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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

NORTON-KING'S DAUGHTERS' HEALTH

Madison, IN · CCN 150069 · Rates published

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You selected 59510 (CPT)

This facility hasn’t published a payer-negotiated rate for this exact code. See its full rate list below.

12,885 distinct procedures filed
29 distinct payers
279,968 rate rows
2026-05-05 last MRF observed
Data quality

261,632 of 279,968 rate rows are consumer-grade (93.5%)

18,336 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
professional (physician) fee — not the facility price 17,353
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 514
placeholder amount (≤ $0.02) — excluded from medians 316
percent-of-charges filed in the dollar field — excluded from medians 126
exceeds 10× this hospital's gross charge — excluded from medians 19
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 6
template filing: same amount across many unrelated codes — excluded 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/10275/350895832-1518916048_norton-kings-daughters-health-inc_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/NortonKingsDaughtersHealth/10275
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-08-11
Content fingerprint a050685b070e2994… · 258,661,178 bytes · first seen 2026-05-14

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
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $3,710,000.00 $3,710,000.00 $3,710,000.00 nat. median
$3,685,267
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,710,000.00 $3,710,000.00 $3,710,000.00 nat. median
$3,508,750
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 2 $2,332,000.00 $4,664,000.00 $3,498,000.00 nat. median
$2,332,000
1.5× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 2 $3,321,781.51 $3,360,000.00 $3,340,890.75 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 1 $3,193,000.00 $3,193,000.00 $3,193,000.00 nat. median
$3,248,446
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 1 $2,968,000.00 $2,968,000.00 $2,968,000.00 nat. median
$2,968,000
1.0× median
Q2054
HCPCS 		Box 29 $511,851.30 $3,634,436.74 $2,773,649.09 nat. median
$579,571
outlier · 4.8×
Q2055
HCPCS 		Flex Cont 29 $523,328.35 $3,613,657.02 $2,757,790.88 nat. median
$574,037
outlier · 4.8×
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 3 $2,231,250.00 $4,806,917.50 $2,403,458.75 nat. median
$2,455,111
1.0× median
Q2053
HCPCS 		Flex Cont 29 $445,200.00 $2,278,100.00 $1,738,550.00 nat. median
$513,770
outlier · 3.4×
Q2041
HCPCS 		Package 29 $485,100.00 $2,278,100.00 $1,738,550.00 nat. median
$562,501
outlier · 3.1×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 2 $565,623.84 $1,131,247.68 $848,435.76 nat. median
$621,313
1.4× median
J2326
HCPCS 		Vial 29 $1,078.51 $1,000,684.88 $763,680.56 nat. median
$1,667
outlier · 458.2×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 3 $502,897.50 $1,102,636.68 $551,318.34 nat. median
$599,737
0.9× median
A9513
HCPCS 		Vial 29 $293.45 $458,583.47 $349,971.59 nat. median
$550
outlier · 635.8×
Q2043
HCPCS 		Flex Cont 29 $52,000.34 $428,201.10 $326,785.05 nat. median
$63,499
outlier · 5.1×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 $289,278.75 $775,903.15 $321,420.83 nat. median
$168,055
1.9× median
J9043
HCPCS 		Vial 29 $191.90 $402,735.10 $307,350.47 nat. median
$509
outlier · 603.8×
J9226
HCPCS 		Box 29 $45,261.80 $343,242.26 $261,948.04 nat. median
$57,036
outlier · 4.6×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 15 $216,222.65 $579,534.60 $240,247.39 nat. median
$186,516
1.3× median
J0223
HCPCS 		Vial 29 $105.79 $300,234.96 $229,126.68 nat. median
$127
outlier · 1804.7×
J1823
HCPCS 		Vial 29 $445.88 $298,680.00 $227,940.00 nat. median
$562
outlier · 405.4×
C9293
HCPCS 		Vial 29 $74,706.62 $295,713.72 $225,676.26 nat. median
$57,284
outlier · 3.9×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 15 $182,195.63 $488,072.89 $202,439.59 nat. median
$131,925
1.5× median
J9359
HCPCS 		Vial 29 $182.04 $264,751.47 $202,047.17 nat. median
$292
outlier · 691.1×
J0567
HCPCS 		Box 29 $111.93 $245,378.16 $187,262.28 nat. median
$245
outlier · 765.7×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 15 $164,658.19 $440,933.74 $182,953.54 nat. median
$145,435
1.3× median
J9269
HCPCS 		Vial 29 $308.25 $230,895.49 $176,209.71 nat. median
$544
outlier · 324.1×
J9229
HCPCS 		Vial 29 $2,386.69 $222,475.71 $169,784.10 nat. median
$4,856
outlier · 35.0×
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 2 $111,860.00 $223,720.00 $167,790.00 nat. median
$95,583
1.8× median
J2507
HCPCS 		Vial 29 $3,077.72 $210,282.06 $160,478.42 nat. median
$4,390
outlier · 36.6×
J2327
HCPCS 		Syringe 29 $15.08 $204,137.44 $155,789.10 nat. median
$48
outlier · 3247.3×
J0202
HCPCS 		Vial 29 $2,162.53 $203,450.62 $155,264.95 nat. median
$3,427
outlier · 45.3×
J9266
HCPCS 		Vial 29 $22,711.73 $188,001.05 $143,474.48 nat. median
$31,084
outlier · 4.6×
J9281
HCPCS 		Box 29 $279.65 $174,043.80 $132,822.90 nat. median
$403
outlier · 329.8×
J9600
HCPCS 		Vial 29 $21,664.64 $159,529.32 $121,746.06 nat. median
$26,416
outlier · 4.6×
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 2 $80,943.19 $161,886.38 $121,414.79 nat. median
$68,802
1.8× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 15 $108,769.83 $290,710.62 $120,855.37 nat. median
$97,418
1.2× median
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 3 $120,746.59 $120,746.59 $120,746.59 nat. median
$286,698
outlier · 0.4×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 15 $100,899.71 $269,556.43 $112,110.79 nat. median
$72,715
1.5× median
7
MS_DRG 		Lung Transplant 15 $100,647.12 $268,877.49 $111,830.13 nat. median
$70,649
1.6× median
J0638
HCPCS 		Vial 29 $115.17 $146,268.95 $111,626.30 nat. median
$235
outlier · 475.4×
J1246
HCPCS 		Vial 29 $36,172.12 $143,181.32 $109,269.96 nat. median
$24,768
outlier · 4.4×
J9309
HCPCS 		Vial 29 $113.78 $134,940.15 $102,980.64 nat. median
$399
outlier · 258.3×
24
APR_DRG 		Heart &/or Lung Transplant 3 $102,876.88 $102,876.88 $102,876.88 nat. median
$225,531
outlier · 0.5×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 3 $72,648.53 $199,999.98 $99,999.99 nat. median
$108,243
0.9× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 3 $98,189.67 $98,189.67 $98,189.67 nat. median
$202,242
outlier · 0.5×
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 2 $63,402.04 $126,804.08 $95,103.06 nat. median
$66,211
1.4× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 $84,962.78 $226,719.31 $94,403.09 nat. median
$65,418
1.4× median
J3241
HCPCS 		Vial 29 $310.07 $123,249.62 $94,058.92 nat. median
$709
outlier · 132.7×

Other procedures at this hospital

Browse this hospital's 12,885 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
             
J1414 HCPCS Inj, Beqvez, Per Tx Dose 1 1 — — $3,710,000.00 $3,710,000.00 $3,710,000.00 2026-05-05
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 1 1 — — $3,710,000.00 $3,710,000.00 $3,710,000.00 2026-05-05
J3392 HCPCS Inj, Exagamglogene Autotem 2 2 — — $2,332,000.00 $4,664,000.00 $3,498,000.00 2026-05-05
J1413 HCPCS Inj Delandistrogene Mox Rokl 2 2 — — $3,321,781.51 $3,360,000.00 $3,340,890.75 2026-05-05
J3394 HCPCS Inj, Lovotibeglogene Autotem 1 1 — — $3,193,000.00 $3,193,000.00 $3,193,000.00 2026-05-05
J3393 HCPCS Inj, Betibeglogene Autotemce 1 1 — — $2,968,000.00 $2,968,000.00 $2,968,000.00 2026-05-05
Q2054 HCPCS Box 50 29 $3,825,722.88 $841,659.04 78% off $511,851.30 $3,634,436.74 $2,773,649.09 2026-05-05
Q2055 HCPCS Flex Cont 50 29 $3,803,849.50 $836,846.89 78% off $523,328.35 $3,613,657.02 $2,757,790.88 2026-05-05
J3399 HCPCS Inj Onase Abepar-xioi Treat 3 3 — — $2,231,250.00 $4,806,917.50 $2,403,458.75 2026-05-05
Q2041 HCPCS Package 50 29 $2,398,000.00 $527,560.00 78% off $485,100.00 $2,278,100.00 $1,738,550.00 2026-05-05
Q2053 HCPCS Flex Cont 50 29 $2,398,000.00 $527,560.00 78% off $445,200.00 $2,278,100.00 $1,738,550.00 2026-05-05
Q2042 HCPCS Tisagenlecleucel Car-pos T 2 2 — — $565,623.84 $1,131,247.68 $848,435.76 2026-05-05
J2326 HCPCS Vial 55 29 $1,053,352.50 $231,737.55 78% off $1,078.51 $1,000,684.88 $763,680.56 2026-05-05
Q2056 HCPCS Ciltacabtagene Car-pos T 3 3 — — $502,897.50 $1,102,636.68 $551,318.34 2026-05-05
A9513 HCPCS Vial 38 29 $482,719.44 $106,198.28 78% off $293.45 $458,583.47 $349,971.59 2026-05-05
Q2043 HCPCS Flex Cont 55 29 $450,738.00 $99,162.36 78% off $52,000.34 $428,201.10 $326,785.05 2026-05-05
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 17 15 — — $289,278.75 $775,903.15 $321,420.83 2026-05-05
J9043 HCPCS Vial 55 29 $423,931.68 $93,264.97 78% off $191.90 $402,735.10 $307,350.47 2026-05-05
J9226 HCPCS Box 50 29 $361,307.64 $79,487.69 78% off $45,261.80 $343,242.26 $261,948.04 2026-05-05
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 17 15 — — $216,222.65 $579,534.60 $240,247.39 2026-05-05
J0223 HCPCS Vial 55 29 $316,036.80 $69,528.10 78% off $105.79 $300,234.96 $229,126.68 2026-05-05
J1823 HCPCS Vial 55 29 $314,400.00 $69,168.00 78% off $445.88 $298,680.00 $227,940.00 2026-05-05
C9293 HCPCS Vial 38 29 $311,277.60 $68,481.08 78% off $74,706.62 $295,713.72 $225,676.26 2026-05-05
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 17 15 — — $182,195.63 $488,072.89 $202,439.59 2026-05-05
J9359 HCPCS Vial 55 29 $278,685.76 $61,310.87 78% off $182.04 $264,751.47 $202,047.17 2026-05-05
J0567 HCPCS Box 41 29 $258,292.80 $56,824.42 78% off $111.93 $245,378.16 $187,262.28 2026-05-05
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 17 15 — — $164,658.19 $440,933.74 $182,953.54 2026-05-05
J9269 HCPCS Vial 55 29 $243,047.88 $53,470.54 78% off $308.25 $230,895.49 $176,209.71 2026-05-05
J9229 HCPCS Vial 55 29 $234,184.96 $51,520.70 78% off $2,386.69 $222,475.71 $169,784.10 2026-05-05
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 2 2 — — $111,860.00 $223,720.00 $167,790.00 2026-05-05
J2507 HCPCS Vial 55 29 $221,349.54 $48,696.90 78% off $3,077.72 $210,282.06 $160,478.42 2026-05-05
J2327 HCPCS Syringe 56 29 $214,881.52 $47,273.94 78% off $15.08 $204,137.44 $155,789.10 2026-05-05
J0202 HCPCS Vial 55 29 $214,158.54 $47,114.88 78% off $2,162.53 $203,450.62 $155,264.95 2026-05-05
J9266 HCPCS Vial 55 29 $197,895.84 $43,537.09 78% off $22,711.73 $188,001.05 $143,474.48 2026-05-05
J9281 HCPCS Box 55 29 $183,204.00 $40,304.88 78% off $279.65 $174,043.80 $132,822.90 2026-05-05
J9600 HCPCS Vial 52 29 $167,925.60 $36,943.64 78% off $21,664.64 $159,529.32 $121,746.06 2026-05-05
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 2 2 — — $80,943.19 $161,886.38 $121,414.79 2026-05-05
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 17 15 — — $108,769.83 $290,710.62 $120,855.37 2026-05-05
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 3 3 — — $120,746.59 $120,746.59 $120,746.59 2026-05-05
14 MS_DRG Allogeneic Bone Marrow Transplant 17 15 — — $100,899.71 $269,556.43 $112,110.79 2026-05-05
7 MS_DRG Lung Transplant 17 15 — — $100,647.12 $268,877.49 $111,830.13 2026-05-05
J0638 HCPCS Vial 55 29 $153,967.32 $33,872.82 78% off $115.17 $146,268.95 $111,626.30 2026-05-05
J1246 HCPCS Vial 38 29 $150,717.18 $33,157.78 78% off $36,172.12 $143,181.32 $109,269.96 2026-05-05
J9309 HCPCS Vial 55 29 $142,042.26 $31,249.30 78% off $113.78 $134,940.15 $102,980.64 2026-05-05
24 APR_DRG Heart &/or Lung Transplant 3 3 — — $102,876.88 $102,876.88 $102,876.88 2026-05-05
Q0480 HCPCS Driver Pneumatic Vad, Rep 3 3 — — $72,648.53 $199,999.98 $99,999.99 2026-05-05
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 3 3 — — $98,189.67 $98,189.67 $98,189.67 2026-05-05
J9029 HCPCS Instill Adstiladrin, Tx Dose 2 2 — — $63,402.04 $126,804.08 $95,103.06 2026-05-05
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 17 15 — — $84,962.78 $226,719.31 $94,403.09 2026-05-05
J3241 HCPCS Vial 55 29 $129,736.44 $28,542.02 78% off $310.07 $123,249.62 $94,058.92 2026-05-05
J3245 HCPCS Syringe 55 29 $129,322.38 $28,450.93 78% off $132.39 $122,856.26 $93,758.73 2026-05-05
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 17 15 — — $83,999.87 $224,131.10 $93,333.19 2026-05-05
38240 CPT Transplt Allo Hct/donor 2 2 — — $61,956.32 $123,912.64 $92,934.48 2026-05-05
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 17 15 — — $82,128.39 $219,100.76 $91,253.77 2026-05-05
215 MS_DRG Other Heart Assist System Implant 17 15 — — $81,710.48 $217,977.42 $90,789.42 2026-05-05
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 15 — — $80,796.56 $215,520.88 $89,773.95 2026-05-05
J7205 HCPCS Vial 52 29 $120,600.00 $26,532.00 78% off $2.06 $114,570.00 $87,435.00 2026-05-05
J9272 HCPCS Vial 55 29 $117,800.48 $25,916.11 78% off $215.75 $111,910.46 $85,405.35 2026-05-05
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 15 — — $74,487.16 $198,561.73 $82,763.51 2026-05-05
J3357 HCPCS Syringe 71 29 $110,192.64 $24,242.39 78% off $149.31 $209,365.79 $79,889.66 2026-05-05
850 MS_DRG Acute Leukemia With Other Procedures 17 15 — — $71,125.40 $189,525.63 $79,028.22 2026-05-05
14 APR_DRG Liver Transplant &/or Intestinal Transplant 3 3 — — $74,753.59 $74,753.59 $74,753.59 2026-05-05
C1882 HCPCS Hb Icd Unify Crt-d 40 Cd323140q 55 29 $103,017.00 $22,663.74 78% off $21,716.64 $97,866.15 $74,687.32 2026-05-05
90288 CPT Vial 38 29 $102,600.00 $22,572.00 78% off $24,624.00 $97,470.00 $74,385.00 2026-05-05
231 MS_DRG Coronary Bypass With Ptca With Mcc 17 15 — — $65,476.56 $174,342.02 $72,751.73 2026-05-05
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 17 15 — — $65,440.58 $174,245.32 $72,711.76 2026-05-05
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 17 15 — — $64,456.24 $171,599.50 $71,618.04 2026-05-05
74 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $71,287.16 $71,287.16 $71,287.16 2026-05-05
33276 CPT Insj Phrnc Nrv Stim Sys 2 2 — — $47,141.62 $94,283.25 $70,712.43 2026-05-05
0266T CPT Apc 2 2 — — $47,141.62 $94,283.25 $70,712.43 2026-05-05
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 3 3 — — $70,199.98 $70,199.98 $70,199.98 2026-05-05
J2562 HCPCS Vial 55 29 $95,693.44 $21,052.56 78% off $21.87 $90,908.77 $69,377.74 2026-05-05
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 17 15 — — $62,316.89 $165,849.07 $69,240.99 2026-05-05
5914 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 3 3 — — $69,213.62 $69,213.62 $69,213.62 2026-05-05
10 MS_DRG Pancreas Transplant 17 15 — — $61,642.53 $164,036.50 $68,491.70 2026-05-05
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 17 15 — — $61,292.74 $163,096.27 $68,103.04 2026-05-05
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 17 15 — — $60,443.87 $160,814.61 $67,159.86 2026-05-05
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 3 3 — — $66,516.63 $66,516.63 $66,516.63 2026-05-05
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 15 — — $59,839.96 $159,191.33 $66,488.84 2026-05-05
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $66,418.38 $66,418.38 $66,418.38 2026-05-05
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 17 15 — — $57,748.05 $153,568.45 $64,164.50 2026-05-05
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 3 3 — — $63,940.65 $63,940.65 $63,940.65 2026-05-05
J9022 HCPCS Vial 71 29 $85,946.76 $18,908.29 78% off $77.83 $81,649.42 $62,311.40 2026-05-05
L8701 HCPCS Ewh S/d Uprt Micro Sensor 2 2 — — $41,141.33 $82,282.66 $61,712.00 2026-05-05
J9037 HCPCS Vial 55 29 $84,734.08 $18,641.50 78% off $41.73 $80,497.38 $61,432.21 2026-05-05
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 15 — — $54,981.03 $146,130.95 $61,090.03 2026-05-05
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 17 15 — — $54,707.77 $145,396.46 $60,786.41 2026-05-05
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 17 15 — — $53,861.98 $143,123.03 $59,846.64 2026-05-05
23 APR_DRG Heart &/or Lung Transplant 3 3 — — $59,674.83 $59,674.83 $59,674.83 2026-05-05
J1640 HCPCS Vial 55 29 $82,275.54 $18,100.62 78% off $27.97 $78,161.76 $59,649.76 2026-05-05
J9119 HCPCS Vial 55 29 $81,609.49 $17,954.09 78% off $26.23 $77,529.01 $59,166.88 2026-05-05
22 APR_DRG Heart &/or Lung Transplant 3 3 — — $58,793.28 $58,793.28 $58,793.28 2026-05-05
955 MS_DRG Craniotomy For Multiple Significant Trauma 17 15 — — $52,880.71 $140,485.44 $58,756.34 2026-05-05
21 APR_DRG Heart &/or Lung Transplant 3 3 — — $58,487.68 $58,487.68 $58,487.68 2026-05-05
5833 APR_DRG Neonate W Ecmo 3 3 — — $58,293.94 $58,293.94 $58,293.94 2026-05-05
5834 APR_DRG Neonate W Ecmo 3 3 — — $58,293.94 $58,293.94 $58,293.94 2026-05-05
5832 APR_DRG Neonate W Ecmo 3 3 — — $58,293.94 $58,293.94 $58,293.94 2026-05-05
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 17 15 — — $51,934.64 $137,942.50 $57,705.15 2026-05-05
L7181 HCPCS Electronic Elbo Simultaneous 3 3 — — $37,858.44 $115,229.02 $57,614.51 2026-05-05
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 17 15 — — $51,737.16 $137,411.69 $57,485.73 2026-05-05
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 17 15 — — $51,650.66 $137,179.20 $57,389.62 2026-05-05
J9153 HCPCS Vial 55 29 $79,056.00 $17,392.32 78% off $211.02 $75,103.20 $57,315.60 2026-05-05
A9543 HCPCS Y90 Ibritumomab, Rx 3 3 — — $12,505.30 $113,649.10 $56,824.55 2026-05-05
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 3 3 — — $55,725.09 $55,725.09 $55,725.09 2026-05-05
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 17 15 — — $50,116.75 $133,056.17 $55,685.28 2026-05-05
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 15 — — $50,045.57 $132,864.83 $55,606.19 2026-05-05
5831 APR_DRG Neonate W Ecmo 3 3 — — $55,484.74 $55,484.74 $55,484.74 2026-05-05
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 3 3 — — $55,222.91 $55,222.91 $55,222.91 2026-05-05
J9144 HCPCS Vial 55 29 $76,117.41 $16,745.84 78% off $45.07 $72,311.54 $55,185.12 2026-05-05
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 2 2 — — $36,665.82 $73,331.65 $54,998.74 2026-05-05
J9203 HCPCS Vial 52 29 $75,611.16 $16,634.46 78% off $209.45 $71,830.60 $54,818.09 2026-05-05
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 17 15 — — $49,022.96 $130,116.15 $54,469.95 2026-05-05
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 3 3 — — $54,408.64 $54,408.64 $54,408.64 2026-05-05
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 3 3 — — $54,408.64 $54,408.64 $54,408.64 2026-05-05
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 3 3 — — $53,686.70 $53,686.70 $53,686.70 2026-05-05
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 17 15 — — $48,028.67 $127,443.59 $53,365.19 2026-05-05
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 17 15 — — $47,967.43 $127,278.99 $53,297.14 2026-05-05
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 17 15 — — $47,751.58 $126,698.81 $53,057.31 2026-05-05
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 17 15 — — $47,587.01 $126,256.47 $52,874.46 2026-05-05
J3380 HCPCS Vial 55 29 $72,782.64 $16,012.19 78% off $20.90 $69,143.51 $52,767.42 2026-05-05
232 MS_DRG Coronary Bypass With Ptca Without Mcc 17 15 — — $47,372.69 $125,680.39 $52,636.32 2026-05-05
28 MS_DRG Spinal Procedures With Mcc 17 15 — — $47,149.20 $125,079.63 $52,388.00 2026-05-05
L7180 HCPCS Electronic Elbow Sequential 3 3 — — $25,912.94 $104,555.80 $52,277.90 2026-05-05
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 17 15 — — $46,815.46 $124,182.61 $52,017.18 2026-05-05
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 17 15 — — $46,815.46 $124,182.61 $52,017.18 2026-05-05
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 17 15 — — $46,470.25 $123,254.72 $51,633.61 2026-05-05
6114 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 3 3 — — $51,442.32 $51,442.32 $51,442.32 2026-05-05
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 3 3 — — $51,405.78 $51,405.78 $51,405.78 2026-05-05
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 15 — — $46,152.60 $122,400.90 $51,280.67 2026-05-05
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 17 15 — — $46,118.16 $122,308.32 $51,242.40 2026-05-05
J0222 HCPCS Vial 55 29 $70,452.00 $15,499.44 78% off $97.05 $66,929.40 $51,077.70 2026-05-05
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 17 15 — — $45,654.32 $121,061.53 $50,727.02 2026-05-05
J9316 HCPCS Vial 71 29 $69,802.56 $15,356.57 78% off $63.88 $99,472.50 $50,606.86 2026-05-05
C1721 HCPCS Hb Icd Evera MRI Xt Df1 Ddmb1d1 55 29 $69,752.00 $15,345.44 78% off $14,504.40 $66,264.40 $50,570.20 2026-05-05
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 2 2 — — $33,587.07 $67,174.14 $50,380.60 2026-05-05
33270 CPT Ins/rep Subq Defibrillator 2 2 — — $33,587.07 $67,174.14 $50,380.60 2026-05-05
33249 CPT Insj/rplcmt Defib W/lead(s) 2 2 — — $33,587.07 $67,174.14 $50,380.60 2026-05-05
33231 CPT Insrt Pulse Gen W/mult Leads 2 2 — — $33,587.07 $67,174.14 $50,380.60 2026-05-05
0915T CPT Insj Perm Ccm-d Sys Pg&eltrd 2 2 — — $33,587.07 $67,174.14 $50,380.60 2026-05-05
0408T CPT Insj/rplc Cardiac Modulj Sys 2 2 — — $33,587.07 $67,174.14 $50,380.60 2026-05-05
0571T CPT Insj/rplcmt Icds Ss Eltrd 2 2 — — $33,587.07 $67,174.14 $50,380.60 2026-05-05
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 17 15 — — $45,180.51 $119,788.00 $50,200.57 2026-05-05
69930 CPT Implant Cochlear Device 2 2 — — $33,321.24 $66,642.47 $49,981.85 2026-05-05
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 17 15 — — $44,545.98 $118,082.42 $49,495.53 2026-05-05
J9301 HCPCS Vial 55 29 $68,042.16 $14,969.28 78% off $64.49 $64,640.05 $49,330.57 2026-05-05
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 17 15 — — $44,283.43 $117,376.73 $49,203.81 2026-05-05
Q4130 HCPCS Hb Graft Strattice 20x20 2020002 41 29 $67,541.00 $14,859.02 78% off $48.68 $64,163.95 $48,967.22 2026-05-05
L8619 HCPCS Hb Kit Processor Sonnet 2 S2200 55 29 $67,465.00 $14,842.30 78% off $6,045.36 $64,091.75 $48,912.12 2026-05-05
J9228 HCPCS Vial 71 29 $66,498.00 $14,629.56 78% off $159.69 $252,691.94 $48,211.05 2026-05-05
653 MS_DRG Major Bladder Procedures With Mcc 17 15 — — $43,284.56 $114,691.82 $48,093.95 2026-05-05
61886 CPT Implant Neurostim Arrays 2 2 — — $31,923.52 $63,847.05 $47,885.29 2026-05-05
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 2 2 — — $31,923.52 $63,847.05 $47,885.29 2026-05-05
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 2 2 — — $31,923.52 $63,847.05 $47,885.29 2026-05-05
63685 CPT Ins/rplc Spi Npg/rcvr Pocket 2 2 — — $31,923.52 $63,847.05 $47,885.29 2026-05-05
64568 CPT Opn Impltj Crnl Nrv Nea&pg 2 2 — — $31,923.52 $63,847.05 $47,885.29 2026-05-05
0268T CPT Apc 2 2 — — $31,923.52 $63,847.05 $47,885.29 2026-05-05
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 2 2 — — $31,923.52 $63,847.05 $47,885.29 2026-05-05
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 17 15 — — $42,922.50 $113,718.67 $47,691.67 2026-05-05
834 MS_DRG Acute Leukemia With Mcc 17 15 — — $42,922.50 $113,718.67 $47,691.67 2026-05-05
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 15 — — $42,744.92 $113,241.35 $47,494.36 2026-05-05
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 3 3 — — $47,352.45 $47,352.45 $47,352.45 2026-05-05
64 APR_DRG Pancreas Transplant 3 3 — — $47,243.73 $47,243.73 $47,243.73 2026-05-05
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 17 15 — — $42,487.75 $112,550.07 $47,208.61 2026-05-05
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 17 15 — — $42,262.71 $111,945.19 $46,958.57 2026-05-05
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 17 15 — — $42,167.80 $111,690.07 $46,853.11 2026-05-05
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 17 15 — — $41,955.78 $111,120.17 $46,617.53 2026-05-05
J9042 HCPCS Vial 55 29 $64,286.40 $14,143.01 78% off $205.81 $61,072.08 $46,607.64 2026-05-05
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 17 15 — — $41,916.74 $111,015.25 $46,574.15 2026-05-05
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 17 15 — — $41,912.15 $111,002.90 $46,569.05 2026-05-05
C9047 HCPCS Box 46 29 $64,184.76 $14,120.65 78% off $692.27 $60,975.52 $46,533.95 2026-05-05
J2323 HCPCS Vial 55 29 $63,930.33 $14,064.68 78% off $22.95 $60,733.81 $46,349.49 2026-05-05
54 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 3 3 — — $46,238.10 $46,238.10 $46,238.10 2026-05-05
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 3 3 — — $46,057.33 $46,057.33 $46,057.33 2026-05-05
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 17 15 — — $41,337.32 $109,457.79 $45,930.35 2026-05-05
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 15 — — $41,157.43 $108,974.31 $45,730.48 2026-05-05
Q3027 HCPCS Box 55 29 $62,192.16 $13,682.28 78% off $52.42 $59,082.55 $45,089.32 2026-05-05
33289 CPT Tcat Impl Wrls P-art Prs Snr 2 2 — — $29,780.95 $59,561.90 $44,671.43 2026-05-05
J3101 HCPCS Box 55 29 $61,532.52 $13,537.16 78% off $138.38 $58,455.89 $44,611.07 2026-05-05
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 17 15 — — $40,035.32 $105,958.16 $44,483.69 2026-05-05
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 17 15 — — $39,904.44 $105,606.34 $44,338.27 2026-05-05
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 3 3 — — $44,264.24 $44,264.24 $44,264.24 2026-05-05
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 17 15 — — $39,610.51 $104,816.30 $44,011.68 2026-05-05
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 17 15 — — $39,491.10 $104,495.35 $43,879.00 2026-05-05
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 17 15 — — $39,168.86 $103,629.18 $43,520.96 2026-05-05
71 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $43,327.01 $43,327.01 $43,327.01 2026-05-05
73 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $43,327.01 $43,327.01 $43,327.01 2026-05-05
72 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $43,327.01 $43,327.01 $43,327.01 2026-05-05
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 17 15 — — $38,941.53 $103,018.13 $43,268.37 2026-05-05
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 17 15 — — $38,911.69 $102,937.89 $43,235.21 2026-05-05
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 17 15 — — $38,896.37 $102,896.75 $43,218.19 2026-05-05
C9760 HCPCS Non-blind Interatrial Shunt 2 2 — — $28,808.97 $57,617.95 $43,213.46 2026-05-05
228 MS_DRG Other Cardiothoracic Procedures With Mcc 17 15 — — $38,758.59 $102,526.41 $43,065.10 2026-05-05
J9223 HCPCS Vial 55 29 $59,400.00 $13,068.00 78% off $179.15 $56,430.00 $43,065.00 2026-05-05
245 MS_DRG Aicd Generator Procedures 17 15 — — $38,019.95 $100,541.02 $42,244.39 2026-05-05
471 MS_DRG Cervical Spinal Fusion With Mcc 17 15 — — $37,794.16 $99,934.09 $41,993.51 2026-05-05
6 MS_DRG Liver Transplant Without Mcc 17 15 — — $37,732.15 $99,767.44 $41,924.61 2026-05-05
J2350 HCPCS Vial 71 29 $57,600.00 $12,672.00 78% off $57.46 $148,525.76 $41,760.00 2026-05-05
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 3 3 — — $41,722.68 $41,722.68 $41,722.68 2026-05-05
L8614 HCPCS Cochlear Device 2 2 — — $27,812.64 $55,625.28 $41,718.96 2026-05-05
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 17 15 — — $37,168.03 $98,251.14 $41,297.81 2026-05-05
799 MS_DRG Splenic Procedures With Mcc 17 15 — — $37,009.58 $97,825.26 $41,121.76 2026-05-05
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 17 15 — — $37,002.71 $97,806.74 $41,114.12 2026-05-05
J0180 HCPCS Vial 71 29 $56,357.76 $12,398.71 78% off $200.67 $53,539.87 $40,859.38 2026-05-05
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 17 15 — — $36,626.12 $96,794.50 $40,695.69 2026-05-05
J1930 HCPCS Syringe 119 29 $55,864.80 $12,290.26 78% off $35.33 $68,016.96 $40,501.98 2026-05-05
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 17 15 — — $36,433.22 $96,276.03 $40,481.35 2026-05-05
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 17 15 — — $36,221.97 $95,708.19 $40,246.63 2026-05-05
163 MS_DRG Major Chest Procedures With Mcc 17 15 — — $35,895.13 $94,829.68 $39,883.48 2026-05-05
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 17 15 — — $35,880.58 $94,790.59 $39,867.31 2026-05-05
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 15 — — $35,768.06 $94,488.15 $39,742.29 2026-05-05
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 17 15 — — $35,762.71 $94,473.75 $39,736.34 2026-05-05
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 17 15 — — $35,148.07 $92,821.66 $39,053.41 2026-05-05
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $38,926.08 $38,926.08 $38,926.08 2026-05-05
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $38,926.08 $38,926.08 $38,926.08 2026-05-05
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $38,926.08 $38,926.08 $38,926.08 2026-05-05
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 17 15 — — $34,942.19 $92,268.22 $38,824.65 2026-05-05
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 17 15 — — $34,847.26 $92,013.10 $38,719.18 2026-05-05
J9273 HCPCS Vial 55 29 $53,285.76 $11,722.87 78% off $150.27 $50,621.47 $38,632.18 2026-05-05
93653 CPT Compre Ep Eval Tx Svt 2 2 — — $25,699.55 $51,399.09 $38,549.32 2026-05-05
93654 CPT Compre Ep Eval Tx Vt 2 2 — — $25,699.55 $51,399.09 $38,549.32 2026-05-05
93656 CPT Compre Ep Eval Abltj Atr Fib 2 2 — — $25,699.55 $51,399.09 $38,549.32 2026-05-05
J0491 HCPCS Vial 55 29 $53,013.60 $11,663.00 78% off $15.72 $50,362.92 $38,434.86 2026-05-05
901 MS_DRG Wound Debridements For Injuries With Mcc 17 15 — — $34,527.31 $91,153.11 $38,363.68 2026-05-05
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 17 15 — — $34,238.75 $90,377.47 $38,043.05 2026-05-05
4404 APR_DRG Kidney Transplant 3 3 — — $37,709.06 $37,709.06 $37,709.06 2026-05-05
L5973 HCPCS Ank-foot Sys Dors-plant Flex 2 2 — — $25,092.86 $50,185.72 $37,639.29 2026-05-05
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours Without Skin Graft 17 15 — — $33,734.32 $89,021.64 $37,482.58 2026-05-05
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 17 15 — — $33,666.21 $88,838.53 $37,406.90 2026-05-05
8634 APR_DRG Neonatal Aftercare 3 3 — — $37,168.91 $37,168.91 $37,168.91 2026-05-05
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 17 15 — — $33,265.89 $87,762.51 $36,962.10 2026-05-05
J9021 HCPCS Vial 55 29 $50,976.00 $11,214.72 78% off $46.32 $48,427.20 $36,957.60 2026-05-05
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 17 15 — — $33,217.67 $87,632.90 $36,908.52 2026-05-05
140 MS_DRG Major Head And Neck Procedures With Mcc 17 15 — — $32,986.50 $87,011.56 $36,651.67 2026-05-05
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 3 3 — — $36,540.35 $36,540.35 $36,540.35 2026-05-05
31 MS_DRG Ventricular Shunt Procedures With Mcc 17 15 — — $32,691.05 $86,217.40 $36,323.39 2026-05-05
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 17 15 — — $32,683.41 $86,196.83 $36,314.90 2026-05-05
793 MS_DRG Full Term Neonate With Major Problems 17 15 — — $32,537.21 $85,803.87 $36,152.46 2026-05-05
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 17 15 — — $32,462.20 $85,602.24 $36,069.11 2026-05-05
J9306 HCPCS Vial 55 29 $49,598.56 $10,911.69 78% off $13.88 $47,118.63 $35,958.96 2026-05-05
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 3 3 — — $35,952.04 $35,952.04 $35,952.04 2026-05-05
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 17 15 — — $32,090.20 $84,602.35 $35,655.78 2026-05-05
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 17 15 — — $32,072.59 $84,555.03 $35,636.21 2026-05-05
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 17 15 — — $32,025.91 $84,429.52 $35,584.34 2026-05-05
J9307 HCPCS Vial 71 29 $48,870.12 $10,751.43 78% off $261.55 $92,853.29 $35,430.83 2026-05-05
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 17 15 — — $31,871.30 $84,013.93 $35,412.55 2026-05-05
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 17 15 — — $31,748.06 $83,682.69 $35,275.62 2026-05-05
0614T CPT Rmvl&rplcmt Ss Impl Dfb Pg 2 2 — — $23,514.18 $47,028.36 $35,271.27 2026-05-05
0409T CPT Insj/rplc Car Modulj Pls Gn 2 2 — — $23,514.18 $47,028.36 $35,271.27 2026-05-05
0916T CPT Insj Perm Ccm-d Sys Pg Only 2 2 — — $23,514.18 $47,028.36 $35,271.27 2026-05-05
0923T CPT Rmvl&rplcmt Perm Ccm-d Pg 2 2 — — $23,514.18 $47,028.36 $35,271.27 2026-05-05
0515T CPT Insj Wcs Lv Compl Sys 2 2 — — $23,514.18 $47,028.36 $35,271.27 2026-05-05
33263 CPT Rmvl & Rplcmt Dfb Gen 2 Lead 2 2 — — $23,514.18 $47,028.36 $35,271.27 2026-05-05
33262 CPT Rmvl& Replc Pulse Gen 1 Lead 2 2 — — $23,514.18 $47,028.36 $35,271.27 2026-05-05
33240 CPT Insrt Pulse Gen W/singl Lead 2 2 — — $23,514.18 $47,028.36 $35,271.27 2026-05-05
33230 CPT Insrt Pulse Gen W/dual Leads 2 2 — — $23,514.18 $47,028.36 $35,271.27 2026-05-05
0414T CPT Rmvl & Rpl Car Modulj Pls Gn 2 2 — — $23,514.18 $47,028.36 $35,271.27 2026-05-05
6092 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 3 3 — — $35,213.14 $35,213.14 $35,213.14 2026-05-05
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 3 3 — — $35,213.14 $35,213.14 $35,213.14 2026-05-05
6091 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 3 3 — — $35,213.14 $35,213.14 $35,213.14 2026-05-05
791 MS_DRG Prematurity With Major Problems 17 15 — — $31,690.65 $83,528.38 $35,211.83 2026-05-05
J1303 HCPCS Vial 71 29 $48,206.75 $10,605.49 78% off $214.51 $167,920.19 $34,949.90 2026-05-05
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 3 3 — — $34,687.56 $34,687.56 $34,687.56 2026-05-05
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 3 3 — — $34,687.56 $34,687.56 $34,687.56 2026-05-05
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 3 3 — — $34,600.74 $34,600.74 $34,600.74 2026-05-05
L5856 HCPCS Elec Knee-shin Swing/stance 3 3 — — $17,323.21 $69,136.70 $34,568.35 2026-05-05
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 17 15 — — $31,107.38 $81,960.64 $34,563.76 2026-05-05
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 17 15 — — $31,085.96 $81,903.04 $34,539.95 2026-05-05
L6880 HCPCS Elec Hand Ind Art Digits 3 3 — — $22,574.88 $68,727.94 $34,363.97 2026-05-05
J9311 HCPCS Vial 71 29 $47,351.38 $10,417.31 78% off $35.81 $51,410.08 $34,329.75 2026-05-05
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 17 15 — — $30,816.52 $81,178.83 $34,240.58 2026-05-05
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 17 15 — — $30,754.54 $81,012.18 $34,171.71 2026-05-05
1624 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 3 3 — — $34,127.18 $34,127.18 $34,127.18 2026-05-05
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 17 15 — — $30,693.29 $80,847.59 $34,103.66 2026-05-05
J1299 HCPCS Vial 38 29 $46,965.60 $10,332.44 78% off $11,271.74 $44,617.32 $34,050.06 2026-05-05
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 17 15 — — $30,560.10 $80,489.60 $33,955.67 2026-05-05
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 17 15 — — $30,545.57 $80,450.51 $33,939.52 2026-05-05
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 3 3 — — $33,777.96 $33,777.96 $33,777.96 2026-05-05
34 MS_DRG Carotid Artery Stent Procedures With Mcc 17 15 — — $30,380.23 $80,006.11 $33,755.81 2026-05-05
0817T CPT Opn Insj/rplcmt Ins Ptn Subf 2 2 — — $22,464.71 $44,929.43 $33,697.07 2026-05-05
61891 CPT Rev/rplcmt Sk-mnt Crnl Nstm 2 2 — — $22,464.71 $44,929.43 $33,697.07 2026-05-05
61885 CPT Insrt/redo Neurostim 1 Array 2 2 — — $22,464.71 $44,929.43 $33,697.07 2026-05-05
0680T CPT Insj/rplcmt Pg Only Isdss 2 2 — — $22,464.71 $44,929.43 $33,697.07 2026-05-05
64580 CPT Opn Impltj Nea Neuromuscular 2 2 — — $22,464.71 $44,929.43 $33,697.07 2026-05-05
64590 CPT Ins/rpl Prph Sac/gstr Npg/r 2 2 — — $22,464.71 $44,929.43 $33,697.07 2026-05-05
0816T CPT Opn Insj/rplcmt Ins Ptn Subq 2 2 — — $22,464.71 $44,929.43 $33,697.07 2026-05-05
63655 CPT Implant Neuroelectrodes 2 2 — — $22,464.71 $44,929.43 $33,697.07 2026-05-05
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 17 15 — — $30,198.83 $79,518.51 $33,554.26 2026-05-05
6073 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 3 3 — — $33,549.13 $33,549.13 $33,549.13 2026-05-05
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 17 15 — — $30,168.98 $79,438.27 $33,521.09 2026-05-05
J2506 HCPCS Syringe 55 29 $46,209.54 $10,166.10 78% off $19.98 $43,899.06 $33,501.92 2026-05-05
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 17 15 — — $30,086.32 $79,216.07 $33,429.24 2026-05-05
41 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 3 3 — — $33,390.07 $33,390.07 $33,390.07 2026-05-05
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 17 15 — — $29,872.75 $78,642.06 $33,191.94 2026-05-05
J7170 HCPCS Vial 100 29 $36,387.36 $8,005.22 78% off $48.12 $129,630.03 $33,112.50 2026-05-05
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 17 15 — — $29,714.31 $78,216.18 $33,015.90 2026-05-05
J0717 HCPCS Box 55 29 $45,355.68 $9,978.25 78% off $3.90 $43,087.90 $32,882.87 2026-05-05
C1767 HCPCS Hb Stimulator Interstim Neur 3023 55 29 $41,883.00 $9,214.26 78% off $10,051.92 $49,600.45 $32,878.16 2026-05-05
5932 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 3 3 — — $32,776.83 $32,776.83 $32,776.83 2026-05-05
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 17 15 — — $29,487.75 $77,607.19 $32,764.17 2026-05-05
63 APR_DRG Pancreas Transplant 3 3 — — $32,709.67 $32,709.67 $32,709.67 2026-05-05
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