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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 SHAWNEE MISSION

Shawnee Mission, KS · CCN 170104 · Rates published

25,281 distinct procedures filed
31 distinct payers
742,383 rate rows
2026-04-01 last MRF observed
Data quality

719,232 of 742,383 rate rows are consumer-grade (96.9%)

23,151 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 16,779
exceeds 10× this hospital's gross charge — excluded from medians 3,817
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 896
template filing: same amount across many unrelated codes — excluded 889
per-diem day rate — not a per-procedure price 549
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 198
placeholder amount (≤ $0.02) — excluded from medians 23
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://urldefense.com/v3/__https://hospitalpricedisclosure.com/download.aspx?pi=yH*__*IHP8lFSh*__*1*__*uy0umYNg*-*__;KioqKioqKio!!OwHQNGuS!NNxzc3gzcCDbWC_3aBKJU3Bm28st5mdzWI_DoAkJmDmhsUhsHjB8niD15jvlGIrs7b_d4aR0fJBjowy6rVbgBT4DAN3lAA$
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 · 2026-10-12
Content fingerprint fe6207e2079f2a00… · 30,418,603 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
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 5 $2,403,458.75 $4,173,688.03 $3,756,319.23 nat. median
$2,455,111
1.5× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $2,945,740.00 $4,713,184.00 $3,737,491.10 nat. median
$2,968,000
1.3× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,710,000.00 $3,710,000.00 $3,710,000.00 nat. median
$3,508,750
1.1× median
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
J3392
HCPCS 		Inj, Exagamglogene Autotem 5 $2,332,000.00 $4,967,160.00 $3,649,580.00 nat. median
$2,332,000
1.6× 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
Q2054
HCPCS 		Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 23 $454,489.00 $4,369,759.00 $1,592,051.19 nat. median
$579,571
outlier · 2.7×
Q2055
HCPCS 		Idecabtagene Vicleucel 460000000 Cells IV Susp 23 $460,227.00 $4,467,708.00 $1,591,700.02 nat. median
$574,037
outlier · 2.8×
Q2042
HCPCS 		Tisagenlecleucel IV Infusion (wrapped) 23 $466,070.00 $4,295,932.22 $1,566,712.27 nat. median
$621,313
outlier · 2.5×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 6 $551,318.34 $4,108,208.54 $1,544,822.22 nat. median
$599,737
outlier · 2.6×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 6 $489,517.15 $3,871,251.04 $1,455,718.37 nat. median
$562,501
outlier · 2.6×
Q2053
HCPCS 		Brexucabtagene Car Pos T 6 $488,051.51 $3,552,351.45 $1,335,801.58 nat. median
$513,770
outlier · 2.6×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 21 $129,318.00 $1,840,913.00 $378,844.30 nat. median
$168,055
outlier · 2.3×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 21 $106,702.00 $1,375,007.00 $264,847.67 nat. median
$186,516
1.4× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 21 $115,671.00 $1,075,355.00 $249,071.73 nat. median
$131,925
1.9× median
13925-522-01
NDC 		Pentamidine Isethionate 300 Mg In Solr 11 $130,892.00 $356,977.00 $218,351.00 —
58914-501-56
NDC 		Mesalamine 1000 Mg Re Supp 11 $123,003.00 $335,462.00 $205,191.00 nat. median
$47
outlier · 4351.0×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 21 $83,931.00 $1,046,162.00 $201,052.10 nat. median
$145,435
1.4× median
52427-273-75
NDC 		Naproxen Sodium ER 500 Mg Po Tb24 11 $111,950.00 $305,319.00 $186,753.00 —
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 6 $63,342.28 $459,864.97 $172,924.43 nat. median
$66,211
outlier · 2.6×
63323-877-15
NDC 		Pentamidine Isethionate 300 Mg In Solr 11 $102,660.00 $279,982.00 $171,256.00 —
58468-0132-2
NDC 		Sevelamer Carbonate 0.8 G Po Pack 11 $97,091.00 $264,794.00 $161,966.00 —
58468-0132-1
NDC 		Sevelamer Carbonate 0.8 G Po Pack 11 $97,091.00 $264,794.00 $161,966.00 —
C9089
HCPCS 		Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl 19 $81,468.00 $228,405.00 $161,332.00 nat. median
$1
outlier · 130106.5×
68382-395-04
NDC 		Ribavirin 6 G In Solr 11 $90,654.00 $247,239.00 $151,228.00 —
68382-395-01
NDC 		Ribavirin 6 G In Solr 11 $90,654.00 $247,239.00 $151,228.00 —
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 6 $55,272.32 $401,277.07 $150,893.44 nat. median
$63,499
outlier · 2.4×
C1831
HCPCS 		Kit Imp Aprevo Spine Lvl 1 19 $34,086.00 $393,300.00 $146,570.00 nat. median
$5,834
outlier · 25.1×
59385-027-60
NDC 		Buprenorphine Hcl 900 Mcg Bu Film 11 $87,198.00 $237,813.00 $145,462.00 —
59385-027-01
NDC 		Buprenorphine Hcl 900 Mcg Bu Film 11 $87,198.00 $237,813.00 $145,462.00 —
14
MS_DRG 		Allogeneic Bone Marrow Transplant 21 $40,206.00 $593,905.00 $139,139.14 nat. median
$72,715
1.9× median
C1824
HCPCS 		Generator Pul Implantable Optimizer Smt F/hrt Fail 19 $27,612.00 $204,516.00 $136,776.00 nat. median
$32,119
outlier · 4.3×
24338-050-08
NDC 		Carmustine In Polifeprosan 7.7 Mg Il Wafr 11 $80,494.00 $219,530.00 $134,279.00 —
C1827
HCPCS 		Generator Imp Vivistim Vns Ipg 1001 19 $9,009.00 $232,047.00 $134,072.00 nat. median
$34
outlier · 3920.2×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 21 $57,874.00 $689,742.00 $131,883.00 nat. median
$97,418
1.4× median
C1823
HCPCS 		Generator Implantable Remede Pul Cent Sleep Apnea 19 $12,474.00 $212,058.00 $130,533.00 nat. median
$86,625
1.5× median
209
MS_DRG 		Complex Aortic Arch Procedures 9 $62,253.40 $342,167.32 $129,639.12 nat. median
$2,110
outlier · 61.4×
J9226
HCPCS 		Supprelin La Implant 6 $45,020.65 $326,849.92 $122,906.37 nat. median
$57,036
outlier · 2.2×
7
MS_DRG 		Lung Transplant 21 $48,286.00 $637,940.00 $122,633.74 nat. median
$70,649
1.7× median
C1825
HCPCS 		System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 19 $29,736.00 $220,248.00 $121,917.50 nat. median
$35,000
outlier · 3.5×
A9543
HCPCS 		Y90 Ibritumomab, Rx 6 $56,824.55 $412,546.23 $121,036.29 nat. median
$65,477
1.8× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 $60,616.60 $511,346.00 $120,173.32 nat. median
$2,736
outlier · 43.9×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 21 $40,748.00 $482,737.00 $116,882.21 nat. median
$69,922
1.7× median
0187-0007-14
NDC 		Ribavirin 6 G In Solr 11 $69,528.00 $189,621.00 $115,985.00 —
0781-5893-31
NDC 		Nevirapine ER 400 Mg Po Tb24 11 $68,166.00 $185,908.00 $113,714.00 —
C1822
HCPCS 		Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm 19 $26,876.00 $204,516.00 $110,189.50 nat. median
$30,046
outlier · 3.7×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 21 $48,209.00 $537,916.00 $105,348.61 nat. median
$65,418
1.6× median
850
MS_DRG 		Acute Leukemia With Other Procedures 21 $47,627.25 $449,670.00 $104,581.90 nat. median
$2,633
outlier · 39.7×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 21 $52,114.00 $531,775.00 $102,598.01 nat. median
$74,509
1.4× median

Other procedures at this hospital

Browse this hospital's 25,281 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 5 — — $2,403,458.75 $4,173,688.03 $3,756,319.23 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 4 4 — — $2,945,740.00 $4,713,184.00 $3,737,491.10 2026-04-01
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
J3392 HCPCS Inj, Exagamglogene Autotem 6 5 — — $2,332,000.00 $4,967,160.00 $3,649,580.00 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
Q2054 HCPCS Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 48 23 $4,855,287.41 $2,427,643.70 50% off $454,489.00 $4,369,759.00 $1,592,051.19 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel 460000000 Cells IV Susp 48 23 $4,964,120.33 $2,482,060.16 50% off $460,227.00 $4,467,708.00 $1,591,700.02 2026-04-01
Q2042 HCPCS Tisagenlecleucel IV Infusion (wrapped) 48 23 $4,253,411.58 $2,126,705.79 50% off $466,070.00 $4,295,932.22 $1,566,712.27 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 15 6 — — $551,318.34 $4,108,208.54 $1,544,822.22 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 15 6 — — $489,517.15 $3,871,251.04 $1,455,718.37 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 15 6 — — $488,051.51 $3,552,351.45 $1,335,801.58 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 44 21 $0.01 — $129,318.00 $1,840,913.00 $378,844.30 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 44 21 $0.01 — $106,702.00 $1,375,007.00 $264,847.67 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 44 21 $0.01 — $115,671.00 $1,075,355.00 $249,071.73 2026-04-01
13925-522-01 NDC Pentamidine Isethionate 300 Mg In Solr 17 11 $396,641.51 $198,320.76 50% off $130,892.00 $356,977.00 $218,351.00 2024-12-15
58914-501-56 NDC Mesalamine 1000 Mg Re Supp 17 11 $372,735.21 $186,367.60 50% off $123,003.00 $335,462.00 $205,191.00 2024-12-15
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 44 21 $0.01 — $83,931.00 $1,046,162.00 $201,052.10 2026-04-01
52427-273-75 NDC Naproxen Sodium ER 500 Mg Po Tb24 17 11 $339,243.38 $169,621.69 50% off $111,950.00 $305,319.00 $186,753.00 2024-12-15
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 15 6 — — $63,342.28 $459,864.97 $172,924.43 2026-04-01
63323-877-15 NDC Pentamidine Isethionate 300 Mg In Solr 17 11 $311,091.56 $155,545.78 50% off $102,660.00 $279,982.00 $171,256.00 2024-12-15
58468-0132-2 NDC Sevelamer Carbonate 0.8 G Po Pack 17 11 $294,215.74 $147,107.87 50% off $97,091.00 $264,794.00 $161,966.00 2024-12-15
58468-0132-1 NDC Sevelamer Carbonate 0.8 G Po Pack 17 11 $294,215.74 $147,107.87 50% off $97,091.00 $264,794.00 $161,966.00 2024-12-15
C9089 HCPCS Bupivacaine Hcl (300 Mg Dose) 3 X 100 Mg Il Impl 50 19 $246,873.71 $123,436.86 50% off $81,468.00 $228,405.00 $161,332.00 2024-12-15
68382-395-01 NDC Ribavirin 6 G In Solr 17 11 $274,709.53 $137,354.77 50% off $90,654.00 $247,239.00 $151,228.00 2024-12-15
68382-395-04 NDC Ribavirin 6 G In Solr 17 11 $274,709.53 $137,354.77 50% off $90,654.00 $247,239.00 $151,228.00 2024-12-15
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 15 6 — — $55,272.32 $401,277.07 $150,893.44 2026-04-01
C1831 HCPCS Kit Imp Aprevo Spine Lvl 1 106 19 $305,900.00 $152,950.00 50% off $34,086.00 $393,300.00 $146,570.00 2024-12-15
59385-027-60 NDC Buprenorphine Hcl 900 Mcg Bu Film 17 11 $264,236.27 $132,118.13 50% off $87,198.00 $237,813.00 $145,462.00 2024-12-15
59385-027-01 NDC Buprenorphine Hcl 900 Mcg Bu Film 17 11 $264,236.27 $132,118.13 50% off $87,198.00 $237,813.00 $145,462.00 2024-12-15
14 MS_DRG Allogeneic Bone Marrow Transplant 44 21 $0.01 — $40,206.00 $593,905.00 $139,139.14 2026-04-01
C1824 HCPCS Generator Pul Implantable Optimizer Smt F/hrt Fail 53 19 $227,240.00 $113,620.00 50% off $27,612.00 $204,516.00 $136,776.00 2024-12-15
24338-050-08 NDC Carmustine In Polifeprosan 7.7 Mg Il Wafr 17 11 $243,921.81 $121,960.90 50% off $80,494.00 $219,530.00 $134,279.00 2024-12-15
C1827 HCPCS Generator Imp Vivistim Vns Ipg 1001 53 19 $257,830.00 $128,915.00 50% off $9,009.00 $232,047.00 $134,072.00 2024-12-15
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 44 21 $0.01 — $57,874.00 $689,742.00 $131,883.00 2026-04-01
C1823 HCPCS Generator Implantable Remede Pul Cent Sleep Apnea 49 19 $235,620.00 $117,810.00 50% off $12,474.00 $212,058.00 $130,533.00 2024-12-15
209 MS_DRG Complex Aortic Arch Procedures 20 9 — — $62,253.40 $342,167.32 $129,639.12 2026-04-01
J9226 HCPCS Supprelin La Implant 15 6 — — $45,020.65 $326,849.92 $122,906.37 2026-04-01
7 MS_DRG Lung Transplant 44 21 $0.01 — $48,286.00 $637,940.00 $122,633.74 2026-04-01
C1825 HCPCS System Neo Barostim Includes 2102 Ipg 1036 Csl Kit 53 19 $198,240.00 $99,120.00 50% off $29,736.00 $220,248.00 $121,917.50 2024-12-15
A9543 HCPCS Y90 Ibritumomab, Rx 11 6 — — $56,824.55 $412,546.23 $121,036.29 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 44 21 $0.01 — $60,616.60 $511,346.00 $120,173.32 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 44 21 $0.01 — $40,748.00 $482,737.00 $116,882.21 2026-04-01
0187-0007-14 NDC Ribavirin 6 G In Solr 17 11 $210,690.03 $105,345.02 50% off $69,528.00 $189,621.00 $115,985.00 2024-12-15
0781-5893-31 NDC Nevirapine ER 400 Mg Po Tb24 17 11 $206,564.77 $103,282.38 50% off $68,166.00 $185,908.00 $113,714.00 2024-12-15
C1822 HCPCS Construct Neuromod Nevro Pain Mgmt Omnia With Ipg Rm 66 19 $179,170.00 $89,585.00 50% off $26,876.00 $204,516.00 $110,189.50 2024-12-15
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 44 21 $0.01 — $48,209.00 $537,916.00 $105,348.61 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 44 21 $0.01 — $47,627.25 $449,670.00 $104,581.90 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 44 21 $0.01 — $52,114.00 $531,775.00 $102,598.01 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 14 7 — — $3,245.00 $432,345.48 $98,260.33 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 44 21 $0.01 — $49,552.80 $407,138.00 $97,147.96 2026-04-01
215 MS_DRG Other Heart Assist System Implant 44 21 $0.01 — $49,446.00 $517,175.00 $96,865.30 2026-04-01
47781-153-01 NDC Naproxen Sodium ER 375 Mg Po Tb24 17 11 $171,325.06 $85,662.53 50% off $56,537.00 $154,193.00 $94,314.00 2024-12-15
38240 CPT Hc Trnsplj Allogeneic Hematopoietic Cells Per Donor 31 19 $178,757.65 $89,378.82 50% off $1,759.00 $354,050.00 $91,864.00 2024-12-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 44 21 $0.01 — $46,972.00 $471,109.00 $91,597.12 2026-04-01
C1816 HCPCS System Stim Nerv Stimq-4 8 Elect Dl Transm Kt 72 19 $157,320.00 $78,660.00 50% off $2,622.00 $161,253.00 $89,615.00 2024-12-15
C2624 HCPCS System Cardiomems Hrt Failure Ptnt 35 19 $141,246.00 $70,623.00 50% off $21,187.00 $127,121.00 $86,866.00 2024-12-15
10 MS_DRG Pancreas Transplant 44 21 $0.01 — $18,943.00 $361,416.00 $84,035.57 2026-04-01
C1767 HCPCS Stimulator Proclaim Elite 7 Rechrg-free Scs 457 19 $144,210.00 $72,105.00 50% off $13,444.00 $307,915.00 $83,079.00 2024-12-15
C1882 HCPCS Defibrillator Consulta 2chb Is1 Df1 Av 35jl 38ml 6 1,048 19 $148,486.80 $74,243.40 50% off $6.00 $271,027.00 $81,339.50 2024-12-15
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 44 21 $0.01 — $39,702.30 $346,711.00 $81,297.50 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 44 21 $0.01 — $39,279.00 $413,645.00 $79,672.05 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 44 21 $0.01 — $38,815.00 $413,416.00 $79,524.63 2026-04-01
0187-3013-30 NDC Pyridostigmine Bromide ER 180 Mg Po Tbcr 17 11 $141,474.57 $70,737.28 50% off $46,687.00 $127,327.00 $77,882.00 2024-12-15
51167-331-01 NDC Elexacaf-tezacaf-ivacaf&ivacaf 100-50-75 (trikafta Kit Morning Dose) 17 11 $140,799.12 $70,399.56 50% off $46,464.00 $126,719.00 $77,510.00 2024-12-15
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 2 2 — — $73,826.00 $80,239.83 $77,032.92 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 44 21 $0.01 — $36,748.80 $327,283.00 $76,742.00 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 44 21 $0.01 — $30,387.00 $302,755.00 $76,446.50 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 44 21 $0.01 — $39,047.00 $393,495.00 $75,081.52 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 45 21 $0.01 — $37,307.00 $377,698.00 $72,926.00 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 44 21 $0.01 — $37,732.00 $381,550.00 $72,874.48 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 44 21 $0.01 — $36,775.75 $301,983.00 $72,345.07 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 10 5 — — $29,214.57 $212,097.77 $72,189.20 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 44 21 $0.01 — $31,469.00 $386,963.00 $71,726.50 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 45 21 $0.01 — $32,689.25 $269,478.00 $71,482.47 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 44 21 $0.01 — $28,802.00 $364,357.00 $71,095.21 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 14 7 — — $3,245.00 $302,749.72 $68,806.76 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 14 7 — — $3,245.00 $302,749.72 $68,806.76 2026-04-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 14 7 — — $3,245.00 $302,749.72 $68,806.76 2026-04-01
5378 OTHER Level 8 Urology And Related Services 1 1 — — $68,704.52 $68,704.52 $68,704.52 2026-04-01
0078-0697-19 NDC Eltrombopag Olamine 25 Mg Po Pack 17 11 $124,394.78 $62,197.39 50% off $41,050.00 $111,955.00 $68,479.00 2024-12-15
0078-0697-61 NDC Eltrombopag Olamine 25 Mg Po Pack 17 11 $124,394.78 $62,197.39 50% off $41,050.00 $111,955.00 $68,479.00 2024-12-15
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 44 21 $0.01 — $21,688.00 $273,607.00 $67,154.90 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 44 21 $0.01 — $34,059.00 $344,969.00 $66,915.71 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 20 9 — — $31,387.95 $172,519.59 $65,877.21 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 44 21 $0.01 — $26,521.00 $263,925.00 $65,590.29 2026-04-01
C1721 HCPCS Defibrillator Lumax 540 Dr-t 2chb Home Mon 865 19 $123,723.60 $61,861.80 50% off $11.00 $171,451.00 $64,349.00 2024-12-15
955 MS_DRG Craniotomy For Multiple Significant Trauma 44 21 $0.01 — $24,278.00 $333,317.00 $63,908.90 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 44 21 $0.01 — $33,170.00 $325,472.00 $63,843.42 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 44 21 $0.01 — $20,644.00 $273,607.00 $63,737.13 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 44 21 $0.01 — $31,719.05 $267,037.00 $63,314.24 2026-04-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 11 6 — — $21,140.00 $215,748.69 $63,298.17 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 44 21 $0.01 — $30,921.00 $268,677.00 $63,000.00 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 46 21 $0.01 — $26,344.62 $339,575.00 $62,742.22 2026-04-01
0909T OTHER Rplcmt Int Nstim Sys Vgs Nrv 11 6 — — $5,562.00 $212,097.77 $62,227.03 2026-04-01
0908T OTHER Opn Imp Int Nstm Sys Vgs Nrv 11 6 — — $5,562.00 $212,097.77 $62,227.03 2026-04-01
0955-1052-01 NDC Sevelamer Carbonate 0.8 G Po Pack 17 11 $112,748.02 $56,374.01 50% off $37,207.00 $101,473.00 $62,068.00 2024-12-15
0955-1052-90 NDC Sevelamer Carbonate 0.8 G Po Pack 17 11 $112,748.02 $56,374.01 50% off $37,207.00 $101,473.00 $62,068.00 2024-12-15
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 44 21 $0.01 — $20,722.00 $246,645.00 $62,026.13 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 44 21 $0.01 — $30,812.00 $315,236.00 $61,428.96 2026-04-01
C1722 HCPCS Defibrillator Maximo Ii Vr 1chb Is1 Df1 Av 35jl 37 848 19 $117,348.00 $58,674.00 50% off $6,778.00 $185,447.00 $61,002.50 2024-12-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 45 21 $0.01 — $31,798.17 $315,690.00 $60,666.35 2026-04-01
C1772 HCPCS Pump Inf Synchromed Ii Ti 3.4x0.78x0.78in 20ml 53 19 $100,510.00 $50,255.00 50% off $12,979.00 $90,459.00 $60,497.00 2024-12-15
653 MS_DRG Major Bladder Procedures With Mcc 44 21 $0.01 — $25,361.00 $252,697.00 $60,076.96 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 44 21 $0.01 — $27,294.00 $300,606.00 $59,903.80 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 44 21 $0.01 — $27,565.00 $290,409.00 $59,148.57 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 44 21 $0.01 — $29,312.80 $251,397.00 $59,133.32 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 44 21 $0.01 — $30,155.00 $308,714.00 $58,659.31 2026-04-01
C1820 HCPCS System Chrgr Prc Fam Neurostim Ptnt Kt 321 19 $114,319.20 $57,159.60 50% off $1,239.00 $201,016.00 $58,576.00 2024-12-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 44 21 $0.01 — $30,039.00 $302,373.00 $57,506.11 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 44 21 $0.01 — $28,802.00 $298,190.00 $57,366.10 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 44 21 $0.01 — $33,706.20 $292,435.00 $57,120.78 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 44 21 $0.01 — $27,835.00 $296,765.00 $56,972.62 2026-04-01
61958-1004-1 NDC Ranolazine ER 1000 Mg Po Tb12 17 11 $102,106.23 $51,053.12 50% off $33,695.00 $91,896.00 $56,209.00 2024-12-15
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 44 21 $0.01 — $30,376.50 $299,557.00 $55,524.50 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 45 21 $0.01 — $28,454.00 $287,231.00 $55,329.16 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 44 21 $0.01 — $16,469.00 $226,976.00 $55,272.29 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 44 21 $0.01 — $27,951.00 $280,163.00 $55,157.06 2026-04-01
0960T OTHER Rpl S-sclp Eltr Ra Rcvr&tlmt 11 6 — — $21,140.00 $186,503.39 $54,717.94 2026-04-01
0956T OTHER Prt Crn Ch Cr&tun Elt S-sclp 11 6 — — $21,140.00 $186,503.39 $54,717.94 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 44 21 $0.01 — $25,168.00 $278,489.00 $53,898.13 2026-04-01
0686T OTHER Histotripsy Mal Hepatcel Tis 14 7 — — $3,245.00 $235,472.75 $53,516.54 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 44 21 $0.01 — $19,059.00 $219,814.00 $53,477.01 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 5 3 — — $22,537.47 $110,578.32 $52,421.36 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 44 21 $0.01 — $26,057.00 $263,644.00 $52,319.44 2026-04-01
55566-9800-2 NDC Fecal Microbiota, Live-jslm 150 Ml Re Susp 17 11 $94,953.71 $47,476.86 50% off $31,335.00 $85,458.00 $52,272.00 2024-12-15
55566-9800-0 NDC Fecal Microbiota, Live-jslm 150 Ml Re Susp 17 11 $94,953.71 $47,476.86 50% off $31,335.00 $85,458.00 $52,272.00 2024-12-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 44 21 $0.01 — $19,755.00 $212,122.00 $52,230.32 2026-04-01
69468-151-04 NDC Uridine Triacetate 10 G Po Pack 17 11 $94,691.13 $47,345.56 50% off $31,248.00 $85,222.00 $52,127.00 2024-12-15
834 MS_DRG Acute Leukemia With Mcc 44 21 $0.01 — $19,021.00 $269,810.00 $51,926.89 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 11 6 — — $24,228.42 $175,898.33 $51,606.53 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 45 21 $0.01 — $21,186.00 $264,997.00 $51,575.87 2026-04-01
69930 HCPCS Implant Cochlear Device 14 7 — — $6,329.00 $226,631.08 $51,507.06 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 44 21 $0.01 — $20,297.00 $263,395.00 $51,138.62 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 44 21 $0.01 — $28,376.00 $269,810.00 $51,002.47 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 44 21 $0.01 — $25,168.00 $259,700.00 $50,822.67 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 44 21 $0.01 — $25,361.00 $258,553.00 $50,099.32 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 44 21 $0.01 — $21,572.00 $244,231.00 $49,979.11 2026-04-01
C2616 HCPCS Sphere Embol Sir Msphre 90 63 22 $129,882.60 $64,941.30 50% off $17,177.00 $129,017.53 $49,972.08 2026-04-01
67546-212-21 NDC Nitazoxanide 100 Mg/5ml Po Susr Bulk 17 11 $89,264.62 $44,632.31 50% off $29,457.00 $80,338.00 $49,140.00 2024-12-15
0571T OTHER Insj/rplcmt Icds Ss Eltrd 14 7 — — $3,245.00 $215,748.69 $49,033.79 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 14 7 — — $3,245.00 $215,748.69 $49,033.79 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 14 7 — — $3,245.00 $215,748.69 $49,033.79 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 14 7 — — $3,245.00 $215,748.69 $49,033.79 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 14 7 — — $3,245.00 $215,748.69 $49,033.79 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 14 7 — — $3,245.00 $215,748.69 $49,033.79 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 44 21 $0.01 — $24,936.00 $263,366.00 $48,817.00 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 3 2 — — $301.51 $72,549.69 $48,786.04 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 44 21 $0.01 — $23,853.00 $248,688.00 $48,546.76 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 45 21 $0.01 — $24,472.00 $250,562.00 $48,379.00 2026-04-01
L8614 HCPCS Electrode Hires Ultra 3d Ci Hifocus Slimj Cochlear 215 19 $94,916.25 $47,458.12 50% off $257.00 $151,222.00 $48,209.00 2024-12-15
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 14 7 — — $3,245.00 $212,097.77 $48,204.04 2026-04-01
61886 HCPCS Implant Neurostim Arrays 14 7 — — $3,245.00 $212,097.77 $48,204.04 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 14 7 — — $3,245.00 $212,097.77 $48,204.04 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 14 7 — — $3,245.00 $212,097.77 $48,204.04 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 14 7 — — $2,788.00 $212,097.77 $48,204.04 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 14 7 — — $3,245.00 $212,097.77 $48,204.04 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 14 7 — — $2,788.00 $212,097.77 $48,204.04 2026-04-01
0310-0283-60 NDC Quetiapine Fumarate ER 300 Mg Po Tb24 17 11 $87,338.95 $43,669.47 50% off $28,822.00 $78,605.00 $48,080.00 2024-12-15
140 MS_DRG Major Head And Neck Procedures With Mcc 44 21 $0.01 — $16,585.00 $191,710.00 $47,955.01 2026-04-01
791 MS_DRG Prematurity With Major Problems 46 21 $0.01 — $22,324.50 $184,035.00 $47,854.79 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 45 21 $0.01 — $23,273.00 $245,871.00 $47,473.00 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 12 6 — — $9,839.00 $179,656.35 $47,388.69 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 12 6 — — $9,839.00 $179,656.35 $47,388.69 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 12 6 — — $9,839.00 $179,656.35 $47,388.69 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 44 21 $0.01 — $17,320.00 $189,915.00 $47,388.31 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 44 21 $0.01 — $23,324.40 $199,332.00 $47,181.46 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 45 21 $0.01 — $22,964.00 $247,926.00 $47,021.21 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 44 21 $0.01 — $24,394.00 $243,255.00 $46,806.04 2026-04-01
0008-0423-03 NDC Antivenin Micrurus Fulvius IV Solr 17 11 $84,789.87 $42,394.94 50% off $27,981.00 $76,311.00 $46,677.00 2024-12-15
0008-0423-01 NDC Antivenin Micrurus Fulvius IV Solr 17 11 $84,789.87 $42,394.94 50% off $27,981.00 $76,311.00 $46,677.00 2024-12-15
793 MS_DRG Full Term Neonate With Major Problems 45 21 $0.01 — $4,021.00 $189,049.00 $46,673.31 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 47 21 $0.01 — $11,206.51 $244,133.00 $46,561.12 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 44 21 $0.01 — $15,039.00 $184,375.00 $46,431.88 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 44 21 $0.01 — $11,791.00 $196,138.00 $45,829.27 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 44 21 $0.01 — $22,655.00 $237,104.00 $45,652.49 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 44 21 $0.01 — $22,500.00 $224,183.00 $45,616.85 2026-04-01
47335-625-60 NDC Ranolazine ER 1000 Mg Po Pack 17 11 $82,310.16 $41,155.08 50% off $27,162.00 $74,079.00 $45,312.00 2024-12-15
459 MS_DRG Spinal Fusion Except Cervical With Mcc 1 1 — — $45,291.74 $45,291.74 $45,291.74 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 44 21 $0.01 — $22,112.75 $190,970.00 $45,018.71 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 45 21 $0.01 — $23,621.00 $229,655.00 $44,884.82 2026-04-01
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 11 6 — — $21,059.14 $152,889.33 $44,855.96 2026-04-01
0916T OTHER Insj Perm Ccm-d Sys Pg Only 11 6 — — $21,059.14 $152,889.33 $44,855.96 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 14 7 — — $3,245.00 $197,152.60 $44,807.41 2026-04-01
C1833 HCPCS Monitor Crdc The Guardian Amsg3-e 35 19 $72,570.00 $36,285.00 50% off $10,886.00 $65,313.00 $44,630.50 2024-12-15
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 46 21 $0.01 — $21,263.00 $218,311.00 $44,581.15 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 44 21 $0.01 — $20,297.00 $233,111.00 $44,555.65 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 44 21 $0.01 — $22,461.00 $232,057.00 $44,520.15 2026-04-01
33365 CPT Hc Cath Replace Aortic Valve Open Transaortic Approach 15 11 $80,395.84 $40,197.92 50% off $3,259.00 $72,356.00 $44,258.00 2024-12-15
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 44 21 $0.01 — $21,070.00 $224,901.00 $43,874.40 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 44 21 $0.01 — $21,727.00 $232,101.00 $43,756.24 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 44 21 $0.01 — $23,157.00 $227,078.00 $43,693.61 2026-04-01
73702-140-71 NDC Indomethacin 100 Mg Re Supp 17 11 $79,128.71 $39,564.36 50% off $26,112.00 $71,216.00 $43,560.00 2024-12-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 46 21 $0.01 — $22,655.00 $224,149.00 $43,307.40 2026-04-01
245 MS_DRG Aicd Generator Procedures 45 21 $0.01 — $21,920.00 $238,544.00 $43,014.31 2026-04-01
37275 HCPCS Rvsc Evsc Fpvt St Athrc Sf 1 10 5 — — $17,355.50 $126,000.95 $42,885.44 2026-04-01
37277 HCPCS Rvsc Evsc Fpvt St Athr Cpx 1 10 5 — — $17,355.50 $126,000.95 $42,885.44 2026-04-01
37271 HCPCS Revsc Evsc Fpvt Athrc Sf 1st 10 5 — — $17,355.50 $126,000.95 $42,885.44 2026-04-01
37292 HCPCS Rvsc Evsc Tpvt St Athrc Sf 1 10 5 — — $17,355.50 $126,000.95 $42,885.44 2026-04-01
37294 HCPCS Rvsc Evsc Tpvt St Athr Cpx 1 10 5 — — $17,355.50 $126,000.95 $42,885.44 2026-04-01
92930 HCPCS Prq Tcat Plmt Ntrac St 2+les 10 5 — — $17,355.50 $126,000.95 $42,885.44 2026-04-01
0981T OTHER Tcat Impl Wrls Ivc Snr 10 5 — — $17,355.50 $126,000.95 $42,885.44 2026-04-01
37288 HCPCS Revsc Evsc Tpvt Athrc Sf 1st 10 5 — — $17,355.50 $126,000.95 $42,885.44 2026-04-01
37273 HCPCS Revsc Evsc Fpvt Athrc Cplx 1 10 5 — — $17,355.50 $126,000.95 $42,885.44 2026-04-01
37286 HCPCS Revsc Evasc Tpvt St Cplx 1st 10 5 — — $17,355.50 $126,000.95 $42,885.44 2026-04-01
37284 HCPCS Revsc Evasc Tpvt St Sf 1st 10 5 — — $17,355.50 $126,000.95 $42,885.44 2026-04-01
37290 HCPCS Revsc Evsc Tpvt Athrc Cplx 1 10 5 — — $17,355.50 $126,000.95 $42,885.44 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 45 21 $0.01 — $20,451.00 $220,229.00 $42,885.14 2026-04-01
J1324 HCPCS Enfuvirtide 90 Mg Sc Solr 33 19 $63,146.42 $31,573.21 50% off $20,838.00 $56,832.00 $42,845.00 2024-12-15
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 44 21 $0.01 — $14,304.00 $175,024.00 $42,689.68 2026-04-01
33289 CPT Hc Rhc W/plc Pressure Sensor 34 21 $86,635.40 $43,317.70 50% off $3,259.00 $188,309.00 $42,646.50 2024-12-15
20696 HCPCS Comp Multiplane Ext Fixation 14 7 — — $4,376.00 $186,503.39 $42,387.13 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 14 7 — — $3,245.00 $186,503.39 $42,387.13 2026-04-01
22558 HCPCS Lumbar Spine Fusion 14 7 — — $3,245.00 $186,503.39 $42,387.13 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 14 7 — — $4,562.00 $186,503.39 $42,387.13 2026-04-01
22630 HCPCS Lumbar Spine Fusion 14 7 — — $3,245.00 $186,503.39 $42,387.13 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 14 7 — — $3,245.00 $186,503.39 $42,387.13 2026-04-01
81416 CPT Hc Exome Sequence Analysis Each Comparator Exome 31 19 $92,610.00 $46,305.00 50% off $12,000.00 $83,349.00 $42,323.00 2024-12-15
C9760 HCPCS Non-blind Interatrial Shunt 14 7 — — $3,245.00 $185,015.03 $42,048.87 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 44 21 $0.01 — $21,108.00 $214,430.00 $41,739.11 2026-04-01
0078-0494-71 NDC Tobramycin 300 Mg/5ml In Nebu 17 11 $75,495.29 $37,747.64 50% off $24,913.00 $67,946.00 $41,560.00 2024-12-15
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 44 21 $0.01 — $12,410.00 $169,625.00 $41,401.49 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 44 21 $0.01 — $19,794.00 $218,916.00 $41,370.73 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 46 21 $0.01 — $17,281.00 $224,993.00 $41,110.21 2026-04-01
33240 CPT Hc Insj Implntbl Defib Pulse Gen W/1 Existing Ld 42 19 $79,329.69 $39,664.84 50% off $3,259.00 $152,719.00 $41,009.50 2024-12-15
31 MS_DRG Ventricular Shunt Procedures With Mcc 44 21 $0.01 — $19,021.00 $204,560.00 $40,869.07 2026-04-01
33264 CPT Hc Rmvl Impltbl Dfb Pls Gen W/rplcmt Pls Gen Mlt Ld 42 19 $62,630.09 $31,315.04 50% off $3,259.00 $213,153.00 $40,846.50 2024-12-15
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 44 21 $0.01 — $19,330.00 $208,226.00 $40,809.66 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 44 21 $0.01 — $18,982.00 $216,270.00 $40,661.27 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 44 21 $0.01 — $20,026.00 $207,918.00 $40,471.87 2026-04-01
0591-2720-60 NDC Metformin Hcl ER (osm) 1000 Mg Po Tb24 17 11 $72,962.64 $36,481.32 50% off $24,078.00 $65,666.00 $40,166.00 2024-12-15
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 20 9 — — $18,912.30 $103,948.88 $40,104.99 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 44 21 $0.01 — $20,838.00 $210,779.00 $40,018.13 2026-04-01
J9266 HCPCS Hc Pegaspargase/singl Dose Vial 45 23 $29,471.26 $14,735.63 50% off $10,197.00 $206,358.67 $39,982.00 2026-04-01
69344-102-33 NDC Indomethacin 50 Mg Re Supp 17 11 $72,208.70 $36,104.35 50% off $23,829.00 $64,988.00 $39,751.00 2024-12-15
332 MS_DRG Rectal Resection With Mcc 44 21 $0.01 — $16,508.00 $157,236.00 $39,702.50 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 44 21 $0.01 — $20,142.00 $203,100.00 $39,515.67 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 44 21 $0.01 — $16,121.00 $200,616.00 $39,231.82 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 44 21 $0.01 — $15,773.00 $200,318.00 $39,212.72 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 44 21 $0.01 — $19,562.00 $200,728.00 $39,124.51 2026-04-01
61958-1003-1 NDC Ranolazine ER 500 Mg Po Tb12 17 11 $70,311.18 $35,155.59 50% off $23,203.00 $63,280.00 $38,706.00 2024-12-15
L8619 HCPCS Hc Supply Cochlear Implnt, Ext Speech Processor_cont Rplcmt - L8619 262 19 $81,290.79 $40,645.39 50% off $421.00 $133,812.00 $38,589.50 2024-12-15
35355 CPT Hc Thromboendarterectomy With Without Patch Graft Iliofemoral 25 11 $58,423.66 $29,211.83 50% off $1,759.00 $105,163.00 $38,384.00 2024-12-15
35371 CPT Hc Thromboendartectmy Femoral Common 25 11 $58,423.66 $29,211.83 50% off $1,759.00 $105,163.00 $38,384.00 2024-12-15
J0571 HCPCS Buprenorphine Hcl 300 Mcg Bu Film 33 19 $56,121.38 $28,060.69 50% off $18,520.00 $50,509.00 $38,078.00 2024-12-15
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 44 21 $0.01 — $18,866.00 $190,877.00 $37,875.10 2026-04-01
33230 CPT Hc Ep Insj Implntbl Defib Pulse Gen W/exist Dual Leads 31 19 $73,431.05 $36,715.52 50% off $3,259.00 $152,719.00 $37,736.00 2024-12-15
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 45 21 $0.01 — $16,315.00 $194,460.00 $37,546.00 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 44 21 $0.01 — $16,392.00 $191,819.00 $36,737.14 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 44 21 $0.01 — $18,016.00 $189,823.00 $36,571.98 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 44 21 $0.01 — $14,111.00 $144,168.00 $36,390.59 2026-04-01
59676-565-01 NDC Darunavir 100 Mg/ml Po Susp Bulk 17 11 $66,064.35 $33,032.18 50% off $21,801.00 $59,458.00 $36,368.00 2024-12-15
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 44 21 $0.01 — $17,513.00 $185,576.00 $36,356.19 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 44 21 $0.01 — $13,028.00 $192,605.00 $36,162.13 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 44 21 $0.01 — $17,767.20 $150,640.00 $36,045.43 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 44 21 $0.01 — $15,889.00 $194,324.00 $36,019.00 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 44 21 $0.01 — $17,784.00 $184,131.00 $35,977.69 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 44 21 $0.01 — $15,039.00 $174,988.00 $35,930.54 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 44 21 $0.01 — $14,884.00 $187,949.00 $35,764.02 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 44 21 $0.01 — $15,464.00 $186,587.00 $35,751.78 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 44 21 $0.01 — $17,049.00 $192,210.00 $35,627.50 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 2 2 — — $27,282.86 $43,893.48 $35,588.17 2026-04-01
C8003 HCPCS Imp Extar Knee Shck Absrb 11 6 — — $16,600.17 $120,517.20 $35,358.35 2026-04-01
652 MS_DRG Kidney Transplant 44 21 $0.01 — $14,072.00 $139,227.00 $35,155.50 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 14 7 — — $3,245.00 $152,889.33 $34,747.57 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 14 7 — — $3,245.00 $152,889.33 $34,747.57 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 14 7 — — $3,245.00 $152,889.33 $34,747.57 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 14 7 — — $3,245.00 $152,889.33 $34,747.57 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 14 7 — — $3,245.00 $152,889.33 $34,747.57 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 14 7 — — $3,245.00 $152,889.33 $34,747.57 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 14 7 — — $3,245.00 $152,889.33 $34,747.57 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 14 7 — — $3,245.00 $152,889.33 $34,747.57 2026-04-01
54092-252-90 NDC Lanthanum Carbonate 500 Mg Po Chew 17 11 $62,957.87 $31,478.94 50% off $20,776.00 $56,662.00 $34,658.00 2024-12-15
54092-252-45 NDC Lanthanum Carbonate 500 Mg Po Chew 17 11 $62,957.87 $31,478.94 50% off $20,776.00 $56,662.00 $34,658.00 2024-12-15
0888T OTHER Histotripsy Mal Renal Tissue 11 6 — — $16,217.36 $117,738.06 $34,542.98 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 44 21 $0.01 — $16,817.00 $174,949.00 $34,507.13 2026-04-01
54092-191-12 NDC Mesalamine ER 500 Mg Po Cpcr 17 11 $62,289.39 $31,144.70 50% off $20,555.00 $56,060.00 $34,290.00 2024-12-15
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 44 21 $0.01 — $19,864.90 $174,979.00 $33,918.53 2026-04-01
265 MS_DRG Aicd Lead Procedures 44 21 $0.01 — $17,088.00 $174,129.00 $33,866.69 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 44 21 $0.01 — $16,199.00 $169,507.00 $33,833.14 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 44 21 $0.01 — $19,356.70 $178,108.00 $33,784.95 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 44 21 $0.01 — $16,469.00 $171,855.00 $33,682.55 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 45 21 $0.01 — $16,160.00 $176,873.00 $33,666.45 2026-04-01
50474-598-66 NDC Levetiracetam ER 500 Mg Po Tb24 17 11 $61,109.72 $30,554.86 50% off $20,166.00 $54,999.00 $33,641.00 2024-12-15
C2622 HCPCS Prosthesis Penile Genisis Kt Semi Rgd Malle 9.5x23 72 19 $58,155.12 $29,077.56 50% off $1,778.00 $61,913.00 $33,611.00 2024-12-15
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 45 21 $0.01 — $12,835.00 $188,666.00 $33,513.00 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 45 21 $0.01 — $15,928.00 $173,348.00 $33,470.00 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 44 21 $0.01 — $14,613.00 $161,179.00 $33,467.50 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 44 21 $0.01 — $14,343.00 $170,912.00 $33,308.24 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 44 21 $0.01 — $13,570.00 $171,034.00 $33,305.60 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 45 21 $0.01 — $1,650.00 $132,196.00 $33,246.00 2026-04-01
92933 HCPCS Prq Card Stent/ath/angio 12 6 — — $7,256.00 $126,000.95 $33,235.79 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 12 6 — — $8,747.00 $126,000.95 $33,235.79 2026-04-01
93580 HCPCS Transcath Closure Of Asd 12 6 — — $8,747.00 $126,000.95 $33,235.79 2026-04-01
93581 HCPCS Transcath Closure Of Vsd 12 6 — — $8,747.00 $126,000.95 $33,235.79 2026-04-01
93582 HCPCS Perq Transcath Closure Pda 12 6 — — $8,747.00 $126,000.95 $33,235.79 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 12 6 — — $8,747.00 $126,000.95 $33,235.79 2026-04-01
66683 HCPCS Implantation Iris Prosthesis 11 6 — — $12,199.00 $113,142.10 $33,194.58 2026-04-01
33229 CPT Hc Remvl Perm Pm Pls Gen W/repl Plse Gen Mult Lead 45 21 $68,033.29 $34,016.64 50% off $3,259.00 $126,244.00 $33,138.00 2024-12-15
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