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

ADVENTHEALTH OTTAWA

Ottawa, KS · CCN 170014 · Rates published

Your selected procedure

You selected 27447 (HCPCS)

Total knee arthroplasty

This hospital’s price: $14,248 across 6 payers · range $3,245-$20,524

Source: https://urldefense.com/v3/__https://hospitalpricedisclosure.com/download.aspx?pi=kKeNKqg*__*JaoVT6NgHgOmSw*-*__;KioqKg!!OwHQNGuS!NNxzc3gzcCDbWC_3aBKJU3Bm28st5mdzWI_DoAkJmDmhsUhsHjB8niD15jvlGIrs7b_d4aR0fJBjowy6rVbgBT48J8eGGw$ · observed 2026-04-01

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.

26,460 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 1,281
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 168
placeholder amount (≤ $0.02) — excluded from medians 19
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hospitalpricedisclosure.com/download.aspx?pi=kKeNKqg*__*JaoVT6NgHgOmSw*-*
Found on page https://urldefense.com/v3/__https://HospitalPriceDisclosure.com/Default.aspx?ci=RsbcVwMa5jfnDZuYpIqAxQ*-*__;Kio!!OwHQNGuS!NNxzc3gzcCDbWC_3aBKJU3Bm28st5mdzWI_DoAkJmDmhsUhsHjB8niD15jvlGIrs7b_d4aR0fJBjowy6rVbgBT5sJPyOLA$
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-12
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
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 2 $3,685,266.67 $3,710,000.00 $3,697,633.33 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 2 $3,316,462.59 $3,321,781.51 $3,319,122.05 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 3 $3,193,000.00 $4,970,121.94 $3,248,445.72 nat. median
$3,286,000
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
$2,460,273
1.3× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 3 $2,945,740.00 $4,506,982.20 $2,968,000.00 nat. median
$2,997,086
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $2,332,000.00 $3,964,400.00 $2,949,980.00 nat. median
$2,405,851
1.2× median
Q2042
HCPCS 		Tisagenlecleucel IV Infusion (wrapped) 17 $466,070.00 $3,828,070.00 $2,147,070.00 nat. median
$691,418
outlier · 3.1×
Q2055
HCPCS 		Idecabtagene Vicleucel 460000000 Cells IV Susp 18 $460,227.00 $4,467,708.00 $2,123,043.25 nat. median
$610,161
outlier · 3.5×
Q2054
HCPCS 		Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 18 $454,489.00 $4,369,759.00 $2,077,586.00 nat. median
$624,417
outlier · 3.3×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $489,517.15 $906,491.29 $674,536.17 nat. median
$588,565
1.1× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $488,051.51 $831,817.83 $618,970.33 nat. median
$577,541
1.1× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 5 $494,704.54 $961,977.21 $565,868.94 nat. median
$631,793
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
$1,032
outlier · 547.0×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 12 $129,318.00 $745,896.50 $359,327.99 nat. median
$370,165
1.0× median
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
$261,939
1.0× median
13925-522-01
NDC 		Pentamidine Isethionate 300 Mg In Solr 14 $103,127.00 $356,977.00 $230,052.00 nat. median
$83,907
outlier · 2.7×
58914-501-56
NDC 		Mesalamine 1000 Mg Re Supp 14 $96,911.00 $335,462.00 $216,186.50 nat. median
$45,242
outlier · 4.8×
C1831
HCPCS 		Kit Imp Aprevo Spine Lvl 1 14 $9,900.00 $437,000.00 $213,116.00 nat. median
$7,752
outlier · 27.5×
A9588
HCPCS 		Fluciclovine F 18 9-221 Mci/ml IV Soln 16 $80.00 $414,100.00 $204,519.50 nat. median
$741
outlier · 275.9×
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
$205,166
1.0× median
52427-273-75
NDC 		Naproxen Sodium ER 500 Mg Po Tb24 14 $88,203.00 $305,319.00 $196,761.00 nat. median
$111,860
1.8× median
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
$2
outlier · 123600.3×
63323-877-15
NDC 		Pentamidine Isethionate 300 Mg In Solr 14 $80,884.00 $279,982.00 $180,433.00 nat. median
$64,153
outlier · 2.8×
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
$199,832
0.9× median
A9572
HCPCS 		Indium In-111 Pentetreotide IV Kit 16 $57.00 $348,013.00 $171,880.00 nat. median
$4,658
outlier · 36.9×
58468-0132-1
NDC 		Sevelamer Carbonate 0.8 G Po Pack 14 $76,496.00 $264,794.00 $170,645.00 nat. median
$92,408
1.8× median
58468-0132-2
NDC 		Sevelamer Carbonate 0.8 G Po Pack 14 $76,496.00 $264,794.00 $170,645.00 nat. median
$92,261
1.8× median
68382-395-04
NDC 		Ribavirin 6 G In Solr 14 $71,424.00 $247,239.00 $159,331.50 nat. median
$88,073
1.8× median
68382-395-01
NDC 		Ribavirin 6 G In Solr 14 $71,424.00 $247,239.00 $159,331.50 nat. median
$88,073
1.8× median
59385-027-60
NDC 		Buprenorphine Hcl 900 Mcg Bu Film 14 $68,701.00 $237,813.00 $153,257.00 nat. median
$85,763
1.8× median
59385-027-01
NDC 		Buprenorphine Hcl 900 Mcg Bu Film 14 $68,701.00 $237,813.00 $153,257.00 nat. median
$87,698
1.7× median
A9595
HCPCS 		Piflufolastat F 18 9 Mci IV Sosy 17 $332.44 $427,589.00 $152,982.00 nat. median
$896
outlier · 170.7×
C1825
HCPCS 		System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 14 $9,900.00 $244,720.00 $151,059.00 nat. median
$53,130
outlier · 2.8×
209
MS_DRG 		Complex Aortic Arch Procedures 5 $76,874.09 $195,509.63 $148,072.54 nat. median
$96,134
1.5× median
24338-050-08
NDC 		Carmustine In Polifeprosan 7.7 Mg Il Wafr 14 $63,420.00 $219,530.00 $141,475.00 nat. median
$49,264
outlier · 2.9×
A9569
HCPCS 		Technetium-99 (tc-99) Exametazime White Blood Cells Radio-isotope Injection 16 $55.00 $285,633.00 $141,071.00 nat. median
$1,956
outlier · 72.1×
C1824
HCPCS 		Generator Pul Implantable Optimizer Smt F/hrt Fail 14 $9,900.00 $227,240.00 $140,269.00 nat. median
$35,282
outlier · 4.0×
C1822
HCPCS 		Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm 14 $9,900.00 $227,240.00 $139,080.00 nat. median
$32,176
outlier · 4.3×
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
$96,835
1.3× median
0187-0007-14
NDC 		Ribavirin 6 G In Solr 14 $54,779.00 $189,621.00 $122,200.00 nat. median
$69,528
1.8× median
0781-5893-31
NDC 		Nevirapine ER 400 Mg Po Tb24 14 $53,707.00 $185,908.00 $119,807.50 nat. median
$68,166
1.8× median
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
$132,706
0.9× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 12 $40,206.00 $216,940.00 $116,638.24 nat. median
$114,305
1.0× median
850
MS_DRG 		Acute Leukemia With Other Procedures 11 $58,812.88 $152,531.00 $111,572.00 nat. median
$81,364
1.4× median
C1882
HCPCS 		Defibrillator Consulta 2chb Is1 Df1 Av 35jl 38ml 6 14 $13.00 $301,141.00 $109,621.00 nat. median
$27,675
outlier · 4.0×
7
MS_DRG 		Lung Transplant 12 $48,286.00 $223,688.80 $109,043.00 nat. median
$122,690
0.9× 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
$108,240
1.0× median
C1767
HCPCS 		Stimulator Proclaim Elite 5 W/pat Cntrlr 14 $9,900.00 $342,127.00 $103,735.00 nat. median
$23,668
outlier · 4.4×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 11 $61,190.66 $155,622.82 $102,331.00 nat. median
$81,124
1.3× median

Other procedures at this hospital

Browse this hospital's 26,460 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
59385-027-01 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
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
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
0078-0697-19 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
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
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
0955-1052-01 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
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
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 39 14 $44,941.54 $22,470.77 50% off $68.00 $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
25607 CPT Hc Open Rx Distal Radius Fx, Extra-articular 38 14 $44,392.55 $22,196.28 50% off $68.00 $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
37215 CPT Hc Tcat IV Stent Crv Crtd Art Embolic Protecj 33 11 $40,299.75 $20,149.88 50% off $208.00 $72,540.00 $33,449.00 2024-12-15
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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