Hospital

NORTON SCOTT HOSPITAL

Scottsburg, IN · CCN 151334 · Rates published

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You selected 93306 (CPT)

HB ECHO MMODE 2D SPECTCOLOR 93306

This hospital’s price: $1,341 across 16 payers · range $524-$2,146

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/12590/461113518-1013251594_norton-healthcareindiana%2C-inc_standardcharges.csv · observed 2026-06-03

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

13,354 distinct procedures filed

21 distinct payers

253,841 rate rows

2026-06-03 last MRF observed

Data quality

252,278 of 253,841 rate rows are consumer-grade (99.4%)

1,563 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	984
placeholder amount (≤ $0.02) — excluded from medians	324
per-diem day rate — not a per-procedure price	175
percent-of-charges filed in the dollar field — excluded from medians	58
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	18
exceeds 10× this hospital's gross charge — excluded from medians	4

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

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/12590/461113518-1013251594_norton-healthcareindiana%2C-inc_standardcharges.csv
Found on page	https://search.hospitalpriceindex.com/hpi2/machineReadable/NortonScottHospital/12590
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-10-01
Content fingerprint	e8d955309a4f325b… · 214,028,668 bytes · first seen 2026-08-01

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
J1414 HCPCS	Inj, Beqvez, Per Tx Dose	2	$3,710,000.00	$3,932,600.00	$3,821,300.00	nat. median $3,710,000 1.0× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	8	$3,675,000.00	$3,932,600.00	$3,710,875.00	nat. median $3,705,478 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	8	$3,321,781.51	$3,528,000.00	$3,376,800.00	nat. median $3,324,572 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	2	$3,193,000.00	$3,384,580.00	$3,288,790.00	nat. median $3,286,000 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	2	$2,968,000.00	$3,146,080.00	$3,057,040.00	nat. median $2,994,107 1.0× median
Q2054 HCPCS	Lisocabtagene Maraleucel 70000000 Cd8+ Cells/ml IV Susp	21	$516,485.97	$3,443,150.59	$2,844,233.67	nat. median $640,950 outlier · 4.4×
Q2055 HCPCS	Idecabtagene Vicleucel 460000000 Cells IV Susp	21	$528,312.43	$3,423,464.55	$2,827,971.91	nat. median $622,450 outlier · 4.5×
J3392 HCPCS	Inj, Exagamglogene Autotem	2	$2,332,000.00	$2,471,920.00	$2,401,960.00	nat. median $2,401,965 1.0× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	8	$2,231,250.00	$2,547,666.28	$2,298,187.50	nat. median $2,467,386 0.9× median
Q2041 HCPCS	Axicabtagene Ciloleucel 200000000 Cells IV Susp	21	$489,517.15	$4,712,620.80	$1,782,793.10	nat. median $608,239 outlier · 2.9×
Q2053 HCPCS	Brexucabtagene Autoleucel 200000000 Cells IV Susp	21	$485,100.00	$2,158,200.00	$1,782,793.10	nat. median $591,721 outlier · 3.0×
J2326 HCPCS	Nusinersen 12 Mg/5ml It Soln	21	$1,242.83	$948,017.25	$783,114.92	nat. median $2,480 outlier · 315.7×
Q2042 HCPCS	Tisagenlecleucel Car-pos T	2	$565,623.84	$599,561.27	$582,592.56	nat. median $739,258 0.8× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	8	$548,128.28	$584,397.44	$552,463.95	nat. median $646,415 0.9× median
Q2043 HCPCS	Sipuleucel-t 50000000 Cells IV Susp	21	$55,536.50	$405,664.20	$335,101.16	nat. median $65,720 outlier · 5.1×
J9043 HCPCS	Cabazitaxel 60 Mg/6ml IV Soln	21	$224.09	$381,538.51	$315,172.01	nat. median $735 outlier · 429.1×
J9226 HCPCS	Histrelin Acetate (cpp) 50 Mg Sc Kit	21	$45,261.80	$325,176.88	$268,614.16	nat. median $55,159 outlier · 4.9×
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	1	$239,997.00	$246,987.21	$239,997.00	nat. median $359,454 0.7× median
J0223 HCPCS	Givosiran Sodium 189 Mg/ml Sc Soln	21	$115.47	$284,433.12	$234,957.56	nat. median $153 outlier · 1540.0×
J1823 HCPCS	Inebilizumab-cdon 100 Mg/10ml IV Soln	21	$479.83	$282,960.00	$233,740.68	nat. median $818 outlier · 285.9×
C9293 HCPCS	Glucarpidase 1000 Units IV Solr	17	$379.25	$280,149.84	$231,419.33	nat. median $30,297 outlier · 7.6×
J9359 HCPCS	Loncastuximab Tesirine-lpyl 10 Mg IV Solr	21	$212.12	$250,817.18	$207,188.92	nat. median $742 outlier · 279.0×
J0567 HCPCS	Cerliponase Alfa 2 X 150 Mg/5ml Ve Kit	20	$116.40	$232,463.52	$192,027.78	nat. median $171 outlier · 1120.4×
J9269 HCPCS	Tagraxofusp-erzs 1000 Mcg/ml IV Soln	21	$337.57	$218,743.09	$180,693.95	nat. median $512 outlier · 352.6×
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	1	$179,257.91	$184,479.02	$179,257.91	nat. median $249,036 0.7× median
J9229 HCPCS	Inotuzumab Ozogamicin 0.9 Mg IV Solr	21	$2,633.05	$210,766.46	$174,104.80	nat. median $6,176 outlier · 28.2×
J2507 HCPCS	Pegloticase 8 Mg/ml IV Soln	21	$3,550.05	$199,214.59	$164,562.32	nat. median $9,200 outlier · 17.9×
J2327 HCPCS	Risankizumab-rzaa 150 Mg/ml Sc Sol Presyrg	21	$15.08	$193,393.37	$159,753.67	nat. median $2,076 outlier · 77.0×
J0202 HCPCS	Alemtuzumab 12 Mg/1.2ml IV Soln	21	$2,413.36	$192,742.69	$159,216.17	nat. median $3,902 outlier · 40.8×
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	1	$150,977.74	$155,375.15	$150,977.74	nat. median $198,418 0.8× median
J9266 HCPCS	Pegaspargase 750 Unit/ml Ij Soln	21	$26,815.15	$178,106.26	$147,125.67	nat. median $33,233 outlier · 4.4×
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	1	$136,387.07	$140,359.51	$136,387.07	nat. median $190,559 0.7× median
J9281 HCPCS	Mitomycin 80 (2 X 40) Mg Ul Solr	21	$311.36	$164,883.60	$136,203.02	nat. median $532 outlier · 256.0×
J9600 HCPCS	Porfimer Sodium 75 Mg IV Solr	19	$3,968.52	$151,133.04	$124,844.29	nat. median $30,131 outlier · 4.1×
J0638 HCPCS	Canakinumab 150 Mg/ml Sc Soln	21	$135.88	$138,570.59	$114,467.01	nat. median $253 outlier · 452.9×
J1246 HCPCS	Dinutuximab 17.5 Mg/5ml IV Soln	21	$33,157.78	$135,645.46	$112,050.68	nat. median $4,092 outlier · 27.4×
5884 APR_DRG	Neonate Bwt <1500g W Major Procedure	6	$109,403.98	$114,874.18	$109,403.98	nat. median $247,214 outlier · 0.4×
J9309 HCPCS	Polatuzumab Vedotin-piiq 140 Mg IV Solr	21	$132.92	$127,838.03	$105,601.32	nat. median $4,472 outlier · 23.6×
24 APR_DRG	Heart &/or Lung Transplant	6	$98,727.72	$103,664.11	$98,727.72	nat. median $241,437 outlier · 0.4×
J3241 HCPCS	Teprotumumab-trbw 500 Mg IV Solr	21	$347.10	$116,762.80	$96,452.56	nat. median $729 outlier · 132.2×
J3245 HCPCS	Tildrakizumab-asmn 100 Mg/ml Sc Sol Presyrg	21	$133.18	$116,390.14	$96,144.72	nat. median $256 outlier · 375.4×
K1007 HCPCS	Bil Hkaf Pc S/d Micro Sensor	2	$93,216.70	$98,809.70	$96,013.20	nat. median $96,983 1.0× median
1614 APR_DRG	Cardiac Defibrillator & Heart Assist Implant	6	$95,450.99	$100,223.54	$95,450.99	nat. median $202,993 outlier · 0.5×
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And…	1	$89,921.07	$92,540.13	$89,921.07	nat. median $126,695 0.7× median
J7205 HCPCS	Antihem Fact (bdd-rfviiifc) 6000 Units IV Solr	21	$2.34	$108,540.00	$89,660.07	nat. median $4 outlier · 21322.3×
J9272 HCPCS	Dostarlimab-gxly 500 Mg/10ml IV Soln	21	$240.06	$106,020.43	$87,578.76	nat. median $786 outlier · 111.4×
14 MS_DRG	Allogeneic Bone Marrow Transplant	1	$83,377.36	$85,805.82	$83,377.36	nat. median $110,307 0.8× median
7 MS_DRG	Lung Transplant	1	$83,167.34	$85,589.69	$83,167.34	nat. median $117,974 0.7× median
J3357 HCPCS	Ustekinumab 90 Mg/ml Sc Sol Presyrg	21	$155.88	$198,346.54	$81,922.72	nat. median $14,744 outlier · 5.6×
90288 CPT	Botulism Immune Globulin Human 100 Mg IV Solr	21	$22,572.00	$92,340.00	$76,277.97	nat. median $51,570 1.5× median

Other procedures at this hospital

Browse this hospital's 13,354 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

J1414	HCPCS	Inj, Beqvez, Per Tx Dose	4	2	—	—	$3,710,000.00	$3,932,600.00	$3,821,300.00	2026-06-03
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	10	8	—	—	$3,675,000.00	$3,932,600.00	$3,710,875.00	2026-06-03
J1413	HCPCS	Inj Delandistrogene Mox Rokl	10	8	—	—	$3,321,781.51	$3,528,000.00	$3,376,800.00	2026-06-03
J3394	HCPCS	Inj, Lovotibeglogene Autotem	4	2	—	—	$3,193,000.00	$3,384,580.00	$3,288,790.00	2026-06-03
J3393	HCPCS	Inj, Betibeglogene Autotemce	4	2	—	—	$2,968,000.00	$3,146,080.00	$3,057,040.00	2026-06-03
Q2054	HCPCS	Lisocabtagene Maraleucel 70000000 Cd8+ Cells/ml IV Susp	51	21	$3,825,722.88	$765,144.58 80% off	$516,485.97	$3,443,150.59	$2,844,233.67	2026-06-03
Q2055	HCPCS	Idecabtagene Vicleucel 460000000 Cells IV Susp	51	21	$3,803,849.50	$760,769.90 80% off	$528,312.43	$3,423,464.55	$2,827,971.91	2026-06-03
J3392	HCPCS	Inj, Exagamglogene Autotem	4	2	—	—	$2,332,000.00	$2,471,920.00	$2,401,960.00	2026-06-03
J3399	HCPCS	Inj Onase Abepar-xioi Treat	10	8	—	—	$2,231,250.00	$2,547,666.28	$2,298,187.50	2026-06-03
Q2053	HCPCS	Brexucabtagene Autoleucel 200000000 Cells IV Susp	51	21	$2,398,000.00	$479,600.00 80% off	$485,100.00	$2,158,200.00	$1,782,793.10	2026-06-03
Q2041	HCPCS	Axicabtagene Ciloleucel 200000000 Cells IV Susp	48	21	$2,398,000.00	$479,600.00 80% off	$489,517.15	$4,712,620.80	$1,782,793.10	2026-06-03
J2326	HCPCS	Nusinersen 12 Mg/5ml It Soln	51	21	$1,053,352.50	$210,670.50 80% off	$1,242.83	$948,017.25	$783,114.92	2026-06-03
Q2042	HCPCS	Tisagenlecleucel Car-pos T	4	2	—	—	$565,623.84	$599,561.27	$582,592.56	2026-06-03
Q2056	HCPCS	Ciltacabtagene Car-pos T	10	8	—	—	$548,128.28	$584,397.44	$552,463.95	2026-06-03
Q2043	HCPCS	Sipuleucel-t 50000000 Cells IV Susp	51	21	$450,738.00	$90,147.60 80% off	$55,536.50	$405,664.20	$335,101.16	2026-06-03
J9043	HCPCS	Cabazitaxel 60 Mg/6ml IV Soln	51	21	$423,931.68	$84,786.34 80% off	$224.09	$381,538.51	$315,172.01	2026-06-03
J9226	HCPCS	Histrelin Acetate (cpp) 50 Mg Sc Kit	51	21	$361,307.64	$72,261.53 80% off	$45,261.80	$325,176.88	$268,614.16	2026-06-03
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	1	—	—	$239,997.00	$246,987.21	$239,997.00	2026-06-03
J0223	HCPCS	Givosiran Sodium 189 Mg/ml Sc Soln	51	21	$316,036.80	$63,207.36 80% off	$115.47	$284,433.12	$234,957.56	2026-06-03
J1823	HCPCS	Inebilizumab-cdon 100 Mg/10ml IV Soln	51	21	$314,400.00	$62,880.00 80% off	$479.83	$282,960.00	$233,740.68	2026-06-03
C9293	HCPCS	Glucarpidase 1000 Units IV Solr	37	17	$311,277.60	$62,255.52 80% off	$379.25	$280,149.84	$231,419.33	2026-06-03
J9359	HCPCS	Loncastuximab Tesirine-lpyl 10 Mg IV Solr	51	21	$278,685.76	$55,737.16 80% off	$212.12	$250,817.18	$207,188.92	2026-06-03
J0567	HCPCS	Cerliponase Alfa 2 X 150 Mg/5ml Ve Kit	44	20	$258,292.80	$51,658.56 80% off	$116.40	$232,463.52	$192,027.78	2026-06-03
J9269	HCPCS	Tagraxofusp-erzs 1000 Mcg/ml IV Soln	51	21	$243,047.88	$48,609.58 80% off	$337.57	$218,743.09	$180,693.95	2026-06-03
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	3	1	—	—	$179,257.91	$184,479.02	$179,257.91	2026-06-03
J9229	HCPCS	Inotuzumab Ozogamicin 0.9 Mg IV Solr	51	21	$234,184.96	$46,837.00 80% off	$2,633.05	$210,766.46	$174,104.80	2026-06-03
J2507	HCPCS	Pegloticase 8 Mg/ml IV Soln	51	21	$221,349.54	$44,269.91 80% off	$3,550.05	$199,214.59	$164,562.32	2026-06-03
J2327	HCPCS	Risankizumab-rzaa 150 Mg/ml Sc Sol Presyrg	51	21	$214,881.52	$42,976.31 80% off	$15.08	$193,393.37	$159,753.67	2026-06-03
J0202	HCPCS	Alemtuzumab 12 Mg/1.2ml IV Soln	51	21	$214,158.54	$42,831.71 80% off	$2,413.36	$192,742.69	$159,216.17	2026-06-03
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	3	1	—	—	$150,977.74	$155,375.15	$150,977.74	2026-06-03
J9266	HCPCS	Pegaspargase 750 Unit/ml Ij Soln	51	21	$197,895.84	$39,579.17 80% off	$26,815.15	$178,106.26	$147,125.67	2026-06-03
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	3	1	—	—	$136,387.07	$140,359.51	$136,387.07	2026-06-03
J9281	HCPCS	Mitomycin 80 (2 X 40) Mg Ul Solr	51	21	$183,204.00	$36,640.80 80% off	$311.36	$164,883.60	$136,203.02	2026-06-03
J9600	HCPCS	Porfimer Sodium 75 Mg IV Solr	42	19	$167,925.60	$33,585.12 80% off	$3,968.52	$151,133.04	$124,844.29	2026-06-03
J0638	HCPCS	Canakinumab 150 Mg/ml Sc Soln	51	21	$153,967.32	$30,793.47 80% off	$135.88	$138,570.59	$114,467.01	2026-06-03
J1246	HCPCS	Dinutuximab 17.5 Mg/5ml IV Soln	41	21	$150,717.18	$30,143.44 80% off	$33,157.78	$135,645.46	$112,050.68	2026-06-03
5884	APR_DRG	Neonate Bwt <1500g W Major Procedure	6	6	—	—	$109,403.98	$114,874.18	$109,403.98	2026-06-03
J9309	HCPCS	Polatuzumab Vedotin-piiq 140 Mg IV Solr	51	21	$142,042.26	$28,408.46 80% off	$132.92	$127,838.03	$105,601.32	2026-06-03
24	APR_DRG	Heart &/or Lung Transplant	6	6	—	—	$98,727.72	$103,664.11	$98,727.72	2026-06-03
J3241	HCPCS	Teprotumumab-trbw 500 Mg IV Solr	51	21	$129,736.44	$25,947.29 80% off	$347.10	$116,762.80	$96,452.56	2026-06-03
J3245	HCPCS	Tildrakizumab-asmn 100 Mg/ml Sc Sol Presyrg	51	21	$129,322.38	$25,864.48 80% off	$133.18	$116,390.14	$96,144.72	2026-06-03
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	4	2	—	—	$93,216.70	$98,809.70	$96,013.20	2026-06-03
1614	APR_DRG	Cardiac Defibrillator & Heart Assist Implant	6	6	—	—	$95,450.99	$100,223.54	$95,450.99	2026-06-03
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …	3	1	—	—	$89,921.07	$92,540.13	$89,921.07	2026-06-03
J7205	HCPCS	Antihem Fact (bdd-rfviiifc) 6000 Units IV Solr	45	21	$120,600.00	$24,120.00 80% off	$2.34	$108,540.00	$89,660.07	2026-06-03
J9272	HCPCS	Dostarlimab-gxly 500 Mg/10ml IV Soln	51	21	$117,800.48	$23,560.10 80% off	$240.06	$106,020.43	$87,578.76	2026-06-03
14	MS_DRG	Allogeneic Bone Marrow Transplant	3	1	—	—	$83,377.36	$85,805.82	$83,377.36	2026-06-03
7	MS_DRG	Lung Transplant	3	1	—	—	$83,167.34	$85,589.69	$83,167.34	2026-06-03
J3357	HCPCS	Ustekinumab 90 Mg/ml Sc Sol Presyrg	69	21	$220,385.04	$44,077.01 80% off	$155.88	$198,346.54	$81,922.72	2026-06-03
90288	CPT	Botulism Immune Globulin Human 100 Mg IV Solr	41	21	$102,600.00	$20,520.00 80% off	$22,572.00	$92,340.00	$76,277.97	2026-06-03
Q0480	HCPCS	Driver Pneumatic Vad, Rep	10	8	—	—	$72,648.53	$105,999.95	$74,827.99	2026-06-03
14	APR_DRG	Liver Transplant &/or Intestinal Transplant	6	6	—	—	$71,979.64	$75,578.62	$71,979.64	2026-06-03
J2562	HCPCS	Plerixafor 24 Mg/1.2ml Sc Soln	51	21	$95,693.44	$19,138.69 80% off	$21.87	$86,124.10	$71,143.29	2026-06-03
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	3	1	—	—	$70,132.08	$72,174.76	$70,132.08	2026-06-03
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	4	2	—	—	$67,452.66	$71,499.82	$69,476.24	2026-06-03
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	3	1	—	—	$69,326.37	$71,345.59	$69,326.37	2026-06-03
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	3	1	—	—	$67,770.31	$69,744.21	$67,770.31	2026-06-03
215	MS_DRG	Other Heart Assist System Implant	3	1	—	—	$67,424.10	$69,387.91	$67,424.10	2026-06-03
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	3	1	—	—	$66,707.49	$68,650.42	$66,707.49	2026-06-03
74	APR_DRG	Allogeneic Bone Marrow Transplant	6	6	—	—	$66,644.33	$69,976.55	$66,644.33	2026-06-03
44	APR_DRG	Tracheostomy W Mv 96+ Hours W Extensive Procedure	6	6	—	—	$65,369.09	$68,637.54	$65,369.09	2026-06-03
94	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$65,007.90	$68,258.30	$65,007.90	2026-06-03
J9029	HCPCS	Instill Adstiladrin, Tx Dose	12	10	—	—	$63,000.00	$83,738.55	$64,467.05	2026-06-03
5914	APR_DRG	Neonate Birthwt 500-749g Without Major Procedure	6	6	—	—	$63,630.47	$66,811.99	$63,630.47	2026-06-03
J9037	HCPCS	Belantamab Mafodotin-blmf 100 Mg IV Solr	51	21	$84,734.08	$16,946.82 80% off	$41.73	$76,260.67	$62,995.55	2026-06-03
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	3	1	—	—	$61,417.52	$63,206.38	$61,417.52	2026-06-03
J1640	HCPCS	Hemin 350 Mg IV Solr	51	21	$82,275.54	$16,455.11 80% off	$32.08	$74,047.99	$61,167.75	2026-06-03
38240	CPT	Transplt Allo Hct/donor	4	2	—	—	$59,142.33	$62,690.87	$60,916.60	2026-06-03
J9119	HCPCS	Cemiplimab-rwlc 350 Mg/7ml IV Soln	51	21	$81,609.49	$16,321.90 80% off	$28.21	$73,448.54	$60,672.57	2026-06-03
6094	APR_DRG	Neonate Bwt 1500-2499g W Major Procedure	6	6	—	—	$60,298.76	$63,313.70	$60,298.76	2026-06-03
J9153	HCPCS	Daunorubicin-cytarabine Lipo 44-100 Mg IV Susr	51	21	$79,056.00	$15,811.20 80% off	$248.41	$71,150.40	$58,774.18	2026-06-03
850	MS_DRG	Acute Leukemia With Other Procedures	3	1	—	—	$58,622.99	$60,330.45	$58,622.99	2026-06-03
23	APR_DRG	Heart &/or Lung Transplant	6	6	—	—	$56,959.66	$59,807.64	$56,959.66	2026-06-03
21	APR_DRG	Heart &/or Lung Transplant	6	6	—	—	$56,959.66	$59,807.64	$56,959.66	2026-06-03
22	APR_DRG	Heart &/or Lung Transplant	6	6	—	—	$56,959.66	$59,807.64	$56,959.66	2026-06-03
5934	APR_DRG	Neonate Birthwt 750-999g Without Major Procedure	6	6	—	—	$56,876.50	$59,720.33	$56,876.50	2026-06-03
J9144	HCPCS	Daratumumab-hyaluronidase-fihj 1800-30000 Mg-ut/15ml Sc Soln	51	21	$76,117.41	$15,223.49 80% off	$51.39	$68,505.67	$56,589.49	2026-06-03
J9228	HCPCS	Ipilimumab 200 Mg/40ml IV Soln	69	21	$265,991.52	$53,198.31 80% off	$180.05	$239,392.37	$56,523.30	2026-06-03
J9203	HCPCS	Gemtuzumab Ozogamicin 4.5 Mg IV Solr	42	19	$75,611.16	$15,122.24 80% off	$233.12	$68,050.04	$55,286.88	2026-06-03
J1412	HCPCS	Inj Roctavian Ml 2x10^13vc G	12	10	—	—	$11,667.97	$99,914.06	$55,058.97	2026-06-03
J3380	HCPCS	Vedolizumab 300 Mg IV Solr	51	21	$72,782.64	$14,556.53 80% off	$21.67	$65,504.38	$54,110.25	2026-06-03
5831	APR_DRG	Neonate W Ecmo	6	6	—	—	$53,956.72	$56,654.56	$53,956.72	2026-06-03
5832	APR_DRG	Neonate W Ecmo	6	6	—	—	$53,956.72	$56,654.56	$53,956.72	2026-06-03
5833	APR_DRG	Neonate W Ecmo	6	6	—	—	$53,956.72	$56,654.56	$53,956.72	2026-06-03
5834	APR_DRG	Neonate W Ecmo	6	6	—	—	$53,956.72	$56,654.56	$53,956.72	2026-06-03
231	MS_DRG	Coronary Bypass With Ptca With Mcc	3	1	—	—	$53,926.80	$55,497.49	$53,926.80	2026-06-03
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	3	1	—	—	$53,896.25	$55,466.05	$53,896.25	2026-06-03
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	3	1	—	—	$53,077.82	$54,623.77	$53,077.82	2026-06-03
J0222	HCPCS	Patisiran Sodium 10 Mg/5ml IV Soln	51	21	$70,452.00	$14,090.40 80% off	$98.83	$63,406.80	$52,377.54	2026-06-03
J9316	HCPCS	Pertuz-trastuz-hyaluron-zzxf 60-60-2000 Mg-mg-u/ml Sc Soln	69	21	$69,802.56	$13,960.52 80% off	$63.88	$94,237.10	$51,894.71	2026-06-03
6314	APR_DRG	Neonate Birthwt >2499g W Other Major Procedure	6	6	—	—	$51,684.96	$54,269.21	$51,684.96	2026-06-03
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	3	1	—	—	$51,299.01	$52,793.15	$51,299.01	2026-06-03
6304	APR_DRG	Neonate Birthwt >2499g W Major Cardiovascular Procedure	6	6	—	—	$51,124.33	$53,680.55	$51,124.33	2026-06-03
10	MS_DRG	Pancreas Transplant	3	1	—	—	$50,739.59	$52,217.44	$50,739.59	2026-06-03
J9301	HCPCS	Obinutuzumab 1000 Mg/40ml IV Soln	51	21	$68,042.16	$13,608.44 80% off	$74.83	$61,237.94	$50,585.94	2026-06-03
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	3	1	—	—	$50,447.47	$51,916.82	$50,447.47	2026-06-03
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	3	1	—	—	$49,741.68	$51,190.46	$49,741.68	2026-06-03
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	3	1	—	—	$49,240.17	$50,674.35	$49,240.17	2026-06-03
5883	APR_DRG	Neonate Bwt <1500g W Major Procedure	6	6	—	—	$47,896.92	$50,291.77	$47,896.92	2026-06-03
5882	APR_DRG	Neonate Bwt <1500g W Major Procedure	6	6	—	—	$47,896.92	$50,291.77	$47,896.92	2026-06-03
5881	APR_DRG	Neonate Bwt <1500g W Major Procedure	6	6	—	—	$47,896.92	$50,291.77	$47,896.92	2026-06-03
J9042	HCPCS	Brentuximab Vedotin 50 Mg IV Solr	51	21	$64,286.40	$12,857.28 80% off	$246.58	$57,857.76	$47,793.72	2026-06-03
C9047	HCPCS	Caplacizumab-yhdp 11 Mg Ij Kit	43	20	$64,184.76	$12,836.96 80% off	$786.74	$57,766.28	$47,718.16	2026-06-03
J2323	HCPCS	Natalizumab 300 Mg/15ml IV Conc	51	21	$63,930.33	$12,786.07 80% off	$23.88	$57,537.30	$47,529.00	2026-06-03
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	3	1	—	—	$47,500.83	$48,884.35	$47,500.83	2026-06-03
33276	CPT	Insj Phrnc Nrv Stim Sys	4	2	—	—	$45,000.50	$47,700.53	$46,350.52	2026-06-03
0266T	CPT	Apc	4	2	—	—	$45,000.50	$47,700.53	$46,350.52	2026-06-03
64	APR_DRG	Pancreas Transplant	6	6	—	—	$46,244.64	$48,556.87	$46,244.64	2026-06-03
Q3027	HCPCS	Interferon Beta-1a 30 Mcg/0.5ml IM Auto-ij	51	21	$62,192.16	$12,438.44 80% off	$55.62	$55,972.94	$46,236.76	2026-06-03
6114	APR_DRG	Neonate Birthwt 1500-1999g W Major Anomaly	6	6	—	—	$45,988.46	$48,287.88	$45,988.46	2026-06-03
J3101	HCPCS	Tenecteplase 50 Mg IV Kit	51	21	$61,532.52	$12,306.51 80% off	$162.43	$55,379.27	$45,746.36	2026-06-03
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	3	1	—	—	$45,177.88	$46,493.74	$45,177.88	2026-06-03
5933	APR_DRG	Neonate Birthwt 750-999g Without Major Procedure	6	6	—	—	$45,117.39	$47,373.26	$45,117.39	2026-06-03
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	3	1	—	—	$44,972.95	$46,282.84	$44,972.95	2026-06-03
J9022	HCPCS	Atezolizumab 840 Mg/14ml IV Soln	69	21	$60,162.82	$12,032.57 80% off	$88.22	$77,352.08	$44,728.04	2026-06-03
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	3	1	—	—	$44,272.88	$45,562.38	$44,272.88	2026-06-03
J9223	HCPCS	Lurbinectedin 4 Mg IV Solr	51	21	$59,400.00	$11,880.00 80% off	$204.90	$53,460.00	$44,160.93	2026-06-03
955	MS_DRG	Craniotomy For Multiple Significant Trauma	3	1	—	—	$43,454.43	$44,720.10	$43,454.43	2026-06-03
J2350	HCPCS	Eteplirsen 500 Mg/10ml IV Soln	69	21	$57,600.00	$11,520.00 80% off	$58.77	$140,708.61	$42,822.72	2026-06-03
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	3	1	—	—	$42,667.18	$43,909.92	$42,667.18	2026-06-03
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	3	1	—	—	$42,503.62	$43,741.59	$42,503.62	2026-06-03
54	APR_DRG	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	6	6	—	—	$42,465.06	$44,588.31	$42,465.06	2026-06-03
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	3	1	—	—	$42,431.70	$43,667.58	$42,431.70	2026-06-03
J7330	HCPCS	Cultured Chondrocytes Implnt	2	2	—	—	$42,139.40	$42,139.40	$42,139.40	2026-06-03
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	3	1	—	—	$41,162.03	$42,360.93	$41,162.03	2026-06-03
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	3	1	—	—	$41,096.49	$42,293.47	$41,096.49	2026-06-03
J1303	HCPCS	Ravulizumab-cwvz 1100 Mg/11ml IV Soln	69	21	$176,758.10	$35,351.62 80% off	$220.59	$159,082.29	$40,975.74	2026-06-03
6024	APR_DRG	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$40,664.43	$42,697.65	$40,664.43	2026-06-03
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	3	1	—	—	$40,246.86	$41,419.10	$40,246.86	2026-06-03
72	APR_DRG	Allogeneic Bone Marrow Transplant	6	6	—	—	$40,223.96	$42,235.16	$40,223.96	2026-06-03
73	APR_DRG	Allogeneic Bone Marrow Transplant	6	6	—	—	$40,223.96	$42,235.16	$40,223.96	2026-06-03
71	APR_DRG	Allogeneic Bone Marrow Transplant	6	6	—	—	$40,223.96	$42,235.16	$40,223.96	2026-06-03
L2006	HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	4	2	—	—	$38,762.63	$41,088.39	$39,925.51	2026-06-03
J9273	HCPCS	Tisotumab Vedotin-tftv 40 Mg IV Solr	51	21	$53,285.76	$10,657.16 80% off	$181.87	$47,957.18	$39,615.29	2026-06-03
6074	APR_DRG	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$39,580.87	$41,559.91	$39,580.87	2026-06-03
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	3	1	—	—	$39,420.14	$40,568.30	$39,420.14	2026-06-03
J0491	HCPCS	Anifrolumab-fnia 300 Mg/2ml IV Soln	51	21	$53,013.60	$10,602.72 80% off	$17.76	$47,712.24	$39,412.96	2026-06-03
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	3	1	—	—	$39,369.23	$40,515.90	$39,369.23	2026-06-03
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	3	1	—	—	$39,189.76	$40,331.21	$39,189.76	2026-06-03
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	3	1	—	—	$39,055.47	$40,193.01	$39,055.47	2026-06-03
L7181	HCPCS	Electronic Elbo Simultaneous	10	8	—	—	$37,858.44	$51,273.01	$38,994.19	2026-06-03
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	3	1	—	—	$38,874.72	$40,007.00	$38,874.72	2026-06-03
28	MS_DRG	Spinal Procedures With Mcc	3	1	—	—	$38,688.89	$39,815.75	$38,688.89	2026-06-03
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	3	1	—	—	$38,411.41	$39,530.19	$38,411.41	2026-06-03
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	3	1	—	—	$38,411.41	$39,530.19	$38,411.41	2026-06-03
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	3	1	—	—	$38,124.38	$39,234.80	$38,124.38	2026-06-03
J9021	HCPCS	Asparaginase Erwinia Chry-rywn 10 Mg/0.5ml IM Soln	51	21	$50,976.00	$10,195.20 80% off	$53.87	$45,878.40	$37,898.11	2026-06-03
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	3	1	—	—	$37,861.54	$38,964.31	$37,861.54	2026-06-03
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	3	1	—	—	$37,835.44	$38,937.45	$37,835.44	2026-06-03
6214	APR_DRG	Neonate Bwt 2000-2499g W Major Anomaly	6	6	—	—	$37,726.32	$39,612.64	$37,726.32	2026-06-03
6023	APR_DRG	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$37,576.21	$39,455.02	$37,576.21	2026-06-03
93	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$37,515.60	$39,391.38	$37,515.60	2026-06-03
91	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$37,515.60	$39,391.38	$37,515.60	2026-06-03
92	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$37,515.60	$39,391.38	$37,515.60	2026-06-03
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	3	1	—	—	$37,445.95	$38,536.61	$37,445.95	2026-06-03
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	3	1	—	—	$37,052.00	$38,131.19	$37,052.00	2026-06-03
J9306	HCPCS	Pertuzumab 420 Mg/14ml IV Soln	51	21	$49,598.56	$9,919.72 80% off	$16.19	$44,638.70	$36,874.04	2026-06-03
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	3	1	—	—	$36,524.41	$37,588.23	$36,524.41	2026-06-03
4404	APR_DRG	Kidney Transplant	6	6	—	—	$36,521.91	$38,348.01	$36,521.91	2026-06-03
J9307	HCPCS	Pralatrexate 40 Mg/2ml IV Soln	69	21	$97,740.30	$19,548.06 80% off	$261.55	$87,966.27	$36,332.49	2026-06-03
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	3	1	—	—	$36,306.12	$37,363.58	$36,306.12	2026-06-03
0620T	CPT	Evasc Ven Artlz Tibl/prnl Vn	4	2	—	—	$35,000.50	$37,100.53	$36,050.52	2026-06-03
653	MS_DRG	Major Bladder Procedures With Mcc	3	1	—	—	$35,475.58	$36,508.85	$35,475.58	2026-06-03
L8701	HCPCS	Ewh S/d Uprt Micro Sensor	4	2	—	—	$34,284.44	$36,341.51	$35,312.97	2026-06-03
J9311	HCPCS	Rituximab-hyaluronidase Human 1600-26800 Mg -ut/13.4ml Sc Soln	69	21	$54,115.87	$10,823.18 80% off	$36.58	$48,704.29	$35,203.38	2026-06-03
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	3	1	—	—	$35,177.10	$36,201.67	$35,177.10	2026-06-03
834	MS_DRG	Acute Leukemia With Mcc	3	1	—	—	$35,174.55	$36,199.05	$35,174.55	2026-06-03
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	3	1	—	—	$35,036.45	$36,056.93	$35,036.45	2026-06-03
J1299	HCPCS	Eculizumab 300 Mg/30ml IV Soln	41	21	$46,965.60	$9,393.12 80% off	$10,332.43	$42,269.04	$34,916.57	2026-06-03
1604	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	6	6	—	—	$34,847.77	$36,590.16	$34,847.77	2026-06-03
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	3	1	—	—	$34,813.06	$35,827.04	$34,813.06	2026-06-03
3034	APR_DRG	Dorsal & Lumbar Fusion Proc For Curvature Of Back	6	6	—	—	$34,706.12	$36,441.43	$34,706.12	2026-06-03
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	3	1	—	—	$34,626.59	$35,635.13	$34,626.59	2026-06-03
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	3	1	—	—	$34,547.67	$35,553.92	$34,547.67	2026-06-03
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	3	1	—	—	$34,371.39	$35,372.50	$34,371.39	2026-06-03
J2506	HCPCS	Pegfilgrastim (inf Dev) 6 Mg/0.6ml Sc Sol Presyrg	51	21	$46,209.54	$9,241.91 80% off	$19.98	$41,588.59	$34,354.49	2026-06-03
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	3	1	—	—	$34,338.92	$35,339.09	$34,338.92	2026-06-03
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	3	1	—	—	$34,334.47	$35,334.51	$34,334.47	2026-06-03
8634	APR_DRG	Neonatal Aftercare	6	6	—	—	$33,901.29	$35,596.35	$33,901.29	2026-06-03
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	3	1	—	—	$33,857.15	$34,843.28	$33,857.15	2026-06-03
J0717	HCPCS	Certolizumab Pegol 200 Mg/ml Sc Pre Syrg Kit	51	21	$45,355.68	$9,071.14 80% off	$3.90	$40,820.11	$33,719.68	2026-06-03
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	3	1	—	—	$33,706.96	$34,688.71	$33,706.96	2026-06-03
0571T	CPT	Insj/rplcmt Icds Ss Eltrd	4	2	—	—	$32,061.58	$33,985.27	$33,023.43	2026-06-03
0408T	CPT	Insj/rplc Cardiac Modulj Sys	4	2	—	—	$32,061.58	$33,985.27	$33,023.43	2026-06-03
33264	CPT	Rmvl & Rplcmt Dfb Gen Mlt Ld	4	2	—	—	$32,061.58	$33,985.27	$33,023.43	2026-06-03
33270	CPT	Ins/rep Subq Defibrillator	4	2	—	—	$32,061.58	$33,985.27	$33,023.43	2026-06-03
33231	CPT	Insrt Pulse Gen W/mult Leads	4	2	—	—	$32,061.58	$33,985.27	$33,023.43	2026-06-03
33249	CPT	Insj/rplcmt Defib W/lead(s)	4	2	—	—	$32,061.58	$33,985.27	$33,023.43	2026-06-03
0915T	CPT	Insj Perm Ccm-d Sys Pg&eltrd	4	2	—	—	$32,061.58	$33,985.27	$33,023.43	2026-06-03
J1930	HCPCS	Lanreotide Acetate 90 Mg/0.3ml Sc Soln	123	21	$55,864.80	$11,172.96 80% off	$27.54	$64,437.12	$32,787.05	2026-06-03
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	3	1	—	—	$32,773.96	$33,728.54	$32,773.96	2026-06-03
69930	CPT	Implant Cochlear Device	4	2	—	—	$31,807.82	$33,716.29	$32,762.05	2026-06-03
J7170	HCPCS	Emicizumab-kxwh 30 Mg/ml Sc Soln	97	20	$54,581.04	$10,916.21 80% off	$52.02	$122,807.39	$32,748.64	2026-06-03
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	3	1	—	—	$32,666.41	$33,617.86	$32,666.41	2026-06-03
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	3	1	—	—	$32,421.38	$33,365.69	$32,421.38	2026-06-03
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	3	1	—	—	$32,322.10	$33,263.52	$32,322.10	2026-06-03
1624	APR_DRG	Cardiac Valve Procedures W Ami Or Complex Pdx	6	6	—	—	$32,246.54	$33,858.87	$32,246.54	2026-06-03
J0517	HCPCS	Benralizumab 30 Mg/ml Sc Sol Presyrg	51	21	$43,361.76	$8,672.36 80% off	$165.89	$39,025.58	$32,237.30	2026-06-03
J9271	HCPCS	Pembrolizumab 100 Mg/4ml IV Soln	51	21	$43,312.92	$8,662.59 80% off	$57.60	$38,981.63	$32,200.99	2026-06-03
43	APR_DRG	Tracheostomy W Mv 96+ Hours W Extensive Procedure	6	6	—	—	$32,097.13	$33,701.99	$32,097.13	2026-06-03
41	APR_DRG	Tracheostomy W Mv 96+ Hours W Extensive Procedure	6	6	—	—	$32,097.13	$33,701.99	$32,097.13	2026-06-03
42	APR_DRG	Tracheostomy W Mv 96+ Hours W Extensive Procedure	6	6	—	—	$32,097.13	$33,701.99	$32,097.13	2026-06-03
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	3	1	—	—	$32,053.53	$32,987.13	$32,053.53	2026-06-03
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	3	1	—	—	$31,864.51	$32,792.61	$31,864.51	2026-06-03
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	3	1	—	—	$31,839.69	$32,767.06	$31,839.69	2026-06-03
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	3	1	—	—	$31,830.78	$32,757.89	$31,830.78	2026-06-03
6093	APR_DRG	Neonate Bwt 1500-2499g W Major Procedure	6	6	—	—	$31,722.21	$33,308.32	$31,722.21	2026-06-03
6092	APR_DRG	Neonate Bwt 1500-2499g W Major Procedure	6	6	—	—	$31,722.21	$33,308.32	$31,722.21	2026-06-03
6091	APR_DRG	Neonate Bwt 1500-2499g W Major Procedure	6	6	—	—	$31,722.21	$33,308.32	$31,722.21	2026-06-03
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	3	1	—	—	$31,712.40	$32,636.06	$31,712.40	2026-06-03
62	APR_DRG	Pancreas Transplant	6	6	—	—	$31,710.58	$33,296.11	$31,710.58	2026-06-03
63	APR_DRG	Pancreas Transplant	6	6	—	—	$31,710.58	$33,296.11	$31,710.58	2026-06-03
61	APR_DRG	Pancreas Transplant	6	6	—	—	$31,710.58	$33,296.11	$31,710.58	2026-06-03
J7189	HCPCS	Coagulation Factor Viia Recomb 5 Mg IV Solr	96	19	$42,480.00	$8,496.00 80% off	$2.55	$152,928.00	$31,581.76	2026-06-03
64582	CPT	Opn Mpltj Hpglsl Nstm Ary Pg	4	2	—	—	$30,473.59	$32,302.01	$31,387.80	2026-06-03
61886	CPT	Implant Neurostim Arrays	4	2	—	—	$30,473.59	$32,302.01	$31,387.80	2026-06-03
64568	CPT	Opn Impltj Crnl Nrv Nea&pg	4	2	—	—	$30,473.59	$32,302.01	$31,387.80	2026-06-03
63685	CPT	Ins/rplc Spi Npg/rcvr Pocket	4	2	—	—	$30,473.59	$32,302.01	$31,387.80	2026-06-03
33287	CPT	Rmv&rplcmt Phrnc Nrv Stim Pg	4	2	—	—	$30,473.59	$32,302.01	$31,387.80	2026-06-03
0268T	CPT	Apc	4	2	—	—	$30,473.59	$32,302.01	$31,387.80	2026-06-03
0674T	CPT	Laps Insj Nw/rpcmt Prm Isdss	4	2	—	—	$30,473.59	$32,302.01	$31,387.80	2026-06-03
245	MS_DRG	Aicd Generator Procedures	3	1	—	—	$31,098.89	$32,004.69	$31,098.89	2026-06-03
471	MS_DRG	Cervical Spinal Fusion With Mcc	3	1	—	—	$30,911.14	$31,811.47	$30,911.14	2026-06-03
6	MS_DRG	Liver Transplant Without Mcc	3	1	—	—	$30,859.59	$31,758.42	$30,859.59	2026-06-03
J1290	HCPCS	Ecallantide 10 Mg/ml Sc Soln	51	21	$41,087.36	$8,217.48 80% off	$563.10	$36,978.62	$30,546.40	2026-06-03
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	3	1	—	—	$30,390.55	$31,275.71	$30,390.55	2026-06-03
799	MS_DRG	Splenic Procedures With Mcc	3	1	—	—	$30,258.80	$31,140.13	$30,258.80	2026-06-03
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	3	1	—	—	$30,257.54	$31,138.83	$30,257.54	2026-06-03
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	3	1	—	—	$29,939.96	$30,812.00	$29,939.96	2026-06-03
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	3	1	—	—	$29,779.59	$30,646.95	$29,779.59	2026-06-03
J9039	HCPCS	Blinatumomab 35 Mcg IV Solr	51	21	$40,008.72	$8,001.75 80% off	$152.51	$36,007.85	$29,744.49	2026-06-03
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	3	1	—	—	$29,607.75	$30,470.11	$29,607.75	2026-06-03
84	APR_DRG	Autologous Bone Marrow Transplant	6	6	—	—	$29,423.31	$30,894.48	$29,423.31	2026-06-03
104	APR_DRG	Head Trauma With Deep Coma	6	6	—	—	$29,365.88	$30,834.17	$29,365.88	2026-06-03
163	MS_DRG	Major Chest Procedures With Mcc	3	1	—	—	$29,332.18	$30,186.51	$29,332.18	2026-06-03
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	3	1	—	—	$29,320.08	$30,174.07	$29,320.08	2026-06-03
33289	CPT	Tcat Impl Wrls P-art Prs Snr	4	2	—	—	$28,428.33	$30,134.03	$29,281.18	2026-06-03
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	3	1	—	—	$29,226.53	$30,077.79	$29,226.53	2026-06-03
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	3	1	—	—	$29,222.71	$30,073.85	$29,222.71	2026-06-03
5912	APR_DRG	Neonate Birthwt 500-749g Without Major Procedure	6	6	—	—	$29,104.41	$30,559.63	$29,104.41	2026-06-03
5911	APR_DRG	Neonate Birthwt 500-749g Without Major Procedure	6	6	—	—	$29,104.41	$30,559.63	$29,104.41	2026-06-03
5913	APR_DRG	Neonate Birthwt 500-749g Without Major Procedure	6	6	—	—	$29,104.41	$30,559.63	$29,104.41	2026-06-03
1654	APR_DRG	Coronary Bypass W Ami Or Complex Pdx	6	6	—	—	$28,873.61	$30,317.29	$28,873.61	2026-06-03
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	3	1	—	—	$28,711.02	$29,547.27	$28,711.02	2026-06-03
6073	APR_DRG	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$28,682.97	$30,117.12	$28,682.97	2026-06-03
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	3	1	—	—	$28,539.83	$29,371.08	$28,539.83	2026-06-03
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	3	1	—	—	$28,460.91	$29,289.87	$28,460.91	2026-06-03
J7504	HCPCS	Lymphocyte,anti-thymo Imm Glob 50 Mg/ml IV Soln	69	21	$38,263.56	$7,652.72 80% off	$4,355.73	$34,437.20	$28,447.00	2026-06-03
5931	APR_DRG	Neonate Birthwt 750-999g Without Major Procedure	6	6	—	—	$28,427.85	$29,849.24	$28,427.85	2026-06-03
5932	APR_DRG	Neonate Birthwt 750-999g Without Major Procedure	6	6	—	—	$28,427.85	$29,849.24	$28,427.85	2026-06-03
C9760	HCPCS	Non-blind Interatrial Shunt	4	2	—	—	$27,500.50	$29,150.53	$28,325.52	2026-06-03
1634	APR_DRG	Cardiac Valve Procedures Without Ami Or Complex Pdx	6	6	—	—	$28,225.94	$29,637.24	$28,225.94	2026-06-03
901	MS_DRG	Wound Debridements For Injuries With Mcc	3	1	—	—	$28,194.88	$29,016.09	$28,194.88	2026-06-03
3032	APR_DRG	Dorsal & Lumbar Fusion Proc For Curvature Of Back	6	6	—	—	$28,148.77	$29,556.21	$28,148.77	2026-06-03
3031	APR_DRG	Dorsal & Lumbar Fusion Proc For Curvature Of Back	6	6	—	—	$28,148.77	$29,556.21	$28,148.77	2026-06-03
3033	APR_DRG	Dorsal & Lumbar Fusion Proc For Curvature Of Back	6	6	—	—	$28,148.77	$29,556.21	$28,148.77	2026-06-03
J9057	HCPCS	Copanlisib Hcl 60 Mg IV Solr	51	21	$37,825.92	$7,565.19 80% off	$89.16	$34,043.33	$28,121.68	2026-06-03
Q5120	HCPCS	Pegfilgrastim-bmez 6 Mg/0.6ml Sc Sol Presyrg	51	21	$37,685.12	$7,537.03 80% off	$24.71	$33,916.61	$28,017.01	2026-06-03
Q5122	HCPCS	Pegfilgrastim-apgf 6 Mg/0.6ml Sc Sol Presyrg	51	21	$37,680.00	$7,536.00 80% off	$117.01	$33,912.00	$28,013.19	2026-06-03
J9015	HCPCS	Aldesleukin 22000000 Units IV Solr	63	21	$44,411.76	$8,882.36 80% off	$2,787.62	$39,970.58	$27,979.41	2026-06-03
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	3	1	—	—	$27,954.95	$28,769.17	$27,954.95	2026-06-03
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	3	1	—	—	$27,536.18	$28,338.21	$27,536.18	2026-06-03
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	3	1	—	—	$27,478.91	$28,279.26	$27,478.91	2026-06-03
103	APR_DRG	Head Trauma With Deep Coma	6	6	—	—	$27,256.56	$28,619.39	$27,256.56	2026-06-03
101	APR_DRG	Head Trauma With Deep Coma	6	6	—	—	$27,256.56	$28,619.39	$27,256.56	2026-06-03
102	APR_DRG	Head Trauma With Deep Coma	6	6	—	—	$27,256.56	$28,619.39	$27,256.56	2026-06-03
J9061	HCPCS	Amivantamab-vmjw 350 Mg/7ml IV Soln	51	21	$36,544.14	$7,308.83 80% off	$21.56	$32,889.73	$27,168.74	2026-06-03
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	3	1	—	—	$27,146.05	$27,936.71	$27,146.05	2026-06-03
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	3	1	—	—	$27,106.60	$27,896.12	$27,106.60	2026-06-03
140	MS_DRG	Major Head And Neck Procedures With Mcc	3	1	—	—	$26,914.39	$27,698.31	$26,914.39	2026-06-03
J1807	HCPCS	Ethacrynate Sodium 50 Mg IV Solr	41	21	$36,105.54	$7,221.11 80% off	$7,943.22	$32,494.99	$26,842.67	2026-06-03
L7180	HCPCS	Electronic Elbow Sequential	10	8	—	—	$25,912.94	$49,799.20	$26,690.33	2026-06-03
31	MS_DRG	Ventricular Shunt Procedures With Mcc	3	1	—	—	$26,668.10	$27,444.84	$26,668.10	2026-06-03
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	3	1	—	—	$26,666.20	$27,442.88	$26,666.20	2026-06-03
6021	APR_DRG	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$26,658.23	$27,991.14	$26,658.23	2026-06-03
6022	APR_DRG	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$26,658.23	$27,991.14	$26,658.23	2026-06-03
J1162	HCPCS	Digoxin Immune Fab 40 Mg IV Solr	45	21	$35,812.80	$7,162.56 80% off	$5,069.98	$32,231.52	$26,625.03	2026-06-03
793	MS_DRG	Full Term Neonate With Major Problems	3	1	—	—	$26,542.73	$27,315.82	$26,542.73	2026-06-03
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	3	1	—	—	$26,477.81	$27,249.01	$26,477.81	2026-06-03
6072	APR_DRG	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$26,453.85	$27,776.54	$26,453.85	2026-06-03
53	APR_DRG	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	6	6	—	—	$26,392.18	$27,711.79	$26,392.18	2026-06-03
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	3	1	—	—	$26,168.51	$26,930.70	$26,168.51	2026-06-03
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	3	1	—	—	$26,153.87	$26,915.64	$26,153.87	2026-06-03
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	3	1	—	—	$26,115.05	$26,875.69	$26,115.05	2026-06-03
J9204	HCPCS	Mogamulizumab-kpkc 20 Mg/5ml IV Soln	51	21	$35,121.90	$7,024.38 80% off	$241.33	$31,609.71	$26,111.38	2026-06-03
J1437	HCPCS	Ferric Derisomaltose(one Dose) 1000 Mg/10ml IV Soln	51	21	$35,060.96	$7,012.20 80% off	$20.77	$31,554.86	$26,066.07	2026-06-03
6334	APR_DRG	Neonate Birthwt >2499g W Major Anomaly	6	6	—	—	$25,999.28	$27,299.24	$25,999.28	2026-06-03
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	3	1	—	—	$25,986.49	$26,743.38	$25,986.49	2026-06-03
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	3	1	—	—	$25,884.02	$26,637.93	$25,884.02	2026-06-03
791	MS_DRG	Prematurity With Major Problems	3	1	—	—	$25,839.48	$26,592.08	$25,839.48	2026-06-03
8633	APR_DRG	Neonatal Aftercare	6	6	—	—	$25,544.02	$26,821.22	$25,544.02	2026-06-03
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	3	1	—	—	$25,351.98	$26,090.38	$25,351.98	2026-06-03
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	3	1	—	—	$25,334.16	$26,072.05	$25,334.16	2026-06-03
93654	CPT	Compre Ep Eval Tx Vt	4	2	—	—	$24,532.30	$26,004.24	$25,268.27	2026-06-03
93653	CPT	Compre Ep Eval Tx Svt	4	2	—	—	$24,532.30	$26,004.24	$25,268.27	2026-06-03
93656	CPT	Compre Ep Eval Abltj Atr Fib	4	2	—	—	$24,532.30	$26,004.24	$25,268.27	2026-06-03
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	3	1	—	—	$25,115.22	$25,846.73	$25,115.22	2026-06-03
6124	APR_DRG	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	6	6	—	—	$25,088.04	$26,342.44	$25,088.04	2026-06-03
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	3	1	—	—	$25,057.94	$25,787.79	$25,057.94	2026-06-03
J9356	HCPCS	Trastuzumab-hyaluronidase-oysk 600-10000 Mg-unt/5ml Sc Soln	51	21	$33,661.74	$6,732.35 80% off	$63.06	$30,295.57	$25,025.83	2026-06-03

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