Hospital

MEMORIAL HOSPITAL OF SOUTH BEND

South Bend, IN · CCN 150058 · Rates published

29,491 distinct procedures filed

17 distinct payers

573,154 rate rows

2026-05-13 last MRF observed

Data quality

568,370 of 573,154 rate rows are consumer-grade (99.2%)

4,784 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	1,819
per-diem day rate — not a per-procedure price	1,746
placeholder amount (≤ $0.02) — excluded from medians	781
percent-of-charges filed in the dollar field — excluded from medians	378
template filing: same amount across many unrelated codes — excluded	60

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://www.beaconhealthsystem.org/wp-content/uploads/2026/03/350868132_Memorial-Hospital-of-South-Bend_standardcharges.csv
Found on page	https://www.beaconhealthsystem.org/hospital-chargemaster/
Discovered via	CMS hospital list
Last fetch	not_modified · 2026-05-18
Content fingerprint	5e2ee62b857495ec… · 102,194,934 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
J3391 OTHER	Inj- Atidarsagene Autotemcel	7	$2,414,680.00	$4,730,250.00	$4,505,000.00	nat. median $4,505,000 1.0× median
J1414 OTHER	Inj- Beqvez- Per Tx Dose	6	$3,675,000.00	$3,675,000.00	$3,675,000.00	nat. median $3,710,000 1.0× median
J1411 OTHER	Inj- Hemgenix- Per Tx Dose	10	$1,975,302.94	$3,869,530.00	$3,675,000.00	nat. median $3,685,267 1.0× median
C9172 OTHER	Inj- Beqvez- Per Tx Dose	6	$3,675,000.00	$3,675,000.00	$3,675,000.00	nat. median $3,675,000 1.0× median
J1413 OTHER	Inj Delandistrogene Mox Rokl	11	$1,777,623.95	$4,986,857.85	$3,360,000.00	nat. median $3,327,860 1.0× median
J3394 OTHER	Inj- Lovotibeglogene Autotem	8	$1,741,166.91	$4,892,032.50	$3,248,445.72	nat. median $3,286,000 1.0× median
J3393 OTHER	Inj- Betibeglogene Autotemce	9	$1,578,916.64	$4,713,184.00	$2,945,740.00	nat. median $2,968,000 1.0× median
J3392 OTHER	Inj- Exagamglogene Autotem	10	$1,249,952.00	$4,430,800.00	$2,332,000.00	nat. median $2,332,000 1.0× median
J3399 OTHER	Inj Onase Abepar-xioi Treat	11	$1,315,939.29	$4,664,710.16	$2,231,250.00	nat. median $2,472,216 0.9× median
Q2057 OTHER	Afamitresgene Autoleucel	11	$413,052.32	$1,464,178.00	$763,350.00	nat. median $770,620 1.0× median
114 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	7	$177,405.59	$647,979.12	$647,979.12	nat. median $10,012 outlier · 64.7×
Q2042 OTHER	Tisagenlecleucel Car-pos T	10	$317,165.24	$1,124,279.78	$591,726.20	nat. median $591,726 1.0× median
5833 OTHER	Neonate With Ecmo	7	$180,341.03	$588,944.20	$588,944.20	nat. median $252,069 outlier · 2.3×
5834 OTHER	Neonate With Ecmo	7	$191,228.48	$588,944.20	$588,944.20	nat. median $372,748 1.6× median
Q2056 OTHER	Ciltacabtagene Car-pos T	11	$303,305.76	$1,075,151.01	$583,075.96	nat. median $583,076 1.0× median
5832 OTHER	Neonate With Ecmo	7	$100,230.25	$558,502.30	$558,502.30	nat. median $152,272 outlier · 3.7×
5831 OTHER	Neonate With Ecmo	7	$90,026.85	$558,502.30	$558,502.30	nat. median $139,037 outlier · 4.0×
Q2054 OTHER	Lisocabtagene Mara Car Pos T	11	$301,520.47	$1,068,822.56	$557,917.92	nat. median $562,538 1.0× median
Q2055 OTHER	Idecabtagene Vicleucel Car	11	$298,722.41	$1,058,904.07	$554,728.05	nat. median $558,082 1.0× median
Q2058 OTHER	Obecbtge Autol Up To 400 Mil	11	$149,142.00	$551,250.00	$539,962.50	nat. median $281,111 1.9× median
24 OTHER	Heart And/or Lung Transplant	7	$553.00	$537,458.68	$537,458.68	nat. median $27,988 outlier · 19.2×
Q2041 OTHER	Axicabtagene Ciloleucel Car+	11	$285,811.37	$1,013,137.32	$528,759.00	nat. median $533,230 1.0× median
5884 OTHER	Neonate Bwt <1500g W Major Procedure	7	$194,088.23	$503,124.62	$503,124.62	nat. median $243,175 outlier · 2.1×
Q2053 OTHER	Brexucabtagene Car Pos T	11	$262,267.27	$929,678.76	$485,100.00	nat. median $489,720 1.0× median
MS-018 OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	11	$345,198.35	$855,753.55	$477,692.94	nat. median $309,559 1.5× median
1614 OTHER	Implantable Heart Assist Systems	7	$146,815.70	$469,930.95	$469,930.95	nat. median $194,298 outlier · 2.4×
6314 OTHER	Neonate Birthwt >2499g W Other Major Procedure	7	$164,228.17	$469,136.53	$469,136.53	nat. median $163,675 outlier · 2.9×
5883 OTHER	Neonate Bwt <1500g W Major Procedure	7	$128,398.70	$396,403.43	$396,403.43	nat. median $163,694 outlier · 2.4×
44 OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	7	$94,208.19	$393,435.20	$393,435.20	nat. median $33,835 outlier · 11.6×
113 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	7	$132,169.26	$378,177.99	$378,177.99	nat. median $18,223 outlier · 20.8×
74 OTHER	Allogeneic Bone Marrow Transplant	7	$110,764.16	$333,375.47	$333,375.47	nat. median $10,670 outlier · 31.2×
5914 OTHER	Neonate Birthwt 500-749g Without Major Procedure	7	$116,500.55	$332,614.53	$332,614.53	nat. median $149,152 outlier · 2.2×
14 OTHER	Liver Transplant And/or Intestinal Transplant	7	$553.00	$328,688.97	$328,688.97	nat. median $100,915 outlier · 3.3×
5934 OTHER	Neonate Birthwt 750-999g Without Major Procedure	7	$111,580.00	$317,330.38	$317,330.38	nat. median $129,842 outlier · 2.4×
E0766 OTHER	Elec Stim Cancer Treatment	1	$314,107.50	$314,107.50	$314,107.50	nat. median $16,410 outlier · 19.1×
MS-001 OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	11	$224,278.27	$555,349.63	$310,352.39	nat. median $224,278 1.4× median
112 OTHER	Extracorporeal Membrane Oxygenation (ecmo)	7	$105,186.77	$304,837.81	$304,837.81	nat. median $3,671 outlier · 83.0×
1613 OTHER	Implantable Heart Assist Systems	7	$79,670.23	$303,870.59	$303,870.59	nat. median $79 outlier · 3860.1×
1612 OTHER	Implantable Heart Assist Systems	7	$67,714.74	$303,851.24	$303,851.24	nat. median $84,765 outlier · 3.6×
1611 OTHER	Implantable Heart Assist Systems	7	$55,181.08	$302,838.59	$302,838.59	nat. median $80,527 outlier · 3.8×
23 OTHER	Heart And/or Lung Transplant	7	$553.00	$295,712.02	$295,712.02	nat. median $56,822 outlier · 5.2×
5881 OTHER	Neonate Bwt <1500g W Major Procedure	7	$92,664.62	$294,207.35	$294,207.35	nat. median $14,014 outlier · 21.0×
5882 OTHER	Neonate Bwt <1500g W Major Procedure	7	$108,017.95	$294,207.35	$294,207.35	nat. median $119,369 outlier · 2.5×
J3403 OTHER	Revakinagene- Per Implant	9	$138,020.00	$489,250.00	$257,500.00	nat. median $265,000 1.0× median
6094 OTHER	Neonate Bwt 1500-2499g W Major Procedure	7	$135,485.25	$250,369.68	$250,369.68	nat. median $170,784 1.5× median
6024 OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	7	$54,187.99	$245,243.37	$245,243.37	nat. median $99,381 outlier · 2.5×
22 OTHER	Heart And/or Lung Transplant	7	$553.00	$243,586.70	$243,586.70	nat. median $36,392 outlier · 6.7×
1604 OTHER	Major Cardiothoracic Repair Of Heart Anomaly	7	$80,148.73	$242,358.25	$242,358.25	nat. median $44,507 outlier · 5.4×
MS-927 OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	11	$171,045.65	$423,102.86	$236,684.09	nat. median $175,322 1.4× median
6304 OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	7	$121,216.75	$235,523.02	$235,523.02	nat. median $164,743 1.4× median

Other procedures at this hospital

Browse this hospital's 29,491 published procedures. Use the slice to choose what to show, then sort or filter any column.

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	OTHER	Inj- Atidarsagene Autotemcel	9	7	—	—	$2,414,680.00	$4,730,250.00	$4,505,000.00	2026-05-13
J1414	OTHER	Inj- Beqvez- Per Tx Dose	13	6	—	—	$3,675,000.00	$3,675,000.00	$3,675,000.00	2026-05-13
C9172	OTHER	Inj- Beqvez- Per Tx Dose	13	6	—	—	$3,675,000.00	$3,675,000.00	$3,675,000.00	2026-05-13
J1411	OTHER	Inj- Hemgenix- Per Tx Dose	23	10	—	—	$1,975,302.94	$3,869,530.00	$3,675,000.00	2026-05-13
J1413	OTHER	Inj Delandistrogene Mox Rokl	24	11	—	—	$1,777,623.95	$4,986,857.85	$3,360,000.00	2026-05-13
J3394	OTHER	Inj- Lovotibeglogene Autotem	10	8	—	—	$1,741,166.91	$4,892,032.50	$3,248,445.72	2026-05-13
J3393	OTHER	Inj- Betibeglogene Autotemce	11	9	—	—	$1,578,916.64	$4,713,184.00	$2,945,740.00	2026-05-13
J3392	OTHER	Inj- Exagamglogene Autotem	13	10	—	—	$1,249,952.00	$4,430,800.00	$2,332,000.00	2026-05-13
J3399	OTHER	Inj Onase Abepar-xioi Treat	27	11	—	—	$1,315,939.29	$4,664,710.16	$2,231,250.00	2026-05-13
Q2057	OTHER	Afamitresgene Autoleucel	26	11	—	—	$413,052.32	$1,464,178.00	$763,350.00	2026-05-13
114	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	15	7	—	—	$177,405.59	$647,979.12	$647,979.12	2026-05-13
Q2042	OTHER	Tisagenlecleucel Car-pos T	13	10	—	—	$317,165.24	$1,124,279.78	$591,726.20	2026-05-13
5833	OTHER	Neonate With Ecmo	16	7	—	—	$180,341.03	$588,944.20	$588,944.20	2026-05-13
5834	OTHER	Neonate With Ecmo	16	7	—	—	$191,228.48	$588,944.20	$588,944.20	2026-05-13
Q2056	OTHER	Ciltacabtagene Car-pos T	27	11	—	—	$303,305.76	$1,075,151.01	$583,075.96	2026-05-13
5832	OTHER	Neonate With Ecmo	16	7	—	—	$100,230.25	$558,502.30	$558,502.30	2026-05-13
5831	OTHER	Neonate With Ecmo	16	7	—	—	$90,026.85	$558,502.30	$558,502.30	2026-05-13
Q2054	OTHER	Lisocabtagene Mara Car Pos T	27	11	—	—	$301,520.47	$1,068,822.56	$557,917.92	2026-05-13
Q2055	OTHER	Idecabtagene Vicleucel Car	27	11	—	—	$298,722.41	$1,058,904.07	$554,728.05	2026-05-13
Q2058	OTHER	Obecbtge Autol Up To 400 Mil	26	11	—	—	$149,142.00	$551,250.00	$539,962.50	2026-05-13
24	OTHER	Heart And/or Lung Transplant	16	7	—	—	$553.00	$537,458.68	$537,458.68	2026-05-13
Q2041	OTHER	Axicabtagene Ciloleucel Car+	27	11	—	—	$285,811.37	$1,013,137.32	$528,759.00	2026-05-13
5884	OTHER	Neonate Bwt <1500g W Major Procedure	16	7	—	—	$194,088.23	$503,124.62	$503,124.62	2026-05-13
Q2053	OTHER	Brexucabtagene Car Pos T	27	11	—	—	$262,267.27	$929,678.76	$485,100.00	2026-05-13
MS-018	OTHER	Chimeric Antigen Receptor (car) T-cell Immunotherapy	16	11	—	—	$345,198.35	$855,753.55	$477,692.94	2026-05-13
1614	OTHER	Implantable Heart Assist Systems	16	7	—	—	$146,815.70	$469,930.95	$469,930.95	2026-05-13
6314	OTHER	Neonate Birthwt >2499g W Other Major Procedure	16	7	—	—	$164,228.17	$469,136.53	$469,136.53	2026-05-13
5883	OTHER	Neonate Bwt <1500g W Major Procedure	16	7	—	—	$128,398.70	$396,403.43	$396,403.43	2026-05-13
44	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	16	7	—	—	$94,208.19	$393,435.20	$393,435.20	2026-05-13
113	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	15	7	—	—	$132,169.26	$378,177.99	$378,177.99	2026-05-13
74	OTHER	Allogeneic Bone Marrow Transplant	16	7	—	—	$110,764.16	$333,375.47	$333,375.47	2026-05-13
5914	OTHER	Neonate Birthwt 500-749g Without Major Procedure	16	7	—	—	$116,500.55	$332,614.53	$332,614.53	2026-05-13
14	OTHER	Liver Transplant And/or Intestinal Transplant	16	7	—	—	$553.00	$328,688.97	$328,688.97	2026-05-13
5934	OTHER	Neonate Birthwt 750-999g Without Major Procedure	16	7	—	—	$111,580.00	$317,330.38	$317,330.38	2026-05-13
E0766	OTHER	Elec Stim Cancer Treatment	1	1	—	—	$314,107.50	$314,107.50	$314,107.50	2026-05-13
MS-001	OTHER	Heart Transplant Or Implant Of Heart Assist System With Mcc	16	11	—	—	$224,278.27	$555,349.63	$310,352.39	2026-05-13
112	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	15	7	—	—	$105,186.77	$304,837.81	$304,837.81	2026-05-13
1613	OTHER	Implantable Heart Assist Systems	16	7	—	—	$79,670.23	$303,870.59	$303,870.59	2026-05-13
1612	OTHER	Implantable Heart Assist Systems	16	7	—	—	$67,714.74	$303,851.24	$303,851.24	2026-05-13
1611	OTHER	Implantable Heart Assist Systems	16	7	—	—	$55,181.08	$302,838.59	$302,838.59	2026-05-13
23	OTHER	Heart And/or Lung Transplant	16	7	—	—	$553.00	$295,712.02	$295,712.02	2026-05-13
5882	OTHER	Neonate Bwt <1500g W Major Procedure	16	7	—	—	$108,017.95	$294,207.35	$294,207.35	2026-05-13
5881	OTHER	Neonate Bwt <1500g W Major Procedure	16	7	—	—	$92,664.62	$294,207.35	$294,207.35	2026-05-13
J3403	OTHER	Revakinagene- Per Implant	12	9	—	—	$138,020.00	$489,250.00	$257,500.00	2026-05-13
6094	OTHER	Neonate Bwt 1500-2499g W Major Procedure	16	7	—	—	$135,485.25	$250,369.68	$250,369.68	2026-05-13
6024	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	16	7	—	—	$54,187.99	$245,243.37	$245,243.37	2026-05-13
22	OTHER	Heart And/or Lung Transplant	16	7	—	—	$553.00	$243,586.70	$243,586.70	2026-05-13
1604	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	16	7	—	—	$80,148.73	$242,358.25	$242,358.25	2026-05-13
MS-927	OTHER	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	16	11	—	—	$171,045.65	$423,102.86	$236,684.09	2026-05-13
6304	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	16	7	—	—	$121,216.75	$235,523.02	$235,523.02	2026-05-13
MS-003	OTHER	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth…	16	11	—	—	$170,046.16	$420,619.79	$235,300.89	2026-05-13
54	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	16	7	—	—	$61,810.96	$228,748.68	$228,748.68	2026-05-13
94	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	16	7	—	—	$109,523.99	$228,301.56	$227,390.60	2026-05-13
73	OTHER	Allogeneic Bone Marrow Transplant	16	7	—	—	$59,138.26	$220,943.88	$220,943.88	2026-05-13
6074	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	16	7	—	—	$40,752.01	$219,132.78	$219,132.78	2026-05-13
21	OTHER	Heart And/or Lung Transplant	16	7	—	—	$553.00	$217,018.03	$217,018.03	2026-05-13
J3402	OTHER	Inj. Remestemcel-l-rknd/ Td	12	9	—	—	$110,223.04	$390,716.00	$205,640.00	2026-05-13
43	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	16	7	—	—	$64,311.12	$199,957.70	$199,957.70	2026-05-13
72	OTHER	Allogeneic Bone Marrow Transplant	16	7	—	—	$58,533.55	$198,437.33	$198,437.33	2026-05-13
5933	OTHER	Neonate Birthwt 750-999g Without Major Procedure	16	7	—	—	$81,235.12	$191,842.30	$191,842.30	2026-05-13
8504	OTHER	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	16	7	—	—	$42,394.61	$186,758.52	$186,758.52	2026-05-13
1624	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	16	7	—	—	$47,221.34	$181,159.91	$181,159.91	2026-05-13
13	OTHER	Liver Transplant And/or Intestinal Transplant	16	7	—	—	$553.00	$180,772.13	$180,772.13	2026-05-13
8514	OTHER	Gender Related Procedures	15	7	—	—	$49,493.69	$180,152.55	$180,152.55	2026-05-13
3034	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	16	7	—	—	$52,363.44	$180,120.92	$180,120.92	2026-05-13
6023	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	16	7	—	—	$37,559.57	$172,990.93	$172,990.93	2026-05-13
63	OTHER	Pancreas Transplant	16	7	—	—	$553.00	$171,455.28	$171,455.28	2026-05-13
62	OTHER	Pancreas Transplant	16	7	—	—	$553.00	$171,455.28	$171,455.28	2026-05-13
64	OTHER	Pancreas Transplant	16	7	—	—	$553.00	$171,455.28	$171,455.28	2026-05-13
6334	OTHER	Neonate Birthwt >2499g W Major Anomaly	16	7	—	—	$22,736.40	$169,641.18	$169,641.18	2026-05-13
5932	OTHER	Neonate Birthwt 750-999g Without Major Procedure	16	7	—	—	$52,506.80	$167,555.65	$167,555.65	2026-05-13
53	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	16	7	—	—	$54,675.93	$166,227.07	$166,227.07	2026-05-13
84	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	16	7	—	—	$50,750.54	$166,222.61	$166,222.61	2026-05-13
83	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	16	7	—	—	$35,884.11	$166,061.36	$166,061.36	2026-05-13
6093	OTHER	Neonate Bwt 1500-2499g W Major Procedure	16	7	—	—	$46,708.90	$157,422.04	$157,422.04	2026-05-13
MS-004	OTHER	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec…	16	11	—	—	$111,226.56	$274,493.19	$153,900.81	2026-05-13
6124	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	16	7	—	—	$42,675.60	$153,859.46	$153,859.46	2026-05-13
6114	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	16	7	—	—	$31,865.41	$163,952.35	$152,229.56	2026-05-13
6092	OTHER	Neonate Bwt 1500-2499g W Major Procedure	16	7	—	—	$29,866.74	$151,921.76	$151,921.76	2026-05-13
6091	OTHER	Neonate Bwt 1500-2499g W Major Procedure	16	7	—	—	$24,837.24	$150,780.11	$150,780.11	2026-05-13
8634	OTHER	Neonatal Aftercare	16	7	—	—	$47,094.66	$150,117.29	$150,117.29	2026-05-13
6214	OTHER	Neonate Bwt 2000-2499g W Major Anomaly	16	7	—	—	$17,517.67	$149,016.91	$149,016.91	2026-05-13
5913	OTHER	Neonate Birthwt 500-749g Without Major Procedure	16	7	—	—	$91,132.52	$147,993.49	$147,993.49	2026-05-13
MS-007	OTHER	Lung Transplant	16	11	—	—	$104,037.83	$256,634.11	$143,952.36	2026-05-13
3033	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	16	7	—	—	$36,471.61	$142,378.87	$142,378.87	2026-05-13
9504	OTHER	Extensive Procedure Unrelated To Principal Diagnosis	16	7	—	—	$27,049.12	$141,031.91	$141,031.91	2026-05-13
4404	OTHER	Kidney Transplant	16	7	—	—	$553.00	$140,057.84	$140,057.84	2026-05-13
4403	OTHER	Kidney Transplant	16	7	—	—	$553.00	$138,967.79	$138,967.79	2026-05-13
4402	OTHER	Kidney Transplant	16	7	—	—	$553.00	$138,883.94	$138,883.94	2026-05-13
4401	OTHER	Kidney Transplant	16	7	—	—	$553.00	$138,825.89	$138,825.89	2026-05-13
6022	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	16	7	—	—	$30,200.89	$135,568.66	$135,568.66	2026-05-13
6073	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	16	7	—	—	$27,751.83	$134,562.75	$134,562.75	2026-05-13
5894	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	16	7	—	—	$2,028.80	$134,367.74	$134,367.74	2026-05-13
5893	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	16	7	—	—	$66,187.58	$134,367.74	$134,367.74	2026-05-13
MS-014	OTHER	Allogeneic Bone Marrow Transplant	16	11	—	—	$96,601.03	$238,158.72	$133,660.62	2026-05-13
9124	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	16	7	—	—	$31,155.92	$132,125.87	$132,125.87	2026-05-13
1674	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	16	7	—	—	$40,481.45	$131,273.94	$131,273.94	2026-05-13
9114	OTHER	Extensive Abdominal/thoracic Procedures For Mult Significant Trauma	16	7	—	—	$35,944.58	$131,271.86	$131,271.86	2026-05-13
3004	OTHER	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	15	7	—	—	$27,427.06	$129,752.55	$129,752.55	2026-05-13
5891	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	16	7	—	—	$66,187.58	$127,924.41	$127,924.41	2026-05-13
5892	OTHER	Neonate Bwt <500g Or Ga <24 Weeks	16	7	—	—	$66,187.58	$127,924.41	$127,924.41	2026-05-13
9104	OTHER	Craniotomy For Multiple Significant Trauma	16	7	—	—	$31,231.51	$127,441.76	$127,441.76	2026-05-13
MS-002	OTHER	Heart Transplant Or Implant Of Heart Assist System Without Mcc	16	11	—	—	$91,128.11	$224,562.28	$126,086.68	2026-05-13
224	OTHER	Ventricular Shunt Procedures	16	7	—	—	$21,628.12	$124,923.91	$124,923.91	2026-05-13
71	OTHER	Allogeneic Bone Marrow Transplant	16	7	—	—	$52,628.26	$142,486.60	$122,893.92	2026-05-13
MS-426	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	16	11	—	—	$88,650.52	$218,407.12	$122,657.96	2026-05-13
111	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	15	7	—	—	$52,085.59	$122,184.42	$122,184.42	2026-05-13
MS-212	OTHER	Testes Procedures Age 0-17	16	11	—	—	$87,477.13	$215,492.04	$121,034.12	2026-05-13
12	OTHER	Liver Transplant And/or Intestinal Transplant	16	7	—	—	$553.00	$120,077.11	$120,077.11	2026-05-13
93	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	16	7	—	—	$78,947.66	$132,078.56	$119,929.30	2026-05-13
8414	OTHER	Extensive Third Degree Burns With Skin Graft	2	2	—	—	$119,802.46	$119,802.46	$119,802.46	2026-05-13
1784	OTHER	External Heart Assist Systems	15	7	—	—	$35,639.10	$118,390.37	$118,390.37	2026-05-13
MS-209	OTHER	Kidney And Urinary Tract Signs And Symptoms Age 0-17	14	10	—	—	$91,024.41	$224,304.66	$117,756.25	2026-05-13
6814	OTHER	Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms	16	7	—	—	$28,375.30	$116,133.18	$116,133.18	2026-05-13
6034	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	16	7	—	—	$60,846.56	$115,963.34	$115,963.34	2026-05-13
6033	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	16	7	—	—	$35,087.04	$115,169.99	$115,169.99	2026-05-13
2994	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	15	7	—	—	$35,779.85	$115,017.12	$115,017.12	2026-05-13
2993	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	15	7	—	—	$28,099.01	$114,901.02	$114,901.02	2026-05-13
MS-005	OTHER	Liver Transplant With Mcc Or Intestinal Transplant	16	11	—	—	$82,981.38	$204,323.18	$114,812.47	2026-05-13
42	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	16	7	—	—	$41,153.93	$114,623.02	$114,623.02	2026-05-13
8633	OTHER	Neonatal Aftercare	16	7	—	—	$22,297.47	$113,807.97	$113,807.97	2026-05-13
1834	OTHER	Percutaneous Structural Cardiac Procedures	15	7	—	—	$32,131.27	$113,743.82	$113,743.82	2026-05-13
5931	OTHER	Neonate Birthwt 750-999g Without Major Procedure	16	7	—	—	$30,982.32	$112,777.42	$112,777.42	2026-05-13
5912	OTHER	Neonate Birthwt 500-749g Without Major Procedure	16	7	—	—	$77,804.45	$112,195.05	$112,195.05	2026-05-13
6344	OTHER	Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond	16	7	—	—	$14,978.93	$111,911.47	$111,911.47	2026-05-13
204	OTHER	Open Craniotomy For Trauma	16	7	—	—	$36,483.08	$111,739.26	$111,739.26	2026-05-13
6954	OTHER	Chemotherapy For Acute Leukemia	16	7	—	—	$31,296.15	$111,363.86	$111,363.86	2026-05-13
6804	OTHER	Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms	16	7	—	—	$37,601.27	$111,276.39	$111,276.39	2026-05-13
3044	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	16	7	—	—	$29,308.43	$111,053.89	$111,053.89	2026-05-13
MS-215	OTHER	Other Heart Assist System Implant	16	11	—	—	$80,161.56	$197,317.87	$110,910.15	2026-05-13
2604	OTHER	Major Pancreas, Liver And Shunt Procedures	16	7	—	—	$21,770.95	$110,819.19	$110,819.19	2026-05-13
6123	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	16	7	—	—	$29,896.98	$109,899.76	$109,899.76	2026-05-13
5911	OTHER	Neonate Birthwt 500-749g Without Major Procedure	16	7	—	—	$15,737.43	$109,627.95	$109,627.95	2026-05-13
MS-216	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	16	11	—	—	$78,772.01	$193,865.75	$108,987.15	2026-05-13
2004	OTHER	Cardiac Structural And Valvular Disorders	16	7	—	—	$19,720.68	$107,954.58	$107,954.58	2026-05-13
6072	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	16	7	—	—	$21,102.65	$104,674.53	$104,674.53	2026-05-13
1694	OTHER	Major Abdominal Vascular Procedures	16	7	—	—	$30,666.94	$104,651.81	$104,651.81	2026-05-13
104	OTHER	Head Trauma With Deep Coma	1	1	—	—	$104,064.07	$104,064.07	$104,064.07	2026-05-13
1814	OTHER	Lower Extremity Vascular Procedures	16	7	—	—	$27,029.83	$103,777.96	$103,777.96	2026-05-13
1304	OTHER	Respiratory System Diagnosis With Ventilator Support > 96 Hours	16	7	—	—	$26,067.51	$102,054.57	$102,054.57	2026-05-13
7104	OTHER	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	16	7	—	—	$19,777.50	$101,277.72	$101,277.72	2026-05-13
3032	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	16	7	—	—	$24,564.60	$101,038.94	$101,038.94	2026-05-13
2304	OTHER	Major Small Bowel Procedures	16	7	—	—	$26,644.07	$100,576.91	$100,576.91	2026-05-13
MS-429	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	16	11	—	—	$72,604.31	$178,543.24	$100,451.71	2026-05-13
6224	OTHER	Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond	16	7	—	—	$28,120.91	$98,064.99	$98,064.99	2026-05-13
1664	OTHER	Coronary Bypass Without Ami Or Complex Principal Diagnosis	16	7	—	—	$33,411.06	$97,549.52	$97,549.52	2026-05-13
6084	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	16	7	—	—	$25,654.64	$97,374.00	$97,374.00	2026-05-13
2204	OTHER	Major Stomach, Esophageal And Duodenal Procedures	16	7	—	—	$26,392.80	$97,069.40	$97,069.40	2026-05-13
3214	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	16	7	—	—	$23,587.16	$97,040.10	$97,040.10	2026-05-13
6083	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	16	7	—	—	$22,220.83	$96,948.30	$96,948.30	2026-05-13
3213	OTHER	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	16	7	—	—	$20,477.09	$96,872.40	$96,872.40	2026-05-13
6303	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	16	7	—	—	$48,672.85	$96,758.04	$96,758.04	2026-05-13
6302	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	16	7	—	—	$30,026.78	$96,758.04	$96,758.04	2026-05-13
6301	OTHER	Neonate Birthwt >2499g W Major Cardiovascular Procedure	16	7	—	—	$15,706.15	$96,758.04	$96,758.04	2026-05-13
102	OTHER	Head Trauma With Deep Coma	1	1	—	—	$96,681.47	$96,681.47	$96,681.47	2026-05-13
103	OTHER	Head Trauma With Deep Coma	1	1	—	—	$96,681.47	$96,681.47	$96,681.47	2026-05-13
101	OTHER	Head Trauma With Deep Coma	1	1	—	—	$96,681.47	$96,681.47	$96,681.47	2026-05-13
MS-850	OTHER	Acute Leukemia With Other Procedures	16	11	—	—	$69,811.62	$171,605.31	$96,586.93	2026-05-13
6904	OTHER	Acute Leukemia	16	7	—	—	$34,766.44	$95,802.54	$95,802.54	2026-05-13
6903	OTHER	Acute Leukemia	16	7	—	—	$26,718.61	$95,802.54	$95,802.54	2026-05-13
6113	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	16	7	—	—	$17,080.30	$94,985.80	$94,985.80	2026-05-13
3043	OTHER	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	16	7	—	—	$23,698.20	$94,520.97	$94,520.97	2026-05-13
MS-231	OTHER	Coronary Bypass With Ptca With Mcc	16	11	—	—	$67,980.13	$167,055.33	$94,052.34	2026-05-13
MS-456	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	16	11	—	—	$67,768.75	$166,530.18	$93,759.80	2026-05-13
6021	OTHER	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	16	7	—	—	$26,594.02	$95,180.70	$93,687.08	2026-05-13
7114	OTHER	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	16	7	—	—	$23,030.93	$93,332.37	$93,332.37	2026-05-13
9514	OTHER	Moderately Extensive Procedure Unrelated To Principal Diagnosis	16	7	—	—	$20,949.38	$93,047.62	$93,047.62	2026-05-13
52	OTHER	Tracheostomy With Mv >96 Hours Without Extensive Procedure	16	7	—	—	$24,404.56	$92,323.37	$92,323.37	2026-05-13
1204	OTHER	Major Respiratory And Chest Procedures	16	7	—	—	$28,463.40	$92,232.30	$92,232.30	2026-05-13
3031	OTHER	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	16	7	—	—	$22,670.72	$98,772.21	$90,448.37	2026-05-13
1783	OTHER	External Heart Assist Systems	15	7	—	—	$28,863.24	$90,339.64	$90,339.64	2026-05-13
2992	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	15	7	—	—	$20,812.28	$90,231.60	$90,231.60	2026-05-13
234	OTHER	Spinal Procedures	16	7	—	—	$26,125.89	$90,204.57	$90,204.57	2026-05-13
1623	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	16	7	—	—	$37,035.14	$89,298.56	$89,298.56	2026-05-13
92	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	16	7	—	—	$47,840.12	$132,078.56	$88,620.13	2026-05-13
91	OTHER	Extracorporeal Membrane Oxygenation (ecmo)	16	7	—	—	$34,388.50	$132,078.56	$88,491.13	2026-05-13
J7330	OTHER	Cultured Chondrocytes Implnt	1	1	—	—	$87,964.25	$87,964.25	$87,964.25	2026-05-13
MS-020	OTHER	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	16	11	—	—	$63,504.32	$155,936.01	$87,858.29	2026-05-13
1653	OTHER	Coronary Bypass With Ami Or Complex Principal Diagnosis	16	7	—	—	$29,357.43	$87,793.50	$87,793.50	2026-05-13
304	OTHER	Percutaneous Intracranial And Extracranial Vascular Procedures	15	7	—	—	$22,301.64	$87,568.42	$87,568.42	2026-05-13
9304	OTHER	Multiple Significant Trauma Without O.r. Procedure	16	7	—	—	$13,970.74	$85,912.30	$85,912.30	2026-05-13
MS-219	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	16	11	—	—	$61,984.76	$152,160.87	$85,755.38	2026-05-13
1794	OTHER	Defibrillator Implants	15	7	—	—	$29,719.21	$85,673.79	$85,673.79	2026-05-13
894	OTHER	Major Cranial/facial Bone Procedures	16	7	—	—	$29,663.43	$85,568.88	$85,568.88	2026-05-13
MS-233	OTHER	Coronary Bypass With Cardiac Catheterization With Mcc	16	11	—	—	$61,720.71	$151,504.93	$85,389.96	2026-05-13
MS-957	OTHER	Other O.r. Procedures For Multiple Significant Trauma With Mcc	16	11	—	—	$61,518.91	$151,003.56	$85,110.70	2026-05-13
274	OTHER	Other Open Craniotomy	16	8	—	—	$80.00	$84,403.30	$84,403.30	2026-05-13
8424	OTHER	Burns With Skin Graft Except Extensive Third Degree Burns	2	2	—	—	$84,402.02	$84,402.02	$84,402.02	2026-05-13
7924	OTHER	Extensive Or Procedures For Other Complications Of Treatment	16	7	—	—	$27,675.20	$83,239.52	$83,239.52	2026-05-13
4054	OTHER	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	16	7	—	—	$25,812.59	$80,814.58	$80,814.58	2026-05-13
MS-427	OTHER	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	16	11	—	—	$58,317.80	$143,051.00	$80,680.70	2026-05-13
82	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	16	7	—	—	$24,792.93	$80,603.23	$80,603.23	2026-05-13
81	OTHER	Autologous Bone Marrow Transplant Or T-cell Immunotherapy	16	7	—	—	$19,755.09	$80,551.63	$80,551.63	2026-05-13
MS-010	OTHER	Pancreas Transplant	16	11	—	—	$57,975.59	$142,200.85	$80,207.11	2026-05-13
MS-928	OTHER	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	16	11	—	—	$57,951.66	$142,141.40	$80,174.01	2026-05-13
6313	OTHER	Neonate Birthwt >2499g W Other Major Procedure	16	7	—	—	$41,806.08	$79,950.34	$79,950.34	2026-05-13
MS-019	OTHER	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	16	11	—	—	$57,647.73	$141,386.37	$79,753.40	2026-05-13
MS-275	OTHER	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	16	11	—	—	$57,614.24	$141,303.14	$79,707.04	2026-05-13
6902	OTHER	Acute Leukemia	16	7	—	—	$17,575.53	$79,314.45	$79,314.45	2026-05-13
4414	OTHER	Major Bladder Procedures	16	7	—	—	$29,593.06	$79,252.26	$79,252.26	2026-05-13
6144	OTHER	Neonate Bwt 1500-1999g W Or Without Other Significant Condition	16	7	—	—	$26,830.69	$78,591.47	$78,591.47	2026-05-13
1214	OTHER	Other Respiratory And Chest Procedures	16	7	—	—	$23,536.07	$78,448.14	$78,448.14	2026-05-13
213	OTHER	Open Craniotomy Except Trauma	16	7	—	—	$26,071.16	$78,298.23	$78,298.23	2026-05-13
4284	OTHER	Genetic Disorders	15	7	—	—	$24,751.22	$78,294.40	$78,294.40	2026-05-13
41	OTHER	Tracheostomy With Mv >96 Hours With Extensive Procedure	16	7	—	—	$28,838.74	$113,049.42	$78,058.12	2026-05-13
4474	OTHER	Other Kidney, Urinary Tract And Related Procedures	16	7	—	—	$20,601.68	$77,900.70	$77,900.70	2026-05-13
MS-870	OTHER	Septicemia Or Severe Sepsis With Mv >96 Hours	16	11	—	—	$55,870.50	$136,971.14	$77,293.89	2026-05-13
554	OTHER	Head Trauma With Coma > 1 Hour Or Hemorrhage	16	7	—	—	$13,885.25	$77,121.40	$77,121.40	2026-05-13
6143	OTHER	Neonate Bwt 1500-1999g W Or Without Other Significant Condition	16	7	—	—	$19,983.94	$76,940.27	$76,940.27	2026-05-13
1633	OTHER	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	16	7	—	—	$30,633.05	$76,935.52	$76,935.52	2026-05-13
MS-268	OTHER	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	16	11	—	—	$55,600.08	$136,299.34	$76,919.66	2026-05-13
2644	OTHER	Other Hepatobiliary, Pancreas And Abdominal Procedures	16	7	—	—	$24,462.95	$76,544.35	$76,544.35	2026-05-13
707201004	OTHER	Carmustine 7.7 Mg Implant Dev (per Box, Qty #8)	21	13	$104,632.00	$68,010.80 35% off	$20,926.40	$104,632.00	$76,381.36	2026-05-13
3124	OTHER	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	16	7	—	—	$30,820.20	$87,926.72	$76,239.22	2026-05-13
6223	OTHER	Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond	16	7	—	—	$19,031.00	$75,527.18	$75,527.18	2026-05-13
MS-955	OTHER	Craniotomy For Multiple Significant Trauma	16	11	—	—	$54,429.08	$133,390.21	$75,299.13	2026-05-13
3134	OTHER	Knee And Lower Leg Procedures Except Foot	16	7	—	—	$22,559.16	$75,266.96	$75,266.96	2026-05-13
MS-317	OTHER	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	16	11	—	—	$54,073.32	$132,506.37	$74,806.78	2026-05-13
MS-447	OTHER	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	16	11	—	—	$54,034.25	$132,409.27	$74,752.71	2026-05-13
3084	OTHER	Hip And Femur Fracture Repair	16	7	—	—	$21,702.66	$74,569.02	$74,569.02	2026-05-13
1833	OTHER	Percutaneous Structural Cardiac Procedures	15	7	—	—	$23,499.06	$74,455.37	$74,455.37	2026-05-13
4484	OTHER	Other Kidney, Urinary Tract And Related Percutaneous Procedures	15	7	—	—	$19,695.66	$74,022.53	$74,022.53	2026-05-13
1782	OTHER	External Heart Assist Systems	15	7	—	—	$23,604.36	$73,715.50	$73,715.50	2026-05-13
MS-217	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	16	11	—	—	$53,186.30	$130,302.72	$73,579.24	2026-05-13
MS-218	OTHER	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	16	11	—	—	$53,186.30	$130,302.72	$73,579.24	2026-05-13
5204	OTHER	Other GYN Procedures For Malignancy	15	7	—	—	$23,400.54	$73,420.43	$73,420.43	2026-05-13
MS-573	OTHER	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	16	11	—	—	$52,995.66	$129,829.09	$73,315.42	2026-05-13
625165124	OTHER	Plug Vascular Amplatzer Amulet 18mm	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625165284	OTHER	System Sapien 3 Ultra Resilia Thv 20cm	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625149934	OTHER	Stent Tag Conform Thoracic Sg Ac 26mmx26mmx10cm 20fr	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625149629	OTHER	Implant Autologous Cultured Chondrocytes Single	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625152171	OTHER	Generator Implantable Pulse	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625149292	OTHER	Valve Evolut Fx 29mm	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625150093	OTHER	Valve Heart Sapien Ultra 26mm (thv) W/commander System	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625149291	OTHER	Valve Evolut Fx 26mm	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625165119	OTHER	Plug Vascular Amplatzer Amulet 25mm	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625149950	OTHER	Stent Tag Conform Thoracic Sg Ac 37mmx37mmx10cm 22fr	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625151565	OTHER	Mitraclip G4 System	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625155997	OTHER	System Sapien 3 Ultra Resilia Thv 23mm	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625150092	OTHER	Valve Heart Sapien Ultra 23mm (thv) W/commander System	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625155999	OTHER	System Sapien 3 Ultra Resilia Thv 29mm	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625142101	OTHER	System Cardiomems Pa Sensor And Delivery	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625155998	OTHER	System Sapien 3 Ultra Resilia Thv 26mm	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625143680	OTHER	S-icd Emblem MRI	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625149893	OTHER	Device Impella Cp Smart Assit Cp C8 Optical	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625165123	OTHER	Plug Vascular Amplatzer Amulet 16mm	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
625149937	OTHER	Stent Tag Conform Thoracic Sg Ac 28mmx28mmx10cm 20fr	21	13	$99,999.00	$64,999.35 35% off	$19,999.80	$99,999.00	$72,999.27	2026-05-13
1622	OTHER	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	16	7	—	—	$30,855.13	$72,944.62	$72,944.62	2026-05-13
Q0480	OTHER	Driver Pneumatic Vad- Rep	30	11	—	—	$58,277.79	$206,581.72	$72,648.53	2026-05-13
MS-790	OTHER	Extreme Immaturity Or Respiratory Distress Syndrome- Neonate	17	12	—	—	$48,146.53	$117,782.34	$72,218.30	2026-05-13
MS-207	OTHER	Respiratory System Diagnosis With Ventilator Support >96 Hours	16	11	—	—	$52,064.75	$127,516.45	$72,027.13	2026-05-13
6082	OTHER	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	16	7	—	—	$15,522.13	$71,420.76	$71,420.76	2026-05-13
625157917	OTHER	Defibrilator Crt Hf MRI Df1 Cobalt Xt	21	13	$97,020.00	$63,063.00 35% off	$19,404.00	$97,020.00	$70,824.60	2026-05-13
625164211	OTHER	Defibrillator Cobalt Xt Hf Crt-d MRI Surescan Dual Chamber	21	13	$97,020.00	$63,063.00 35% off	$19,404.00	$97,020.00	$70,824.60	2026-05-13
625156339	OTHER	Defibrillator Cobalt Xt Hf Quad Crt-d MRI Surescan	21	13	$97,020.00	$63,063.00 35% off	$19,404.00	$97,020.00	$70,824.60	2026-05-13
1824	OTHER	Other Peripheral Vascular Procedures	16	7	—	—	$23,459.44	$70,195.10	$70,195.10	2026-05-13
6213	OTHER	Neonate Bwt 2000-2499g W Major Anomaly	16	7	—	—	$9,075.73	$70,070.79	$70,070.79	2026-05-13
4424	OTHER	Kidney And Urinary Tract Procedures For Malignancy	16	7	—	—	$25,532.13	$69,722.43	$69,722.43	2026-05-13
707270221	OTHER	Polatuzumab Vedotin-piiq 140 Mg/7 Ml Inj	21	13	$94,740.29	$61,581.19 35% off	$18,948.06	$94,740.29	$69,160.41	2026-05-13
6122	OTHER	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	16	7	—	—	$15,914.67	$69,137.09	$69,137.09	2026-05-13
6953	OTHER	Chemotherapy For Acute Leukemia	16	7	—	—	$16,118.50	$69,037.41	$69,037.41	2026-05-13
6032	OTHER	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	16	7	—	—	$26,101.91	$84,467.93	$68,755.81	2026-05-13
2064	OTHER	Malfunction,reaction,complication Of Cardiac/vasc Device Or Procedure	16	7	—	—	$12,831.18	$68,672.66	$68,672.66	2026-05-13
MS-266	OTHER	Endovascular Cardiac Valve Replacement W Mcc	16	11	—	—	$49,621.45	$121,446.50	$68,645.87	2026-05-13
MS-969	OTHER	HIV With Extensive O.r. Procedures With Mcc	16	11	—	—	$49,564.81	$121,305.80	$68,567.48	2026-05-13
625158259	OTHER	Wm Flx Pro Device Header	21	13	$93,500.00	$60,775.00 35% off	$18,700.00	$93,500.00	$68,255.00	2026-05-13
MS-232	OTHER	Coronary Bypass With Ptca Without Mcc	16	11	—	—	$49,096.57	$120,142.54	$67,919.50	2026-05-13
625150451	OTHER	Crt-d Gallant Hf	21	13	$92,565.00	$60,167.25 35% off	$18,513.00	$92,565.00	$67,572.45	2026-05-13
1793	OTHER	Defibrillator Implants	15	7	—	—	$22,764.55	$67,549.46	$67,549.46	2026-05-13
L8702	OTHER	Ewhf S/d Uprt Micro Sensor	16	10	—	—	$2,299.94	$128,160.05	$67,452.66	2026-05-13
MS-028	OTHER	Spinal Procedures With Mcc	16	11	—	—	$48,663.42	$119,066.48	$67,320.07	2026-05-13
MS-276	OTHER	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	16	11	—	—	$48,649.87	$119,032.79	$67,301.30	2026-05-13
707270224	OTHER	Ipilimumab 200 Mg/40 Ml Inj	21	13	$92,151.00	$59,898.15 35% off	$18,430.20	$92,151.00	$67,270.23	2026-05-13
625151535	OTHER	Crtd Cobalt Quad Hf MRI Is4 Df1	21	13	$91,630.00	$59,559.50 35% off	$18,326.00	$91,630.00	$66,889.90	2026-05-13
625144232	OTHER	Defibulator Claria MRI Crt-d Surescan Dtma1qq	21	13	$91,630.00	$59,559.50 35% off	$18,326.00	$91,630.00	$66,889.90	2026-05-13
MS-457	OTHER	Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex…	16	11	—	—	$48,302.89	$118,170.75	$66,821.12	2026-05-13
6071	OTHER	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	16	7	—	—	$15,085.80	$66,705.33	$66,705.33	2026-05-13
1673	OTHER	Other Cardiothoracic And Thoracic Vascular Procedures	16	7	—	—	$22,463.76	$66,541.14	$66,541.14	2026-05-13
MS-016	OTHER	Autologous Bone Marrow Transplant With Cc/mcc	16	11	—	—	$48,036.45	$117,508.86	$66,452.40	2026-05-13
233	OTHER	Spinal Procedures	16	7	—	—	$21,308.56	$66,407.89	$66,407.89	2026-05-13
2244	OTHER	Peritoneal Adhesiolysis	16	7	—	—	$25,454.98	$66,397.62	$66,397.62	2026-05-13
734	OTHER	Orbit And Eye Procedures	16	7	—	—	$21,650.01	$66,312.82	$66,312.82	2026-05-13
293	OTHER	Other Percutaneous Intracranial Procedures	15	7	—	—	$20,773.18	$66,238.49	$66,238.49	2026-05-13
1924	OTHER	Cardiac Catheterization For Other Non-coronary Conditions	16	7	—	—	$16,573.59	$66,086.72	$66,086.72	2026-05-13
1804	OTHER	Other Circulatory System Procedures	16	7	—	—	$19,186.87	$65,886.11	$65,886.11	2026-05-13
MS-235	OTHER	Coronary Bypass Without Cardiac Catheterization With Mcc	16	11	—	—	$47,549.06	$116,298.05	$65,777.90	2026-05-13
MS-820	OTHER	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	16	11	—	—	$47,518.76	$116,222.74	$65,735.96	2026-05-13
Q2043	OTHER	Sipuleucel-t Auto Cd54+	30	11	—	—	$29,625.96	$105,017.41	$65,732.65	2026-05-13
264	OTHER	Other Nervous System And Related Procedures	16	7	—	—	$17,621.40	$65,432.59	$65,432.59	2026-05-13
1603	OTHER	Major Cardiothoracic Repair Of Heart Anomaly	16	7	—	—	$47,961.59	$65,226.10	$65,226.10	2026-05-13
2294	OTHER	Other Digestive System And Abdominal Procedures	16	7	—	—	$17,596.38	$65,179.74	$65,179.74	2026-05-13
3054	OTHER	Amputation Of Lower Limb Except Toes	16	7	—	—	$18,662.96	$65,173.95	$65,173.95	2026-05-13
9123	OTHER	Musculoskeletal And Other Procedures For Multiple Significant Trauma	16	7	—	—	$20,666.32	$65,116.56	$65,116.56	2026-05-13
2804	OTHER	Alcoholic Liver Disease	16	7	—	—	$13,635.02	$65,080.29	$65,080.29	2026-05-13
6333	OTHER	Neonate Birthwt >2499g W Major Anomaly	16	7	—	—	$9,220.66	$64,851.31	$64,851.31	2026-05-13
MS-430	OTHER	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	16	11	—	—	$46,739.42	$114,286.62	$64,657.44	2026-05-13
6112	OTHER	Neonate Birthwt 1500-1999g W Major Anomaly	16	7	—	—	$13,583.41	$72,122.13	$64,275.23	2026-05-13
MS-023	OTHER	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	16	11	—	—	$46,445.87	$113,557.36	$64,251.20	2026-05-13
625150467	OTHER	Conduit Konect Resilia Aortic Valved 27mm	21	13	$88,000.00	$57,200.00 35% off	$17,600.00	$88,000.00	$64,240.00	2026-05-13
625150465	OTHER	Conduit Konect Resilia Aortic Valved 21mm	21	13	$88,000.00	$57,200.00 35% off	$17,600.00	$88,000.00	$64,240.00	2026-05-13

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