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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

ADVENTHEALTH OTTAWA

Ottawa, KS · CCN 170014 · Rates published

26,459 distinct procedures filed
20 distinct payers
710,266 rate rows
2026-04-01 last MRF observed
Data quality

693,251 of 710,266 rate rows are consumer-grade (97.6%)

17,015 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 14,680
template filing: same amount across many unrelated codes — excluded 1,236
exceeds 10× this hospital's gross charge — excluded from medians 589
per-diem day rate — not a per-procedure price 272
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 213
placeholder amount (≤ $0.02) — excluded from medians 19
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://HospitalPriceDisclosure.com/download.aspx?pi=kKeNKqg*__*JaoVT6NgHgOmSw*-*
Found on page https://HospitalPriceDisclosure.com/Default.aspx?ci=RsbcVwMa5jfnDZuYpIqAxQ*-*
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-03
Content fingerprint 2d32f50ce89541f0… · 19,397,727 bytes · first seen 2026-05-09

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 1 $3,710,000.00 $3,710,000.00 $3,710,000.00 nat. median
$3,508,750
1.1× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 2 $3,685,266.67 $3,710,000.00 $3,697,633.33 nat. median
$3,685,267
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 2 $3,316,462.59 $3,321,781.51 $3,319,122.05 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 3 $3,193,000.00 $4,970,121.94 $3,248,445.72 nat. median
$3,248,446
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $2,403,458.75 $4,173,688.03 $3,105,714.92 nat. median
$2,455,111
1.3× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 3 $2,945,740.00 $4,506,982.20 $2,968,000.00 nat. median
$2,968,000
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $2,332,000.00 $3,964,400.00 $2,949,980.00 nat. median
$2,332,000
1.3× median
Q2042
HCPCS 		Tisagenlecleucel IV Infusion (wrapped) 17 $466,070.00 $3,828,070.00 $2,147,070.00 nat. median
$621,313
outlier · 3.5×
Q2055
HCPCS 		Idecabtagene Vicleucel 460000000 Cells IV Susp 18 $460,227.00 $4,467,708.00 $2,123,043.25 nat. median
$574,037
outlier · 3.7×
Q2054
HCPCS 		Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 18 $454,489.00 $4,369,759.00 $2,077,586.00 nat. median
$579,571
outlier · 3.6×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $489,517.15 $906,491.29 $674,536.17 nat. median
$562,501
1.2× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $488,051.51 $831,817.83 $618,970.33 nat. median
$513,770
1.2× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 5 $494,704.54 $961,977.21 $565,868.94 nat. median
$599,737
0.9× median
A9520
HCPCS 		Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection 13 $10.00 $693,347.00 $564,693.00 nat. median
$767
outlier · 736.0×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 12 $129,318.00 $745,896.50 $359,327.99 nat. median
$168,055
outlier · 2.1×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 12 $106,702.00 $484,056.82 $261,399.59 nat. median
$186,516
1.4× median
13925-522-01
NDC 		Pentamidine Isethionate 300 Mg In Solr 14 $103,127.00 $356,977.00 $230,052.00 —
58914-501-56
NDC 		Mesalamine 1000 Mg Re Supp 14 $96,911.00 $335,462.00 $216,186.50 nat. median
$47
outlier · 4584.1×
C1831
HCPCS 		Kit Imp Aprevo Spine Lvl 1 14 $9,900.00 $437,000.00 $213,116.00 nat. median
$5,834
outlier · 36.5×
A9588
HCPCS 		Fluciclovine F 18 9-221 Mci/ml IV Soln 16 $80.00 $414,100.00 $204,519.50 nat. median
$547
outlier · 373.8×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 $114,065.15 $392,802.00 $197,356.00 nat. median
$131,925
1.5× median
52427-273-75
NDC 		Naproxen Sodium ER 500 Mg Po Tb24 14 $88,203.00 $305,319.00 $196,761.00 —
C9089
HCPCS 		Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl 14 $64,187.00 $228,405.00 $186,636.50 nat. median
$1
outlier · 150513.3×
63323-877-15
NDC 		Pentamidine Isethionate 300 Mg In Solr 14 $80,884.00 $279,982.00 $180,433.00 —
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 $83,931.00 $366,622.88 $178,364.00 nat. median
$145,435
1.2× median
A9572
HCPCS 		Indium In-111 Pentetreotide IV Kit 16 $57.00 $348,013.00 $171,880.00 nat. median
$3,702
outlier · 46.4×
58468-0132-1
NDC 		Sevelamer Carbonate 0.8 G Po Pack 14 $76,496.00 $264,794.00 $170,645.00 —
58468-0132-2
NDC 		Sevelamer Carbonate 0.8 G Po Pack 14 $76,496.00 $264,794.00 $170,645.00 —
68382-395-01
NDC 		Ribavirin 6 G In Solr 14 $71,424.00 $247,239.00 $159,331.50 —
68382-395-04
NDC 		Ribavirin 6 G In Solr 14 $71,424.00 $247,239.00 $159,331.50 —
59385-027-60
NDC 		Buprenorphine Hcl 900 Mcg Bu Film 14 $68,701.00 $237,813.00 $153,257.00 —
59385-027-01
NDC 		Buprenorphine Hcl 900 Mcg Bu Film 14 $68,701.00 $237,813.00 $153,257.00 —
A9595
HCPCS 		Piflufolastat F 18 9 Mci IV Sosy 17 $332.44 $427,589.00 $152,982.00 nat. median
$631
outlier · 242.5×
C1825
HCPCS 		System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 14 $9,900.00 $244,720.00 $151,059.00 nat. median
$35,000
outlier · 4.3×
209
MS_DRG 		Complex Aortic Arch Procedures 5 $76,874.09 $195,509.63 $148,072.54 nat. median
$2,110
outlier · 70.2×
24338-050-08
NDC 		Carmustine In Polifeprosan 7.7 Mg Il Wafr 14 $63,420.00 $219,530.00 $141,475.00 —
A9569
HCPCS 		Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection 16 $55.00 $285,633.00 $141,071.00 nat. median
$1,675
outlier · 84.2×
C1824
HCPCS 		Generator Pul Implantable Optimizer Smt F/hrt Fail 14 $9,900.00 $227,240.00 $140,269.00 nat. median
$32,119
outlier · 4.4×
C1822
HCPCS 		Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm 14 $9,900.00 $227,240.00 $139,080.00 nat. median
$30,046
outlier · 4.6×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 11 $74,852.88 $190,369.19 $128,431.50 nat. median
$2,736
outlier · 46.9×
0187-0007-14
NDC 		Ribavirin 6 G In Solr 14 $54,779.00 $189,621.00 $122,200.00 —
0781-5893-31
NDC 		Nevirapine ER 400 Mg Po Tb24 14 $53,707.00 $185,908.00 $119,807.50 —
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 $57,874.00 $239,255.23 $117,840.00 nat. median
$97,418
1.2× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 12 $40,206.00 $216,940.00 $116,638.24 nat. median
$72,715
1.6× median
850
MS_DRG 		Acute Leukemia With Other Procedures 11 $58,812.88 $152,531.00 $111,572.00 nat. median
$2,633
outlier · 42.4×
C1882
HCPCS 		Defibrillator Consulta 2chb Is1 Df1 Av 35jl 38ml 6 14 $13.00 $301,141.00 $109,621.00 nat. median
$24,131
outlier · 4.5×
7
MS_DRG 		Lung Transplant 12 $48,286.00 $223,688.80 $109,043.00 nat. median
$70,649
1.5× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 $48,209.00 $195,734.18 $106,829.28 nat. median
$65,418
1.6× median
C1767
HCPCS 		Stimulator Proclaim Elite 5 W/pat Cntrlr 14 $9,900.00 $342,127.00 $103,735.00 nat. median
$25,172
outlier · 4.1×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 11 $61,190.66 $155,622.82 $102,331.00 nat. median
$2,596
outlier · 39.4×

Other procedures at this hospital

Browse this hospital's 26,459 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 2 2 — — $3,685,266.67 $3,710,000.00 $3,697,633.33 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 2 2 — — $3,316,462.59 $3,321,781.51 $3,319,122.05 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 3 3 — — $3,193,000.00 $4,970,121.94 $3,248,445.72 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 4 4 — — $2,403,458.75 $4,173,688.03 $3,105,714.92 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 3 3 — — $2,945,740.00 $4,506,982.20 $2,968,000.00 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 4 4 — — $2,332,000.00 $3,964,400.00 $2,949,980.00 2026-04-01
Q2042 HCPCS Tisagenlecleucel IV Infusion (wrapped) 29 17 $4,253,411.58 $2,126,705.79 50% off $466,070.00 $3,828,070.00 $2,147,070.00 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel 460000000 Cells IV Susp 30 18 $4,964,120.33 $2,482,060.16 50% off $460,227.00 $4,467,708.00 $2,123,043.25 2026-04-01
Q2054 HCPCS Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 30 18 $4,855,287.41 $2,427,643.70 50% off $454,489.00 $4,369,759.00 $2,077,586.00 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 4 4 — — $489,517.15 $906,491.29 $674,536.17 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 4 4 — — $488,051.51 $831,817.83 $618,970.33 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 5 5 — — $494,704.54 $961,977.21 $565,868.94 2026-04-01
A9520 HCPCS Technetium-99 (tc-99) Tilmanocept (lymphoseek) Radio-isotope Injection 22 13 $770,386.00 $385,193.00 50% off $10.00 $693,347.00 $564,693.00 2024-12-15
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 20 12 $0.01 — $129,318.00 $745,896.50 $359,327.99 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 20 12 $0.01 — $106,702.00 $484,056.82 $261,399.59 2026-04-01
13925-522-01 NDC Pentamidine Isethionate 300 Mg In Solr 25 14 $396,641.51 $198,320.76 50% off $103,127.00 $356,977.00 $230,052.00 2024-12-15
58914-501-56 NDC Mesalamine 1000 Mg Re Supp 25 14 $372,735.21 $186,367.60 50% off $96,911.00 $335,462.00 $216,186.50 2024-12-15
C1831 HCPCS Kit Imp Aprevo Spine Lvl 1 99 14 $332,120.00 $166,060.00 50% off $9,900.00 $437,000.00 $213,116.00 2024-12-15
A9588 HCPCS Fluciclovine F 18 9-221 Mci/ml IV Soln 26 16 $460,111.00 $230,055.50 50% off $80.00 $414,100.00 $204,519.50 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 20 12 $0.01 — $114,065.15 $392,802.00 $197,356.00 2026-04-01
52427-273-75 NDC Naproxen Sodium ER 500 Mg Po Tb24 25 14 $339,243.38 $169,621.69 50% off $88,203.00 $305,319.00 $196,761.00 2024-12-15
C9089 HCPCS Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl 42 14 $246,873.71 $123,436.86 50% off $64,187.00 $228,405.00 $186,636.50 2024-12-15
63323-877-15 NDC Pentamidine Isethionate 300 Mg In Solr 25 14 $311,091.56 $155,545.78 50% off $80,884.00 $279,982.00 $180,433.00 2024-12-15
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 20 12 $0.01 — $83,931.00 $366,622.88 $178,364.00 2026-04-01
A9572 HCPCS Indium In-111 Pentetreotide IV Kit 26 16 $386,681.14 $193,340.57 50% off $57.00 $348,013.00 $171,880.00 2026-04-01
58468-0132-2 NDC Sevelamer Carbonate 0.8 G Po Pack 25 14 $294,215.74 $147,107.87 50% off $76,496.00 $264,794.00 $170,645.00 2024-12-15
58468-0132-1 NDC Sevelamer Carbonate 0.8 G Po Pack 25 14 $294,215.74 $147,107.87 50% off $76,496.00 $264,794.00 $170,645.00 2024-12-15
68382-395-04 NDC Ribavirin 6 G In Solr 25 14 $274,709.53 $137,354.77 50% off $71,424.00 $247,239.00 $159,331.50 2024-12-15
68382-395-01 NDC Ribavirin 6 G In Solr 25 14 $274,709.53 $137,354.77 50% off $71,424.00 $247,239.00 $159,331.50 2024-12-15
59385-027-60 NDC Buprenorphine Hcl 900 Mcg Bu Film 25 14 $264,236.27 $132,118.13 50% off $68,701.00 $237,813.00 $153,257.00 2024-12-15
59385-027-01 NDC Buprenorphine Hcl 900 Mcg Bu Film 25 14 $264,236.27 $132,118.13 50% off $68,701.00 $237,813.00 $153,257.00 2024-12-15
A9595 HCPCS Piflufolastat F 18 9 Mci IV Sosy 27 17 $475,098.80 $237,549.40 50% off $332.44 $427,589.00 $152,982.00 2026-04-01
C1825 HCPCS System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 45 14 $198,240.00 $99,120.00 50% off $9,900.00 $244,720.00 $151,059.00 2024-12-15
209 MS_DRG Complex Aortic Arch Procedures 9 5 — — $76,874.09 $195,509.63 $148,072.54 2026-04-01
24338-050-08 NDC Carmustine In Polifeprosan 7.7 Mg Il Wafr 25 14 $243,921.81 $121,960.90 50% off $63,420.00 $219,530.00 $141,475.00 2024-12-15
A9569 HCPCS Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection 26 16 $317,369.80 $158,684.90 50% off $55.00 $285,633.00 $141,071.00 2026-04-01
C1824 HCPCS Generator Pul Implantable Optimizer Smt F/hrt Fail 45 14 $227,240.00 $113,620.00 50% off $9,900.00 $227,240.00 $140,269.00 2024-12-15
C1822 HCPCS Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm 63 14 $194,246.50 $97,123.25 50% off $9,900.00 $227,240.00 $139,080.00 2024-12-15
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 11 $0.01 — $74,852.88 $190,369.19 $128,431.50 2026-04-01
0187-0007-14 NDC Ribavirin 6 G In Solr 25 14 $210,690.03 $105,345.02 50% off $54,779.00 $189,621.00 $122,200.00 2024-12-15
0781-5893-31 NDC Nevirapine ER 400 Mg Po Tb24 25 14 $206,564.77 $103,282.38 50% off $53,707.00 $185,908.00 $119,807.50 2024-12-15
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 20 12 $0.01 — $57,874.00 $239,255.23 $117,840.00 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 20 12 $0.01 — $40,206.00 $216,940.00 $116,638.24 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 19 11 $0.01 — $58,812.88 $152,531.00 $111,572.00 2026-04-01
C1882 HCPCS Defibrillator Consulta 2chb Is1 Df1 Av 35jl 38ml 6 1,089 14 $148,486.80 $74,243.40 50% off $13.00 $301,141.00 $109,621.00 2024-12-15
7 MS_DRG Lung Transplant 20 12 $0.01 — $48,286.00 $223,688.80 $109,043.00 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 20 12 $0.01 — $48,209.00 $195,734.18 $106,829.28 2026-04-01
C1767 HCPCS Stimulator Proclaim Elite 5 W/pat Cntrlr 477 14 $144,210.00 $72,105.00 50% off $9,900.00 $342,127.00 $103,735.00 2024-12-15
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 19 11 $0.01 — $61,190.66 $155,622.82 $102,331.00 2026-04-01
C1816 HCPCS System Stim Nerv Stimq-4 8 Elect Dl Transm Kt 64 14 $157,320.00 $78,660.00 50% off $3,758.00 $179,170.00 $99,887.50 2024-12-15
47781-153-01 NDC Naproxen Sodium ER 375 Mg Po Tb24 25 14 $171,325.06 $85,662.53 50% off $44,545.00 $154,193.00 $99,369.00 2024-12-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 20 12 $0.01 — $40,748.00 $178,093.27 $99,186.77 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 20 12 $0.01 — $52,114.00 $187,828.33 $98,644.39 2026-04-01
C2616 HCPCS Sphere Embol Sir Msphre 90 45 14 $129,882.60 $64,941.30 50% off $9,900.00 $129,883.00 $97,082.00 2024-12-15
215 MS_DRG Other Heart Assist System Implant 20 12 $0.01 — $49,446.00 $175,429.00 $92,858.93 2026-04-01
C1721 HCPCS Defibrillator Lumax 540 Dr-t 2chb Home Mon 907 14 $123,723.60 $61,861.80 50% off $24.00 $190,501.00 $88,011.00 2024-12-15
J2326 HCPCS Nusinersen 12 Mg/5ml It Soln 26 16 $255,909.86 $127,954.93 50% off $1,170.00 $230,319.00 $87,137.50 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 11 $0.01 — $49,026.69 $124,686.88 $86,818.10 2026-04-01
Q3001 HCPCS Hc I-125 Iotrex - 2 Ml 24 13 $118,208.95 $59,104.48 50% off $735.00 $118,209.00 $86,647.50 2024-12-15
38240 CPT Hc Trnsplj Allogeneic Hematopoietic Cells Per Donor 25 14 $178,757.65 $89,378.82 50% off $11,694.00 $160,882.00 $86,288.00 2024-12-15
C1827 HCPCS Generator Imp Vivistim Vns Ipg 1001 45 14 $257,830.00 $128,915.00 50% off $9,900.00 $257,830.00 $85,084.00 2024-12-15
A9591 HCPCS Fluoroestradiol F 18 4-100 Mci/ml IV Soln 26 16 $243,748.00 $121,874.00 50% off $66.00 $219,373.00 $82,996.50 2026-04-01
0187-3013-30 NDC Pyridostigmine Bromide ER 180 Mg Po Tbcr 25 14 $141,474.57 $70,737.28 50% off $36,783.00 $127,327.00 $82,055.00 2024-12-15
51167-331-01 NDC Elexacaf-tezacaf-ivacaf&ivacaf 100-50-75 (trikafta Kit Morning Dose) 25 14 $140,799.12 $70,399.56 50% off $36,608.00 $126,719.00 $81,663.50 2024-12-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 12 $0.01 — $46,972.00 $168,978.30 $81,568.14 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 19 11 $0.01 — $45,379.54 $115,411.28 $81,400.00 2026-04-01
C1722 HCPCS Defibrillator Maximo Ii Vr 1chb Is1 Df1 Av 35jl 37 873 14 $117,348.00 $58,674.00 50% off $9,900.00 $206,052.00 $80,266.00 2024-12-15
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 4 4 — — $63,342.28 $107,681.88 $80,157.87 2026-04-01
C2624 HCPCS System Cardiomems Hrt Failure Ptnt 27 14 $141,246.00 $70,623.00 50% off $9,900.00 $141,246.00 $78,744.50 2024-12-15
C1820 HCPCS System Chrgr Prc Fam Neurostim Ptnt Kt 333 14 $114,319.20 $57,159.60 50% off $1,776.00 $223,351.00 $77,983.00 2024-12-15
C1823 HCPCS Generator Implantable Remede Pul Cent Sleep Apnea 45 14 $235,620.00 $117,810.00 50% off $9,900.00 $235,620.00 $77,755.00 2024-12-15
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 19 11 $0.01 — $45,412.82 $115,495.91 $75,993.00 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $75,434.06 $75,434.06 $75,434.06 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 9 5 — — $38,759.65 $98,575.28 $74,657.67 2026-04-01
C9047 HCPCS Caplacizumab-yhdp 11 Mg Ij Kit 22 13 $98,637.57 $49,318.78 50% off $745.00 $88,774.00 $72,301.50 2024-12-15
0078-0697-61 NDC Eltrombopag Olamine 25 Mg Po Pack 25 14 $124,394.78 $62,197.39 50% off $32,343.00 $111,955.00 $72,149.00 2024-12-15
0078-0697-19 NDC Eltrombopag Olamine 25 Mg Po Pack 25 14 $124,394.78 $62,197.39 50% off $32,343.00 $111,955.00 $72,149.00 2024-12-15
A9543 HCPCS Y90 Ibritumomab, Rx 4 4 — — $56,824.55 $96,601.73 $71,883.05 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 20 12 $0.01 — $40,366.57 $102,662.08 $71,868.74 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 20 12 $0.01 — $31,469.00 $131,260.00 $71,492.89 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 20 12 $0.01 — $39,279.00 $145,609.66 $70,955.00 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 12 $0.01 — $38,815.00 $145,151.93 $70,916.00 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 4 4 — — $55,272.32 $93,962.95 $70,051.58 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 20 12 $0.01 — $39,047.00 $135,917.78 $67,738.99 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 11 $0.01 — $38,183.04 $97,108.81 $67,615.79 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 19 11 $0.01 — $39,168.51 $99,615.12 $67,240.50 2026-04-01
10 MS_DRG Pancreas Transplant 20 12 $0.01 — $18,943.00 $132,017.00 $66,803.00 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 20 12 $0.01 — $37,732.00 $132,055.54 $66,022.42 2026-04-01
C1772 HCPCS Pump Inf Synchromed Ii Ti 3.4x0.78x0.78in 20ml 45 14 $100,510.00 $50,255.00 50% off $9,900.00 $100,510.00 $65,933.00 2024-12-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 12 $0.01 — $37,307.00 $132,627.28 $65,502.20 2026-04-01
0955-1052-90 NDC Sevelamer Carbonate 0.8 G Po Pack 25 14 $112,748.02 $56,374.01 50% off $29,314.00 $101,473.00 $65,393.50 2024-12-15
0955-1052-01 NDC Sevelamer Carbonate 0.8 G Po Pack 25 14 $112,748.02 $56,374.01 50% off $29,314.00 $101,473.00 $65,393.50 2024-12-15
L8614 HCPCS Electrode Hires Ultra 3d Ci Hifocus Slimj Cochlear 222 14 $94,916.25 $47,458.12 50% off $552.00 $148,680.00 $64,491.00 2024-12-15
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 19 11 $0.01 — $36,197.14 $92,058.18 $63,323.00 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 20 12 $0.01 — $28,802.00 $131,618.53 $62,586.00 2026-04-01
A9555 HCPCS Rubidium-82 (rb-82) Radio-isotope Injection 22 13 $84,001.00 $42,000.50 50% off $78.00 $75,601.00 $61,573.00 2024-12-15
33365 CPT Hc Cath Replace Aortic Valve Open Transaortic Approach 17 10 $80,395.84 $40,197.92 50% off $1,623.00 $72,356.00 $61,262.00 2024-12-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 20 12 $0.01 — $34,059.00 $123,163.40 $60,963.76 2026-04-01
J7674 HCPCS Methacholine Chloride 100 Mg In Solr 22 13 $81,687.09 $40,843.54 50% off $125.00 $73,518.00 $59,876.50 2024-12-15
61958-1004-1 NDC Ranolazine ER 1000 Mg Po Tb12 25 14 $102,106.23 $51,053.12 50% off $26,548.00 $91,896.00 $59,222.00 2024-12-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 20 12 $0.01 — $31,895.00 $119,387.52 $58,377.00 2026-04-01
A9592 HCPCS Copper Cu 64 Dotatate 1 Mci/ml IV Soln 26 16 $170,101.00 $85,050.50 50% off $258.00 $153,091.00 $57,919.50 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 20 12 $0.01 — $24,278.00 $116,266.29 $57,315.00 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 20 12 $0.01 — $21,688.00 $102,423.71 $57,188.55 2026-04-01
J9226 HCPCS Supprelin La Implant 4 4 — — $45,020.65 $76,535.10 $57,071.69 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 20 12 $0.01 — $33,170.00 $118,801.97 $56,576.07 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 20 12 $0.01 — $30,387.00 $123,894.05 $56,076.00 2026-04-01
33240 CPT Hc Insj Implntbl Defib Pulse Gen W/1 Existing Ld 40 14 $79,329.69 $39,664.84 50% off $1,623.00 $71,397.00 $55,954.00 2024-12-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 20 12 $0.01 — $33,480.00 $111,146.57 $55,862.54 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 1 1 — — $55,282.47 $55,282.47 $55,282.47 2026-04-01
55566-9800-0 NDC Fecal Microbiota, Live-jslm 150 Ml Re Susp 25 14 $94,953.71 $47,476.86 50% off $24,688.00 $85,458.00 $55,073.00 2024-12-15
55566-9800-2 NDC Fecal Microbiota, Live-jslm 150 Ml Re Susp 25 14 $94,953.71 $47,476.86 50% off $24,688.00 $85,458.00 $55,073.00 2024-12-15
69468-151-04 NDC Uridine Triacetate 10 G Po Pack 25 14 $94,691.13 $47,345.56 50% off $24,620.00 $85,222.00 $54,921.00 2024-12-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 20 12 $0.01 — $35,722.00 $105,855.85 $54,317.20 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 12 $0.01 — $30,812.00 $113,575.16 $54,244.00 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 1 1 — — $54,026.33 $54,026.33 $54,026.33 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 20 12 $0.01 — $30,039.00 $103,752.00 $53,602.60 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 20 12 $0.01 — $30,155.00 $105,733.21 $53,137.00 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 20 12 $0.01 — $26,521.00 $101,302.69 $52,974.43 2026-04-01
0398T CPT Hc MRI Guided Focused US Stereo Lesion Ablate 22 13 $71,584.70 $35,792.35 50% off $1,623.00 $64,426.00 $52,472.00 2024-12-15
33363 CPT Hc Replace Aortic Valve Open Axillry Artry Approach 31 10 $69,725.12 $34,862.56 50% off $1,623.00 $62,753.00 $52,294.00 2024-12-15
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 20 12 $0.01 — $20,722.00 $96,808.26 $52,119.79 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 20 12 $0.01 — $28,454.00 $101,368.33 $51,959.71 2026-04-01
34708 CPT Hc Evasc Rpr Dplmnt Ilio-iliac Ndgft Rpt 31 10 $124,978.98 $62,489.49 50% off $1,058.00 $112,481.00 $51,866.00 2024-12-15
67546-212-21 NDC Nitazoxanide 100 Mg/5ml Po Susr Bulk 25 14 $89,264.62 $44,632.31 50% off $23,209.00 $80,338.00 $51,773.50 2024-12-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 20 12 $0.01 — $27,195.36 $113,162.33 $51,760.00 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 20 12 $0.01 — $31,392.00 $101,611.00 $51,582.00 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 20 12 $0.01 — $28,802.00 $104,719.29 $51,350.00 2026-04-01
33362 CPT Hc Replace Aortic Valve Openfemoral Artery Approach 17 10 $67,313.25 $33,656.62 50% off $1,623.00 $60,582.00 $51,293.00 2024-12-15
L8619 HCPCS Hc Supply Cochlear Implnt, Ext Speech Processor_cont Rplcmt - L8619 283 17 $81,420.00 $40,710.00 50% off $903.00 $148,680.00 $51,172.00 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 20 12 $0.01 — $27,835.00 $103,781.37 $51,108.00 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 20 12 $0.01 — $20,644.00 $99,942.00 $50,746.00 2026-04-01
77371 CPT Hc Tr Srs 1 Session Multi Cobalt 60 24 14 $93,660.20 $46,830.10 50% off $6,537.00 $84,294.00 $50,670.50 2024-12-15
0310-0283-60 NDC Quetiapine Fumarate ER 300 Mg Po Tb24 25 14 $87,338.95 $43,669.47 50% off $22,708.00 $78,605.00 $50,656.50 2024-12-15
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 19 11 $0.01 — $28,802.32 $73,251.34 $50,283.00 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 12 $0.01 — $27,565.00 $113,575.16 $50,029.00 2026-04-01
791 MS_DRG Prematurity With Major Problems 20 12 $0.01 — $27,567.58 $70,111.11 $49,194.79 2026-04-01
0008-0423-03 NDC Antivenin Micrurus Fulvius IV Solr 25 14 $84,789.87 $42,394.94 50% off $22,045.00 $76,311.00 $49,178.00 2024-12-15
0008-0423-01 NDC Antivenin Micrurus Fulvius IV Solr 25 14 $84,789.87 $42,394.94 50% off $22,045.00 $76,311.00 $49,178.00 2024-12-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 20 12 $0.01 — $28,376.00 $91,521.00 $49,009.93 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 12 $0.01 — $27,951.00 $103,000.63 $48,996.30 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 20 12 $0.01 — $25,168.00 $94,357.22 $48,977.41 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 20 12 $0.01 — $19,021.00 $94,827.04 $48,657.24 2026-04-01
35371 CPT Hc Thromboendartectmy Femoral Common 31 10 $116,847.32 $58,423.66 50% off $68.00 $105,163.00 $48,492.00 2024-12-15
35355 CPT Hc Thromboendarterectomy With Without Patch Graft Iliofemoral 31 10 $116,847.32 $58,423.66 50% off $1,058.00 $105,163.00 $48,492.00 2024-12-15
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 19 11 $0.01 — $27,306.10 $69,446.10 $48,188.50 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 20 12 $0.01 — $25,168.00 $98,979.47 $48,004.00 2026-04-01
47335-625-60 NDC Ranolazine ER 1000 Mg Po Pack 25 14 $82,310.16 $41,155.08 50% off $21,401.00 $74,079.00 $47,740.00 2024-12-15
33264 CPT Hc Rmvl Impltbl Dfb Pls Gen W/rplcmt Pls Gen Mlt Ld 41 14 $62,630.09 $31,315.04 50% off $1,623.00 $70,932.00 $47,724.00 2024-12-15
81416 CPT Hc Exome Sequence Analysis Each Comparator Exome 25 14 $92,610.00 $46,305.00 50% off $12,000.00 $83,349.00 $47,674.50 2024-12-15
34705 CPT Hc Evasc Rpr Dplmnt Aorto-bi-iliac Ndgft 17 10 $62,489.49 $31,244.74 50% off $1,623.00 $56,241.00 $47,617.00 2024-12-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 20 12 $0.01 — $24,394.00 $85,456.44 $47,348.08 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 20 12 $0.01 — $25,361.00 $92,304.00 $46,923.00 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 20 12 $0.01 — $21,186.00 $94,491.95 $46,409.53 2026-04-01
34707 CPT Hc Evasc Rpr Dplmnt Ilio-iliac Ndgft 31 10 $55,641.55 $27,820.78 50% off $1,623.00 $100,155.00 $46,182.00 2024-12-15
73702-140-71 NDC Indomethacin 100 Mg Re Supp 25 14 $79,128.71 $39,564.36 50% off $20,573.00 $71,216.00 $45,894.50 2024-12-15
33229 CPT Hc Remvl Perm Pm Pls Gen W/repl Plse Gen Mult Lead 40 14 $68,033.29 $34,016.64 50% off $1,623.00 $61,230.00 $45,580.00 2024-12-15
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 20 12 $0.01 — $26,057.00 $98,447.46 $45,484.00 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 20 12 $0.01 — $20,297.00 $94,208.67 $45,441.00 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 20 12 $0.01 — $24,936.00 $89,335.00 $45,436.00 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 20 12 $0.01 — $19,059.00 $80,293.00 $45,334.62 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 9 5 — — $23,354.00 $59,394.94 $44,983.77 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 12 $0.01 — $25,361.00 $92,113.45 $44,816.01 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 20 12 $0.01 — $23,621.00 $82,233.30 $44,792.60 2026-04-01
31253 CPT Hc Nasal/sinus Endo Total With Tiss Rem 38 14 $58,344.44 $29,172.22 50% off $3,288.00 $105,020.00 $44,458.00 2024-12-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 20 12 $0.01 — $16,469.00 $82,984.67 $44,278.15 2026-04-01
245 MS_DRG Aicd Generator Procedures 20 12 $0.01 — $21,920.00 $80,916.00 $44,162.60 2026-04-01
0078-0494-71 NDC Tobramycin 300 Mg/5ml In Nebu 25 14 $75,495.29 $37,747.64 50% off $19,629.00 $67,946.00 $43,787.50 2024-12-15
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 20 12 $0.01 — $23,853.00 $89,912.87 $43,416.26 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 20 12 $0.01 — $24,472.00 $91,137.53 $43,262.00 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 20 12 $0.01 — $22,964.00 $86,147.36 $43,231.07 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 20 12 $0.01 — $21,572.00 $96,144.97 $43,098.74 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 20 12 $0.01 — $21,070.00 $81,207.28 $42,927.10 2026-04-01
J2353 HCPCS Octreotide Acetate 10 Mg IM Kit 73 16 $243,787.15 $121,893.58 50% off $67.00 $618,699.00 $42,541.00 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 20 12 $0.01 — $23,273.00 $85,012.52 $42,466.00 2026-04-01
34710 CPT Hc Dlyd Placement Xtn Prosth For Evasc Rpr 1st Vsl 17 10 $55,641.55 $27,820.78 50% off $1,623.00 $50,077.00 $42,399.00 2024-12-15
34701 CPT Hc Ccl Evasc Rpr A-ao Non-ruptre 17 10 $55,641.55 $27,820.78 50% off $1,623.00 $50,077.00 $42,399.00 2024-12-15
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 20 12 $0.01 — $23,157.00 $79,775.35 $42,361.78 2026-04-01
0591-2720-60 NDC Metformin Hcl ER (osm) 1000 Mg Po Tb24 25 14 $72,962.64 $36,481.32 50% off $18,970.00 $65,666.00 $42,318.00 2024-12-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 20 12 $0.01 — $21,998.00 $85,304.44 $42,171.00 2026-04-01
33881 CPT Hc Endovasc Taa Rew/o Subcl 20 11 $55,641.55 $27,820.78 50% off $1,316.00 $50,077.00 $42,065.00 2024-12-15
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 20 12 $0.01 — $20,297.00 $80,799.64 $41,887.90 2026-04-01
69344-102-33 NDC Indomethacin 50 Mg Re Supp 25 14 $72,208.70 $36,104.35 50% off $18,774.00 $64,988.00 $41,881.00 2024-12-15
24341 CPT Hc Repair Tend/musc Upr Arm/elb Each 38 14 $54,655.25 $27,327.62 50% off $1,058.00 $98,379.00 $41,647.00 2024-12-15
37231 CPT Hc Revascularize Tibial/peron Artery,angioplasty/stent/atherectomy Init 38 14 $54,603.61 $27,301.80 50% off $1,623.00 $98,286.00 $41,608.00 2024-12-15
33270 CPT Hc Ins/rplcmnt Perm Subq Impltbl Dfb W/subq Eltrd 25 14 $57,753.41 $28,876.70 50% off $15,016.00 $51,978.00 $41,351.00 2024-12-15
799 MS_DRG Splenic Procedures With Mcc 20 12 $0.01 — $21,727.00 $78,730.00 $41,193.74 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 20 12 $0.01 — $22,655.00 $83,406.14 $41,094.53 2026-04-01
33289 CPT Hc Rhc W/plc Pressure Sensor 25 14 $86,635.40 $43,317.70 50% off $1,623.00 $77,972.00 $40,788.00 2024-12-15
61958-1003-1 NDC Ranolazine ER 500 Mg Po Tb12 25 14 $70,311.18 $35,155.59 50% off $18,281.00 $63,280.00 $40,780.50 2024-12-15
C1833 HCPCS Monitor Crdc The Guardian Amsg3-e 27 14 $72,570.00 $36,285.00 50% off $9,900.00 $72,570.00 $40,458.00 2024-12-15
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 1 1 — — $40,302.54 $40,302.54 $40,302.54 2026-04-01
27446 CPT Hc Knee Arthroplasty Condyle/plateau Medial Or Lateral Comptmnt 38 14 $52,870.37 $26,435.18 50% off $1,058.00 $95,167.00 $40,287.00 2024-12-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 20 12 $0.01 — $22,461.00 $81,041.46 $40,120.00 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 21 12 $0.01 — $22,655.00 $79,395.34 $40,116.00 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 20 12 $0.01 — $17,281.00 $77,414.13 $40,013.07 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 12 $0.01 — $22,500.00 $87,059.37 $39,906.68 2026-04-01
C2621 HCPCS Pacemaker Consulta Bip Is1 Av 15ml 26gm 406 14 $54,516.00 $27,258.00 50% off $7,733.00 $102,090.00 $39,851.00 2024-12-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 20 12 $0.01 — $19,755.00 $79,193.25 $39,630.78 2026-04-01
C1817 HCPCS Occluder Sept Amplatzer Cvd Dbl Disc 45deg 4mm 6fr 153 14 $58,070.16 $29,035.08 50% off $8,116.00 $73,597.00 $39,443.00 2024-12-15
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 20 12 $0.01 — $20,026.00 $74,747.18 $38,435.06 2026-04-01
C1875 HCPCS Stent G-armor Cov 5.2cm Lgth 10 Zig 226 15 $51,302.03 $25,651.02 50% off $9,665.00 $63,616.00 $38,403.50 2026-04-01
59676-565-01 NDC Darunavir 100 Mg/ml Po Susp Bulk 25 14 $66,064.35 $33,032.18 50% off $17,177.00 $59,458.00 $38,317.50 2024-12-15
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 20 12 $0.01 — $20,451.00 $78,569.70 $38,200.96 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 19 11 $0.01 — $21,939.96 $55,798.70 $38,087.00 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 20 12 $0.01 — $19,794.00 $74,258.00 $37,888.00 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 20 12 $0.01 — $21,263.00 $78,535.15 $37,786.00 2026-04-01
33263 CPT Hc Rmvl Impltbl Dfb Plse Gen W/rplcmt Plse Gen 2 Ld 41 14 $76,768.82 $38,384.41 50% off $1,623.00 $69,092.00 $37,536.00 2024-12-15
901 MS_DRG Wound Debridements For Injuries With Mcc 20 12 $0.01 — $18,982.00 $73,360.00 $37,439.00 2026-04-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 4 4 — — $21,140.00 $50,179.48 $37,339.43 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 4 4 — — $25,277.30 $49,993.29 $37,200.89 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 12 $0.01 — $20,838.00 $72,073.32 $37,191.51 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 20 12 $0.01 — $19,562.00 $72,353.14 $37,158.85 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 20 12 $0.01 — $21,108.00 $77,087.67 $37,127.00 2026-04-01
27428 CPT Hc Ligament Reconst Knee, Intra-artic (open) 38 14 $48,659.87 $24,329.94 50% off $1,058.00 $87,588.00 $37,079.00 2024-12-15
0908T OTHER Opn Imp Int Nstm Sys Vgs Nrv 4 4 — — $5,562.00 $49,330.34 $36,707.58 2026-04-01
0909T OTHER Rplcmt Int Nstim Sys Vgs Nrv 4 4 — — $5,562.00 $49,330.34 $36,707.58 2026-04-01
J1324 HCPCS Enfuvirtide 90 Mg Sc Solr 25 14 $63,146.42 $31,573.21 50% off $16,418.00 $56,832.00 $36,625.00 2024-12-15
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 20 12 $0.01 — $11,791.00 $71,645.00 $36,580.00 2026-04-01
54092-252-90 NDC Lanthanum Carbonate 500 Mg Po Chew 25 14 $62,957.87 $31,478.94 50% off $16,369.00 $56,662.00 $36,515.50 2024-12-15
54092-252-45 NDC Lanthanum Carbonate 500 Mg Po Chew 25 14 $62,957.87 $31,478.94 50% off $16,369.00 $56,662.00 $36,515.50 2024-12-15
Q0479 HCPCS Module Pwr Heartmate Ii Cntrlr Tethered Operation 27 14 $65,318.40 $32,659.20 50% off $9,900.00 $65,318.00 $36,429.00 2024-12-15
33880 CPT Hc Endovasc Taa Repr Incl Subcl 20 11 $48,174.49 $24,087.24 50% off $1,533.00 $43,357.00 $36,420.00 2024-12-15
54092-191-12 NDC Mesalamine ER 500 Mg Po Cpcr 25 14 $62,289.39 $31,144.70 50% off $16,195.00 $56,060.00 $36,127.50 2024-12-15
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 20 12 $0.01 — $19,330.00 $75,876.83 $36,073.00 2026-04-01
33477 CPT Hc Cath Tcat Pulmonary Valve Implantation Prq Approach 17 10 $47,291.51 $23,645.76 50% off $1,623.00 $42,562.00 $36,036.00 2024-12-15
0483T CPT Hc Cath Tmvi W/prosthetic Valve Percutaneous Approach 22 13 $49,127.40 $24,563.70 50% off $140.00 $44,215.00 $36,010.50 2024-12-15
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 20 12 $0.01 — $15,464.00 $64,998.30 $35,885.79 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 20 12 $0.01 — $16,585.00 $73,674.53 $35,770.00 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 20 12 $0.01 — $19,021.00 $77,391.68 $35,450.00 2026-04-01
50474-598-66 NDC Levetiracetam ER 500 Mg Po Tb24 25 14 $61,109.72 $30,554.86 50% off $15,889.00 $54,999.00 $35,444.00 2024-12-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 20 12 $0.01 — $17,320.00 $72,574.24 $35,442.00 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 20 12 $0.01 — $20,142.00 $72,947.33 $35,315.12 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 20 12 $0.01 — $4,021.00 $72,021.50 $35,284.00 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 1 1 — — $35,265.52 $35,265.52 $35,265.52 2026-04-01
0408T CPT Hc Ins/repl Ccm System, Pulse Gen With Tv Electrodes 22 13 $46,579.28 $23,289.64 50% off $1,758.00 $46,169.00 $35,213.50 2024-12-15
25609 CPT Hc Open Rx Distal Radius Fx, Intra-articular, 3+ Frag 39 14 $46,177.30 $23,088.65 50% off $2,378.00 $83,119.00 $35,187.00 2024-12-15
Q0495 HCPCS Charger Batt Heartmate Univ 45 14 $58,786.56 $29,393.28 50% off $4,900.00 $58,787.00 $35,140.00 2024-12-15
27870 CPT Hc Asc Ankle Arthrodesis Open 27870 38 14 $46,090.31 $23,045.16 50% off $1,368.00 $82,963.00 $35,121.00 2024-12-15
Q5111 HCPCS Pegfilgrastim-cbqv 6 Mg/0.6ml Sc Soaj 42 16 $66,398.25 $33,199.12 50% off $106.33 $59,758.00 $35,022.00 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 20 12 $0.01 — $16,121.00 $72,786.69 $34,781.00 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 20 12 $0.01 — $15,773.00 $72,822.97 $34,730.00 2026-04-01
37230 CPT Hc Revascularize Tibial/peron Artery,angioplasty/stent Initial 38 14 $45,503.02 $22,751.51 50% off $1,623.00 $81,905.00 $34,673.00 2024-12-15
33995 CPT Hc Insert Perq Vad R Hrt Venous 17 10 $45,405.18 $22,702.59 50% off $1,623.00 $40,865.00 $34,599.00 2024-12-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 20 12 $0.01 — $15,039.00 $71,734.77 $34,429.00 2026-04-01
54092-254-90 NDC Lanthanum Carbonate 1000 Mg Po Chew 25 14 $59,222.24 $29,611.12 50% off $15,398.00 $53,300.00 $34,349.00 2024-12-15
54092-253-90 NDC Lanthanum Carbonate 750 Mg Po Chew 25 14 $59,222.24 $29,611.12 50% off $15,398.00 $53,300.00 $34,349.00 2024-12-15
29888 CPT Hc Knee Scope,aid Ant Cruciate Repair 38 14 $44,941.54 $22,470.77 50% off $1,058.00 $80,895.00 $34,245.00 2024-12-15
0009-7667-01 NDC Clindamycin Phosphate 100 Mg Va Supp 25 14 $58,996.14 $29,498.07 50% off $15,339.00 $53,097.00 $34,218.00 2024-12-15
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 20 12 $0.01 — $17,049.00 $65,199.00 $34,166.81 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 20 12 $0.01 — $16,199.00 $64,010.28 $33,962.58 2026-04-01
37215 CPT Hc Tcat IV Stent Crv Crtd Art Embolic Protecj 30 10 $40,299.75 $20,149.88 50% off $1,623.00 $72,540.00 $33,852.00 2024-12-15
25607 CPT Hc Open Rx Distal Radius Fx, Extra-articular 37 13 $44,392.55 $22,196.28 50% off $2,378.00 $79,907.00 $33,827.00 2024-12-15
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 20 12 $0.01 — $16,315.00 $66,316.23 $33,735.00 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 20 12 $0.01 — $15,889.00 $65,916.00 $33,712.00 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 20 12 $0.01 — $13,028.00 $65,333.00 $33,420.00 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 20 12 $0.01 — $16,392.00 $66,758.42 $33,287.00 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 20 12 $0.01 — $18,866.00 $71,259.76 $33,127.00 2026-04-01
33230 CPT Hc Ep Insj Implntbl Defib Pulse Gen W/exist Dual Leads 25 14 $73,431.05 $36,715.52 50% off $1,623.00 $66,088.00 $33,079.00 2024-12-15
34 MS_DRG Carotid Artery Stent Procedures With Mcc 20 12 $0.01 — $18,016.00 $66,858.60 $32,948.00 2026-04-01
A9560 HCPCS Technetium-99 (tc-99) Labeled Red Blood Cells (ultratag) Radio-isotope Injection 22 13 $44,934.70 $22,467.35 50% off $186.00 $40,441.00 $32,937.00 2024-12-15
37227 CPT Hc Revascularize Fem/pop Artery,angioplasty/stent/atherectomy 38 14 $43,206.82 $21,603.41 50% off $1,623.00 $77,772.00 $32,924.00 2024-12-15
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 20 12 $0.01 — $12,835.00 $63,997.00 $32,752.00 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 20 12 $0.01 — $14,304.00 $63,932.00 $32,719.00 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 20 12 $0.01 — $14,884.00 $64,561.29 $32,630.00 2026-04-01
0085-1328-01 NDC Posaconazole 40 Mg/ml Po Susp Bulk 25 14 $56,226.98 $28,113.49 50% off $14,619.00 $50,604.00 $32,611.50 2024-12-15
J0571 HCPCS Buprenorphine Hcl 300 Mcg Bu Film 25 14 $56,121.38 $28,060.69 50% off $14,592.00 $50,509.00 $32,550.50 2024-12-15
63304-089-13 NDC Mesalamine ER 500 Mg Po Cpcr 25 14 $56,076.44 $28,038.22 50% off $14,580.00 $50,469.00 $32,524.50 2024-12-15
C2622 HCPCS Prosthesis Penile Genisis Kt Semi Rgd Malle 9.5x23 64 14 $58,155.12 $29,077.56 50% off $2,548.00 $68,792.00 $32,421.50 2024-12-15
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 20 12 $0.01 — $17,513.00 $67,570.25 $32,283.22 2026-04-01
0960T OTHER Rpl S-sclp Eltr Ra Rcvr&tlmt 4 4 — — $21,140.00 $43,377.52 $32,277.98 2026-04-01
0956T OTHER Prt Crn Ch Cr&tun Elt S-sclp 4 4 — — $21,140.00 $43,377.52 $32,277.98 2026-04-01
33262 CPT Hc Rmvl Impltbl Dfb Plse Gen W/repl Plse Gen 1 Lead 40 14 $84,270.87 $42,135.44 50% off $1,623.00 $75,844.00 $32,174.00 2024-12-15
335 MS_DRG Peritoneal Adhesiolysis With Mcc 21 12 $0.01 — $16,160.00 $61,680.16 $32,130.07 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 20 12 $0.01 — $18,132.00 $58,456.00 $32,037.20 2026-04-01
28725 CPT Hc Fusion Foot Bones,subtalar 38 14 $42,009.16 $21,004.58 50% off $68.00 $75,616.00 $32,011.00 2024-12-15
27827 CPT Hc Open Treatment Fracture Distal Tibia Only 39 14 $42,009.16 $21,004.58 50% off $1,435.00 $75,616.00 $32,011.00 2024-12-15
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 20 12 $0.01 — $17,784.00 $66,694.51 $31,981.00 2026-04-01
13811-715-30 NDC Venlafaxine Hcl ER 225 Mg Po Tb24 25 14 $55,014.17 $27,507.08 50% off $14,304.00 $49,513.00 $31,908.50 2024-12-15
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 20 12 $0.01 — $12,410.00 $61,960.00 $31,732.00 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 9 5 — — $16,450.90 $41,838.66 $31,687.22 2026-04-01
332 MS_DRG Rectal Resection With Mcc 20 12 $0.01 — $16,508.00 $62,540.35 $31,660.67 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 9 5 — — $16,397.24 $41,702.20 $31,583.87 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 20 12 $0.01 — $16,701.00 $56,165.00 $31,546.33 2026-04-01
64980-282-03 NDC Mesalamine 1000 Mg Re Supp 25 14 $54,125.21 $27,062.60 50% off $14,073.00 $48,713.00 $31,393.00 2024-12-15
59762-0118-3 NDC Mesalamine 1000 Mg Re Supp 25 14 $54,125.21 $27,062.60 50% off $14,073.00 $48,713.00 $31,393.00 2024-12-15
33361 CPT Hc Replace Aortic Valve Perq Femoral Artry Approach 31 10 $62,489.49 $31,244.74 50% off $1,623.00 $56,241.00 $31,151.00 2024-12-15
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 20 12 $0.01 — $22,848.00 $60,790.60 $30,959.00 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 20 12 $0.01 — $22,964.00 $62,386.62 $30,650.06 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 4 4 — — $24,228.42 $41,188.31 $30,648.95 2026-04-01
68180-354-07 NDC Ranolazine ER 500 Mg Po Tb12 25 14 $52,829.52 $26,414.76 50% off $13,736.00 $47,547.00 $30,641.50 2024-12-15
28415 CPT Hc Open Treatment Calcaneal Fracture 38 14 $40,164.60 $20,082.30 50% off $68.00 $72,296.00 $30,605.00 2024-12-15
63664 CPT Hc Revision Spinal Neurostim Electrode Plate/paddle Inc Fluoro 22 13 $41,673.08 $20,836.54 50% off $1,058.00 $37,506.00 $30,546.50 2024-12-15
Q0138 HCPCS Ferumoxytol 510 Mg/17ml IV Soln 25 16 $84,832.31 $42,416.15 50% off $0.32 $76,349.00 $30,455.00 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 20 12 $0.01 — $15,039.00 $68,817.36 $30,429.00 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 20 12 $0.01 — $16,817.00 $64,554.38 $30,422.00 2026-04-01
652 MS_DRG Kidney Transplant 20 12 $0.01 — $14,072.00 $55,783.15 $30,414.24 2026-04-01
55111-284-48 NDC Fluoxetine Hcl 90 Mg Po Cpdr 25 14 $52,355.85 $26,177.93 50% off $13,613.00 $47,120.00 $30,366.50 2024-12-15
265 MS_DRG Aicd Lead Procedures 20 12 $0.01 — $17,088.00 $62,497.17 $30,283.00 2026-04-01
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