HCPCS Trnscth Renal Symp Denrv Unl 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
0339T HCPCS Trnscth Renal Symp Denrv Bil 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34706 HCPCS Evasc Rpr A-biiliac Rpt 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34703 HCPCS Evasc Rpr A-unilac Ndgft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34704 HCPCS Evasc Rpr A-unilac Ndgft Rpt 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34705 HCPCS Evac Rpr A-biiliac Ndgft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34701 HCPCS Evasc Rpr A-ao Ndgft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34707 HCPCS Evasc Rpr Ilio-iliac Ndgft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33886 HCPCS Endovasc Prosth Delayed 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34848 HCPCS Visc & Infraren Abd 4+ Prost 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
35840 HCPCS Explore Abdominal Vessels 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34847 HCPCS Visc & Infraren Abd 3 Prosth 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33894 HCPCS Evasc St Rpr Thrc/aa Acrs Br 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33895 HCPCS Evasc St Rpr Thrc/aa X Crsg 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33880 HCPCS Endovasc Taa Repr Incl Subcl 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33881 HCPCS Endovasc Taa Repr Without Subcl 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34843 HCPCS Endovasc Visc Aorta 3 Graft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34844 HCPCS Endovasc Visc Aorta 4 Graft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34841 HCPCS Endovasc Visc Aorta 1 Graft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34813 HCPCS Femoral Endovas Graft Add-on 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33883 HCPCS Insert Endovasc Prosth Taa 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34820 HCPCS Opn Iliac Art Expos 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34842 HCPCS Endovasc Visc Aorta 2 Graft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34845 HCPCS Visc & Infraren Abd 1 Prosth 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34713 HCPCS Perq Access & Clsr Fem Art 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
0254T HCPCS Evasc Rpr Iliac Art Bifur 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34717 HCPCS Evasc Rpr A-iliac Ndgft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34711 HCPCS Dlyd Plmt Xtn Prosth Ea Addl 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34712 HCPCS Tcat Dlvr Enhncd Fixj Dev 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34718 HCPCS Evasc Rpr N/a A-iliac Ndgft 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
0234T HCPCS Trluml Perip Athrc Renal Art 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34709 HCPCS Plmt Xtn Prosth Evasc Rpr 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34702 HCPCS Evasc Rpr A-ao Ndgft Rpt 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
33884 HCPCS Endovasc Prosth Taa Add-on 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34708 HCPCS Evasc Rpr Ilio-iliac Rpt 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34846 HCPCS Visc & Infraren Abd 2 Prosth 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
34808 HCPCS Endovas Iliac A Device Addon 8 4 — — $33,999.49 $33,999.49 $33,999.49 2025-01-21
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