Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

MERCYONE CENTERVILLE MEDICAL CENTER

Centerville, IA · CCN 161377 · Rates published

Your selected procedure

You selected 93306 (CPT)

HC Echocardiography Transthoracic 2d Complete W/M-Mode & Doppler

This hospital’s price: $437 across 42 payers · range $63-$2,350

Source: https://hpt.trinity-health.org/420680308_st-josephs-mercy-hospital-centerville_standardcharges.zip · observed 2026-03-31

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.

8,455 distinct procedures filed
783 distinct payers
4,698,108 rate rows
2026-03-31 last MRF observed
Data quality

2,989,030 of 4,698,108 rate rows are consumer-grade (63.6%)

1,709,078 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 1,694,528
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 8,248
placeholder amount (≤ $0.02) — excluded from medians 3,474
per-diem day rate — not a per-procedure price 1,372
percent-of-charges filed in the dollar field — excluded from medians 1,320
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 136
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hpt.trinity-health.org/420680308_st-josephs-mercy-hospital-centerville_standardcharges.zip
Found on page https://www.mercyone.org/for-patients/billing-and-financial-information/price-estimator
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-12
Content fingerprint 1549226ddd4ab4ed… · 80,749,080 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
SUP-958196
CDM 		Console Cryo Smartfreeze 42 $44,810.89 $163,305.00 $153,016.79 nat. median
$132,074
1.2× median
J2326
HCPCS 		Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 108 $124,949.56 $455,355.55 $146,299.20 nat. median
$2,487
outlier · 58.8×
SUP-235283
CDM 		Pump Heart Mate Ii Pckt Cntrl 42 $41,273.19 $150,412.50 $140,936.51 nat. median
$120,312
1.2× median
J0225
HCPCS 		Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe 108 $74,646.82 $272,036.50 $124,596.50 nat. median
$8,223
outlier · 15.2×
J7330
HCPCS 		Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes 42 $27,555.40 $100,420.54 $94,094.05 nat. median
$75,037
1.3× median
SUP-962194
CDM 		Power Cntrl/ 5 Ellipsys Vas Caths 42 $23,938.45 $87,239.25 $81,743.18 nat. median
$61,940
1.3× median
SUP-878598
CDM 		Device Impella 5.5 Smartassist 42 $21,226.21 $77,355.00 $72,481.64 nat. median
$64,591
1.1× median
J9118
HCPCS 		Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution 42 $21,225.48 $77,352.35 $72,479.15 nat. median
$200
outlier · 362.7×
A9543
HCPCS 		Yttrium Y-90 Ibritumomab Ther 108 $15,101.60 $66,804.65 $66,804.65 nat. median
$63,643
1.0× median
SUP-977545
CDM 		Kit Triclip G4 Sys W/any 3 Clips 42 $18,396.05 $67,041.00 $62,817.42 nat. median
$55,979
1.1× median
J2350
HCPCS 		Ocrelizumab 30 Mg/ml Intravenous Solution 42 $17,875.21 $65,142.90 $61,038.90 nat. median
$414
outlier · 147.3×
SUP-943847
CDM 		Valve Sapien Thv Edwards Resilia 23mm 42 $16,037.58 $58,446.00 $54,763.90 nat. median
$48,802
1.1× median
SUP-775386
CDM 		Implant Gammatile Therapy Device 6pk 42 $15,999.85 $58,308.48 $54,635.05 nat. median
$48,688
1.1× median
SUP-775558
CDM 		Intrdcr Lotus 23 Edge 42 $15,330.04 $55,867.50 $52,347.85 nat. median
$47,450
1.1× median
SUP-220542
CDM 		Valve Sapien 3 Thv 20mm W/command System 42 $15,330.04 $55,867.50 $52,347.85 nat. median
$46,286
1.1× median
SUP-960412
CDM 		Cage Capri Cerv Expand Corp W/set Screw 12x14mm 32-46mm 0deg 42 $14,896.56 $54,287.74 $50,867.61 nat. median
$38,544
1.3× median
J3245
HCPCS 		Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe 42 $14,785.87 $53,884.35 $50,489.64 nat. median
$256
outlier · 197.0×
SUP-130379
CDM 		Handpiece Electr Ster Disp Electrosurgical 42 $14,742.95 $53,727.95 $50,343.09 nat. median
$44,433
1.1× median
SUP-956570
CDM 		Pascal Precision System Mitral 42 $14,433.82 $52,601.40 $49,287.51 nat. median
$43,922
1.1× median
SUP-977299
CDM 		Heart Aortic Evolut Fx+ 29mm 42 $14,333.59 $52,236.11 $48,945.24 nat. median
$43,617
1.1× median
SUP-977300
CDM 		Heart Aortic Evolut Fx+ 34mm 42 $14,295.94 $52,098.92 $48,816.69 nat. median
$43,503
1.1× median
SUP-977297
CDM 		Heart Aortic Evolut Fx+ 23mm 42 $14,295.04 $52,095.62 $48,813.60 nat. median
$43,500
1.1× median
SUP-977298
CDM 		Heart Aortic Evolut Fx+ 26mm 42 $14,171.03 $51,643.68 $48,390.13 nat. median
$43,122
1.1× median
SUP-748688
CDM 		Kit Mitraclip 1 Mbr0101 42 $14,150.81 $51,570.00 $48,321.09 nat. median
$43,061
1.1× median
SUP-220532
CDM 		Valve Aort 23mm Evolutr 42 $14,150.81 $51,570.00 $48,321.09 nat. median
$42,726
1.1× median
SUP-232785
CDM 		Valve Aort 23mm Pro Perc 42 $14,150.81 $51,570.00 $48,321.09 nat. median
$42,726
1.1× median
SUP-968130
CDM 		Implant Bear 42 $13,574.72 $49,470.57 $46,353.92 nat. median
$34,629
1.3× median
SUP-211836
CDM 		Cath Impella Ld 42 $13,207.42 $48,132.00 $45,099.68 nat. median
$40,880
1.1× median
SUP-787598
CDM 		Implant Gammatile Therapy Device 4pk 42 $12,999.88 $47,375.64 $44,390.97 nat. median
$39,559
1.1× median
C1825
HCPCS 		Generator Stim Baroreceptor Neo Legacy Implant Pulse 42 $12,264.03 $57,801.38 $41,878.28 nat. median
$53,125
0.8× median
SUP-937190
CDM 		Generator 16 Channel Octrode Ipg 42 $12,080.34 $44,024.57 $41,251.02 nat. median
$32,402
1.3× median
SUP-777716
CDM 		Synergraft Pulm Valve + Condui 42 $11,910.26 $43,404.75 $40,670.25 nat. median
$36,243
1.1× median
SUP-976016
CDM 		Limflow System Arterial Catheter 42 $11,792.34 $42,975.00 $40,267.58 nat. median
$36,500
1.1× median
SUP-962396
CDM 		System Cap Setour Torus Stent Grafts 42 $11,792.34 $42,975.00 $40,267.58 nat. median
$32,010
1.3× median
SUP-382358
CDM 		Set Pump Impella Cp 42 $11,792.34 $42,975.00 $40,267.58 nat. median
$35,605
1.1× median
SUP-775387
CDM 		Implant Gammatile Therapy Device 3pk 42 $11,792.34 $42,975.00 $40,267.58 nat. median
$35,884
1.1× median
SUP-976262
CDM 		System Optimizer Heart Pulse Strl 42 $11,556.49 $42,115.50 $39,462.22 nat. median
$29,009
1.4× median
SUP-975298
CDM 		System Eternal Penta With Paddle Lead 42 $11,405.55 $41,565.42 $38,946.80 nat. median
$34,375
1.1× median
SUP-972645
CDM 		Valve Heart Navitor Radiopaque Marker 35mm 42 $11,320.65 $41,256.00 $38,656.87 nat. median
$34,449
1.1× median
SUP-972642
CDM 		Valve Heart Navitor Radiopaque Marker 25mm 42 $11,320.65 $41,256.00 $38,656.87 nat. median
$34,449
1.1× median
SUP-970723
CDM 		Set Pump Cath Sys Rp Flex W/smart Assist 42 $11,203.22 $40,828.05 $38,255.88 nat. median
$35,627
1.1× median
SUP-972644
CDM 		Valve Heart Navitor Radiopaque Marker 29mm 42 $11,131.97 $40,568.40 $38,012.59 nat. median
$33,875
1.1× median
SUP-972643
CDM 		Valve Heart Navitor Radiopaque Marker 27mm 42 $11,084.80 $40,396.50 $37,851.52 nat. median
$33,731
1.1× median
C1824
HCPCS 		Kit Ipg Optimizer Smart 42 $10,848.95 $44,694.00 $37,046.17 nat. median
$35,360
1.0× median
C1822
HCPCS 		Kit Hfx Iq Ipg Bundle 42 $10,747.54 $40,833.13 $36,699.87 nat. median
$31,540
1.2× median
SUP-937176
CDM 		Generator Implantable Proclaim 5 42 $10,555.09 $38,466.06 $36,042.70 nat. median
$28,652
1.3× median
J9298
HCPCS 		Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 108 $25,898.57 $94,382.55 $34,606.40 nat. median
$559
outlier · 61.9×
SUP-937183
CDM 		Proclaim Plus 7 Ipg Iphone Patient Controller 42 $9,536.86 $34,755.31 $32,565.73 nat. median
$29,392
1.1× median
SUP-211834
CDM 		Set Pump Impella 2.5 Aic 42 $9,433.87 $34,380.00 $32,214.06 nat. median
$28,484
1.1× median
J9359
HCPCS 		Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution 108 $23,897.32 $87,089.35 $31,783.46 nat. median
$739
outlier · 43.0×

Other procedures at this hospital

Browse this hospital's 8,455 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
             
SUP-958196 CDM Console Cryo Smartfreeze 86 42 $163,305.00 $163,305.00 $44,810.89 $163,305.00 $153,016.79 2026-03-31
J2326 HCPCS Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 220 108 $455,355.55 $455,355.55 $124,949.56 $455,355.55 $146,299.20 2026-03-31
SUP-235283 CDM Pump Heart Mate Ii Pckt Cntrl 86 42 $150,412.50 $150,412.50 $41,273.19 $150,412.50 $140,936.51 2026-03-31
J0225 HCPCS Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe 220 108 $272,036.50 $272,036.50 $74,646.82 $272,036.50 $124,596.50 2026-03-31
J7330 HCPCS Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes 86 42 $100,420.54 $100,420.54 $27,555.40 $100,420.54 $94,094.05 2026-03-31
SUP-962194 CDM Power Cntrl/ 5 Ellipsys Vas Caths 86 42 $87,239.25 $87,239.25 $23,938.45 $87,239.25 $81,743.18 2026-03-31
SUP-878598 CDM Device Impella 5.5 Smartassist 86 42 $77,355.00 $77,355.00 $21,226.21 $77,355.00 $72,481.64 2026-03-31
J9118 HCPCS Calaspargase Pegol-mknl 750 Unit/ml Intravenous Solution 86 42 $77,352.35 $77,352.35 $21,225.48 $77,352.35 $72,479.15 2026-03-31
A9543 HCPCS Yttrium Y-90 Ibritumomab Ther 220 108 $55,035.00 $55,035.00 $15,101.60 $66,804.65 $66,804.65 2026-03-31
SUP-977545 CDM Kit Triclip G4 Sys W/any 3 Clips 86 42 $67,041.00 $67,041.00 $18,396.05 $67,041.00 $62,817.42 2026-03-31
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 86 42 $65,142.90 $65,142.90 $17,875.21 $65,142.90 $61,038.90 2026-03-31
SUP-943847 CDM Valve Sapien Thv Edwards Resilia 23mm 86 42 $58,446.00 $58,446.00 $16,037.58 $58,446.00 $54,763.90 2026-03-31
SUP-775386 CDM Implant Gammatile Therapy Device 6pk 86 42 $58,308.48 $58,308.48 $15,999.85 $58,308.48 $54,635.05 2026-03-31
SUP-220542 CDM Valve Sapien 3 Thv 20mm W/command System 86 42 $55,867.50 $55,867.50 $15,330.04 $55,867.50 $52,347.85 2026-03-31
SUP-775558 CDM Intrdcr Lotus 23 Edge 86 42 $55,867.50 $55,867.50 $15,330.04 $55,867.50 $52,347.85 2026-03-31
SUP-960412 CDM Cage Capri Cerv Expand Corp W/set Screw 12x14mm 32-46mm 0deg 86 42 $54,287.74 $54,287.74 $14,896.56 $54,287.74 $50,867.61 2026-03-31
J3245 HCPCS Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe 86 42 $53,884.35 $53,884.35 $14,785.87 $53,884.35 $50,489.64 2026-03-31
SUP-130379 CDM Handpiece Electr Ster Disp Electrosurgical 86 42 $53,727.95 $53,727.95 $14,742.95 $53,727.95 $50,343.09 2026-03-31
SUP-956570 CDM Pascal Precision System Mitral 86 42 $52,601.40 $52,601.40 $14,433.82 $52,601.40 $49,287.51 2026-03-31
SUP-977299 CDM Heart Aortic Evolut Fx+ 29mm 86 42 $52,236.11 $52,236.11 $14,333.59 $52,236.11 $48,945.24 2026-03-31
SUP-977300 CDM Heart Aortic Evolut Fx+ 34mm 86 42 $52,098.92 $52,098.92 $14,295.94 $52,098.92 $48,816.69 2026-03-31
SUP-977297 CDM Heart Aortic Evolut Fx+ 23mm 86 42 $52,095.62 $52,095.62 $14,295.04 $52,095.62 $48,813.60 2026-03-31
SUP-977298 CDM Heart Aortic Evolut Fx+ 26mm 86 42 $51,643.68 $51,643.68 $14,171.03 $51,643.68 $48,390.13 2026-03-31
SUP-232785 CDM Valve Aort 23mm Pro Perc 86 42 $51,570.00 $51,570.00 $14,150.81 $51,570.00 $48,321.09 2026-03-31
SUP-220532 CDM Valve Aort 23mm Evolutr 86 42 $51,570.00 $51,570.00 $14,150.81 $51,570.00 $48,321.09 2026-03-31
SUP-748688 CDM Kit Mitraclip 1 Mbr0101 86 42 $51,570.00 $51,570.00 $14,150.81 $51,570.00 $48,321.09 2026-03-31
SUP-968130 CDM Implant Bear 86 42 $49,470.57 $49,470.57 $13,574.72 $49,470.57 $46,353.92 2026-03-31
SUP-211836 CDM Cath Impella Ld 86 42 $48,132.00 $48,132.00 $13,207.42 $48,132.00 $45,099.68 2026-03-31
SUP-787598 CDM Implant Gammatile Therapy Device 4pk 86 42 $47,375.64 $47,375.64 $12,999.88 $47,375.64 $44,390.97 2026-03-31
C1825 HCPCS Generator Stim Baroreceptor Neo Legacy Implant Pulse 172 42 $51,247.69 $51,247.69 $12,264.03 $57,801.38 $41,878.28 2026-03-31
SUP-937190 CDM Generator 16 Channel Octrode Ipg 86 42 $44,024.57 $44,024.57 $12,080.34 $44,024.57 $41,251.02 2026-03-31
SUP-777716 CDM Synergraft Pulm Valve + Condui 86 42 $43,404.75 $43,404.75 $11,910.26 $43,404.75 $40,670.25 2026-03-31
SUP-962396 CDM System Cap Setour Torus Stent Grafts 86 42 $42,975.00 $42,975.00 $11,792.34 $42,975.00 $40,267.58 2026-03-31
SUP-382358 CDM Set Pump Impella Cp 86 42 $42,975.00 $42,975.00 $11,792.34 $42,975.00 $40,267.58 2026-03-31
SUP-775387 CDM Implant Gammatile Therapy Device 3pk 86 42 $42,975.00 $42,975.00 $11,792.34 $42,975.00 $40,267.58 2026-03-31
SUP-976016 CDM Limflow System Arterial Catheter 86 42 $42,975.00 $42,975.00 $11,792.34 $42,975.00 $40,267.58 2026-03-31
SUP-976262 CDM System Optimizer Heart Pulse Strl 86 42 $42,115.50 $42,115.50 $11,556.49 $42,115.50 $39,462.22 2026-03-31
SUP-975298 CDM System Eternal Penta With Paddle Lead 86 42 $41,565.42 $41,565.42 $11,405.55 $41,565.42 $38,946.80 2026-03-31
SUP-972645 CDM Valve Heart Navitor Radiopaque Marker 35mm 86 42 $41,256.00 $41,256.00 $11,320.65 $41,256.00 $38,656.87 2026-03-31
SUP-972642 CDM Valve Heart Navitor Radiopaque Marker 25mm 86 42 $41,256.00 $41,256.00 $11,320.65 $41,256.00 $38,656.87 2026-03-31
SUP-970723 CDM Set Pump Cath Sys Rp Flex W/smart Assist 86 42 $40,828.05 $40,828.05 $11,203.22 $40,828.05 $38,255.88 2026-03-31
SUP-972644 CDM Valve Heart Navitor Radiopaque Marker 29mm 86 42 $40,568.40 $40,568.40 $11,131.97 $40,568.40 $38,012.59 2026-03-31
SUP-972643 CDM Valve Heart Navitor Radiopaque Marker 27mm 86 42 $40,396.50 $40,396.50 $11,084.80 $40,396.50 $37,851.52 2026-03-31
C1824 HCPCS Kit Ipg Optimizer Smart 172 42 $42,115.50 $42,115.50 $10,848.95 $44,694.00 $37,046.17 2026-03-31
C1822 HCPCS Kit Hfx Iq Ipg Bundle 258 42 $39,360.18 $39,360.18 $10,747.54 $40,833.13 $36,699.87 2026-03-31
SUP-937176 CDM Generator Implantable Proclaim 5 86 42 $38,466.06 $38,466.06 $10,555.09 $38,466.06 $36,042.70 2026-03-31
J9298 HCPCS Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 220 108 $94,382.55 $94,382.55 $25,898.57 $94,382.55 $34,606.40 2026-03-31
SUP-937183 CDM Proclaim Plus 7 Ipg Iphone Patient Controller 86 42 $34,755.31 $34,755.31 $9,536.86 $34,755.31 $32,565.73 2026-03-31
SUP-211834 CDM Set Pump Impella 2.5 Aic 86 42 $34,380.00 $34,380.00 $9,433.87 $34,380.00 $32,214.06 2026-03-31
J9359 HCPCS Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution 354 108 $87,089.35 $87,089.35 $23,897.32 $87,089.35 $31,783.46 2026-03-31
J9144 HCPCS Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 86 42 $33,713.70 $33,713.70 $9,251.04 $33,713.70 $31,589.74 2026-03-31
SUP-548505 CDM System Mntr Heartmate Ii 86 42 $32,858.69 $32,858.69 $9,016.42 $32,858.69 $30,788.59 2026-03-31
SUP-756496 CDM Stent Graft Confrm Thor 34x34x15 22f 86 42 $31,440.51 $31,440.51 $8,627.28 $31,440.51 $29,459.76 2026-03-31
SUP-215756 CDM Stent Graft Prox 46x46x200mm Valiant Captivia Free Flo Str 86 42 $31,364.87 $31,364.87 $8,606.52 $31,364.87 $29,388.88 2026-03-31
J0202 HCPCS Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 220 108 $89,232.75 $89,232.75 $24,485.47 $89,232.75 $29,288.40 2026-03-31
J2507 HCPCS Pegloticase 8 Mg/ml Intravenous Solution 220 108 $95,364.75 $95,364.75 $26,168.09 $95,364.75 $29,110.88 2026-03-31
J9228 HCPCS Ipilimumab 5 Mg/ml Intravenous Solution (wrapper) 440 108 $69,268.68 $69,268.68 $7,602.94 $110,829.85 $29,059.60 2026-03-31
SUP-122716 CDM Set Bvs Bld Pump 32f 86 42 $30,942.00 $30,942.00 $8,490.48 $30,942.00 $28,992.65 2026-03-31
SUP-751994 CDM Stent Valiant Navion Vnmc3434c182tu Coveredseal 175mm 86 42 $30,934.26 $30,934.26 $8,488.36 $30,934.26 $28,985.40 2026-03-31
SUP-215747 CDM Stent Graft Prox 40x40x200mm Valiant Captivia Free Flo Str 86 42 $30,762.79 $30,762.79 $8,441.31 $30,762.79 $28,824.73 2026-03-31
SUP-215703 CDM Stent Graft Closed 38x38x200mm Web Strght Valiant Captivia 86 42 $30,158.14 $30,158.14 $8,275.39 $30,158.14 $28,258.18 2026-03-31
J1930 HCPCS Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe 86 42 $29,832.00 $29,832.00 $8,185.90 $29,832.00 $27,952.58 2026-03-31
SUP-381140 CDM Stent Graft Prox 38x38x150mm 86 42 $29,755.89 $29,755.89 $8,165.02 $29,755.89 $27,881.27 2026-03-31
SUP-905476 CDM Plug Cardiac Amulet Amplatzer 28mm 86 42 $29,676.82 $29,676.82 $8,143.32 $29,676.82 $27,807.18 2026-03-31
SUP-962229 CDM Device Watchman Flx Pro Procedure 86 42 $29,626.97 $29,626.97 $8,129.64 $29,626.97 $27,760.47 2026-03-31
SUP-215742 CDM Stent Graft Prox 36x36x150mm Valiant Captivia Free Flo Str 86 42 $29,470.33 $29,470.33 $8,086.66 $29,470.33 $27,613.70 2026-03-31
SUP-962231 CDM Device Clsur Watchman Flx Pro Laa 20mm 86 42 $29,223.00 $29,223.00 $8,018.79 $29,223.00 $27,381.95 2026-03-31
SUP-973139 CDM Kit Freedom Pns Receiver W/tnes 1 Channel 86 42 $29,223.00 $29,223.00 $8,018.79 $29,223.00 $27,381.95 2026-03-31
SUP-215718 CDM Stent Graft Closed 44x44x200mm Web Strght Valiant Captivia 86 42 $29,000.39 $29,000.39 $7,957.71 $29,000.39 $27,173.37 2026-03-31
SUP-215746 CDM Stent Graft Prox 40x40x150mm Valiant Captivia Free Flo Str 86 42 $28,613.61 $28,613.61 $7,851.57 $28,613.61 $26,810.95 2026-03-31
J9229 HCPCS Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) IV Soln 220 108 $73,182.85 $73,182.85 $20,081.37 $73,182.85 $26,573.31 2026-03-31
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 6 3 — $55,879.29 $25,940.14 $26,448.77 $26,321.61 2026-03-31
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 6 3 — $65,305.23 $25,644.55 $26,147.39 $26,021.68 2026-03-31
C1735 HCPCS Cath Symplicity Spyral 86 42 $27,504.00 $27,504.00 $7,547.10 $27,504.00 $25,771.25 2026-03-31
A9588 HCPCS F-18 Fluciclovine Per Mci 86 42 $27,455.00 $27,455.00 $7,533.65 $27,455.00 $25,725.34 2026-03-31
SUP-215670 CDM Stent Graft Closed 24x24x150mm Web Strght Valiant Captivia 86 42 $27,453.29 $27,453.29 $7,533.18 $27,453.29 $25,723.73 2026-03-31
SUP-381139 CDM Stent Graft Prox 40x40x100mm Valiant Captivia Free Flo Str 86 42 $27,342.41 $27,342.41 $7,502.76 $27,342.41 $25,619.84 2026-03-31
SUP-960332 CDM Prolift Pl Expandable Interbody 8x28x8-13 Mm 7deg 86 42 $27,172.23 $27,172.23 $7,456.06 $27,172.23 $25,460.38 2026-03-31
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 6 3 — $38,899.97 $24,977.47 $25,467.23 $25,344.79 2026-03-31
SUP-969166 CDM Coil Web Sgl Layer 6x2mm 86 42 $26,937.16 $26,937.16 $7,391.56 $26,937.16 $25,240.12 2026-03-31
SUP-137567 CDM Connect Perf Y 1/2x3/8x3/8in Unequal 86 42 $26,866.27 $26,866.27 $7,372.10 $26,866.27 $25,173.69 2026-03-31
SUP-973913 CDM Stent Ped3-027-550-50 V03 Vantage 86 42 $26,665.13 $26,665.13 $7,316.91 $26,665.13 $24,985.23 2026-03-31
SUP-973905 CDM Stent Ped3-027-450-25 V03 Vantage 86 42 $26,665.13 $26,665.13 $7,316.91 $26,665.13 $24,985.23 2026-03-31
SUP-977301 CDM Pump Infuse 3000 Hepatic Artery 30ml Codman It Implant 86 42 $26,454.55 $26,454.55 $7,259.13 $26,454.55 $24,787.91 2026-03-31
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 6 3 — $22,791.70 $24,344.90 $24,822.25 $24,702.91 2026-03-31
SUP-402362 CDM Graft Bn Canc Crsh Frzdr 30ml 86 42 $25,812.47 $25,812.47 $7,082.94 $25,812.47 $24,186.28 2026-03-31
SUP-870892 CDM Conduit Konect Resilia Aortic Vlv 21mm 86 42 $25,785.00 $25,785.00 $7,075.40 $25,785.00 $24,160.55 2026-03-31
SUP-831750 CDM Centrifuge Angel US 86 42 $25,785.00 $25,785.00 $7,075.40 $25,785.00 $24,160.55 2026-03-31
SUP-970768 CDM Vein Saphns 85cm Or Greater A B Ab O Bld Type 86 42 $25,779.41 $25,779.41 $7,073.87 $25,779.41 $24,155.31 2026-03-31
SUP-970766 CDM Set Tubing Cardiovasc Proc Kit Bld Syst Vein 50-70cm 86 42 $25,779.41 $25,779.41 $7,073.87 $25,779.41 $24,155.31 2026-03-31
SUP-754168 CDM Coil Web Sngl Layer 4x3 86 42 $25,699.05 $25,699.05 $7,051.82 $25,699.05 $24,080.01 2026-03-31
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 6 3 — $91,384.93 $23,695.07 $24,159.68 $24,043.53 2026-03-31
SUP-901208 CDM Set Circuit Adv Hls Beq-hls 7050 7.0 86 42 $25,584.17 $25,584.17 $7,020.30 $25,584.17 $23,972.37 2026-03-31
SUP-755515 CDM Coil Pulserider T Shp 3.5-4.5mm 10.6mm Arch Wdth 86 42 $25,523.13 $25,523.13 $7,003.55 $25,523.13 $23,915.17 2026-03-31
J9274 HCPCS Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution 220 108 $107,550.00 $107,550.00 $23,757.00 $107,550.00 $23,757.00 2026-03-31
SUP-226164 CDM Vale Heart Intuity Elite 19mm 86 42 $25,260.00 $25,260.00 $6,931.34 $25,260.00 $23,668.62 2026-03-31
SUP-226165 CDM Vale Heart Intuity Elite 21mm 86 42 $25,260.00 $25,260.00 $6,931.34 $25,260.00 $23,668.62 2026-03-31
SUP-960431 CDM Cage Spinal 5mm 3deg Lg Ti Interbody Syst Cerv Lordotic 86 42 $24,925.50 $24,925.50 $6,839.56 $24,925.50 $23,355.19 2026-03-31
SUP-973920 CDM Stent Ped3-021-250-16 V03 Vantage 86 42 $24,873.93 $24,873.93 $6,825.41 $24,873.93 $23,306.87 2026-03-31
SUP-973944 CDM Stent Ped3-027-450-16 V03 Vantage 86 42 $24,873.93 $24,873.93 $6,825.41 $24,873.93 $23,306.87 2026-03-31
SUP-224095 CDM Valve Aortic Heart 16mm Cryopreserved 86 42 $24,456.94 $24,456.94 $6,710.98 $24,456.94 $22,916.15 2026-03-31
A9582 HCPCS I-123 Iobenguane Diag 86 42 $24,445.60 $24,445.60 $6,707.87 $24,445.60 $22,905.53 2026-03-31
SUP-754185 CDM Coil Web Sngl Layer 10x5 86 42 $24,414.10 $24,414.10 $6,699.23 $24,414.10 $22,876.01 2026-03-31
SUP-960250 CDM Cage Spinal 12x14x6x3.94x8.5mm 0deg Peek Gry Cerv Interbody 86 42 $24,366.83 $24,366.83 $6,686.26 $24,366.83 $22,831.72 2026-03-31
J9347 HCPCS Tremelimumab-actl 20 Mg/ml Intravenous Solution 440 108 $68,935.43 $68,935.43 $2,910.14 $127,265.40 $22,763.54 2026-03-31
SUP-866893 CDM Graft Stent Body Aortic Alto Pma 29mm 86 42 $24,205.40 $24,205.40 $6,641.96 $24,205.40 $22,680.46 2026-03-31
SUP-220772 CDM Device Embol 4.25x25 Pipeline 86 42 $24,186.33 $24,186.33 $6,636.73 $24,186.33 $22,662.59 2026-03-31
C1882 HCPCS Defib Icd Bi Vent Gallant Hr Crt D 2,494 42 $25,419.90 $25,419.90 $44.66 $42,975.00 $22,382.33 2026-03-31
C2624 HCPCS System Cardiomems Hosp Electronics 344 42 $29,723.62 $29,723.62 $4,340.06 $36,958.50 $22,326.37 2026-03-31
SUP-756275 CDM Bone Allograft Cartiform 20x25mm Disc 86 42 $23,155.00 $23,155.00 $6,353.73 $23,155.00 $21,696.24 2026-03-31
SUP-962780 CDM Pack Priming Pre-connected Centrimag Sys Bypass 86 42 $23,155.00 $23,155.00 $6,353.73 $23,155.00 $21,696.24 2026-03-31
SUP-222235 CDM Stent Graft 22-40-13-40mm Afx2 Bifurcated 86 42 $23,049.75 $23,049.75 $6,324.85 $23,049.75 $21,597.62 2026-03-31
SUP-220790 CDM Device Embol 4.75x25 Pipeline 86 42 $23,034.60 $23,034.60 $6,320.69 $23,034.60 $21,583.42 2026-03-31
SUP-215833 CDM Device Embolization 3x25mm Pipeline Strl 86 42 $23,034.60 $23,034.60 $6,320.69 $23,034.60 $21,583.42 2026-03-31
J2356 HCPCS Tezepelumab-ekko 210 Mg/1.91 Ml (110 Mg/ml) Subcutaneous Syringe 86 42 $22,937.05 $22,937.05 $6,293.93 $22,937.05 $21,492.02 2026-03-31
SUP-224865 CDM Device Epi-sense 3cm Guide 86 42 $22,839.25 $22,839.25 $6,267.09 $22,839.25 $21,400.38 2026-03-31
J9333 HCPCS Rozanolixizumab-noli 140 Mg/ml Subcutaneous Solution 220 108 $56,796.70 $56,796.70 $15,585.01 $56,796.70 $21,294.00 2026-03-31
SUP-218240 CDM Stent Graft 25-80-20-40mm 86 42 $22,586.65 $22,586.65 $6,197.78 $22,586.65 $21,163.69 2026-03-31
SUP-220733 CDM Device Embol 3.25x16 Pipeline 86 42 $22,561.88 $22,561.88 $6,190.98 $22,561.88 $21,140.48 2026-03-31
C1605 HCPCS Pacemaker Leadless 19.5f 32.2mm Ra 86 42 $22,352.16 $22,352.16 $6,133.43 $22,352.16 $20,943.97 2026-03-31
SUP-886127 CDM Cannula Angiovac 20d Dilator P 86 42 $22,347.00 $22,347.00 $6,132.02 $22,347.00 $20,939.14 2026-03-31
SUP-961973 CDM Fee Vte Price Per Procedure Replc Parts 86 42 $22,102.50 $22,102.50 $6,064.93 $22,102.50 $20,710.04 2026-03-31
L8614 HCPCS Dornhoffer Fixed Part W/window 946 42 $26,307.58 $26,307.58 $376.45 $31,736.18 $20,697.53 2026-03-31
50590 CPT Hc Lithotripsy Eswl Lt 172 42 $27,427.50 $27,427.50 $6,020.88 $32,913.00 $20,559.65 2026-03-31
SUP-224094 CDM Valve Aortic Heart 17-21mm Cryopreserved 86 42 $21,882.53 $21,882.53 $6,004.57 $21,882.53 $20,503.93 2026-03-31
C1721 HCPCS Defib Dev Fortify Dr Df1 Dual Chamber 1,720 42 $23,051.26 $23,051.26 $660.03 $30,942.00 $20,440.21 2026-03-31
SUP-224840 CDM Excluder Aort Ibc 23x10x10 Fa 86 42 $21,793.07 $21,793.07 $5,980.02 $21,793.07 $20,420.11 2026-03-31
SUP-960397 CDM Cage Spinal 22x8.5x16mm Ti Cx Vertebral Pors Cascadia 86 42 $21,681.75 $21,681.75 $5,949.47 $21,681.75 $20,315.80 2026-03-31
SUP-219341 CDM Excluder Aort C3 23x12x16cm 86 42 $21,576.25 $21,576.25 $5,920.52 $21,576.25 $20,216.95 2026-03-31
J1303 HCPCS Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 440 108 $46,867.70 $46,867.70 $5,511.64 $73,649.25 $20,147.75 2026-03-31
SUP-220798 CDM Device Embolization 5x20mm Pipeline Bare-metal Flex Aneu Lf 86 42 $21,487.50 $21,487.50 $5,896.17 $21,487.50 $20,133.79 2026-03-31
SUP-220710 CDM Device Embolization 2.5x12mm Pipeline Bare-metal Flex Aneu 86 42 $21,487.50 $21,487.50 $5,896.17 $21,487.50 $20,133.79 2026-03-31
SUP-220744 CDM Device Embol 3.5x20mm Pipeline 86 42 $21,487.50 $21,487.50 $5,896.17 $21,487.50 $20,133.79 2026-03-31
SUP-10010740 CDM Cath 16 Flash 100cm W/element Sheath 65cm Htorq 86 42 $21,047.90 $21,047.90 $5,775.54 $21,047.90 $19,721.88 2026-03-31
374 MS_DRG Digestive Malignancy With Mcc 6 3 — $7,122.90 $19,369.42 $19,749.22 $19,654.27 2026-03-31
SUP-399856 CDM Pack Heartware Monitor 86 42 $20,944.75 $20,944.75 $5,747.24 $20,944.75 $19,625.23 2026-03-31
C1722 HCPCS Crt-d Ilivia Neo 7 Hf-t Qp/hf-t 2,236 42 $22,606.65 $22,606.65 $206.65 $34,380.00 $19,248.79 2026-03-31
SUP-219336 CDM Excluder Aort C3 23x12x14cm 86 42 $20,418.50 $20,418.50 $5,602.84 $20,418.50 $19,132.13 2026-03-31
SUP-301306 CDM Stent Syst Hydrphlc 3.5x15mm Wingspan 86 42 $20,319.57 $20,319.57 $5,575.69 $20,319.57 $19,039.44 2026-03-31
SUP-603021 CDM Cage Cnt Pc Obelisc 23-31 20mm 86 42 $20,058.02 $20,058.02 $5,503.92 $20,058.02 $18,794.36 2026-03-31
SUP-217059 CDM Stent Endur Ii Aui 32x14x102 86 42 $19,652.28 $19,652.28 $5,392.59 $19,652.28 $18,414.19 2026-03-31
SUP-219709 CDM Stent Endur Aaa Bif 36x14x103 86 42 $19,652.28 $19,652.28 $5,392.59 $19,652.28 $18,414.19 2026-03-31
SUP-216997 CDM Stent Endur Ii Bif 28x16x145 Bifurcated 86 42 $19,652.28 $19,652.28 $5,392.59 $19,652.28 $18,414.19 2026-03-31
SUP-219707 CDM Stent Endur Aaa Bif 28x14x103 86 42 $19,605.74 $19,605.74 $5,379.82 $19,605.74 $18,370.58 2026-03-31
SUP-219706 CDM Stent Endur Aaa Bif 25x14x103 86 42 $19,582.77 $19,582.77 $5,373.51 $19,582.77 $18,349.06 2026-03-31
SUP-217058 CDM Stent Endur Ii Aui 28x14x102 86 42 $19,557.95 $19,557.95 $5,366.70 $19,557.95 $18,325.80 2026-03-31
SUP-219705 CDM Stent Endur Aaa Bif 23x14x103 86 42 $19,492.97 $19,492.97 $5,348.87 $19,492.97 $18,264.91 2026-03-31
SUP-972595 CDM Electrode Vivaer Stylus Alt Current 86 42 $19,471.25 $19,471.25 $5,342.91 $19,471.25 $18,244.56 2026-03-31
SUP-219708 CDM Stent Endur Aaa Bif 32x14x103 86 42 $19,445.38 $19,445.38 $5,335.81 $19,445.38 $18,220.32 2026-03-31
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 6 3 — $34,347.08 $17,945.55 $18,297.43 $18,209.46 2026-03-31
C1820 HCPCS Adaptive Stim Implantable Neurostimulator 2,752 42 $27,730.05 $27,730.05 $18.85 $45,975.98 $18,191.41 2026-03-31
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 6 3 — $54,003.21 $17,909.89 $18,261.07 $18,173.28 2026-03-31
SUP-217060 CDM Stent Endur Ii Aui 36x14x102 86 42 $19,274.96 $19,274.96 $5,289.05 $19,274.96 $18,060.64 2026-03-31
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 6 3 — $2,609.00 $17,797.18 $18,146.15 $18,058.91 2026-03-31
SUP-217057 CDM Stent Endur Ii Aui 25x14x102 86 42 $19,233.03 $19,233.03 $5,277.54 $19,233.03 $18,021.35 2026-03-31
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 6 3 — $22,886.23 $17,674.12 $18,020.67 $17,934.03 2026-03-31
SUP-747197 CDM Valve Mitral Master 15mm Hip 86 42 $19,113.40 $19,113.40 $5,244.72 $19,113.40 $17,909.26 2026-03-31
SUP-779679 CDM Tissue Matrix Dermacell 16x20cm 0.75-1.50mm 86 42 $19,069.62 $19,069.62 $5,232.70 $19,069.62 $17,868.23 2026-03-31
SUP-946547 CDM Lead Stimulator Respistim Rt 24mm 86 42 $18,945.00 $18,945.00 $5,198.51 $18,945.00 $17,751.47 2026-03-31
SUP-217010 CDM Stent Endur Ii Bif 36x20x166 Bifurcated 86 42 $18,897.64 $18,897.64 $5,185.51 $18,897.64 $17,707.09 2026-03-31
SUP-216987 CDM Stent Endur Ii Bif 25x13x124 Bifurcated 86 42 $18,897.64 $18,897.64 $5,185.51 $18,897.64 $17,707.09 2026-03-31
SUP-603922 CDM Cage Cnt Pc Obelisc 27-38 20mm 86 42 $18,812.91 $18,812.91 $5,162.26 $18,812.91 $17,627.70 2026-03-31
SUP-226945 CDM Valve Aortic Perceval Sm 86 42 $18,734.50 $18,734.50 $5,140.75 $18,734.50 $17,554.23 2026-03-31
Q0479 HCPCS Unit Mobile Power Mpu 86 42 $18,187.20 $18,187.20 $4,990.57 $18,187.20 $17,041.41 2026-03-31
177 MS_DRG Respiratory Infections And Inflammations With Mcc 6 3 — $17,119.00 $16,561.94 $16,886.69 $16,805.50 2026-03-31
571 MS_DRG Skin Debridement With Cc 6 3 — $51,928.60 $16,559.64 $16,884.34 $16,803.16 2026-03-31
SUP-756274 CDM Bone Allograft Cartiform 20mm Disc 86 42 $17,892.50 $17,892.50 $4,909.70 $17,892.50 $16,765.27 2026-03-31
SUP-869948 CDM Stent Graft Bifurcate 28x120mm 86 42 $17,841.98 $17,841.98 $4,895.84 $17,841.98 $16,717.94 2026-03-31
A9566 HCPCS Tc-99m Fanolesomab Diag 86 42 $17,688.75 $17,688.75 $4,853.79 $17,688.75 $16,574.36 2026-03-31
J9345 HCPCS Retifanlimab-dlwr 500 Mg/20 Ml Intravenous Solution 220 108 $45,114.00 $45,114.00 $12,379.28 $45,114.00 $16,405.00 2026-03-31
385 MS_DRG Inflammatory Bowel Disease With Mcc 6 3 — $16,644.70 $16,038.62 $16,353.11 $16,274.48 2026-03-31
SUP-749182 CDM Valve Aortic Inspiris 23 23mm 86 42 $17,263.11 $17,263.11 $4,737.00 $17,263.11 $16,175.53 2026-03-31
SUP-749184 CDM Valve Aortic Inspiris 27 27mm 86 42 $17,263.11 $17,263.11 $4,737.00 $17,263.11 $16,175.53 2026-03-31
SUP-749181 CDM Valve Aortic Inspiris 21 21mm 86 42 $17,263.11 $17,263.11 $4,737.00 $17,263.11 $16,175.53 2026-03-31
SUP-749183 CDM Valve Aortic Inspiris 25 25mm 86 42 $17,156.28 $17,156.28 $4,707.68 $17,156.28 $16,075.43 2026-03-31
SUP-212231 CDM Stent Neuroform Ez 4.5x30mm 86 42 $17,022.65 $17,022.65 $4,671.02 $17,022.65 $15,950.22 2026-03-31
SUP-909989 CDM Valve Mitral Mitris Resilia Sz 33 86 42 $17,010.61 $17,010.61 $4,667.71 $17,010.61 $15,938.94 2026-03-31
SUP-749185 CDM Valve Aortic Inspiris 29 29mm 86 42 $16,899.89 $16,899.89 $4,637.33 $16,899.89 $15,835.20 2026-03-31
SUP-749180 CDM Valve Aortic Inspiris 19 19mm 86 42 $16,785.52 $16,785.52 $4,605.95 $16,785.52 $15,728.03 2026-03-31
415 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Cc 6 3 — $58,380.57 $15,479.66 $15,783.19 $15,707.30 2026-03-31
SUP-909987 CDM Valve Mitral Mitris Resilia Sz 29 86 42 $16,558.04 $16,558.04 $4,543.53 $16,558.04 $15,514.88 2026-03-31
SUP-909988 CDM Valve Mitral Mitris Resilia Sz 31 86 42 $16,408.48 $16,408.48 $4,502.49 $16,408.48 $15,374.75 2026-03-31
A9600 HCPCS Sr-89 Stront Chlor Ther / Mci 220 108 $40,862.00 $40,862.00 $11,212.53 $40,862.00 $15,000.00 2026-03-31
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 6 3 — $16,914.99 $14,750.48 $15,039.70 $14,967.39 2026-03-31
J9043 HCPCS Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 220 108 $44,159.55 $44,159.55 $12,117.38 $44,159.55 $14,911.20 2026-03-31
SUP-981600 CDM Spacer Identiti Nanotec Lif Porous 8x18x55mm 10deg 86 42 $15,842.12 $15,842.12 $4,347.08 $15,842.12 $14,844.07 2026-03-31
SUP-874153 CDM Device Ifd Nanolock 16d Lrg 14mm 86 42 $15,787.50 $15,787.50 $4,332.09 $15,787.50 $14,792.89 2026-03-31
SUP-886913 CDM Cage Capri 13x16x24mm 0d 20-24 86 42 $15,734.88 $15,734.88 $4,317.65 $15,734.88 $14,743.58 2026-03-31
A9587 HCPCS Ga-68 Gallium 68 Dotatate 86 42 $15,600.00 $15,600.00 $4,280.64 $15,600.00 $14,617.20 2026-03-31
SUP-960411 CDM Cage Capri Cerv Expand Corp W/set Screw 12x14mm 26-36mm 0deg 86 42 $15,498.86 $15,498.86 $4,252.89 $15,498.86 $14,522.43 2026-03-31
J9309 HCPCS Polatuzumab Vedotin-piiq 140 Mg Intravenous Solution 440 108 $35,933.35 $35,933.35 $3,480.05 $59,184.30 $14,461.28 2026-03-31
SUP-981748 CDM Spacer Identiti Alif Sa 20deg 6x34x24mm 86 42 $15,344.86 $15,344.86 $4,210.63 $15,344.86 $14,378.13 2026-03-31
A9572 HCPCS In-111 Pentetreotide 86 42 $15,327.00 $15,327.00 $4,205.73 $15,327.00 $14,361.40 2026-03-31
SUP-10014746 CDM Spacer Identiti 6x22x45mm 10deg Nanotec Lif Porous 86 42 $15,221.68 $15,221.68 $4,176.83 $15,221.68 $14,262.71 2026-03-31
SUP-960409 CDM Cage Capri Cerv Expand Corp W/set Screw 12x14mm 20-24mm 0deg 86 42 $15,210.37 $15,210.37 $4,173.73 $15,210.37 $14,252.12 2026-03-31
A9586 HCPCS F-18 Florbetapir Less Than Or Equal To 10 Mci 86 42 $15,145.00 $15,145.00 $4,155.79 $15,145.00 $14,190.87 2026-03-31
SUP-752076 CDM Cath Bln 9350bc25a 86 42 $15,124.43 $15,124.43 $4,150.14 $15,124.43 $14,171.59 2026-03-31
SUP-980811 CDM Spacer Identiti Alif Sa 20deg 9x42x30mm 86 42 $15,123.27 $15,123.27 $4,149.83 $15,123.27 $14,170.50 2026-03-31
J9042 HCPCS Brentuximab Vedotin 50 Mg Intravenous Solution 220 108 $39,510.50 $39,510.50 $10,841.68 $39,510.50 $14,145.00 2026-03-31
SUP-981657 CDM Spacer Identiti Nanotec Lif Porous 10x22x60mm 10deg 86 42 $15,056.22 $15,056.22 $4,131.43 $15,056.22 $14,107.68 2026-03-31
J1323 HCPCS Elranatamab-bcmm 40 Mg/ml Subcutaneous Solution 220 108 $42,858.30 $42,858.30 $11,760.32 $42,858.30 $14,083.56 2026-03-31
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 6 3 — $10,097.45 $13,840.72 $14,112.10 $14,044.26 2026-03-31
SUP-217053 CDM Stent Endur Ii Aoext 28x28x70 Aortic Extension 86 42 $14,924.45 $14,924.45 $4,095.27 $14,924.45 $13,984.21 2026-03-31
SUP-960410 CDM Cage Capri Cerv Expand Corp W/set Screw 12x14mm 22-28mm 0deg 86 42 $14,843.24 $14,843.24 $4,072.99 $14,843.24 $13,908.12 2026-03-31
SUP-10014758 CDM Spacer Identiti Alif Sa 10deg 13x42x30mm 86 42 $14,811.71 $14,811.71 $4,064.33 $14,811.71 $13,878.57 2026-03-31
SUP-978694 CDM Spacer Spinal 28x38x9mm 10deg Identiti Alif Interbody Strl 86 42 $14,785.86 $14,785.86 $4,057.24 $14,785.86 $13,854.35 2026-03-31
SUP-10009051 CDM Implant Disc Cranial 8x9cm Xl Crvd Clearfit Ots Resinous 86 42 $14,735.00 $14,735.00 $4,043.28 $14,735.00 $13,806.70 2026-03-31
SUP-969980 CDM Stent Vasc Intraluminal 3.5x17mm 86 42 $14,726.58 $14,726.58 $4,040.97 $14,726.58 $13,798.81 2026-03-31
SUP-217051 CDM Stent Endur Ii Aoext 23x23x70 Aortic Extension 86 42 $14,726.58 $14,726.58 $4,040.97 $14,726.58 $13,798.81 2026-03-31
SUP-960408 CDM Cage Capri Cerv Expand Corp W/set Screw 12x14mm 18-21mm 0deg 86 42 $14,716.31 $14,716.31 $4,038.16 $14,716.31 $13,789.18 2026-03-31
SUP-886914 CDM Cage Capri 13x16x28mm 0d 22-28 86 42 $14,633.43 $14,633.43 $4,015.41 $14,633.43 $13,711.52 2026-03-31
SUP-905592 CDM Spacer Identiti Alif Sa Spacer 9x38x28mm 86 42 $14,578.96 $14,578.96 $4,000.47 $14,578.96 $13,660.49 2026-03-31
SUP-981417 CDM Spacer Identiti Alif Sa 10deg 10x34x24mm 86 42 $14,568.73 $14,568.73 $3,997.66 $14,568.73 $13,650.90 2026-03-31
SUP-10008036 CDM Spacer Hedron Ia 29x39 15mm 15deg 86 42 $14,556.77 $14,556.77 $3,994.38 $14,556.77 $13,639.69 2026-03-31
SUP-10005364 CDM Spacer Identiti Alif Sa 10deg 6x34x24mm 86 42 $14,548.03 $14,548.03 $3,991.98 $14,548.03 $13,631.50 2026-03-31
SUP-156598 CDM Valve Aort 23mm Root Freestyle Fr99523 Prosthesis 86 42 $14,524.50 $14,524.50 $3,985.52 $14,524.50 $13,609.46 2026-03-31
SUP-981593 CDM Spacer Identiti Alif Sa 15deg 6x34x24mm 86 42 $14,485.89 $14,485.89 $3,974.93 $14,485.89 $13,573.28 2026-03-31
SUP-978693 CDM Spacer Spinal 28x38x7mm 15deg Identiti Alif Interbody Strl 86 42 $14,485.89 $14,485.89 $3,974.93 $14,485.89 $13,573.28 2026-03-31
SUP-969984 CDM Stent Vasc Intraluminal 3x18mm 86 42 $14,459.77 $14,459.77 $3,967.76 $14,459.77 $13,548.80 2026-03-31
SUP-896589 CDM Hedron Ia Spacer 29x39 13mm 15deg 86 42 $14,452.93 $14,452.93 $3,965.88 $14,452.93 $13,542.40 2026-03-31
SUP-878194 CDM Spacer Identiti Alif Sa 8x34x24mm 10deg 86 42 $14,423.46 $14,423.46 $3,957.80 $14,423.46 $13,514.78 2026-03-31
SUP-217054 CDM Stent Endur Ii Aoext 32x32x70 Aortic Extension 86 42 $14,350.84 $14,350.84 $3,937.87 $14,350.84 $13,446.74 2026-03-31
SUP-207390 CDM Valve Donduit Pulmonic 12mm 86 42 $14,328.74 $14,328.74 $3,931.81 $14,328.74 $13,426.03 2026-03-31
SUP-10005401 CDM Spacer Identiti Alif Sa 15deg 11x38x28mm 86 42 $14,320.40 $14,320.40 $3,929.52 $14,320.40 $13,418.21 2026-03-31
SUP-10009052 CDM Implant Disc Cranial 6.5x7.5cm Lg Crvd Clearfit Ots Resinous 86 42 $14,314.00 $14,314.00 $3,927.76 $14,314.00 $13,412.22 2026-03-31
291 MS_DRG Heart Failure And Shock With Mcc 6 3 — $11,954.80 $13,203.54 $13,462.44 $13,397.71 2026-03-31
SUP-980810 CDM Spacer Identiti Alif Sa 15deg 6x42x30mm 86 42 $14,268.87 $14,268.87 $3,915.38 $14,268.87 $13,369.93 2026-03-31
J9272 HCPCS Dostarlimab-gxly 50 Mg/ml Intravenous Solution 220 108 $36,812.65 $36,812.65 $10,101.39 $36,812.65 $13,341.50 2026-03-31
SUP-969972 CDM Stent Vasc Intraluminal 4x31mm 86 42 $14,192.96 $14,192.96 $3,894.55 $14,192.96 $13,298.80 2026-03-31
SUP-603477 CDM Endplate Fortify-r 14mm Core 16-20mm 14 86 42 $14,172.97 $14,172.97 $3,889.06 $14,172.97 $13,280.07 2026-03-31
SUP-983712 CDM Spacer Identiti Alif Sa 15deg 10x42x30mm 86 42 $14,113.77 $14,113.77 $3,872.82 $14,113.77 $13,224.60 2026-03-31
SUP-948309 CDM Cage Spnl Fusion 36x28x10mm Monterey 86 42 $13,954.66 $13,954.66 $3,829.16 $13,954.66 $13,075.52 2026-03-31
SUP-215805 CDM Embolic Syst Onyx Hd500 86 42 $13,926.68 $13,926.68 $3,821.48 $13,926.68 $13,049.30 2026-03-31
SUP-364002 CDM Valve Aort Magna Ease 23mm Perimount Magna Ease 86 42 $13,905.10 $13,905.10 $3,815.56 $13,905.10 $13,029.08 2026-03-31
C1832 HCPCS System Recell Skin Grafting/harvesting 86 42 $13,777.23 $13,777.23 $3,780.47 $13,777.23 $12,909.26 2026-03-31
SUP-782091 CDM Cage Alif 3d Print 39x11mm X8 86 42 $13,682.50 $13,682.50 $3,754.48 $13,682.50 $12,820.50 2026-03-31
SUP-10009048 CDM Implant Disc Cranial 4x5cm Xsm Crvd Clearfit Resinous 86 42 $13,682.50 $13,682.50 $3,754.48 $13,682.50 $12,820.50 2026-03-31
SUP-364004 CDM Valve Aort Magna Ease 27mm Perimount Magna Ease 86 42 $13,674.63 $13,674.63 $3,752.32 $13,674.63 $12,813.13 2026-03-31
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 6 3 — $14,228.55 $12,605.48 $12,852.64 $12,790.85 2026-03-31
315 MS_DRG Other Circulatory System Diagnoses With Cc 6 3 — $5,237.95 $12,588.23 $12,835.06 $12,773.35 2026-03-31
SUP-364003 CDM Valve Aort Magna Ease 25mm Perimount Magna Ease 86 42 $13,609.44 $13,609.44 $3,734.43 $13,609.44 $12,752.05 2026-03-31
399 MS_DRG Appendix Procedures Without Cc/mcc 6 3 — $35,847.45 $12,545.67 $12,791.67 $12,730.17 2026-03-31
SUP-975787 CDM Spacer Monument Sm 11mm 15deg 86 42 $13,579.36 $13,579.36 $3,726.18 $13,579.36 $12,723.86 2026-03-31
SUP-364001 CDM Valve Aort Magna Ease 21mm Perimount Magna Ease 86 42 $13,512.06 $13,512.06 $3,707.71 $13,512.06 $12,660.80 2026-03-31
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 6 3 — $15,516.75 $12,466.31 $12,710.74 $12,649.64 2026-03-31
SUP-901296 CDM Spacer Spinal 11mm Short Interbody Catalyft Pl40 86 42 $13,499.37 $13,499.37 $3,704.23 $13,499.37 $12,648.91 2026-03-31
SUP-585315 CDM X-mesh Lat Med 0 Deg 51-71mm 86 42 $13,438.32 $13,438.32 $3,687.48 $13,438.32 $12,591.71 2026-03-31
SUP-983148 CDM Plate Core Expand 16mm 50-75mm Tl Vbr 86 42 $13,408.85 $13,408.85 $3,679.39 $13,408.85 $12,564.09 2026-03-31
SUP-777462 CDM Device Haart 200 Aort Annuloplasty 21mm 86 42 $13,366.75 $13,366.75 $3,667.84 $13,366.75 $12,524.64 2026-03-31
J9325 HCPCS Talimogene Laherparepvec 10exp6 (1 Million) Pfu/ml Susp For Injection 440 108 $44,450.67 $44,450.67 $241.57 $88,021.00 $12,516.66 2026-03-31
SUP-774870 CDM Cage Spinal 26x32x13mm 12deg Aero Lmbr Peek Ant Strl Lf 86 42 $13,178.73 $13,178.73 $3,616.24 $13,178.73 $12,348.47 2026-03-31
SUP-751485 CDM Device Embotrap Ii 5x33 Revasc 86 42 $13,172.96 $13,172.96 $3,614.66 $13,172.96 $12,343.06 2026-03-31
SUP-901297 CDM Spacer Spinal 7mm Long Interbody Catalyft Pl40 86 42 $13,160.46 $13,160.46 $3,611.23 $13,160.46 $12,331.35 2026-03-31
SUP-756273 CDM Bone Allograft Cartiform 12x19mm Disc 86 42 $13,156.25 $13,156.25 $3,610.08 $13,156.25 $12,327.41 2026-03-31
369 MS_DRG Major Esophageal Disorders With Cc 6 3 — $20,899.50 $12,141.97 $12,380.05 $12,320.53 2026-03-31
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 6 3 — $3,066.45 $12,120.12 $12,357.77 $12,298.36 2026-03-31
SUP-375190 CDM Valve Mitral Magna Thrmfx 33mm 86 42 $13,112.05 $13,112.05 $3,597.95 $13,112.05 $12,285.99 2026-03-31
J9153 HCPCS Daunorubicin 44 Mg And Cytarabine 100 Mg In Liposome IV Solution 220 108 $34,410.00 $34,410.00 $9,442.10 $34,410.00 $12,283.04 2026-03-31
SUP-375187 CDM Valve Mitral Magna Thrmfx 27mm 86 42 $13,105.96 $13,105.96 $3,596.28 $13,105.96 $12,280.28 2026-03-31
SUP-777717 CDM Femoral Politeal Artery 86 42 $13,072.05 $13,072.05 $3,586.97 $13,072.05 $12,248.51 2026-03-31
SUP-960319 CDM Mesa Small Stature Rail 4d Deformity Implants Contoured Deformity Contour Ti 375… 86 42 $13,063.63 $13,063.63 $3,584.66 $13,063.63 $12,240.62 2026-03-31
SUP-886703 CDM Device Suturing Serosafuse Ste 86 42 $13,051.84 $13,051.84 $3,581.42 $13,051.84 $12,229.57 2026-03-31
SUP-777467 CDM Device Haart 300 Aort Annuloplasty 21mm 86 42 $13,008.90 $13,008.90 $3,569.64 $13,008.90 $12,189.34 2026-03-31
SUP-901298 CDM Spacer Spinal 9mm Long Interbody Catalyft Pl40 86 42 $12,991.01 $12,991.01 $3,564.73 $12,991.01 $12,172.58 2026-03-31
SUP-10005846 CDM Ltx Spacer 6 X 22 X 50 Mm 15deg 86 42 $12,990.48 $12,990.48 $3,564.59 $12,990.48 $12,172.08 2026-03-31
SUP-375188 CDM Valve Mitral Magna Thrmfx 29mm 86 42 $12,975.22 $12,975.22 $3,560.40 $12,975.22 $12,157.78 2026-03-31
SUP-364005 CDM Valve Aort Magna Ease 29mm Perimount Magna Ease 86 42 $12,947.86 $12,947.86 $3,552.89 $12,947.86 $12,132.14 2026-03-31
SUP-896783 CDM Sable 12x26mm 9-16mm 22deg 86 42 $12,945.75 $12,945.75 $3,552.31 $12,945.75 $12,130.17 2026-03-31
SUP-289105 CDM Kit Insrt Cann Fem Dlp Vnt 21f 86 42 $12,882.60 $12,882.60 $3,534.99 $12,882.60 $12,071.00 2026-03-31
SUP-375189 CDM Valve Mitral Magna Thrmfx 31mm 86 42 $12,865.76 $12,865.76 $3,530.36 $12,865.76 $12,055.22 2026-03-31
SUP-982472 CDM Spacer Identiti Lif Porous 10x18x50mm 0deg Ti 86 42 $12,822.61 $12,822.61 $3,518.52 $12,822.61 $12,014.79 2026-03-31
SUP-10005842 CDM Ltx Spacer 6 X 18 X 45 Mm 15deg 86 42 $12,805.41 $12,805.41 $3,513.80 $12,805.41 $11,998.67 2026-03-31
SUP-585339 CDM Cage Spinal 16mm 0deg Sm X-mesh Vbr Titan Expand Mesh Lf 86 42 $12,764.72 $12,764.72 $3,502.64 $12,764.72 $11,960.54 2026-03-31
J1640 HCPCS Hemin 350 Mg Intravenous Powder For Solution 220 108 $34,281.50 $34,281.50 $9,406.84 $34,281.50 $11,959.50 2026-03-31
SUP-10005845 CDM Ltx Spacer 6 X 22 X 45 Mm 15deg 86 42 $12,761.56 $12,761.56 $3,501.77 $12,761.56 $11,957.58 2026-03-31
J9022 HCPCS Atezolizumab 60 Mg/ml Intravenous Solution (wrapper) 220 108 $35,811.20 $35,811.20 $9,826.59 $35,811.20 $11,953.20 2026-03-31
J0896 HCPCS Luspatercept-aamt 25 Mg Subcutaneous Solution 440 108 $25,172.35 $25,172.35 $3,453.65 $37,758.50 $11,950.60 2026-03-31
SUP-749549 CDM Coil Assist Stent Lvis 5.5x30 86 42 $12,724.73 $12,724.73 $3,491.67 $12,724.73 $11,923.07 2026-03-31
SUP-961844 CDM Cage Spnl Stalif M Flex 33x15 16deg 86 42 $12,724.73 $12,724.73 $3,491.67 $12,724.73 $11,923.07 2026-03-31
SUP-10017234 CDM Cath Ablat 8.5f 25-35mm Bi-directional 86 42 $12,718.96 $12,718.96 $3,490.08 $12,718.96 $11,917.67 2026-03-31
378 MS_DRG Gastrointestinal Hemorrhage With Cc 6 3 — $40,873.45 $11,741.72 $11,971.95 $11,914.39 2026-03-31
SUP-10005847 CDM Ltx Spacer 6 X 22 X 55 Mm 15deg 86 42 $12,682.63 $12,682.63 $3,480.11 $12,682.63 $11,883.62 2026-03-31
SUP-901293 CDM Spacer Spinal 11mm Long Interbody Catalyft Pl 86 42 $12,674.21 $12,674.21 $3,477.80 $12,674.21 $11,875.73 2026-03-31
SUP-901299 CDM Spacer Spinal 11mm Long Interbody Catalyft Pl40 86 42 $12,670.00 $12,670.00 $3,476.65 $12,670.00 $11,871.79 2026-03-31
SUP-906304 CDM Normandy Corpectomy Cage - 12x14mm 17-25mm Tall 5deg 86 42 $12,630.00 $12,630.00 $3,465.67 $12,630.00 $11,834.31 2026-03-31
SUP-364000 CDM Valve Aort Magna Ease 19mm Perimount Magna Ease 86 42 $12,619.48 $12,619.48 $3,462.79 $12,619.48 $11,824.45 2026-03-31
SUP-217033 CDM Stent Endur Ii Limb 16x24x156 Contralateral Limb 86 42 $12,608.95 $12,608.95 $3,459.90 $12,608.95 $11,814.59 2026-03-31
SUP-873805 CDM Stent Endur Ii Limb 16x20x146mm 86 42 $12,553.48 $12,553.48 $3,444.67 $12,553.48 $11,762.61 2026-03-31
SUP-975831 CDM Valve Heart Aortic 19mm Avalus Ult Xenograft Strl Avalustm 86 42 $12,524.75 $12,524.75 $3,436.79 $12,524.75 $11,735.69 2026-03-31
SUP-217030 CDM Stent Endur Ii Limb 16x13x156 Contralateral Limb 86 42 $12,509.09 $12,509.09 $3,432.49 $12,509.09 $11,721.02 2026-03-31
SUP-217031 CDM Stent Endur Ii Limb 16x16x156 Contralateral Limb 86 42 $12,498.92 $12,498.92 $3,429.70 $12,498.92 $11,711.49 2026-03-31
SUP-217032 CDM Stent Endur Ii Limb 16x20x156 Contralateral Limb 86 42 $12,498.29 $12,498.29 $3,429.53 $12,498.29 $11,710.90 2026-03-31
SUP-217034 CDM Stent Endur Ii Limb 16x28x156 Contralateral Limb 86 42 $12,487.91 $12,487.91 $3,426.68 $12,487.91 $11,701.17 2026-03-31
SUP-212228 CDM Stent Neuroform Ez 3.5x30mm 86 42 $12,461.60 $12,461.60 $3,419.46 $12,461.60 $11,676.52 2026-03-31
J9203 HCPCS Gemtuzumab Ozogamicin 4.5 Mg (1 Mg/ml Initial Concentration) IV Soln 220 108 $31,504.65 $31,504.65 $8,644.88 $31,504.65 $11,652.30 2026-03-31
SUP-224103 CDM Graft Pulmonary Artery 16mm Cryopreserved 86 42 $12,435.29 $12,435.29 $3,412.24 $12,435.29 $11,651.87 2026-03-31
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 6 3 — $27,016.27 $11,479.50 $11,704.59 $11,648.31 2026-03-31
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 6 3 — $9,308.85 $11,462.24 $11,686.99 $11,630.80 2026-03-31
SUP-873803 CDM Stent Graft Etlw1613c146e Endur Ii Limb 86 42 $12,410.68 $12,410.68 $3,405.49 $12,410.68 $11,628.81 2026-03-31
SUP-896773 CDM Sable 10x26mm 9-16mm 8deg 86 42 $12,385.59 $12,385.59 $3,398.61 $12,385.59 $11,605.30 2026-03-31
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