|
J3393
|
HCPCS
|
H Gene Therapy Zynteglo
|
8
|
8
|
—
|
$4,550,000.00
|
$2,405,000.00
|
$4,875,000.00
|
$4,225,000.00
|
2026-09-01
|
|
002 - 4
|
OTHER
|
Heart And/or Lung Transplant
|
3
|
3
|
—
|
—
|
$154,176.09
|
$4,798,189.11
|
$3,802,338.54
|
2026-09-01
|
|
J3394
|
HCPCS
|
H Gene Therapy Lyfgenia
|
5
|
5
|
$4,429,000.00
|
$3,100,300.00
30% off
|
$1,860,180.00
|
$4,207,550.00
|
$3,100,300.00
|
2026-09-01
|
|
J3392
|
HCPCS
|
H Gene Therapy Casgevy
|
2
|
2
|
—
|
—
|
$1,615,000.00
|
$3,990,000.00
|
$2,802,500.00
|
2026-09-01
|
|
609 - 4
|
OTHER
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
13
|
12
|
$3,000,015.25
|
$2,100,010.67
30% off
|
$95,059.15
|
$2,700,013.73
|
$2,400,012.20
|
2026-09-01
|
|
002 - 3
|
OTHER
|
Heart And/or Lung Transplant
|
36
|
27
|
$3,348,951.00
|
$2,344,265.70
30% off
|
$86,673.03
|
$3,181,503.45
|
$2,344,265.70
|
2026-09-01
|
|
Q2042
|
HCPCS
|
H Kymriah Per Dose
|
11
|
10
|
$2,900,000.00
|
$2,030,000.00
30% off
|
$1,073,000.00
|
$2,610,000.00
|
$2,030,000.00
|
2026-09-01
|
|
261 - 4
|
OTHER
|
Major Biliary Tract Procedures
|
37
|
29
|
$2,075,678.38
|
$1,452,974.86
30% off
|
$30,795.66
|
$1,971,894.46
|
$1,452,974.86
|
2026-09-01
|
|
161 - 3
|
OTHER
|
Implantable Heart Assist Systems
|
52
|
42
|
$1,947,080.75
|
$1,362,956.52
30% off
|
$111,268.19
|
$1,849,726.71
|
$1,372,691.93
|
2026-09-01
|
|
591 - 4
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
2
|
2
|
$1,721,074.50
|
$1,204,752.15
30% off
|
$1,204,752.15
|
$1,514,545.56
|
$1,359,648.85
|
2026-09-01
|
|
091 - 4
|
OTHER
|
Other Major Head And Neck Procedures
|
1
|
1
|
$1,128,064.13
|
$789,644.89
30% off
|
$1,015,257.71
|
$1,015,257.71
|
$1,015,257.71
|
2026-09-01
|
|
860 - 4
|
OTHER
|
Rehabilitation
|
1
|
1
|
$1,429,953.25
|
$1,000,967.27
30% off
|
$1,000,967.27
|
$1,000,967.27
|
$1,000,967.27
|
2026-09-01
|
|
440 - 4
|
OTHER
|
Kidney Transplant
|
1
|
1
|
$1,036,407.88
|
$725,485.51
30% off
|
$932,767.09
|
$932,767.09
|
$932,767.09
|
2026-09-01
|
|
169 - 4
|
OTHER
|
Major Abdominal Vascular Procedures
|
1
|
1
|
$1,057,897.13
|
$740,527.99
30% off
|
$899,212.56
|
$899,212.56
|
$899,212.56
|
2026-09-01
|
|
630 - 4
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
1
|
1
|
$1,440,891.75
|
$1,008,624.22
30% off
|
$864,535.05
|
$864,535.05
|
$864,535.05
|
2026-09-01
|
|
952 - 4
|
OTHER
|
Non-extensive O.r. Procedure Unrelated To Principal Diagnosis
|
25
|
20
|
$1,130,062.13
|
$791,043.49
30% off
|
$21,124.13
|
$1,017,055.91
|
$847,546.59
|
2026-09-01
|
|
220 - 4
|
OTHER
|
Major Stomach Esophageal And Duodenal Procedures
|
26
|
23
|
$1,026,746.69
|
$718,722.68
30% off
|
$33,613.18
|
$975,409.35
|
$795,728.69
|
2026-09-01
|
|
691 - 4
|
OTHER
|
Lymphoma Myeloma And Non-acute Leukemia
|
30
|
26
|
$990,676.31
|
$693,473.42
30% off
|
$19,053.12
|
$941,142.50
|
$792,541.05
|
2026-09-01
|
|
007 - 2
|
OTHER
|
Allogeneic Bone Marrow Transplant
|
3
|
3
|
$888,033.88
|
$621,623.71
30% off
|
$621,623.71
|
$799,230.49
|
$781,469.81
|
2026-09-01
|
|
813 - 4
|
OTHER
|
Other Complications Of Treatment
|
5
|
5
|
$1,250,769.38
|
$875,538.56
30% off
|
$10,725.07
|
$1,125,692.44
|
$750,461.63
|
2026-09-01
|
|
710 - 4
|
OTHER
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
2
|
2
|
$1,200,742.00
|
$840,519.40
30% off
|
$636,393.26
|
$840,519.40
|
$738,456.33
|
2026-09-01
|
|
179 - 3
|
OTHER
|
Defibrillator Implants
|
9
|
9
|
$850,494.50
|
$595,346.15
30% off
|
$31,993.27
|
$807,969.77
|
$722,920.32
|
2026-09-01
|
|
J3402
|
HCPCS
|
Ryoncil
|
21
|
20
|
$1,000,000.00
|
$700,000.00
30% off
|
$442,000.00
|
$950,000.00
|
$710,000.00
|
2026-09-01
|
|
793 - 4
|
OTHER
|
Moderately Extensive O.r. Procedures For Other Complications Of Treatment
|
1
|
1
|
$945,652.75
|
$661,956.92
30% off
|
$709,239.56
|
$709,239.56
|
$709,239.56
|
2026-09-01
|
|
317 - 4
|
OTHER
|
Tendon Muscle And Other Soft Tissue Procedures
|
14
|
12
|
$932,353.38
|
$652,647.36
30% off
|
$21,056.95
|
$857,765.10
|
$699,265.03
|
2026-09-01
|
|
661 - 4
|
OTHER
|
Coagulation And Platelet Disorders
|
4
|
4
|
$910,388.63
|
$637,272.04
30% off
|
$15,300.09
|
$819,349.76
|
$682,791.47
|
2026-09-01
|
|
120 - 4
|
OTHER
|
Major Respiratory And Chest Procedures
|
7
|
7
|
$1,116,969.25
|
$781,878.47
30% off
|
$32,588.49
|
$1,005,272.33
|
$670,181.55
|
2026-09-01
|
|
950 - 4
|
OTHER
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
9
|
9
|
$916,325.75
|
$641,428.02
30% off
|
$33,057.19
|
$824,693.18
|
$641,428.02
|
2026-09-01
|
|
850 - 3
|
OTHER
|
Procedure With Diagnosis Of Rehabilitation Aftercare Or Other Contact With Healt…
|
15
|
14
|
$916,138.38
|
$641,296.86
30% off
|
$16,979.08
|
$870,331.46
|
$641,296.86
|
2026-09-01
|
|
163 - 4
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
1
|
1
|
$848,264.19
|
$593,784.93
30% off
|
$636,198.14
|
$636,198.14
|
$636,198.14
|
2026-09-01
|
|
347 - 4
|
OTHER
|
Other Back And Neck Disorders Fractures And Injuries
|
6
|
6
|
$965,256.56
|
$675,679.59
30% off
|
$10,651.44
|
$868,730.91
|
$627,416.76
|
2026-09-01
|
|
004 - 3
|
OTHER
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
4
|
4
|
$712,363.50
|
$498,654.45
30% off
|
$68,511.85
|
$626,879.88
|
$587,699.89
|
2026-09-01
|
|
001 - 2
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
1
|
1
|
$614,978.88
|
$430,485.21
30% off
|
$541,181.41
|
$541,181.41
|
$541,181.41
|
2026-09-01
|
|
279 - 4
|
OTHER
|
Hepatic Coma And Other Major Acute Liver Disorders
|
34
|
28
|
$748,010.81
|
$523,607.57
30% off
|
$11,925.47
|
$688,169.95
|
$523,607.57
|
2026-09-01
|
|
163 - 3
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
9
|
6
|
$645,174.06
|
$451,621.84
30% off
|
$32,812.40
|
$580,656.66
|
$516,139.25
|
2026-09-01
|
|
059 - 4
|
OTHER
|
Anoxic And Other Severe Brain Damage
|
11
|
11
|
$536,504.81
|
$375,553.37
30% off
|
$10,123.92
|
$509,679.57
|
$482,854.33
|
2026-09-01
|
|
631 - 3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
6
|
5
|
$655,301.81
|
$458,711.27
30% off
|
$35,046.60
|
$622,536.72
|
$475,093.82
|
2026-09-01
|
|
050 - 4
|
OTHER
|
Non-bacterial Infections Of Nervous System Except Viral Meningitis
|
1
|
1
|
$539,558.38
|
$377,690.86
30% off
|
$474,811.37
|
$474,811.37
|
$474,811.37
|
2026-09-01
|
|
190 - 4
|
OTHER
|
Acute Myocardial Infarction
|
1
|
1
|
$535,529.31
|
$374,870.52
30% off
|
$471,265.79
|
$471,265.79
|
$471,265.79
|
2026-09-01
|
|
020 - 4
|
OTHER
|
Open Craniotomy For Trauma
|
17
|
13
|
$638,427.25
|
$446,899.07
30% off
|
$32,739.53
|
$574,584.53
|
$446,899.07
|
2026-09-01
|
|
200 - 4
|
OTHER
|
Cardiac Structural And Valvular Disorders
|
4
|
4
|
$1,121,663.50
|
$785,164.45
30% off
|
$8,747.42
|
$987,063.88
|
$425,434.89
|
2026-09-01
|
|
611 - 3
|
OTHER
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
1
|
1
|
$798,215.31
|
$558,750.72
30% off
|
$423,054.12
|
$423,054.12
|
$423,054.12
|
2026-09-01
|
|
423 - 4
|
OTHER
|
Inborn Errors Of Metabolism
|
1
|
1
|
$601,430.19
|
$421,001.13
30% off
|
$421,001.13
|
$421,001.13
|
$421,001.13
|
2026-09-01
|
|
440 - 3
|
OTHER
|
Kidney Transplant
|
2
|
2
|
$533,818.81
|
$373,673.17
30% off
|
$320,291.29
|
$453,745.99
|
$387,018.64
|
2026-09-01
|
|
029 - 3
|
OTHER
|
Other Percutaneous Intracranial Procedures
|
21
|
18
|
$442,981.22
|
$310,086.85
30% off
|
$15,353.62
|
$420,832.16
|
$376,534.04
|
2026-09-01
|
|
443 - 4
|
OTHER
|
Kidney And Urinary Tract Procedures For Non-malignancy
|
42
|
35
|
$537,837.19
|
$376,486.03
30% off
|
$20,333.22
|
$510,945.33
|
$376,486.03
|
2026-09-01
|
|
440 - 2
|
OTHER
|
Kidney Transplant
|
3
|
3
|
$494,471.44
|
$346,130.01
30% off
|
$29,761.49
|
$469,747.87
|
$370,853.58
|
2026-09-01
|
|
621 - 4
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
2
|
2
|
$580,539.94
|
$406,377.96
30% off
|
$307,686.17
|
$406,377.96
|
$357,032.07
|
2026-09-01
|
|
160 - 2
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
1
|
1
|
$502,892.22
|
$352,024.55
30% off
|
$352,024.55
|
$352,024.55
|
$352,024.55
|
2026-09-01
|
|
305 - 3
|
OTHER
|
Amputation Of Lower Limb Except Toes
|
9
|
9
|
$495,264.66
|
$346,685.26
30% off
|
$12,926.63
|
$470,501.42
|
$346,685.26
|
2026-09-01
|
|
621 - 3
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
9
|
9
|
$530,701.19
|
$371,490.83
30% off
|
$19,088.04
|
$504,166.13
|
$344,955.77
|
2026-09-01
|
|
466 - 4
|
OTHER
|
Malfunction Reaction Complication Of Genitourinary Device Or Procedure
|
1
|
1
|
$378,978.69
|
$265,285.08
30% off
|
$333,501.24
|
$333,501.24
|
$333,501.24
|
2026-09-01
|
|
183 - 4
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
20
|
18
|
$379,107.47
|
$265,375.23
30% off
|
$189,553.73
|
$360,152.10
|
$318,450.28
|
2026-09-01
|
|
680 - 3
|
OTHER
|
Major O.r. Procedures For Lymphatic Hematopoietic Or Other Neoplasms
|
30
|
28
|
$408,959.03
|
$286,271.32
30% off
|
$20,734.75
|
$388,511.08
|
$316,943.25
|
2026-09-01
|
|
181 - 1
|
OTHER
|
Lower Extremity Arterial Procedures
|
26
|
22
|
$367,669.13
|
$257,368.39
30% off
|
$9,389.94
|
$349,285.67
|
$303,327.03
|
2026-09-01
|
|
4174012
|
CDM
|
H Heart Dd W Preservation
|
1
|
1
|
$331,520.00
|
$232,064.00
30% off
|
$298,368.00
|
$298,368.00
|
$298,368.00
|
2026-09-01
|
|
309 - 4
|
OTHER
|
Other Significant Hip And Femur Surgery
|
1
|
1
|
$395,622.63
|
$276,935.84
30% off
|
$296,716.97
|
$296,716.97
|
$296,716.97
|
2026-09-01
|
|
021 - 2
|
OTHER
|
Open Craniotomy Except Trauma
|
16
|
16
|
$362,821.81
|
$253,975.27
30% off
|
$15,202.95
|
$344,680.72
|
$290,257.45
|
2026-09-01
|
|
230 - 3
|
OTHER
|
Major Small Bowel Procedures
|
1
|
1
|
$303,106.38
|
$212,174.46
30% off
|
$287,951.06
|
$287,951.06
|
$287,951.06
|
2026-09-01
|
|
445 - 4
|
OTHER
|
Other Bladder Procedures
|
9
|
8
|
$367,801.41
|
$257,460.98
30% off
|
$220,680.84
|
$331,021.27
|
$275,851.05
|
2026-09-01
|
|
441 - 2
|
OTHER
|
Major Bladder Procedures
|
1
|
1
|
$304,350.91
|
$213,045.63
30% off
|
$273,915.82
|
$273,915.82
|
$273,915.82
|
2026-09-01
|
|
089 - 3
|
OTHER
|
Major Cranial Or Facial Bone Procedures
|
27
|
22
|
$313,403.78
|
$219,382.65
30% off
|
$23,186.03
|
$297,733.59
|
$266,393.21
|
2026-09-01
|
|
4174013
|
CDM
|
H Liver Dd W Preservation
|
38
|
34
|
$331,520.00
|
$232,064.00
30% off
|
$113,048.32
|
$314,944.00
|
$265,216.00
|
2026-09-01
|
|
462 - 4
|
OTHER
|
Nephritis And Nephrosis
|
1
|
1
|
$301,198.63
|
$210,839.04
30% off
|
$265,054.79
|
$265,054.79
|
$265,054.79
|
2026-09-01
|
|
721 - 4
|
OTHER
|
Post-operative Post-traumatic Other Device Infections
|
22
|
19
|
$333,856.72
|
$233,699.70
30% off
|
$12,578.99
|
$300,471.05
|
$258,738.96
|
2026-09-01
|
|
252 - 4
|
OTHER
|
Malfunction Reaction And Complication Of Gastrointestinal Device Or Procedure
|
1
|
1
|
$271,066.66
|
$189,746.66
30% off
|
$257,513.32
|
$257,513.32
|
$257,513.32
|
2026-09-01
|
|
145 - 4
|
OTHER
|
Acute Bronchitis And Related Symptoms
|
8
|
8
|
$364,909.31
|
$255,436.52
30% off
|
$7,140.18
|
$328,418.38
|
$255,436.52
|
2026-09-01
|
|
020 - 3
|
OTHER
|
Open Craniotomy For Trauma
|
3
|
3
|
$364,348.13
|
$255,043.69
30% off
|
$218,608.88
|
$320,626.35
|
$255,043.69
|
2026-09-01
|
|
681 - 4
|
OTHER
|
Other O.r. Procedures For Lymphatic Hematopoietic Or Other Neoplasms
|
4
|
4
|
$554,413.13
|
$388,089.19
30% off
|
$33,872.38
|
$487,883.55
|
$254,255.37
|
2026-09-01
|
|
220 - 2
|
OTHER
|
Major Stomach Esophageal And Duodenal Procedures
|
1
|
1
|
$265,964.41
|
$186,175.08
30% off
|
$239,367.97
|
$239,367.97
|
$239,367.97
|
2026-09-01
|
|
711 - 4
|
OTHER
|
Post-operative Post-trauma Other Device Infections With O.r. Procedure
|
3
|
3
|
$338,781.28
|
$237,146.90
30% off
|
$203,268.77
|
$254,085.96
|
$237,146.90
|
2026-09-01
|
|
468 - 4
|
OTHER
|
Other Kidney And Urinary Tract Diagnoses Signs And Symptoms
|
7
|
6
|
$385,826.47
|
$270,078.53
30% off
|
$9,616.51
|
$347,243.82
|
$231,495.88
|
2026-09-01
|
|
030 - 3
|
OTHER
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
3
|
3
|
$330,012.53
|
$231,008.77
30% off
|
$138,605.26
|
$290,411.03
|
$231,008.77
|
2026-09-01
|
|
222 - 3
|
OTHER
|
Other Stomach Esophageal And Duodenal Procedures
|
1
|
1
|
$260,389.75
|
$182,272.82
30% off
|
$221,331.29
|
$221,331.29
|
$221,331.29
|
2026-09-01
|
|
194 - 3
|
OTHER
|
Heart Failure
|
41
|
33
|
$272,016.28
|
$190,411.40
30% off
|
$5,729.52
|
$258,415.47
|
$217,613.03
|
2026-09-01
|
|
260 - 2
|
OTHER
|
Major Pancreas Liver And Shunt Procedures
|
31
|
25
|
$309,627.84
|
$216,739.49
30% off
|
$13,539.54
|
$294,146.45
|
$216,739.49
|
2026-09-01
|
|
120 - 3
|
OTHER
|
Major Respiratory And Chest Procedures
|
29
|
27
|
$257,334.11
|
$180,133.88
30% off
|
$18,682.34
|
$244,467.40
|
$212,300.64
|
2026-09-01
|
|
160 - 1
|
OTHER
|
Major Cardiothoracic Repair Of Heart Anomaly
|
48
|
38
|
$300,876.16
|
$210,613.31
30% off
|
$17,358.97
|
$285,832.35
|
$210,613.31
|
2026-09-01
|
|
192 - 3
|
OTHER
|
Cardiac Catheterization For Other Non-coronary Conditions
|
13
|
13
|
$242,386.08
|
$169,670.25
30% off
|
$128,464.62
|
$218,147.47
|
$206,028.17
|
2026-09-01
|
|
401 - 3
|
OTHER
|
Adrenal Procedures
|
8
|
8
|
$244,719.53
|
$171,303.67
30% off
|
$122,359.77
|
$220,247.58
|
$201,893.61
|
2026-09-01
|
|
441 - 1
|
OTHER
|
Major Bladder Procedures
|
31
|
26
|
$246,758.67
|
$172,731.07
30% off
|
$9,050.27
|
$234,420.74
|
$197,406.94
|
2026-09-01
|
|
792 - 3
|
OTHER
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
8
|
8
|
$220,102.41
|
$154,071.68
30% off
|
$176,081.93
|
$209,097.29
|
$195,891.15
|
2026-09-01
|
|
098 - 4
|
OTHER
|
Other Ear Nose Mouth Throat Craniofacial And Neck Procedures
|
5
|
5
|
$323,619.53
|
$226,533.67
30% off
|
$22,182.84
|
$284,785.19
|
$194,171.72
|
2026-09-01
|
|
245 - 4
|
OTHER
|
Inflammatory Bowel Disease
|
5
|
5
|
$219,570.50
|
$153,699.35
30% off
|
$10,894.71
|
$208,591.97
|
$193,222.04
|
2026-09-01
|
|
233 - 3
|
OTHER
|
Appendectomy With Complex Principal Diagnosis
|
14
|
13
|
$221,590.47
|
$155,113.33
30% off
|
$11,688.27
|
$199,431.42
|
$191,675.76
|
2026-09-01
|
|
951 - 3
|
OTHER
|
Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
2
|
2
|
$311,128.38
|
$217,789.86
30% off
|
$164,898.04
|
$217,789.86
|
$191,343.95
|
2026-09-01
|
|
175 - 2
|
OTHER
|
Percutaneous Cardiac Intervention Without Ami
|
18
|
16
|
$210,365.91
|
$147,256.13
30% off
|
$13,890.97
|
$199,847.61
|
$187,225.66
|
2026-09-01
|
|
696 - 4
|
OTHER
|
Other Chemotherapy
|
4
|
4
|
$209,748.88
|
$146,824.21
30% off
|
$14,853.42
|
$188,773.99
|
$184,579.01
|
2026-09-01
|
|
251 - 4
|
OTHER
|
Abdominal Pain
|
1
|
1
|
$249,105.81
|
$174,374.07
30% off
|
$174,374.07
|
$174,374.07
|
$174,374.07
|
2026-09-01
|
|
073 - 3
|
OTHER
|
Orbit And Eye Procedures
|
21
|
21
|
$211,350.02
|
$147,945.01
30% off
|
$10,949.74
|
$200,782.51
|
$174,363.76
|
2026-09-01
|
|
304 - 3
|
OTHER
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
3
|
3
|
$402,301.34
|
$281,610.94
30% off
|
$28,723.90
|
$213,219.71
|
$168,966.56
|
2026-09-01
|
|
041 - 4
|
OTHER
|
Nervous System Malignancy
|
18
|
17
|
$225,791.42
|
$158,054.00
30% off
|
$9,387.28
|
$214,501.85
|
$163,698.79
|
2026-09-01
|
|
021 - 3
|
OTHER
|
Open Craniotomy Except Trauma
|
2
|
2
|
$427,911.31
|
$299,537.92
30% off
|
$25,019.93
|
$299,537.92
|
$162,278.92
|
2026-09-01
|
|
182 - 3
|
OTHER
|
Other Peripheral Vascular And Related Procedures
|
25
|
22
|
$228,792.38
|
$160,154.66
30% off
|
$14,913.38
|
$217,352.76
|
$160,154.66
|
2026-09-01
|
|
171 - 4
|
OTHER
|
Permanent Cardiac Pacemaker Implant Without Ami Heart Failure Or Shock
|
2
|
2
|
$201,964.70
|
$141,375.29
30% off
|
$141,375.29
|
$177,728.94
|
$159,552.11
|
2026-09-01
|
|
163 - 1
|
OTHER
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
2
|
2
|
$310,305.34
|
$217,213.74
30% off
|
$23,467.63
|
$294,790.08
|
$159,128.86
|
2026-09-01
|
|
309 - 2
|
OTHER
|
Other Significant Hip And Femur Surgery
|
13
|
13
|
$191,720.52
|
$134,204.36
30% off
|
$11,059.04
|
$182,134.49
|
$153,376.41
|
2026-09-01
|
|
710 - 3
|
OTHER
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
39
|
30
|
$214,724.45
|
$150,307.12
30% off
|
$14,784.73
|
$193,252.01
|
$152,454.36
|
2026-09-01
|
|
314 - 3
|
OTHER
|
Foot And Toe Procedures
|
11
|
10
|
$179,260.16
|
$125,482.11
30% off
|
$9,560.72
|
$164,919.34
|
$152,371.13
|
2026-09-01
|
|
4174008
|
CDM
|
H Multivisceral Dd Acquistion
|
42
|
34
|
$188,156.00
|
$131,709.20
30% off
|
$69,617.72
|
$178,748.20
|
$150,524.80
|
2026-09-01
|
|
4174011
|
CDM
|
H Heart Dd W Device Acquisition
|
1
|
1
|
$175,295.00
|
$122,706.50
30% off
|
$149,000.75
|
$149,000.75
|
$149,000.75
|
2026-09-01
|
|
130 - 3
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
1
|
1
|
$278,511.97
|
$194,958.38
30% off
|
$147,611.34
|
$147,611.34
|
$147,611.34
|
2026-09-01
|
|
583 - 3
|
OTHER
|
Neonate With Ecmo
|
4
|
4
|
—
|
—
|
$146,673.05
|
$161,340.20
|
$147,406.39
|
2026-09-01
|
|
442 - 2
|
OTHER
|
Kidney And Urinary Tract Procedures For Malignancy
|
3
|
3
|
$165,766.55
|
$116,036.58
30% off
|
$9,830.55
|
$149,189.89
|
$145,874.56
|
2026-09-01
|
|
224 - 2
|
OTHER
|
Peritoneal Adhesiolysis
|
23
|
19
|
$207,573.45
|
$145,301.42
30% off
|
$9,467.36
|
$190,967.58
|
$145,301.42
|
2026-09-01
|
|
050 - 3
|
OTHER
|
Non-bacterial Infections Of Nervous System Except Viral Meningitis
|
2
|
2
|
$181,282.97
|
$126,898.08
30% off
|
$126,898.08
|
$163,154.67
|
$145,026.38
|
2026-09-01
|
|
55048
|
LOCAL
|
Devc Ventricular Assist Impella 5.5
|
29
|
27
|
$180,000.00
|
$126,000.00
30% off
|
$66,600.00
|
$171,000.00
|
$144,000.00
|
2026-09-01
|
|
351 - 4
|
OTHER
|
Other Musculoskeletal System And Connective Tissue Diagnoses
|
6
|
6
|
$205,079.50
|
$143,555.65
30% off
|
$9,988.43
|
$180,469.96
|
$143,555.65
|
2026-09-01
|
|
483 - 3
|
OTHER
|
Penis Testes And Scrotal Procedures
|
15
|
12
|
$205,044.88
|
$143,531.41
30% off
|
$11,329.25
|
$194,792.63
|
$143,531.41
|
2026-09-01
|
|
183 - 2
|
OTHER
|
Percutaneous Structural Cardiac Procedures
|
2
|
2
|
$296,860.47
|
$207,802.33
30% off
|
$25,205.42
|
$261,237.21
|
$143,221.32
|
2026-09-01
|
|
690 - 2
|
OTHER
|
Acute Leukemia
|
2
|
2
|
$196,734.84
|
$137,714.39
30% off
|
$104,269.47
|
$177,061.36
|
$140,665.41
|
2026-09-01
|
|
52604
|
LOCAL
|
Blood Pump Valve 6mm 10ml
|
9
|
8
|
$174,584.00
|
$122,208.80
30% off
|
$77,166.13
|
$160,617.28
|
$139,667.20
|
2026-09-01
|
|
205 - 4
|
OTHER
|
Cardiomyopathy
|
1
|
1
|
$158,337.13
|
$110,835.99
30% off
|
$139,336.67
|
$139,336.67
|
$139,336.67
|
2026-09-01
|
|
J0221
|
HCPCS
|
Alglucosidase Alfa 50 Mg Intravenous Solution
|
12
|
9
|
$160,495.64
|
$112,346.95
30% off
|
$89,877.56
|
$144,446.08
|
$138,828.73
|
2026-09-01
|
|
229 - 2
|
OTHER
|
Other Digestive System And Abdominal Procedures
|
2
|
2
|
$204,456.19
|
$143,119.33
30% off
|
$122,673.71
|
$153,342.14
|
$138,007.93
|
2026-09-01
|
|
651 - 3
|
OTHER
|
Other Procedures Of Blood And Blood-forming Organs
|
1
|
1
|
$196,241.94
|
$137,369.36
30% off
|
$137,369.36
|
$137,369.36
|
$137,369.36
|
2026-09-01
|
|
663 - 4
|
OTHER
|
Other Anemia And Disorders Of Blood And Blood-forming Organs
|
16
|
15
|
$162,731.09
|
$113,911.77
30% off
|
$9,496.58
|
$154,594.54
|
$136,287.29
|
2026-09-01
|
|
092 - 3
|
OTHER
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
6
|
6
|
$198,965.88
|
$139,276.11
30% off
|
$114,604.34
|
$189,017.58
|
$134,301.96
|
2026-09-01
|
|
405 - 2
|
OTHER
|
Other Procedures For Endocrine Nutritional And Metabolic Disorders
|
1
|
1
|
$152,147.30
|
$106,503.11
30% off
|
$133,889.62
|
$133,889.62
|
$133,889.62
|
2026-09-01
|
|
61678
|
LOCAL
|
Valve Pulmonary Sapien3 Alterra
|
8
|
6
|
$166,000.00
|
$116,200.00
30% off
|
$99,600.00
|
$157,700.00
|
$131,140.00
|
2026-09-01
|
|
091 - 2
|
OTHER
|
Other Major Head And Neck Procedures
|
1
|
1
|
$238,868.38
|
$167,207.86
30% off
|
$126,600.24
|
$126,600.24
|
$126,600.24
|
2026-09-01
|
|
4174001
|
CDM
|
H Kidney Dd Acquisition
|
39
|
30
|
$157,432.00
|
$110,202.40
30% off
|
$56,990.38
|
$149,560.40
|
$125,945.60
|
2026-09-01
|
|
201 - 3
|
OTHER
|
Cardiac Arrhythmia And Conduction Disorders
|
11
|
10
|
$179,046.80
|
$125,332.76
30% off
|
$5,275.62
|
$170,094.46
|
$125,332.76
|
2026-09-01
|
|
405 - 3
|
OTHER
|
Other Procedures For Endocrine Nutritional And Metabolic Disorders
|
5
|
5
|
$206,876.80
|
$144,813.76
30% off
|
$86,888.25
|
$196,532.96
|
$124,126.08
|
2026-09-01
|
|
52795
|
LOCAL
|
Blood Pump Valve 9mm 25ml
|
21
|
18
|
$174,584.00
|
$122,208.80
30% off
|
$29,679.28
|
$165,854.80
|
$123,954.64
|
2026-09-01
|
|
52611
|
LOCAL
|
Blood Pump Valve 9mm 15ml
|
25
|
19
|
$174,584.00
|
$122,208.80
30% off
|
$29,679.28
|
$165,854.80
|
$123,954.64
|
2026-09-01
|
|
041 - 2
|
OTHER
|
Nervous System Malignancy
|
2
|
2
|
$138,373.06
|
$96,861.14
30% off
|
$121,768.29
|
$124,535.76
|
$123,152.02
|
2026-09-01
|
|
52600
|
LOCAL
|
Blood Pump Outflow Valve 9mm 30ml
|
7
|
7
|
$174,584.00
|
$122,208.80
30% off
|
$88,688.67
|
$144,031.80
|
$122,208.80
|
2026-09-01
|
|
J1303
|
HCPCS
|
Ravulizumab-cwvz 100 Mg/ml Intravenous Solution
|
7
|
6
|
$168,723.58
|
$118,106.50
30% off
|
$42,180.90
|
$251,880.21
|
$118,106.50
|
2026-09-01
|
|
483 - 4
|
OTHER
|
Penis Testes And Scrotal Procedures
|
2
|
2
|
$164,303.92
|
$115,012.75
30% off
|
$87,081.08
|
$147,873.53
|
$117,477.30
|
2026-09-01
|
|
444 - 2
|
OTHER
|
Renal Dialysis Access Device Procedures
|
1
|
1
|
$138,092.89
|
$96,665.02
30% off
|
$117,378.96
|
$117,378.96
|
$117,378.96
|
2026-09-01
|
|
6
|
MS_DRG
|
Liver Transplant Without Mcc
|
2
|
1
|
$826,561.75
|
$578,593.22
30% off
|
$114,628.80
|
$119,255.25
|
$116,942.02
|
2026-09-01
|
|
695 - 4
|
OTHER
|
Chemotherapy For Acute Leukemia
|
1
|
1
|
$218,595.17
|
$153,016.62
30% off
|
$115,855.44
|
$115,855.44
|
$115,855.44
|
2026-09-01
|
|
425 - 3
|
OTHER
|
Other Non-hypovolemic Electrolyte Disorders
|
5
|
5
|
$135,771.14
|
$95,039.80
30% off
|
$4,811.28
|
$122,194.03
|
$115,405.47
|
2026-09-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
1
|
1
|
—
|
—
|
$114,668.51
|
$114,668.51
|
$114,668.51
|
2026-09-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
1
|
1
|
$1,426,108.00
|
$998,275.60
30% off
|
$114,628.80
|
$114,628.80
|
$114,628.80
|
2026-09-01
|
|
130 - 2
|
OTHER
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
6
|
6
|
$157,778.44
|
$110,444.91
30% off
|
$19,504.36
|
$126,222.75
|
$114,389.37
|
2026-09-01
|
|
201 - 4
|
OTHER
|
Cardiac Arrhythmia And Conduction Disorders
|
7
|
6
|
$190,589.81
|
$133,412.87
30% off
|
$8,665.06
|
$152,471.85
|
$114,353.89
|
2026-09-01
|
|
4174005
|
CDM
|
H Intestinal Dd Acquisition
|
19
|
18
|
$134,393.00
|
$94,075.10
30% off
|
$49,725.41
|
$127,673.35
|
$114,234.05
|
2026-09-01
|
|
053 - 4
|
OTHER
|
Seizure
|
3
|
3
|
$160,746.72
|
$112,522.70
30% off
|
$11,177.45
|
$136,634.71
|
$112,522.70
|
2026-09-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
2
|
1
|
$2,789,834.50
|
$1,952,884.15
30% off
|
$110,220.00
|
$114,668.51
|
$112,444.26
|
2026-09-01
|
|
192 - 1
|
OTHER
|
Cardiac Catheterization For Other Non-coronary Conditions
|
1
|
1
|
$159,633.20
|
$111,743.24
30% off
|
$111,743.24
|
$111,743.24
|
$111,743.24
|
2026-09-01
|
|
230 - 1
|
OTHER
|
Major Small Bowel Procedures
|
1
|
1
|
$129,684.95
|
$90,779.47
30% off
|
$110,232.21
|
$110,232.21
|
$110,232.21
|
2026-09-01
|
|
198 - 3
|
OTHER
|
Angina Pectoris And Coronary Atherosclerosis
|
6
|
5
|
$156,850.41
|
$109,795.28
30% off
|
$4,532.92
|
$138,028.36
|
$109,795.28
|
2026-09-01
|
|
4174004
|
CDM
|
H Liver Dd Acquisition
|
45
|
36
|
$134,393.00
|
$94,075.10
30% off
|
$45,828.01
|
$127,673.35
|
$107,514.40
|
2026-09-01
|
|
52998
|
LOCAL
|
Valve Aortic Commander 23mm
|
7
|
7
|
$130,000.00
|
$91,000.00
30% off
|
$54,600.00
|
$123,500.00
|
$107,250.00
|
2026-09-01
|
|
4174003
|
CDM
|
H Liver Live Acquistion
|
46
|
35
|
$134,393.00
|
$94,075.10
30% off
|
$22,846.81
|
$127,673.35
|
$106,372.06
|
2026-09-01
|
|
261 - 3
|
OTHER
|
Major Biliary Tract Procedures
|
2
|
2
|
$279,670.66
|
$195,769.46
30% off
|
$16,168.06
|
$195,769.46
|
$105,968.76
|
2026-09-01
|
|
466 - 3
|
OTHER
|
Malfunction Reaction Complication Of Genitourinary Device Or Procedure
|
4
|
4
|
$132,907.09
|
$93,034.97
30% off
|
$55,820.98
|
$119,616.38
|
$104,996.61
|
2026-09-01
|
|
52601
|
LOCAL
|
Blood Pump Outflow Valve 12mm 50ml
|
1
|
1
|
$174,584.00
|
$122,208.80
30% off
|
$104,750.40
|
$104,750.40
|
$104,750.40
|
2026-09-01
|
|
52796
|
LOCAL
|
Blood Pump Outflow Valve 12mm 60ml
|
3
|
2
|
$174,584.00
|
$122,208.80
30% off
|
$60,755.23
|
$160,617.28
|
$104,750.40
|
2026-09-01
|
|
346 - 3
|
OTHER
|
Connective Tissue Disorders
|
19
|
16
|
$149,174.70
|
$104,422.29
30% off
|
$7,489.71
|
$141,715.97
|
$104,422.29
|
2026-09-01
|
|
651 - 2
|
OTHER
|
Other Procedures Of Blood And Blood-forming Organs
|
2
|
2
|
$209,253.56
|
$146,477.49
30% off
|
$9,437.37
|
$198,790.88
|
$104,114.12
|
2026-09-01
|
|
L8679
|
HCPCS
|
Generator Neurostimulator Rns
|
22
|
19
|
$148,160.00
|
$103,712.00
30% off
|
$74,080.00
|
$136,307.20
|
$103,712.00
|
2026-09-01
|
|
043 - 1
|
OTHER
|
Multiple Sclerosis Other Demyelinating Disease And Inflammatory Neuropathies
|
3
|
3
|
$147,968.56
|
$103,577.99
30% off
|
$5,396.99
|
$133,171.71
|
$103,577.99
|
2026-09-01
|
|
446 - 2
|
OTHER
|
Urethral And Transurethral Procedures
|
5
|
4
|
$114,044.95
|
$79,831.47
30% off
|
$96,938.21
|
$102,640.46
|
$102,640.46
|
2026-09-01
|
|
4174002
|
CDM
|
H Kidney Live Acquisition
|
42
|
33
|
$126,835.00
|
$88,784.50
30% off
|
$21,561.95
|
$120,493.25
|
$101,468.00
|
2026-09-01
|
|
J9286
|
HCPCS
|
Glofitamab-gxbm 1 Mg/ml Intravenous Solution
|
14
|
13
|
$118,842.57
|
$83,189.80
30% off
|
$62,986.56
|
$109,335.16
|
$101,016.18
|
2026-09-01
|
|
52999
|
LOCAL
|
Valve Aortic Commander 29mm
|
4
|
3
|
$130,000.00
|
$91,000.00
30% off
|
$84,500.00
|
$117,000.00
|
$100,750.00
|
2026-09-01
|
|
344 - 3
|
OTHER
|
Osteomyelitis Septic Arthritis And Other Musculoskeletal Infections
|
15
|
14
|
$125,287.25
|
$87,701.07
30% off
|
$7,374.34
|
$119,022.89
|
$100,229.80
|
2026-09-01
|
|
001 - 4
|
OTHER
|
Liver Transplant And/or Intestinal Transplant
|
1
|
1
|
$1,546,727.63
|
$1,082,709.34
30% off
|
$98,558.89
|
$98,558.89
|
$98,558.89
|
2026-09-01
|
|
J0217
|
HCPCS
|
Velmanase Alfa-tycv 10 Mg Intravenous Solution
|
46
|
38
|
$130,195.30
|
$91,136.71
30% off
|
$22,133.20
|
$123,685.53
|
$97,646.47
|
2026-09-01
|
|
230 - 2
|
OTHER
|
Major Small Bowel Procedures
|
3
|
3
|
$182,223.16
|
$127,556.21
30% off
|
$76,533.73
|
$160,356.38
|
$96,578.27
|
2026-09-01
|
|
023 - 1
|
OTHER
|
Spinal Procedures
|
3
|
3
|
$128,436.51
|
$89,905.56
30% off
|
$77,061.90
|
$113,024.13
|
$96,327.38
|
2026-09-01
|
|
61316
|
LOCAL
|
Valve Pulmonary Harmony Rvot 25mm
|
6
|
6
|
$132,000.00
|
$92,400.00
30% off
|
$79,200.00
|
$125,400.00
|
$95,700.00
|
2026-09-01
|
|
53000
|
LOCAL
|
Valve Aortic Commander 26mm
|
10
|
10
|
$130,000.00
|
$91,000.00
30% off
|
$45,240.00
|
$123,500.00
|
$94,250.00
|
2026-09-01
|
|
4174000
|
CDM
|
H Heart Dd Aquisition
|
3
|
3
|
$134,393.00
|
$94,075.10
30% off
|
$67,196.50
|
$94,075.10
|
$94,075.10
|
2026-09-01
|
|
247 - 4
|
OTHER
|
Intestinal Obstruction
|
4
|
4
|
$138,850.36
|
$97,195.25
30% off
|
$73,590.69
|
$124,965.32
|
$93,723.99
|
2026-09-01
|
|
136 - 3
|
OTHER
|
Respiratory Malignancy
|
3
|
3
|
$124,866.83
|
$87,406.78
30% off
|
$74,920.10
|
$106,136.80
|
$93,650.12
|
2026-09-01
|
|
61317
|
LOCAL
|
Valve Pulmonary Harmony Rvot 22mm
|
23
|
17
|
$132,000.00
|
$92,400.00
30% off
|
$45,936.00
|
$125,400.00
|
$92,400.00
|
2026-09-01
|
|
138 - 4
|
OTHER
|
Bronchiolitis And Rsv Pneumonia
|
2
|
2
|
$129,222.96
|
$90,456.07
30% off
|
$68,488.17
|
$116,300.66
|
$92,394.42
|
2026-09-01
|
|
143 - 3
|
OTHER
|
Other Respiratory Diagnoses Except Signs Symptoms And Miscellaneous Diagnoses
|
1
|
1
|
$219,777.61
|
$153,844.33
30% off
|
$92,306.60
|
$92,306.60
|
$92,306.60
|
2026-09-01
|
|
120 - 1
|
OTHER
|
Major Respiratory And Chest Procedures
|
2
|
2
|
$126,033.64
|
$88,223.55
30% off
|
$88,223.55
|
$94,525.23
|
$91,374.39
|
2026-09-01
|
|
042 - 2
|
OTHER
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
1
|
1
|
$130,292.96
|
$91,205.07
30% off
|
$91,205.07
|
$91,205.07
|
$91,205.07
|
2026-09-01
|
|
231 - 1
|
OTHER
|
Major Large Bowel Procedures
|
1
|
1
|
$94,959.54
|
$66,471.68
30% off
|
$90,211.56
|
$90,211.56
|
$90,211.56
|
2026-09-01
|
|
51269
|
LOCAL
|
Set Ventricular Assist Impella 2.5in
|
5
|
4
|
$100,000.00
|
$70,000.00
30% off
|
$53,000.00
|
$90,000.00
|
$90,000.00
|
2026-09-01
|
|
404 - 2
|
OTHER
|
Thyroid Parathyroid And Thyroglossal Procedures
|
1
|
1
|
$99,889.05
|
$69,922.33
30% off
|
$89,900.14
|
$89,900.14
|
$89,900.14
|
2026-09-01
|
|
776 - 2
|
OTHER
|
Other Drug Abuse And Dependence
|
1
|
1
|
$99,724.09
|
$69,806.87
30% off
|
$89,751.68
|
$89,751.68
|
$89,751.68
|
2026-09-01
|
|
639 - 2
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Significant Condition
|
3
|
3
|
$101,164.09
|
$70,814.87
30% off
|
$53,616.97
|
$91,047.68
|
$89,024.40
|
2026-09-01
|
|
C1767
|
HCPCS
|
Generator Neurostimulator Dbs Activa 11 X 55 X 60mm
|
103
|
41
|
$128,734.12
|
$90,113.88
30% off
|
$11,971.20
|
$145,264.43
|
$86,887.00
|
2026-09-01
|
|
68607
|
LOCAL
|
Valve Pulmonary Living Heart Tissue
|
4
|
4
|
$100,000.00
|
$70,000.00
30% off
|
$47,500.00
|
$95,000.00
|
$86,500.00
|
2026-09-01
|
|
055 - 4
|
OTHER
|
Head Trauma With Coma > 1 Hour Or Hemorrhage
|
2
|
2
|
$173,889.89
|
$121,722.92
30% off
|
$15,631.56
|
$156,500.90
|
$86,066.23
|
2026-09-01
|
|
443 - 1
|
OTHER
|
Kidney And Urinary Tract Procedures For Non-malignancy
|
25
|
22
|
$122,931.98
|
$86,052.39
30% off
|
$7,125.75
|
$116,785.39
|
$86,052.39
|
2026-09-01
|
|
310 - 3
|
OTHER
|
Vertebral And Intervertebral Spinal Procedures Including Disc Procedures
|
1
|
1
|
$204,466.89
|
$143,126.82
30% off
|
$85,876.09
|
$85,876.09
|
$85,876.09
|
2026-09-01
|
|
625 - 3
|
OTHER
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
2
|
2
|
$149,484.38
|
$104,639.06
30% off
|
$62,783.44
|
$104,639.06
|
$83,711.25
|
2026-09-01
|
|
J9021
|
HCPCS
|
Asparaginase Erwinia Chrysanthemi-rywn 10 Mg/0.5 Ml IM Solution
|
61
|
37
|
$111,585.60
|
$78,109.92
30% off
|
$7,747.62
|
$204,573.60
|
$83,689.20
|
2026-09-01
|
|
J1951
|
HCPCS
|
Leuprolide 45 Mg (pediatric 6 Month) Subcutaneous Syringe
|
53
|
41
|
$103,734.80
|
$72,614.36
30% off
|
$38,381.87
|
$98,548.06
|
$82,987.84
|
2026-09-01
|
|
175 - 3
|
OTHER
|
Percutaneous Cardiac Intervention Without Ami
|
2
|
2
|
$162,348.19
|
$113,643.73
30% off
|
$18,858.15
|
$146,113.37
|
$82,485.76
|
2026-09-01
|
|
233 - 2
|
OTHER
|
Appendectomy With Complex Principal Diagnosis
|
1
|
1
|
$117,749.43
|
$82,424.60
30% off
|
$82,424.60
|
$82,424.60
|
$82,424.60
|
2026-09-01
|
|
022 - 2
|
OTHER
|
Ventricular Shunt Procedures
|
20
|
20
|
$116,639.85
|
$81,647.90
30% off
|
$9,657.11
|
$110,807.86
|
$81,647.90
|
2026-09-01
|
|
55743
|
LOCAL
|
Valve Pulmonary Melody 18mm
|
7
|
7
|
$102,000.00
|
$71,400.00
30% off
|
$42,840.00
|
$96,900.00
|
$81,600.00
|
2026-09-01
|
|
720 - 2
|
OTHER
|
Septicemia And Disseminated Infections
|
5
|
5
|
$94,749.33
|
$66,324.53
30% off
|
$39,794.72
|
$85,274.40
|
$80,536.93
|
2026-09-01
|
|
68608
|
LOCAL
|
Valve Aortic Living Heart Tissue
|
4
|
4
|
$100,000.00
|
$70,000.00
30% off
|
$70,000.00
|
$90,000.00
|
$79,000.00
|
2026-09-01
|
|
279 - 3
|
OTHER
|
Hepatic Coma And Other Major Acute Liver Disorders
|
1
|
1
|
$112,638.80
|
$78,847.16
30% off
|
$78,847.16
|
$78,847.16
|
$78,847.16
|
2026-09-01
|
|
320 - 2
|
OTHER
|
Other Musculoskeletal System And Connective Tissue Procedures
|
6
|
6
|
$139,124.91
|
$97,387.43
30% off
|
$9,827.13
|
$125,212.42
|
$78,605.57
|
2026-09-01
|
|
55469
|
LOCAL
|
Valve Aortic 14fr 20mm
|
4
|
4
|
$130,000.00
|
$91,000.00
30% off
|
$54,600.00
|
$117,000.00
|
$78,000.00
|
2026-09-01
|
|
308 - 2
|
OTHER
|
Hip And Femur Fracture Repair
|
1
|
1
|
$88,218.58
|
$61,753.00
30% off
|
$77,632.35
|
$77,632.35
|
$77,632.35
|
2026-09-01
|
|
636 - 3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
1
|
1
|
$102,431.46
|
$71,702.02
30% off
|
$76,823.60
|
$76,823.60
|
$76,823.60
|
2026-09-01
|
|
J0219
|
HCPCS
|
Avalglucosidase Alfa-ngpt 100 Mg Intravenous Solution
|
28
|
20
|
$87,543.08
|
$61,280.15
30% off
|
$41,582.96
|
$110,887.90
|
$76,454.29
|
2026-09-01
|
|
711 - 1
|
OTHER
|
Post-operative Post-trauma Other Device Infections With O.r. Procedure
|
43
|
33
|
$100,674.08
|
$70,471.85
30% off
|
$6,338.64
|
$95,640.37
|
$75,505.56
|
2026-09-01
|
|
245 - 3
|
OTHER
|
Inflammatory Bowel Disease
|
53
|
42
|
$94,064.48
|
$65,845.13
30% off
|
$6,235.04
|
$89,361.25
|
$75,251.58
|
2026-09-01
|
|
51271
|
LOCAL
|
Set Ventricular Assist Impella Rp Right
|
7
|
6
|
$100,000.00
|
$70,000.00
30% off
|
$42,000.00
|
$95,000.00
|
$75,000.00
|
2026-09-01
|
|
68606
|
LOCAL
|
Valve Tricuspid Living Heart Tissue
|
11
|
11
|
$100,000.00
|
$70,000.00
30% off
|
$42,000.00
|
$90,000.00
|
$75,000.00
|
2026-09-01
|
|
206 - 3
|
OTHER
|
Malfunction Reaction Complication Of Cardiac Or Vascular Device Or Procedure
|
31
|
27
|
$104,476.47
|
$73,133.53
30% off
|
$5,906.38
|
$99,252.65
|
$73,133.53
|
2026-09-01
|
|
68605
|
LOCAL
|
Valve Mitral Living Heart Tissue
|
22
|
19
|
$100,000.00
|
$70,000.00
30% off
|
$34,800.00
|
$95,000.00
|
$73,000.00
|
2026-09-01
|
|
143 - 4
|
OTHER
|
Other Respiratory Diagnoses Except Signs Symptoms And Miscellaneous Diagnoses
|
25
|
22
|
$103,742.31
|
$72,619.62
30% off
|
$9,554.64
|
$98,555.20
|
$72,619.62
|
2026-09-01
|
|
220 - 1
|
OTHER
|
Major Stomach Esophageal And Duodenal Procedures
|
29
|
25
|
$102,854.54
|
$71,998.18
30% off
|
$8,611.55
|
$97,711.81
|
$71,998.18
|
2026-09-01
|
|
141 - 3
|
OTHER
|
Asthma
|
3
|
3
|
$79,840.19
|
$55,888.13
30% off
|
$59,880.14
|
$71,856.17
|
$71,856.17
|
2026-09-01
|
|
310 - 1
|
OTHER
|
Vertebral And Intervertebral Spinal Procedures Including Disc Procedures
|
4
|
3
|
$118,974.29
|
$83,282.00
30% off
|
$6,769.01
|
$83,282.00
|
$71,384.57
|
2026-09-01
|
|
33270
|
CPT
|
H Cc 33270 Ins/rep Subq Defibrillator
|
3
|
3
|
$80,822.00
|
$56,575.40
30% off
|
$40,411.00
|
$72,739.80
|
$71,123.36
|
2026-09-01
|
|
51270
|
LOCAL
|
Set Ventricular Assist Impella Cp
|
2
|
2
|
$112,000.00
|
$78,400.00
30% off
|
$47,040.00
|
$95,200.00
|
$71,120.00
|
2026-09-01
|
|
469 - 3
|
OTHER
|
Acute Kidney Injury
|
12
|
11
|
$100,762.66
|
$70,533.86
30% off
|
$5,720.79
|
$95,724.52
|
$70,533.86
|
2026-09-01
|
|
J0218
|
HCPCS
|
Olipudase Alfa-rpcp 20 Mg Intravenous Solution
|
206
|
48
|
$113,775.33
|
$79,642.73
30% off
|
$12,990.05
|
$138,778.33
|
$69,529.37
|
2026-09-01
|
|
69260
|
LOCAL
|
Generator Neurostimulator Pulse-v
|
13
|
13
|
$86,400.00
|
$60,480.00
30% off
|
$43,200.00
|
$82,080.00
|
$69,120.00
|
2026-09-01
|
|
321 - 1
|
OTHER
|
Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures
|
17
|
14
|
$86,109.19
|
$60,276.43
30% off
|
$10,684.46
|
$81,803.73
|
$68,887.35
|
2026-09-01
|
|
043 - 2
|
OTHER
|
Multiple Sclerosis Other Demyelinating Disease And Inflammatory Neuropathies
|
1
|
1
|
$112,928.74
|
$79,050.12
30% off
|
$67,757.25
|
$67,757.25
|
$67,757.25
|
2026-09-01
|
|
J9118
|
HCPCS
|
Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution
|
166
|
48
|
$109,756.59
|
$76,829.62
30% off
|
$12,594.57
|
$118,866.40
|
$66,677.13
|
2026-09-01
|
|
56446
|
LOCAL
|
Pump Cannula 29fr
|
24
|
21
|
$86,000.00
|
$60,200.00
30% off
|
$29,928.00
|
$81,700.00
|
$66,650.00
|
2026-09-01
|
|
750 - 1
|
OTHER
|
Schizophrenia
|
1
|
1
|
$75,563.22
|
$52,894.25
30% off
|
$66,495.63
|
$66,495.63
|
$66,495.63
|
2026-09-01
|
|
952 - 1
|
OTHER
|
Non-extensive O.r. Procedure Unrelated To Principal Diagnosis
|
1
|
1
|
$74,905.38
|
$52,433.77
30% off
|
$65,916.74
|
$65,916.74
|
$65,916.74
|
2026-09-01
|
|
J1931
|
HCPCS
|
Laronidase 2.9 Mg/5 Ml Intravenous Solution
|
109
|
46
|
$108,381.39
|
$75,866.97
30% off
|
$12,401.33
|
$102,962.32
|
$65,028.83
|
2026-09-01
|
|
639 - 3
|
OTHER
|
Neonate Birth Weight > 2499 Grams With Other Significant Condition
|
2
|
2
|
$227,511.14
|
$159,257.80
30% off
|
$9,388.80
|
$120,580.90
|
$64,984.85
|
2026-09-01
|
|
263 - 1
|
OTHER
|
Cholecystectomy
|
11
|
11
|
$75,893.60
|
$53,125.52
30% off
|
$31,875.31
|
$68,304.24
|
$64,509.56
|
2026-09-01
|
|
816 - 3
|
OTHER
|
Toxic Effects Of Non-medicinal Substances
|
3
|
3
|
$72,800.49
|
$50,960.34
30% off
|
$50,960.34
|
$65,520.44
|
$64,064.43
|
2026-09-01
|
|
254 - 3
|
OTHER
|
Other Digestive System Diagnoses
|
20
|
18
|
$80,034.95
|
$56,024.46
30% off
|
$5,976.59
|
$76,033.20
|
$64,027.96
|
2026-09-01
|
|
C1820
|
HCPCS
|
Generator Neurostimulator Dbs Percept
|
45
|
25
|
$77,528.00
|
$54,269.60
30% off
|
$26,979.74
|
$106,821.80
|
$63,900.00
|
2026-09-01
|
|
222 - 2
|
OTHER
|
Other Stomach Esophageal And Duodenal Procedures
|
11
|
11
|
$90,778.11
|
$63,544.68
30% off
|
$7,753.09
|
$81,700.30
|
$63,544.68
|
2026-09-01
|
|
242 - 1
|
OTHER
|
Major Esophageal Disorders
|
2
|
2
|
$87,082.03
|
$60,957.42
30% off
|
$46,153.48
|
$78,373.83
|
$62,263.65
|
2026-09-01
|
|
115 - 3
|
OTHER
|
Other Ear Nose Mouth Throat And Cranial Or Facial Diagnoses
|
1
|
1
|
$88,544.09
|
$61,980.87
30% off
|
$61,980.87
|
$61,980.87
|
$61,980.87
|
2026-09-01
|
|
052 - 2
|
OTHER
|
Alteration In Consciousness
|
7
|
7
|
$77,110.43
|
$53,977.30
30% off
|
$38,555.21
|
$70,941.60
|
$61,688.34
|
2026-09-01
|
|
J9342
|
HCPCS
|
Thiotepa 100 Mg Solution For Injection
|
6
|
6
|
$89,505.00
|
$62,653.50
30% off
|
$45,468.54
|
$62,653.50
|
$61,448.62
|
2026-09-01
|
|
463 - 3
|
OTHER
|
Kidney And Urinary Tract Infections
|
2
|
2
|
$70,772.68
|
$49,540.88
30% off
|
$60,156.78
|
$62,279.96
|
$61,218.37
|
2026-09-01
|
|
091 - 1
|
OTHER
|
Other Major Head And Neck Procedures
|
4
|
4
|
$89,833.77
|
$62,883.64
30% off
|
$8,969.81
|
$79,053.71
|
$60,637.79
|
2026-09-01
|
|
J1786
|
HCPCS
|
Imiglucerase 400 Unit Intravenous Solution
|
52
|
39
|
$75,663.51
|
$52,964.46
30% off
|
$31,778.67
|
$71,880.33
|
$60,530.81
|
2026-09-01
|
|
38210
|
CPT
|
H Nmh Cell Selection Normal
|
62
|
46
|
$78,818.00
|
$55,172.60
30% off
|
$84.00
|
$74,877.10
|
$60,413.99
|
2026-09-01
|
|
56447
|
LOCAL
|
Blood Pump 31fr 28cm
|
1
|
1
|
$86,000.00
|
$60,200.00
30% off
|
$60,200.00
|
$60,200.00
|
$60,200.00
|
2026-09-01
|
|
758 - 2
|
OTHER
|
Behavioral Disorders
|
1
|
1
|
$63,344.99
|
$44,341.49
30% off
|
$60,177.74
|
$60,177.74
|
$60,177.74
|
2026-09-01
|
|
514 - 2
|
OTHER
|
Female Reproductive System Reconstructive Procedures
|
2
|
2
|
$85,267.87
|
$59,687.51
30% off
|
$45,191.97
|
$75,035.72
|
$60,113.85
|
2026-09-01
|
|
8209014
|
CDM
|
H Marrow Procurement (donor)
|
28
|
23
|
$71,553.00
|
$50,087.10
30% off
|
$35,776.50
|
$67,975.35
|
$59,925.64
|
2026-09-01
|
|
55996
|
LOCAL
|
Battery Generator Neurostimulator
|
29
|
25
|
$78,800.00
|
$55,160.00
30% off
|
$39,400.00
|
$74,860.00
|
$59,100.00
|
2026-09-01
|
|
197 - 2
|
OTHER
|
Peripheral And Other Vascular Disorders
|
1
|
1
|
$84,048.50
|
$58,833.95
30% off
|
$58,833.95
|
$58,833.95
|
$58,833.95
|
2026-09-01
|
|
144 - 2
|
OTHER
|
Respiratory Signs Symptoms And Miscellaneous Diagnoses
|
8
|
8
|
$68,694.36
|
$48,086.05
30% off
|
$3,908.24
|
$65,259.64
|
$58,561.94
|
2026-09-01
|
|
313 - 1
|
OTHER
|
Knee And Lower Leg Procedures Except Foot
|
41
|
35
|
$77,633.69
|
$54,343.58
30% off
|
$7,989.15
|
$73,752.00
|
$58,225.27
|
2026-09-01
|
|
952 - 2
|
OTHER
|
Non-extensive O.r. Procedure Unrelated To Principal Diagnosis
|
6
|
6
|
$126,581.98
|
$88,607.38
30% off
|
$7,538.67
|
$120,252.88
|
$57,943.60
|
2026-09-01
|
|
794 - 2
|
OTHER
|
Non-extensive O.r. Procedures For Other Complications Of Treatment
|
2
|
2
|
$64,805.55
|
$45,363.88
30% off
|
$57,028.88
|
$58,324.99
|
$57,676.93
|
2026-09-01
|
|
097 - 3
|
OTHER
|
Tonsil And Adenoid Procedures
|
2
|
2
|
$77,885.52
|
$54,519.86
30% off
|
$46,731.31
|
$68,539.25
|
$57,635.28
|
2026-09-01
|
|
681 - 1
|
OTHER
|
Other O.r. Procedures For Lymphatic Hematopoietic Or Other Neoplasms
|
9
|
9
|
$82,279.25
|
$57,595.47
30% off
|
$7,137.98
|
$74,051.32
|
$57,595.47
|
2026-09-01
|
|
J7170
|
HCPCS
|
Emicizumab-kxwh 60 Mg/0.4 Ml Subcutaneous Solution
|
11
|
10
|
$81,871.56
|
$57,310.09
30% off
|
$30,292.48
|
$72,046.98
|
$57,310.09
|
2026-09-01
|
|
42373
|
LOCAL
|
Valve Aortic 16mm
|
3
|
3
|
$63,555.00
|
$44,488.50
30% off
|
$55,928.40
|
$57,199.50
|
$57,199.50
|
2026-09-01
|
|
223 - 2
|
OTHER
|
Other Small And Large Bowel Procedures
|
2
|
2
|
$64,210.30
|
$44,947.21
30% off
|
$56,505.06
|
$57,789.27
|
$57,147.16
|
2026-09-01
|
|
J2508
|
HCPCS
|
Pegunigalsidase Alfa-iwxj 2 Mg/ml Intravenous Solution
|
33
|
28
|
$71,147.22
|
$49,803.05
30% off
|
$12,095.03
|
$65,455.44
|
$56,917.78
|
2026-09-01
|
|
247 - 3
|
OTHER
|
Intestinal Obstruction
|
32
|
25
|
$81,074.62
|
$56,752.23
30% off
|
$5,598.59
|
$77,020.89
|
$56,752.23
|
2026-09-01
|
|
42375
|
LOCAL
|
Valve Pulmonary Sml
|
4
|
3
|
$63,555.00
|
$44,488.50
30% off
|
$54,021.75
|
$57,199.50
|
$56,563.95
|
2026-09-01
|
|
226 - 3
|
OTHER
|
Anal And Perineal Procedures
|
2
|
2
|
$63,106.13
|
$44,174.29
30% off
|
$55,533.39
|
$56,795.52
|
$56,164.46
|
2026-09-01
|
|
591 - 3
|
OTHER
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
1
|
1
|
—
|
—
|
$56,047.77
|
$56,047.77
|
$56,047.77
|
2026-09-01
|
|
308 - 1
|
OTHER
|
Hip And Femur Fracture Repair
|
4
|
4
|
$68,654.03
|
$48,057.82
30% off
|
$41,192.42
|
$61,788.63
|
$55,953.04
|
2026-09-01
|
|
231 - 2
|
OTHER
|
Major Large Bowel Procedures
|
4
|
4
|
$112,821.20
|
$78,974.84
30% off
|
$11,310.66
|
$101,539.08
|
$55,862.18
|
2026-09-01
|
|
228 - 1
|
OTHER
|
Inguinal Femoral And Umbilical Hernia Procedures
|
3
|
3
|
$61,754.77
|
$43,228.34
30% off
|
$6,027.78
|
$58,667.03
|
$55,579.29
|
2026-09-01
|
|
49895
|
LOCAL
|
Defibrillator Protecta Dr Dual Chamber
|
24
|
22
|
$74,012.00
|
$51,808.40
30% off
|
$25,756.18
|
$70,311.40
|
$55,509.00
|
2026-09-01
|
|
058 - 2
|
OTHER
|
Other Disorders Of Nervous System
|
21
|
19
|
$79,270.28
|
$55,489.20
30% off
|
$6,321.19
|
$75,306.77
|
$55,489.20
|
2026-09-01
|
|
002 - 1
|
OTHER
|
Heart And/or Lung Transplant
|
1
|
1
|
—
|
—
|
$55,139.97
|
$55,139.97
|
$55,139.97
|
2026-09-01
|
|
J3385
|
HCPCS
|
Velaglucerase Alfa 400 Unit Intravenous Solution
|
82
|
42
|
$76,749.75
|
$53,724.82
30% off
|
$10,675.19
|
$86,169.04
|
$54,457.43
|
2026-09-01
|
|
723 - 4
|
OTHER
|
Viral Illness
|
33
|
26
|
$76,093.50
|
$53,265.45
30% off
|
$9,347.43
|
$72,288.82
|
$54,026.38
|
2026-09-01
|
|
812 - 3
|
OTHER
|
Poisoning Of Medicinal Agents
|
8
|
8
|
$65,453.77
|
$45,817.64
30% off
|
$4,502.93
|
$62,181.08
|
$53,344.82
|
2026-09-01
|
|
199 - 2
|
OTHER
|
Hypertension
|
47
|
38
|
$65,462.79
|
$45,823.96
30% off
|
$3,748.84
|
$62,189.65
|
$52,370.23
|
2026-09-01
|
|
180 - 1
|
OTHER
|
Other Circulatory System Procedures
|
1
|
1
|
$87,156.13
|
$61,009.29
30% off
|
$52,293.68
|
$52,293.68
|
$52,293.68
|
2026-09-01
|
|
J9042
|
HCPCS
|
Brentuximab Vedotin 50 Mg Intravenous Solution
|
82
|
46
|
$57,882.48
|
$40,517.74
30% off
|
$16,748.97
|
$93,597.19
|
$52,094.23
|
2026-09-01
|
|
252 - 3
|
OTHER
|
Malfunction Reaction And Complication Of Gastrointestinal Device Or Procedure
|
28
|
25
|
$67,146.77
|
$47,002.74
30% off
|
$6,085.89
|
$63,789.43
|
$52,038.74
|
2026-09-01
|
|
518 - 1
|
OTHER
|
Other Female Reproductive System And Related Procedures
|
23
|
21
|
$69,142.09
|
$48,399.47
30% off
|
$4,966.70
|
$65,684.99
|
$51,856.57
|
2026-09-01
|
|
842 - 4
|
OTHER
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
1
|
1
|
—
|
—
|
$51,761.91
|
$51,761.91
|
$51,761.91
|
2026-09-01
|
|
445 - 1
|
OTHER
|
Other Bladder Procedures
|
5
|
5
|
$85,539.66
|
$59,877.76
30% off
|
$5,830.85
|
$75,274.90
|
$51,323.80
|
2026-09-01
|
|
694 - 2
|
OTHER
|
Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior
|
35
|
27
|
$62,807.98
|
$43,965.59
30% off
|
$4,657.02
|
$59,667.58
|
$50,246.38
|
2026-09-01
|
|
J1950
|
HCPCS
|
Leuprolide 11.25 Mg (pediatric 3 Month) Intramuscular Syringe Kit
|
103
|
46
|
$55,760.09
|
$39,032.06
30% off
|
$9,479.22
|
$93,349.49
|
$50,184.08
|
2026-09-01
|
|
L8614
|
HCPCS
|
Cochlear Flex28 Electrode .8mm .5mm
|
231
|
48
|
$69,376.68
|
$48,563.68
30% off
|
$10,754.95
|
$76,171.91
|
$50,065.00
|
2026-09-01
|
|
757 - 2
|
OTHER
|
Organic Mental Health Disturbances
|
3
|
3
|
$94,213.88
|
$65,949.71
30% off
|
$4,058.59
|
$65,949.71
|
$49,933.35
|
2026-09-01
|
|
055 - 3
|
OTHER
|
Head Trauma With Coma > 1 Hour Or Hemorrhage
|
1
|
1
|
$82,709.27
|
$57,896.49
30% off
|
$49,625.56
|
$49,625.56
|
$49,625.56
|
2026-09-01
|
|
420 - 3
|
OTHER
|
Diabetes
|
7
|
7
|
$82,515.49
|
$57,760.84
30% off
|
$5,022.49
|
$72,613.63
|
$49,509.30
|
2026-09-01
|
|
466 - 2
|
OTHER
|
Malfunction Reaction Complication Of Genitourinary Device Or Procedure
|
2
|
2
|
$53,848.14
|
$37,693.70
30% off
|
$47,386.36
|
$51,155.73
|
$49,271.04
|
2026-09-01
|
|
662 - 2
|
OTHER
|
Sickle Cell Anemia Crisis
|
4
|
4
|
$70,182.56
|
$49,127.79
30% off
|
$37,196.76
|
$52,636.92
|
$49,127.79
|
2026-09-01
|
|
142 - 2
|
OTHER
|
Interstitial And Alveolar Lung Diseases
|
47
|
36
|
$70,037.74
|
$49,026.42
30% off
|
$4,454.36
|
$66,535.86
|
$49,026.42
|
2026-09-01
|
|
364 - 1
|
OTHER
|
Other Skin Subcutaneous Tissue And Related Procedures
|
6
|
6
|
$58,802.57
|
$41,161.80
30% off
|
$5,034.21
|
$51,746.27
|
$48,512.12
|
2026-09-01
|
|
49892
|
LOCAL
|
Defibrillator Protecta Xt Vr Single Chamber
|
18
|
13
|
$69,248.00
|
$48,473.60
30% off
|
$24,098.30
|
$65,785.60
|
$48,473.60
|
2026-09-01
|
|
049 - 2
|
OTHER
|
Bacterial And Tuberculous Infections Of Nervous System
|
2
|
2
|
$122,324.07
|
$85,626.85
30% off
|
$11,254.87
|
$85,626.85
|
$48,440.86
|
2026-09-01
|
|
403 - 1
|
OTHER
|
Procedures For Obesity
|
1
|
1
|
$90,473.36
|
$63,331.35
30% off
|
$47,950.88
|
$47,950.88
|
$47,950.88
|
2026-09-01
|
|
143 - 2
|
OTHER
|
Other Respiratory Diagnoses Except Signs Symptoms And Miscellaneous Diagnoses
|
1
|
1
|
$89,410.20
|
$62,587.14
30% off
|
$47,387.41
|
$47,387.41
|
$47,387.41
|
2026-09-01
|
|
196 - 3
|
OTHER
|
Cardiac Arrest And Shock
|
1
|
1
|
$53,554.20
|
$37,487.94
30% off
|
$47,127.70
|
$47,127.70
|
$47,127.70
|
2026-09-01
|
|
751 - 2
|
OTHER
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
3
|
3
|
$52,110.82
|
$36,477.57
30% off
|
$36,477.57
|
$46,899.74
|
$46,899.74
|
2026-09-01
|
|
C1721
|
HCPCS
|
Defibrillator Evera S Dr Dual Chamber
|
47
|
29
|
$65,592.00
|
$45,914.40
30% off
|
$11,024.32
|
$63,505.60
|
$46,793.60
|
2026-09-01
|
|
053 - 3
|
OTHER
|
Seizure
|
5
|
5
|
$61,774.00
|
$43,241.80
30% off
|
$5,403.67
|
$54,361.12
|
$46,330.50
|
2026-09-01
|
|
815 - 2
|
OTHER
|
Other Injury Poisoning And Toxic Effect Diagnoses
|
5
|
4
|
$76,472.76
|
$53,530.93
30% off
|
$3,334.41
|
$53,530.93
|
$45,883.65
|
2026-09-01
|
|
49896
|
LOCAL
|
Defibrillator Protecta Single Chamber
|
18
|
16
|
$65,328.00
|
$45,729.60
30% off
|
$28,874.98
|
$62,061.60
|
$45,729.60
|
2026-09-01
|
|
054 - 3
|
OTHER
|
Migraine And Other Headaches
|
2
|
2
|
$123,129.84
|
$86,190.89
30% off
|
$5,026.66
|
$86,190.89
|
$45,608.77
|
2026-09-01
|
|
228 - 2
|
OTHER
|
Inguinal Femoral And Umbilical Hernia Procedures
|
1
|
1
|
$47,719.87
|
$33,403.91
30% off
|
$45,333.88
|
$45,333.88
|
$45,333.88
|
2026-09-01
|
|
423 - 2
|
OTHER
|
Inborn Errors Of Metabolism
|
3
|
3
|
$64,682.21
|
$45,277.55
30% off
|
$4,079.78
|
$58,213.99
|
$45,277.55
|
2026-09-01
|
|
138 - 3
|
OTHER
|
Bronchiolitis And Rsv Pneumonia
|
36
|
30
|
$64,326.37
|
$45,028.46
30% off
|
$4,023.61
|
$61,110.05
|
$45,028.46
|
2026-09-01
|
|
42374
|
LOCAL
|
Valve Pulmonary 21mm
|
16
|
15
|
$63,555.00
|
$44,488.50
30% off
|
$31,777.50
|
$60,377.25
|
$44,488.50
|
2026-09-01
|
|
8209000
|
CDM
|
H Procure'nt Test/umbl'cl Cord Bld
|
54
|
40
|
$57,382.00
|
$40,167.40
30% off
|
$9,754.94
|
$54,512.90
|
$44,471.05
|
2026-09-01
|
|
199 - 3
|
OTHER
|
Hypertension
|
1
|
1
|
$63,338.00
|
$44,336.60
30% off
|
$44,336.60
|
$44,336.60
|
$44,336.60
|
2026-09-01
|
|
532 - 3
|
OTHER
|
Menstrual And Other Female Reproductive System Disorders
|
4
|
4
|
$90,948.77
|
$63,664.14
30% off
|
$4,890.80
|
$86,401.33
|
$43,616.89
|
2026-09-01
|
|
J0180
|
HCPCS
|
Agalsidase Beta 5 Mg Intravenous Solution
|
30
|
22
|
$82,912.32
|
$58,038.62
30% off
|
$14,095.09
|
$78,766.70
|
$42,958.94
|
2026-09-01
|